2023-02-10T13:43:43-06:00 2022-03-31 410746749 CLIFTONLARSONALLEN LLP 475 REGENCY PARK SUITE 175 OFALLON IL 62269 990 2021-07-01 237426289 HARRISBURG MEDICAL CENTER INC HARR 6182537671 100 DR WARREN TUTTLE DRIVE HARRISBURG IL 62946 DONALD H HUTSON CEO 6182537671 2023-02-10 1 DONALD HUTSON XXX-XX-XXXX JEFF PARKER P00970069 6182331200 2023-02-07 3 AAL1 IAL1 2021 2023-03-07 01:45:13Z DONALD H HUTSON 100 DR WARREN TUTTLE DRIVE HARRISBURG IL 62946 39584498 0 X WWW.HARRISBURGMC.COM X 1975 IL TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. 11 9 576 17 0 0 12797053 4212279 51202471 34849559 158706 64066 204718 71921 64362948 39197825 0 0 0 0 30889993 24060963 0 0 0 26824795 24378619 57714788 48439582 6648160 -9241757 53080348 43345882 27674972 27110612 25405376 16235270 HARRISBURG MEDICAL CENTER AND SOUTHERN ILLINOIS HEALTHCARE IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL THE PEOPLE IN THE COMMUNITIES WE SERVE. 0 0 29629957 0 26876647 IN SUPPORT OF ITS MISSION, THE HOSPITAL PROVIDES CARE TO PATIENTS AT LESS THAN ITS ESTABLISHED CHARGES FOR PATIENTS THAT MEET THE HOSPITAL'S FINANCIAL ASSISTANCE CRITERIA. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, THEY ARE NOT REPORTED IN NET PATIENT SERVICE REVENUE. CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) WERE APPROXIMATELY $1,630,000 FOR FISCAL YEAR 2022. IN ADDITION, THE HOSPITAL 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 THE PAYMENTS ARE LESS THAN THE COST OF RENDERING CARE. 9852703 0 7972912 MULBERRY CENTER AT HARRISBURG OFFERS PATIENT-CENTERED PSYCHIATRIC CARE IN AN ENVIRONMENT WHERE COMPREHENSIVE MEDICAL CARE IS AVAILABLE. THROUGH INTERACTIVE EXPERIENCES, PATIENTS LEARN TO BETTER UNDERSTAND THEIR SYMPTOMS AND LEARN HOW TO MANAGE THEM AFTER DISCHARGE. THE INPATIENT UNIT IS DIVIDED INTO TWO WINGS. ONE IS A GENERAL ADULT UNIT, HOUSING INDIVIDUALS WITH PSYCHIATRIC DISORDERS WHICH DO NOT INVOLVE DEMENTIA. THE SECOND WING IS A GEROPSYCHIATRIC UNIT WHICH TREATS PATIENTS WHOSE ILLNESS IS COMPLICATED BY DEMENTIA AND EMPHASIS IS PLACED ON MANAGING COGNITIVE DEFICITS ASSOCIATED WITH DEMENTIA. IN BOTH WINGS, PATIENTS RECEIVE SERVICES FROM A MULTI-DISCIPLINARY TEAM UNDER THE DIRECTION OF PSYCHIATRISTS. THE MULBERRY CENTER PROVIDES FOR 24/7 EMERGENCY ADMISSIONS. 39482660 1 0 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 52 0 576 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 9 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X X JUNE HAYES 6182537671 100 DR WARREN TUTTLE DR HARRISBURG IL 62946 DENNIS MURPHY BOARD CHAIR 4.00 0.00 X X 0 0 0 MICHAEL WILLIAMS SECRETARY/TREASURER 4.00 0.00 X X 0 0 0 LARRY JONES MD BOARD MEMBER (TERM ENDED 1/22) 2.00 0.00 X 0 0 0 BENNA DAUGHERTY BOARD MEMBER 2.00 0.00 X 0 0 0 MICHAEL TISON BOARD MEMBER 4.00 0.00 X 0 0 0 MATT BUSINARO VICE CHAIR 4.00 0.00 X X 0 0 0 KELLY PHELPS BOARD MEMBER (TERM ENDED 8/21) 2.00 0.00 X 0 0 0 ANGELA ROWE BOARD MEMBER 2.00 1.00 X 0 0 0 GINA SIRACH BOARD MEMBER 2.00 0.00 X 0 0 0 JACQUELINE SCOTT BOARD MEMBER 2.00 0.00 X 0 0 0 MATT WINKELMAN BOARD MEMBER 2.00 0.00 X 0 0 0 REX BUDDE PRESIDENT/CEO - SIH 1.00 39.00 X 0 2396463 48546 JOHN B MILLSTEAD SENIOR VP/COO - SIH 1.00 39.00 X 0 836256 226646 DONALD HUTSON PRESIDENT/CEO, VP/ADMINISTRATOR 40.00 0.50 X 230049 152164 34665 LESLIE FERRELL FORMER VICE-PRESIDENT/CNO (TERM 6/21) 40.00 0.00 X 103548 0 7923 THERESA JUNE HAYES VICE-PRESIDENT/CFO, FINANCE DIRECTOR 40.00 0.50 X 204250 0 12599 JAMES ALEXANDER VICE-PRESIDENT/CMO 40.00 0.00 X 682212 0 14809 MARIE GORSKI PHYSICIAN 40.00 0.00 X 279346 0 2756 CLAYTON FORD PHYSICIAN 40.00 0.00 X 431615 0 18127 ANDREA MILLER PHYSICIAN 40.00 0.00 X 262935 0 23059 THOMAS BUTLER CRNA 36.00 0.00 X 286834 0 12363 JASON VALLETTE CRNA 40.00 0.00 X 267804 0 36601 2748593 3384883 438094 34 0 1 0 SOUTHERN ILLINOIS PSYCHIATRY LLC 112 AIRWAY DR MARION IL 62959 CONTRACTED PHYSICIANS AND OTHER STAFF 1712279 STATERA HEALTHCARE LLC 2250 N ILLINOIS AVE CARBONDALE IL 62902 CONTRACTED PHYSICIANS AND OTHER STAFF 1467422 TRINITY MEDICAL STAFFING LLC 2250 N ILLINOIS AVE CARBONDALE IL 62902 CONTRACTED PHYSICIANS AND OTHER STAFF 1258268 AB STAFFING SOLUTIONS LLC 3451 S MERCY ROAD SUITE 102 GILBERT AZ 85297 CONTRACTED PHYSICIANS AND OTHER STAFF 546388 POLSINELLI PC 900 W 48TH PLACE SUITE 900 KANSAS CITY MO 64112 LEGAL SERVICES 299988 13 4212279 4212279 PATIENT SERVICE REVENUE 624110 34780292 34780292 RENT REVENUE 624100 69267 69267 34849559 49520 49520 401219 386673 14546 14546 14546 CAFETERIA REVENUE 624110 46602 46602 OTHER REVENUE 624100 21656 21656 COIN MACHINES & TV 624100 3350 3350 313 313 71921 39197825 34849559 0 135987 X 1269554 1269554 17223346 15279347 1943999 491616 394824 96792 3822521 3066406 756115 1253926 1007046 246880 299988 299988 116192 116192 15727 15727 9417729 7928533 1489196 146360 146360 4155376 3302713 852663 540235 492061 48174 80775 77955 2820 30838 23930 6908 428825 372792 56033 2068170 2068170 534158 464362 69796 PHARMACY SUPPLIES 2384757 2384757 BAD DEBT EXPENSE 1862536 1862536 MEDICAL SUPPLIES 1557338 284293 1273045 LOSS ON REACQUISITION 292348 292348 447267 180587 266680 48439582 39482660 8956922 0 823645 502460 15067728 7191728 360586 6493164 6518533 65642 46259 1609933 1392714 822394 625176 58347019 33383852 26508113 24963167 1684511 1744281 5218 978 53080348 43345882 8194320 5880884 497846 150400 18034183 18052288 948623 717905 1674398 0 634737 27674972 27110612 X 25405376 16235270 25405376 16235270 53080348 43345882 -9241757 71651 0 X X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 15727 15727 0 PART II-B, LINE 1: THE HOSPITAL PAYS MEMBERSHIP DUES TO THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION (IHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA), A PERCENTAGE OF THESE DUES IS SPENT ON LOBBYING ACTIVITIES BY THESE ASSOCIATIONS. 772443 772443 38242567 18319983 19922584 667589 532903 134686 18559713 14530966 4028747 104707 104707 24963167 DUE TO RELATED PARTY 634737 634737 X PART X, LINE 2: TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE-LIKELY-THAN-NOT" RECOGNITION THESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AT MARCH 31, 2022. 1 1 X 1 X 1 X 1 1 0 1 1 538738 538738 0.01160 13001418 7183743 5817675 0.12490 13540156 7183743 6356413 0.13650 13540156 7183743 6356413 0.13650 1 1862536 620845 10152161 14026398 -3874237 X 1 1 1 1 HARRISBURG MEDICAL CENTER 100 DR WARREN TUTTLE DRIVE HARRISBURG IL 62946 WWW.HARRISBURGMC.COM 521 X X X HARRISBURG MEDICAL CENTER 1 0 0 1 X X X X X X X X X 21 1 0 0 1 X SEE PART V, PAGE 8, SECTION C X 1 21 1 SEE PART V, PAGE 8, SECTION C 0 1 X 200.000000000000 300.000000000000 X X X X 1 1 X X X X 1 X SEE PART V, PAGE 8, SECTION C X SEE PART V, PAGE 8, SECTION C X SEE PART V, PAGE 8, SECTION C X X X X X 1 X 0 X X X X 1 X 0 0 HARRISBURG MEDICAL CENTER PART V, SECTION B, LINE 5: THE CHNA AND DEVELOPMENT OF ITS IMPLEMENTATION PLAN IS A WAY FOR THE HOSPITAL'S CORPORATE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES (SIH), AND COMMUNITY PARTNERS TO WORK COLLABORATIVELY TO IMPROVE THE HEALTH AND WELL-BEING OF ALL THE PEOPLE IN THE COMMUNITIES SERVED. SIH COLLABORATED WITH INDIVIDUALS FROM THE ELEVEN COUNTIES (FRANKLIN, JACKSON, JOHNSON, PERRY, SALINE, UNION, WILLIAMSON, WHITE, GALLATIN, POPE, AND HARDIN) TO CONDUCT THE ASSESSMENT. APPROXIMATELY 781 PEOPLE ACROSS THE ELEVEN COUNTIES PROVIDED INPUT INTO THIS PROCESS THROUGH THE FOLLOWING METHODS: 1) COMMUNITY MEMBER & COMMUNITY PARTNER SURVEY 637 SURVEY RESPONDENTS; 2) PHYSICIAN & HEALTHCARE PROVIDER/LEADER SURVEY 17 PEOPLE PARTICIPATED, INCLUDING VARIOUS PHYSICIANS AND KEY LEADERS WITHIN THE SIH HEALTHCARE SYSTEM; 3) SIH CHNA ADVISORY TEAM THE 53-MEMBER TEAM REVIEWED THE DATA, PROVIDED INPUT AND SHARED THEIR PERCEPTIONS OF OVERALL IMPACT, MAGNITUDE OF THE PROBLEM, SEVERITY, AND ABILITY AND INTEREST OF THE COMMUNITY TO ADDRESS THE ISSUES, AND VOTED ON THE TOP PRIORITY HEALTH ISSUES. HARRISBURG MEDICAL CENTER PART V, SECTION B, LINE 11: THE MOST RECENTLY CONDUCTED CHNA WAS COMPLETED IN MARCH 2022 FOR WHICH AN IMPLEMENTATION STRATEGY WAS DEVELOPED FOR THE NEXT THREE YEARS BEGINNING APRIL 1, 2022. THE INFORMATION BELOW DESCRIBES HOW THE HOSPITAL IS ADDRESSING THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA. THREE IMPLEMENTATION PLAN TEAMS WERE DEVELOPED IN ORDER TO BRING EXPERTS TOGETHER WITH EXPERTISE AND INTEREST IN EACH OF THE CHOSEN AREAS. KEY ISSUES AND NEEDS WERE IDENTIFIED AND INTERVENTION STRATEGIES WERE DEVELOPED. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WAS REVIEWED AND ADOPTED BY THE SIH BOARD OF TRUSTEES IN MARCH 2022. THE PRIORITY AREAS THROUGH THIS NEEDS ASSESSMENT WILL BE USED TO FOCUS COMMUNITY BENEFITS DEPARTMENT PLANNING FOR THE NEXT THREE YEARS. THE PRIORITY HEALTH ISSUES THAT THE FOUR HOSPITALS WILL ADDRESS FROM 2022 - 2025 ARE: SOCIAL DETERMINANTS OF HEALTH (ACCESS TO CARE, HUNGER/FOOD ACCESS, HOUSING, AND POVERTY), BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE MISUSE), AND CHRONIC DISEASE PREVENTION AND MANAGEMENT. FOR EACH HEALTH PRIORITY, STAFF WILL CONDUCT EVALUATION EFFORTS TO DEMONSTRATE IMPACT OF THE RELATED STRATEGIES AND ACTIVITIES. THESE PLANS WILL INCLUDE SPECIFIC DATA SOURCES SUCH AS PROGRAM RECORDS, HOSPITAL PATIENT DATA, AND/OR COMMUNITY-LEVEL DATA SUCH AS THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA). MEASURES MAY INCLUDE (BUT NOT LIMITED TO): COMMUNITY INDICATORS, PARTNERS, FUNDING, AND PROGRAMMATIC OUTCOMES VIA PROGRAM RECORDS). DATA WILL BE REVIEWED BY THE SIH COMMUNITY BENEFITS ADVISORY COMMITTEE TO BE REPORTED AT APPROPRIATE INTERVALS. HARRISBURG MEDICAL CENTER PART V, SECTION B, LINE 13H: IF A PATIENT MEETS CERTAIN PRESUMPTIVE ELIGIBILITY CRITERIA, THE PATIENT SHALL NOT BE REQUIRED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND SHALL BE DEEMED TO RECEIVE A 100% ALLOWANCE. PRESUMPTIVE ELIGIBILITY CATEGORIES ARE: 1) HOMELESSNESS, DEFINED AS AN INDIVIDUAL WITHOUT PERMANENT HOUSING WHO MAY LIVE ON THE STREETS, STAY IN A SHELTER, MISSION, SINGLE ROOM OCCUPANCY FACILITIES, ABANDONED BUILDING OR VEHICLE, OR IN ANY OTHER UNSTABLE OR NON-PERMANENT SITUATION; 2) DECEASED WITH NO ESTATE; 3) MENTAL INCAPACITATION WITH NO REPRESENTATIVE; 4) MEDICAID ELIGIBLE BUT NOT ON DATE OF SERVICE; 5) MEDICAID ELIGIBLE ON DATE OF SERVICE, BUT THE SERVICE IS NON-COVERED, AND 6) INCARCERATION IN A PENAL INSTITUTION. SCHEDULE H, PART V, SECTION B, LINE 16A THE FAP WAS WIDELY AVAILABLE AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2022/12/HEALTHCARE-ASSISTANCE-PROGRAM-AND-PRESUMPTIVE-HB-PI-003.PDF SCHEDULE H, PART V, SECTION B, LINE 16B THE FAP APPLICATION WAS WIDELY AVAILABLE AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2022/12/HEALTHCARE-ASSISTANCE-PROGRAM_12082022.PDF SCHEDULE H, PART V, SECTION B, LINE 16C THE FAP PLAIN LANGUAGE SUMMARY WAS WIDELY AVAILABLE AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2022/12/HEALTHCARE-ASSISTANCE-PROGRAM_12082022.PDF SCHEDULE H, PART V, SECTION B, LINE 7A THE ORGANIZATION'S MOST RECENT CHNA REPORT CAN BE FOUND AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2022/03/2021-JOINT-COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF SCHEDULE H, PART V, SECTION B, LINE 10A THE ORGANIZATION'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND AT:HTTPS://HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2022/03/2021-JOINT-IMPLEMENTATION-PLAN.PDF 6 1 - HMC CLINIC AT HARRISBURG 901 S COMMERCIAL HARRISBURG IL 62946 PROVIDER BASED RURAL HEALTH CLINIC 2 - ELDORADO PRIMARY CARE 1007 US HIGHWAY 45 ELDORADO IL 62930 PROVIDER BASED RURAL HEALTH CLINIC 3 - HMC CLINIC AT MARION 3106 OUTER DRIVE MARION IL 62959 PROVIDER BASED RURAL HEALTH CLINIC 4 - MACH MINE CLINIC 16468 LIBERTY SCHOOL ROAD MARION IL 62959 PRIMARY CARE CLINIC 5 - VIKING MINE CLINIC 13643 NORTH THOMPSONVILLE ROAD MACEDONIA IL 62860 PRIMARY CARE CLINIC 6 - HMC SURGICAL SERVICES CLINIC 50 DR WARREN TUTTLE DRIVE HARRISBURG IL 62946 SURGICAL MEDICINE CLINIC PART I, LINE 3C: FACTORS OTHER THAN FEDERAL POVERTY GUIDELINES (FPG) USED TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE INCLUDE A) HOMELESSNESS, B) DECEASED WITH NO ESTATE, C) MENTAL INCAPACITATION WITH NO REPRESENTATIVE, D) MEDICAID ELIGIBLE BUT NOT ON DATE OF SERVICE, E) MEDICAID ELIGIBLE ON DATE OF SERVICE BUT SERVICE IS NON-COVERED, AND F) INCARCERATION IN A PENAL INSTITUTION. THESE FACTORS ARE DESCRIBED UNDER THE HOSPITAL'S PRESUMPTIVE ELIGIBILITY RULES FOR FINANCIAL ASSISTANCE. THE HOSPITAL DOES NOT USE AN ASSET TEST AS A FACTOR IN DETERMINING ELIGIBILITY. PART I, LINE 7: THE ORGANIZATION USED A COST-TO-CHARGE RATIO AS CALCULATED UTILIZING DATA FROM INTERNAL ACCOUNTING RECORDS AND USING A METHODOLOGY CONSISTENT WITH SCHEDULE H INSTRUCTIONS TO DETERMINE AMOUNTS ON LINES 7A AND 7B OF PART I SCHEDULE H. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 1,862,536. PART III, LINE 2: THE HOSPITAL CALCULATED BAD DEBT EXPENSE AT COST USING THE COST-TO-CHARGE RATIO, AS CALCULATED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT ONLY AFTER ALL COLLECTION PROCEDURES HAVE BEEN EXHAUSTED AND AFTER ALL DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED. PART III, LINE 3: BASED ON THE HOSPITAL'S EXPERIENCE WITH ALL ITS PATIENTS, THE ORGANIZATION ESTIMATES THAT IT IS LIKELY THAT UP TO ONE-THIRD OF ACCOUNTS WRITTEN OFF TO BAD DEBT MAY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE, BUT THE PATIENT CHOSE NOT TO APPLY. THEREFORE, 33.333% OF THE BAD DEBT ADJUSTMENTS ARE INCLUDED ON PART III, LINE 3 AT COST. PART III, LINE 4: THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGE 12 OF SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES, INC CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTARY INFORMATION MARCH 31, 2022, AND 2021. PART III, LINE 8: UNPAID COST OF MEDICARE REPRESENTS THE COST (DETERMINED USING THE OVERALL COST TO CHARGE RATIO) OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM, IN EXCESS OF PAYMENTS FOR THOSE SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. PART III, LINE 9B: THE HOSPITAL'S COLLECTION POLICY AND FINANCIAL ASSISTANCE POLICY (FAP) CONTAIN PROVISIONS FOR COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO BE ELIGIBLE FOR FINANCIAL ASSISTANT. THESE PRACTICES ALSO APPLY BROADLY TO ALL TYPES OF PATIENTS. HOSPITAL WILL PROVIDE PATIENTS WITH A PLAIN LANGUAGE SUMMARY OF THE FAP. HOSPITAL WILL MAKE A REASONABLE EFFORT TO ORALLY NOTIFY THE INDIVIDUAL ABOUT THE FAP AND ABOUT HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FAP APPLICATION. IF HOSPITAL DETERMINES THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, HOSPITAL WILL A) PROVIDE THE INDIVIDUAL WITH A BILLING STATEMENT THAT INDICATES THE AMOUNT HE OR SHE OWES FOR THE CARE RECEIVED, ASSUMING THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE OTHER THAN FREE CARE AND HOW THAT AMOUNT WAS DETERMINED, B) REFUND TO THE INDIVIDUAL ANY AMOUNT HE OR SHE HAS PAID THAT EXCEEDS THE AMOUNT THE INDIVIDUAL IS DETERMINED TO BE PERSONALLY RESPONSIBLE FOR PAYING, C) TAKE ALL REASONABLE AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS ("ECAS") TAKEN AGAINST THE INDIVIDUAL. FOR ALL TYPES OF PATIENTS, HOSPITAL TAKES THE FOLLOWING ACTIONS AT LEAST 30 DAYS BEFORE INITIATING ECA TO OBTAIN PAYMENT FOR CARE: A) PROVIDE THE INDIVIDUAL WITH A WRITTEN NOTICE THAT INDICATES FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS, B) IDENTIFIES THE ECA(S) THAT HOSPITAL (OR OTHER AUTHORIZED PARTY) INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE AND C) STATES A DEADLINE AFTER WHICH SUCH ECAS MAY BE INITIATED THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN NOTICE IS PROVIDED. PART VI, LINE 2: THE HOSPITAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY AND THEY MIGHT BE ADDRESSED BY PARTICIPATING IN STRATEGIC AND OPERATIONAL PLANNING SESSIONS THAT INCLUDE THE BOARD OF DIRECTORS, STATE LEGISLATORS, OFFICIALS FROM THE LOCAL COMMUNITY COLLEGE AND LOCAL CLERGY. THE CEO PARTICIPATES IN STRATEGIC PLANNING MEETINGS WITH LEADERSHIP OF HOSPITAL'S CORPORATE MEMBER. HOSPITAL LEADERSHIP MEETS WITH LEADERSHIP FROM LOCAL HEALTH DEPARTMENTS, AREA HOSPITALS, AREA LONG TERM CARE FACILITIES AND EMERGENCY PLANNERS ON AN ONGOING BASIS. THE PRESIDENT OF THE MEDICAL STAFF MEETS REGULARLY WITH PRIMARY BEHAVIORAL HEALTH CLINIC LEADERS AS WELL AS REPRESENTATIVES FROM COMMUNITY BEHAVIORAL HEALTH AND SUPPORT ORGANIZATIONS TO ASCERTAIN NEEDS AND ASSESS MEETING OF THE NEEDS. HOSPITAL DATA IS REVIEWED TO DETERMINE PATIENTS' NEEDS BY ANALYZING DIAGNOSIS, READMISSION RATES AND THE MEDICARE CASE MIX INDEX. THE HOSPITAL PARTICIPATES IN REGIONAL HAZARD ASSESSMENTS AND DRILLS. PART VI, LINE 3: ALL PATIENTS WITHOUT THIRD PARTY COVERAGE, I.E., CONSIDERED "SELF-PAY", RECEIVE A COPY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM (FAP) PLAIN LANGUAGE SUMMARY DURING REGISTRATION THAT DETAILS THE FAP. HOSPITAL PATIENT BILLING STATEMENTS INCLUDE A STATEMENT EXPLAINING HOW A PATIENT MAY APPLY FOR CONDSIDERATION UNDER THE HOSPITAL'S FAP. SIGNAGE IS DISPLAYED IN REGISTRATION, PATIENT CARE, AND BUSINESS OFFICE AREAS THAT ANNOUNCES FINANCIAL HELP WITH BILLS FOR THOSE PATIENTS WHO QUALIFY. IF A PATIENT CONTACTS THE BUSINESS OFFICE REGARDING DIFFICULTY IN MAKING PAYMENTS, HOSPITAL PERSONNEL INFORMS THE PATIENT OF THE FAP. ONE FULL-TIME FINANCIAL COUNSELOR ASSISTS THE HOSPITAL'S PATIENTS IN APPLYING FOR GOVERNMENT FUNDED MEDICAL COVERAGE. PART VI, LINE 4: WHILE EACH OF THE ELEVEN COUNTIES IN THE HOSPITAL SYSTEM SERVICE AREA IS UNIQUE, ALL SHARE SIMILAR CHALLENGES. ALL HAVE ISOLATED HOUSEHOLDS, RESIDENTS WITH LOW INCOME AND LOW EDUCATIONAL LEVELS, AND HIGH RATES OF POVERTY, ILLNESS, AND MORTALITY. ALL HAVE A LARGE NUMBER OF MEDICALLY UNDERSERVED RESIDENTS. IN GENERAL, SOUTHERN ILLINOIS RESIDENTS ARE MORE PRONE TO HAVE HIGHER BMI, HIGHER BLOOD PRESSURE, INCREASED RISK FOR DIABETES AND ARE MORE APT TO SMOKE AND BE SEDENTARY THAN ALL OTHER ILLINOISANS. IMPROVEMENTS ARE NEEDED IN AREAS SUCH AS PREVENTATIVE SCREENINGS, HEALTHY EATING, AND PHYSICAL ACTIVITY. RESIDENTS FACE CONSIDERABLE BARRIERS TO ACCESS, DEMONSTRATED BY UNMET OR MISSED PRIMARY CARE APPOINTMENTS AND HIGH EMERGENCY DEPARTMENT UTILIZATION. UNEMPLOYMENT, POVERTY, FOOD INSECURITY, ACCESS TO CARE AND LACK OF TRANSPORTATION SERVE AS BARRIERS TO HEALTH AND HEALTHCARE.HARRISBURG MEDICAL CENTER PREDOMINATELY SERVES A FIVE-COUNTY AREA INCLUDING SALINE, GALLATIN, HARDIN, POPE, AND WHITE COUNTIES. EACH OF THE COUNTIES IS FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA. THE POPULATION OF THE FIVE COUNTIES IS APPROXIMATELY 50,000 AND THE POPULATION HAS SHOWN A DECLINING TREND FOR AT LEAST THE PAST TWENTY YEARS. APPROXIMATELY 17% OF THE POPULATION IS 65 YEARS OLD OR OLDER AS COMPARED TO 12% OF ALL ILLINOISANS. EIGHTY-SEVEN PERCENT OF THE POPULATION HAVE A HIGH SCHOOL DIPLOMA WHILE ONLY 16% OF THE POPULATION OVER 25 YEARS OLD HAVE EARNED A BACHELOR'S DEGREE OR HIGHER. INCOME PER CAPITAL IS $26,500 FOR THE POPULATION WHICH IS 26% LESS THAN THE INCOME PER CAPITAL OF THE STATE OF ILLINOIS AND 22% LESS THAN OF THE U.S. THE PERCENTAGE OF INDIVIDUALS IN THIS AREA LIVING IN POVERTY EXCEEDS THE PERCENTAGE FOR THE STATE OF ILLINOIS AND FOR THE UNITED STATES OF AMERICA. THIRTY-TWO PERCENT OF THE SERVICE AREA RECEIVES MEDICAID AS COMPARED TO 21% OF ILLINOISANS AND 22% OF THE U.S. POPULATION. FIFTY-NINE PERCENT OF CHILDREN LIVING IN THE 5-COUNTY SERVICE AREA ARE ELIGIBLE FOR FREE OR REDUCED-PRICE SCHOOL LUNCHES. PART VI, LINE 5: HMC IS PASSIONATE ABOUT THE HEALTH AND WELL-BEING OF THE COMMUNITIES SERVED. HMC PARTICIPATES IN MANY COMMUNITY EVENTS TO PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITY. COVID-19 SAFETY PRECAUTIONS HAVE PREVENTED THE HOSPITAL FROM HOLDING MOST OF THE COMMUNITY EVENTS NORMALLY HELD, BUT WE HAVE FOUND WAYS TO SUPPORT AND PROVIDE OUTREACH FOR OUR COMMUNITY. HMC PARTICIPATES IN MANY COMMUNITY ORGANIZATIONS EVENTS TO PROMOTE HEALTH SUCH AS HEALTH FAIRS AT THE COMMUNITY COLLEGE, LOCAL PARADES, SALINE COUNTY CHAMBER OF COMMERCE, SALINE COUNTY CHAMBER GOLF TOURNAMENT.THE HOSPITAL ACTIVELY SUPPORTS AND WORKS WITH OTHER HEALTH-RELATED ORGANIZATIONS SUCH AS HOSPICE OF SOUTHERN ILLINOIS AND EGYPTIAN HEALTH DEPARTMENT, AS WELL AS OTHER AREA HOSPITALS, AND NURSING HOMES. HMC HOSTS SEMI-ANNUAL BLOOD DRIVES FOR THE AMERICAN RED CROSS AT THE HOSPITAL. DURING THE COVID-19 PANDEMIC, THE HOSPITAL AND CLINICS HAVE SUPPORTED OUR LOCAL SCHOOLS IN SALINE COUNTY BY PROVIDING FACE MASKS, HAND SANITIZER, AND DISINFECTING WIPES FOR STUDENTS THAT ARE UNABLE TO PURCHASE THEIR OWN. THE HOSPITAL AND CLINICS HAVE ALSO CONDUCTED FOOD DRIVES FOR LOCAL FOOD PANTRIES, A BABY SUPPLY DRIVE FOR OUR LOCAL CRISIS PREGNANCY CENTER, AND COAT/GLOVE DRIVES FOR THE LOCAL KIDS. HMC CLINICS ALSO PROVIDED FOOD BASKETS TO LOCAL FAMILIES AT THANKSGIVING AND CHRISTMAS AND ALSO PURCHASED GIFTS FOR THE SCHOOLS UNDERPRIVILEGED STUDENTS. HMC IS A SPONSOR OF THE SALINE COUNTY "CREATING ENTREPRENEURIAL OPPORTUNITIES (CEO) PROGRAM" FOR LOCAL HIGH SCHOOL STUDENTS AND HMC'S CEO AND MARKETING DIRECTOR ARE ACTIVELY INVOLVED AS MENTORS TO THE STUDENTS THROUGHOUT THE YEAR. SALINE COUNTY CEO PROGRAM IS A MENTORING PROGRAM THAT PROVIDES EFFECTIVE NETWORKING MODEL FOR STUDENTS. HMC IS ACTIVE WITH THE GOLDEN CIRCLE SENIOR CITIZENS ORGANIZATION IN HARRISBURG. HMC'S REGISTERED DIETICIANS REVIEW AND APPROVE THEIR MENU EVERY MONTH AT NO CHARGE. OUR REGISTERED DIETICIANS ALSO PROVIDE NUTRITIONAL CONSULTS AT NO CHARGE IN THE CLINICS. HMC PROVIDES AN ATHLETIC TRAINER AND DRUG SCREENING TESTS AT NO CHARGE TO THE HARRISBURG HIGH SCHOOL. PART VI, LINE 6: THE HOSPITAL IS PART OF A LARGER SYSTEM, SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS), THAT PROVIDES HEALTH SERVICES TO THE POPULATION OF SOUTHERN ILLINOIS. SIHS PROVIDES CARE THROUGH ITS FOUR HOSPITALS AND A COMMUNITY HEALTH CENTER. THREE OF THE HOSPITALS ARE REPORTED AS SOUTHERN ILLINOIS HOSPITAL SERVICES AND ONE IS REPORTED AS HARRISBURG MEDICAL CENTER. HARRISBURG MEDICAL CENTER ALSO PROVIDES CARE THROUGH TWO RURAL HEALTH CLINICS. SOUTHERN ILLINOIS MEDICAL SERVICES (SIMS) PROVIDES CARE THROUGH PHYSICIAN PRACTICES. THESE PRACTICES ARE COMPRISED OF THE CENTER FOR MEDICAL ARTS, LOGAN PRIMARY CARE, PHYSICIAN CARE GROUP, INDIVIDUAL PHYSICIAN PRACTICES, HOSPITAL PHYSICIAN AND EMERGENCY ROOM PHYSICIANS. SIHS AND SIMS WORK TOGETHER IN PROVIDING CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED. BOTH PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. X X X X X 0 1 0 0 0 0 0 0 0 REX BUDDE PRESIDENT/CEO - SIH 0 778971 0 121287 0 1496205 0 11525 0 37021 0 2445009 0 1452756 JOHN B MILLSTEAD SENIOR VP/COO - SIH 0 532848 0 83514 0 219894 0 181753 0 44893 0 1062902 0 186021 JAMES ALEXANDER VICE-PRESIDENT/CMO 345663 0 335189 0 1360 0 11000 0 3809 0 697021 0 0 0 CLAYTON FORD PHYSICIAN 320185 0 102303 0 9127 0 11000 0 7127 0 449742 0 0 0 DONALD HUTSON PRESIDENT/CEO, VP/ADMINISTRATOR 211392 128167 10000 0 8657 23997 8398 3459 5765 17043 244212 172666 0 0 JASON VALLETTE CRNA 259042 0 35 0 8727 0 10274 0 26327 0 304405 0 0 0 THOMAS BUTLER CRNA 282510 0 35 0 4289 0 10824 0 1539 0 299197 0 0 0 ANDREA MILLER PHYSICIAN 186466 0 66592 0 9877 0 9953 0 13106 0 285994 0 0 0 MARIE GORSKI PHYSICIAN 279311 0 35 0 0 0 0 0 2756 0 282102 0 0 0 THERESA JUNE HAYES VICE-PRESIDENT/CFO, FINANCE DIRECTOR 197979 0 35 0 6236 0 7823 0 4776 0 216849 0 0 0 PART I, LINE 4B JAMES ALEXANDER, NON-QUALIFIED RETIREMENT PLAN CONTRIBUTIONS: $19,500 THOMAS BUTLER, NON-QUALIFIED RETIREMENT PLAN CONTRIBUTIONS: $19,500 A ILLINOIS FINANCE AUTHORITY 861091967 2021-12-01 18565000 REFUND TAX-EXEMPT SERIES 2017 BONDS (ISSUED 3/14/17) 0 0 0 A 135000 18565000 337239 18227761 2017 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 1 0 0 0 1 A 1 SCHEDULE K, PART II, LINE 17 ADEQUATE BOOKS AND RECORDS WILL BE AVAILABLE TO SUPPORT THE FINAL ALLOCATION OF PROCEEDS ONCE THEY ARE MADE. TIFFANY BUSINARO EMPLOYEE - WIFE OF BOARD MEMBER MATT BUSINARO 57390 WAGES 0 FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED IN THE BYLAWS. FORM 990, PART VI, SECTION A, LINE 4 SOUTHERN ILLINOIS HOSPITAL SERVICES BECAME THE SOLE MEMBER OF THE ORGANIZATION ON AUGUST 1, 2021. ON THAT DATE, THE ORGANIZATION'S BYLAWS WERE AMENDED TO REFERENCE THE NEW SOLE MEMBER AND ITS RESERVED POWERS. FORM 990, PART VI, SECTION A, LINE 6 IN 2020, THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES WAS AUTHORIZED TO NEGOTIATE A LETTER OF INTENT WITH SOUTHERN ILLINOIS HOSPITAL SERVICES. THE ORGANIZATION'S BOARD OF TRUSTEES AGREED UPON AND SIGNED THE LETTER OF INTENT AND AFFILIATION AGREEMENT IN JULY 2021 AND SOUTHERN ILLINOIS HOSPITAL SERVICES BECAME THE SOLE MEMBER OF THE ORGANIZATION ON AUGUST 1, 2021. THE MEMBER HAS THE RIGHT TO ELECT MEMBERS TO BOARD OF TRUSTEES AND TO APPROVE SOME DECISIONS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 7A THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES (CORPORATE MEMBER), HAS THE EXCLUSIVE RIGHT TO ELECT BOARD MEMBERS TO THE ORGANIZATION'S BOARD OF TRUSTEES FORM 990, PART VI, SECTION A, LINE 7B THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES (CORPORATE MEMBER), HAS RESERVED POWERS FOUND IN THE ORGANIZATION'S BYLAWS THE FOLLOWING MATTERS REQUIRE THE APPROVAL OF THE CORPORATE MEMBER: 1. APPROVAL AND REMOVAL OF THE MEMBERS OF THE BOARD OF TRUSTEES; 2. APPROVAL OF ANY CHANGE TO THE STATEMENT OF MISSION, PHILOSOPHY, ROLE AND PURPOSE OF THE CORPORATION; 3. APPROVAL OF CAPITAL EXPENDITURES IN EXCESS OF $50,000; 4. APPROVAL OF THE BUYING, SELLING, LEASING, MORTGAGING OR DISPOSING OF PROPERTY; 5. APPROVAL OF STRATEGIC PLANS; 6. APPROVAL OF THE CREATION OR DISSOLUTION OF ANY CORPORATION, THE SOLE MEMBER OR MAJORITY STOCKHOLDER OF WHICH IS THE CORPORATION; 7. APPROVAL OF MERGER, DISSOLUTION, CONSOLIDATION OR REORGANIZATION OF THE CORPORATION; 8. APPROVAL OF JOINT VENTURES OR AFFILIATIONS; 9. APPROVAL OF THE INCURRENCE OF ANY INDEBTEDNESS; 10. APPROVAL OF SUCH OTHER MATTERS AS MAY BE REQUIRED BY LAW OR BY THE CORPORATION'S ARTICLES OF INCORPORATION, OR BY THE BYLAWS TO BE SUBMITTED TO THE CORPORATE MEMBER; 11. APPROVAL OF ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; AND 12. SELECTION AND TERMINATION OF THE ADMINISTRATOR OF THE CORPORATION, FOLLOWING CONSULTATION WITH THE BOARD. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT OF THE FORM 990 AND SUPPLEMENTAL SCHEDULES WAS DISTRIBUTED TO THE ORGANIZATION'S ADMINISTRATOR AND FINANCE DIRECTOR, AND TO THE CORPORATE MEMBER'S CFO AND FINANCIAL STAFF FOR REVIEW AND COMMENTS. AFTER A REVIEW AND COMMENT PERIOD, ALL SUGGESTIONS AND COMMENTS WERE CONSIDERED, AND THE FORM 990 WAS UPDATED AS APPROPRIATE. THE FINALIZED FORM 990 AND SUPPLEMENTAL SCHEDULES WAS THEN PRESENTED TO THE ORGANIZATION'S BOARD OF TRUSTEES AND A COPY OF THE RETURN WAS MADE AVAILABLE TO EVERY MEMBER OF THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C ANNUALLY, THE CORPORATE MEMBER'S GENERAL COUNSEL SENDS OUT A CONFLICT-OF-INTEREST QUESTIONNAIRE TO EACH TRUSTEE, DIRECTOR, OFFICER, MANAGER, AND KEY EMPLOYEE TO COMPLETE AND RETURN. THE GENERAL COUNSEL THEN REVIEWS THESE QUESTIONNAIRES TO DETERMINE WHAT CONFLICTS, REAL OR PERCEIVED, EXIST. PER THE POLICY, THE TRUSTEES ARE OBLIGATED TO GIVE NOTICE IF A CONFLICT HAS BEEN OVERLOOKED OR IF A DISCUSSION OR ACTION COMES BEFORE THE BOARD WHICH MAY INVOLVE OR CREATE A CONFLICT OF INTEREST FOR SOMEONE. IF A TRUSTEE HAS A CONFLICT OF INTEREST, THE TRUSTEE OR THE GENERAL COUNSEL DISCLOSES THE CONFLICT. THE TRUSTEE WITH THE CONFLICT IS ALLOWED TO REMAIN IN THE MEETING TO ANSWER ANY QUESTION THE TRUSTEE MAY NEED TO ANSWER AND THEN THE CONFLICTED TRUSTEE IS EXCUSED FROM THE MEETING. THE REMAINING TRUSTEES THEN DISCUSS THE MATTER FURTHER AND ACTION IS TAKEN ON THE MATTER. FINALLY, THE CONFLICTED TRUSTEE IS THEN INVITED BACK INTO THE MEETING. INTERESTED PERSONS MAY ALSO BE ASKED, IN RARE SITUATIONS, TO RESIGN THEIR POSITION ON THE BOARD. FORM 990, PART VI, SECTION B, LINE 15 THE CORPORATE MEMBER'S BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF THE PRESIDENT/CEO FOR THE FULL BOARD. ONLY THE FULL BOARD HAS THE AUTHORITY TO APPROVE THE COMPENSATION OF THE PRESIDENT/CEO. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN SIHS' GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2021. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION TO THE FULL BOARD AS TO THE COMPENSATION PACKAGE OF ALL OFFICERS. ONLY THE COMMITTEE HAS THE AUTHORITY TO APPROVE THE COMPENSATION OF THE SENIOR MANAGEMENT TEAM AND WILL REPORT ITS ACTIONS TO THE BOARD. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN SIHS' GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS CONFLICT-OF-INTEREST POLICY AVAILABLE TO THE PUBLIC ON ITS WEBSITE AND UPON REQUEST. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104 THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. FORM 990, PART IX, LINE 11G PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 7,877,787. MANAGEMENT AND GENERAL EXPENSES 1,387,337. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,265,124. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 50,746. MANAGEMENT AND GENERAL EXPENSES 101,859. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 152,605. FORM 990, PART XII, LINE 2C EFFECTIVE AUGUST 1, 2021, SOUTHERN ILLINOIS HOSPITAL SERVICES ASSUMED OWNERSHIP OF HARRISBURG MEDICAL CENTER BY BECOMING ITS SOLE MEMBER (CORPORATE MEMBER). THE CORPORATE MEMBER'S AUDIT COMMITTEE HAS RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE CORPORATE MEMBER AND ALL OF ITS AFFILIATED ORGANIZATIONS, AS WELL AS THE SELECTION OF AN INDEPENDENT AUDITOR/ACCOUNTANT. HARRISBURG MEDICAL CENTER FOUNDATION 540 N COMMERCIAL HARRISBURG IL 62946 371411984 FUNDRAISING IL 501(C)(3) LINE 12A, I HARRISBURG MEDICAL CENTER 1 SOUTHERN ILLINOIS HOSPITAL SERVICES PO BOX 3988 CARBONDALE IL 62902 370618939 HEALTHCARE IL 501(C)(3) LINE 3 SOUTHERN ILLINOIS HOSPITAL ENTERPRISES INC 0 SOUTHERN ILLINOIS HOSPITAL ENTERPRISES INC PO BOX 3988 CARBONDALE IL 62902 371136788 HEALTHCARE IL 501(C)(3) LINE 12B, II N/A 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0