KEOKUK AREA HOSPITAL: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- KEOKUK AREA HOSPITAL (EIN 42-0710268)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-03
- IRS object ID
- 202322159349301007
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule H
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-03T10:55:06-04:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363077757 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAY HUNTER STENN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MAINE ST | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420710268 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEOKUK AREA HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KEOK | BusinessNameControlTxt |
| Phone | 3195247150 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN STREET | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICK GERVELER | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 2172231200 | PhoneNum |
| Signature | 2023-07-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | PATRICK | PersonFirstNm |
| Person Last | GERVELER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ERIN J WHARTON CPA | PreparerPersonNm |
| PTIN | P01294277 | PTIN |
| Phone | 2172220304 | PhoneNum |
| Preparation | 2023-08-02 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLESSING HEALTH KEOKUK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRIAN T CANFIELD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1005 BROADWAY | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,942,792 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.BLESSINGHEALTH.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | IMPROVING COMMUNITY HEALTH AND ENSURING ACCESS TO QUALITY HEALTHCARE SERVICES REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 227 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $4,393,415 | PYContributionsGrantsAmt |
| CY Contributions Grants | $11,320,814 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,730,679 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,084,157 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$57,676 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,085 | CYInvestmentIncomeAmt |
| PY Other Revenue | $79,876 | PYOtherRevenueAmt |
| CY Other Revenue | $216,236 | CYOtherRevenueAmt |
| PY Total Revenue | $12,146,294 | PYTotalRevenueAmt |
| CY Total Revenue | $21,632,292 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $138,437 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,977,958 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,430,508 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,321,918 | PYOtherExpensesAmt |
| CY Other Expenses | $6,455,774 | CYOtherExpensesAmt |
| PY Total Expenses | $12,438,313 | PYTotalExpensesAmt |
| CY Total Expenses | $18,886,282 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$292,019 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,746,010 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,149,011 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,237,631 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,949,702 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,292,312 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$800,691 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,945,319 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | IMPROVING COMMUNITY HEALTH AND ENSURING ACCESS TO QUALITY HEALTHCARE SERVICES REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | Yes (true) | SignificantChangeInd |
| Expense | $14,991,399 | ExpenseAmt |
| Revenue | $10,084,157 | RevenueAmt |
| Desc | KEOKUK AREA HOSPITAL (KAH) IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL FULLY ACCREDITED BY THE JOINT COMMISSION. ANNUALLY, KAH SERVICES APPROXIMATELY 300 ADMISSIONS, 7,000 EMERGENCY ROOM VISITS, AND 20,000 OUTPATIENT VISITS TO THE RESIDENTS OF KEOKUK, IOWA AND SURROUNDING AREAS. KAH ALSO SERVICES PATIENTS FROM A TRI-STATE AREA INCLUDING LEE COUNTY, IA, HANCOCK COUNTY, IL, AND CLARK COUNTY, MO. THE HOSPITAL HAS APPROXIMATELY 103 CREDENTIALED PHYSICIANS AND 9 CRNA/ARNPS ON THE MEDICAL STAFF AND IS GOVERNED BY THE KEOKUK HEALTH SYSTEMS BOARD OF DIRECTORS WHICH IS MADE UP OF LOCAL COMMUNITY MEMBERS. | Desc |
| Total Program Service Expenses | $14,991,399 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 227 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (true) | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PATRICK GERVELER | PersonNm |
| Phone | 2172231200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | BROADWAY AT 11TH | AddressLine1Txt |
| City | QUINCY | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62305 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|
| MAUREEN KAHN | |||||||
| PRESIDENT/CE | 0.00 | 40.00 | Yes (X) | $0 | $1,783,418 | $231,327 | |
| PATRICK GERVELER | |||||||
| TREASURER | 0.00 | 40.00 | $0 | $676,198 | $143,011 | Yes (X) | |
| KATHLEEN E HULL | |||||||
| ADMINISTRATO | 0.00 | 40.00 | $0 | $313,144 | $47,276 | Yes (X) | |
| VICKIE RENEAU | |||||||
| ADMINISTRATO | 39.00 | 1.00 | $172,359 | $0 | $22,566 | Yes (X) | |
| TERESA CONLEE | |||||||
| SECRETARY | 40.00 | 0.00 | $50,556 | $0 | $0 | Yes (X) | |
| MIKE DUNN | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KYLE KECK | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR KIRAN KHANOLKAR | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL KLAUSER | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL MAHER | |||||||
| CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| TOM RICHARDSON | |||||||
| VICE CHAIR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| BARB SMIDT | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR DONZA WORDEN | |||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $222,915 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,772,760 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $444,180 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| IOWA EMERGENCY PHYSICIANS LLP | |||||
| 3421 W 9TH ST | WATERLOO | IA | 50702 | STAFFING | $1,966,219 |
| GRAPE TREE MEDICAL STAFFING LLC | |||||
| 2501 BOJI BEND DR SUITE 100 | MILFORD | IA | 51351 | STAFFING | $421,692 |
| BLOOMFIELD ANESTHESISTS PLLC | |||||
| 105 E LOCUST ST | BLOOMFIELD | IA | 52537 | ANESTHESIOLOGY | $132,699 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $851,851 | GovernmentGrantsAmt |
| All Other Contributions | $10,468,963 | AllOtherContributionsAmt |
| Noncash Contributions | $880,286 | NoncashContributionsAmt |
| Total Contributions | $11,320,814 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $10,066,492 | $10,066,492 |
| RENTAL REVENUE | 561000 | $17,665 | $17,665 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,084,157 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,001 | TotalRevenueColumnAmt |
| Exclusion | $1,001 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $320,584 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $310,500 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $10,084 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,084 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,084 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| MISCELLANOUS | 900099 | $179,591 | $179,591 | |
| CAFETERIA REVENUE | 541610 | $36,645 | $36,645 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $216,236 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,632,292 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,273,832 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $37,646 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,481 | TotalAmt |
| Management And General | $245,481 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,582,763 | TotalAmt |
| Program Services | $8,722,008 | ProgramServicesAmt |
| Management And General | $1,860,755 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,089 | TotalAmt |
| Program Services | $10,543 | ProgramServicesAmt |
| Management And General | $2,546 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,095,597 | TotalAmt |
| Program Services | $882,489 | ProgramServicesAmt |
| Management And General | $213,108 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $493,578 | TotalAmt |
| Program Services | $397,571 | ProgramServicesAmt |
| Management And General | $96,007 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,857,082 | TotalAmt |
| Program Services | $1,536,120 | ProgramServicesAmt |
| Management And General | $1,320,962 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,037 | TotalAmt |
| Management And General | $47,037 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $697,959 | TotalAmt |
| Program Services | $595,906 | ProgramServicesAmt |
| Management And General | $102,053 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $626,197 | TotalAmt |
| Program Services | $626,197 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,089 | TotalAmt |
| Program Services | $15,667 | ProgramServicesAmt |
| Management And General | $422 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $778 | TotalAmt |
| Program Services | $778 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,512 | TotalAmt |
| Management And General | $6,512 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,972 | TotalAmt |
| Program Services | $146,972 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,556 | TotalAmt |
| Program Services | $36,556 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MEDICAL SUPPLIES | $1,916,097 | $1,916,097 |
| HOUSEKEEPING/LAUNDRY | $104,495 | $104,495 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,886,282 | TotalAmt |
| Program Services | $14,991,399 | ProgramServicesAmt |
| Management And General | $3,894,883 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,608,211 | BOYAmt |
| EOY | $498,365 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,024 | BOYAmt |
| EOY | $639,843 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,312,198 | BOYAmt |
| EOY | $1,404,493 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,500 | BOYAmt |
| EOY | $240,704 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $541,879 | BOYAmt |
| EOY | $293,377 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,653 | BOYAmt |
| EOY | $50,036 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,277,415 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $278,153 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,349,087 | BOYAmt |
| EOY | $1,999,262 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $167,888 | BOYAmt |
| EOY | $111,551 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,571 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,149,011 | BOYAmt |
| EOY | $5,237,631 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,065,450 | BOYAmt |
| EOY | $3,150,106 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,570,863 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,090 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $248,299 | BOYAmt |
| EOY | $142,206 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,949,702 | BOYAmt |
| EOY | $3,292,312 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$855,423 | BOYAmt |
| EOY | $1,945,011 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,732 | BOYAmt |
| EOY | $308 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$800,691 | BOYAmt |
| EOY | $1,945,319 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,149,011 | BOYAmt |
| EOY | $5,237,631 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,746,010 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $165,800 | OtherCostOrOtherBasisAmt |
| Book Value | $165,800 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,181,652 | OtherCostOrOtherBasisAmt |
| Depreciation | $88,950 | DepreciationAmt |
| Book Value | $1,092,702 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,543 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,016 | DepreciationAmt |
| Book Value | $12,527 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $916,420 | OtherCostOrOtherBasisAmt |
| Depreciation | $188,187 | DepreciationAmt |
| Book Value | $728,233 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,999,262 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| MEDICARE REIMBURSMENTS | $140,706 |
| OTHER LT LIABILITIES | $1,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $142,206 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
Discounted Care Oth Percentage DiscountedCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Discounted Care Other | 6.000000000000 | DiscountedCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | false | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $83,789 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $83,789 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00440 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,127,280 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,127,280 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11260 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,211,069 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,211,069 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11710 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,130 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,130 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,130 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,130 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,214,199 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,214,199 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.11720 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $920,767 | BadDebtExpenseAmt |
| Reimbursed By Medicare | $2,396,679 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $4,746,107 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,349,428 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEOKUK AREA HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | DBA BLESSING HEALTH KEOKUK | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN STREET | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | HTTPS://WWW.BLESSINGHEALTH.ORG/ | WebsiteAddressTxt |
| State License | 560054H | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KEOKUK AREA HOSPITAL | BusinessNameLine1Txt |
| Business Name Line2 | DBA BLESSING HEALTH KEOKUK | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 19 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.BLESSINGHEALTH.ORG/PUBLICATIONS | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | WWW.BLESSINGHEALTH.ORG/PUBLICATIONS | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 600.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FACILITY 1, KEOKUK AREA HOSPITAL - PART V, LINE 3E | THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DISCRIPTION OF THE SIGNIFCANT HEALTH NEEDS OF THE COMMUNITY, SEE BELOW: INDEPENDENTLY, KEOKUK AREA HOSPITAL HAS IDENTIFIED THREE OF THE SIX PRIORITY AREAS TO FOCUS ON FOR THE NEXT THREE YEARS. OBESITY PRESCRIPTION DRUG ABUSE TOBACCO USE PRIORITY: OBESITY STRATEGIES: 1. EVALUATE OPPORTUNITIES TO DEVELOP A WELLNESS PROGRAM FOR STAFF THAT INCLUDES CALORIE COUNTS IN THE CAFETERIA, HEALTH PRESENTATIONS, INCENTIVES FOR PARTICIPATING IN HEALTH EVENTS AND COORDINATION OF A BIGGEST LOSER TYPE PROGRAM. 2. INCREASE PROMOTION OF THE DIABETES EDUCATION AND SUPPORT PROGRAMS AT THE HOSPITAL THROUGHOUT THE COMMUNITY. THIS WILL BE DONE USING SOCIAL MEDIA, PRINT ADVERTISEMENTS, ARTICLES AND PRESENTATIONS. 3. INCREASE SPONSORSHIPS AND PROMOTION OF HEALTH RELATED COMMUNITY EVENTS. PRIORITY: PRESCRIPTION DRUG ABUSE STRATEGIES: 1. ENCOURAGE LOCAL HIGH SCHOOLS TO OFFER STUDENTS THE EVERFI PRESCRIPTION DRUG ABUSE PREVENTION PROGRAM (SPONSORED BY UNITYPOINT HEALTH). 2. PROMOTE LOCAL DRUG TAKE BACK DAYS THAT ARE HELD THROUGHOUT THE AREA. 3. HOST A COMMUNITY PRESENTATION WITH A PHARMACIST OR PHYSICIAN AS THE SPEAKER. 4. INCREASE EDUCATION REGARDING OPIOID DRUGS WITH PATIENTS IN THE EMERGENCY ROOM AND OTHER PATIENT CARE AREAS. PRIORITY: TOBACCO USE STRATEGIES: 1. REVIEW INTERNAL POLICIES. 2. PROMOTE TOBACCO CESSATION EDUCATION PROGRAMS. 3. HOST A LUNG HEALTH EVENT THAT INCORPORATES HEALTH ISSUES RELATED TO TOBACCO USE, INCLUDING OFFERING PULMONARY FUNCTION TESTING. 4. DEVELOP A LUNG CANCER SCREENING PROGRAM. NEEDS NOT ADDRESSED: SOME ISSUES IDENTIFIED THROUGH THE COMMUNITY HEALTH NEEDS ASSESSMENT HAVE NOT BEEN ADDRESSED IN THIS PLAN. THOSE SERVICES WILL BE INCLUDED IN THE LEE COUNTY HEALTH DEPARTMENT PLAN. SOME WILL ALSO BE FOLLOWED UP BY OTHER COMMUNITY GROUPS THROUGHOUT LEE COUNTY. |
| FACILITY 1, KEOKUK AREA HOSPITAL - PART V, LINE 5 | UNITYPOINT HEALTH - KEOKUK, LEE COUNTY HEALTH DEPARTMENT AND FORT MADISON COMMUNITY HOSPITAL ONCE AGAIN COLLABORATED TO BRING MULTIPLE COMMUNITY MEMBERS AND PARTNERSHIPS TOGETHER TO COMPLETE THE COUNTYS COMMUNITY HEALTH NEEDS ASSESSMENT. THE PROCESS IDENTIFIED SIX SPECIFIC HEALTH NEEDS TO ADDRESS IN THE COUNTYS HEALTH IMPROVEMENT PLAN FOR THE NEXT THREE YEARS. ON OCTOBER 4, 2018, 33 REPRESENTATIVES FROM A VARIETY OF COMMUNITY SECTORS MET TO REVIEW AND EVALUATE COUNTY LEVEL DATA/HEALTH INDICATORS, COMMUNITY- WIDE SURVEY RESULTS, AND DISCUSS COMMUNITY ASSETS AND RESOURCES AVAILABLE TO ADDRESS THE NEEDS OF THE COUNTY. ATTENDEES INCLUDED REPRESENTATIVES FROM UNITYPOINT HEALTH - KEOKUK, LEE COUNTY BOARD OF HEALTH, LEE COUNTY HEALTH DEPARTMENT, FORT MADISON COMMUNITY HOSPITAL, CHILDREN FIRST EARLY CHILDHOOD IOWA, SOUTHEAST IOWA REGIONAL PLANNING, LEE COUNTY COMMUNITY SERVICES/SOUTHEAST IOWA LINKDISABILITY SERVICES, MILESTONES AREA AGENCY ON AGING, UNITED WAY OF THE GREAT RIVER REGION, HOERNER YMCA, LEE COUNTY CONSERVATION, RAPE VICTIM ADVOCACY PROGRAM, ALCOHOL & DRUG DEPENDENCY SERVICES AND COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA, INC. |
| FACILITY 1, KEOKUK AREA HOSPITAL - PART V, LINE 6A | KEOKUK AREA HOSPITALS CHNA WAS PERFORMED WITH FORT MADISON COMMUNITY HOSPITAL. |
| FACILITY 1, KEOKUK AREA HOSPITAL - PART V, LINE 6B | KEOKUK AREA HOSPITALS CHNA WAS PERFORMED WITH THE LEE COUNTY HEALTH DEPARTMENT. |
| FACILITY 1, KEOKUK AREA HOSPITAL - PART V, LINE 11 | ALCOHOL CONSUMPTION (EXCESSIVE DRINKING) DATA (19%) EXCEEDED THE NATIONAL DATA (13%) BUT WAS UNDER THE STATE DATA (22%). ALCOHOL-IMPAIRED DRIVING DEATHS (31%) EXCEEDED THE STATE (27%) AND NATIONAL DATA (13%). LEE COUNTY TOBACCO USAGE DATA (17%) EXCEEDED NATIONAL DATA (14%) AND WAS EQUAL TO STATE DATA (17%). MORTALITY RATES OF DRUG POISONING (18) ALSO EXCEEDED THE STATE (9) AND NATIONAL LEVELS (10). LOCAL SURVEY RESULTS SUGGESTED THE COMMUNITY PARTNERS VOTED TO ALSO RECOGNIZE PRESCRIPTION DRUG ABUSE IS INCREASINGLY BECOMING A SIGNIFICANT HEALTH ISSUE. IN AN EFFORT TO PREVENT/REDUCE ALCOHOL, TOBACCO AND OTHER DRUG ABUSE AMONG OUR YOUTH AND ADULTS INCLUDING PRESCRIPTION DRUG ABUSE WE INCREASED EDUCATION IN THE PUBLIC THROUGH SERVICE ANNOUNCEMENTS AND PROMOTED INITIATIVES SUCH AS TAKE BACK IOWA PROGRAMS. WE ARE PROVIDING EDUCATION TO PATIENTS ON ALTERNATIVE TREATMENTS FOR PRESCRIPTION DRUGS, PROPERLY SECURING MEDICATIONS FROM HOUSEHOLD MEMBERS, VISITORS. TO IMPROVE THE POPULATIONS MENTAL HEALTH AND WELL-BEING. WE CONTINUE TO EVALUATE STRATEGIES AND PROCESSES FOR IMPLEMENTING HEALTH TECHNOLOGY FOR PATIENTS SERVED. PROMOTION AND EDUCATION IS GIVEN ON AVAILABLE COMMUNITY RESOURCES. OBESITY AND OTHER CHRONIC HEALTH ISSUES CONTINUE TO BE A TOP PRIORITY TO FOCUS ON AGAIN. DATA REVEALED DIABETES (9%), STROKE RATE (41), HEART DISEASE (225.7) PREVALENCE AND DISEASE MORTALITY STILL EXCEEDS THE STATE AND NATIONAL LEVELS. INDIVIDUALS GETTING ROUTINE PREVENTIVE HEALTH SCREENINGS REMAINS LOW YET PERCENTAGES OF THOSE WITH HIGH CHOLESTEROL (38.78) AND BLOOD PRESSURE (28.5) EXCEED STATE AND NATIONAL LEVELS. INADEQUATE FRUIT AND VEGETABLE CONSUMPTION (83.4%) AND INADEQUATE PHYSICAL ACTIVITY (23.3%) REMAIN HIGHER THAN STATE AND NATIONAL LEVELS. FOOD INSECURITY (14.46%) AND FOOD ACCESS OF OUR VULNERABLE POPULATION SUCH AS OUR SENIORS (19.52) REMAINS AN ISSUE. WE HAVE INCREASED PARTICIPATION IN PROGRAMS BY RAISING AWARENESS AMONG LOCAL PROVIDERS TO HELP BECOME BETTER EDUCATORS ON LOCAL OPPORTUNITIES. WE ALSO ARE OFFERING SENIOR FITNESS CLASSES AND PROMOTING LOCAL HEALTH EVENTS AND SERVICES. WE ARE ACTIVE IN THE LIVE HEALTH LEE COUNTY COALITION WHICH IS WORKING HARD ON EFFORTS TO ENCOURAGE BETTER EATING HABITS IN YOUNG ADULTS AND ADDING NEW HEALTHY OPTIONS. THE GROUP ALSO INCREASED PARTICIPATION IN LOCAL COMMUNITY GARDENING AND PRODUCE BOXES AND OTHER HEALTH INITIATIVES. WORKING TO INCREASE PARTICIPATION IN HEALTH MANAGEMENT EDUCATION AND CARE COORDINATION WITH DIABETES SELF-MANAGEMENT AND WEIGHT MANAGEMENT BY PROMOTING PROPER DIET, EXERCISE, AND MEDICATION MANAGEMENT. INCREASING SPONSORSHIPS AND PROMOTION OF HEALTH-RELATED COMMUNITY EVENTS. TEEN BIRTH RATES IN LEE COUNTY IS A PRIORITY HEALTH NEED. THE LEE COUNTY TEEN BIRTH RATE FOR AGES 15-19 (47.9) IS HIGHER THAN THE STATE RATE (29.9) AND NATIONAL RATE (36.6). LOW BIRTH WEIGHT RATES (7.9%) ALSO WERE HIGHER THAN THE STATE (6.8%) BUT LOWER THAN NATIONAL LEVEL (8.2%). WE ARE UTILIZING MESSAGING FOR OUTREACH EDUCATION. IN AN EFFORT TO PREVENT OR REDUCE TEEN BIRTHS AND STDS AMONG YOUTH/YOUNG ADULTS WE ARE PROVIDING ACCESS TO CONDOMS AT KEY LOCATIONS LIKE PUBLIC AND STAFF RESTROOMS. |
| FACILITY 1, KEOKUK AREA HOSPITAL - PART V, LINE 13H | PATIENTS WHO QUALIFY AND ARE RECEIVING BENEFITS FROM THE FOLLOWING PROGRAMS MAY BE PRESUMED ELIGIBLE FOR 100% FINANCIAL ASSISTANCE: THE US. DEPARTMENT OF AGRICULTURE FOOD AND NUTRITION SERVICE FOOD STAMP PROGRAM; WOMEN, INFANTS & CHILDREN (WIC); AND VARIOUS COUNTY AND STATE RELIEF PROGRAMS. THIRD PARTY AGENCIES ARE USED TO ASSIST WITH COLLECTIONS AND, IF THOSE AGENCIES PROVIDE A STATEMENT REGARDING A PATIENTS LIKELY INCOME LEVEL, THAT INFORMATION IS USED IN DETERMINING THE ELIGIBILITY STATUS AND THE LEVEL OF DISCOUNT AVAILABLE. STATE LAW REQUIREMENTS THAT OFFER ADDITIONAL AND/OR MORE STRINGENT ELIGIBILITY REQUIREMENTS WILL BE FOLLOWED FOR THOSE STATES. FACILITY 1, KEOKUK AREA HOSPITAL, PART V, LINE 16A, FAP WEBSITE: HTTPS://WWW.BLESSINGHEALTH.ORG/PATIENTS/BILLING-INSURANCE/FINANCIAL- ASSISTANCE FACILITY 1, KEOKUK AREA HOSPITAL, PART V, LINE 16B, FAP APPLICATION WEBSITE: HTTPS://WWW.BLESSINGHEALTH.ORG/PATIENTS/BILLING-INSURANCE/FINANCIAL- ASSISTANCE FACILITY 1, KEOKUK AREA HOSPITAL, PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: HTTPS://WWW.BLESSINGHEALTH.ORG/PATIENTS/BILLING-INSURANCE/FINANCIAL- ASSISTANCE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-STATE MEDICAL GROUP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 MORGAN | AddressLine1Txt |
| City | KEOKUK | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52632 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | PRIMARY CARE CLINIC | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE H, PART I, LINE 6A | KEOKUK AREA HOSPITAL'S COMMUNITY BENEFIT REPORT IS AVAILABLE UPON REQUEST FROM BLESSING CORPORATE SERVICES, INC. |
| SCHEDULE H, PART I, LINE 7 | A COST-TO-CHARGE RATIO (FROM WORKSHEET 2) IS USED TO CALCULATE THE AMOUNTS ON LINE 7A. THE AMOUNTS ON LINES 7B-7C (UNREIMBURSED MEDICAID AND OTHER MEANS-TESTED GOVERNMENT PROGRAMS) ARE OBTAINED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO COST ACCOUNTING SYSTEM USE COST-TO-CHARGE RATIO. THE AMOUNTS FOR LINES 7E, F, H, AND I WOULD COME FROM THE BOOKS AND RECORDS OF SPECIFIC SEGMENTS OF THE ORGANIZATION AND ARE BASED ON COST. THE AMOUNTS ON 7G ARE DERIVED FROM A COST ACCOUNTING SYSTEM OF APPLICABLE PATIENT SEGMENTS. SEGMENTS NOT PASSED TO A COST ACCOUNTING SYSTEM USE THE COST-TO-CHARGE RATIO. |
| SCHEDULE H, PART II | KEOKUK AREA HOSPITALS COMMUNITY BUILDING ACTIVITIES PROMOTE THE HEALTH OF THE COMMUNITY THROUGH INCREASED EDUCATION AND TRAINING OF HEALTHCARE RELATED ISSUES AS WELL AS PROMOTING CAREER DEVELOPMENT IN THE HEALTHCARE FIELD. |
| SCHEDULE H, PART III, LINE 2 | THE HEALTH SYSTEM PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HEALTH SYSTEM BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENTS LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE AMOUNT REPORTED ON LINE 2 IS CALCULATED BASED ON BAD DEBT PATIENT ACTIVITY AS WELL AS PROJECTED BAD DEBT EXPENSE WHICH IS CALCULATED BASED ON OPEN PATIENT ACCOUNTS. |
| SCHEDULE H, PART III, LINE 4 | PAGE 18 OF THE ATTACHED CONSOLIDATED AUDITED FINANCIAL STATEMENTS CONTAINS THE FOODNOTE DESCRIPTION OF BAD DEBT EXPENSE. |
| SCHEDULE H, PART III, LINE 8 | AMOUNTS ON LINE 6 WERE CALCULATED USING IRS WORKSHEET B TOTAL MEDICARE ALLOWABLE COSTS. THE MEDICARE ALLOWABLE COSTS WERE OBTAINED FROM THE MEDICARE COST REPORTS AND THEN REDUCED BY ANY AMOUNTS ALREADY CAPTURED IN COMMUNITY BENEFIT EXPENSE IN PART I ABOVE. THE METHODOLOGY DESCRIBED IN THE INSTRUCTIONS TO SCHEDULE H, PART III SECTION B, LINE 6 DOES NOT TAKE INTO ACCOUNT ALL COSTS INCURRED BY THE HOSPITAL AND DOES NOT REPRESENT THE TOTAL COMMUNITY BENEFIT CONFERRED IN THIS AREA. THE MEDICARE SURPLUS REFLECTED ON SCHEDULE H, PART III, SECTION B WAS DETERMINED USING INFORMATION FROM THE ORGANIZATIONS MEDICARE COST REPORT. HOWEVER THE MEDICARE COST REPORT DISALLOWS CERTAIN ITEMS THAT WE BELIEVE ARE LEGITIMATE EXPENSES INCURRED IN THE PROCESS OF CARING FOR OUR MEDICARE PATIENTS. EXAMPLES OF THESE ITEMS INCLUDE PROVIDER BASED PHYSICIAN EXPENSE, SELF INSURANCE EXPENSE, HOME OFFICE EXPENSE AND THE SHORTFALL FROM FEE SCHEDULE PAYMENTS. THE HOSPITAL BELIEVES THE ENTIRE AMOUNT OF THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT, MORE SPECIFICALLY, AS CHARITY CARE. THE ELDERLY CONSTITUTE A CLEARLY-RECOGNIZED CHARITABLE CLASS, AND MANY MEDICARE BENEFICIARIES, LIKE THEIR MEDICAID COUNTERPARTS, ARE POOR AND THUS WOULD HAVE QUALIFIED FOR THE HOSPITALS CHARITY CARE PROGRAM, MEDICAID OR OTHER NEEDS-BASED GOVERNMENT PROGRAMS ABSENT THE MEDICARE PROGRAM. BY ACCEPTING PAYMENT BELOW COST TO TREAT THESE INDIVIDUALS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS. ADDITIONALLY, THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTION IN REIMBURSEMENT MAY ACTUALLY CREATE DIFFICULTIES IN ACCESS FOR THESE INDIVIDUALS. FINALLY, THE AMOUNT SPENT TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO COVER CHARITY CARE AND OTHER COMMUNITY BENEFIT NEEDS. |
| SCHEDULE H, PART III, LINE 9B | AFTER THE PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS PARTIALLY OR ENTIRELY WRITTEN OFF, AS APPROPRIATE. ANY REMAINING BALANCE, IF ANY, WOULD BE COLLECTED UNDER THE NORMAL DEBT COLLECTION POLICY. |
| SCHEDULE H, PART VI, LINE 2 | KEOKUK AREA HOSPITAL PARTICIPATES WITH MANY HEALTH RELATED ORGANIZATIONS TO ASSESS HEALTHCARE NEEDS IN LEE COUNTY, IOWA AND SHARES THE RESULTS IN A WRITTEN COMMUNITY HEALTH NEEDS ASSESSMENT WHICH IS AVAILABLE ON THE WEBSITE OR BY REQUEST. |
| SCHEDULE H, PART VI, LINE 3 | THE HOSPITAL COMMUNICATES THE AVAILABILITY OF FINANCIAL ASSISTANCE TO ALL PATIENTS AND WITHIN THE COMMUNITY. COPIES OF THE FINANCIAL ASSISTANCE POLICY, FINANCIAL ASSISTANCE APPLICATION AND PLAIN LANGUAGE SUMMARY ARE AVAILABLE BY MAIL, ON EACH HOSPITALS WEBSITE, AND IN PERSON AT EACH HOSPITAL. THE CENTRAL BILLING OFFICE IS AVAILABLE BY PHONE TO ANSWER QUESTIONS ABOUT THE POLICY, OR PATIENTS SHOULD GO TO THE CASHIERS OFFICE AT THE HOSPITAL TO OBTAIN THIS INFORMATION. THE PLAIN LANGUAGE SUMMARY IS OFFERED AS PART OF THE PATIENT INTAKE AND/OR DISCHARGE PROCESS AND INCLUDED WHEN A PATIENT IS SENT WRITTEN NOTICE THAT EXTRAORDINARY COLLECTION ACTIONS MAY BE TAKEN AGAINST HIM/HER. THE FINANCIAL ASSISTANCE POLICY, THE PLAIN LANGUAGE SUMMARY, AND ALL FINANCIAL ASSISTANCE FORMS ARE AVAILABLE IN ENGLISH AND IN ANY OTHER LANGUAGE IN WHICH LIMITED ENGLISH PROFICIENCY (LEP) POPULATIONS CONSTITUTE THE LESSER OF 1,000 PERSONS OR MORE THAN 5% OF THE COMMUNITY SERVED BY THE HOSPITAL. THESE TRANSLATED DOCUMENTS WILL BE AVAILABLE BY MAIL, ON EACH HOSPITALS WEBSITE, AND IN PERSON AT EACH HOSPITAL. |
| SCHEDULE H, PART VI, LINE 4 | KEOKUK HOSPITAL IS A 49 BED COMMUNITY HOSPITAL SERVING THE MIDWEST REGION. KEOKUK HOSPITAL IS NONDENOMINATIONAL AND SERVES ALL WHO COME HERE, REGARDLESS OF REASON OR CIRCUMSTANCE. 76% OF KEOKUK HOSPITAL MARKET RESIDENTS LIVE WITHIN THE IOWA COUNTY OF LEE. KEOKUK HOSPITAL ADMITS APPROXIMATELY 300 INPATIENTS AND CARES FOR 8,000 EMERGENCY PATIENTS PER YEAR. MEDIAN HOUSEHOLD INCOME IS 52,072 AND THE AVERAGE POVERTY RATE IS 11.5%. 71.3% OF KEOKUK HOSPITALS INPATIENTS ARE ELIGIBLE FOR MEDICARE OR MEDICAID. |
| SCHEDULE H, PART VI, LINE 5 | KEOKUK AREA HOSPITAL HAS AN ALL VOLUNTEER BOARD OF DIRECTORS MADE UP OF LOCAL COMMUNITY MEMBERS WHO SERVE WITHOUT COMPENSATION. THE MEDICAL STAFF IS OPEN TO ALL INTERESTED PROVIDERS WHO ARE APPROPRIATELY CREDENTIALED. ALL FUNDS GENERATED BY THE HOSPITAL ARE UTILIZED FOR PATIENT RELATED SERVICES AND TO ENSURE THAT ALL PATIENTS IN THE MARKET HAVE ACCESS TO QUALITY HEALTHCARE SERVICES REGARDLESS OF ABILITY TO PAY. |
| SCHEDULE H, PART VI, LINE 6 | BLESSING CORPORATE SERVICES, INC. IS THE PARENT ORGANIZATION OF A GROUP OF RELATED ORGANIZATIONS AND PROVIDES OVERALL DIRECTION TO ALL ENTITIES WITHIN THE STRUCTURE. DURING THE YEAR ENDED SEPTEMBER 30, 2005, BLESSING CORPORATE SERVICES, INC. BEGAN OPERATING A DIVISION COMPRISED OF PRACTICING PHYSICIANS. THE GROUP IS RELATED THROUGH BOARD CONTROL. THE FOLLOWING IS A BRIEF DESCRIPTION OF EACH MEMBER OF THE GROUP. ORGANIZATION - BLESSING HOSPITAL (HOSPITAL), LOCATED IN QUINCY, ILLINOIS, IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WESTERN ILLINOIS, NORTHEASTERN MISSOURI, AND SOUTHEASTERN IOWA. THE HOSPITAL WAS INCORPORATED IN ILLINOIS IN 1875. ORGANIZATION - THE BLESSING FOUNDATION, INC. SERVES BLESSING CORPORATE SERVICES AND ITS AFFILIATED ENTITIES BY PROVIDING FINANCIAL SUPPORT FOR SERVICES AND PROGRAMS PROMOTING THE IMPROVEMENT AND AVAILABILITY OF HEALTHCARE SERVICES WITHIN THE GENERAL COMMUNITY. ORGANIZATION - DENMAN SERVICES, INC. (A TAXABLE CORPORATION) ENGAGES PRIMARILY IN THE BUSINESS OF SELLING AND RENTING MEDICAL EQUIPMENT AND OPERATING A COMMERCIAL LAUNDRY. DENMAN SERVICES, INC. IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL AND SUBSIDIARY, LOCATED IN PITTSFIELD, ILLINOIS, IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WESTERN ILLINOIS. THE HOSPITAL WAS INCORPORATED ON JANUARY 20, 2000. ORGANIZATION - ILLINI HEALTH SERVICES, LLC CONDUCTS A PHARMACY BUSINESS IN PITTSFIELD, ILLINOIS. THE PHARMACY IS OWNED NINETY-FIVE PERCENT (95%) BY DENMAN SERVICES, INC. AND FIVE PERCENT (5%) BY BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL. ORGANIZATION - CHS HOLDING COMPANY (A TAXABLE CORPORATION) PROVIDES HEALTH INSURANCE PRODUCTS AND SERVICES. ORGANIZATION - BLESSING WALK-IN CLINIC, LLC DBA BLESSING CONVENIENT CARE OPERATES HEALTH CLINICS IN RETAIL FACILITIES. ORGANIZATION - CROSSRIVER QUALITY HEALTH PARTNERS IS A CLINICALLY INTEGRATED NETWORK FOCUSED ON IMPROVING QUALITY AND EFFICIENCY OF PATIENT CARE ACROSS ILLINOIS, MISSOURI, AND IOWA. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - BLESSING ASSURANCE COMPANY IS A WHOLLY OWNED FOREIGN SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. AND IS A PROVIDER OF SELF-INSURANCE TO THE AFFILIATED GROUP. ORGANIZATION - THE HANNIBAL CLINIC, INC. (A TAXABLE CORPORATION) PROVIDES A GROUP OF HEALTH CARE PROVIDERS SERVING NORTHEAST MISSOURI AND WEST CENTRAL ILLINOIS. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - THE BROWN DRUG COMPANY (A TAXABLE CORPORATION) OPERATES A RETAIL PHARMACY. ORGANIZATION - KEOKUK HEALTH SYSTEMS, INC. - A PARENT COMPANY TO FOUR ENTITIES: KEOKUK AREA HOSPITAL DBA BLESSING HEALTH KEOKUK, KEOKUK AREA MEDICAL EQUIPMENT AND SUPPLY INC., KEOKUK AREA HOSPITAL FOUNDATION, AND TRI-STATE MEDICAL GROUP INC. ORGANIZATION - RIVERCROSS DIAGNOSTICS, LLC - A LABORATORY THAT SERVICES BLESSING HEALTH SYSTEM AND OTHER AREA MEDICAL SERVICE PROVIDERS. |
| SCHEDULE H, PART VI, LINE 7 | IOWA |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MAUREEN KAHN | |||||||||||
| PRESIDENT/CEO | $801,859 | $275,184 | $706,375 | $193,419 | $37,908 | $2,014,745 | $435,731 | ||||
| PATRICK GERVELER | |||||||||||
| TREASURER | $502,580 | $150,153 | $23,465 | $110,119 | $32,892 | $819,209 | |||||
| KATHLEEN E HULL | |||||||||||
| ADMINISTRATOR | $235,529 | $73,239 | $4,376 | $14,500 | $32,776 | $360,420 | |||||
| VICKIE RENEAU | |||||||||||
| ADMINISTRATOR | $172,359 | $1,799 | $20,767 | $194,925 | |||||||
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 4 | FormAndLineReferenceDesc |
| Explanation | MAUREEN KAHN 0 178,919 0 PATRICK GERVELER 0 95,619 0 | ExplanationTxt |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $870,955 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | APPRAISER | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | RECEIVABLES | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $9,331 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | DONOR'S BASIS | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 3 | THE ORGANIZATION CEASED OPERATIONS IN SEPTEMBER 2022 WITH THE ANTICIPATION OF TRANSFERRING THE ENTITY TO A NEW MEMBER THAT WOULD ALLOW A RECOMMENCEMENT OF OPERATIONS IN THE FUTURE. |
| FORM 990, PART VI | KEOKUK AREA HOSPITAL CONTRACTS WITH BLESSING CORPORATE SERVICES TO EXECUTE THE DUTIES NORMALLY PERFORMED BY MANAGEMENT. THE MANAGEMENT COMPANY CARRIES OUT THE GOVERNING DECISIONS OF THE BOARD OF DIRECTORS, SIMILAR TO THE ROLE AND FUNCTIONS OF AN EMPLOYEE-OFFICER. BLESSING CORPORATE SERVICES PAID COMPENSATION TO VARIOUS EMPLOYEES COLLECTIVELY ACTING AS MANAGMENT. THE COMPENSATION PAID TO THOSE EMPLOYEES WHO SERVE ON KEOKUK AREA HOSPITAL'S BOARD OF DIRECTORS IS DISCLOSED ON PART VII. |
| FORM 990, PAGE 6, PART VI, LINE 3 | BLESSING CORPORATE SERVICES PROVIDES GENERAL MANAGEMENT SERVICES. |
| FORM 990, PAGE 6, PART VI, LINE 6 | KEOKUK HEALTH SYSTEMS, INC. IS THE SOLE VOTING MEMBER OF KEOKUK AREA HOSPITAL. |
| FORM 990, PAGE 6, PART VI, LINE 7A | KEOKUK HEALTH SYSTEMS, INC., THE SOLE VOTING MEMBER OF KEOKUK AREA HOSPITAL, SHALL POSSESS THE RIGHTS AND RESPONSIBILITIES, WITH THE APPROVAL OF BLESSING CORPORATE SERVICES, INC. (WHO HAS FINAL AUTHORITY) TO APPOINT AND/OR REMOVE AT-LARGE DIRECTORS OF THE CORPORATION AT ANY TIME, WITH OR WITHOUT CAUSE AND APPOINT AND REMOVE THE CORPORATION'S PRESIDENT. |
| FORM 990, PAGE 6, PART VI, LINE 7B | BLESSING CORPORATE SERVICES, INC. ("BCS") SHALL POSSESS THE RIGHTS AND RESPONSIBILITES TO APPROVE: (A) APPOINTMENT AND/OR REMOVAL OF AT-LARGE THE DIRECTORS OF THE CORPORATION AT ANY TIME, WITH OR WITHOUT CAUSE, (B) APPOINTMENT AND REMOVAL OF THE CORPORATION'S PRESIDENT, (C) AMENDING THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS, (D) BORROWING OF MONEY AND OTHER FORMS OF INDEBTEDNESS, INCLUDING, BUT NOT LIMITED TO, LEASES; (E) LONG-RANGE PLANS, CAPITAL AND OPERATING BUDGETS; AND STRATEGIC OR BUSINESS PLANS, (F) PURCHASING AND SELLING REAL AND PERSONAL PROPERTY AND ENTERING INTO CONTRACTS, NOT EXPRESSLY MADE PART OF AN APPROVED BUDGET, THE REASONABLE VALUE OF WHICH EXCEEDS 250,000, (G) MATERIAL INVESTMENT DECISIONS, INCLUDING WITHOUT LIMITATION ESTABLISHMENT AND MODIFICATION OF INVESTMENT POLICIES, ENGAGEMENT AND REMOVAL OF INVESTMENT MANAGERS AND ADVISORS, AND CHANGES IN INVESTMENT ALLOCATIONS NOT PERMITTED BY AN EXISTING INVESTMENT POLICY; (H) DETERMINING THE PARAMETERS FOR TERMS OF EMPLOYMENT OF PHYSICIANS, IF ANY, INCLUDING PHYSICIAN COMPENSATION PLANS, AND ANY MATERIAL VARIANCES FROM SUCH PARAMETERS FOR INDIVIDUAL PHYSICIANS; (I) SELECTION OF AUDITORS AND LEGAL COUNSEL; (J) ADOPTION OF CHARITY CARE AND COMMUNITY BENEFITS-RELATED POLICIES; (K) FORMATION OF SUBSIDIARY ENTITIES AND/OR JOINT VENTURES; (L) FILING OF A PETITION IN BANKRUPTCY, MAKING AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS, OR APPLYING FOR PROTECTION UNDER ANY INSOLVENCY LAWS; (M) PARTICIPATION IN ANY MERGER, COMBINATION, CONSOLIDATION, LIQUIDATION, DISSOLUTION OR OTHER CORPORATE OR BUSINESS ENTITY RESTRUCTURING; AND (N) ENTRY INTO ANY CONTRACT AND THE ENFORCEMENT AND/OR PERFORMANCE OF ANY CONTRACTUAL OBLIGATION; (O) ADDITION OF ANY NEW MEMBERS OF CORPORATION; (P) CREATION, TRANSFER OF OWNERSHIP IN AND/OR DISSOLUTION OF ANY SUBSIDIARY OF CORPORATION; AND (Q) CHANGES TO THE USE OF THE CORPORATION NAME AND BRANDING OF THE CORPORATION WITH OR WITHOUT REFERENCE TO BCS. |
| FORM 990, PAGE 6, PART VI, LINE 9 | PATRICK GERVELER BROADWAY AT 11TH ST. QUINCY, IL 62305 |
| FORM 990, PAGE 6, PART VI, LINE 11B | FOLLOWING MANAGEMENT AND LEGAL REVIEW, THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY. ANNUALLY ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND REPORTING PHYSICIANS ARE REQUESTED TO COMPLETE A QUESTIONNAIRE TO REPORT POTENTIAL CONFLICTS OF INTEREST. PERSONS WHO HAVE NOT RETURNED QUESTIONNAIRES ARE CONTACTED ADDITIONAL TIMES IN AN EFFORT TO RECEIVE COMPLETE AND ACCURATE RESPONSES FROM ALL PERSONS. THE ANNUAL QUESTIONNAIRES INCLUDE AN ACKNOWLEDGEMENT THAT THE OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN: 1) HAS ACCESS TO A COPY OF THE CONFLICT OF INTEREST POLICY; 2) HAS READ AND UNDERSTANDS THE POLICY; 3) AGREES TO COMPLY WITH THE POLICY; 4) UNDERSTANDS THAT THE POLICY APPLIES TO ALL COMMITTEES AND SUBCOMMITTEES HAVING BOARD-DELEGATED POWERS; AND 5) UNDERSTANDS THAT THE ORGANIZATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS TAX-EXEMPT STATUS, IT MUST CONTINUOUSLY ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. THE INFORMATION DISCLOSED IS USED TO IDENTIFY POTENTIAL CONFLICTS OF INTEREST AND TO ASSIST IN COMPLETING IRS AND MEDICAID QUESTIONNAIRES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN TOGETHER WITH ALL MATERIAL FACTS, SHOULD BE DISCLOSED TO THE BOARD OF DIRECTORS AND MADE A MATTER OF RECORD, EITHER THROUGH AN ANNUAL PROCEDURE OR WHEN THE INTEREST OCCURS OR BECOMES A MATTER OF BOARD ACTION. ANY ORGANIZATIONAL OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN HAVING A CONFLICT OF INTEREST IN ANY MATTER SHOULD NOT BE PRESENT DURING GENERAL DISCUSSION NOR VOTE OR USE HIS OR HER PERSONAL INFLUENCE ON THE MATTER, AND HE OR SHE SHOULD NOT BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM FOR PURPOSES OF THE MATTER OR ITEM AS TO WHICH A CONFLICT EXISTS. THE BOARD SHOULD EXCLUDE THE INDIVIDUAL FROM ANY DISCUSSION OR VOTE IN WHICH THE BOARD DECIDES WHETHER OR NOT A CONFLICT OF INTEREST EXISTS. IN CASES IN WHICH AN OFFICER, DIRECTOR, KEY EMPLOYEE, REPORTING PHYSICIAN OR THE INDIVIDUALS HOUSEHOLD MEMBER HAS A CONFLICT OF INTEREST IN AN ARRANGEMENT OR TRANSACTION, THE FOLLOWING ADDITIONAL STEPS MAY BE TAKEN AT THE DIRECTION OF THE BOARD OF DIRECTORS: 1) AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL 1) DECIDE IF A CONFLICT OF INTEREST EXISTS, 2) A DISINTERESTED PERSON OR COMMITTEE MAY BE APPOINTED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED ARRANGEMENT OR TRANSACTION; 3) IN ORDER TO APPROVE THE ARRANGEMENT OR TRANSACTION, THE BOARD MUST FIRST FIND, BY MAJORITY VOTE OF DISINTERESTED MEMBERS, THAT THE ARRANGEMENT OR TRANSACTION IS IN THE ORGANIZATIONS BEST INTEREST, IS FAIR AND REASONABLE TO THE ORGANIZATION, AND, AFTER REASONABLE INVESTIGATION, THE DISINTERESTED MEMBERS HAVE DETERMINED THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT CANNOT BE OBTAINED WITH REASONABLE EFFORTS UNDER THE CIRCUMSTANCES; THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD-DELEGATED POWERS SHALL CONTAIN: 1) THE NAMES OF THE PERSONS WHO DISCLOSED OR OTHERWISE WERE FOUND TO HAVE A FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE NATURE OF THE FINANCIAL INTEREST, ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT, AND THE BOARDS OR COMMITTEES DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED; 2) THE NAMES OF THE PERSONS WHO WERE PRESENT FOR DISCUSSIONS AND VOTES RELATING TO THE TRANSACTION OR ARRANGEMENT, THE CONTENT OF THE DISCUSSION, INCLUDING ANY ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT, AND A RECORD OF ANY VOTES TAKEN IN CONNECTION THEREWITH; IN ORDER TO PROTECT THE ORGANIZATIONS BEST INTERESTS, APPROPRIATE DISCIPLINARY ACTION MAY BE TAKEN WITH RESPECT TO AN OFFICER, DIRECTOR, KEY EMPLOYEE OR REPORTING PHYSICIAN WHO VIOLATES THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION ARRANGEMENTS WITH HIGHLY PAID EMPLOYEES UTILIZE BENCHMARK DATA FROM VARIOUS SOURCES INCLUDING THE IOWA HOSPITAL ASSOCIATION WAGE AND SALARY SURVEYS AND PHYSICIAN COMPENSATION SURVEYS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION ARRANGEMENTS WITH HIGHLY PAID EMPLOYEES UTILIZE BENCHMARK DATA FROM VARIOUS SOURCES INCLUDING THE IOWA HOSPITAL ASSOCIATION WAGE AND SALARY SURVEYS AND PHYSICIAN COMPENSATION SURVEYS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THESE FORMS ARE LOCATED IN THE CORPORATE ADMINISTRATIVE OFFICES AND ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. |
| FORM 990, PART IX, LINE 11G | HEALTH PROFESSIONALS 365,769 0 0 MISC. PURCHASED SERVICES 1,170,351 1,320,962 0 TOTAL 1,536,120 1,320,962 0 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (11 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BLESSING CORPORATE SERVICES INC | ||||||||||||
| BROADWAY AT 11TH PO BOX 7005 | QUINCY | IL | 623057005 | 371128706 | MGMT SVCS | IL | 501C3 | 10 | N/A | false | ||
| THE BLESSING FOUNDATION | ||||||||||||
| BROADWAY AT 11TH POBOX 7005 | QUINCY | IL | 623057005 | 371128705 | FUNDRAISE | IL | 501C3 | 12B | false | BCS INC | BCS INC | |
| BLESSINGCARE CORP DBA ILLINI COMM H | ||||||||||||
| 640 WEST WASHINGTON | PITTSFIELD | IL | 62363 | 371396010 | HOSPITAL | IL | 501C3 | 3 | false | BCS INC | BCS INC | |
| BLESSINGCARE CORPORATION - MISSOURI | ||||||||||||
| 1005 BROADWAY | QUINCY | IL | 62301 | 431371818 | INACTIVE | MO | 501C3 | 3 | false | BCS INC | BCS INC | |
| BLESSING VOLUNTEERS IN PARTNERSHIP | ||||||||||||
| BROADWAY AT 11TH PO BOX 7005 | QUINCY | IL | 623057005 | 237160187 | HSP SUPPRT | IL | 501C3 | 12B | N/A | false | ||
| BLESSING AFFILIATES INC | ||||||||||||
| BROADWAY AT 11TH PO BOX 7005 | QUINCY | IL | 623057005 | 371128708 | INACTIVE | IL | 501C3 | 10 | false | BCS INC | ||
| BLESSING WALK-IN CLINIC LLC | ||||||||||||
| 1005 BROADWAY | QUINCY | IL | 62301 | 814181593 | MED SVCS | IL | 501C3 | 3 | false | BCS INC | BCS INC | |
| BLESSING HOSPITAL | ||||||||||||
| 1005 BROADWAY | QUINCY | IL | 62301 | 370661183 | HOSPITAL | IL | 501C3 | 3 | false | BCS INC | ||
| KEOKUK AREA HOSPITAL FOUNDATION | ||||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 421202608 | FUNDRAISIN | IA | 501C3 | 12B | false | KHS INC | ||
| TRI-STATE MEDICAL GROUP INC | ||||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 411435525 | HOSPITAL | IA | 501C3 | 3 | false | KHS INC | ||
| KEOKUK HEALTH SYSTEMS INC | ||||||||||||
| 1600 MORGAN STREET | KEOKUK | IA | 52632 | 421237361 | MGMT SVCS | IA | 501C3 | 12B | false | BCS INC | ||
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd |
|---|---|---|---|---|---|---|---|---|---|
| ILLINI HEALTH SERVICES LLC | |||||||||
| PO BOX 40 | QUINCY | IL | 623060040 | 470901851 | PHARMACY | DENMAN | DENMAN | false | false |
| CURRENT HEALTH NETWORK LLC | |||||||||
| 1005 BROADWAY | QUINCY | IL | 62301 | 811681509 | PRVDR NTWK | CHS HLDGS | false | false | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Business Name Line2DirectControllingEntityName/BusinessNameLine2Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DENMAN SERVICES INC | ||||||||||||||||
| BROADWAY AT 11TH PO BOX 40 | QUINCY | IL | 62306 | 371132117 | MED EQUIP | IL | BCS INC | BCS INC | C CORP | false | ||||||
| CHS HOLDING COMPANY | ||||||||||||||||
| 1005 BROADWAY | QUINCY | IL | 62301 | 320481381 | GRP HLTH | IL | BCS INC | BCS INC | C CORP | false | ||||||
| THE HANNIBAL CLINIC INC | ||||||||||||||||
| 100 MEDICAL DRIVE | HANNIBAL | MO | 63401 | 431033473 | MED SVCS | MO | BCS INC | C CORP | false | |||||||
| BLESSING ASSURANCE COMPANY | ||||||||||||||||
| 981454767 | SELF-INSUR | BCS INC | BCS INC | C CORP | false | PO BOX 1159 | GRAND CAYMAN | CAYMAN ISLANDS | CJ | KY1-1102 | CJ | |||||
| BROWN DRUG COMPANY | ||||||||||||||||
| 1121 MAINE ST | QUINCY | IL | 62301 | 370193505 | PHARMACY | IL | BCS INC | S CORP | false | |||||||
| KEOKUK AREA MEDICAL EQUIP & SUPPLY | ||||||||||||||||
| 420 NORTH 17TH STREET | KEOKUK | IA | 52632 | 421237312 | MED EQUIP. | IA | KHS INC | C CORP | false | |||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| BLESSING CORPORATE SERVICES INC | ||
| M | $221,880 | FMV |
| BLESSING HOSPITAL | ||
| M | $962,837 | FMV |
| TRI-STATE MEDICAL GROUP INC | ||
| S | $1,498,731 | FMV |