2023-08-03T15:28:02-04:00 2022-09-30 363077757 GRAY HUNTER STENN LLP 500 MAINE ST QUINCY IL 62301 990 2021-10-01 371128706 BLESSING CORPORATE SERVICES INC PATRICK GERVELER BLES 2172231200 BROADWAY AT 11TH PO BOX 7005 QUINCY IL 623057005 PATRICK M GERVELER TREASURER & CFO 2172231200 2023-08-10 true PATRICK GERVELER 999009999 ERIN J WHARTON CPA P01294277 2172220304 2023-08-03 2021 2023-04-26 12:10:37Z BRIAN T CANFIELD 1005 BROADWAY QUINCY IL 62301 134447585 false X WWW.BLESSINGHEALTHSYSTEM.ORG X 1983 IL THE PURPOSE OF BLESSING CORPORATE SERVICES, INC. IS TO DEVELOP EXPANDED HEALTH CARE SERVICES TO ITS REGIONAL MARKETPLACE. BLESSING CORPORATE SERVICES, INC. IS THE PARENT COMPANY TO ALL ORGANIZATIONS WITHIN THE BLESSING HEALTH SYSTEM. 10 9 840 15 -60893 68187338 57519353 80232412 76237393 -32874 13474 1205100 677365 149591976 134447585 140228 140228 0 92645289 78455233 0 0 44917305 43104982 137702822 121700443 11889154 12747142 79435059 58294053 40458632 27256598 38976427 31037455 X BLESSING CORPORATE SERVICES, INC. (BCS) IS THE PARENT COMPANY TO THE FOLLOWING ORGANIZATIONS: BLESSING HOSPITAL - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN QUINCY, IL. THE BLESSING FOUNDATION, INC. - RAISES, MANAGES, AND DISTRIBUTES CHARITABLE DONATIONS ON BEHALF OF THE BLESSING HEALTH SYSTEM. DENMAN SERVICES, INC. - A TAXABLE CORPORATION THAT IS ENGAGED PRIMARILY IN THE BUSINESS OF SELLING AND RENTING MEDICAL EQUIPMENT AND OPERATING A COMMERCIAL LAUNDRY. THE ENTITY IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. BLESSINGCARE CORPORATION - OWNS AND OPERATES ILLINI COMMUNITY HOSPITAL, A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN PITTSFIELD, IL. BLESSING AFFILIATES, INC. - CURRENTLY INACTIVE. BLESSINGCARE CORPORATION - MISSOURI - CURRENTLY INACTIVE. CHS HOLDING COMPANY - A TAXABLE CORPORATION THAT PROVIDES HEALTH INSURANCE PRODUCTS AND SERVICES. BLESSING PHYSICIAN SERVICES (BPS) - A DIVISION OF BCS THAT OPERATES A PHYSICIAN CLINIC PROVIDING MULTI-SPECIALTY OUTP false false 76482146 140228 47247760 PHYSICIAN SERVICES - THE ORGANIZATION OPERATES A HEALTH CARE PROVIDER PRACTICE DBA BLESSING PHYSICIAN SERVICES (BPS). THIS PROVIDER GROUP SERVES RESIDENTS OF QUINCY AS WELL AS THE SURROUNDING REGIONS IN WHICH MULTIPLE RURAL CLINICS OPERATE. DURING THE YEAR BPS PROVIDED 238,559 PATIENT VISITS AND 134,513 DIAGNOSTIC TESTS. WITHIN THESE PROVIDER PRACTICES, IT IS THE POLICY OF THE ORGANIZATION THAT NO ONE IS TO BE DENIED HEALTH CARE FOR INABILITY TO PAY. THE BLESSING HEALTH SYSTEM'S STRATEGIC OBJECTIVES FOR THE UPCOMING YEARS-PLEASE SEE BELOW: A) BE THE PLACE WHERE PEOPLE CHOOSE TO WORK B) LIVE OUT OUR CHARITABLE PURPOSE C) BUILD LOYAL RELATIONSHIPS D) BE FINANCIALLY SECURE AND INDEPENDENT E) SERVE MORE CONSUMERS AS A CONNECTED HEALTH SYSTEM OF CARE F) ACHIEVE TOP DECILE PERFORMANCE 21295414 25121619 MANAGEMENT SERVICES - THE ORGANIZATION PROVIDES MANAGEMENT SERVICES TO ITS FOLLOWING TAX EXEMPT SUBSIDIARIES: BLESSING HOSPITAL, THE BLESSING FOUNDATION, INC., BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL, CROSSRIVER QUALITY HEALTH PARTNERS, KEOKUK AREA HOSPITAL AND BLESSING WALK-IN CLINIC, LLC. IT ALSO PROVIDES MANAGEMENT SERVICES TO ITS TAXABLE SUBSIDIARIES: DENMAN SERVICES,INC., CHS HOLDING COMPANY, THE HANNIBAL CLINIC, INC., BLESSING ASSURANCE COMPANY, AND THE BROWN DRUG COMPANY. MANAGEMENT SERVICES PROVIDED INCLUDE STRATEGIC AND BUSINESS DEVELOPMENT, ENGINEERING AND FACILITY DEVELOPMENT, CAPITAL AND INFORMATION TECHNOLOGY DEVELOPMENT, PHYSICIAN PRACTICE OPERATIONS, AND CORPORATE COMPLIANCE. IN ADDITION, BLESSING CORPORATE SERVICES OVERSEES BLESSING AFFILIATES, INC. AND BLESSINGCARE CORPORATION-MISSOURI, BOTH OF WHICH ARE CURRENTLY INACTIVE. 1235929 51000 CROSSRIVER QUALITY HEALTH PARTNERS IS A CLINICALLY INTEGRATED NETWORK OF REGIONAL PHYSICIANS DEDICATED TO ENHANCING CARE QUALITY. 1559379 3817014 RIVERCROSS DIAGNOSTICS, LLC. IS A QUALIFED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. RIVERCROSS DIAGNOSTICS, LLC. PROVIDES DIAGNOSTIC SERVICES TO MEMBERS OF THE BLESSING HEALTHSYSTEM. 1559379 3817014 100572868 true true false true false false false false false false true true false true true false false true false false true false false false false false false true false true false false false true false false false false true false false false true true true true false false true 69 0 true 840 true true true true CJ false false false false false false false false true false X 10 9 false false false false true true false true true false false true true true true true true true true true true IL X PATRICK GERVELER 2172231200 BROADWAY AT 11TH QUINCY IL 623057005 MAUREEN KAHN PRESIDENT & 40.00 0.00 X X 1783418 0 231327 DARR W LEUTZ PHYSICIAN 40.00 X 1307396 0 57680 NEILL M WRIGHT PHYSICIAN 40.00 X 1148275 0 42503 JOHN P OLSON MD PHYSICIAN 40.00 X 1097182 0 36555 JEFFREY R COOK MD PHYSICIAN 40.00 X 1050831 0 38903 STEVEN W KRAUSE DO PHYSICIAN 40.00 X 1032992 0 43685 PATRICK M GERVELER TREASURER & 40.00 X 676198 0 133260 RONALD S KOELLIKER VP BPS 40.00 X 482452 0 87690 IRSHAD SIDDIQUI MD EVP CHIEF IT 40.00 X 516832 0 42503 TIMOTHY A MOORE CAO 40.00 X 394322 0 38083 LEA ANN EICKELSCHULTE CTO 40.00 X 356120 0 26597 DIANE G JACOBY CHIEF LEGAL 40.00 X 346733 0 19916 KATHLEEN E HULL PRESIDENT/CE 40.00 X 313144 0 42503 JOELLEN L RANDALL VP HUMAN RES 40.00 X 306845 0 30009 JULIE A DUKE CHIEF REV. C 40.00 X 201948 0 31251 SANDRA E MCELHOE SECRETARY 40.00 X 80358 0 27450 BRIAN T CANFIELD BH PRESIDENT 40.00 0.00 X 19423 0 0 JERRY D KENNETT MD MACC TRUSTEE 1.00 X 17500 0 0 SAYEED ALI TRUSTEE 1.00 X 0 0 0 JULIE ANN BRINK TRUSTEE 1.00 X 0 0 0 GARY E GILLESPIE TRUSTEE 1.00 X 0 0 0 ROBERT J HOFMEISTER TRUSTEE 1.00 X 0 0 0 LYNN PROTHRO HOUSE TRUSTEE 1.00 X 0 0 0 TIMOTHY D KOONTZ CHAIRMAN 1.00 X X 0 0 0 WILLIAM BILL METZINGER TRUSTEE 1.00 X 0 0 0 CHRISTOPHER J NIEMANN VICE-CHAIR 1.00 X 0 0 0 JACK R SHARKEY TRUSTEE 1.00 X 0 0 0 MARY OAKLEY WINTERS TRUSTEE 1.00 X 0 0 0 11131969 929915 16 false true false VIZIENT INC PO BOX 842175 DALLAS TX 75284 CONSULTING SVCS 952585 SPECIALISTS IN MEDICAL IMAGING SC C/O RADIOLOG PARTNERS INC 2330 UTAH AVE STE 200 EL SEGUNDO CA 90245 RADIOLOGY SVCS. 883468 GUIDEHOUSE 4511 PAYSPHERE CIRCLE CHICAGO IL 60674 CONSULTING SVCS 513781 PHYSICIAN MANAGEMENT SERVICES LLC 9828 ALLENDALE DR ST LOUIS MO 63123 PHYSICIAN SVCS. 494291 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 STAFFING SVCS. 425776 25 56137102 1350564 31687 5741495 57519353 PHYSICIAN PRACTICE REVENUE 621110 45486717 45486717 CORPORATE FEES 541610 25085921 25085921 DIAGNOSTIC SERVICE REVENUE 621110 3817014 3817014 ADMIN. FEES - CLINICS 541610 1761043 1761043 UNRELATED BUS. MGMT. FEES 541610 86698 86698 76237393 13474 13474 OTHER INCOME 621300 819447 819447 INCOME (LOSS) IN SUBSIDIARIES 900099 4898 4898 MISCELLANEOUS INCOME 900099 611 611 -147591 -147591 677365 134447585 76975651 -60893 13474 140228 140228 6393266 5805725 587541 55673581 50539503 5134078 4358257 3685302 672955 12030129 10220192 1809937 8969473 4425221 4544252 1826535 1463004 363531 119219 95526 23693 116346 96411 19935 93687 23015 70672 5331257 5106845 224412 112206 98912 13294 25887 18323 7564 479222 454893 24329 529276 496246 33030 2252040 1036866 1215174 SUPPLIES 6939353 6651545 287808 OTHER OPERATING EXPENSES 6093540 1184688 4908852 OUTSIDE MEDICAL SERVICES 3673933 3579973 93960 BAD DEBT EXPENSE 1833356 1833959 -603 4709652 3616491 1093161 121700443 100572868 21127575 0 1394028 1569451 7917545 6510917 9202 3535 3395335 2371036 69752 422198 354598 200787 5136794 1496629 4098185 3640165 45613124 38266301 16583290 5309663 79435059 58294053 6419902 2362854 11495 9556 20200000 19732000 13827235 5152188 40458632 27256598 X 38976427 31005768 31687 38976427 31037455 79435059 58294053 X 12747142 -20686114 X false true X true false X 31532271 47469484 60845640 68187338 57519353 265554086 65418595 63343590 67469539 81690374 76975651 354897749 96950866 110813074 128315179 149877712 134495004 620451835 26780802 16631807 16123191 18699915 20702692 98938407 26780802 16631807 16123191 18699915 20702692 98938407 521513428 2842 48150 38657 22083 13474 125206 55690 18301 73991 58532 66451 38657 22083 13474 199197 97009398 110879525 128353836 149899795 134508478 620651032 0.84030 0.82910 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 162000 162000 false SCHEDULE C, PART II-B, LINE 1 BLESSING CORPORATE SERVICES HAS RETAINED PICKERING & ASSOC., LLC & SCHOLZ AND SCHOLZ LLP. THE WORK ON BEHALF OF THE BLESSING HEALTH SYSTEM WILL INCLUDE PROVIDING STRATEGIC COUNSEL, TACTICAL PLANNING AND DIRECT LOBBYING WITH REGARD TO GOVERNMENT AFFAIRS WITH THE STATE OF ILLINOIS EXECUTIVE AND LEGISLATIVE BRANCHES. ISSUES MAY INCLUDE CAPITAL FUNDING, MEDICAID, PROFESSIONAL REGULATION, AND PUBLIC HEALTH. 1318626 364402 954224 3257582 617531 2640051 560586 514696 45890 3640165 38266301 C 38266301 ASSETS LIMITED TO PAY RETIREMENT BEN 4020141 ACCOUNTS RECEIVABLE -RELATED PARTIES 692449 CIP 309295 NOTES RECEIVABLE - RELATED PARTIES 238407 OTHER CURRENT ASSETS 49371 5309663 DEFERRED COMPENSATION 4747641 CURRENT NOTES PAYABLE 468000 ESTIMATED PRO. LIABILITY CLAIMS 51433 DUE TO RELATED ORGANIZATIONS 877 DEFERRED FINANCE COSTS OF BOND ISSUE -115763 5152188 111928115 111928115 22519470 22519470 134447585 119867087 119867087 1833356 1833356 121700443 SCHEDULE D, PAGE 4, PART XI, LINE 4B EQUITY EARNINGS IN SUBSIDIARIES 20,686,114 PROVISION FOR BAD DEBTS 1,833,356 SCHEDULE D, PAGE 4, PART XII, LINE 4B PROVISION FOR BAD DEBTS 1,833,356 false CENTRAL AMERICA AND THE CARIBBEAN INVESTMENT 250000 CENTRAL AMERICA AND THE CARIBBEAN TRAVEL EXPENSES INVESTMENT MGMT. 13571 263571 263571 true false true false false false SCHEDULE F, PAGE 1, PART I, LINE 3 CENTRAL AMERICA AND THE CARIBBEAN 0 250,000 CENTRAL AMERICA AND THE CARIBBEAN 13,571 0 SCHEDULE F, PAGE 5, PART V EXPENDITURES ARE REPORTED ON AN ACCRUAL BASIS. true QUINCY FAMILY PRACTICE 612 NORTH 11TH STREET QUINCY IL 62301 376005961 501C3 140228 N/A N/A ACADEMIC GRANT 1 SCHEDULE I, PAGE 1, PART I, LINE 2 SIU HEALTHCARE - QUINCY FAMILY PRACTICE CENTER - SIU (QUINCY FAMILY PRACTICE) PROVIDES THE BOARD OF TRUSTEES WITH AN ANNUAL UPDATE REGARDING ITS USE OF THE GRANT FUNDS PROVIDED TO THEIR PROGRAM. X X X X false true false false false false false false false MAUREEN KAHN PRESIDENT & CEO 801859 275184 706375 193419 37908 2014745 435731 DARR W LEUTZ PHYSICIAN 1281261 26135 14500 43180 1365076 NEILL M WRIGHT PHYSICIAN 1144769 3506 14500 37750 1190778 JOHN P OLSON MD PHYSICIAN 1091640 5542 10028 36506 1133737 JEFFREY R COOK MD PHYSICIAN 748487 273906 28438 10900 34850 1089734 STEVEN W KRAUSE DO PHYSICIAN 772797 253989 6206 14500 37943 1076677 PATRICK M GERVELER TREASURER & CFO 502580 150153 23465 110119 32892 809458 RONALD S KOELLIKER VP BPS 334904 122678 24870 77721 16183 570142 IRSHAD SIDDIQUI MD EVP CHIEF IT & INNOV 376051 116219 24562 14500 35612 559335 TIMOTHY A MOORE CAO 296556 75300 22466 14500 29804 432405 LEA ANN EICKELSCHULTE CTO 268715 67035 20370 14500 17632 382717 DIANE G JACOBY CHIEF LEGAL OFFICER 273484 48496 24753 3776 18533 366649 KATHLEEN E HULL PRESIDENT/CEO, BCC 235529 73239 4376 14500 32776 355647 JOELLEN L RANDALL VP HUMAN RESOURCES 229945 70770 6130 11638 22744 336854 JULIE A DUKE CHIEF REV. CYCLE OFC 167723 30131 4094 10481 23007 233199 SCHEDULE J, PAGE 1, PART I, LINE 4 MAUREEN KAHN 0 178,919 0 PATRICK M. GERVELER 0 95,619 0 IRSHAD SIDDIQUI MD EMPLOYEE EEAP X 3634 3535 false true true 3535 X 1 5741495 PROFESSIONAL APPRAISAL false true false FORM 990 - ORGANIZATION'S MISSION BLESSING CORPORATE SERVICES, INC. (BCS) IS THE PARENT COMPANY TO THE FOLLOWING ORGANIZATIONS: BLESSING HOSPITAL - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN QUINCY, IL. THE BLESSING FOUNDATION, INC. - RAISES, MANAGES, AND DISTRIBUTES CHARITABLE DONATIONS ON BEHALF OF THE BLESSING HEALTH SYSTEM. DENMAN SERVICES, INC. - A TAXABLE CORPORATION THAT IS ENGAGED PRIMARILY IN THE BUSINESS OF SELLING AND RENTING MEDICAL EQUIPMENT AND OPERATING A COMMERCIAL LAUNDRY. THE ENTITY IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. BLESSINGCARE CORPORATION - OWNS AND OPERATES ILLINI COMMUNITY HOSPITAL, A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN PITTSFIELD, IL. BLESSING AFFILIATES, INC. - CURRENTLY INACTIVE. BLESSINGCARE CORPORATION - MISSOURI - CURRENTLY INACTIVE. CHS HOLDING COMPANY - A TAXABLE CORPORATION THAT PROVIDES HEALTH INSURANCE PRODUCTS AND SERVICES. BLESSING PHYSICIAN SERVICES (BPS) - A DIVISION OF BCS THAT OPERATES A PHYSICIAN CLINIC PROVIDING MULTI-SPECIALTY OUTPATIENT SERVICES TO THE REGION. BLESSING WALK-IN CLINIC, LLC DBA BLESSING CONVENIENT CARE - OPERATES HEALTH CLINICS IN RETAIL FACILITIES. CROSSRIVER QUALITY HEALTH PARTNERS - A CLINICALLY INTEGRATED NETWORK OF REGIONAL PHYSICIANS DEDICATED TO ENHANCING HEALTH CARE QUALITY AND EFFICIENCY ACROSS ILLINOIS, MISSOURI, AND IOWA. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. BLESSING ASSURANCE COMPANY - A WHOLLY OWNED FOREIGN SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. THAT PROVIDES SELF-INSURANCE TO THE AFFILIATED GROUP. THE HANNIBAL CLINIC, INC. - A TAXABLE CORPORATION THAT OPERATES A PHYSICIAN CLINIC PROVIDING MULTI-SPECIALTY OUTPATIENT SERVICES TO THE REGION. IT IS WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. THE BROWN DRUG COMPANY - A TAXABLE CORPORATION THAT OPERATES A RETAIL PHARMACY KEOKUK HEALTH SYSTEMS, INC. - A PARENT COMPANY OF FOUR ENTITIES, THREE OF WHICH ARE NOT-FOR-PROFIT: KEOKUK AREA HOSPITAL DBA BLESSING HEALTH KEOKUK, KEOKUK AREA MEDICAL EQUIPMENT AND SUPPLY, INC., KEOKUK AREA HOSPITAL FOUNDATION, AND TRI-STATE MEDICAL GROUP, INC. (A TAXABLE ENTITIY). RIVERCROSS DIAGNOSTICS, LLC. - A LABORATORY THAT SERVES BLESSING HEALTH SYSTEM AND OTHER AREA MEDICAL SERVICE PROVIDERS. THE ENTITY IS A TAXABLE CORPORATION. FORM 990, PAGE 2, PART III, LINE 4A PHYSICIAN SERVICES - THE ORGANIZATION OPERATES A HEALTH CARE PROVIDER PRACTICE DBA BLESSING PHYSICIAN SERVICES (BPS). THIS PROVIDER GROUP SERVES RESIDENTS OF QUINCY AS WELL AS THE SURROUNDING REGIONS IN WHICH MULTIPLE RURAL CLINICS OPERATE. DURING THE YEAR BPS PROVIDED 238,559 PATIENT VISITS AND 134,513 DIAGNOSTIC TESTS. WITHIN THESE PROVIDER PRACTICES, IT IS THE POLICY OF THE ORGANIZATION THAT NO ONE IS TO BE DENIED HEALTH CARE FOR INABILITY TO PAY. THE BLESSING HEALTH SYSTEM'S STRATEGIC OBJECTIVES FOR THE UPCOMING YEARS-PLEASE SEE BELOW: A) BE THE PLACE WHERE PEOPLE CHOOSE TO WORK B) LIVE OUT OUR CHARITABLE PURPOSE C) BUILD LOYAL RELATIONSHIPS D) BE FINANCIALLY SECURE AND INDEPENDENT E) SERVE MORE CONSUMERS AS A CONNECTED HEALTH SYSTEM OF CARE F) ACHIEVE TOP DECILE PERFORMANCE FORM 990, PAGE 2, PART III, LINE 4B MANAGEMENT SERVICES - THE ORGANIZATION PROVIDES MANAGEMENT SERVICES TO ITS FOLLOWING TAX EXEMPT SUBSIDIARIES: BLESSING HOSPITAL, THE BLESSING FOUNDATION, INC., BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL, CROSSRIVER QUALITY HEALTH PARTNERS, KEOKUK AREA HOSPITAL AND BLESSING WALK-IN CLINIC, LLC. IT ALSO PROVIDES MANAGEMENT SERVICES TO ITS TAXABLE SUBSIDIARIES: DENMAN SERVICES,INC., CHS HOLDING COMPANY, THE HANNIBAL CLINIC, INC., BLESSING ASSURANCE COMPANY, AND THE BROWN DRUG COMPANY. MANAGEMENT SERVICES PROVIDED INCLUDE STRATEGIC AND BUSINESS DEVELOPMENT, ENGINEERING AND FACILITY DEVELOPMENT, CAPITAL AND INFORMATION TECHNOLOGY DEVELOPMENT, PHYSICIAN PRACTICE OPERATIONS, AND CORPORATE COMPLIANCE. IN ADDITION, BLESSING CORPORATE SERVICES OVERSEES BLESSING AFFILIATES, INC. AND BLESSINGCARE CORPORATION-MISSOURI, BOTH OF WHICH ARE CURRENTLY INACTIVE. FORM 990, PAGE 2, PART III, LINE 4D RIVERCROSS DIAGNOSTICS, LLC. IS A QUALIFED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. RIVERCROSS DIAGNOSTICS, LLC. PROVIDES DIAGNOSTIC SERVICES TO MEMBERS OF THE BLESSING HEALTHSYSTEM. FORM 990, PART V, LINE 4B CAYMAN ISLANDS FORM 990, PAGE 6, PART VI, LINE 6 THE MEMBERS OF THE CORPORATION ARE AS FOLLOWS: (A) THOSE PERSONS FROM TIME TO TIME SERVING ON THE BOARD OF TRUSTEES OF THE CORPORATION; (B) THE CHAIRMEN OF BLESSING HOSPITAL, BLESSING PHYSICIAN SERVICES, BLESSING AFFILIATES, INC., THE BLESSING FOUNDATION, INC., DENMAN SERVICES, INC., AND BLESSINGCARE CORPORATION; (C) NON-TRUSTEE MEMBERS OF STANDING COMMITTEES OF THE CORPORATION; AND (D) FOUR REPRESENTIVES OF BLESSING PHYSICIAN SERVICES, AS SELECTED BY THE BOARD OF TRUSTEES OF SUCH ORGANIZATION, AND FOUR REPRESENTATIVES OF EACH OF THE FOLLOWING ORGANIZATIONS OF BLESSING HOSPITAL, AS SELECTED BY EACH SUCH ORGANIZATION: MEDICAL-DENTAL STAFF, BLESSING-REIMAN COLLEGE OF NURSING & HEALTH SCIENCES, AND BLESSING VOLUNTEERS IN PARTNERSHIP. FORM 990, PAGE 6, PART VI, LINE 7A MEMBERS OF BCS ELECT THE APPROPRIATE NUMBER OF TRUSTEES TO FILL THE POSITIONS LEFT VACANT OR TO BE VACANT BY TRUSTEES WHOSE TERMS HAVE EXPIRED OR WILL BE EXPIRING. FORM 990, PAGE 6, PART VI, LINE 11B FOLLOWING MANAGEMENT AND LEGAL REVIEW, FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT PRIOR TO FILING. FORM 990, PAGE 6, PART VI, LINE 12C A COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO BE READ, SIGNED, AND RETURNED TO THE ORGANIZATION. THE SIGNED POLICIES ARE RETAINED IN THE CORPORATE ADMINISTRATIVE FILES. IN ADDITION, EACH OFFICER, DIRECTOR, OR TRUSTEE IS REQUIRED TO DECLARE NO CONFLICT OF INTEREST IN REGARDS TO AGENDA ITEMS BEING PRESENTED AT THE START OF EACH MONTHLY BOARD MEETING. FORM 990, PAGE 6, PART VI, LINE 15A ON A BI-ANNUAL BASIS COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO THE BLESSING CORPORATE SERVICES BOARD OF TRUSTEES FOR APPROVAL. FORM 990, PAGE 6, PART VI, LINE 15B ON A BI-ANNUAL BASIS COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO THE BLESSING CORPORATE SERVICES BOARD OF TRUSTEES FOR APPROVAL. 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 XI, LINE 9 EQUITY EARNINGS IN SUBSIDIARIES -20,686,114 PROVISION FOR BAD DEBTS -1,833,356 PROVISION FOR BAD DEBTS 1,833,356 EQUITY EARNINGS IN SUBSIDIARIES 0 TOTAL -20,686,114 CROSSRIVER QUALITY HEALTH PARTNERS 1005 BROADWAY QUINCY IL 62301 301007158 QUALITY IL 878070 1252727 BCS INC RIVERCROSS DIAGNOSTICS LLC 1005 BROADWAY QUINCY IL 62301 862422969 LABORATORY IL 3817014 2270270 BCS INC BLESSING HOSPITAL 1005 BROADWAY QUINCY IL 62301 370661183 HOSPITAL IL 501C3 3 BCS INC BCS INC true THE BLESSING FOUNDATION BROADWAY AT 11TH PO BOX 7005 QUINCY IL 623057005 371128705 FUNDRAISE IL 501C3 12B BCS INC BCS INC true BLESSING AFFILIATES INC BROADWAY AT 11TH PO BOX 7005 QUINCY IL 623057005 371128708 INACTIVE IL 501C3 10 BCS INC BCS INC true BLESSINGCARE CORPORATION DBA ILLINI 640 WEST WASHINGTON PITTSFIELD IL 62363 371396010 HOSPITAL IL 501C3 3 BCS INC BCS INC true BLESSINGCARE CORPORATION - MISSOURI 1005 BROADWAY QUINCY IL 62301 431371818 INACTIVE MO 501C3 3 BCS INC BCS INC true BLESSING WALK-IN CLINIC LLC 1005 BROADWAY QUINCY IL 62301 814181593 MED SVCS IL 501C3 3 BCS INC true KEOKUK AREA HOSPITAL DBA BLESSING 1600 MORGAN STREET KEOKUK IA 52632 420710268 HOSPITAL 501C3 3 KHS INC false KEOKUK AREA HOSPITAL FOUNDATION 1600 MORGAN STREET KEOKUK IA 52632 421202608 FUNDRAISE 501C3 12B KHS INC false TRI-STATE MEDICAL GROUP INC 1600 MORGAN STREET KEOKUK IA 52632 411435525 HOSPITAL 501C3 3 KHS INC false KEOKUK HEALTH SYSTEMS INC 1600 MORGAN STREET KEOKUK IA 52632 421237361 MGMT SVCS 501C3 12B BCS INC false ILLINI HEALTH SERVICES LLC PO BOX 40 QUINCY IL 623060040 470901851 PHARMACY IL DENMAN DENMAN false false CURRENT HEALTH NETWORK LLC 1005 BROADWAY QUINCY IL 62301 811681509 PRVDR NTWK IL CHS HLDGS false false DENMAN SERVICES INC PO BOX 40 QUINCY IL 62306 371132117 MED. EQUIP IL BCS INC C CORP 18086123 12790111 1.00000 false CHS HOLDING COMPANY 1005 BROADWAY QUINCY IL 62301 320481381 GRP HLTH IL BCS INC C CORP 319738 1678415 1.00000 false THE HANNIBAL CLINIC INC 100 MEDICAL DRIVE HANNIBAL MO 63401 431033473 MED SVCS MO BCS INC C CORP 63368139 29276794 1.00000 false BLESSING ASSURANCE COMPANY PO BOX 1159 GRAND CAYMAN CAYMAN ISLANDS CJ KY1-1102 981454767 SELF-INSUR CJ BCS INC C CORP 3216698 30992455 1.00000 false THE BROWN DRUG COMPANY 1121 MAINE STREET QUINCY IL 62301 370193505 PHARMACY IL BCS INC S CORP -22244 911258 1.00000 false KEOKUK AREA MEDICAL EQUIP & SUPPLY 420 NORTH 17TH STREET KEOKUK IA 52632 421237312 MED EQUIP IL KHS INC C CORP false false false true false false true false false false false true true true true false true false true true BLESSING HOSPITAL C 50395607 FMV BLESSING HOSPITAL L 23333529 FMV BLESSING HOSPITAL M 2262485 FMV BLESSING HOSPITAL K 1742306 FMV THE BLESSING FOUNDATION INC K 2509466 FMV THE BLESSING FOUNDATION INC L 360112 FMV BLESSINGCARE CORPORATION L 733486 FMV BLESSINGCARE CORPORATION P 400645 FMV BLESSINGCARE CORPORATION K 89926 FMV DENMAN SERVICES INC L 97428 FMV HANNIBAL CLINIC INC L 161575 FMV BLESSING ASSURANCE COMPANY R 9721498 FMV BLESSING ASSURANCE COMPANY F 226975 FMV BLESSING ASSURANCE COMPANY S 5054235 FMV BLESSING HEALTH KEOKUK L 221880 FMV