FERRELL HOSPITAL COMMUNITY FOUNDATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- FERRELL HOSPITAL COMMUNITY FOUNDATION (EIN 20-1244058)
- Tax period
- 2020-04-01 to 2021-03-31
- Filed
- 2022-02-15
- IRS object ID
- 202230469349301953
- Schema version
- 2020v4.2
- 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 C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-02-15T11:49:32-06:00 | ReturnTs |
| Tax Period End | 2021-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 351178661 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE & CO LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2650 EASTPOINT PKWY SUITE 300 | AddressLine1Txt |
| City | LOUISVILLE | CityNm |
| State Abbreviation | KY | StateAbbreviationCd |
| ZIP | 40223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201244058 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FERRELL HOSPITAL COMMUNITY FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FERR | BusinessNameControlTxt |
| Phone | 6182733361 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 PINE STREET | AddressLine1Txt |
| City | ELDORADO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62930 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DIRK MORGAN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6182733361 | PhoneNum |
| Signature | 2022-02-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DIRK | PersonFirstNm |
| Person Last | MORGAN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CARRIE A MERRILL CPA | PreparerPersonNm |
| PTIN | P00832283 | PTIN |
| Phone | 5029923500 | PhoneNum |
| Preparation | 2022-02-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DIRK MORGAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 PINE STREET | AddressLine1Txt |
| City | ELDORADO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62930 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $31,549,796 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FERRELLHOSP.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | OPERATE ACUTE CARE HOSPITAL - DEDICATED TO IMPROVING THE HEALTH AND QUALITY OF LIFE FOR THE PEOPLE AND COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 327 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $688,360 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,554,106 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $26,187,043 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $26,789,321 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,766 | PYInvestmentIncomeAmt |
| CY Investment Income | $20,316 | CYInvestmentIncomeAmt |
| PY Other Revenue | $185,850 | PYOtherRevenueAmt |
| CY Other Revenue | $186,053 | CYOtherRevenueAmt |
| PY Total Revenue | $27,081,019 | PYTotalRevenueAmt |
| CY Total Revenue | $31,549,796 | 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 | $14,421,491 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,876,140 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $12,843,172 | PYOtherExpensesAmt |
| CY Other Expenses | $14,624,895 | CYOtherExpensesAmt |
| PY Total Expenses | $27,264,663 | PYTotalExpensesAmt |
| CY Total Expenses | $29,501,035 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$183,644 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,048,761 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,980,464 | TotalAssetsBOYAmt |
| Total Assets EOY | $53,152,353 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,067,017 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $47,514,318 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,913,447 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,638,035 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OPERATE ACUTE CARE HOSPITAL - DEDICATED TO IMPROVING THE HEALTH AND QUALITY OF LIFE FOR THE PEOPLE AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $25,689,742 | ExpenseAmt |
| Revenue | $26,926,907 | RevenueAmt |
| Desc | FERRELL HOSPITAL COMMUNITY FOUNDATION (FHCF) OFFERS QUALITY HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. FHCF PROVIDES MEDICAL CARE TO OUTPATIENTS AND INPATIENTS AS WELL AS PROVIDES VARIOUS COMMUNITY BENEFITS TO THE COMMUNITY. | Desc |
| Total Program Service Expenses | $25,689,742 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 327 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | DIRK MORGAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6182733361 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 PINE STREET | AddressLine1Txt |
| City | ELDORADO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62930 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| CLIFFORD EUGENE MORRIS | |||||||
| CHAIRMAN | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| E T SEELY | |||||||
| VICE-CHAIRMAN | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| BARB DEVOUS | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| NATE OLDHAM MD | |||||||
| BOARD MEMBER/PHYSICIAN | 40.00 | Yes (X) | $420,015 | $0 | $19,926 | ||
| JEFF CAMPBELL | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| AYN BARTIK | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| NIKKI ROSER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JARED FLORENCE | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DR JAMES PORTER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| AUSTIN RAHMOELLER | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RACHEL PRATHER | |||||||
| CHIEF NURSING OFFICER | 40.00 | $90,680 | $0 | $15,484 | Yes (X) | ||
| CALEIGH BRUCE | |||||||
| CHIEF COMPLIANCE OFFICER | 40.00 | $80,128 | $0 | $2,826 | Yes (X) | ||
| ALISA COLEMAN | |||||||
| CEO | 50.00 | $0 | $0 | $0 | Yes (X) | ||
| DIRK MORGAN | |||||||
| CFO | 50.00 | $0 | $0 | $0 | Yes (X) | ||
| JOSEPH A JACKSON MD | |||||||
| PHYSICIAN | 40.00 | $508,303 | $0 | $20,112 | Yes (X) | ||
| JANNA PATHI MD | |||||||
| SURGEON | 30.00 | $451,638 | $0 | $6,480 | Yes (X) | ||
| LUKE HALL | |||||||
| PHYSICIAN | 40.00 | $265,653 | $0 | $15,507 | Yes (X) | ||
| CALEB MITCHELL DO | |||||||
| PHYSICIAN | 40.00 | $277,050 | $0 | $21,113 | Yes (X) | ||
| CARY HANNI | |||||||
| SURGEON | 40.00 | $176,361 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,269,828 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $101,448 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | 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 |
|---|---|---|---|---|---|
| DEACONESS REGIONAL HEALTHCARE SERVICES | |||||
| 600 MARY ST | EVANSVILLE | IN | 47747 | ER PHYSICIANS, MANAGEMENT FEES | $1,714,665 |
| CROSSROADS EMERGENCY PHYSICIANS | |||||
| PO BOX 677979 | DALLAS | TX | 75267 | ER PHYSICIANS | $1,556,401 |
| BLUE CROSS BLUE SHIELD | |||||
| 300 EAST RANDOLPH ST | CHICAGO | IL | 606015099 | MEDICAL PLAN | $1,100,377 |
| PROGRESSIVE HEALTH OF INDIANA LLC | |||||
| PO BOX 6890 | EVANSVILLE | IN | 47719 | PHYSICAL AND OCCUPATIONAL THERAPIST | $566,517 |
| SYSTEMS SOLUTIONS | |||||
| 110 CARLISLE COURT | PADUCAH | KY | 42001 | INFORMATION TECHNOLOGY SYSTEMS | $393,498 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $69,301 | FundraisingAmt |
| Government Grants | $4,292,892 | GovernmentGrantsAmt |
| All Other Contributions | $191,913 | AllOtherContributionsAmt |
| Total Contributions | $4,554,106 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $24,043,284 | $24,043,284 |
| 340B INCOME | 621110 | $2,746,037 | $2,746,037 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $26,789,321 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,316 | TotalRevenueColumnAmt |
| Exclusion | $20,316 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,120 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,120 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,120 | TotalRevenueColumnAmt |
| Exclusion | $9,120 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $69,301 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| REBATES AND MISCELLANEOUS INCOME | 900099 | $137,586 | $137,586 | |
| EMPLOYEE CAFETERIA | 722210 | $39,347 | $39,347 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $176,933 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,549,796 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $26,926,907 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $68,783 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $189,118 | TotalAmt |
| Program Services | $156,476 | ProgramServicesAmt |
| Management And General | $32,642 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,583,537 | TotalAmt |
| Program Services | $10,411,618 | ProgramServicesAmt |
| Management And General | $2,171,919 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,755 | TotalAmt |
| Program Services | $137,317 | ProgramServicesAmt |
| Management And General | $26,438 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,116,220 | TotalAmt |
| Program Services | $936,010 | ProgramServicesAmt |
| Management And General | $180,210 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $823,510 | TotalAmt |
| Program Services | $690,557 | ProgramServicesAmt |
| Management And General | $132,953 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,020,000 | TotalAmt |
| Program Services | $856,800 | ProgramServicesAmt |
| Management And General | $163,200 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,542,849 | TotalAmt |
| Program Services | $6,327,554 | ProgramServicesAmt |
| Management And General | $215,295 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,015 | TotalAmt |
| Management And General | $79,015 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $565,771 | TotalAmt |
| Program Services | $430,302 | ProgramServicesAmt |
| Management And General | $135,469 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500,380 | TotalAmt |
| Program Services | $386,524 | ProgramServicesAmt |
| Management And General | $113,856 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,417 | TotalAmt |
| Program Services | $78,533 | ProgramServicesAmt |
| Management And General | $884 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,782 | TotalAmt |
| Program Services | $357,259 | ProgramServicesAmt |
| Management And General | $44,523 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,212,910 | TotalAmt |
| Program Services | $761,489 | ProgramServicesAmt |
| Management And General | $451,421 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $215,310 | TotalAmt |
| Program Services | $155,386 | ProgramServicesAmt |
| Management And General | $59,924 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUG | $2,814,351 | $2,814,351 | |
| PROVIDER TAX | $558,609 | $558,609 | |
| FOOD | $127,577 | $126,157 | $1,420 |
| DUES & SUBSCRIPTIONS | $79,115 | $78,235 | $880 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $427,809 | TotalAmt |
| Program Services | $426,565 | ProgramServicesAmt |
| Management And General | $1,244 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,501,035 | TotalAmt |
| Program Services | $25,689,742 | ProgramServicesAmt |
| Management And General | $3,811,293 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,138,993 | BOYAmt |
| EOY | $2,139,158 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $993,853 | BOYAmt |
| EOY | $12,619,462 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,340,595 | BOYAmt |
| EOY | $1,789,306 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $289,480 | BOYAmt |
| EOY | $519,435 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,761 | BOYAmt |
| EOY | $309,162 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $40,413,619 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,863,140 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,837,117 | BOYAmt |
| EOY | $32,550,479 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,884,310 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,278,355 | BOYAmt |
| EOY | $3,225,351 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,980,464 | BOYAmt |
| EOY | $53,152,353 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,124,158 | BOYAmt |
| EOY | $7,423,527 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,381,563 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,977,364 | BOYAmt |
| EOY | $30,106,133 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,965,495 | BOYAmt |
| EOY | $3,603,095 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,067,017 | BOYAmt |
| EOY | $47,514,318 | 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 | $4,913,447 | BOYAmt |
| EOY | $5,638,035 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,913,447 | BOYAmt |
| EOY | $5,638,035 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,980,464 | BOYAmt |
| EOY | $53,152,353 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,048,761 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$1,324,173 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | 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 | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $10,099 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,099 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS DUES TO IHA AND AHA ANNUALLY. 37% AND 25.56% OF THESE DUES ARE USED FOR LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $188,327 | OtherCostOrOtherBasisAmt |
| Book Value | $188,327 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,422,664 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,077,561 | DepreciationAmt |
| Book Value | $7,345,103 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,892 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,956 | DepreciationAmt |
| Book Value | $936 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,775,032 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,742,623 | DepreciationAmt |
| Book Value | $24,032,409 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $983,704 | OtherCostOrOtherBasisAmt |
| Book Value | $983,704 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $32,550,479 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $787,883 |
| THIRD PARTY PAYOR | $2,437,468 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,225,351 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF MARCH 31, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | NAMING RIGHTS | Event1Nm |
| Gross Receipts Event1 | $69,301 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $69,301 | CharitableContriEvent1Amt |
| Gross Receipts Total | $69,301 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $69,301 | CharitableContributionsTotAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE G, PART II | FormAndLineReferenceDesc |
| Explanation | DUE TO COVID, THERE WERE NO PHYSICAL FUNDRAISERS FOR THE FY 2020. FERRELL HOSPITAL COMMUNITY FOUNDATION HELD A CAMPAIGN TO RAISE MONEY FOR DONORS TO NAME AREAS OF THE HOSPITAL. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $411,157 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,379,757 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,322,990 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,559,190 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,763,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05980 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,734,147 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,938,947 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,763,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05980 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,734,147 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,938,947 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,763,800 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05980 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,489,811 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $9,023,007 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $11,624,546 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,601,539 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FERRELL HOSPITAL COMMUNITY FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 PINE STREET | AddressLine1Txt |
| City | ELDORADO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62930 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | FERRELLHOSP.ORG | WebsiteAddressTxt |
| State License | 0005363 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FERRELL HOSPITAL COMMUNITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE WEBSITE ADDRESS LISTED IN PART V, SECTION B, LINE 7D. | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE WEBSITE ADDRESS LISTED IN PART V, SECTION B, LINE 7D. | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://FERRELLHOSP.ORG/FOR-YOU/PATIENTS-VISITORS/PATIENTS/FINANCIAL-ASSIST | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://FERRELLHOSP.ORG/FOR-YOU/PATIENTS-VISITORS/PATIENTS/FINANCIAL-ASSIST | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://FERRELLHOSP.ORG/FOR-YOU/PATIENTS-VISITORS/PATIENTS/FINANCIAL-ASSIST | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FERRELL HOSPITAL COMMUNITY | PART V, SECTION B, LINE 5: FERRELL HOSPITAL LED THE PLANNING, IMPLEMENTATION, AND COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT THROUGH A CONSULTING ARRANGEMENT WITH THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK. TERRY MADSEN, AN ICAHN CONSULTANT, ATTORNEY, FORMER EDUCATOR, AND COMMUNITY DEVELOPMENT SPECIALIST, CONFERENCED WITH HOSPITALEXECUTIVE STAFF TO DEFINE THE COMMUNITY, SCOPE OF THE PROJECT, AND SPECIAL NEEDS AND CONCERNS. AN INTERNAL WORKING GROUP, POSSIBLE LOCAL SOURCES FOR SECONDARY DATA AND KEY EXTERNAL CONTACTS WERE IDENTIFIED, AND A TIMELINE WAS ESTABLISHED.INTERNAL -FERRELL HOSPITAL UNDERTOOK A FOUR-MONTH PLANNING AND IMPLEMENTATION EFFORT TO DEVELOP THE CHNA, AND TO IDENTIFY AND PRIORITIZE COMMUNITY HEALTH NEEDS FOR ITS SERVICE AREA. THESE PLANNING AND DEVELOPMENT ACTIVITIES INCLUDED THE FOLLOWING STEPS: THE PROJECT WAS OVERSEEN AT THE OPERATIONAL LEVEL BY THE DIRECTOR OF COMMUNITY EDUCATION, REPORTING DIRECTLY TO THE CEO. ARRANGEMENTS WERE MADE WITH ICAHN TO FACILITATE THREE FOCUS GROUPS AND A MEETING TO IDENTIFY AND PRIORITIZE SIGNIFICANT NEEDS. ICAHN WAS ALSO ENGAGED TO COLLECT, ANALYZE, AND PRESENT SECONDARY DATA AND TO PREPARE A FINAL REPORT FOR SUBMISSION TO FERRELL HOSPITAL. THE DIRECTOR OF COMMUNITY EDUCATION WORKED CLOSELY WITH ICAHN'S CONSULTANT TO IDENTIFY AND ENGAGE KEY COMMUNITY PARTNERS AND TO COORDINATE LOCAL MEETINGS AND GROUP ACTIVITIES.EXTERNAL- FERRELL HOSPITAL ALSO LEVERAGED EXISTING RELATIONSHIPS THAT PROVIDED DIVERSE INPUT FOR A COMPREHENSIVE REVIEW AND ANALYSIS OF COMMUNITY HEALTH NEEDS IN THE HOSPITAL'S SERVICE AREA. THESE STEPS INCLUDED: THE DIRECTOR OF COMMUNITY EDUCATION SECURED THE PARTICIPATION OF A DIVERSE GROUP OF REPRESENTATIVES FROM THE COMMUNITY AND THE HEALTH PROFESSION. ICAHN'S CONSULTANT PROVIDED SECONDARY DATA FROM MULTIPLE SOURCES SET OUT BELOW IN SECTION III. DATA COLLECTION AND ANALYSIS. PARTICIPATION INCLUDED REPRESENTATIVES OF COUNTY HEALTH DEPARTMENTS SERVING THE AREA SERVED BY THE HOSPITAL. |
| FERRELL HOSPITAL COMMUNITY | PART V, SECTION B, LINE 7D: HTTPS://WWW.FERRELLHOSP.ORG/ABOUT-US/DOCUMENTS-ABOUT-US/HOME-PAGE-LINK-COMMUNITY-HEALTH-NEEDS-ASSESSMENT-7 |
| FERRELL HOSPITAL COMMUNITY | PART V, SECTION B, LINE 11: THE HEALTH PROFILE OF THE FERRELL HOSPITAL'S SERVICE AREA IS INFLUENCED BY THE FOLLOWING INDICATORS OF SOCIAL DETERMINANTS OF HEALTH: POVERTY - CHILDREN LIVING IN POVERTY POVERTY - POPULATION BELOW 100% OF FEDERAL POVERTY LEVEL BUILT ENVIRONMENT - RECREATION AND FITNESS FACILITY ACCESSTHE NEEDS IDENTIFIED AND PRIORITIZED THROUGH THE CHNA CARRIED FORWARD VARIANTS OF PREVIOUS CHNAS AND ADDED OTHERS. THE IDENTIFIED AND PRIORITIZED NEEDS SELECTED INCLUDE:1. EXPLORING THE CAUSES OF CHRONIC ILLNESS AND IMPROVING EARLY IDENTIFICATION THROUGH SCREENINGS AND OTHER METHODS, ESPECIALLY CANCER AND HEART DISEASE.2. EDUCATION AND GUIDANCE FOR SENIORS ON THE TOPICS OF MEDICARE, SENIOR WELLNESS, AND OTHER HEALTH SERVICES FOR OLDER ADULTS.3. MENTAL HEALTH, WITH SPECIFIC REFERENCE TO THE FOLLOWING IDENTIFIED NEEDS: -AN ATTEMPT TO ADDRESS THE LOCAL SHORTAGE OF MENTAL HEALTH SERVICES PROVIDERS, INCLUDING THE NEED TO IMPROVE LOCAL ACCESS TO PHYSICIANS- IMPROVED AVAILABILITY OF MENTAL HEALTH AND SUBSTANCE USE AND MISUSE TREATMENT BEDS, BOTH LOCAL AND TRANSFER- IMPROVED ACCESS TO LOCAL MENTAL HEALTH SERVICES IN GENERAL FOR PERSONS SUFFERING DEPRESSION AND OTHER SITUATIONAL CONDITIONS INFLUENCED ESPECIALLY BY TRAUMA AND/OR POVERTY- LOCAL ACCESS TO MEDICATION-ASSISTED TREATMENT FOR OPIOID USE DISORDER AND OTHER SUBSTANCES4. ADDRESSING TEEN BIRTH RATE, LOW BIRTH WEIGHT, AND INFANT MORTALITY THROUGH EDUCATION AND ACCESS TO CARE5. LOCAL ACCESS TO DENTAL CARE, ESPECIALLY FOR PERSONS ON MEDICAID.HOSPITAL PERSONNEL AND COMMUNITY ADVISORS MEET TO EVALUATE THE FINDINGS IN THE CHNA AND ASSESS THE PERFORMANCE OF THE HOSPITAL IN EACH OF THE TARGETED AREAS. MANAGEMENT MONITORS PROGRESS AND DEVOTES RESOURCES TO THE ACCOMPLISHMENT OF IDENTIFIED PLANS TO MEET THE NEEDS IDENTIFIED. |
| FERRELL HOSPITAL COMMUNITY | PART V, SECTION B, LINE 23: THE HOSPITAL CHARGES THE SAME AMOUNT FOR EMERGENCY AND OTHER MEDICALLY NECESSARY CARE FOR FAP-ELIGIBLE PATIENTS AND ALL OTHER PATIENTS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - FERRELL HOSPITAL FAMILY PRACTICE | ||||
| 1036 MAPLE STREET | ELDORADO | IL | 62930 | RURAL HEALTH CLINIC |
| 2 - ELDORADO FAMILY MEDICINE | ||||
| 1407 LOCUST STREET | ELDORADO | IL | 62930 | RURAL HEALTH CLINIC |
| 3 - CARMI FAMILY MEDICINE | ||||
| 1340 IL HWY 1 SUITE A | CARMI | IL | 62821 | RURAL HEALTH CLINIC |
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE HOSPITAL USED A COST TO CHARGE RATIO AS CALCULATED FROM WORKSHEET 2; RATIO OF PATIENT CARE COST TO CHARGES INCLUDED IN THE SCHEDULE H INSTRUCTIONS TO DETERMINE THE AMOUNTS ON LINE 7A OF PART 1 OF SCHEDULE H. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | FERRELL HOSPITAL COMMUNITY FOUNDATION OFFERS VARIOUS BENEFITS TO THE COMMUNITY INCLUDING BUT NOT LIMITED TO CPR/FIRST AID, PARTICIPATION IN THE SALINE COUNTY HEALTHY COALITION, PARTICIPATION IN HEALTH FAIRS AT LOCAL HIGH SCHOOLS AND COLLEGES, POISON PREVENTION AND HEALTH CARE CAREER PRESENTATIONS TO LOCAL SCHOOLS, PROVIDE TOURS OF THE HOSPITAL, HOLD FLU VACCINATION CLINICS, PERIODIC BLOOD PRESSURE AND GLUCOSE SCREENINGS, SPEAKING ENGAGEMENTS FOR COMMUNITY ORGANIZATIONS, CO-SPONSOR THE KIDNEY MOBILE, SPONSOR THE LOCAL HIGH SCHOOL PROM, PARTICIPATE IN THE RELAY FOR LIFE, SPONSOR FUNCTIONS AT THE LOCAL SENIOR CITIZENS CENTER, HOLD WELLNESS WORKSHOPS, PROVIDE A TRAINER FOR THE LOCAL HIGH SCHOOL SPORTS TEAMS, PROVIDE FIRST AID KITS FOR LOCAL SPORTS TEAMS, PROVIDE CLOTHING FOR DOMESTIC ABUSE VICTIMS AND PARTICIPATE IN THE SAFE HAVEN PROGRAM. |
| PART III, LINE 2: | THE BAD DEBT EXPENSE IS FROM THE TRIAL BALANCE. SEE ATTACHED PY FINANCIAL STMT PAGES 7 & 8 FOR METHODOLOGY. |
| PART III, LINE 3: | FINANCIAL ASSISTANCE COUNSELORS ARE IN PLACE TO CONTACT ANY PATIENT EXPRESSING INTEREST IN THE PROGRAM. PROCEDURES ARE IN PLACE TO MAKE DETERMINATIONS OF ALL PATIENTS' ELIGIBILITY AND TO PROVIDE THE APPROPRIATE ASSISTANCE. |
| PART III, LINE 4: | SEE THE PAGES 7 & 8 OF THE ATTACHED AUDITED FINANCIAL STATEMENT. |
| PART III, LINE 8: | THE SOURCE USED TO DETERMINE THE AMOUNT OF MEDICARE REVENUE AND ALLOWABLE COSTS REPORTED FOR PART III, SECTION B, LINE 8: THE MEDICARE TOTAL REVENUE AND ALLOWABLE COSTS WERE BASED ON THE 2020 MEDICARE COST REPORT. THE MEDICARE SHORTFALL SHOULD BE TREATED AS COMMUNITY BENEFIT DUE TO THE HOSPTIAL PROVIDING CARE TO MEDICARE PATIENTS AT LESS THAN THE ALLOWABLE MEDICARE COSTS. |
| PART III, LINE 9B: | FERRELL HOSPITAL COMMUNITY FOUNDATION PROVIDES ASSISTANCE TO MEET THE NEEDS OF THE UNINSURED PATIENTS TO WHICH THEY SERVE. FOR THOSE PATIENTS WHO ARE EXPECTED TO QUALIFY UNDER THEIR FINANCIAL ASSISTANCE POLICY, THE HOSPITAL ASSIGNS THE FINANCIAL CARRIER FOR CHARITY CARE AT THE TIME OF THE REQUEST FOR THE HEALTH ASSISTANCE PROGRAM (HAP) APPLICATION. ONCE ASSIGNED, SEVERAL PROCEDURES ARE IN PLACE TO COMPLETE THE PROCESS INCLUDING INVESTIGATION FOR ANY OTHER AVAILABLE FUNDING SOURCES SUCH AS MEDICAID AND INCOME VERIFICATION. THOSE THAT COMPLETE THE HAP ACCURATELY AND QUALIFY UNDER THE HOSPITALS POLICY RECEIVE FREE OR DISCOUNTED CARE. |
| PART VI, LINE 2: | FCHF IS INVOLVED IN COMMUNITY ORGANIZATIONS, INCLUDING CHURCHES, CIVIC GROUPS AND PROFESSIONAL ORGANIZATIONS. |
| PART VI, LINE 3: | OUR FINANCIAL ASSISTANCE PROGRAM IS EASILY ACCESSED THROUGH OUR WEBSITE AND HAS THE FORMS LISTED FOR THE PATIENT TO PRINT OFF IF NEEDED. THE CONTACT PHONE NUMBERS OF OUR FINANCIAL COUNSELORS ARE ALSO LISTED. THERE ARE FERRELL HOSPITAL FINANCIAL ASSISTANCE BROUCHURES IN THE LOBBY AREAS OF THE HOSPITAL. ALL SELF PAY PATIENTS IN THE HOSPITAL ARE VISITED BY THE FINANCIAL COUNSELOR AND GIVEN THE NECESSARY PAPERWORK IF THE PATIENT REQUESTS IT. IF THE FINANCIAL COUNSELOR DOES NOT GET TO SEE THE PATIENT OR FAMILY, THEN A LETTER IS MAILED ALONG WITH THE APPLICATION TO THE PATIENT. UPON REGISTRATION OF THE PATIENT, THE REGISTRATION STAFF INFORMS THE PATIENT OF THE HOSPITAL FINANCIAL ASSISTANCE PROGRAMS AND GIVES THEM A BROCHURE. IF THE PATIENT REQUESTS TO TALK TO THE FINANCIAL COUNSELOR THEN THAT PERSON IS CALLED. |
| PART VI, LINE 4: | THE MAJORITY OF FERRELL HOSPITAL PATIENTS RESIDE IN SALINE, GALLATIN, WHITE AND HAMILTON COUNTIES. WE ALSO SEE SEVERAL PATIENTS FROM POPE AND HARDIN COUNTIES. OUR FACILITIES ARE LOCATED IN SALINE AND GALLATIN COUNTIES. THE UNEMPLOYMENT RATE AND POVERTY RATE OF THESE COUNTIES ARE HIGHER THAN THE NATIONAL AVERAGE AND VERY CLOSE TO THE STATE OF ILLINOIS AVERAGE. THE PAYER MIX IS HEAVILY MEDICAID/MEDICARE DEPENDENT. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NATE OLDHAM MD | ||||||||||||||
| BOARD MEMBER/PHYSICIAN | $324,722 | $0 | $95,293 | $0 | $0 | $0 | $7,446 | $0 | $12,480 | $0 | $439,941 | $0 | $0 | $0 |
| JOSEPH A JACKSON MD | ||||||||||||||
| PHYSICIAN | $361,197 | $0 | $147,106 | $0 | $0 | $0 | $7,632 | $0 | $12,480 | $0 | $528,415 | $0 | $0 | $0 |
| JANNA PATHI MD | ||||||||||||||
| SURGEON | $451,638 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,480 | $0 | $458,118 | $0 | $0 | $0 |
| LUKE HALL | ||||||||||||||
| PHYSICIAN | $265,653 | $0 | $0 | $0 | $0 | $0 | $6,483 | $0 | $9,024 | $0 | $281,160 | $0 | $0 | $0 |
| CALEB MITCHELL DO | ||||||||||||||
| PHYSICIAN | $262,957 | $0 | $14,093 | $0 | $0 | $0 | $6,089 | $0 | $15,024 | $0 | $298,163 | $0 | $0 | $0 |
| CARY HANNI | ||||||||||||||
| SURGEON | $115,161 | $0 | $61,200 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $176,361 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | PHYSICIANS ARE ELIGIBLE FOR INCENTIVE COMPENSATION. THE PHYSICIAN IS COMPENSATED FOR EACH WORK RVU PERFORMED BY A PHYSICIAN IN A YEAR IN EXCESS OF THE PHYSICIAN'S WORK RVU INCENTIVE THRESHOLD FOR THE YEAR. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 861091967 | BondIssuerEIN |
| Bond Issued | 2019-03-27 | BondIssuedDt |
| Issue Price | $33,260,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION AND EQUIPMENT FOR NEW HOSPITAL | 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 | $32,951,953 | TotalProceedsAmt |
| Capitalized Interest | $510,877 | CapitalizedInterestAmt |
| Refunding Escrow | $809,783 | RefundingEscrowAmt |
| Credit Enhancement | $308,047 | CreditEnhancementAmt |
| Capital Expenditures | $30,557,212 | CapitalExpendituresAmt |
| Unspent | $766,034 | UnspentAmt |
| Substantial Completion | 2020 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | 0 | 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 | 0 | 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 | 0 | 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 | Yes (1) | 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 (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | GENE MORRIS AND DR. NATE OLDHAM HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION A, LINE 3 | EFFECTIVE JANUARY 1, 2016, THE HOSPITAL ENTERED INTO A FIVE-YEAR MANAGEMENT SERVICES AGREEMENT. MANAGEMENT SERVICES PROVIDED TO THE HOSPITAL CONSIST OF MANAGEMENT PERSONNEL INCLUDING A CEO AND CFO, FACILITY PLANNING, STRATEGIC PLANNING, RECRUITING, AND SEVERAL OTHER SUPPORT AND OVERSIGHT SERVICES. THE INITIAL TERM OF THE AGREEMENT IS FOR A FIVE-YEAR PERIOD, WHICH CAN BE EXTENDED BEYOND THE INITIAL FIVE-YEAR PERIOD, IF SO DESIRED. THE AGREEMENT CAN BE TERMINATED BY EITHER PARTY WITH A ONE HUNDRED AND EIGHTY DAY NOTICE WITHOUT RECOURSE SUBSEQUENT TO THE INITIAL FIVE-YEAR TERM. IF THE AGREEMENT IS TERMINATED BY THE HOSPITAL WITHIN THE INITIAL FIVE YEAR TERM OF THE AGREEMENT, THE HOSPITAL WILL BE ASSESSED A PENALTY IN THE AMOUNT OF $500,000 TO BE PAYABLE TO THE MANAGEMENT SERVICE ORGANIZATION. THE HOSPITAL WILL REIMBURSE THE MANAGEMENT SERVICE PROVIDER THE ACTUAL COST OF PROVIDING THE MANAGEMENT SERVICES ON A MONTHLY BASIS FOR THE YEARS ENDED MARCH 31, 2021 AND 2020, MANAGEMENT FEES INCURRED WERE $120,000 PER YEAR DURING THE 2020 YEAR, A PORTION OF COST REPORT PROCEEDS TOTALING $833,400 AND THE FOLLOWING INDIVIDUALS WERE COMPENSATED BY THE MANAGEMENT SERVICE PROVIDER: ALISA COLEMAN, CHIEF EXECUTIVE OFFICER AND DIRK MORGAN, CHIEF FINANCIAL OFFICER TOTALING $590,855. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND CFO REVIEW THE COMPLETED FORM 990 AS PREPARED BY THE PAID PROVIDER FOR COMPLETENESS AND ACCURACY. THE BOARD CHAIR AND THE CEO AND CFO SUBMIT THE FORM TO THE BOARD FOR FINAL APPROVAL IMMEDIATELY PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | COPIES OF THE CONFLICT OF INTEREST POLICY ARE PROVIDED TO EACH DIRECTOR, OFFICER, AND MANAGEMENT PERSON AT LEAST ONCE PER YEAR, WITH REQUIREMENT THAT THEY COMPLETE A CERTIFICATE. THE CERTIFICATE CONFIRMS THAT THEY UNDERSTAND THIS POLICY, AGREE TO COMPLY, INDICATE ANY KNOWN CONFLICTS, AND HAVE NO KNOWLEDGE OF ANY ADDITIONAL VIOLATIONS OF THE POLICY. ANY PERSON WITH A CONFLICT IS REQUIRED TO COMPLETE A SPECIFIC DISCLOSURE NOTICE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO'S SALARY WAS DETERMINED BY COMPARISON WITH PRIOR PERSONS EMPLOYED IN THE POSITION, INDUSTRY COMPARISONS, RELATIVE EXPERIENCE AND KNOWLEDGE. THE CEO'S SALARY WAS APPROVED BY THE BOARD OF DIRECTORS. ALL DELIBERATIONS ARE INCLUDED IN BOARD MINUTES. THIS PROCESS WAS LAST COMPLETED IN 2016. THE CFO'S SALARY WAS DETERMINED AND APPROVED IN THE SAME MANNER AS THE CEO'S SALARY. ALL OTHER EXECUTIVE SALARIES ARE APPROVED BY EXECUTIVE MANAGEMENT AND ANALYZED BASED ON INDUSTRY COMPARATIVE DATA AND POSITION DESCRIPTIONS, COMMENSURATE EXPERIENCE, EXPERTISE AND TRAINING. THIS PROCESS WAS LAST COMPLETED IN 2016. |
| FORM 990, PART VI, SECTION C, LINE 19 | FERRELL HOSPITAL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, AND FEDERAL FORM 990 TAX RETURNS ARE AVAILABLE TO THE PUBLIC BY REQUEST. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,504,725. MANAGEMENT AND GENERAL EXPENSES 164,097. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,668,822. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,822,829. MANAGEMENT AND GENERAL EXPENSES 51,198. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,874,027. |
| FORM 990, PART XI, LINE 2C, AUDIT OVERSIGHT | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
| FORM 990 PART XII | AUDITED FINANCIAL STATEMENTS ARE IN PROCESS BUT HAVE NOT BEEN ISSUED FOR THE PERIOD ENDED MARCH 31, 2021. WE HAVE ATTACHED THE PRIOR YEAR AUDITED FINANCIAL STATEMENTS TO THIS TAX RETURN. |