PANA COMMUNITY HOSPITAL ASSOCIATION: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- PANA COMMUNITY HOSPITAL ASSOCIATION (EIN 37-6062326)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-08-21
- IRS object ID
- 202322339349300977
- Schema version
- 2022v5.0
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-21T11:55:12-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 WASHINGTON AVENUE SUITE 1800 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 376062326 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PANA COMMUNITY HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PANA | BusinessNameControlTxt |
| Phone | 2175622131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST NINTH STREET | AddressLine1Txt |
| City | PANA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62557 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KATRINA CASNER | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 2175622131 | PhoneNum |
| Signature | 2023-08-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KATRINA | PersonFirstNm |
| Person Last | CASNER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AMBER ROGNAN-HAMILTON | PreparerPersonNm |
| PTIN | P01251012 | PTIN |
| Phone | 3149254300 | PhoneNum |
| Preparation | 2023-08-17 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KATRINA CASNER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST NINTH STREET | AddressLine1Txt |
| City | PANA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62557 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,836,563 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PANAHOSPITAL.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1966 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO BE A LEADING PARTNER IN ASSURING COMMUNITY-BASED QUALITY HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 339 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $2,834 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,824,896 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,612,977 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $32,060,873 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $33,834,911 | CYProgramServiceRevenueAmt |
| PY Investment Income | $279,932 | PYInvestmentIncomeAmt |
| CY Investment Income | $249,817 | CYInvestmentIncomeAmt |
| PY Other Revenue | $121,961 | PYOtherRevenueAmt |
| CY Other Revenue | $109,818 | CYOtherRevenueAmt |
| PY Total Revenue | $35,287,662 | PYTotalRevenueAmt |
| CY Total Revenue | $35,807,523 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $360 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,476,635 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,048,540 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $76,629 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,426,918 | PYOtherExpensesAmt |
| CY Other Expenses | $15,815,675 | CYOtherExpensesAmt |
| PY Total Expenses | $30,903,553 | PYTotalExpensesAmt |
| CY Total Expenses | $33,864,575 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,384,109 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,942,948 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $52,819,444 | TotalAssetsBOYAmt |
| Total Assets EOY | $51,242,193 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,033,510 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,545,908 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $38,785,934 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $39,696,285 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO BE A LEADING PARTNER IN ASSURING COMMUNITY-BASED QUALITY HEALTH CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $24,517,375 | ExpenseAmt |
| Grant | $360 | GrantAmt |
| Revenue | $33,941,984 | RevenueAmt |
| Desc | TO PROVIDE HEALTH CARE SERVICES TO THE CITIZENS OF PANA, ILLINOIS AND THE SURROUNDING AREA. THESE SERVICES INCLUDE NURSING, EMERGENCY AND ANCILLARY SERVICES FOR 718 INPATIENT DAYS, 22,911 OUTPATIENT ADMISSIONS, 5,531 EMERGENCY VISITS AND 536 OUTPATIENT SURGICAL PATIENTS.WE PROMOTE A VISION STRIVING TO DEVELOP A COMPREHENSIVE SYSTEM OF HEALTHCARE SERVICES, IN PARTNERSHIP WITH THE OTHER COMMUNITY HEALTHCARE PROVIDERS, TO ASSIST OUR SERVICE AREA RESIDENTS IN REACHING THEIR PERSONAL MAXIMUM FOR HEALTH; TO PROVIDE PROGRAMS THAT PROMOTE HEALTH EDUCATION AND WELLNESS; TO ENHANCE OUR PERSONALIZED CARE CONCEPT IN THE PROVISION OF SERVICES TO OUR COMMUNITY; TO MAINTAIN AN ENVIRONMENT WHICH PROMOTES SATISFACTION AND OPPORTUNITY FOR THE PATIENT, THEIR FAMILY, THE EMPLOYEE, AND THE PHYSICIAN; TO MAINTAIN THE HOSPITAL'S ABILITY TO SUPPORT THE DELIVERY OF QUALITY HEALTH CARE AT A REASONABLE COST, IN ACCORDANCE WITH COMMUNITY NEEDS AND THE HEALTH CARE REGULATORY ENVIRONMENT; AND TO DEMONSTRATE BY ACTIONS AND RESULTS OUR COMMITMENT TO CONTINUOUS QUALITY IMPROVEMENT. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | -$107,073 | RevenueAmt |
| Desc | THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THE HOSPITAL PROVIDES 100% CHARITY CARE TO PATIENTS WHOSE INCOME LEVEL IS BELOW 200% OF THE FEDERAL POVERTY LEVEL. FOR PATIENTS WHOSE INCOME LEVEL IS BETWEEN 200% AND 300% OF THE FEDERAL POVERTY LEVEL, THE HOSPITAL PROVIDES 50% CHARITY CARE. THE HOSPITAL USES COST AS THE MEASUREMENT BASIS FOR CHARITY CARE DISCLOSURE PURPOSES WITH THE COST BEING IDENTIFIED AS THE DIRECT AND INDIRECT COSTS OF PROVIDING THE CHARITY CARE. CHARITY CARE INCLUDES THE AMOUNT OF COSTS FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. CHARITY CARE COST WAS DETERMINED ON THE APPLICATION OF THE ASSOCIATED COST-TO-CHARGE RATIOS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $24,517,375 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 339 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES MOON CFO | PersonNm |
| Phone | 2175622131 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST NINTH STREET | AddressLine1Txt |
| City | PANA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62557 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RICK SCHMITZ | ||||||||
| CHAIRMAN (TERM ENDED 4/22) | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SARAH MYER | ||||||||
| CHAIRMAN | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CHARLES O'MALLEY | ||||||||
| TREASURER | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR DAVID LETT | ||||||||
| DIRECTOR (TERM ENDED 4/22) | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVE DORN JR | ||||||||
| VICE CHAIRMAN | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAVE SLATER | ||||||||
| DIRECTOR | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JIM BREWER | ||||||||
| SECRETARY | 1.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GREGORY HOLTHAUS | ||||||||
| DIRECTOR | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DR TERRY CUNNINGTON | ||||||||
| DIRECTOR, PHYSICIAN | 40.00 | 0.00 | Yes (X) | $340,162 | $0 | $40,456 | ||
| KENNETH FLESCH | ||||||||
| DIRECTOR | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| REV LEON GOFF | ||||||||
| DIRECTOR | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANK MCCHRISTY | ||||||||
| DIRECTOR | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON BAUER | ||||||||
| DIRECTOR | 1.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| KATRINA CASNER | ||||||||
| PRESIDENT & CEO | 40.00 | 1.50 | Yes (X) | $224,729 | $0 | $17,031 | ||
| JAMES MOON | ||||||||
| CFO | 40.00 | 1.50 | Yes (X) | $142,124 | $0 | $18,847 | ||
| VICKIE COEN | ||||||||
| CCO & CNE | 40.00 | 0.00 | Yes (X) | $156,664 | $0 | $13,183 | ||
| DIANNE BAILEY | ||||||||
| CIO | 40.00 | 0.00 | Yes (X) | $105,542 | $0 | $19,590 | ||
| ROBERT LUDWIG | ||||||||
| CRNA | 40.00 | 0.00 | $247,361 | $0 | $16,320 | Yes (X) | ||
| DR MARLON MUNESES | ||||||||
| PHYSICIAN | 40.00 | 1.50 | $290,432 | $0 | $42,235 | Yes (X) | ||
| DR CATHERINE TEODORO | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $190,996 | $0 | $15,097 | Yes (X) | ||
| DR DEMOSTHENES ASUNCION | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $239,957 | $0 | $11,508 | Yes (X) | ||
| MARC SCHOLES | ||||||||
| NURSE PRACTICIONER | 40.00 | 0.00 | $227,992 | $0 | $37,848 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,165,959 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $232,115 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 23 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CROSSROADS EMERGENCY PHYSICIANS LLP | |||||
| PO BOX 677979 | DALLAS | TX | 752677979 | EMERGENCY PHYSICIANS | $1,909,387 |
| CERNER CORPORATION | |||||
| 2800 ROCKCREEK PARKWAY | KANSAS CITY | MO | 64117 | SOFTWARE HOUSING | $902,126 |
| ELECTROMEK DIAGNOSTIC SYSTEMS | |||||
| 412 W US HWY 40 | TROY | IL | 62294 | EQUIPMENT MAINTENANCE | $450,418 |
| YAP FAMILY PRACTICE LTD | |||||
| 2979 LINDBERG BLVD | SPRINGFIELD | IL | 62704 | PHYSICIAN SERVICES | $266,301 |
| SPRINGFIELD CLINIC LLP | |||||
| 800 NORTH 1ST STREET | SPRINGFIELD | IL | 62702 | PHYSICIAN SERVICES | $254,144 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $9,661 | RelatedOrganizationsAmt |
| Government Grants | $1,465,330 | GovernmentGrantsAmt |
| All Other Contributions | $137,986 | AllOtherContributionsAmt |
| Total Contributions | $1,612,977 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT CARE SERVICES | 621110 | $33,607,758 | $33,607,758 |
| 340B PHARMACY REVENUE | 621110 | $148,803 | $148,803 |
| OTHER OPERATING REVENUE | 621110 | $78,350 | $78,350 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $33,834,911 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $276,582 | TotalRevenueColumnAmt |
| Exclusion | $276,582 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $63,090 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $63,090 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,090 | TotalRevenueColumnAmt |
| Exclusion | $63,090 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,275 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $29,040 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$26,765 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$26,765 | TotalRevenueColumnAmt |
| Exclusion | -$26,765 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| CAFETERIA & VENDING | 722514 | $49,046 | $49,046 | |
| CATERING | 722320 | $2,834 | $2,834 | |
| LOSS FROM SOUTH CENTRAL HOSPITAL | 621110 | -$5,152 | -$5,152 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $46,728 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,807,523 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,834,911 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $2,834 | UnrelatedBusinessRevenueAmt |
| Exclusion | $356,801 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360 | TotalAmt |
| Program Services | $360 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,078,328 | TotalAmt |
| Program Services | $365,394 | ProgramServicesAmt |
| Management And General | $712,934 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,345,333 | TotalAmt |
| Program Services | $10,940,598 | ProgramServicesAmt |
| Management And General | $2,346,977 | ManagementAndGeneralAmt |
| Fundraising | $57,758 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $350,206 | TotalAmt |
| Program Services | $264,495 | ProgramServicesAmt |
| Management And General | $84,183 | ManagementAndGeneralAmt |
| Fundraising | $1,528 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,686,380 | TotalAmt |
| Program Services | $1,933,943 | ProgramServicesAmt |
| Management And General | $737,441 | ManagementAndGeneralAmt |
| Fundraising | $14,996 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $588,293 | TotalAmt |
| Program Services | $419,148 | ProgramServicesAmt |
| Management And General | $166,798 | ManagementAndGeneralAmt |
| Fundraising | $2,347 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,009 | TotalAmt |
| Management And General | $11,009 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,051 | TotalAmt |
| Management And General | $70,051 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,626 | TotalAmt |
| Management And General | $12,626 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,978,595 | TotalAmt |
| Program Services | $4,468,934 | ProgramServicesAmt |
| Management And General | $509,661 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,033 | TotalAmt |
| Management And General | $63,033 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $564,673 | TotalAmt |
| Program Services | $350,492 | ProgramServicesAmt |
| Management And General | $214,181 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $895,660 | TotalAmt |
| Program Services | $680,066 | ProgramServicesAmt |
| Management And General | $215,594 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $709,231 | TotalAmt |
| Program Services | $29,927 | ProgramServicesAmt |
| Management And General | $679,304 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,116 | TotalAmt |
| Program Services | $134,116 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,114 | TotalAmt |
| Program Services | $22,005 | ProgramServicesAmt |
| Management And General | $25,109 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,428 | TotalAmt |
| Management And General | $258,428 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,252,923 | TotalAmt |
| Management And General | $2,252,923 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,036 | TotalAmt |
| Program Services | $48,990 | ProgramServicesAmt |
| Management And General | $239,046 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,455,686 | $2,455,686 | |
| BAD DEBT EXPENSE | $1,603,302 | $1,603,302 | |
| MCAID PROVIDER ASSESSME | $541,416 | $541,416 | |
| OTHER SUPPLIES | $318,713 | $318,713 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $611,063 | TotalAmt |
| Program Services | $258,503 | ProgramServicesAmt |
| Management And General | $352,560 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,864,575 | TotalAmt |
| Program Services | $24,517,375 | ProgramServicesAmt |
| Management And General | $9,270,571 | ManagementAndGeneralAmt |
| Fundraising | $76,629 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,425 | BOYAmt |
| EOY | $1,625 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,440,153 | BOYAmt |
| EOY | $13,317,152 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,562,041 | BOYAmt |
| EOY | $3,895,427 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,405 | BOYAmt |
| EOY | $174,072 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $605,893 | BOYAmt |
| EOY | $574,573 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $178,195 | BOYAmt |
| EOY | $205,556 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $45,411,026 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $18,317,213 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,665,639 | BOYAmt |
| EOY | $27,093,813 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,673,610 | BOYAmt |
| EOY | $3,824,897 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $302,522 | BOYAmt |
| EOY | $291,171 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,999 | BOYAmt |
| EOY | $224,748 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,238,562 | BOYAmt |
| EOY | $1,639,159 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,819,444 | BOYAmt |
| EOY | $51,242,193 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,667,243 | BOYAmt |
| EOY | $4,005,441 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,995,284 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,539,083 | BOYAmt |
| EOY | $6,335,165 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $831,900 | BOYAmt |
| EOY | $648,780 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $135,827 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $420,695 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,033,510 | BOYAmt |
| EOY | $11,545,908 | 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 | $38,785,934 | BOYAmt |
| EOY | $39,696,285 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,785,934 | BOYAmt |
| EOY | $39,696,285 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,819,444 | BOYAmt |
| EOY | $51,242,193 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,942,948 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,026,398 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$6,199 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $12,626 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $12,626 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | WE PARTICIPATE INDIRECTLY WITH LOBBYING ACTIVITIES THROUGH OUR MEMBERSHIPS IN THE ILLINOIS HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $51,361 | OtherCostOrOtherBasisAmt |
| Book Value | $51,361 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $31,503,247 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,424,703 | DepreciationAmt |
| Book Value | $20,078,544 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,017,777 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,149,469 | DepreciationAmt |
| Book Value | $1,868,308 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,710,762 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,743,041 | DepreciationAmt |
| Book Value | $2,967,721 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,127,879 | OtherCostOrOtherBasisAmt |
| Book Value | $2,127,879 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $27,093,813 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | 457(B) PLAN LIABILITY | Desc |
| Amt | $420,695 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $420,695 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AT DECEMBER 31, 2022 AND 2021, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED. PRESENTLY, THERE ARE NO ONGOING INCOME TAX AUDITS OR UNRESOLVED DISPUTES WITH THE TAX AUTHORITIES THAT THE ORGANIZATION CURRENTLY FILES OR HAS FILED WITH. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $580,276 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $580,276 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01710 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,563,508 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,069,220 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $494,288 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01460 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,143,784 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,069,220 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,074,564 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03170 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $53,489 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,110 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $51,379 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00150 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,613 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $48,613 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,839,989 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,433,381 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,406,608 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07110 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,942,091 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,435,491 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,506,600 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07400 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,085,875 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,504,711 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,581,164 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10570 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,603,302 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $961,981 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,720,290 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,593,600 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $126,690 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | 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 | PANA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST 9TH STREET | AddressLine1Txt |
| City | PANA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62557 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.PANAHOSPITAL.COM | WebsiteAddressTxt |
| State License | 0001776 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PANA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PG.8 FOR URL | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, PG.8 FOR URL | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | 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 | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | 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 (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE NOTE ON THE FOLLOWING PAGES FOR FULL URL OF FAP | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE NOTE ON FOLLOWING PAGES FOR FULL URL OF FAP APPLICATION | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE NOTE ON FOLLOWING PAGES FOR FULL URL OF FAP PLAIN LANGUAGE SUMMARY | 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 |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | 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 (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PANA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 5: PCH CONSULTED THE CHRISTIAN COUNTY HEALTH DEPT. AND CONDUCTED COMMUNITY MEETINGS WHICH A DIVERSE BACKGROUND OF INDIVIDUALS COULD ATTEND. ALL OF THIS WAS DONE UNDER THE DIRECTION OF A CONSULTANT FROM THE ILLINOIS CRITICAL ACCESS HOSPTIAL NETWORK.DATA WAS ALSO GATHERED REPRESENTING THE BROAD INTERESTS OF THE COMMUNITY. THE HOSPITAL TOOK INTO ACCOUNT INPUT FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL, INCLUDING THOSE WITH SPECIAL KNOWLEDGE OF, OR EXPERTISE IN PUBLIC HEALTH (LOCAL, REGIONAL, STATE AND/OR TRIBAL). MEMBERS OF MEDICALLY UNDERSERVED, LOW-INCOME, AND MINORITY POPULATIONS SERVED BY THE HOSPITAL OR INDIVIDUALS OR ORGANIZATIONS REPRESENTING THE INTERESTS OF SUCH POPULATIONS ALSO PROVIDED INPUT. |
| PANA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 11: A) EXPAND ACCESS TO LOCAL MENTAL HEALTH SERVICES INCLUDING COUNSELING, PSYCHIATRY, AND PROFESSIONAL CONSULTATION, ESPECIALLY FOR UNINSURED AND UNDER-INSURED.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS ACCESS TO MENTAL HEALTH SERVICES:1) ATTEMPT TO RECRUIT A LICENSED CLINICAL SOCIAL WORKER, A LICENSED CLINICAL PROFESSIONAL COUNSELOR, OR A PSYCHIATRIC ADVANCED PRACTICE NURSE TO PROVIDE SERVICES AT AN OUTPATIENT LOCATION2) EXPLORE TELEHEALTH ACCESS TO PSYCHIATRIST SUPPORT FOR THE CLINICIAN3) EXPLORE A MODEL FOR PROVIDING EXPANDED MENTAL HEALTH SERVICE TO UNINSURED AND UNDER-INSURED PERSONSB) ADDRESS HOMELESSNESS: THE HOSPITAL RECOGNIZES THE PRESENCE AND IMPACT OF HOMELESS PERSONS WITHIN ITS SERVICE AREA AND OFFERS APPROPRIATE CARE TO THOSE THAT PRESENT FOR SERVICES.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE NEEDS OF HOMELESSNESS:1) CONTINUE TO PARTNER WITH COMMUNITY ORGANIZATIONS, LOCAL GOVERNMENTS AND AGENCIES, AND OTHER INTERESTED GROUPS AND PERSONS TO COLLABORATE TOWARD A COMMUNITY-WIDE STRATEGY TO ADDRESS LOCAL HOMELESSNESSC) IMPROVE ACCESS TO DAY CARE, ESPECIALLY FOR HEALTHCARE WORKFORCE.ACTIONS THE HOSPITAL INTENDS TO TAKE TO IMPROVE ACCESS TO DAY CARE:1) INVESTIGATE AND ANALYZE OPPORTUNITIES TO PROVIDE DAY CARE SERVICES TO EMPLOYEES OF PANA COMMUNITY HOSPITALD) EXPAND LOCAL PREVENTION EFFORTS AND SERVICES FOR SUBSTANCE ABUSE AND SUBSTANCE USE DISORDERS.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS SUBSTANCE ABUSE AND SUBSTANCE USE DISORDERS:1) ATTEMPT TO RECRUIT A LICENSED CLINICAL SOCIAL WORKER, A LICENSED CLINICAL PROFESSIONAL COUNSELOR, OR A PSYCHIATRIC ADVANCED PRACTICE NURSE TO PROVIDE SERVICES AT AN OUTPATIENT LOCATION2) EXPLORE TELEHEALTH ACCESS TO PSYCHIATRIST SUPPORT FOR THE CLINICIAN3) SUPPORT COLLABORATIVE EFFORTS TO ADDRESS COMMUNITY NEEDS RELATED TO SUBSTANCE ABUSE AND SUBSTANCE USE DISORDERSE) EXPAND LOCAL AVAILABILITY OF IN-HOME CARE.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS AVAILABILITY OF IN-HOME CARE:1) EXPLORE OPPORTUNITIES TO PROVIDE IN-HOME NURSING SERVICES |
| PANA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 13B: THE COST OF THE SERVICE MAY IMPACT AN INDIVIDUAL'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. PRESUMPTIVE ELIGIBILITY FOR FREE CARE IS AVAILABLE FOR INDIVIDUALS WHO ARE HOMELESS, MENTALLY INCAPACITATED WITH NOBODY TO ACT ON THEIR BEHALF, MEDICAID ELIGIBLE (BUT NOT ON THE DATE OF SERVICE), FILING PERSONAL BANKRUPCTY, DECEASED WITH NO ESTATE, INCARCERATED IN A PENAL INSTITUTION, OR AFFILIATED WITH A RELIGIOUS ORDER AND TAKING A VOW OF POVERTY.BASED ON THE GUIDANCE FROM THE ILLINOIS ATTORNEY GENERAL'S OFFICE, PANA DETERMINES THE DISCOUNT PERCENT REQUIRED TO GIVE UNINSURED PATIENTS AT 300% OF FPG. THE SAME DISCOUNT IS GIVEN TO UNDERINSURED. |
| PANA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 7A:URL FOR CHNA:HTTPS://PANAHOSPITAL.COM/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT- |
| PANA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 10A:URL FOR IMPLEMENTATION STRATEGY:HTTP://WWW.PANAHOSPITAL.COM/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT- |
| PANA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 16A:URL FOR FAP:HTTPS://PANAHOSPITAL.COM/PATIENTS-AND-VISITORS/PATIENTS-AND-VISITORS/PROFILE/FINANCIAL-ASSISTANCE |
| PANA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 16B:URL FOR FAP APPLICATION:HTTPS://PANAHOSPITAL.COM/PATIENTS-AND-VISITORS/PATIENTS-AND-VISITORS/PROFILE/FINANCIAL-ASSISTANCE |
| PANA COMMUNITY HOSPITAL | PART V, SECTION B, LINE 16C:URL FOR FAP PLAIN LANGUAGE SUMMARY:HTTPS://PANAHOSPITAL.COM/PATIENTS-AND-VISITORS/PATIENTS-AND-VISITORS/PROFILE/FINANCIAL-ASSISTANCE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 8 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - COMMUNITY MEDICAL CLINIC OF PANA | ||||
| 101 EAST 9TH STREET | PANA | IL | 62557 | PHYSICIAN SATELLITE OFFICE |
| 2 - QUAD COUNTY HOME HEALTH & HOSPICE | ||||
| 8 HUBER STREET | PANA | IL | 62557 | HOME HEALTH & HOSPICE AGENCY |
| 3 - COMMUNITY MEDICAL CLINIC OF ASSUMPTION | ||||
| 118 N WALNUT STREET | ASSUMPTION | IL | 62510 | PHYSICIAN SATELLITE OFFICE |
| 4 - COMMUNITY MEDICAL CLINIC OF RAMSEY | ||||
| 715 S SUPERIOR | RAMSEY | IL | 62080 | PHYSICIAN SATELLITE OFFICE |
| 5 - COMMUNITY MEDICAL CLINIC OF NOKOMIS | ||||
| 120 CEDAR STREET | NOKOMIS | IL | 62075 | PHYSICIAN SATELLITE OFFICE |
| 6 - PANA MEDICAL GROUP | ||||
| 217 SOUTH LOCUST STREET | PANA | IL | 62557 | PHYSICIAN SATELLITE OFFICE |
| 7 - NOKOMIS MEDICAL GROUP | ||||
| 107 WEST STATE STREET | NOKOMIS | IL | 62075 | PHYSICIAN SATELLITE OFFICE |
| 8 - COWDEN MEDICAL GROUP | ||||
| 209 E ELM STREET | COWDEN | IL | 62422 | PHYSICIAN SATELLITE OFFICE |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | ELGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON FAMILY INCOME COMPARED TO FEDERAL POVERTY GUIDELINES AS WELL AS SUBMISSION OF A COMPLETE FINANCIAL ASSISTANCE APPLICATION. HOWEVER, IN THE FOLLOWING INSTANCES, AN INDIVIDUAL MAY PRESUMPTIVELY QUALIFY FOR 100% FINANCIAL ASSISTANCE WITHOUT SUBMITTING A FINANCIAL ASSISTANCE APPLICATION AND REGARDLESS OF THEIR INCOME: ENROLLMENT IN CERTAIN FEDERAL OR STATE PROGRAMS (E.G. WIC, SUPPLEMENTAL NUTRITION AND ASSISTANCE PROGRAM, ILLINOIS FREE BREAKFAST/LUNCH PROGRAM, TEMPORARY ASSISTANCE FOR NEEDY FAMILIES, ETC.), HOMELESSNESS, MENTAL INCAPACITATION WITH NO ONE TO ACT ON THE PATIENT'S BEHALF, MEDICAID ELIGIBILITY, RECENT PERSONAL BANKRUPTCY, DECEASED WITH NO ESTATE, INCARCERATION IN A PENAL INSTITUTION, AND AFFILIATION WITH A RELIGIOUS ORDER AND A VOW OF POVERTY. |
| PART I, LINE 7: | FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7 USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS. |
| PART I, LN 7 COL(F): | FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST. THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $1,603,302 REPORTED ON PART IX, LINE 24. HOWEVER, IT HAS BEEN SUBTRACTED FOR PURPOSED OF CALCULATING THE PERCENTAGE IN THIS COLUMN. |
| PART III, LINE 2: | ACCOUNTS RECEIVABLE ARE REDUCTED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND BAD DEBT EXPENSE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 3: | THE BAD DEBT EXPENSE REPORTED ON LINE 2 REPRESENTS THE EXPENSE REPORTED ON THE ATTACHED FINANCIAL STATEMENTS BASED ON NET REALIZABLE AMOUNTS FROM THIRD PARTY PAYERS, PATIENTS AND OTHERS. BAD DEBT EXPENSE IS DETERMINED BASED ON THE CRITERIA DESCRIBED ABOVE. IT IS ESTIMATED THAT APPROXIMATELY 60% OF OUR BAD DEBT EXPENSE QUALIFIES UNDER THE ORGANIZATION'S CHARITY CARE POLICY. THIS PERCENTAGE WAS DETERMINED BASED UPON ANALYSIS OF DEMOGRAPHICS AND RECORD REVIEWS. |
| PART III, LINE 4: | SEE NOTE 9: NET PATIENT SERVICE REVENUE ON PAGES 23-17 OF THE AUDITED FINANCIAL STATEMENTS. ALSO, SEE NOTE 1: PATIENT ACCOUNTS RECEIVABLE ON PAGE 10 OF THE AUDITED FINANCIAL STATEMENTS. |
| PART III, LINE 8: | MEDICARE. LINE 6 COSTS WERE TAKEN DIRECTLY FROM THE ORGANIZATION'S 12/31/22 MEDICARE COST REPORT.THE ORGANIZATION PARTICIPATES IN MEDICARE AND INCURS COSTS TO PROVIDE HEALTHCARE SERVICES TO MEDICARE BENEFICIARIES, WHO ARE A SIGNIFICANT PORTION OF OUR COMMUNITY. AS A DESIGNATED CRITICAL ACCESS HOSPITAL, THESE COSTS ARE REIMBURSED AT 101%, RESULTING IN THE SURPLUS REPORTED IN PART III, LINE 7. |
| PART III, LINE 9B: | THE COLLECTION PRACTICES FOLLOWED BY THE ORGANIZATION FOR PATIENTS WHO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE ARE ADDRESSED IN ITS HEALTHCARE ASSISTANCE POLICY. |
| PART VI, LINE 2: | NEEDS ASSESSMENT. THE ORGANIZATION ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH STRATEGIC PLANNING ACTIVITIES THAT INCORPORATE ANALYSIS OF SERVICE AREA DEMOGRAPHICS AND STRUCTURED AND CONSISTENT PATIENT SURVEY PROCESSES. THE ORGANIZATION ALSO ASSESSES COMMUNITY HEALTH NEEDS THROUGH INPUT FROM ITS ACTIVE AND CONSULTING MEDICAL STAFF, COMMUNITY LEADERS, ORGANIZATION BOARD MEMBERS AND COUNTY HEALTH DEPARTMENTS. |
| PART VI, LINE 3: | PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE. THE ORGANIZATION INFORMS AND EDUCATES ITS PATIENTS REGARDING ASSISTANCE FROM FEDERAL, STATE, OR LOCAL GOVERNMENT PROGRAMS THROUGH ITS SOCIAL SERVICES DIRECTOR. THE ORGANIZATION INFORMS AND EDUCATES PATIENTS REGARDING ASSISTANCE FROM ITS CHARITY CARE POLICY THROUGH DISCUSSION AT REGISTRATION OR DISCHARGE, AN INFORMATIONAL DOCUMENT SENT WITH BILLING STATEMENTS AND A DESCRIPTION OF THE PROGRAM PLUS AN APPLICATION POSTED ON ITS WEBSITE. |
| PART VI, LINE 4: | COMMUNITY INFORMATION. THE ORGANIZATION SERVES A RURAL AREA THAT INCLUDES 13 SMALL COMMUNITIES. THE POPULATION OF THE SERVICE AREA TOTALS APPROXIMATELY 21,000 RESIDENTS. APPROXIMATELY 17% ARE BELOW THE FEDERAL POVERTY LEVEL AND THE PER CAPITA INCOME IS APPROXIMATELY $20,100. OUR SERVICE AREA POPULATION CONSISTS OF 17.01% MEDICAID AND APPROXIMATELY 2.44% UNINSURED. OUR ORGANIZATION PROVIDES SERVICES TO FEDERALLY-DESIGNATED MEDICALLY UNDESERVED AREAS. |
| PART VI, LINE 5: | PROMOTION OF COMMUNITY HEALTH IS ONE OF THE VERY IMPORTANT RESPONSIBILITIES OF A COMMUNITY HOSPITAL. THE HOSPITAL, AS AN ORGANIZATION, FILLS THE ROLE AS THE FOCAL POINT OF THE COMMUNITY'S HEALTHCARE ACTIVITIES AND THE CATALYST WHICH BRINGS TOGETHER THE PRACTICING PHYSICIANS, OTHER HEALTHCARE PROVIDERS, COMMUNITY HEALTHCARE AGENCIES, AND OTHER HEALTHCARE FOCUSED RESOURCES TO MAINTAIN AND PRESERVE THE COMMUNITY'S HEALTH STATUS. THE ORGANIZATION IS GOVERNED BY A VOLUNTEER BOARD OF DIRECTORS THAT CONSIST OF INDIVIDUALS WHO RESIDE IN THE HOSPITAL'S SERVICE AREA. MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL PHYSICIANS IN OUR SERVICE AREA. SURPLUS FUNDS GENERATED THROUGH THE PROVISION OF SERVICES ARE INVESTED IN IMPROVED PATIENT CARE TECHNOLOGIES AND ENHANCED TREATMENT AREAS SO THAT THE ORGANIZATION CAN CONTINUE TO PROVIDE QUALITY PATIENT CARE. |
| PART VI, LINE 6: | NOT APPLICABLE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR TERRY CUNNINGTON | ||||||||||||||
| DIRECTOR, PHYSICIAN | $206,725 | $0 | $133,437 | $0 | $0 | $0 | $8,631 | $0 | $31,825 | $0 | $380,618 | $0 | $0 | $0 |
| DR MARLON MUNESES | ||||||||||||||
| PHYSICIAN | $290,432 | $0 | $0 | $0 | $0 | $0 | $10,410 | $0 | $31,825 | $0 | $332,667 | $0 | $0 | $0 |
| MARC SCHOLES | ||||||||||||||
| NURSE PRACTICIONER | $99,026 | $0 | $128,966 | $0 | $0 | $0 | $6,023 | $0 | $31,825 | $0 | $265,840 | $0 | $0 | $0 |
| ROBERT LUDWIG | ||||||||||||||
| CRNA | $247,361 | $0 | $0 | $0 | $0 | $0 | $9,338 | $0 | $6,982 | $0 | $263,681 | $0 | $0 | $0 |
| DR DEMOSTHENES ASUNCION | ||||||||||||||
| PHYSICIAN | $239,957 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $11,508 | $0 | $251,465 | $0 | $0 | $0 |
| KATRINA CASNER | ||||||||||||||
| PRESIDENT & CEO | $202,734 | $0 | $21,995 | $0 | $0 | $0 | $10,049 | $0 | $6,982 | $0 | $241,760 | $0 | $0 | $0 |
| DR CATHERINE TEODORO | ||||||||||||||
| PHYSICIAN | $186,688 | $0 | $4,308 | $0 | $0 | $0 | $8,115 | $0 | $6,982 | $0 | $206,093 | $0 | $0 | $0 |
| VICKIE COEN | ||||||||||||||
| CCO & CNE | $145,870 | $0 | $10,794 | $0 | $0 | $0 | $2,912 | $0 | $10,271 | $0 | $169,847 | $0 | $0 | $0 |
| JAMES MOON | ||||||||||||||
| CFO | $142,124 | $0 | $0 | $0 | $0 | $0 | $5,981 | $0 | $12,866 | $0 | $160,971 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | MARLON MUNESES, TERRY CUNNINGTON AND CATHERINE TEODORO ARE COMPENSATED USING A BASE SALARY PLUS PRODUCTIVITY COMPENSATION. THE PRODUCTIVITY COMPENSATION IS CALCULATED BASED UPON MINIMUM LEVELS OF RECEIPTS GENERATED BY EACH PHYSICIAN. BONUSES ARE BASED ON COLLECTIONS. A CERTAIN PORTION OF COLLECTIONS ARE SHARED WITH THE PHYSICIANS AFTER REACHING A MINIMUM THRESHOLD. AFTER REACHING THE THRESHOLD, AN INCREASING % IS SHARED AS COLLECTIONS INCREASE. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE COUNTY OF CHRISTIAN ILLINOIS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 376000560 | BondIssuerEIN |
| Bond Issued | 2018-02-22 | BondIssuedDt |
| Issue Price | $7,000,000 | IssuePriceAmt |
| Purpose | EXPANSION AND RENOVATION PROJECT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $572,469 | RetiredAmt |
| Total Proceeds | $7,000,000 | TotalProceedsAmt |
| Capital Expenditures | $7,000,000 | CapitalExpendituresAmt |
| Substantial Completion | 2019 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | Yes (1) | MgmtContractBondFincdPropInd |
| Engage Bond Counsel Contracts | Yes (1) | EngageBondCounselContractsInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| DR LAURIE CUNNINGTON | |||
| WIFE OF DR. TERRY CUNNINGTON, A BOARD MEMBER | $26,600 | EMPLOYED BY HOSPITAL | 0 |
| ANDREW CASNER | |||
| SON OF KATRINA CASNER, PRESIDENT & CEO | $47,357 | EMPLOYED BY HOSPITAL | 0 |
| TIMOTHY CASNER | |||
| HUSBAND OF KATRINA CASNER, PRESIDENT & CEO | $38,028 | EMPLOYED BY HOSPITAL | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE OFFICERS AND ONE OTHER MEMBER OF THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE HAS THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN THE REGULAR MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED ANY ACTION TAKEN SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESS WISHES OF THE BOARD OF DIRECTORS AND THAT IT SHALL REFER ALL MATTERS OF MAJOR IMPORTANCE TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 6 | PANA COMMUNITY HOSPITAL HAS TWO CLASSES OF MEMBERS, KNOWN AS REGULAR MEMBERS AND LIFE MEMBERS. REGULAR MEMBERS CONSIST OF INDIVIDUALS WHO PAY THE APPROPRIATE MEMBERSHIP DUES TO PANA COMMUNITY HOSPITAL. LIFE MEMBERS CONSIST OF INDIVIDUALS WHO CONTRIBUTE $5000.00 OR MORE TO PANA COMMUNITY HOSPITAL OR PANA COMMUNITY HOSPITAL FOUNDATION, FOR THE PURPOSE OF SUPPORTING THE FINANCING OF BUILDING, EQUIPMENT, LIFE MEMBERSHIP, ENDOWMENT, OR ANY OTHER LAWFUL PURPOSE. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS OF THE HOSPITAL VOTE FOR THE MEMBERS OF THE GOVERNING BODY DURING THE HOSPITAL'S ANNUAL MEETING. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION CONTRACTS WITH A PUBLIC ACCOUNTING FIRM FOR THE PREPARATION OF THE FORM 990. THE RETURN IS PREPARED BASED ON INFORMATION PROVIDED BY FINANCIAL MANAGEMENT AND OTHERS WITHIN THE FOUNDATION. THE FORM 990 IS REVIEWED BY THE CFO PRIOR TO FILING WITH THE IRS. CFO PRESENTS A COPY OF FORM 990 TO THE GOVERNING BOARD FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS, MEMBERS OF THE MEDICAL STAFF, ADMINISTRATION AND DEPARTMENT MANAGERS ARE ASKED TO COMPLETE A CONFLICT OF INTEREST QUESTIONNIARE ANNUALLY. THE HUMAN RESOURCES MANAGER REVIEWS QUESTIONNAIRES AND PRESENTS ANY CONFLICTS NOTED TO THE PRESIDENT & CEO TO REVIEW AND RESOLVE. IF ANY CONFLICTS ARE NOTED, THE PRESIDENT & CEO, WITH BOARD APPROVAL, IMPOSES APPROPRIATE RESTRICTIONS ON THE INDIVIDUAL(S) WITH A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | EACH YEAR THE BOARD OF DIRECTORS DETERMINES COMPENSATION FOR THE CEO, CCO/CNE AND THE CFO. THE BOARD USES COMPARATIVE COMPENSATION INFORMATION FROM THE ILLINOIS HOSPITAL ASSOCIATION TO DETERMINE THE ABOVE INDIVIDUALS' COMPENSATION. THIS PROCESS LAST TOOK PLACE IN 2022. |
| FORM 990, PART VI, SECTION C, LINE 19 | REQUESTS FOR THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY WILL BE EVALUATED ON A CASE-BY-CASE BASIS. IF DEEMED APPROPRIATE, THE DOCUMENT(S) WILL BE PROVIDED TO THE PUBLIC. THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS ARE AVAILABLE FOR THE PUBLIC TO REVIEW DURING THE ORGANIZATION'S ANNUAL MEETING. |
| FORM 990, PART IX, LINE 11G | IMAGING: PROGRAM SERVICE EXPENSES 550,575. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 550,575. EMERGENCY DEPARTMENT: PROGRAM SERVICE EXPENSES 1,914,216. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,914,216. LAB: PROGRAM SERVICE EXPENSES 221,689. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 221,689. OTHER: PROGRAM SERVICE EXPENSES 1,676,111. MANAGEMENT AND GENERAL EXPENSES 327,487. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,003,598. CONTRACT LABOR: PROGRAM SERVICE EXPENSES 106,343. MANAGEMENT AND GENERAL EXPENSES 182,174. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 288,517. |
| FORM 990, PART XI, LINE 9: | CHANGE IN VALUE OF AFFILIATE - QUAD COUNTY -6,199. |
| FORM 990, PART XII, LINE 2C | NO CHANGE IN PROCESS FROM PRIOR YEARS |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PANA COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 EAST 9TH STREET | AddressLine1Txt |
| City | PANA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62557 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371293506 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PANA COMMUNITY HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH CENTRAL HOSPITAL ALLIANCE LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 N OLD STATE CAPITOL PLAZA STE 200 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 844250687 | EIN |
| Primary Activities | HOSPITAL ALLIANCE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$4,044 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $94,315 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | Yes (1) | GeneralOrManagingPartnerInd |
| Ownership | 0.25000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUAD COUNTY HOME MEDICAL SUPPLIES & EQUIPMENT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8 HUBER STREET | AddressLine1Txt |
| City | PANA | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62557 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371198049 | EIN |
| Primary Activities | EQUIPMENT RETAILER | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PANA COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $78,718 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $289,068 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUAD COUNTY HOME MEDICAL SUPPLIES & EQUIPMENT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | D | TransactionTypeTxt |
| Involved | $110,269 | InvolvedAmt |
| Method Of Amount Determination | GENERAL LEDGER | MethodOfAmountDeterminationTxt |