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COMMUNITY HOSPITAL OF STAUNTON: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HOSPITAL OF STAUNTON (EIN 37-0624255)
Tax period
2023-01-01 to 2023-12-31
Filed
2024-11-14
IRS object ID
202423199349316012
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)
Return2024-11-14T16:46:10-06:00ReturnTs
Tax Period End2023-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1475 REGENCY PARK SUITE 175AddressLine1Txt
CityOFALLONCityNm
State AbbreviationILStateAbbreviationCd
ZIP62269ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN370624255EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HOSPITAL OF STAUNTONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone6186354245PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 N CALDWELL STAddressLine1Txt
CitySTAUNTONCityNm
State AbbreviationILStateAbbreviationCd
ZIP62088ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICK J GARVEY CPAPersonNm
Person TitleCFOPersonTitleTxt
Phone6183916421PhoneNum
Signature2024-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJEFF PARKERPreparerPersonNm
PTINP00970069PTIN
Phone6182331200PhoneNum
Preparation2024-11-14PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2024-10-15 13:58:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLARRY F SPOURPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 N CALDWELL STAddressLine1Txt
CitySTAUNTONCityNm
State AbbreviationILStateAbbreviationCd
ZIP62088ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$22,300,781GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.STAUNTONHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1946FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionCOMMUNITY HOSPITAL OF STAUNTON PROVIDES COMPASSIONATE PATIENT-CENTERED HEALTH CARE SERVICES, WHILE MAINTAINING CLINICAL EXCELLENCE AND FINANCIAL VIABILITY.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee149TotalEmployeeCnt
Total Volunteers8TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$939,440PYContributionsGrantsAmt
CY Contributions Grants$3,264CYContributionsGrantsAmt
PY Program Service Revenue$20,559,407PYProgramServiceRevenueAmt
CY Program Service Revenue$20,908,899CYProgramServiceRevenueAmt
PY Investment Income$309,387PYInvestmentIncomeAmt
CY Investment Income$378,622CYInvestmentIncomeAmt
PY Other Revenue$215,206PYOtherRevenueAmt
CY Other Revenue$279,015CYOtherRevenueAmt
PY Total Revenue$22,023,440PYTotalRevenueAmt
CY Total Revenue$21,569,800CYTotalRevenueAmt
PY Grants And Similar Paid$5,521PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$9,470CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,590,515PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,486,108CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,800,678PYOtherExpensesAmt
CY Other Expenses$11,271,469CYOtherExpensesAmt
PY Total Expenses$19,396,714PYTotalExpensesAmt
CY Total Expenses$19,767,047CYTotalExpensesAmt
PY Revenues Less Expenses$2,626,726PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,802,753CYRevenuesLessExpensesAmt
Total Assets BOY$27,855,025TotalAssetsBOYAmt
Total Assets EOY$39,147,624TotalAssetsEOYAmt
Total Liabilities BOY$9,141,582TotalLiabilitiesBOYAmt
Total Liabilities EOY$9,432,674TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$18,713,443NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$29,714,950NetAssetsOrFundBalancesEOYAmt
MissionTO BE THE LEADER IN PROVIDING AND PROMOTING EXCELLENCE IN HEALTHCARE AND WELLNESS SERVICES IN PARTNERSHIP WITH THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$15,916,326ExpenseAmt
Grant$9,470GrantAmt
Revenue$21,155,939RevenueAmt
DescTHE ORGANIZATION OPERATES A FULL SERVICE CRITICAL ACCESS HOSPITAL IN STAUNTON, ILLINOIS WITH A TOTAL OF 25 BEDS. TOTAL PATIENT DAYS FOR THE PERIOD ENDING DECEMBER 31, 2023 WAS 249 ACUTE DAYS AND 824 SWING BED DAYS. THE HOSPITAL ALSO PROVIDED SERVICES TO 23,602 OUTPATIENTS, 5,642 EMERGENCY DEPARTMENT VISITS, AND 4,670 PHYSICIAN OFFICE VISITS.Desc
Total Program Service Expenses$15,916,326TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
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 Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee149EmployeeCnt
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 Members7GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PATRICK GARVEY CPABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6183916421PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line16800 STATE ROUTE 162AddressLine1Txt
CityMARYVILLECityNm
State AbbreviationILStateAbbreviationCd
ZIP62062ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
CLIFF HOMEIER
PRESIDENT1.500.25Yes (X)Yes (X)$0$0$0
DERREK TIBURZI
VICE PRESIDENT0.250.00Yes (X)Yes (X)$0$0$0
AILEE TAYLOR
SECRETARY0.500.00Yes (X)Yes (X)$0$0$0
MIKE BROWN
BOARD MEMBER0.250.00Yes (X)$0$0$0
BILL HANKS
BOARD MEMBER0.250.00Yes (X)$0$0$0
RON MAEDGE
BOARD MEMBER0.250.00Yes (X)$0$0$0
BECKY PAINTER
BOARD MEMBER0.250.00Yes (X)$0$0$0
DONALD KASUBKE
BOARD MEMBER (UNTIL 4/23)0.500.50Yes (X)$0$0$0
SUE CAMPBELL
PRESIDENT & CEO (UNTIL 12/23)40.000.25Yes (X)$260,898$0$12,262
LARRY SPOUR
PRESIDENT & CEO40.000.25Yes (X)$166,707$0$16,981
MICHAEL MARSHALL
ANDERSON HEALTHCARE COO3.5040.25Yes (X)$0$327,905$52,419
PATRICK GARVEY
ANDERSON HEALTHCARE CFO3.5035.50Yes (X)$0$103,223$5,991
KEITH PAGE
ANDERSON HEALTHCARE PRESIDENT/CEO3.5040.25Yes (X)$0$560,441$110,100
JOSH BUSCHLING
PHYSICIAN36.000.00$265,393$0$16,044Yes (X)
TIFFANY SPUDICH
PHARMACY MANAGER40.000.00$122,904$0$21,765Yes (X)
MELISSA OSTENDORF
SPECIALTY CARE RN36.000.00$149,494$0$28,277Yes (X)
ROBIN PRUDEN
SPECIALTY CARE RN36.000.00$101,872$0$12,684Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,067,268TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$991,569TotReportableCompRltdOrgAmt
Total Other Compensation$276,523TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
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
ANDERSON HOSPITAL
6800 STATE ROUTE 62MARYVILLEIL62062STAFFING$1,613,282
MIDWEST EMERGENCY DEPARTMENT
320 EAST US HIGHWAY 50OFALLONMO622692704EMERGENCY PHYSICIANS$1,414,148
AYA HEALTHCARE INC
1200 E CAMPBELL RD SUITE 108RICHARDSONTX75081MEDICAL STAFFING$1,054,575
ALTON PHYSICAL THERAPY
1719 CLAWSONALTONIL62002PHYSICAL THERAPY$966,860
ANDERS MINKLER HUBER & HELM
800 MARKET ST SUITE 500ST LOUISMO63101PROFESSIONAL SERVICES$175,700
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
All Other Contributions$3,264AllOtherContributionsAmt
Total Contributions$3,264TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business621110BusinessCd
Total Revenue Column$20,908,899TotalRevenueColumnAmt
Related Or Exempt Func Income$20,908,899RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$20,908,899TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$321,984TotalRevenueColumnAmt
Exclusion$321,984ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$27,371RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$27,371RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,371TotalRevenueColumnAmt
Exclusion$27,371ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$787,619SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$730,981SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$56,638SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,638TotalRevenueColumnAmt
Exclusion$56,638ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
REBATE INCOME621110$111,744$111,744
ANCILLARY SERVICES621110$87,072$87,072
OTHER INCOME621110$48,224$48,224

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,604TotalRevenueColumnAmt
Exclusion$4,604ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$251,644OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$21,569,800TotalRevenueColumnAmt
Related Or Exempt Func Income$21,155,939RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$410,597ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$8,045TotalAmt
Program Services$8,045ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$1,425TotalAmt
Program Services$1,425ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$456,848TotalAmt
Management And General$456,848ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,698,296TotalAmt
Program Services$5,568,892ProgramServicesAmt
Management And General$1,129,404ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$39,419TotalAmt
Program Services$33,888ProgramServicesAmt
Management And General$5,531ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$831,150TotalAmt
Program Services$669,315ProgramServicesAmt
Management And General$161,835ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$460,395TotalAmt
Program Services$359,799ProgramServicesAmt
Management And General$100,596ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$80,826TotalAmt
Management And General$80,826ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$24,086TotalAmt
Management And General$24,086ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$152,350TotalAmt
Management And General$152,350ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$28,900TotalAmt
Management And General$28,900ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,286,146TotalAmt
Program Services$3,349,623ProgramServicesAmt
Management And General$936,523ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$19,420TotalAmt
Program Services$15,177ProgramServicesAmt
Management And General$4,243ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,532,958TotalAmt
Program Services$2,510,128ProgramServicesAmt
Management And General$22,830ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$517,131TotalAmt
Program Services$404,138ProgramServicesAmt
Management And General$112,993ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$569,544TotalAmt
Program Services$445,099ProgramServicesAmt
Management And General$124,445ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,040TotalAmt
Program Services$3,158ProgramServicesAmt
Management And General$882ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$257,490TotalAmt
Program Services$257,490ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,395,741TotalAmt
Program Services$1,090,767ProgramServicesAmt
Management And General$304,974ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$270,453TotalAmt
Program Services$211,359ProgramServicesAmt
Management And General$59,094ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
HOSPITAL PROVIDER ASSES$471,691$471,691
OTHER EXPENSES$286,236$223,694$62,542
MAINTENANCE & REPAIRS$206,749$161,574$45,175
EQUIPMENT$85,680$66,959$18,721

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$82,028TotalAmt
Program Services$64,105ProgramServicesAmt
Management And General$17,923ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$19,767,047TotalAmt
Program Services$15,916,326ProgramServicesAmt
Management And General$3,850,721ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,312,715BOYAmt
EOY$4,248,219EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,412,127BOYAmt
EOY$2,719,651EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$333,121BOYAmt
EOY$286,741EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$132,613BOYAmt
EOY$140,955EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$31,302,855LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$11,441,354LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$12,963,158BOYAmt
EOY$19,861,501EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$10,392,991BOYAmt
EOY$11,728,086EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$308,300BOYAmt
EOY$162,471EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$27,855,025BOYAmt
EOY$39,147,624EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,558,919BOYAmt
EOY$2,036,899EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$7,582,663BOYAmt
EOY$7,309,232EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$86,543EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,141,582BOYAmt
EOY$9,432,674EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$18,713,443BOYAmt
EOY$29,714,950EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$18,713,443BOYAmt
EOY$29,714,950EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$27,855,025BOYAmt
EOY$39,147,624EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,802,753ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,044,530NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments$8,154,224PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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 D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$177,500OtherCostOrOtherBasisAmt
Book Value$177,500BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,825,051OtherCostOrOtherBasisAmt
Depreciation$9,946,282DepreciationAmt
Book Value$17,878,769BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,300,304OtherCostOrOtherBasisAmt
Depreciation$1,495,072DepreciationAmt
Book Value$1,805,232BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$19,861,501TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO RELATED PARTYDesc
Amt$86,543Amt
FieldValueIRS element (for citing)
Total Liability$86,543TotalLiabilityAmt

Schedule H IRS990ScheduleH

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

Free Care Oth Percentage FreeCareOthPercentageGrp

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$110,053TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$110,053NetCommunityBenefitExpnsAmt
Total Expense0.00560TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,361,715TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,786,475DirectOffsettingRevenueAmt
Net Community Benefit Expns$575,240NetCommunityBenefitExpnsAmt
Total Expense0.02910TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,471,768TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,786,475DirectOffsettingRevenueAmt
Net Community Benefit Expns$685,293NetCommunityBenefitExpnsAmt
Total Expense0.03470TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,407TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$18,407NetCommunityBenefitExpnsAmt
Total Expense0.00090TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,002,184TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,786,475DirectOffsettingRevenueAmt
Net Community Benefit Expns$215,709NetCommunityBenefitExpnsAmt
Total Expense0.01090TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,730TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$1,730NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,022,321TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,786,475DirectOffsettingRevenueAmt
Net Community Benefit Expns$235,846NetCommunityBenefitExpnsAmt
Total Expense0.01190TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,494,089TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,572,950DirectOffsettingRevenueAmt
Net Community Benefit Expns$921,139NetCommunityBenefitExpnsAmt
Total Expense0.04660TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$996,926BadDebtExpenseAmt
Bad Debt Expense Attributable$600,000BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,336,242ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$11,232,678CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$896,436MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
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 Line1COMMUNITY HOSPITAL OF STAUNTONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1400 CALDWELLAddressLine1Txt
CitySTAUNTONCityNm
State AbbreviationILStateAbbreviationCd
ZIP62088ZIPCd
FieldValueIRS element (for citing)
Website AddressSTAUNTONHOSPITAL.ORGWebsiteAddressTxt
State License0000414StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HOSPITAL OF STAUNTONBusinessNameLine1Txt
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 Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLHTTPS://STAUNTONHOSPITAL.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/OwnWebsiteURLTxt
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt21ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLHTTPS://WWW.STAUNTONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENTStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care125.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://ANDERSONHOSPITAL.ORG/WP-CONTENT/UPLOADS/2023/10/2023-UPDATED-FA-POLFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://ANDERSONHOSPITAL.ORG/WP-CONTENT/UPLOADS/2024/08/ANDERSON-HEALTHCAREFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://ANDERSONHOSPITAL.ORG/WP-CONTENT/UPLOADS/2023/08/PLS_OF_FAP_ENGLISH2FAPSummaryOnWebsiteURLTxt
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 Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
COMMUNITY HOSPITAL OF STAUNTONPART V, SECTION B, LINE 5: THE HOSPITAL HAD TWO FOCUS GROUPS. THE FIRST FOCUS GROUP WAS COMMUNITY LEADERS. THE SECOND FOCUS GROUP INCLUDED MEDICAL PROFESSIONALS. REPRESENTATIVES FROM THE FOLLOWING ORGANIZATIONS PARTICIPATED IN THE FOCUS GROUPS: HERITAGE HEALTH NURSING HOME, GILLESPIE-BENLD AMBULANCE, ST. PAUL'S CHURCH OF CHRIST, ILLINOIS VALLEY ECONOMIC DEVELOPMENT, AND COMMUNITY HOSPITAL OF STAUNTON.
COMMUNITY HOSPITAL OF STAUNTONPART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT IDENTIFIED 5 SIGNIFICANT NEEDS:(1) IMPROVED ACCESS TO MENTAL HEALTH SERVICES (2) IMPROVED PROMOTION OF WELLNESS AND HEALTHY LIVING (3) ACCESS TO HEALTHY FOODS AND NUTRITION EDUCATION (4 )IMPROVED ACCESS TO AFFORDABLE HOUSING (5) SECURE, RELIABLE EMS SERVICES FOR STAUNTON AREAWE COMPLETED THIS CHNA DURING THE COVID PANDEMIC. DURING THE PANDEMIC WE HAVE HAD TO FOCUS ON HOSPITAL OPERATIONS.
FieldValueIRS element (for citing)
Facility1FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line11 - COMMUNITY CLINIC OF STAUNTONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1325 CALDWELLAddressLine1Txt
CitySTAUNTONCityNm
State AbbreviationILStateAbbreviationCd
ZIP62088ZIPCd
FieldValueIRS element (for citing)
FacilityCLINICFacilityTxt

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART III, LINE 2:THE BAD DEBT EXPENSE AS REPORTED ON THE FINANCIAL STATEMENT HAS BEEN REPORTED ON LINE 2, THEREFORE, THE COSTING METHODOLOGY FOR THIS LINE IS BASED ON THE PATIENT CHARGES THAT WERE WRITTEN OFF ON THE BOOKS. NO BAD DEBT AMOUNTS WERE INCLUDED IN COMMUNITY BENEFIT.
PART III, LINE 3:THE HOSPITAL BELIEVES THAT THE COMMUNITY BENEFIT OBTAINED FROM ITS CHARITY CARE IS UNDERSTATED DUE TO PATIENTS THAT COULD QUALIFY FOR CHARITY CARE BUT DO NOT APPLY OR PROVIDE INCOMPLETE INFORMATION. SOME CARE PROVIDED TO PATIENTS IS NOT CLASSIFIED AS CHARITY CARE DUE TO PATIENTS MISSING DOCUMENTATION THAT PROVES THEY QUALIFY FOR CHARITY CARE. THE HOSPITAL'S BAD DEBT DOES INCLUDE AMOUNTS THAT COULD BE CLASSIFIED AS CHARITY CARE IF THE PATIENTS WOULD APPLY OR PROVIDE THE APPROPRIATE INFORMATION TO COMPLETE THE CHARITY CARE APPLICATION. IN LINE WITH ITS MISSION, THE HOSPITAL PROVIDES A SAFETY NET FOR THE COMMUNITIES SERVED TO ACCESS MUCH NEEDED CARE BY OFFERING SOME SERVICES TO PATIENTS WITHOUT REGARD TO THEIR ABILITY TO PAY FOR THOSE SERVICES. FOR SOME OF THEIR PATIENT SERVICES, THE HOSPITAL RECEIVES NO PAYMENT OR PAYMENT THAT IS LESS THAN THE FULL COST OF PROVIDING THE SERVICES. THE HOSPITAL VOLUNTARILY PROVIDES FREE CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR ALL OR PART OF THEIR HEALTH CARE EXPENSES AS DETERMINED BY THE HOSPITAL'S CRITERIA FOR FINANCIAL ASSISTANCE. IN SOME CASES, THE HOSPITAL DOES NOT RECEIVE THE AMOUNT BILLED FOR PATIENT SERVICES EVEN THOUGH IT DID NOT RECEIVE INFORMATION NECESSARY TO DETERMINE IF THE PATIENTS MET THE CRITERIA FOR FINANCIAL ASSISTANCE. BAD DEBT EXPENSE IS THE ESTIMATED AMOUNT OF PATIENT REVENUE THAT THE HOSPITAL WILL NOT COLLECT. PER US CENSUS BUREAU 13.8% OF MACOUPIN COUNTY IS BELOW THE POVERTY LEVEL.
PART III, LINE 8:ANY SHORTFALL SHOULD BE CONSIDERED A COMMUNITY BENEFIT SINCE IT REPRESENTS THE UNREIMBURSED COSTS OF CARING FOR THE ELDERLY IN OUR COMMUNITY.
PART III, LINE 9B:THERE IS NO COLLECTION PRACTICE ON PATIENTS WHO QUALIFY FOR CHARITY. ANY PATIENT WHO SUBMITS AN APPLICATION FOR CHARITY AND MEETS THE GUIDELINES SET IN OUR CHARITY POLICY HAS THEIR ACCOUNT WRITTEN OFF WITH NO COLLECTION EFFORT.
PART VI, LINE 2:THE HOSPITAL'S BOARD IS MADE UP OF INDIVIDUALS WHO LIVE WITHIN THE HOSPITAL'S SERVICE AREA. THESE INDIVIDUALS ALONG WITH SUPPORT FROM THE HOSPITAL'S MANAGEMENT AND MEDICAL STAFF ARE CONTINUALLY REVIEWING HOW THE HOSPITAL CAN BE AN ASSET WITHIN OUR SERVICE AREA. THE HOSPITAL HAS ALSO CONDUCTED A COMMUNITY PERCEPTION SURVEY TO HELP IDENTIFY AREAS TO IMPROVE PATIENT CARE OR THE NEED FOR ADDITIONAL SERVICES.
PART VI, LINE 3:INFORMATION REGARDING THE FINANCIAL ASSISTANCE PROGRAMS THAT THE HOSPITAL OFFERS IS LISTED ON THE HOSPITAL WEBSITE, AND IT IS PRINTED ON THE BOTTOM OF THE STATEMENTS THAT ARE MAILED TO THE PATIENTS. THE INFORMATION IS ALSO POSTED NEAR THE CASHIER'S WINDOW AND THE BUSINESS OFFICE STAFF ARE TRAINED TO PROVIDE THE INFORMATION TO PATIENTS THAT CALL INTO THE OFFICE AND DO NOT HAVE KNOWLEDGE OF THE PROGRAMS.
PART VI, LINE 4:THE COMMUNITY THAT THE ORGANIZATION SERVES CONSISTS OF ABOUT A TWELVE MILE RADIUS SURROUNDING STAUNTON AND THE COMMUNITIES WITHIN THAT RADIUS ARE: WORDEN, HAMEL, ALHAMBRA, LIVINGSTON, NEW DOUGLAS, MT. OLIVE, BENLD, GILLESPIE, BUNKER HILL, AND PRAIRIETOWN. THIS IS A RURAL AREA WITH A DEPRESSED ECONOMIC CLIMATE. MANY OF THE INDIVIDUALS ARE ELDERLY, POOR, AND INDIGENT WHICH RESULTS IN HIGHER NUMBERS OF MEDICARE AND MEDICAID RECIPIENTS.
PART VI, LINE 5:THE HOSPITAL RESTOCKS THE AMBULANCE OF ANY SUPPLIES USED DURING THE TRANSPORT OF PATIENTS AT NO COST TO THE AMBULANCE SERVICE. THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ACTIVITIES AND SERVICES THAT MEET UNMET COMMUNITY NEEDS. MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELF-SUPPORTING OR FINANCIALLY VIABLE. THE HOSPITAL DONATES TO THE LOCAL FOOD PANTRY AND SCHOOL SUPPLY DRIVES IN THE COMMUNITY. THE HOSPITAL PROVIDES SCHOLARSHIPS TO STUDENTS FROM THE SCHOOLS IN OUR SERVICE AREA THAT ARE SEEKING DEGREES IN HEALTHCARE. IN ADDITION, THE HOSPITAL PARTNERS WITH THE LOCAL SCHOOL AND THE UNIVERSITY OF ILLINOIS EXTENSION OFFICE TO PROVIDE FOOD/NUTRITION EDUCATION TO COMMUNITY MEMBERS.
PART VI, LINE 6:ON 7/1/16 COMMUNITY HOSPITAL OF STAUNTON AFFILIATED WITH ANDERSON HOSPITAL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
KEITH PAGE
ANDERSON HEALTHCARE PRESIDENT/CEO$0$552,284$0$0$0$8,157$0$89,703$0$20,397$0$670,541$0$0
MICHAEL MARSHALL
ANDERSON HEALTHCARE COO$0$322,019$0$0$0$5,886$0$23,000$0$29,419$0$380,324$0$0
JOSH BUSCHLING
PHYSICIAN$259,994$0$0$0$5,399$0$7,726$0$8,318$0$281,437$0$0$0
SUE CAMPBELL
PRESIDENT & CEO (UNTIL 12/23)$255,052$0$0$0$5,846$0$3,944$0$8,318$0$273,160$0$0$0
LARRY SPOUR
PRESIDENT & CEO$161,395$0$0$0$5,312$0$0$0$16,981$0$183,688$0$0$0
MELISSA OSTENDORF
SPECIALTY CARE RN$149,494$0$0$0$0$0$1,588$0$26,689$0$177,771$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationNAME: KEITH PAGE, DESCRIPTION: 2023 ANNUAL CONTRIBUTION, CURRENT YEAR AMOUNT: $9,515. PLAN DESCRIPTION: SECTION 457(F) PLAN OF RELATED ORGANIZATION NAME: MICHAEL MARSHALL, DESCRIPTION: 2023 ANNUAL CONTRIBUTION, CURRENT YEAR AMOUNT: $12,975. PLAN DESCRIPTION: SECTION 457(F) PLAN OF RELATED ORGANIZATIONExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE ORGANIZATION HAS A SOLE CORPORATE MEMBER, ANDERSON HEALTHCARE.
FORM 990, PART VI, SECTION A, LINE 7ABOARD MEMBERS MUST BE APPROVED BY ANDERSON HEALTHCARE.
FORM 990, PART VI, SECTION A, LINE 7BANDERSON HEALTHCARE APPROVES BOARD MEMBERS AND ANNUAL BUDGETS. DECISIONS THAT REQUIRE APPROVAL INCLUDE REVISIONS TO THE MISSION; AMENDMENTS OF THE ORGANIZING DOCUMENTS; APPOINTMENT AND REMOVAL OF MEMBERS OF THE BOARD OF TRUSTEES AND THE PRESIDENT OF THE ORGANIZATION; APPROVAL OF STRATEGIC PLANS, BUDGETS, SALE OF LEASE OF ASSETS IN EXCESS OF $100,000, OR INCURRENCE OF DEBT; APPROVAL OF MERGERS OR AFFILIATIONS.
FORM 990, PART VI, SECTION B, LINE 11BTHE CEO REVIEWS THE FORM 990, WHICH IS THEN REVIEWED BY THE BOARD.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY AND A DISCLOSURE STATEMENT ARE PRESENTED TO OFFICERS, DIRECTORS OR TRUSTEES AND KEY EMPLOYEES ANNUALLY. THE DISCLOSURE STATEMENT MUST BE RETURNED AND IS REVIEWED BY FINANCIAL AUDITORS AND HOSPITAL ADMINISTRATION.
FORM 990, PART VI, SECTION B, LINE 15COMMUNITY HOSPITAL OF STAUNTON'S CEO IS EVALUATED BY THE CEO OF ANDERSON HEALTHCARE. THE RESULTS OF THIS EVALUATION ARE USED TO DETERMINE ANY RATE INCREASE IN THE SAME MANNER AS ALL OTHER EMPLOYEES OF COMMUNITY HOSPITAL OF STAUNTON. THE ANDERSON HEALTHCARE CFO SERVES AS THE CFO FOR THE COMMUNITY HOSPITAL OF STAUNTON. THIS POSITION / ROLE IS EVALUATED BY THE CEO OF ANDERSON HEALTHCARE AND THE RESULTS OF THIS EVALUATION ARE USED TO DETERMINE ANY RATE INCREASE IN THE SAME MANNER AS ALL OTHER EMPLOYEES OF COMMUNITY HOSPITAL OF STAUNTON.
FORM 990, PART VI, SECTION C, LINE 19COMMUNITY HOSPITAL OF STAUNTON MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENT AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GCONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,892,123. MANAGEMENT AND GENERAL EXPENSES 529,020. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,421,143. OTHER FEES: PROGRAM SERVICE EXPENSES 1,457,500. MANAGEMENT AND GENERAL EXPENSES 407,503. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,865,003.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
ANDERSON HOSPITAL FOUNDATION
6800 STATE ROUTE 162MARYVILLEIL62062274548522SUPPORT ORGIL501(C)(3)LINE 7ANDERSON HOSPITAL0
ANDERSON HOSPITAL
ILLINOIS ROUTE 162MARYVILLEIL62062370662561HEALTHCAREIL501(C)(3)LINE 3ANDERSON HEALTHCARE0
ANDERSON HEALTHCARE
6800 STATE ROUTE 162MARYVILLEIL62062843965822HEALTHCAREIL501(C)(3)LINE 12C, III-FI0N/A
FRIENDS OF COMMUNITY MEMORIAL HOSPITAL
400 N CALDWELLSTAUNTONIL62088363913722FUNDRAISINGIL501(C)(3)LINE 10COMMUNITY HOSPITAL OF STAUNTONYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerInd
ANDERSON SURGERY CENTER LLC
6800 STATE ROUTE 162MARYVILLEIL62062834200085SURGERYILANDERSON HOSPITALN/A00
ANDERSON REHABILITATION INSTITUTE LLC
6800 STATE ROUTE 162MARYVILLEIL62062832844780REHABILANDERSON HOSPITALN/A00
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 OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
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