2023-11-14T11:05:59-06:00 2022-12-31 FORVIS LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 631022733 990 2022-01-01 370662561 ANDERSON HOSPITAL % PATRICK GARVEY ANDE 6183916400 6800 STATE ROUTE 162 MARYVILLE IL 62062 MICHAEL MARSHALL CFO 6183916421 2023-11-15 true PATRICK GARVEY 999009999 KRISTEN M HANKINS P01256574 3142315544 2023-11-15 3 2022 2023-04-26 12:10:37Z KEITH PAGE 6800 STATE ROUTE 162 MARYVILLE IL 62062 204086019 false X WWW.ANDERSONHOSPITAL.ORG X 1977 IL OUR COMMUNITY TURNS TO ANDERSON FIRST FOR ALL HEALTHCARE NEEDS. 16 15 1845 160 0 0 13006120 2041907 179304867 176751078 8484084 4122704 1634736 1894055 202429807 184809744 71000 102460 0 0 72598634 76070001 0 0 0 91465784 102531544 164135418 178704005 38294389 6105739 289114643 249772057 92709353 87508011 196405290 162264046 TO EXCEED EXPECTATIONS IN PROVIDING PERSONAL, CONVENIENT, QUALITY HEALTHCARE. false false 139198095 102460 176809255 NURSING AND ANCILLARY SERVICES FOR 23,039 INPATIENT DAYS, 110,882 OUTPATIENT VISITS, 10,021 OUTPATIENT SURGERIES AND 35,151 EMERGENCY VISITS 139198095 true true false true false false false false false false true false true false true false false true false false false false false false false false true true true false true true false false false false false false false false false false false false false false false true true true false false true 52 0 true 1845 true false false false false false false false false false false false false X 16 15 false false false false true true true true true false false false true true true true true true false true true IL X PATRICK GARVEY 6183916421 6800 STATE ROUTE 162 MARYVILLE IL 62062 KEITH PAGE PRESIDENT 27.0 13.0 X 0 512953 155046 MICHAEL MARSHALL CFO 27.0 13.0 X 0 296500 51883 PATRICK ZIMMERMANN MD TRUSTEE 0.21 40.0 X 0 264582 756 JOHN MAGUIRE RN CHARGE 40.0 0.0 X 212972 0 19138 LISA TWESTEN STAFF RN 40.0 0.0 X 173197 0 20137 ROULA AUBUSCHON RN 40.0 0.0 X 182175 0 7131 ROSE DIECKMAN STAFF RN 40.0 0.0 X 167523 0 17732 KELLEY DEATHERAGE RN 40.0 0.0 X 168767 0 10126 ROBERT CIUFERI TREASURER 0.26 0.0 X X 0 0 0 LENDELL PHELPS JR TRUSTEE 0.14 4.0 X 0 0 0 FRANK FLANIGAN TRUSTEE 0.33 0.34 X 0 0 0 GARY CERETTO TRUSTEE 0.15 0.0 X 0 0 0 GREGORY W COFFEY CHAIR 0.18 0.33 X X 0 0 0 JEFFREY PARRES MD TRUSTEE 0.22 0.0 X 0 0 0 JOSEPH HAGERTY TRUSTEE 0.22 0.37 X 0 0 0 JOSEPH SMITH CHAIRMAN 0.26 0.37 X X 0 0 0 KAY B WERNER ASSISTANT SECRETARY 0.21 0.0 X X 0 0 0 LAURA BERNAIX PHD RN TRUSTEE 0.26 0.33 X 0 0 0 MARK SHASHEK CHAIRMAN 0.33 4.37 X X 0 0 0 MAX K EAKIN MD TRUSTEE 0.25 4.0 X 0 0 0 NANCY THOMAS TRUSTEE 0.22 0.0 X 0 0 0 REV MARK MAYNARD TRUSTEE 0.25 0.0 X 0 0 0 VIRGINIA TRUCANO TRUSTEE 0.22 0.0 X 0 0 0 904634 1074035 281949 174 false true false GENERAL AND LAPAROSCOPIC SURGERY 6810 STATE ROUTE 162 MARYVILLE IL 62062 PHYSICIAN SERVICE 2268180 MID AMERICA PLASTIC SURGERY 4955 S STATE RTE 159 GLEN CARBON IL 62062 PHYSICIAN SERVICE 2080000 AYA HEALTHCARE INC 5930 CORNERSTONE COURT WEST SUITE 3 SAN DIEGO CA 92121 HEALTHCARE 3181312 FAVORITE HEALTHCARE STAFFING 333 SALEM PL SUITE 170 FAIRVIEW HEIGHTS IL 62208 STAFFING 2979899 MIDWESTERN EMERGENCY DEPARTMENT 320 E 50 OFALLON IL 62269 PHYSICIAN SERVICE 1967454 42 0 0 0 333333 1708574 0 0 2041907 NET PATIENT REVENUE 621110 176751078 176751078 176751078 2711085 2711085 0 0 1161897 1161897 0 1161897 1161897 20667894 20000 19232164 44111 1435730 -24111 1411619 1411619 0 0 0 0 0 0 0 0 0 MEDICAL RECORDS FEES 561000 79024 79024 SISHA CONTRACT 624310 58177 58177 CREDIT CARD SHARING 900099 42261 42261 552696 552696 732158 184809744 176809255 5958582 102460 102460 0 0 0 1016382 1016382 0 63583954 54935567 8648387 1207191 1177944 29247 5600816 4882854 717962 4661658 4027601 634057 0 853160 853160 245934 245934 0 0 0 24341877 14884379 9457498 0 42651835 33168837 9482998 0 0 12592071 7563046 5029025 86532 69427 17105 0 0 983667 983667 0 7457800 7457800 2945770 2945770 BAD DEBT EXPENSE 9527002 9527002 EDUCATION 403007 350317 52690 DUES AND SUBSCRIPTIONS 331021 67194 263827 ALL OTHER EXPENSES 111868 111868 178704005 139198095 39505910 0 2009701 875286 8841092 7255093 0 0 25736571 19665429 0 0 0 0 0 0 3491076 3509305 2271031 2185170 171436089 90594315 81272749 80841774 136234482 102768685 0 0 25266524 26426291 914608 2470552 3076809 3774472 289114643 249772057 12919035 17274210 0 0 0 0 35775603 31488159 0 0 0 0 0 0 0 0 44014715 38745642 92709353 87508011 X 196405290 162264046 0 0 196405290 162264046 289114643 249772057 X 6105739 -20168749 -20078234 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 37489 false false false 37489 false PART II-B, LINE F GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES THE AMOUNT REPRESENTS THE PORTION OF DUES PAID TO PROFESSIONAL ORGANIZATIONS THAT IS ALLOCATED TO THE LOBBYING ACTIVITIES OF THOSE ORGANIZATIONS. 1273864 1273864 112424657 54296650 58128007 24000 24000 0 54052484 34351946 19700538 3661084 1921719 1739365 80841774 INVESTMENT IN SUBSIDIARY 26426291 C 26426291 0 DUE TO THIRD PARTY PAYERS 11114116 ESTIMATED SELF-INSURANCE COSTS 19784000 LEASE LIABILITY 2470111 DUE TO CMS 5377415 38745642 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS THE FUNDS ARE DESIGNATED FOR CAPITAL IMPROVEMENTS, TO PROVIDE SELF-INSURANCE COVERAGE, TO MEET BOND REQUIREMENTS, AND TO PROVIDE FUNDS FOR HEALTH CARE PROGRAMS. HOWEVER, NONE OF THE FUNDS MEETS THE DEFINITION OF AN ENDOWMENT FUND UNDER SFAS 117, THEREFORE, PART V HAS NOT BEEN COMPLETED. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS UNDER ASC 740 MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true X true X true X 600. true true true false true true 1002844 1002844 0.00590 31440087 27463724 3976363 0.02350 32442931 27463724 4979207 0.02940 398715 398715 0.00240 2162940 2162940 0.01280 180638 180638 0.00110 2742293 2742293 0.01630 35185224 27463724 7721500 0.04570 true 9527002 27756356 37471456 -9715100 X true true 1 1 ANDERSON HOSPITAL 6800 STATE ROUTE 162 MARYVILLE IL 62062 WWW.ANDERSONHOSPITAL.ORG 0004119 X X X ANDERSON HOSPITAL 1 false false true X X X X X X X X X 21 true false false true X See Part V, Section C true 21 true SEE PART V, SECTION C false true X 200. 600. X X X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 IN CONDUCTING THE MOST RECENT CHNA, ANDERSON HOSPITAL ELICITED INPUT FROM THE COMMUNITY MEMBERS THROUGH A VARIETY OF METHODS. WE PARTNERED WITH THE MADISON COUNTY HEALTH DEPARTMENT TO HOLD FOCUS GROUPS, CONDUCT A COMMUNITY HEALTH SURVEY, AND ORGANIZE MEETINGS TO SET TOP HEALTH PRIORITIES. THE STAKEHOLDER FOCUS GROUPS ALLOWED US TO OBTAIN PERTINENT INFORMATION FROM OUR COMMUNITY LEADERS AND STAFF MEMBERS TO ESTABLISH KEY HEALTH CONCERNS. EIGHT TOTAL FOCUS GROUPS WERE HELD THROUGHOUT THE COMMUNITY IN MADISON COUNTY, WITH ONE BEING HELD AT ANDERSON HOSPITAL. THE ATTENDEES OF THE STAKEHOLDER FOCUS GROUPS WERE INDIVIDUALS WHO ARE INVOLVED WITH THE HEALTH OF THE COMMUNITY THROUGH THEIR PROFESSION OR PERSONAL INTEREST IN HEALTH AND WELLNESS. EXAMPLES INCLUDED HEALTH EDUCATORS AND ADMINISTRATORS FROM HOSPITALS AND ASSISTED LIVING FACILITIES IN THE AREA, FACULTY FROM LOCAL UNIVERSITIES AND COLLEGES, PHARMACISTS, HEALTH EDUCATORS FROM THE MADISON COUNTY HEALTH DEPARTMENT, COLLEAGUES THAT WORK WITH SPECIFIC POPULATIONS AND PERSONS WITH DISABILITIES, AND STAFF FROM ORGANIZATIONS THAT FOCUS ON THE HEALTH AND WELLBEING OF THE COMMUNITY. THE FOCUS GROUP QUESTIONS TARGETED WHAT IS IMPORTANT TO THE HEALTH OF OUR COMMUNITY, WHAT ARE THE MOST URGENT HEALTH CONCERNS, WHAT ARE THE CAUSES OF THESE PROBLEMS, WHAT ARE THE STRENGTHS OF THE SERVICES IN THE COMMUNITY, AND WHAT ARE THE GREATEST OBSTACLES. PARTICIPANTS WERE ASKED FOR FURTHER INVOLVEMENT IN PROMOTING COMPLETION OF THE COMMUNITY HEALTH SURVEY. THE COMMUNITY HEALTH SURVEY WAS DISSEMINATED ELECTRONICALLY THROUGH EMAIL AND THROUGH PAPER SURVEYS THAT WERE PLACED AROUND THE COMMUNITY AND AT ANDERSON HOSPITAL. THE SURVEY YIELDED 389 RESPONSES FROM OUR PRIMARY SERVICE AREA. QUESTIONS FOCUSED ON WHAT ARE THE MOST URGENT HEALTH CONCERNS, WHAT KEEPS PEOPLE FROM BEING HEALTHY, WHY PEOPLE DO NOT GET NEEDED HEALTH CARE, AND RATE HEALTH ISSUES ON A SCALE OF MOST URGENT TO NOT A PROBLEM. FROM THE SURVEY RESULTS, TEN TOP HEALTH CONCERNS WERE IDENTIFIED. ANDERSON HOSPITAL PARTICIPATED IN THE MADISON COUNTY HEALTH DEPARTMENT MEETINGS TO IDENTIFY THEIR TOP CONCERNS TO GAIN INSIGHT, THEN MET WITH OUR INTERNAL TEAM TO DETERMINE WHAT THE TOP CONCERNS WERE FOR OUR SPECIFIC SERVICE AREA. ANDERSON HOSPITAL'S HEALTH EDUCATION PLANNING COMMITTEE MET AND MEMBERS INDIVIDUALLY CHOSE THEIR TOP CONCERNS, AND THEN DISCUSSED EACH TOPIC AS A COMMITTEE TO ULTIMATELY DETERMINE OUR TOP 4 PRIORITY TOPICS. THE TOPICS INCLUDED CANCER, POVERTY, OBESITY, AND SUBSTANCE ABUSE. SCHEDULE H, PART V, SECTION B, LINE 7D HTTPS://ANDERSONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART V, SECTION B, LINE 10A IMPLEMENTATION STRATEGY WEBSITE: HTTPS://ANDERSONHOSPITAL.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ SCHEDULE H, PART V, SECTION B, LINE 11 ANDERSON HOSPITAL'S HEALTH EDUCATION PLANNING COMMITTEE FACILITATES AND MAINTAINS AN ANNUAL DASHBOARD FOCUSED ON THE TOP HEALTH PRIORITIES FOR 2022-2025 THAT WERE IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS CONDUCTED IN 2021. ANDERSON CHOSE A TOTAL OF FOUR INTERNAL AND EXTERNAL HEALTH PRIORITIES BASED ON TOP HEALTH CONCERNS IN OUR SERVICE AREA. EACH HEALTH PRIORITY HAS A LIST OF OBJECTIVES THAT WERE THE PRIMARY FOCUS OVER THE LAST THREE YEARS. ANDERSON WORKED CLOSELY WITH OUR COMMUNITY PARTNERS TO MEET THESE OBJECTIVES. ALTHOUGH THERE WERE MANY HEALTH CONCERNS IN OUR COMMUNITY THAT NEEDED TO BE ADDRESSED, WE PRIORITIZED ON THE TOP FOUR WITH THE BEST INTEREST OF IMPROVING THESE CONCERNS OVER THE THREE YEAR TIME PERIOD. THE HEALTH EDUCATION PLANNING COMMITTEE MEETS AT LEAST QUARTERLY TO UPDATE THE DASHBOARD WITH THE OBJECTIVES THAT HAVE BEEN MET, AS WELL AS DOCUMENT IF A PARTICULAR OBJECTIVE COULD NOT BE MET AND WHY. ADDITIONALLY, WE RECORD AND MAINTAIN ALL COMMUNITY BENEFIT DATA FOR ANDERSON HOSPITAL IN THE CBISA DATABASE. WITH THIS INFORMATION, WE CAN IDENTIFY HOW WE HAVE MET OUR GOALS AND OBJECTIVES, AND FOCUS ON AREAS OF GROWTH IN THE FUTURE. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C WEBSITE URL FOR FAP: THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP ARE ALL FOUND AT THE FOLLOWING LINK: HTTPS://WWW.ANDERSONHOSPITAL.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE 13 MARYVILLE IMAGING 2023 VADALABENE DR MARYVILLE IL 62062 IMAGING SERVICES ANDERSON SLEEP CENTER 2809 NORTH CENTER MARYVILLE IL 62062 SLEEP STUDY COLLINSVILLE EXPRESS CARE 1103 BELT LINE RD COLLINSVILLE IL 62234 ER - OTHER GLEN CARBON EXPRESS CARE 17 GINGER CREEK GLEN CARBON IL 62034 ER - OTHER HIGHLAND EXPRESS CARE 2504 COMMERCE LN HIGHLAND IL 62249 ER - OTHER WELLNESS CENTER 2133 VADALABENE DR MARYVILLE IL 62062 REHAB SERVICES ANDERSON HOME HEALTH 6800 STATE ROUTE 162 MARYVILLE IL 62062 HOME HEALTH SERVICES BETHALTO EXPRESS CARE 159 E MCARTHUR BETHALTO IL 62010 ER - OTHER ANDERSON CANCER CENTER 2227 VADALABENE MARYVILLE IL 62062 CANCER TREATMENT ANDERSON PEDIATRIC CENTER 6820 STATE ROUTE 162 MARYVILLE IL 62062 PEDIATRIC SERVICES ONCOLOGY TREATMENT CENTER 6836 STATE ROUTE 162 MARYVILLE IL 62062 CANCER TREATMENT ANDERSON REHAB SERVICES 1212 BROADWAY HIGHLAND IL 62249 REHAB SERVICES TROY EXPRESS CARE 108 WEST US HIGHWAY 40 TROY IL 62294 ER - OTHER SCHEDULE H, PART III, SECTION A, LINE 2 BAD DEBTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY 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 PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SCHEDULE H, PART III, SECTION A, LINE 4 SEE PAGES 9, 15, AND 17 OF THE ATTACHED AUDITED FINANCIAL STATEMENTS. SCHEDULE H, PART III, SECTION B, LINE 8 MEDICARE COSTING METHODOLOGY IS BASED ON COST-TO-CHARGE RATIOS. MEDICARE SHORTFALLS SHOULD BE RECORDED AS COMMUNITY BENEFIT AS RATES ARE SET BY THE GOVERNMENT AT LEVELS SIGNIFICANTLY BELOW COSTS. 30% OR MORE OF ANDERSON'S TOTAL BUSINESS IS PATIENTS IN OUR COMMUNITY WITH MEDICARE COVERAGE. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES ALL BILLING AND COLLECTION POLICIES AND PRACTICES WILL REFLECT THE MISSION AND VALUES OF ANDERSON HOSPITAL, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. ANDERSON HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. ANDERSON HOSPITAL'S BILLING AND COLLECTION PRACTICES WILL BE FAIR AND CONSISTENTLY APPLIED WITHIN EACH ENTITY. PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE PROVIDED THAT ASSISTANCE AND THEIR ACCOUNTS ARE WRITTEN OFF AND NO FURTHER COLLECTION ACTIVITY OCCURS ON THE PORTION OF THE BILL THAT QUALIFIES FOR CHARITY. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT THE COMMUNITY BENEFIT PLAN IDENTIFIES COMMUNITY HEALTH NEEDS AND GAPS THROUGH COMMUNITY, EMPLOYEE, AND VOLUNTEER SURVEYS, PERIOD MEETINGS WITH THE LOCAL MAYOR, AND COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND ALIGNS THOSE WITH THE HOSPITAL'S INITIATIVES. THE PLAN IS DEVELOPED BY THE HEALTH EDUCATION PLANNING COMMITTEE IN COLLABORATION WITH THE MADISON COUNTY PARTNERSHIP FOR COMMUNITY HEALTH AND COMMUNITY LEADERS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL COUNSELORS ASSIST PATIENTS WITH THEIR HEALTH INSURANCE OR FINANCIAL ASSISTANCE NEEDS. DURING THE BILLING CYCLE, PATIENT FINANCIAL SERVICES WORKS WITH PATIENTS WHO NEED ASSISTANCE OR PAYMENT PLANS. FINANCIAL ASSISTANCE INFORMATION IS POSTED ON THE ANDERSON HOSPITAL WEBSITE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION ANDERSON HOSPITAL SERVES PATIENTS IN MADISON COUNTY, AND THE ILLINOIS CITIES OF TROY, MARYVILLE, EDWARDSVILLE, GLEN CARBON, GRANITE CITY, AND HIGHLAND. THE COMMUNITY IS MOSTLY A WHITE COLLAR COMMUNITY WITH LITTLE INDUSTRY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH TO CONTINUE MCPCH INVOLVEMENT WITH COMMITTEE REPRESENTATION FROM ANDERSON HOSPITAL, INCLUDING: MOTOR VEHICLE COMMITTEE, ADDICTIVE BEHAVIOR COMMITTEE, SEXUAL RISK BEHAVIORS COMMITTEE, CANCER COMMITTEE, CARDIOVASCULAR COMMITTEE, AND MCPCH COMMITTEE MEMBERS TO REPORT AT HEPC. TO CONTINUE TO INCREASE AWARENESS OF DISASTER PREPAREDNESS IN THE COMMUNITY BY: AUGMENTING MCPCH COMMUNITY DISASTER PLANS AND PRESENTING TO LOCAL BUSINESSES. TO EDUCATE AND DISSEMINATE INFORMATION TO THE COMMUNITY REGARDING INFECTION CONTROL, TARGETING MRSA, INFLUENZA A, H1N1, AND PREVENTATIVE PRACTICES AND EDUCATION OF THESE TO LOCAL SCHOOLS. TO MAINTAIN PARTNERSHIP WITH LOCAL BUSINESSES AND PUBLIC SERVICES TO MEET THEIR EMPLOYEES' SPECIFIC HEALTHCARE NEEDS. TO EXPAND HEALTH AND WELLNESS EXPOSURE AT ANDERSON HOSPITAL. TO INCREASE COMMUNITY AWARENESS RELATED TO CONGESTIVE HEART FAILURE. IN COLLABORATION WITH COMMUNITY LEADERS, ANDERSON'S COMMUNITY INCLUDES SEMI-ANNUAL MEETINGS WITH THE LOCAL MAYORS TO DISCUSS THE STRATEGIC PLAN OF THE HOSPITAL, PROVIDE UPDATES ON PLANNED CAPITAL SPENDING, DISCUSS NEW SERVICES, AND TO RECEIVE FEEDBACK FROM THE COMMUNITY REGARDING CURRENT SERVICES OR THE NEEDS FOR ADDITIONAL SERVICES. SCHEDULE H, PART VI, LINE 6 OTHER INFORMATION ANDERSON HOSPITAL WILL PROVIDE QUALITY HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. EACH PERSON WILL BE TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. ANDERSON HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE AND STRIVES TO INCREASE ACCESS TO CARE FOR ALL MEMBERS OF THE COMMUNITY. ANDERSON HOSPITAL IS AN EMS RESOURCE HOSPITAL PROVIDING TRAINING AND EDUCATION TO LOCAL EMS PERSONNEL. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT ILLINOIS SCHEDULE H, PART I, LINE 7 FINANCIAL ASSISTANCE & OTHER COMMUNITY BENEFITS THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7, USED A RATIO OF PATIENT CARE COST TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS. SCHEDULE H, PART I, LINE 7, COLUMN F FINANCIAL ASSISTANCE & OTHER COMMUNITY BENEFITS - PERCENT OF TOTAL EXPENSE THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $9,527,002 REPORTED ON PART IX, LINE 25; HOWEVER IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. SCHEDULE H, PART 1, LINE 3C FACTORS OTHER THAN FPG IN ADDITION TO FPG, THE ORGANIZATION USES THE FOLLOWING FACTORS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY. true CITY OF EDWARDSVILLE 118 HILLSBORO AVENUE PO BOX 407 EDWARDSVILLE IL 62025 376001409 GOVERNMENT 66600 COMMUNITY FITNESS CENTER 1 0 SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES THE ORGANIZATION ONLY MAKES GRANTS TO PRE-SELECTED CHARITABLE AND GOVERNMENTAL ORGANIZATIONS. false true false false false false false false false PATRICK ZIMMERMANN MD TRUSTEE 0 263885 0 0 0 697 0 0 0 756 0 265338 KEITH PAGE PRESIDENT 0 509480 0 0 0 3473 0 134263 0 20783 0 667999 MICHAEL MARSHALL CFO 0 295098 0 0 0 1402 0 21931 0 29952 0 348383 JOHN MAGUIRE RN CHARGE 212972 0 0 0 0 0 14083 0 5055 0 232110 0 ROSE DIECKMAN STAFF RN 167523 0 0 0 0 0 17732 0 0 0 185255 0 ROULA AUBUSCHON RN 182175 0 0 0 0 0 4323 0 2808 0 189306 0 LISA TWESTEN STAFF RN 173197 0 0 0 0 0 17359 0 2778 0 193334 0 KELLEY DEATHERAGE RN 168767 0 0 0 0 0 10126 0 0 0 178893 0 SCHEDULE J, PART 1, LINE 3 The president and CFO are compensated by a related organization. The related organization used the following factors to establish compensation: 1. Compensation committee 2. Compensation survey or study 3. Approval by the board or compensation committee SCHEDULE J, PART 1, LINE 4B KEITH PAGE PARTICIPATES IN A SEC. 457(F) PLAN. A CONTRIBUTION IN THE AMOUNT OF $20,488 WAS ACCRUED FOR 2022. RAFE HENG PARTICIPATES IN A SEC. 457(F) PLAN. A CONTRIBUTION IN THE AMOUNT OF $20,500 WAS ACCRUED FOR 2022. RONALD GOULD PARTICIPATES IN A SEC. 457(F) PLAN. A CONTRIBUTION IN THE AMOUNT OF $19,500 WAS ACCRUED FOR 2022. A SOUTHWESTERN ILLINOIS DEVELOPMENT AUTHORITY 371234684 000000000 2016-05-17 18258036 NOTE IN PART VI false false false B VILLAGE OF MARYVILLE ILLINOIS 370922463 000000000 2016-06-01 7541971 NOTE IN PART VI false false false C VILLAGE OF MARYVILLE ILLINOIS 370922463 000000000 2016-06-16 8480753 NOTE IN PART VI false false false D VILLAGE OF MARYVILLE ILLINOIS 370922463 000000000 2016-07-01 5175473 NOTE IN PART VI false false false A 7347825 0 18258036 0 0 0 300989 0 0 0 17957047 0 2008 true true true true B 4367949 0 7541971 0 0 0 120657 0 0 0 7421314 0 1999 true false true true C 8013770 0 8480753 0 0 0 94614 0 0 0 8386139 0 2011 true false true true D 2182946 0 5175473 0 0 0 59501 0 0 0 5115972 0 2011 true false true true A false true true true false 0.00500 0.00500 false false false true B false false true true false 0 false false false true C false false false false 0 false false false true D false false false false 0 false false false true A false true false false 0 false 0 true true B false true false false 0 false 0 false true C false true false false 0 false 0 false true D false true false false 0 false 0 false true A true B true C true D true SCHEDULE K, PART I, LINE A, COLUMN F ADVANCE REFUND 2006 BONDS (ORIGINALLY ISSUED ON 12/15/2006) AND CURRENT REFUND 2011B BONDS (ORIGINALLY ISSUED ON 12/29/2011). SCHEDULE K, PART I, LINE B, COLUMN F CURRENT REFUND 2011A BONDS (ORIGINALLY ISSED ON 12/29/2011). SCHEDULE K, PART I, LINE C, COLUMN F CURRENT REFUND 2011 BONDS (ORIGINALLY ISSUED ON 8/4/2011). SCHEDULE K, PART I, LINE D, COLUMN F CURRENT REFUND 2012 BONDS (ORIGINALLY ISSUED ON 02/17/2012). SCHEDULE K, PART II, COLUMN A, LINE 3 BOND PROCEEDS WERE USED TO REFUND PRIOR BOND ISSUES. AS A RESULT, THERE IS NO "PROJECT PERIODEARNINGS IN THE COSTS OF ISSUANCE ACCOUNT AND ESCROW FUND HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS. SCHEDULE K, PART II, COLUMN A, LINE 11 THIS AMOUNT REPRESENTS $7,278,189 OF BOND PROCEEDS USED TO CURRENTLY REFUND THE 2011B BONDS, $10,676,030 USED TO ADVANCE REFUND THE 2006 BONDS, AND $2,828 USED TO PAY INTEREST ON THE BONDS. SCHEDULE K, PART II, COLUMN B, LINE 3 BOND PROCEEDS WERE USED TO REFUND A PRIOR BOND ISSUE. AS A RESULT, THERE IS NO "PROJECT PERIODEARNINGS IN THE COSTS OF ISSUANCE ACCOUNT HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS. SCHEDULE K, PART II, COLUMN B, LINE 11 THIS AMOUNT REPRESENTS $7,419,803 OF BOND PROCEEDS USED TO CURRENTLY REFUND THE 2011A BONDS AND $1,511 USED TO PAY INTEREST ON THE BONDS. SCHEDULE K, PART II, COLUMN C, LINE 3 BOND PROCEEDS WERE USED TO REFUND A PRIOR BOND ISSUE. AS A RESULT, THERE IS NO "PROJECT PERIODEARNINGS IN THE COSTS OF ISSUANCE ACCOUNT HAVE NOT BEEN REFLECTED IN TOTAL PROCEEDS. SCHEDULE K, PART II, COLUMN C, LINE 11 THIS AMOUNT REPRESENTS $8,384,440 OF BOND PROCEEDS USED TO CURRENTLY REFUND THE 2011 BONDS AND $1,700 USED TO PAY INTEREST ON THE BONDS. SCHEDULE K, PART II, COLUMN D, LINE 11 THIS AMOUNT REPRESENTS $5,115,116 OF BOND PROCEEDS USED TO CURRENTLY REFUND THE 2012 BONDS AND $856 USED TO PAY INTEREST ON THE BONDS. SCHEDULE K, PART III, COLUMN A PART III HAS BEEN COMPLETED FOR THE PROJECTS ORIGINALLY FINANCED AFTER JANUARY 1, 2003. SCHEDULE K, PART III, COLUMN A, LINE 4 AMOUNT REPRESENTS THE MAXIMUM AMOUNT OF BOND PROCEEDS USED IN A PRIVATE BUSINESS USE. SCHEDULE K, PART III, COLUMN B PART III HAS BEEN COMPLETED FOR THE PROJECTS ORIGINALLY FINANCED AFTER JANUARY 1, 2003. SCHEDULE K, PART IV, COLUMN A, LINE 6 BOND PROCEEDS WERE DEPOSITED AND INVESTED IN A YIELD RESTRICTED ESCROW FUND UNTIL THE REDEMPTION OF THE 2006 BONDS. SCHEDULE K, PART IV, COLUMN A, LINE 2C ARBITRAGE ANALYSIS COMPLETED AS OF 2/15/2017. A SOUTHWESTERN ILLINOIS DEVELOPMENT AUTHORITY 371234684 000000000 2019-05-30 15229849 NOTE IN PART IV false false false A 5009738 0 15255430 0 0 0 217399 0 0 15038031 0 0 2019 false false true true A false false false false 0 false false false true A false true false false 0 false 0 false true A true SCHEDULE K PART I, LINE A, COLUMN (F) ACQUIRE, CONSTRUCT, FURNISH AND EQUIP HOSPITAL FACILITIES. SCHEDULE K PART II, COLUMN A, LINE 3 TOTAL PROCEEDS OF THE ISSUE DOES NOT EQUAL ISSUE PRICE REPORTED IN PART I AS A RESULT OF INVESTMENT EARNINGS EARNED DURING THE PROJECT PERIOD. SCHEDULE K PART II, COLUMN A, LINE 13 ALL BOND PROCEEDS WERE SPENT AS OF THE FISCAL YEAR END; HOWEVER, NOT ALL PROJECTS WERE COMPLETED AS OF THE FISCAL YEAR END. SCHEDULE K PART II, COLUMN A, LINE 16 THE CLOSE OUT WAS COMPLETED AS OF 12/1/2019. SCHEDULE K PART IV, COLUMN A, LINE 2(c) ARBITRAGE ANALYSIS COMPLETED AS OF 12/1/2019. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE ORGANIZATION IS ANDERSON HEALTHCARE, A TAX-EXEMPT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER HAS THE RIGHT TO APPOINT THE VOTING MEMBERS OF THE GOVERNING BODY. FORM 990, PART VI, SECTION A, LINE 7B THE SOLE MEMBER OF THE ORGANIZATION HAS THE FOLLOWING POWERS AND RESPONSIBILITIES: -REVISIONS TO MISSION STATEMENT AND AMENDMENTS TO GOVERNING DOCUMENTS; -APPOINTMENT AND REMOVAL OF MEMBERS OF THE GOVERNING BODY AND THE PRESIDENT/CEO; -APPROVAL OF UNBUDGETED EXPENDITURES IN EXCESS OF AN ESTABLISHED THRESHOLD; -APPROVAL OF THE DISPOSAL OF ASSETS AND INCURRENCE OF DEBT IN EXCESS OF AN ESTABLISHED THRESHOLD; -APPROVAL OF PLAN OF MERGER, CONSOLIDATION, DISSOLUTION, BANKRUPTCY, REORGANIZATION OR DISPOSITION OF SUBSTANTIALLY ALL ASSETS; -APPROVAL OF AFFILIATIONS WITH OTHER HEALTHCARE ORGANIZATIONS; -APPROVAL OF ESTABLISHMENT, ACQUISITION, OR AFFILIATIONS OF SUBSIDIARIES AND JOINT VENTURES; -TRUSTEE OR OFFICER INDEMNIFICATION; -USE OF FICTITIOUS NAMES FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990 THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND CONTROLLER. INFORMATION FOR THE RETURN IS GATHERED BY THE HOSPITAL'S FINANCE DEPARTMENT AND GIVEN TO AN INDEPENDENT AUDITOR FOR FILING PREPARATION. A COPY OF THE FORM 990 IS MADE AVAILABLE TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE COMPLIANCE OFFICER REVIEWS AND MONITORS THE POLICY ANNUALLY. PERSONS COVERED UNDER THE POLICY INCLUDE TRUSTEES/DIRECTORS/MANAGERS, OFFICERS AND COMMITTEE MEMBERS OF THE ANDERSON ENTITIES; DEPARTMENT DIRECTORS, ADMINISTRATIVE DIRECTORS, ASSISTANT DIRECTORS, MEMBERS OF SENIOR MANAGEMENT AND MEDICAL STAFF LEADERS OF ANDERSON, MEDICAL STAFF MEMBERS AND NON-MANAGEMENT STAFF. CONFLICTS ARE REVIEWED, IDENTIFIED AND MAINTAINED BY THE COMPLIANCE OFFICER. EXPLANATION OF ANY RESTRICTIONS IMPOSED ON PERSONS WITH A CONFLICT: THE COVERED INDIVIDUAL PROMPTLY AND FULLY DISCLOSES THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT THE FOLLOWING TIMES: A. WHEN THE COVERED INDIVIDUAL FIRST BECOMES A COVERED INDIVIDUAL AND AT EVERY ANNUAL MEETING OF THE ANDERSON ENTITY THEREAFTER THROUGH THE SUBMISSION OF A CONFLICT DISCLOSURE STATEMENT AFFIRMING THAT THE COVERED INDIVIDUAL (I) RECEIVED A COPY OF THIS POLICY, (II) READ AND UNDERSTOOD THIS POLICY, AND (III) AGREES TO COMPLY WITH THIS POLICY; B. UPON ANY CHANGES IN CIRCUMSTANCES WHICH GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; AND C. WHEN THE COVERED INDIVIDUAL HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A TRANSACTION OR ARRANGEMENT BEING CONSIDERED AT A BOARD OR COMMITTEE MEETING. FOR MANAGERS AND MEDICAL STAFF LEADERS: THE COVERED INDIVIDUAL PROMPTLY AND FULLY DISCLOSES THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST TO THE COMPLIANCE OFFICER AT THE FOLLOWING TIMES: A. WHEN THE COVERED INDIVIDUAL FIRST BECOMES A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER THROUGH THE SUBMISSION OF A CONFLICT DISCLOSURE STATEMENT AFFIRMING THAT THE COVERED INDIVIDUAL (I) RECEIVED A COPY OF THIS POLICY, (II) READ AND UNDERSTOOD THIS POLICY, AND (III) AGREES TO COMPLY WITH THIS POLICY; AND B. UPON ANY CHANGES IN CIRCUMSTANCES WHICH GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; C. WHEN A COVERED INDIVIDUAL HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A TRANSACTION OR ARRANGEMENT BEING CONSIDERED ON BEHALF OF ANDERSON AND THE COVERED INDIVIDUAL IS IN A POSITION TO INFLUENCE THE OUTCOME OF THE CONSIDERATION. DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST MADE AT THE MEETING AT WHICH THE TRANSACTION OR ARRANGEMENT IS BEING CONSIDERED SHALL BE MADE TO ALL INDIVIDUALS PRESENT AT THE MEETING. FOR OTHER MEDICAL STAFF MEMBERS: DISCLOSURE OCCURS AT APPOINTMENT AND REAPPOINTMENT UNLESS THEY ARE BOARD MEMBERS - THESE PHYSICIANS FOLLOW THE BOARD OF TRUSTEE REQUIREMENTS. EMPLOYEES NOT IN MANAGEMENT POSITIONS: AT TIME OF HIRE AND AT EACH ANNUAL EMPLOYEE EVALUATION. FORM 990, PART VI, SECTION B, LINE 15A REVIEW OF CEO OR TOP MANAGEMENT OFFICIAL COMPENSATION THE CEO SALARY AND BONUS STRUCTURE IS DETERMINED ON AN ANNUAL BASIS BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES, AND APPROVED BY THE FULL BOARD BASED ON AN EVALUATION DONE BY THE COMMITTEE. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 15B REVIEW OF OTHER OFFICER OR KEY EMPLOYEE COMPENSATION THE ADMINISTRATIVE DIRECTOR SALARY STRUCTURE IS DETERMINED BY A REVIEW AND MARKET COMPENSATION STUDY BASED ON OFFICIAL SURVEYS BY SUCH COMPANIES AS TOWERS, PERRIN AND MERCER. RECOMMENDATIONS ARE MADE TO THE CEO BY HUMAN RESOURCES, AND ARE APPROVED BY THE CEO BASED ON PERFORMANCE EVALUATION. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES: TRANSFERS BETWEEN AFFILIATES: $(20,078,234) FORM 990 PART IX LINE 11G DESCRIPTION:ADMINISTRATIVE SERVICES TOTAL FEES:9591572 FORM 990 PART IX LINE 11G DESCRIPTION:SURGERY CONTRACT SERVICES TOTAL FEES:3903261 FORM 990 PART IX LINE 11G DESCRIPTION:REFERENCE LAB CONTRACT SERVICE TOTAL FEES:742079 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER MEDICAL SERVICES TOTAL FEES:10104965 AUXILIARY OF ANDERSON HOSPITAL 6800 STATE ROUTE 162 MARYVILLE IL 62062 376080063 SUPPORT ORG IL 501(C)(3) 12, III-O NA false COMMUNITY HOSPITAL OF STAUNTON 400 N CALDWELL STREET STAUNTON IL 62088 370624255 HOSPITAL IL 501(C)(3) 3 ANDERSON HC true ANDERSON HOSPITAL FOUNDATION 6800 STATE ROUTE 162 MARYVILLE IL 62062 274548522 SUPPORT ORG IL 501(C)(3) 7 ANDERSON HSP true ANDERSON HEALTHCARE 6800 STATE ROUTE 162 MARYVILLE IL 62062 843965822 HEALTH CARE IL 501(C)(3) 11C NA false FRIENDS OF COMMUNITY MEMORIAL HOSPITAL 400 N CALDWELL STREET STAUNTON IL 62088 363913722 FUNDRAISING IL 501(C)(3) 10 CHS true ANDERSON SURGERY CENTER LLC 6800 STATE ROUTE 162 MARYVILLE IL 62062 834200085 SURGERY IL ANDERSON HSP RELATED -1281205 2682384 false true 0.82742 ANDERSON REHABILIATATION INSTITUTE LLC 330 SEVEN SPRINGS WAY BRENTWOOD TN 37027 832844780 REHAB KY ANDERSON HSP RELATED 389877 9075776 false true 0.60000 false false true true false false false false false false false true false false true false false true true ANDERSON HOSPITAL FOUNDATION C 333333 CASH COMMUNITY HOSPITAL OF STAUNTON L 1657798 COST ANDERSON SURGERY CENTER R 1425000 CASH