FREEPORT REGIONAL HEALTH CARE FOUND ATION: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FREEPORT REGIONAL HEALTH CARE FOUND ATION (EIN 36-3290904)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-08-31
- IRS object ID
- 202212439349300901
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule K
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-08-31T10:02:35-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363290904 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREEPORT REGIONAL HEALTH CARE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FREE | BusinessNameControlTxt |
| Phone | 8155996209 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1045 WEST STEPHENSON STREET | AddressLine1Txt |
| City | FREEPORT | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL C CLARK | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 8155996361 | PhoneNum |
| Signature | 2022-08-29 | SignatureDt |
| Discuss With Paid Preparer | 0 | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL | PersonFirstNm |
| Person Last | CLARK | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
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 | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK S GRIDLEY CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1045 W STEPHENSON ST | AddressLine1Txt |
| City | FREEPORT | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $45,662,946 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FHN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1984 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES, WORKING TOGETHER WITH THOSE WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $4,001 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $240,463 | PYContributionsGrantsAmt |
| CY Contributions Grants | $586,449 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $41,040,786 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $44,460,933 | CYProgramServiceRevenueAmt |
| PY Investment Income | $250,648 | PYInvestmentIncomeAmt |
| CY Investment Income | $407,134 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,700 | PYOtherRevenueAmt |
| CY Other Revenue | -$53,619 | CYOtherRevenueAmt |
| PY Total Revenue | $41,530,197 | PYTotalRevenueAmt |
| CY Total Revenue | $45,400,897 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $37,202,957 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $40,857,948 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $219,852 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,845,239 | PYOtherExpensesAmt |
| CY Other Expenses | $29,092,617 | CYOtherExpensesAmt |
| PY Total Expenses | $65,048,196 | PYTotalExpensesAmt |
| CY Total Expenses | $69,950,565 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$23,517,999 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$24,549,668 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $44,158,955 | TotalAssetsBOYAmt |
| Total Assets EOY | $44,647,544 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $42,745,863 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $42,429,075 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,413,092 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,218,469 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,712,409 | ExpenseAmt |
| Revenue | $32,890,118 | RevenueAmt |
| Desc | FREEPORT REGIONAL HEALTH CARE FOUNDATION PROVIDES PHYSICIAN SERVICES TO PATIENTS IN FIVE NORTHWESTERN ILLINOIS COUNTIES. THE FOUNDATION ENSURES CONTINUED ACCESS TO CARE BY SERVING PATIENTS IN MEDICALLY UNDERSERVED AREAS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $27,916,959 | ExpenseAmt |
| Revenue | $12,414,278 | RevenueAmt |
| Desc | OTHER UNCOMPENSATED CARE: THE FOUNDATION IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELY 68% OF ITS PATIENTS BASE QUALIFYING FOR AT LEAST ON OF THESE PROGRAMS. AT PRESENT THE REIMBURSEMENT RATES OF THESE PROGRAMS DO NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THE ESTIMATED UNFUNDED COSTS OF THE SERVICES FOR MEDICARE AND MEDICAID PATIENTS WAS APPROXIMATELY $15,502,681 FOR THE YEAR ENDING 12/31/2021. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $161,550 | ExpenseAmt |
| Revenue | $96,501 | RevenueAmt |
| Desc | CHARITY CARE: THE FOUNDATION PROVIDED CARE BENEFITS UP TO 300% OF THE FEDERALLY DETERMINED PROVERTY LEVEL. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO APPROXIMATELY $161,550 IN 2021. ESTIMATED COSTS OF PROVIDING THESE SERVICES AMOUNTED TO APPROXIMATELY $96,501 IN 2021. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FHN OPERATES AND/OR SUPPORTS A VARIETY OF COMMUNITY BENEFIT PROGRAMS THAT INCLUDED BUT WERE NOT LIMITED TO THE FOLLOWING:COMMUNITY HEALTH EDUCATION PROGRAMS: AS PART OF FHN'S COMMITMENT TO PROVIDING HEALTH EDUCATION TO AREA COMMUNITIES, FHN PROVIDED NUMEROUS COMMUNITY EDUCATION EVENTS AND SCHOOL HEALTH PROGRAMS AND SUPPORT GROUP EVENTS. THE ESTIMATED DIRECT AND INDIRECT COSTS OF THESE PROGRAMS AND DEVELOPMENT OF RESOURCES WERE APPROXIMATELY $49,000.COMMUNITY-BASED CLINICAL SERVICES: AS PART OF FHN'S MISSION TO IMPROVE HEALTH, FHN AND THE STEPHENSON COUNTY HEALTH DEPARTMENT HAVE PARTNERED TO PROVIDE PRIMARY HEALTH CARE SERVICES TO ANYONE IN NEED OF MEDICAL CARE AT THE FHN COMMUNITY HEALTHCARE CENTER. APPROXIMATELY 3,000 PATIENT VISITS WERE PROVIDED IN 2021. SERVICES OFFERED INCLUDE DIAGNOSIS AND TREATMENT OF COMMON ACUTE ILLNESSES AS WELL AS MANAGEMENT OF CHRONIC HEALTH PROBLEMS, INCLUDING NURSE PRACTITIONER EXAMS AND CONSULTATIONS, LAB TESTS, X-RAYS AND HEALTH EDUCATION.FHN ALSO PROVIDED 8,138 HEALTH SCREENS AND SPORTS PHYSICALS, 500 HOURS OF CONDITIONING AND TRAINING SUPPORT AND SPORTS MEDICINE TRAINERS AT 54 EVENTS. THE ESTIMATED DIRECT AND INDIRECT COSTS OF THESE PROGRAMS WERE APPROXIMATELY $475,000.HEALTH CARE SUPPORT SERVICES: SINCE COMMUNITY MEMBERS MAY REQUIRE DIFFERENT TYPES OF ASSISTANCE, FHN PROVIDES INFORMATION AND REFERRAL SERVICES, TRANSLATION SERVICES AND TRANSPORTATION ASSISTANCE. THE ESTIMATED DIRECT AND INDIRECT COSTS OF THESE PROGRAMS WERE APPROXIMATELY $94,000. HEALTH PROFESSIONAL EDUCATION: FHN SUPPORTS THE TRAINING OF HEALTH CARE PROFESSIONALS BY PROVIDING SCHOLARSHIPS, CLINICAL SETTINGS AND SUPERVISION TO NON-FHN EMPLOYEES. THE ESTIMATED DIRECT AND INDIRECT COSTS OF THESE PROGRAMS WERE APPROXIMATELY $322,000.FINANCIAL CONTRIBUTIONS: FHN RECOGNIZES THE IMPORTANCE OF GIVING BACK TO THE COMMUNITY THROUGH CHARITABLE ORGANIZATION AND OTHERS INVOLVED IN PROMOTING HEALTH AND WELLNESS IN OUR COMMUNITY. IN 2021, FHN PROVIDED SUPPORT TO A NUMBER OF COMMUNITY GROUPS THROUGH DIRECT FINANCIAL CONTRIBUTIONS AND PROVIDING ROOMS OR STAFF TIME. THE ESTIMATED DIRECT AND INDIRECT COSTS OF THESE PROGRAMS WERE APPROXIMATELY $39,000.COMMUNITY-BUILDING ACTIVITIES: FHN VALUES THE CONTRIBUTIONS AND EFFORTS OF OTHER ORGANIZATIONS IN IMPROVING THE HEALTH OF OUR COMMUNITIES. AS SUCH, FHN PROVIDED FINANCIAL AND IN-KIND SUPPORT TO ASSIST OTHER LOCAL COMMUNITY DEVELOPMENT ORGANIZATIONS. THE ESTIMATED DIRECT AND INDIRECT COSTS OF THESE PROGRAMS WERE APPROXIMATELY $34,000. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $43,790,918 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| 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 | 0 | 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 | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | Yes (1) | 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
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMY RUNGREN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8155996940 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1045 WEST STEPHENSON STREET | AddressLine1Txt |
| City | FREEPORT | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| CAROL SCHUSTER | |||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| STEVEN KNEUBUEHL | |||||||||
| PAST CHAIRMAN | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| GARY QUINN | |||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| HEATHER MCPHERSON | |||||||||
| VICE CHAIRMAN | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| BRUCE BALDWIN | |||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| MARK WRIGHT | |||||||||
| TREASURER | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| NEAL RICHARDSON | |||||||||
| CHAIRMAN | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| RICH CHANG | |||||||||
| SECRETARY | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| SHOKRY TAWFIK MD | |||||||||
| DIRECTOR | 40.00 | Yes (X) | $136,690 | $0 | $28,875 | ||||
| GLENDA KOELLER | |||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| DAN SCHMITT | |||||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||||
| BETH KALNINS MD | |||||||||
| EMPLOYED PHYSICIAN | 40.00 | Yes (X) | $248,491 | $0 | $35,530 | ||||
| MARK S GRIDLEY | |||||||||
| PRESIDENT & CEO | 14.00 | $206,052 | $350,846 | $55,586 | 26.00 | Yes (X) | |||
| MICHAEL CLARK | |||||||||
| EXECUTIVE VP & CFO | 14.00 | $119,708 | $203,827 | $53,509 | 26.00 | Yes (X) | |||
| LEONARD M CARTER | |||||||||
| VP - HUMAN RESOURCES | 14.00 | $82,006 | $139,632 | $35,627 | 26.00 | Yes (X) | |||
| ROBERT GELLER MD | |||||||||
| PRESIDENT MEDICAL STAFF | 40.00 | $355,811 | $0 | $26,330 | Yes (X) | ||||
| REBECCA PEDERSEN MD | |||||||||
| CHIEF QUALITY CONTROL | 40.00 | $376,988 | $0 | $32,311 | Yes (X) | ||||
| TIMOTHY JESSEN MD | |||||||||
| CHAIR PHYSICIAN COUNCIL | 40.00 | $278,059 | $0 | $50,204 | Yes (X) | ||||
| KATHRYN MARTINEZ | |||||||||
| CNO/COO | 0.00 | $0 | $241,411 | $45,940 | 40.00 | Yes (X) | |||
| TIMOTHY LAURIE MD | |||||||||
| PHYSICIAN | 40.00 | $1,008,598 | $0 | $41,372 | Yes (X) | ||||
| GREGORY DAMMANN MD | |||||||||
| PHYSICIAN | 40.00 | $825,312 | $0 | $39,183 | Yes (X) | ||||
| MADHUSUDAN R MALLADI MD | |||||||||
| PHYSICIAN | 40.00 | $663,950 | $0 | $54,434 | Yes (X) | ||||
| TERRY MILLER MD | |||||||||
| PHYSICIAN | 40.00 | $520,336 | $0 | $42,784 | Yes (X) | ||||
| FARHAN KHAN MD | |||||||||
| PHYSICIAN | 40.00 | $507,306 | $0 | $22,860 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,329,307 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $935,716 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $564,545 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 55 | 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 |
|---|---|---|---|---|---|
| LABORATORY CORPORATION OF AMERICA | |||||
| 1447 YORK CT | BURLINTON | NC | 27216 | LAB SERVICES | $792,193 |
| NORTHERN ILLINOIS TRAUMA | |||||
| 1235 NORTH MULFORD STE 103 | ROCKFORD | IL | 61107 | PHYSICIAN SERVICES | $735,764 |
| CAMELOT RADIOLOGY ASSOCIATES LTD | |||||
| 3849 N PERRYVILLE ROAD | ROCKFORD | IL | 61108 | PHYSICIAN SERVICES | $219,915 |
| EXCALIBUR DDPM | |||||
| 2829 NAVE SUITE 101 | GRAND JUNCTION | CO | 81501 | COLLECTION SERVICES | $216,355 |
| ROCKFORD UROLOGICAL | |||||
| 351 EXECUTIVE PARKWAY | ROCKFORD | IL | 61107 | PHYSICIAN SERVICES | $183,344 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $586,449 | AllOtherContributionsAmt |
| Total Contributions | $586,449 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERV. REVENUE | 621400 | $23,277,118 | $23,273,117 | $4,001 |
| CORPORATE ALLOCATION | 621400 | $19,218,137 | $19,218,137 | |
| OTHER MISC. REVENUE | 621400 | $1,201,997 | $1,201,997 | |
| GOVERNMENT PAYMENT | 621400 | $763,681 | $763,681 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $44,460,933 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $407,138 | TotalRevenueColumnAmt |
| Exclusion | $407,138 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $145,273 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $262,045 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$116,772 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$116,772 | TotalRevenueColumnAmt |
| Exclusion | -$116,772 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $4 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$4 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$4 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $63,153 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $63,153 | TotalRevenueColumnAmt |
| Exclusion | $63,153 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,400,897 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $44,456,928 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $4,001 | UnrelatedBusinessRevenueAmt |
| Exclusion | $353,519 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,030,602 | TotalAmt |
| Program Services | $1,569,289 | ProgramServicesAmt |
| Management And General | $461,313 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,028,786 | TotalAmt |
| Program Services | $24,032,181 | ProgramServicesAmt |
| Management And General | $6,851,640 | ManagementAndGeneralAmt |
| Fundraising | $144,965 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,934,243 | TotalAmt |
| Program Services | $484,720 | ProgramServicesAmt |
| Management And General | $5,449,523 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,864,317 | TotalAmt |
| Program Services | $1,371,736 | ProgramServicesAmt |
| Management And General | $482,043 | ManagementAndGeneralAmt |
| Fundraising | $10,538 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,806 | TotalAmt |
| Management And General | $192,806 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $631,122 | TotalAmt |
| Management And General | $631,122 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $996,701 | TotalAmt |
| Management And General | $996,701 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $490,466 | TotalAmt |
| Program Services | $242,985 | ProgramServicesAmt |
| Management And General | $247,481 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,402 | TotalAmt |
| Program Services | $32,028 | ProgramServicesAmt |
| Management And General | $22,374 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,666 | TotalAmt |
| Program Services | $188,089 | ProgramServicesAmt |
| Management And General | $28,350 | ManagementAndGeneralAmt |
| Fundraising | $227 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,017,226 | TotalAmt |
| Management And General | $1,017,226 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,549,538 | TotalAmt |
| Program Services | $790,526 | ProgramServicesAmt |
| Management And General | $1,753,209 | ManagementAndGeneralAmt |
| Fundraising | $5,803 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,447,081 | TotalAmt |
| Program Services | $959,609 | ProgramServicesAmt |
| Management And General | $487,472 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CORPORATE ALLOCATION | $5,313,476 | $5,313,476 | ||
| CONTRACTED SERVICES | $4,864,822 | $1,481,249 | $3,373,487 | $10,086 |
| DRUGS | $3,148,309 | $1,912,280 | $1,236,029 | |
| MEDICAL SPECIALIST | $2,587,069 | $2,587,069 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,582,933 | TotalAmt |
| Program Services | $2,825,681 | ProgramServicesAmt |
| Management And General | $2,709,019 | ManagementAndGeneralAmt |
| Fundraising | $48,233 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,950,565 | TotalAmt |
| Program Services | $43,790,918 | ProgramServicesAmt |
| Management And General | $25,939,795 | ManagementAndGeneralAmt |
| Fundraising | $219,852 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,636,667 | BOYAmt |
| EOY | $1,831,216 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,328,373 | BOYAmt |
| EOY | $3,416,944 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,119,654 | BOYAmt |
| EOY | $2,066,591 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $57,046,387 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $37,444,179 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,989,121 | BOYAmt |
| EOY | $19,602,208 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,652,811 | BOYAmt |
| EOY | $2,937,174 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,042,857 | BOYAmt |
| EOY | $2,387,033 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,639,282 | BOYAmt |
| EOY | $1,639,282 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,750,190 | BOYAmt |
| EOY | $10,767,096 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,158,955 | BOYAmt |
| EOY | $44,647,544 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,548,234 | BOYAmt |
| EOY | $5,323,924 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,370,000 | BOYAmt |
| EOY | $32,370,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,827,629 | BOYAmt |
| EOY | $4,735,151 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,745,863 | BOYAmt |
| EOY | $42,429,075 | 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 | -$1,655,279 | BOYAmt |
| EOY | -$1,134,314 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,068,371 | BOYAmt |
| EOY | $3,352,783 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,413,092 | BOYAmt |
| EOY | $2,218,469 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,158,955 | BOYAmt |
| EOY | $44,647,544 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$24,549,668 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $463,606 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $24,891,439 | 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) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREEPORT MEMORIAL HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362181997 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (1) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (1) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | 0 | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | 0 | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | 0 | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | 0 | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | 0 | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | 0 | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | 0 | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | 0 | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | 0 | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | 0 | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | 0 | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Majority Dir Trst Supported Org | Yes (1) | MajorityDirTrstSupportedOrgInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,817,072 | OtherCostOrOtherBasisAmt |
| Book Value | $4,817,072 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,737,385 | OtherCostOrOtherBasisAmt |
| Depreciation | $26,464,508 | DepreciationAmt |
| Book Value | $12,272,877 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,380,763 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,979,671 | DepreciationAmt |
| Book Value | $2,401,092 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $111,167 | OtherCostOrOtherBasisAmt |
| Book Value | $111,167 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $19,602,208 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $2,387,033 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,387,033 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp (9 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ADVANCES TO MEMORIAL ENTERPRISES | $39,743 |
| ASSETS WHOSE USE IS LIMITED | $3,906,652 |
| DEFERRED COMPENSATION PLAN ASSETS | $3,090,807 |
| DEFFERED BOND COST | $250,967 |
| DUE FROM JAHS | $236,749 |
| DUE FROM JANE ADDAMS | $1,390,495 |
| DUE FROM NIHA | -$1,154 |
| DUE FROM PHYSICIANS | $71,320 |
| INVESTMENT IN TRI-RIVERS | $1,781,517 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,767,096 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| ASBESTOS ASSET RETIREMENT OBLIGATION | $210,587 |
| DEFERRED COMPENSATION PLAN LIABILITY 457 | $3,090,807 |
| GIFT ANNUITY LIABILITY | $254,553 |
| INTERCOMPANY PAYABLE | -$44,148 |
| MALPRACTICE LIABILITY CURRENT | $122,335 |
| MALPRACTICE LIABILITY LONGTERM | $1,101,017 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,735,151 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | PARTNERS IN GIVING | Event1Nm |
| Gross Receipts Event1 | $63,153 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $63,153 | GrossRevenueEvent1Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Total | $63,153 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $63,153 | GrossRevenueTotalEventsAmt |
| Net Income Summary | $63,153 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 | Yes (1) | 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHOKRY TAWFIK MD | ||||||||||||||
| DIRECTOR | $121,983 | $0 | $0 | $0 | $14,707 | $0 | $0 | $0 | $28,875 | $0 | $165,565 | $0 | $0 | $0 |
| BETH KALNINS MD | ||||||||||||||
| EMPLOYED PHYSICIAN | $237,646 | $0 | $0 | $0 | $10,845 | $0 | $0 | $0 | $35,530 | $0 | $284,021 | $0 | $0 | $0 |
| MARK S GRIDLEY | ||||||||||||||
| PRESIDENT & CEO | $184,658 | $314,418 | $0 | $0 | $21,394 | $36,428 | $7,215 | $12,285 | $13,352 | $22,734 | $226,619 | $385,865 | $0 | $0 |
| MICHAEL CLARK | ||||||||||||||
| EXECUTIVE VP & CFO | $102,278 | $174,149 | $0 | $0 | $17,430 | $29,678 | $7,215 | $12,285 | $12,583 | $21,426 | $139,506 | $237,538 | $0 | $0 |
| LEONARD M CARTER | ||||||||||||||
| VP - HUMAN RESOURCES | $73,320 | $124,842 | $0 | $0 | $8,686 | $14,790 | $0 | $0 | $13,182 | $22,445 | $95,188 | $162,077 | $0 | $0 |
| ROBERT GELLER MD | ||||||||||||||
| PRESIDENT MEDICAL STAFF | $322,539 | $0 | $0 | $0 | $33,272 | $0 | $0 | $0 | $26,330 | $0 | $382,141 | $0 | $0 | $0 |
| REBECCA PEDERSEN MD | ||||||||||||||
| CHIEF QUALITY CONTROL | $366,522 | $0 | $0 | $0 | $10,466 | $0 | $0 | $0 | $32,311 | $0 | $409,299 | $0 | $0 | $0 |
| TIMOTHY JESSEN MD | ||||||||||||||
| CHAIR PHYSICIAN COUNCIL | $251,920 | $0 | $0 | $0 | $26,139 | $0 | $17,524 | $0 | $32,680 | $0 | $328,263 | $0 | $0 | $0 |
| KATHRYN MARTINEZ | ||||||||||||||
| CNO/COO | $0 | $239,481 | $0 | $0 | $0 | $1,930 | $0 | $14,610 | $0 | $31,330 | $0 | $287,351 | $0 | $0 |
| TIMOTHY LAURIE MD | ||||||||||||||
| PHYSICIAN | $965,377 | $0 | $0 | $0 | $43,221 | $0 | $38,012 | $0 | $3,360 | $0 | $1,049,970 | $0 | $0 | $0 |
| GREGORY DAMMANN MD | ||||||||||||||
| PHYSICIAN | $739,721 | $0 | $0 | $0 | $85,591 | $0 | $26,000 | $0 | $13,183 | $0 | $864,495 | $0 | $0 | $0 |
| MADHUSUDAN R MALLADI MD | ||||||||||||||
| PHYSICIAN | $551,427 | $0 | $0 | $0 | $112,523 | $0 | $44,018 | $0 | $10,416 | $0 | $718,384 | $0 | $0 | $0 |
| TERRY MILLER MD | ||||||||||||||
| PHYSICIAN | $487,669 | $0 | $0 | $0 | $32,667 | $0 | $26,000 | $0 | $16,784 | $0 | $563,120 | $0 | $0 | $0 |
| FARHAN KHAN MD | ||||||||||||||
| PHYSICIAN | $500,011 | $0 | $0 | $0 | $7,295 | $0 | $19,500 | $0 | $3,360 | $0 | $530,166 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | FREEPORT REGIONAL HEALTH CARE FOUNDATION REIMBURSED A DIRECTOR/TRUSTEE FOR BUSINESS TRAVEL EXPENSES INCLUDING TRAVEL EXPENSES FOR A SPOUSE. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| CITY OF FREEPORT | ||||||||
| A | 366005886 | NONEAVAIL | 2001-06-20 | $13,300,000 | CAPITAL EXPENDITURES | 0 | 0 | 0 |
| CITY OF FREEPORT | ||||||||
| B | 366005886 | NONEAVAIL | 2008-06-30 | $8,000,000 | CAPITAL EXPENDITURES | 0 | 0 | 0 |
| STEPHENSON COUNTY IL | ||||||||
| C | 366006654 | NONEAVAIL | 2008-06-11 | $10,000,000 | CAPITAL EXPENDITURES | 0 | 0 | 0 |
| ILLINOIS FINANCE AUTHORITY 2014A | ||||||||
| D | 363290904 | NC31317C1 | 2014-02-26 | $11,412,000 | CAPITAL EXPENDITURES | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceedsAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|
| A | $13,300,000 | $266,000 | $13,300,000 | 0 | 0 | Yes (1) | Yes (1) |
| B | $8,000,000 | $125,000 | $8,000,000 | 0 | 0 | Yes (1) | Yes (1) |
| C | $10,000,000 | $170,000 | $10,000,000 | 0 | 0 | Yes (1) | Yes (1) |
| D | $11,412,000 | $366,548 | $11,412,000 | 0 | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| C | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
| D | 0 | 0 | 0 | 0 | 0 | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 |
| B | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 |
| C | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 |
| D | 0 | 0 | Yes (1) | 0 | 0 | 0 | 0 | 0 | 0 |
Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
| D | Yes (1) |
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 | ILLINOIS FINANCE AUTHORITY 2014B | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 363290904 | BondIssuerEIN |
| CUSIP | NC31315C1 | CUSIPNum |
| Bond Issued | 2014-02-26 | BondIssuedDt |
| Issue Price | $11,412,000 | IssuePriceAmt |
| Purpose | CAPITAL EXPENDITURES | 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 |
| Total Proceeds | $11,412,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $366,548 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $11,412,000 | CapitalExpendituresAmt |
| 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 | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| 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 | 0 | RebateNotDueYetInd |
| Exception To Rebate | Yes (1) | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | 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 | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1 | FHN IS A REGIONAL HEALTHCARE SYSTEM COMMITTED TO THE HEALTH AND WELL-BEING OF THE PEOPLE OF NORTHWEST ILLINOIS AND SOUTHERN WISCONSIN. WE HAVE SERVICES NEARBY FOR ALL AGES, SO EVERY MEMBER OF YOUR FAMILY CAN RECEIVE CARING, PERSONAL, PROFESSIONAL HEALTHCARE. AN AVERAGE OF 1,400 PEOPLE VISIT FHN EACH DAY FOR THEIR HEALTHCARE NEEDS (THAT'S MORE THAN 525,000 PATIENT VISITS PER YEAR). FHN IS THE ONLY HEALTHCARE PROVIDER IN OUR SERVICE AREA THAT OFFERS AFFILIATIONS WITH ALL THREE MAJOR HOSPITALS IN ROCKFORD, ILLINOIS, AS WELL AS WITH THE UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS IN MADISON, WISCONSIN. WE SEE EACH PATIENT INTERACTION AS A SERIOUS RESPONSIBILITY THAT REQUIRES CLINICAL EXPERTISE, ACCESS TO THE LATEST IN MEDICAL TECHNOLOGY AND A LEVEL OF TRUST AND COMMITMENT THAT IS EARNED BY OUR PEOPLE, OUR PRODUCTS AND OUR PROCESSES. THE FHN HEALTHCARE SYSTEM ENCOMPASSES: FHN MEMORIAL HOSPITAL, LOCATED IN FREEPORT, ILLINOIS OVER 100 MEDICAL AND ALLIED HEALTH STAFF OVER 39 SPECIALTIES 11 REGIONAL LOCATIONS IN SIX COUNTIES 4 FAMILY HEALTHCARE LOCATIONS IN FREEPORT 3 SPECIALTY CARE LOCATIONS IN FREEPORT FHN LEONARD C. FERGUSON CANCER CENTER FHN FAMILY COUNSELING CENTER OCCUPATIONAL HEALTH SERVICES HOSPICE CHIROPRACTIC CARE AND ACUPUNCTURE NORTHERN ILLINOIS HEALTH PLAN SERVING MORE THAN 17,000 INDIVIDUAL MEMBERS. FHN CONSISTENTLY RANKS HIGHER THAN THE NATIONAL AVERAGE WHEN IT COMES TO PATIENT SATISFACTION, AND WE CONTINUALLY SET EXTREMELY DEMANDING GOALS IN THIS AREA. FHN ALSO IS DEDICATED TO EMPLOYEE SATISFACTION, WHICH HELPS US ATTRACT A TALENTED AND DEDICATED WORKFORCE AND MAINTAIN A LOW EMPLOYEE TURNOVER RATE. WE'RE A PART OF YOUR COMMUNITY. AND WE WANT TO KEEP IT HEALTHY, BOTH ECONOMICALLY AND PHYSICALLY AT WORK, AT PLAY, ON THE FARM, AT SCHOOL AND AT HOME. IN 2006, WE FORMED A PARTNERSHIP WITH THE STEPHENSON COUNTY HEALTH DEPARTMENT TO PROVIDE HEALTHCARE SERVICES FOR THE UNINSURED, UNDERINSURED AND MEDICALLY INDIGENT AT THE FHN COMMUNITY HEALTHCARE CENTER, LOCATED AT THE FORMER CRUSADER COMMUNITY CLINIC INSIDE THE HEALTH DEPARTMENT BUILDING. AND IN SUPPORT OF THE LOCAL UNITED WAY, EACH YEAR OUR EMPLOYEES MAKE THEIR PERSONAL CONTRIBUTIONS, AVERAGING OVER $40,000, AND ALSO SERVE IN LEADERSHIP POSITIONS FOR MANY COMMUNITY ORGANIZATIONS AND BOARDS. FHN IS A COMMUNITY HEALTHCARE SYSTEM, COMPRISED OF LOCAL EXPERTS, INSPIRED BY GLOBAL INNOVATION AND GROUNDED BY ETHICAL LEADERSHIP. AS YOUR PARTNER IN HEALTH, YOU CAN COUNT ON US TO FOCUS ON YOUR WELL-BEING AND FURNISH YOU WITH EXCEPTIONAL HEALTHCARE EVERY STEP OF THE WAY. FREEPORT REGIONAL HEALTH CARE FOUNDATION PROVIDES MEDICALLY NECESSARY CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY AND IN MEDICALLY UNDERSERVED AREAS. INSURED AND UNDERINSURED PATIENTS, WHO MEET CERTAIN FEDERAL POVERTY GUIDELINES AND/OR OTHER UNIQUE CIRCUMSTANCES, ARE PROVIDED FREE OR DISCOUNTED CARE AFTER A NOMINAL CO-PAYMENT. BECAUSE THE FOUNDATION DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE FOUNDATION MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. DURING 2021, THE CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THE FOUNDATION'S CHARITY CARE POLICY WAS $161,550 AT A COST OF $96,501. FREEPORT REGIONAL HEALTH CARE FOUNDATION IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELY 68% OF ITS PATIENT BASE QUALIFYING FOR AT LEAST ONE OF THESE PROGRAMS. AT PRESENT, THE REIMBURSEMENT RATES FOR BOTH PROGRAMS DO NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THE ESTIMATED UNFUNDED COSTS OF SERVICES FOR MEDICAID PATIENTS WERE APPROXIMATELY $4,472,853 FOR THE YEAR ENDING 12/31/2021. MEDICARE PAYMENTS WERE APPROXIMATELY $11,029,828 LESS THAN THE FOUNDATION'S COST TO PROVIDE CARE DURING THE SAME PERIOD. IN ADDITION, THE COST OF CARE PROVIDED TO PEOPLE WHO DID NOT PAY WAS $534,611 IN 2021. FREEPORT REGIONAL HEALTH CARE FOUNDATION PROVIDES DISCOUNTS TO UNINSURED PATIENTS WITHOUT REGARD TO THEIR INCOME. FOR 2021 THESE DISCOUNTS TOTALED $123,477. THE ESTIMATED COSTS ATTRIBUTABLE TO THE DISCOUNTED PORTION OF THESE SERVICES WERE $82,853 FOR 2021. FREEPORT REGIONAL HEALTH CARE FOUNDATION AND THE STEPHENSON COUNTY HEALTH DEPARTMENT HAVE PARTNERED TO PROVIDE PRIMARY HEALTH CARE SERVICES TO ANYONE IN NEED OF MEDICAL CARE AT THE FHN COMMUNITY HEALTHCARE CENTER. SERVICES OFFERED INCLUDE: DIAGNOSIS AND TREATMENT OF COMMON, ACUTE ILLNESSES AS WELL AS MANAGEMENT OF CHRONIC HEALTH PROBLEMS, INCLUDING NURSE PRACTITIONER EXAMS AND CONSULTING LAB TESTS, X-RAYS, AND HEALTH EDUCATION. THE ESTIMATED DIRECT AND INDIRECT COSTS OF THIS PROGRAM IN 2021 WERE $377,536. FREEPORT REGIONAL HEALTH CARE FOUNDATION AND ITS RELATED ORGANIZATIONS SUPPORT AND PARTICIPATE IN MANY COMMUNITY SERVICES AND OUTREACH PROGRAMS, INCLUDING SUPPORT FOR COMMUNITY HEALTH EDUCATION PROGRAMS, COMMUNITY-BASED CLINICAL SERVICES, HEALTH PROFESSIONAL EDUCATION, RESEARCH, SPONSORSHIP OF COMMUNITY EVENTS, AND COMMUNITY-BUILDING ACTIVITIES. THE FOUNDATION, IN COMBINATION WITH ITS RELATED ORGANIZATIONS, CONTRIBUTED $423,800 TOWARDS THESE PROGRAMS. PROGRAM SERVICE EXPENSES: $43,790,918. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE FORM 990 BEFORE THE TAX RETURN IS FILED. QUESTIONS AND EXPLANATIONS ARE ANSWERED BY THE FINANCE DEPARTMENT TO THE BOARD'S SATSIFACTION. THE BOARD REVIEWS ALL TRANSACTIONS THAT AFFECT THE FILING OF THE ORGANIZATION'S FORM 990 AND EQUIVALENT STATE RETURNS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A DEDICATED CORPORATE COMPLIANCE OFFICER. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE. THESE DOCUMENTS ARE REVIEWED BY THE CCO TO DETERMINE IF ANY INDIVIDUAL HAS A CONFLICT OF INTEREST THAT NEEDS TO BE ADDRESSED. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT REVIEWS THE CEO, TOP MANAGEMENT AND EXECUTIVE DIRECTORS COMPENSATION. THE COMMITTEE RELIES ON INTERNAL AND EXTERNAL INFORMATION TO DETERMINE THE APPROPRIATE COMPENSATION AND EMPLOYS AN INDEPENDENT THIRD PARTY TO CONDUCT THE ANNUAL EXECUTIVE COMPENSATION ANALYSIS. THIS ANALYSIS IS USED TO DETERMINE IF THE BOARD'S WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY HAS BEEN MET. THE EXECUTIVE COMPENSATION COMMITTEE ALSO RECEIVES A REASONABLENESS LETTER FROM THE THIRD PARTY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. |
| FORM 990, PART XI, LINE 9: | TRANSFER FROM AFFILIATE FMH 24,565,093. ASSETS RELEASED FROM TEMP RESTRICTED -116,512. INVESTMENT INCOME TEMP RESTRICTED 150,019. CONTRIBUTIONS AND OTHER PERM RESTRICTED 17,556. NET APPROPRIATION RESTRICTED 233,349. NET APPROPRIATION TEMP. NON-RESTRICTED 32,893. INVESTMENT INCOME NON-RESTRICTED 9,041. |
| PART XLL LINE 2C | NO CHANGES HAVE BEEN MADE O THE SELECTION PROCESS TO SELECT THE INDEPENDENT AUDITOR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| FREEPORT MEMORIAL HOSPITAL | ||||||||||
| 1045 WEST STEPHENSON STREET | FREEPORT | IL | 61032 | 362181997 | HEALTH CARE | IL | 501(C)(3) | LINE 3 | FREEPORT REGIONAL HEALTH CARE FOUNDATION | 0 |
| FREEPORT REGIONAL MANAGEMENT SERVICES | ||||||||||
| 1045 WEST STEPHENSON STREET | FREEPORT | IL | 61032 | 363994636 | HEALTH CARE | IL | 501(C)(3) | LINE 3 | FREEPORT REGIONAL HEALTH CARE FOUNDATION | 0 |
| FREEPORT REGIONAL HEALTHCARE SERVICES | ||||||||||
| 1045 WEST STEPHENSON STREET | FREEPORT | IL | 61032 | 363967303 | HEALTH CARE | IL | 501(C)(3) | LINE 3 | FREEPORT REGIONAL HEALTH CARE FOUNDATION | 0 |
| JANE ADDAMS INC | ||||||||||
| 1045 WEST STEPHENSON STREET | FREEPORT | IL | 61032 | 362879689 | HEALTH CARE | IL | 501(C)(3) | LINE 7 | FREEPORT REGIONAL HEALTH CARE FOUNDATION | 0 |
| JANE ADDAMS HEALTHCARE SERVICES INC | ||||||||||
| 1045 WEST STEPHENSON STREET | FREEPORT | IL | 61032 | 363677357 | HEALTH CARE | IL | 501(C)(3) | LINE 11 | FREEPORT REGIONAL HEALTH CARE FOUNDATION | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEMORIAL ENTERPRISES INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1045 WEST STEPHENSON STREET | AddressLine1Txt |
| City | FREEPORT | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61032 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363353871 | EIN |
| Primary Activities | HEALTH CARE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FREEPORT REGIONAL HEALTH CARE FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | 0 | 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 | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | 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 | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |