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BLESSINGCARE CORPORATION: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
BLESSINGCARE CORPORATION (EIN 37-1396010)
Tax period
2023-10-01 to 2024-09-30
Filed
2025-06-05
IRS object ID
202541569349300809
Schema version
2023v6.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2025-06-05T09:26:11-04:00ReturnTs
Tax Period End2024-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN363077757PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GRAY HUNTER STENN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1500 MAINE STAddressLine1Txt
CityQUINCYCityNm
State AbbreviationILStateAbbreviationCd
ZIP62301ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN371396010EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1BLESSINGCARE CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlBLESBusinessNameControlTxt
Phone2172852113PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1640 WEST WASHINGTONAddressLine1Txt
CityPITTSFIELDCityNm
State AbbreviationILStateAbbreviationCd
ZIP62363ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPATRICK M GERVELERPersonNm
Person TitleSECRETARY/TREASURERPersonTitleTxt
Phone2172852113PhoneNum
Signature2025-05-27SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonERIN J WHARTON CPAPreparerPersonNm
PTINP01294277PTIN
Phone2172220304PhoneNum
Preparation2025-05-27PreparationDt
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1ILLINI COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerHOLLY A JONESPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1640 WEST WASHINGTONAddressLine1Txt
CityPITTSFIELDCityNm
State AbbreviationILStateAbbreviationCd
ZIP62363ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$37,372,219GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ILLINIHOSPITAL.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2000FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionTO IMPROVE THE HEALTH OF OUR COMMUNITIES.ActivityOrMissionDesc
Voting Members Governing Body7VotingMembersGoverningBodyCnt
Voting Members Independent4VotingMembersIndependentCnt
Total Employee260TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$8,400TotalGrossUBIAmt
PY Contributions Grants$659,186PYContributionsGrantsAmt
CY Contributions Grants$307,675CYContributionsGrantsAmt
PY Program Service Revenue$36,653,862PYProgramServiceRevenueAmt
CY Program Service Revenue$34,730,140CYProgramServiceRevenueAmt
PY Investment Income$330,729PYInvestmentIncomeAmt
CY Investment Income$715,146CYInvestmentIncomeAmt
PY Other Revenue$779,806PYOtherRevenueAmt
CY Other Revenue$1,614,337CYOtherRevenueAmt
PY Total Revenue$38,423,583PYTotalRevenueAmt
CY Total Revenue$37,367,298CYTotalRevenueAmt
PY Grants And Similar Paid$17,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$10,000CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$20,210,217PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$19,667,392CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$14,521,928PYOtherExpensesAmt
CY Other Expenses$13,783,185CYOtherExpensesAmt
PY Total Expenses$34,749,645PYTotalExpensesAmt
CY Total Expenses$33,460,577CYTotalExpensesAmt
PY Revenues Less Expenses$3,673,938PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$3,906,721CYRevenuesLessExpensesAmt
Total Assets BOY$45,872,855TotalAssetsBOYAmt
Total Assets EOY$50,525,615TotalAssetsEOYAmt
Total Liabilities BOY$9,267,905TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,032,805TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$36,604,950NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$42,492,810NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO IMPROVE THE HEALTH OF OUR COMMUNITIES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$24,422,843ExpenseAmt
Grant$10,000GrantAmt
Revenue$34,730,140RevenueAmt
DescILLINI COMMUNITY HOSPITAL TREATED PATIENTS THROUGH THE FOLLOWING SERVICES DURING FISCAL YEAR 2024: INPATIENT ADMISSIONS 454 OBSERVATION ADMISSIONS 197 OUTPATIENT VISITS 88,336 TOTAL SURGERIES 370 EMERGENCY VISITS 6,333 LABORATORY TESTS 72,108 RESPIRATORY TREATMENTS 641 RADIOLOGY PROCEDURES 9,965 RURAL HEALTH CLINIC & XPRESS VISITS 17,644 IN ADDITION TO THESE HEALTHCARE SERVICES, ILLINI COMMUNITY HOSPITAL PROVIDED 419,967 IN CHARITY CARE AND INCURRED MEDICARE SHORTFALLS OF 106,325. THE HOSPITAL PROVIDED ADDITIONAL BENEFITS DURING FISCAL YEAR 2024 AS FOLLOWS: 1)HEALTH PROFESSIONALS EDUCATION - 2,000 COLLEGE SCHOLARSHIPS 2)IN-KIND CONTRIBUTIONS AND DONATIONS - 19,869 COULSON PUBLICATIONS - WEEKLY WELLNESS PAGE LOCAL FAIRS AND EVENTS SUPPORT 3)COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND SERVICES - 85,570 TRANSPORT VANS FOOD DISTRIBUTIONS DRUG TAKE BACK KIOSK ICAHN MEMBERSHIP PIKE COUNTY CEO AND ECONOMIC DEVELOPMENT FEES TWO RIVERS RESOURCE CONSERVATION AND DEVELOPMENTDesc
Total Program Service Expenses$24,422,843TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingYes (true)LoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (true)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document30IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee260EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members7GoverningBodyVotingMembersCnt
Independent Voting Member4IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonHOLLY A JONESPersonNm
Phone2172852113PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1640 WEST WASHINGTONAddressLine1Txt
CityPITTSFIELDCityNm
State AbbreviationILStateAbbreviationCd
ZIP62363ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MAUREEN A KAHN RETIRED 72023
FORMER VICE-Yes (X)$0$1,399,070$214,544
BRIAN T CANFIELD
VICE-CHAIR$0$976,127$142,4630.0040.00Yes (X)Yes (X)
PATRICK M GERVELER
SECRETARY/TR$0$831,554$136,9050.0040.00Yes (X)Yes (X)
DR ROBERT D THOMAS
TRUSTEE/ED P$444,706$0$39,70340.000.00Yes (X)
DR THOMAS A CLIATT
ED PHYSICIAN$423,612$0$37,03140.000.00Yes (X)
DR STUART L PYATT
ED PHYSICIAN$406,175$0$28,12940.000.00Yes (X)
DR CHRISTOPHER S WAGONER
CLINIC PHYSI$339,816$0$38,65740.000.00Yes (X)
DR ALBORZ JAVADZADEH
PSYCHIATRIST$329,049$0$12,13240.000.00Yes (X)
DR DAKOTA LAMMY
CLINIC PHYSI$295,703$0$36,00240.000.00Yes (X)
KATHLEEN E HULL RETIRED 122022
FORMER ADMINYes (X)$0$296,257$0
HOLLY A JONES
VP/ADMIN-ILL$0$259,093$24,6900.0040.00Yes (X)
DAMAN EMRICK
TRUSTEE$0$0$01.00Yes (X)
K JEANNIE GOODMAN
CHAIR$0$0$01.00Yes (X)Yes (X)
AMY RUEBUSH
VICE-CHAIR$0$0$01.00Yes (X)Yes (X)
JASON STRATTON
TRUSTEE$0$0$01.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,239,061TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,762,101TotReportableCompRltdOrgAmt
Total Other Compensation$710,256TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AIMS OF PITTSFIELD LLC
8657 WEDGEWOOD DRIVEBURR RIDGEIL60527PHYSICIAN SVCS$1,423,185
JOHN PETTY & SONS
105 E WASHINGTON STPITTSFIELDIL62363CONSTRUCTION$1,173,248
MEDICAL SOLUTIONS LLC
PO BOX 850737MINNEAPOLISMN55485STAFFING SVCS$589,291
SHARED MEDICAL SERVICES INC
209 LIMESTONE PASSCOTTAGE GROVEWI53527MRI/RAD SVCS$132,201
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Government Grants$133,700GovernmentGrantsAmt
All Other Contributions$173,975AllOtherContributionsAmt
Total Contributions$307,675TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Total Revenue Column$34,730,140TotalRevenueColumnAmt
Related Or Exempt Func Income$34,730,140RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$34,730,140TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$715,146TotalRevenueColumnAmt
Exclusion$715,146ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$138,321RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$4,921RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$133,400RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$133,400TotalRevenueColumnAmt
Exclusion$133,400ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$20,338GrossSalesOfInventoryAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,338TotalRevenueColumnAmt
Unrelated Business Revenue$8,400UnrelatedBusinessRevenueAmt
Exclusion$11,938ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
OTHER900099$1,417,617$1,417,617
EQUITY IN SUB'S EARNINGS900099$42,982$42,982
FieldValueIRS element (for citing)
Other Revenue Total$1,460,599OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$37,367,298TotalRevenueColumnAmt
Related Or Exempt Func Income$34,730,140RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$8,400UnrelatedBusinessRevenueAmt
Exclusion$2,321,083ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$10,000TotalAmt
Program Services$10,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$529,845TotalAmt
Program Services$529,845ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$14,332,714TotalAmt
Program Services$11,392,847ProgramServicesAmt
Management And General$2,939,867ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$252,228TotalAmt
Program Services$202,336ProgramServicesAmt
Management And General$49,892ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,746,608TotalAmt
Program Services$2,996,920ProgramServicesAmt
Management And General$749,688ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$805,997TotalAmt
Program Services$646,568ProgramServicesAmt
Management And General$159,429ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$673TotalAmt
Management And General$673ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$27,960TotalAmt
Management And General$27,960ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$567,793TotalAmt
Program Services$375,676ProgramServicesAmt
Management And General$192,117ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$23,009TotalAmt
Program Services$10,597ProgramServicesAmt
Management And General$12,412ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$35,397TotalAmt
Management And General$35,397ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,354,193TotalAmt
Program Services$884,923ProgramServicesAmt
Management And General$469,270ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$66,117TotalAmt
Program Services$6,360ProgramServicesAmt
Management And General$59,757ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
OUTSIDE FEES$3,965,721$1,336,428$2,629,293
PATIENT SUPPLIES$2,276,726$2,092,916$183,810
BAD DEBTS$1,528,384$1,514,873$13,511
PHYSICIAN FEES$1,335,549$1,335,549

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,601,663TotalAmt
Program Services$1,087,005ProgramServicesAmt
Management And General$1,514,658ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$33,460,577TotalAmt
Program Services$24,422,843ProgramServicesAmt
Management And General$9,037,734ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$7,127,966BOYAmt
EOY$3,602,285EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,918,989BOYAmt
EOY$12,896,794EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,035,262BOYAmt
EOY$4,202,753EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$25,000EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$1,058,022BOYAmt
EOY$1,009,029EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$139,603BOYAmt
EOY$150,232EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$31,512,403LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$17,911,917LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$14,554,067BOYAmt
EOY$13,600,486EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$9,312,577BOYAmt
EOY$11,515,959EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$1,290,272BOYAmt
EOY$1,371,568EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,436,097BOYAmt
EOY$2,151,509EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$45,872,855BOYAmt
EOY$50,525,615EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$703,286BOYAmt
EOY$743,803EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,384,711BOYAmt
EOY$1,282,295EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,179,908BOYAmt
EOY$6,006,707EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,267,905BOYAmt
EOY$8,032,805EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$36,443,318BOYAmt
EOY$42,417,859EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$161,632BOYAmt
EOY$74,951EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,604,950BOYAmt
EOY$42,492,810EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$45,872,855BOYAmt
EOY$50,525,615EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$3,906,721ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,981,139NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsYes (true)GrantsOtherOrganizationsInd
Grants Other Organizations$12,176GrantsOtherOrganizationsAmt
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesfalseOtherActivitiesInd
Total Lobbying Expenditures$12,176TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1FormAndLineReferenceDesc
ExplanationMEMBERSHIP DUES ARE PAID ON AN ANNUAL BASIS TO THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. 43.5% OF DUES ARE ALLOCABLE TO LOBBYING EXPENDITURES, WHICH INCLUDE CONGRESSIONAL VISITS AND CONTACTING REPRESENTATIVES.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$271,716OtherCostOrOtherBasisAmt
Book Value$271,716BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,132,164OtherCostOrOtherBasisAmt
Depreciation$10,202,668DepreciationAmt
Book Value$9,929,496BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$660,604OtherCostOrOtherBasisAmt
Depreciation$534,372DepreciationAmt
Book Value$126,232BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,976,717OtherCostOrOtherBasisAmt
Depreciation$7,174,877DepreciationAmt
Book Value$2,801,840BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$471,202OtherCostOrOtherBasisAmt
Book Value$471,202BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,600,486TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (9 entries)

DescDescAmtAmt
ESTIMATED THIRD-PARTY SETTLEMENTS$2,285,380
ACCRUED SALARIES$1,374,657
DEFERRED COMPENSATION$1,371,814
DUE TO BLESSING HOSPITAL$553,974
ACCRUED EMPLOYEE BENEFITS$229,922
LEASE OBLIGATIONS - NONCUR. PORTION$116,582
PAYROLL TAXES & WITHHOLDING$39,902
LEASE OBLIGATIONS - CURRENT PORTION$32,694
ACCRUED INTEREST$1,782
FieldValueIRS element (for citing)
Total Liability$6,006,707TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$37,824,974TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,981,139NetUnrealizedGainsInvstAmt
Other Revenue-$1,528,384OtherRevenueAmt
Revenue Not Reported$452,755RevenueNotReportedAmt
Revenue Subtotal$37,372,219RevenueSubtotalAmt
Other Revenues Not Included-$4,921OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$4,921RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$37,367,298TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$31,937,114TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$31,937,114ExpensesSubtotalAmt
Other Expenses Not Included$1,523,463OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$1,523,463ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$33,460,577TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PAGE 4, PART XI, LINE 2DBAD DEBT REDUCTION OF REVENUE ON FS -1,528,384
SCHEDULE D, PAGE 4, PART XI, LINE 4BRENTAL EXPENSES -4,921
SCHEDULE D, PAGE 4, PART XII, LINE 4BBAD DEBT REDUCTION OF REVENUE ON F/S 1,528,384 RENTAL EXPENSES -4,921

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other2.750000000000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other2.750000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$419,967TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$419,967NetCommunityBenefitExpnsAmt
Total Expense0.01310TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,322,034TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,322,034DirectOffsettingRevenueAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,742,001TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,322,034DirectOffsettingRevenueAmt
Net Community Benefit Expns$419,967NetCommunityBenefitExpnsAmt
Total Expense0.01310TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$85,570TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$85,570NetCommunityBenefitExpnsAmt
Total Expense0.00270TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,000TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,000NetCommunityBenefitExpnsAmt
Total Expense0.00010TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$19,869TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$19,869NetCommunityBenefitExpnsAmt
Total Expense0.00060TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$107,439TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$107,439NetCommunityBenefitExpnsAmt
Total Expense0.00340TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,849,440TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$7,322,034DirectOffsettingRevenueAmt
Net Community Benefit Expns$527,406NetCommunityBenefitExpnsAmt
Total Expense0.01650TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$1,514,873BadDebtExpenseAmt
Bad Debt Expense Attributable$70,745BadDebtExpenseAttributableAmt
Reimbursed By Medicare$10,226,794ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$10,333,119CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$106,325MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ILLINI COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1640 WEST WASHINGTON STREETAddressLine1Txt
CityPITTSFIELDCityNm
State AbbreviationILStateAbbreviationCd
ZIP62363ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.BLESSINGHEALTH.ORGWebsiteAddressTxt
State LicenseHF110395StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ILLINI COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted21CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLWWW.BLESSINGHEALTH.ORGOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt22ImplementationStrategyAdptYr
Strategy Posted WebsitefalseStrategyPostedWebsiteInd
Strategy AttachedfalseStrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care275.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care275.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLWWW.BLESSINGHEALTH.ORGFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLWWW.BLESSINGHEALTH.ORGFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLWWW.BLESSINGHEALTH.ORGFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FACILITY 1, ILLINI COMMUNITY HOSPITAL - PART V, LINE 3ETHE CHNA PROCESS HAS IDENTIFIED THE FOLLOWING COMMUNITY HEALTH NEEDS AS A PRIORITY: 1) ADDRESS THE NEEDS TO TAKE HEALTHCARE TO THE PATIENTS 2) BETTER ACCESS TO SCREENINGS FOR YOUTH AND ADULTS 3) IDENTIFY AND ADDRESS THE MENTAL HEALTH IMPLICATIONS OF CHRONIC ILLNESS 4) ADDRESS MENTAL HEALTH ISSUES RELATED TO THE COVID PANDEMIC
FACILITY 1, ILLINI COMMUNITY HOSPITAL - PART V, LINE 5THE CHNA WAS CONDUCTED FOR ILLINI COMMUNITY HOSPITAL THROUGH A CONSULTING ARRANGEMENT WITH THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK (ICAHN). MULTIPLE METHODS WERE USED TO COLLECT DATA FOR THE PROJECT. SURVEY QUESTIONS AND PROTOCOLS WERE DEVELOPED IN PARTNERSHIP WITH THE ICAHN. ILLINI COMMUNITY HOSPITAL UNDERTOOK A THREE-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 CEO. ARRANGEMENTS WERE MADE WITH ICAHN TO FACILITATE TWO 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 ILLINI COMMUNITY HOSPITAL. THE CEO WORKED CLOSELY WITH ICAHN'S CONSULTANT TO IDENTIFY AND ENGAGE KEY COMMUNITY PARTNERS AND TO COORDINATE LOCAL MEETINGS AND GROUP ACTIVITIES. ILLINI COMMUNITY 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 CEO 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. PARTICIPATION INCLUDED REPRESENTATIVES OF COUNTY HEALTH DEPARTMENTS SERVING THE AREA SERVED BY THE HOSPITAL.
FACILITY 1, ILLINI COMMUNITY HOSPITAL - PART V, LINE 6BYES, THE CHNA INCLUDED THE SCHOOL NURSES OF PIKE COUNTY AS WELL AS REPRESENTATIVES FROM THE PIKE COUNTY HEALTH DEPARTMENT.
FACILITY 1, ILLINI COMMUNITY HOSPITAL - PART V, LINE 11BELOW IS A LIST OF THE NEEDS IDENTIFIED IN ILLINI COMMUNITY HOSPITAL'S MOST RECENT CHNA ALONG WITH THE ACTIONS THAT WILL BE TAKEN BY THE HOSPITAL: 1) ADDRESS THE NEED TO TAKE HEALTHCARE TO THE PATIENTS - PURSUE OBTAINING AND OPERATING A MOBILE CLINIC FOR SCREENING, TESTING, BEHAVIORAL HEALTH, AND PRIMARY CARE, INCLUDING VACCINE AT REGULAR CLINICS IN REMOTE LOCATIONS IN THE SERVICE AREA, AND PROVIDE SERVICES AT EVENTS AND DISASTERS - EXPAND MENTAL HEALTH SERVICES BY RETAINING A PSYCHIATRIST FOR INPATIENT, OUTPATIENT, AND POSSIBLY TELEHEALTH SERVICES 2) BETTER ACCESS TO SCREENINGS FOR YOUTH AND ADULTS - EXPLORE A PARTNERSHIP WITH PIKE COUNTY HEALTH DEPARTMENT TO PROVIDE SCREENINGS - ENGAGE SERVICE LINE LEADERSHIP AT BLESSING HEALTH SYSTEM FOR ASSISTANCE WITH INCREASING SCREENING - EXPLORE INCREASED OUTREACH FOR SCREENINGS THROUGH EXTERNAL PARTNERS AND PROVIDERS 3) IDENTIFY AND ADDRESS THE MENTAL HEALTH IMPLICATIONS OF CHRONIC ILLNESS - INITIATE DISCUSSIONS WITH PROVIDERS TO DETERMINE HOW BEST TO APPROACH THIS ISSUE - EDUCATE PROVIDERS ABOUT THE RANGE OF SERVICES FROM THE PALLIATIVE CARE PROGRAM - EXPLORE MAKING SOCIAL WORK SERVICES AVAILABLE TO PATIENTS THROUGH SPECIALTY CARE AND CARE COORDINATION 4) ADDRESS MENTAL HEALTH ISSUES RELATED TO THE COVID PANDEMIC - EXPLORE WAYS TO MAINTAIN THE EMOTIONAL HEALTH OF STAFF - INCREASE SOCIAL MEDIA AWARENESS ABOUT ISOLATION, ANXIETY, AND DEPRESSION OF YOUTH AND ADULTS AND LOCAL SERVICES AVAILABLE TO HELP ADDRESS THOSE CONDITIONS - CONTINUE TO SUPPORT LOCAL FOOD RESOURCES AND DRIVE-THROUGH FOOD DISTRIBUTION PROGRAMS
FACILITY 1, ILLINI COMMUNITY HOSPITAL - PART V, LINE 13BPATIENTS ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE IF THEIR INCOME EXCEEDS 275% OF THE FEDERAL POVERTY GUIDELINES AND THEIR MEDICAL BILLS EXCEED 20% OF THEIR TOTAL REPORTED FAMILY INCOME. ELIGIBILITY IS BASED ON AN INDIVIDUAL'S OR FAMILY'S TOTAL INCOME AND FAMILY SIZE. PATIENTS EXPERIENCING CATASTROPHIC MEDICAL INDIGENCE ARE ELIGIBLE FOR A DISCOUNT OF 85%.

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE H, PART I, LINE 3CPATIENTS ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE IF THEIR INCOME EXCEEDS 275% OF THE FEDERAL POVERTY GUIDELINES AND THEIR MEDICAL BILLS EXCEED 20% OF THEIR TOTAL REPORTED FAMILY INCOME. ELIGIBILITY IS BASED ON AN INDIVIDUAL'S OR FAMILY'S TOTAL INCOME AND FAMILY SIZE. PATIENTS EXPERIENCING CATASTROPHIC MEDICAL INDIGENCE ARE ELIGIBLE FOR AN 85% DISCOUNT.
SCHEDULE H, PART I, LINE 7GILLINI COMMUNITY HOSPITAL DOES NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
SCHEDULE H, PART I, LINE 7, COLUMN (F)BAD DEBT EXPENSE OF 1,514,873 IS SUBTRACTED FROM TOTAL EXPENSES OF 33,460,577 REPORTED ON LINE 25, COLUMN A OF FORM 990, PART IX, FOR A NET TOTAL EXPENSE OF 31,945,704.
SCHEDULE H, PART I, LINE 7WHEN POSSIBLE, CALCULATIONS OF DIRECT AND INDIRECT COSTS ASSOCIATED WITH THE SERVICES PROVIDED ARE REPORTED. IF NOT AVAILABLE, A COST-TO-CHARGE RATIO IS USED TO CALCULATE THE COST AMOUNTS. THIS RATIO IS COMPUTED USING ILLINI COMMUNITY HOSPITAL'S AS-FILED MEDICARE COST REPORT. THESE COSTS AND CHARGES ARE ADJUSTED TO ACCOUNT FOR ITEMS NOT REIMBURSED THROUGH THE COST REPORT SUCH AS PROVIDER-BASED PHYSICIAN SERVICES.
SCHEDULE H, PART III, LINE 2METHODOLOGY USED TO DETERMINE BAD DEBT EXPENSE - BAD DEBT EXPENSE IS CALCULATED ON THE NET PATIENT ACCOUNT BALANCE AFTER THE BALANCE HAS BEEN REDUCED FOR ANY PAYMENTS RECEIVED OR DISCOUNTS/ADJUSTMENTS THAT ARE KNOWN. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE ARE RECOGNIZED AS CHARITY CARE ACCOUNTS WHEN SUFFICIENT INFORMATION IS RECEIVED TO DETERMINE THEIR ELIGIBILITY. PRIOR TO THIS POINT, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CALCULATED ON UNINSURED ACCOUNTS. THIS ALLOWANCE IS REVERSED IF THE ACCOUNT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART III, LINE 3METHODOLOGY OF ESTIMATED AMOUNT & RATIONALE FOR INCLUDING IN COMMUNITY BENEFIT - A NUMBER OF PATIENTS ARE TRULY UNABLE TO PAY FOR THEIR MEDICAL EXPENDITURES BUT DO NOT COMPLETE THE PROCESS REQUIRED TO APPLY FOR FINANCIAL ASSISTANCE. THE HOSPITAL PERFORMS AN ASSESSMENT USING FINANCIAL AND OTHER INFORMATION OF SUCH PATIENTS OTHERWISE AVAILABLE TO THE HOSPITAL TO IDENTIFY THOSE PATIENTS THAT WOULD QUALIFY FOR CHARITY CARE IF THEY COMPLETED THE PAPERWORK. THIS INFORMATION IS USED TO ESTIMATE THE AMOUNT OF THE HOSPITAL'S BAD DEBT EXPENSE THAT WILL BE FOUND TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE BAD DEBT EXPENSE WITH SUCH PATIENTS ACCOUNTS ARE TREATED AS COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 4SEE NOTE (2) ON PAGE 19 (FIRST PARAGRAPH) OF THE ATTACHED AUDITED CONSOLIDATED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 8THE HOSPITAL USES A COST-TO-CHARGE RATIO TO CALCULATE COST AMOUNTS. THIS RATIO IS COMPUTED USING ILLINI COMMUNITY HOSPITAL'S AS-FILED MEDICARE COST REPORT. THESE COSTS AND CHARGES ARE ADJUSTED TO ACCOUNT FOR ITEMS NOT REIMBURSED THROUGH THE COST REPORT SUCH AS PROVIDER-BASED PHYSICIAN SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 9BCOLLECTION PRACTICES ARE NOT PURSUED IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION HAS BEEN RETURNED AND APPROVED.
SCHEDULE H, PART VI, LINE 2THE CHNA WAS CONDUCTED WITH ILLINI COMMUNITY HOSPITAL THROUGH A CONSULTING ARRANGEMENT WITH THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK (ICAHN). A LARGE CROSS SECTION OF COMMUNITY PARTNERS WERE REPRESENTED (GEOGRAPHIC, AGE, SOCIOECONOMIC, ETC.) THAT INCLUDED THE SCHOOL NURSES OF PIKE COUNTY AS WELL AS REPRESENTATIVES FROM THE PIKE COUNTY HEALTH DEPARTMENT.
SCHEDULE H, PART VI, LINE 3BLESSING HOSPITAL FINANCIAL ACCOUNT SPECIALISTS (FAS) ATTEMPT TO CONTACT SELF-PAY INPATIENTS WITHIN 24 HOURS OF ADMISSION. IF THIS ATTEMPT TO MEET WITH THE PATIENT IS UNSUCCESSFUL, FURTHER ATTEMPTS ARE MADE LATER DURING THEIR STAY OR VIA PHONE FOLLOWING DISCHARGE. THE PATIENT IS SCREENED FOR GOVERNMENT PROGRAMS AND ELIGIBILITY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. OUTPATIENTS ARE CONTACTED ONCE THE PATIENT'S CONDITION HAS BEEN STABILIZED AND ARE SCREENED IN THE SAME MANNER AS INPATIENTS. FOR SCHEDULED TESTING, FAS CONTACT UNINSURED PATIENTS PRIOR TO THEIR SERVICE AND PROVIDE ESTIMATES OF CHARGES AND EDUCATION ON AVAILABLE PROGRAMS IF THE SERVICE IS SCHEDULED 3 OR MORE DAYS IN ADVANCE. THE METHOD FOR OUTREACH, WHETHER THAT BE PHONE OR MAIL, IS DEPENDENT ON THE ESTIMATED PATIENT RESPONSIBILITY FOR THE SCHEDULED SERVICES. IF THE FAS ARE NOT AVAILABLE TO MEET WITH THE PATIENT PRIOR TO SERVICE, CONTACT INFORMATION IS GIVEN TO THE PATIENT IF ASSISTANCE IS NEEDED.
SCHEDULE H, PART VI, LINE 4ILLINI COMMUNITY HOSPITAL OPENED ITS DOORS ON JANUARY 26, 1942, TO SERVE THE PEOPLE RESIDING WITHIN A 25 MILE RADIUS OF PITTSFIELD, ILLINOIS, WHICH IS PRIMARILY PIKE COUNTY BUT INCLUDES PARTS OF SCOTT, GREEN, CALHOUN, BROWN, AND ADAMS COUNTY. PIKE COUNTY HAS 831 SQUARE MILES OF LAND AREA AND A POPULATION OF APPROXIMATELY 14,258 PEOPLE. PIKE COUNTY AGE DEMOGRAPHICS INCLUDE 23.2% UNDER 18 YEARS OLD AND 22.2% OVER 65 YEARS OLD. 50.2% OF THE RESIDENTS ARE FEMALE, 95.2% CAUCASIAN AND 1.1% AFRICAN-AMERICAN. 91.8% OF THE POPULATION HAVE GRADUATED FROM HIGH SCHOOL AND 18.8% HAVE A BACHELORS DEGREE OR HIGHER. THE MEDIAN HOUSEHOLD INCOME IS 58,029 AND 15.0% OF THE POPULATION IS BELOW THE POVERTY LEVEL. PIKE COUNTY IS DESIGNATED AS A HEALTH PROFESSIONALS SHORTAGE AREA AND MEDICALLY UNDERSERVED AREA. THE UNEMPLOYMENT RATE IN PIKE COUNTY WAS 4.9% IN 2024. THE REGIONS ECONOMY IS HEAVILY AGRICULTURAL WITH RETAIL AND TOURISM ASSOCIATED WITH DEER HUNTING. ILLINI COMMUNITY HOSPITAL IS ONE OF THE LARGEST EMPLOYERS IN THE COUNTY WITH 260 EMPLOYEES.
SCHEDULE H, PART VI, LINE 5ILLINI COMMUNITY HOSPITAL OFFERS A WIDE RANGE OF SERVICES IMPORTANT TO PROMOTING THE HEALTH AND WELL-BEING OF PIKE COUNTY AND THE SURROUNDING AREA. ILLINI COMMUNITY HOSPITAL OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF THE ABILITY TO PAY. THE FINANCIAL ASSISTANCE POLICY OF ILLINI COMMUNITY HOSPITAL ENABLES PATIENTS TO HAVE ACCESS TO AREA RESOURCES TO ASSIST THEM WITH PAYMENT OF MEDICAL EXPENSES. ILLINI COMMUNITY HOSPITAL IS THE LARGEST EMPLOYER IN THE AREA WITH 260 EMPLOYEES. OF SIGNIFICANT IMPORTANCE ARE THE VOLUNTEERS THAT SERVE THE HOSPITAL, INCLUDING BUSINESS LEADERS, PHYSICIANS, AND OTHER COMMUNITY LEADERS WHO SERVE ON ILLINI COMMUNITY HOSPITAL'S BOARD OF TRUSTEES.
SCHEDULE H, PART VI, LINE 6BLESSING CORPORATE SERVICES, INC. IS THE PARENT ORGANIZATION OF A GROUP OF RELATED ORGANIZATIONS AND PROVIDES OVERALL DIRECTION TO ALL ENTITIES WITHIN THE STRUCTURE. DURING THE YEAR ENDED SEPTEMBER 30, 2005, BLESSING CORPORATE SERVICES, INC. BEGAN OPERATING A DIVISION COMPRISED OF PRACTICING PHYSICIANS. THE GROUP IS RELATED BY THE CONTROL OF BLESSING CORPORATE SERVICES, INC. OVER THE BOARDS OF THE RELATED ORGANIZATIONS. THE FOLLOWING IS A BRIEF DESCRIPTION OF EACH MEMBER OF THE GROUP: BLESSING HOSPITAL - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN QUINCY, ILLINOIS. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WESTERN ILLINOIS, NORTHEASTERN MISSOURI, AND SOUTHEASTERN IOWA. THE HOSPITAL WAS INCORPORATED IN ILLINOIS IN 1873. THE BLESSING FOUNDATION, INC. - RAISES, MANAGES, AND DISTRIBUTES CHARITABLE DONATIONS ON BEHALF OF THE BLESSING HEALTH SYSTEM. DENMAN SERVICES, INC. - A TAXABLE CORPORATION THAT IS ENGAGED PRIMARILY IN THE BUSINESS OF SELLING AND RENTING MEDICAL EQUIPMENT AND OPERATING A COMMERCIAL LAUNDRY. THE ENTITY IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL - A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN PITTSFIELD, ILLINOIS. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WESTERN ILLINOIS. THE HOSPITAL WAS INCORPORATED IN ILLINOIS IN 2000. CHS HOLDING COMPANY - A TAXABLE CORPORATION THAT PROVIDES HEALTH INSURANCE PRODUCTS AND SERVICES. CROSSRIVER QUALITY HEALTH PARTNERS - A CLINICALLY INTEGRATED NETWORK OF REGIONAL PHYSICIANS DEDICATED TO ENHANCING HEALTH CARE QUALITY AND EFFICENCY ACROSS ILLINOIS, MISSOURI, AND IOWA. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. BLESSING ASSURANCE COMPANY - A WHOLLY OWNED FOREIGN SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. THAT PROVIDES SELF-INSURANCE TO THE AFFILIATED GROUP. THE HANNIBAL CLINIC, INC. - A TAXABLE CORPORATION THAT OPERATES A PHYSICIAN CLINIC PROVIDING MULTI-SPECIALTY OUTPATIENT SERVICES TO THE REGION. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. KEOKUK HEALTH SYSTEMS, INC. - A PARENT COMPANY TO KEOKUK AREA MEDICAL EQUIPMENT AND SUPPLY, INC.
SCHEDULE H, PART VI, LINE 7ILLINOIS
SCHEDULE H, PART VIPART I, LINE 6B - ILLINI COMMUNITY HOSPITAL'S COMMUNITY BENEFIT REPORT IS PUBLISHED IN THE LOCAL NEWSPAPER AS AN INSERT AND IS AVAILABLE ON THE HOSPITAL'S WEBSITE @ WWW.BLESSINGHEALTH.ORG

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeFOODGrantTypeTxt
Recipient400RecipientCnt
Non Cash Assistance$10,000NonCashAssistanceAmt
Valuation Method UsedBOOKValuationMethodUsedDesc
Non Cash AssistanceFOODNonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PAGE 1, PART I, LINE 2FormAndLineReferenceDesc
ExplanationON A QUARTERLY BASIS, THE CENTRAL IL FOOD BANK SUPPLIES BLESSINGCARE CORPORATION WITH FOOD TO BE DONATED TO THOSE IN NEED WITHIN THE COMMUNITY. ILLINI THEN DISTRIBUTES THIS FOOD TO FOUR OF THE LARGER CITIES IN THE COUNTY: PITTSFIELD, BARRY, GRIGGSVILLE, AND PLEASANT HILL. THE DONATED FOOD IS AVAILABLE TO ALL RESIDENTS OF THE ENTIRE COUNTY; HOWEVER, DISTRIBUTING THE FOOD TO THESE CENTRALLY LOCATED CITIES PROVIDES GREATER ACCESS TO THOSE IN NEED. ZIP CODES OF THOSE RECEIVING FOOD ARE VERIFIED WHEN THEY DRIVE THROUGH THE FOOD DISTRIBUTION LINE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtBase Compensation Filing OrgBaseCompensationFilingOrgAmtBonus Filing OrganizationBonusFilingOrganizationAmountOther Compensation Filing OrgOtherCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
MAUREEN A KAHN RETIRED 72023
FORMER VICE-CHAIR$837,001$358,631$203,438$179,852$34,692$1,613,614$173,252
BRIAN T CANFIELD
VICE-CHAIR$654,047$293,944$28,136$130,281$12,182$1,118,590
PATRICK M GERVELER
SECRETARY/TREASURER$524,681$195,687$111,186$107,438$29,467$968,459$84,168
DR ROBERT D THOMAS
TRUSTEE/ED PHYSICIAN$395,735$13,750$35,221$5,814$37,258$484,409
DR THOMAS A CLIATT
ED PHYSICIAN$381,480$15,250$26,882$6,600$34,342$460,643
DR STUART L PYATT
ED PHYSICIAN$366,234$15,250$24,691$6,600$25,440$434,304
DR CHRISTOPHER S WAGONER
CLINIC PHYSICIAN$318,429$19,031$2,356$6,600$35,049$378,473
DR ALBORZ JAVADZADEH
PSYCHIATRIST$319,236$9,000$813$1,250$14,677$341,181
DR DAKOTA LAMMY
CLINIC PHYSICIAN$218,338$9,000$68,365$4,795$34,204$331,705
KATHLEEN E HULL RETIRED 122022
FORMER ADMINISTRATOR$296,257$296,257
HOLLY A JONES
VP/ADMIN-ILLINI$188,799$51,021$19,273$5,299$19,479$283,783

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PAGE 1, PART I, LINE 3COMPENSATION OF ORGANIZATION'S CEO - EXECUTIVE DIRECTOR - HOLLY JONES IS AN EMPLOYEE OF BLESSING CORPORATE SERVICES, INC., THE PARENT COMPANY OF BLESSINGCARE CORPORATION. COMPARABILITY DATA PROVIDED BY A THIRD PARTY IS USED TO ESTABLISH A MARKET RANGE OF COMPENSATION. THIS INFORMATION IS SUBMITTED TO THE PRESIDENT OF BLESSING CORPORATE SERVICES FOR REVIEW AND TO THE BLESSING CORPORATE SERVICES BOARD OF TRUSTEES COMPENSATION COMMITTEE FOR APPROVAL. COMPENSATION OF ORGANIZATION'S BOARD MEMBERS - PATRICK GERVELER AND BRIAN CANFIELD ARE EMPLOYEES OF BLESSING CORPORATE SERVICES, INC., THE PARENT COMPANY OF BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL. COMPARABILITY DATA PROVIDED BY A THIRD PARTY IS USED TO ESTABLISH A MARKET RANGE OF COMPENSATION. THIS INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES BOARD OF TRUSTEES COMPENSATION COMMITTEE FOR APPROVAL.
SCHEDULE J, PAGE 1, PART I, LINE 4MAUREEN A. KAHN (RETIRED 7/2023) 0 173,252 0 BRIAN T. CANFIELD 0 124,538 0 PATRICK M. GERVELER 0 100,838 0 KATHLEEN E. HULL (RETIRED 12/2022) 296,257 0 0

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF PITTSFIELDBusinessNameLine1Txt
Business Name Line2PROJECT REVENUE BONDS SERIES 2015BusinessNameLine2Txt
FieldValueIRS element (for citing)
Bond Issuer EIN370817800BondIssuerEIN
Bond Issued2015-05-12BondIssuedDt
Issue Price$3,000,000IssuePriceAmt
PurposeCONSTRUCTION CONSTRUCTION OF HOSPITAL GERIATRIC PSYCHIATRY SERVICE UNIT LOCATED ON WEST WASHINGTON SPurposeDesc
DefeasedfalseDefeasedInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Pool FinancingfalsePoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$826,728RetiredAmt
Total Proceeds$2,156,326TotalProceedsAmt
Issuance Costs From Proceeds$37,000IssuanceCostsFromProceedsAmt
Capital Expenditures$2,119,326CapitalExpendituresAmt
Substantial Completion2016SubstantialCompletionYr
Refunding Tax Exempt BondsfalseRefundingTaxExemptBondsInd
Refunding Taxable BondsfalseRefundingTaxableBondsInd
Final Allocation MadeYes (true)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (true)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed PropertyfalseOwningBondFinancedPropertyInd
Any Lease ArrangementsfalseAnyLeaseArrangementsInd
Mgmt Contract Bond Fincd PropfalseMgmtContractBondFincdPropInd
Any Research AgreementsfalseAnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt TestYes (true)BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed PropfalseChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (true)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T FiledfalseForm8038TFiledInd
Rebate Not Due YetfalseRebateNotDueYetInd
Exception To RebateYes (true)ExceptionToRebateInd
No Rebate DuefalseNoRebateDueInd
Variable Rate IssueYes (true)VariableRateIssueInd
Hedge Identified In Bks And RecfalseHedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGICInd
Gross Proceeds InvestedfalseGrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (true)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (true)ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePURPOSE OF ISSUE DESCRIPTIONFormAndLineReferenceDesc
ExplanationCITY OF PITTSFIELD CONSTRUCTION CONSTRUCTION OF HOSPITAL GERIATRIC PSYCHIATRY SERVICE UNIT LOCATED ON WEST WASHINGTON STREET IN PITTSFIELD, ILLINOIS.ExplanationTxt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp

FieldValueIRS element (for citing)
PersonDR ROBERT D THOMASPersonNm
Relationship With OrgEMPLOYEE/TRUSTEERelationshipWithOrgTxt
Loan PurposeEDUCATIONAL LOANLoanPurposeTxt
Loan From OrganizationYes (X)LoanFromOrganizationInd
Original Principal$30,000OriginalPrincipalAmt
Balance Due$25,000BalanceDueAmt
DefaultfalseDefaultInd
Board Or Committee ApprovalYes (true)BoardOrCommitteeApprovalInd
Written AgreementYes (true)WrittenAgreementInd
FieldValueIRS element (for citing)
Total Balance Due$25,000TotalBalanceDueAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonJOHN HULLPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionFAMILY MEMBERRelationshipDescriptionTxt
Transaction$88,766TransactionAmt
TransactionEMPLOYMENTTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4AILLINI COMMUNITY HOSPITAL TREATED PATIENTS THROUGH THE FOLLOWING SERVICES DURING FISCAL YEAR 2024: INPATIENT ADMISSIONS 454 OBSERVATION ADMISSIONS 197 OUTPATIENT VISITS 88,336 TOTAL SURGERIES 370 EMERGENCY VISITS 6,333 LABORATORY TESTS 72,108 RESPIRATORY TREATMENTS 641 RADIOLOGY PROCEDURES 9,965 RURAL HEALTH CLINIC & XPRESS VISITS 17,644 IN ADDITION TO THESE HEALTHCARE SERVICES, ILLINI COMMUNITY HOSPITAL PROVIDED 419,967 IN CHARITY CARE AND INCURRED MEDICARE SHORTFALLS OF 106,325. THE HOSPITAL PROVIDED ADDITIONAL BENEFITS DURING FISCAL YEAR 2024 AS FOLLOWS: 1)HEALTH PROFESSIONALS EDUCATION - 2,000 COLLEGE SCHOLARSHIPS 2)IN-KIND CONTRIBUTIONS AND DONATIONS - 19,869 COULSON PUBLICATIONS - WEEKLY WELLNESS PAGE LOCAL FAIRS AND EVENTS SUPPORT 3)COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND SERVICES - 85,570 TRANSPORT VANS FOOD DISTRIBUTIONS DRUG TAKE BACK KIOSK ICAHN MEMBERSHIP PIKE COUNTY CEO AND ECONOMIC DEVELOPMENT FEES TWO RIVERS RESOURCE CONSERVATION AND DEVELOPMENT
FORM 990, PART VIBLESSINGCARE CORPORATION CONTRACTS WITH BLESSING CORPORATE SERVICES TO EXECUTE THE DUTIES NORMALLY PERFORMED BY MANAGEMENT. THE MANAGEMENT COMPANY CARRIES OUT THE GOVERNING DECISIONS OF THE BOARD OF DIRECTORS, SIMILAR TO THE ROLE AND FUNCTIONS OF AN EMPLOYEE-OFFICER. BLESSING CORPORATE SERVICES PAID COMPENSATION TO VARIOUS EMPLOYEES COLLECTIVELY ACTING AS MANAGEMENT. THE COMPENSATION PAID TO THREE OF THOSE EMPLOYEES WHO SERVE ON BLESSINGCARE CORPORATION BOARD OF DIRECTORS IS DISCLOSED ON PART VII.
FORM 990, PAGE 6, PART VI, LINE 3IN ORDER TO ACHIEVE COST EFFICIENCIES, BLESSINGCARE CORPORATION AND ITS SOLE MEMBER, BLESSING CORPORATE SERVICES, INC. HAVE ENTERED AN INTERCOMPANY MANAGEMENT SERVICES AGREEMENT WHEREBY BLESSING CORPORATE SERVICES PROVIDES MANAGEMENT SERVICES TO BLESSINGCARE CORPORATION
FORM 990, PAGE 6, PART VI, LINE 6BLESSING CORPORATE SERVICES, INC., AN ILLINOIS NOT FOR PROFIT CORPORATION, IS THE SOLE VOTING MEMBER OF BLESSINGCARE CORPORATION, DBA ILLINI COMMUNITY HOSPITAL.
FORM 990, PAGE 6, PART VI, LINE 7ABLESSING CORPORATE SERVICES, INC., THE SOLE VOTING MEMBER OF BLESSINGCARE CORPORATION, SHALL POSSESS THE RIGHTS AND RESPONSIBILITIES TO APPOINT AND/OR REMOVE ALL THE TRUSTEES OF THE CORPORATION, AND APPOINT THE CORPORATION'S PRESIDENT.
FORM 990, PAGE 6, PART VI, LINE 7BBLESSING CORPORATE SERVICES, INC., THE SOLE VOTING MEMBER OF BLESSINGCARE CORPORATION, SHALL POSSESS THE RIGHTS AND RESPONSIBILITIES TO APPROVE EXPRESSLY ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE; APPROVE CAPITAL AND OPERATING BUDGETS, LONG-TERM DEBT, LONG-RANGE PLANS, THE SALE OR PURCHASE OF REAL ESTATE AND CONTRACTS ENTERED INTO BY THE CORPORATION, THE REASONABLE VALUE OF WHICH EXCEEDS AN AMOUNT SPECIFIED IN THE BYLAWS OF THE MEMBER; APPROVE MATERIAL INVESTMENT DECISIONS, INCLUDING WITHOUT LIMITATION ESTABLISHMENT AND MODIFICATION OF INVESTMENT POLICIES, ENGAGEMENT AND REMOVAL OF INVESTMENT MANAGERS AND ADVISORS, AND CHANGES IN INVESTMENT ALLOCATIONS NOT PERMITTED BY AN EXISTING INVESTMENT POLICY; APPROVE THE PARAMETERS FOR TERMS OF EMPLOYMENT OF PHYSICIANS, INCLUDING PHYSICIAN COMPENSATION PLANS, AND ANY MATERIAL VARIANCES FROM SUCH PARAMETERS FOR INDIVIDUAL PHYSICIANS; APPROVE THE SELECTION OF AUDITORS AND LEGAL COUNSEL; APPROVE CHARITY CARE AND COMMUNITY BENEFITS-RELATED POLICIES; APPROVE THE FORMATION OF SUBSIDIARY ENTITIES AND/OR JOINT VENTURES; APPROVE THE FILING OF A PETITION IN BANKRUPTCY, MAKING AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS, OR APPLYING FOR PROTECTION UNDER ANY INSOLVENCY LAWS; APPROVE THE PARTICIPATION IN ANY MERGER, COMBINATION, CONSOLIDATION, LIQUIDATION, DISSOLUTION, OR OTHER CORPORATE OR BUSINESS ENTITY RESTRUCTURING; HAVE THE POWER TO COMPEL THE CORPORATION TO ENFORCE AND/OR PERFORM ANY CONTRACTUAL OBLIGATION; APPROVE THE DEVELOPMENT, IMPLEMENTATION, MONITORING, AND REPORTING ON THE COMMUNITY BENEFITS PLANS, PROGRAMS, AND OTHER ACTIVITIES OF THE CORPORATION, INCLUDING, BUT NOT LIMITED TO, THE COMMUNITY NEEDS ASSESSMENT; APPROVE ADVOCACY EFFORTS ON BEHALF OF PATIENTS, THE COMMUNITY, AND THE CORPORATION REGARDING THE ALLOCATION OF EXTERNAL AND INTERNAL RESOURCES TO THE COMMUNITY'S HEALTH NEEDS; AND DETERMINE TRUSTEE COMPENSATION, IF ANY.
FORM 990, PAGE 6, PART VI, LINE 11BFOLLOWING MANAGEMENT REVIEW, THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 12CA COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO BE READ, SIGNED, AND RETURNED TO THE ORGANIZATION. THE SIGNED POLICIES ARE RETAINED IN THE CORPORATE ADMINISTRATIVE FILES. IN ADDITION, EACH OFFICER, DIRECTOR, OR TRUSTEE IS REQUIRED TO DECLARE NO CONFLICT OF INTEREST IN REGARDS TO AGENDA ITEMS BEING PRESENTED AT THE START OF EACH MONTHLY BOARD MEETING.
FORM 990, PAGE 6, PART VI, LINE 19THESE DOCUMENTS ARE LOCATED IN THE HOSPITAL'S ADMINISTRATIVE OFFICES AND ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtBusiness Name Line2DirectControllingEntityName/BusinessNameLine2Txt
BLESSING CORPORATE SERVICES INC
BROADWAY AT 11TH PO BOX 7005QUINCYIL623057005371128706MGMT SVCSIL501C310N/Afalse
BLESSING HOSPITAL
1005 BROADWAYQUINCYIL62301370661183HOSPITALIL501C33falseBCS INCBLESSING CORPORATE SERVICES INC
THE BLESSING FOUNDATION INC
BROADWAY AT 11TH PO BOX 7005QUINCYIL623057005371128705FUNDRAISEIL501C312BfalseBCS INCBLESSING CORPORATE SERVICES INC
KEOKUK HEALTH SYSTEMS INC
1600 MORGAN STREETKEOKUKIA52632421237361MGMT SVCSIA501C312BfalseBCS INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CURRENT HEALTH NETWORK LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11005 BROADWAYAddressLine1Txt
CityQUINCYCityNm
State AbbreviationILStateAbbreviationCd
ZIP62301ZIPCd
FieldValueIRS element (for citing)
EIN811681509EIN
Primary ActivitiesPRVDR NTWKPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CHS HLDGSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerfalseGeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
DENMAN SERVICES INC
PO BOX 40QUINCYIL62306371132117MED EQUIPILBCS INCC CORPfalse
CHS HOLDING COMPANY
1005 BROADWAYQUINCYIL62301320481381GRP HLTHILBCS INCC CORPfalse
HANNIBAL CLINIC INC
100 MEDICAL DRIVEHANNIBALMO63401431033473MED SVCSMOBCS INCC CORPfalse
BLESSING ASSURANCE COMPANY
981454767SELF-INSURBCS INCC CORPfalsePO BOX 1159GRAND CAYMANCAYMAN ISLANDSCJKY1-1102CJ
KEOKUK AREA MEDICAL EQUIP & SUPPLY
420 NORTH 17TH STREETKEOKUKIA52632421237312MED EQUIPIAKHS INCC CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (true)LoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangeYes (true)AssetExchangeInd
Rental Of Facilities To Oth OrgYes (true)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd