GRAHAM HOSPITAL ASSOCIATION: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- GRAHAM HOSPITAL ASSOCIATION (EIN 37-0673506)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-02-08
- IRS object ID
- 202120399349300002
- Schema version
- 2019v5.1
- 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 H
- Schedule I
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-02-08T06:35:06-06:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370673506 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAH | BusinessNameControlTxt |
| Phone | 3096475240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61520 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT G SENNEFF | PersonNm |
| Person Title | PRESIDENT AND CEO | PersonTitleTxt |
| Phone | 3096475240 | PhoneNum |
| Signature | 2021-01-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2021-01-27 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT G SENNEFF | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61520 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $151,977,032 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GRAHAMHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES, IN A RESPONSIBLE AND CHARITABLE MANNER, TO THE PEOPLE AND COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 852 | TotalEmployeeCnt |
| Total Volunteers | 74 | TotalVolunteersCnt |
| Total Gross UBI | $232,043 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $399,717 | PYContributionsGrantsAmt |
| CY Contributions Grants | $70,713 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $85,089,299 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $94,803,032 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,397,555 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,566,207 | CYInvestmentIncomeAmt |
| PY Other Revenue | $929,030 | PYOtherRevenueAmt |
| CY Other Revenue | $121,840 | CYOtherRevenueAmt |
| PY Total Revenue | $89,815,601 | PYTotalRevenueAmt |
| CY Total Revenue | $98,561,792 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $82,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $44,648,460 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $42,342,282 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $43,680,585 | PYOtherExpensesAmt |
| CY Other Expenses | $50,144,640 | CYOtherExpensesAmt |
| PY Total Expenses | $88,329,045 | PYTotalExpensesAmt |
| CY Total Expenses | $92,569,422 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,486,556 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,992,370 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $194,646,676 | TotalAssetsBOYAmt |
| Total Assets EOY | $225,591,552 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $61,596,588 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $91,941,161 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $133,050,088 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $133,650,391 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES, IN A RESPONSIBLE AND CHARITABLE MANNER, TO THE PEOPLE AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $38,495,304 | ExpenseAmt |
| Grant | $82,500 | GrantAmt |
| Revenue | $47,877,204 | RevenueAmt |
| Desc | GRAHAM HOSPITAL IS A PROVIDER OF HEALTHCARE SERVICES IN FULTON COUNTY, ELMWOOD AND SURROUNDING AREAS. DURING THIS REPORTING PERIOD, 2,376 ADULTS AND CHILDREN WERE ADMITTED AND 223 BABIES WERE BORN. THEY RECEIVED INPATIENT SERVICES IN THE ACUTE CARE FACILITY. 230 PATIENTS WERE ADMITTED FOR 8,191 DAYS OF SERVICE IN THE EXTENDED CARE FACILITY. 97,648 OUTPATIENT SERVICES WERE PROVIDED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $19,917,618 | ExpenseAmt |
| Revenue | $24,771,850 | RevenueAmt |
| Desc | SURGICAL SERVICES - THE HOSPITAL PERFORMED 548 INPATIENT SURGERIES AND 3,125 OUTPATIENT SURGERIES IN FISCAL YEAR 2020. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $11,498,748 | ExpenseAmt |
| Revenue | $14,301,171 | RevenueAmt |
| Desc | GRAHAM MEDICAL GROUP WHICH PROVIDES PHYSICIAN AND PROFESSIONAL HEALTH CARE SERVICES TO THE PATIENTS IN FULTON COUNTY AND ELMWOOD, ILLINOIS. THIS INCLUDES CHARITY CARE TO QUALIFIED INDIVIDUALS AND 92,794 OFFICE VISITS AND 12,199 NURSING HOME AND HOSPITAL VISITS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,127,418 | ExpenseAmt |
| Revenue | $7,620,764 | RevenueAmt |
| Desc | ED PROGRAM(MISSING PROGRAM DESCRIPTION) | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $6,127,418 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $7,620,764 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $76,039,088 | 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 | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | 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 | 73 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 852 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT SENNEFF | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3096475240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61520 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| BRENT PARRY DPM | ||||||||
| PODIATRIST | 36.00 | Yes (X) | $469,284 | $0 | $44,306 | |||
| JULIO RAMOS MD | ||||||||
| PHYSICIAN | 36.00 | Yes (X) | $408,111 | $0 | $20,066 | |||
| DEVASHISH AGARWAL MD | ||||||||
| PHYSICIAN | 36.00 | Yes (X) | $375,613 | $0 | $45,223 | |||
| JEFFREY HEMP MD | ||||||||
| PHYSICIAN | 36.00 | Yes (X) | $295,503 | $0 | $42,607 | |||
| JOHN QUINONES DO | ||||||||
| PHYSICIAN | 36.00 | Yes (X) | $234,179 | $0 | $0 | |||
| KEITH IFFT MD | ||||||||
| ANESTHESIOLOGIST MEDICAL DIRECTOR | 36.00 | $429,152 | $0 | $61,033 | Yes (X) | |||
| DWAYNE BERNARD MD | ||||||||
| MEDICAL DIRECTOR | 36.00 | $415,312 | $0 | $48,566 | Yes (X) | |||
| ANDREW ROUDEBUSH DO | ||||||||
| WOUND CLINIC DIRECTOR | 36.00 | $288,287 | $0 | $41,827 | Yes (X) | |||
| ROBERT SENNEFF | ||||||||
| PRESIDENT/CEO | 40.00 | $677,924 | $0 | $88,444 | Yes (X) | Yes (X) | ||
| JULIE REEDER | ||||||||
| VP FINANCE/CFO | 40.00 | $206,362 | $0 | $50,782 | Yes (X) | |||
| HOLLY HENLINE | ||||||||
| VP ANCILLARY/CCO | 40.00 | $196,460 | $0 | $67,782 | Yes (X) | |||
| JAMES SCHREINER | ||||||||
| VP INFO SERVICES | 40.00 | $222,455 | $0 | $36,199 | Yes (X) | |||
| TERESA MCCONKEY | ||||||||
| VP PATIENT SERVICES | 40.00 | $220,710 | $0 | $37,674 | Yes (X) | |||
| ALLISON SOURS | ||||||||
| VP QUALITY | 40.00 | $165,133 | $0 | $27,622 | Yes (X) | |||
| MICHELLE DALY | ||||||||
| VP CLINIC SERVICES | 40.00 | $141,766 | $0 | $30,813 | Yes (X) | |||
| MIKE RENNER | ||||||||
| CHAIRMAN | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| ROBERT BOBELL OD | ||||||||
| VICE CHAIRMAN | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| JANIS BLOUT | ||||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| BILL CARLBERG | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| BROOKE DENNISTON | ||||||||
| TRUSTEE (THRU DECEMBER) | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| PAULA GRIGSBY | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| DONALD HACKETT | ||||||||
| TRUSTEE (THRU DECEMBER) | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| ANNE HOLLIS | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| ELIZABETH JAMES | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| KENNETH KROCK MD | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| KEVIN MEADE | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| MARION KUZNIAR | ||||||||
| TRUSTEE (THRU DECEMBER) | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| JOSHUA MILLER | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| TERRY MOSS | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| PATRICK RENICK MD | ||||||||
| TRUSTEE | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,746,251 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $642,944 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | 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 |
|---|---|---|---|---|---|
| COLEMAN MEDICAL ASSOCIATES | |||||
| 180 SOUTH MAIN STREET | CANTON | IL | 61520 | PHYSICIAN SERVICES | $8,235,071 |
| PJ HOERR INC | |||||
| 107 W COMMERCE | PEORIA | IL | 61604 | CONSTRUCTION | $2,683,973 |
| ENDURACARE ACUTE CARE SERVICES | |||||
| PO BOX 654072 | DALLAS | TX | 75265 | REHAB SERVICES | $1,993,404 |
| PEORIA SURGICAL GROUP LTD | |||||
| 1001 MAIN ST SUITE 300 | PEORIA | IL | 61606 | SURGICAL SERVICES | $753,466 |
| PARK PLACE INTERNATIONAL | |||||
| 7227 CHAGRIN ROAD | CHAGRIN FALLS | OH | 44023 | CLOUD CARE SUPPORT SERVICES | $636,063 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $70,713 | AllOtherContributionsAmt |
| Total Contributions | $70,713 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 900099 | $87,468,050 | $87,468,050 | |
| 340(B) REVENUE | 900099 | $5,765,781 | $5,765,781 | |
| SCHOOL OF NURSING | 900099 | $263,547 | $263,547 | |
| LABORATORY | 900099 | $157,347 | $157,347 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,148,307 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,073,611 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $74,696 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $94,803,032 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,887,330 | TotalRevenueColumnAmt |
| Exclusion | $2,887,330 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $397,694 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $275,854 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $121,840 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $121,840 | TotalRevenueColumnAmt |
| Exclusion | $121,840 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $53,803,483 | SecuritiesAmt |
| Other | $14,780 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $53,139,386 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $664,097 | SecuritiesAmt |
| Other | $14,780 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $678,877 | TotalRevenueColumnAmt |
| Exclusion | $678,877 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,561,792 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $94,570,989 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $232,043 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,688,047 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,000 | TotalAmt |
| Program Services | $80,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500 | TotalAmt |
| Program Services | $2,500 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,170,126 | TotalAmt |
| Program Services | $390,505 | ProgramServicesAmt |
| Management And General | $1,779,621 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,084,188 | TotalAmt |
| Program Services | $25,567,893 | ProgramServicesAmt |
| Management And General | $5,516,295 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $550,655 | TotalAmt |
| Program Services | $550,655 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,284,080 | TotalAmt |
| Program Services | $5,218,945 | ProgramServicesAmt |
| Management And General | $1,065,135 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,253,233 | TotalAmt |
| Program Services | $1,834,599 | ProgramServicesAmt |
| Management And General | $418,634 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $226,944 | TotalAmt |
| Management And General | $226,944 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,897 | TotalAmt |
| Management And General | $82,897 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,869 | TotalAmt |
| Management And General | $76,869 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,013,476 | TotalAmt |
| Program Services | $18,821,862 | ProgramServicesAmt |
| Management And General | $1,191,614 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $461,354 | TotalAmt |
| Program Services | $7,279 | ProgramServicesAmt |
| Management And General | $454,075 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $416,203 | TotalAmt |
| Program Services | $172,838 | ProgramServicesAmt |
| Management And General | $243,365 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,489 | TotalAmt |
| Program Services | $75,067 | ProgramServicesAmt |
| Management And General | $86,422 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,761,309 | TotalAmt |
| Program Services | $1,407,376 | ProgramServicesAmt |
| Management And General | $353,933 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,047 | TotalAmt |
| Program Services | $13,233 | ProgramServicesAmt |
| Management And General | $34,814 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,065 | TotalAmt |
| Program Services | $11,653 | ProgramServicesAmt |
| Management And General | $2,412 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,475,076 | TotalAmt |
| Program Services | $1,280,340 | ProgramServicesAmt |
| Management And General | $194,736 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,631,254 | TotalAmt |
| Program Services | $4,867,436 | ProgramServicesAmt |
| Management And General | $763,818 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,137,340 | TotalAmt |
| Management And General | $1,137,340 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $9,961,528 | $9,961,528 | |
| BAD DEBT EXPENSE | $4,358,588 | $4,358,588 | |
| MEDICAID ASSESSMENT | $2,287,704 | $2,287,704 | |
| DIETARY | $663,467 | $641,610 | $21,857 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,367,030 | TotalAmt |
| Program Services | $775,181 | ProgramServicesAmt |
| Management And General | $591,849 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,569,422 | TotalAmt |
| Program Services | $76,039,088 | ProgramServicesAmt |
| Management And General | $16,530,334 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $702,413 | BOYAmt |
| EOY | $6,334,627 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,572,625 | BOYAmt |
| EOY | $14,429,098 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,329,607 | BOYAmt |
| EOY | $9,702,725 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,932,186 | BOYAmt |
| EOY | $3,187,907 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,846,830 | BOYAmt |
| EOY | $2,056,836 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,700,920 | BOYAmt |
| EOY | $1,217,144 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $145,685,064 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $69,353,014 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,588,874 | BOYAmt |
| EOY | $76,332,050 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,868,947 | BOYAmt |
| EOY | $101,499,670 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,764,595 | BOYAmt |
| EOY | $8,560,121 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,339,679 | BOYAmt |
| EOY | $2,271,374 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,646,676 | BOYAmt |
| EOY | $225,591,552 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,915,782 | BOYAmt |
| EOY | $10,276,562 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $9,456,740 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,069,585 | BOYAmt |
| EOY | $59,836,900 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,288,784 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,611,221 | BOYAmt |
| EOY | $11,082,175 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,596,588 | BOYAmt |
| EOY | $91,941,161 | 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 | $124,285,493 | BOYAmt |
| EOY | $125,090,270 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,764,595 | BOYAmt |
| EOY | $8,560,121 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,050,088 | BOYAmt |
| EOY | $133,650,391 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,646,676 | BOYAmt |
| EOY | $225,591,552 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,992,370 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$4,185,837 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$1,206,230 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| 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 | $23,432 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $23,432 | 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 | LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED: 37% OF MEMBERSHIP DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION, OR $13,874; 37% OF MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION, OR $8,806; 27.48% OF MEMBERSHIP DUES PAID TO THE ILLINOIS HEALTH CARE ASSOCIATION, OR $752. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $94,502,686 | BeginningYearBalanceAmt |
| Contributions | $167,929 | ContributionsAmt |
| Investment Earnings Or Losses | -$1,066,495 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $7,200 | GrantsOrScholarshipsAmt |
| Other Expenditures | $114,228 | OtherExpendituresAmt |
| Administrative Expenses | $256,881 | AdministrativeExpensesAmt |
| End Year Balance | $93,225,811 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $91,454,034 | BeginningYearBalanceAmt |
| Contributions | $860,760 | ContributionsAmt |
| Investment Earnings Or Losses | $3,919,679 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $12,300 | GrantsOrScholarshipsAmt |
| Other Expenditures | $256,453 | OtherExpendituresAmt |
| Administrative Expenses | $1,463,034 | AdministrativeExpensesAmt |
| End Year Balance | $94,502,686 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,121,870 | BeginningYearBalanceAmt |
| Contributions | $621,102 | ContributionsAmt |
| Investment Earnings Or Losses | $5,169,957 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $13,150 | GrantsOrScholarshipsAmt |
| Other Expenditures | -$5,143,522 | OtherExpendituresAmt |
| Administrative Expenses | $589,245 | AdministrativeExpensesAmt |
| End Year Balance | $91,454,056 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $76,601,005 | BeginningYearBalanceAmt |
| Contributions | $131,055 | ContributionsAmt |
| Investment Earnings Or Losses | $8,619,102 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $10,550 | GrantsOrScholarshipsAmt |
| Other Expenditures | $302,248 | OtherExpendituresAmt |
| Administrative Expenses | $916,494 | AdministrativeExpensesAmt |
| End Year Balance | $84,121,870 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $74,358,133 | BeginningYearBalanceAmt |
| Contributions | $292,468 | ContributionsAmt |
| Investment Earnings Or Losses | -$235,443 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $8,445 | GrantsOrScholarshipsAmt |
| Other Expenditures | $12,750 | OtherExpendituresAmt |
| Administrative Expenses | $792,958 | AdministrativeExpensesAmt |
| End Year Balance | $73,601,005 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.90820 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.08980 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00200 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,265,233 | OtherCostOrOtherBasisAmt |
| Book Value | $3,265,233 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $90,478,505 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,769,760 | DepreciationAmt |
| Book Value | $56,708,745 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $50,214,692 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,475,782 | DepreciationAmt |
| Book Value | $16,738,910 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,726,634 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,107,472 | DepreciationAmt |
| Book Value | -$380,838 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $76,332,050 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED SELF-INSURANCE COSTS | $2,789,228 |
| ASSET RETIREMENT OBLIGATION | $266,162 |
| DEFERRED COMPENSATION PLAN OBLIGATIONS | $1,287,193 |
| FMV OF SWAP OPTIONS | $4,895,255 |
| DUE TO THIRD PARTY PAYORS | $1,844,337 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,082,175 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $88,902,978 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$4,185,837 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$5,472,977 | OtherRevenueAmt |
| Revenue Not Reported | -$9,658,814 | RevenueNotReportedAmt |
| Revenue Subtotal | $98,561,792 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $98,561,792 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $88,506,341 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$4,063,081 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$4,063,081 | ExpensesNotReportedAmt |
| Expenses Subtotal | $92,569,422 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $92,569,422 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO PROVIDE SCHOLARSHIPS BASED ON STUDENT NEEDS FROM THE INCOME OF THE DONOR-RESTRICTED ENDOWMENT FUNDS. THE PERMANENT ENDOWMENT IS USED FOR THE PURCHASE OF PROPERTY AND EQUIPMENT. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -1,409,896. RENTAL EXPENSES 275,854. BAD DEBT EXPENSE -4,338,935. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE -4,338,935. RENTAL EXPENSES 275,854. |
| PART V, LINE 3A(I) | CHARLES D INGERSOLL TRUST AND WILLIAM P INGERSOLL TRUST ARE ADMINISTERED BY MIDAMERICA NATIONAL BANK AND J.P. MORGAN |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 180.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,645,548 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,645,548 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01780 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,331,723 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,001,548 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,330,175 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02520 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,977,271 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,001,548 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,975,723 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04300 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $48,646 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,125 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $46,521 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,382 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,382 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $199,719 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,200 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $198,519 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00210 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $258,747 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,325 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $255,422 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,236,018 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $14,004,873 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,231,145 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04570 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,916 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,916 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,916 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $6,916 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $1,561,429 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $21,846,540 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $24,310,244 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,463,704 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| 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 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT STREET | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61520 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.GRAHAMHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| State License | 0000869 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 | 19 | 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 SUPPLEMENTAL INFORMATION | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 19 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL INFORMATION | 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 | 180.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| 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 | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | 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 |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| 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 | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 5: FOCUS GROUP 1 COMMUNITY LEADERS AND REPRESENTATIVESRUSTY MELHOUSE FINANCIAL ADVISOR EDWARD D. JONESTRYGVE MEADE ATTORNEY/PROPRIETOR MEADE LAW OFFICEJEFF STANDARD SHERIFF FULTON COUNTY SHERIFF'S DEPARTMENTAMANDA ATCHLEY EXECUTIVE DIRECTOR CANTON AREA CHAMBER OF COMMERCEAARON AND VEANNA THUM OWNERS CRAWFORD'S HOME FURNISHINGSKATHY EDWARDS PRESIDENT GRAHAM HOSPITAL SERVICE LEAGUEROLF SILVERSTEIN SUPERINTENDENT CANTON UNION SCHOOL DISTRICT #66BROOKE DENNISTON EXECUTIVE DIRECTOR CANTON YWCAJAY SHEPLER REPRESENTATIVE ST. MARY'S FOOD PANTRYREV. KEVIN VAN TINE PASTOR COVENANT COMMUNITY FELLOWSHIP, CANTONKENT MCDOWELL MAYOR CITY OF CANTONDICK FAIRBURN PUBLIC SAFETY DIRECTOR CITY OF CANTONIDENTIFICATION AND PRIORITIZATION GROUPAMANDA ATCHLEY EXECUTIVE DIRECTOR CANTON AREA CHAMBER OF COMMERCEKATIE LYNN ADMINISTRATOR FULTON COUNTY HEALTH DEPARTMENTMISSY KOLOWSKI ADMINISTRATOR HEALTH & WELLNESS CONNECTION OF FULTON COUNTYMICHELLE LOCKE CLINICAL SOCIAL WORKER GRAHAM HOSPITALSUE LIVINGSTON DIRECTOR GRAHAM SCHOOL OF NURSINGJEFF HOWD ADMINISTRATOR THE LOFT REHAB & NURSING CENTER, CANTON |
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 7D: HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 11: 1. PREVALENCE OF OBESITY AMONG YOUTH AND ADULTS IN THE COMMUNITY, AND THE NEED FOR NUTRITION EDUCATION FOR THE COMMUNITY AND ACCESS TO HEALTHY FOODS.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED:A) EXPAND THE PRITIKEN CARDIAC PROGRAM:THE PROGRAM WAS CLOSED DOWN FOR CLOSE TO 2 MONTHS, DUE TO COVID, AND HAS TAKEN SOME TIME TO BUILD BACK UP. WE ARE STILL STRUGGLING TO GROW THIS SERVICE, AS PATIENTS SEEM TO HAVE A LESSENED INTEREST IN THE EDUCATIONAL PIECE DURING THIS PANDEMIC, AND THE REFERRALS HAVE BEEN LOWER AS WELL.B) CREATE A COMMUNITY BIKE SHARE PROGRAM:THIS PROGAM WENT LIVE ON APRIL 5, 2019 IN PARTNERSHIP WITH THE CANTON PARK DISTRICT. THE BIKE SHARE PROGRAM HAS 3 LOCATIONS (GRAHAM MEDICAL GROUP, WALLACE PARK, AND LAKELAND PARK) THAT RESIDENTS ARE ABLE TO RENT BIKES USING A MOBILE APP. ADDITIONAL INFORMATION CAN BE FOUND BY VISITING THE CANTON BIKE SHARE FACEBOOK PAGE.C) COLLABORATE WITH THE YMCA TO PRESENT A HEALTHY KIDS DAYD) GROW PROGRAMS FOR BUSINESS AT THE COMMUNITY WELLNESS CENTER:THIS INITIATIVE HAS BEEN TREMENDOUSLY IMPACTED DUE TO COVID. THE HOSPITAL HAS HAD THE WELLNESS CENTER CLOSED DOWN TO THESE TYPE OF OPERATIONS SINCE MARCH.E) CREATE WELLNESS CHECK PROGRAMS:THIS INITIATIVE HAS BEEN TREMENDOUSLY IMPACTED DUE TO COVID. THE HOSPITAL HAS HAD THE WELLNESS CENTER CLOSED DOWN TO THESE TYPE OF OPERATIONS SINCE MARCH.F) IMPROVE PATIENT BMI THROUGH TRACKING AND EDUCATION AT CLINICS AND THE WELLNESS CENTER:THIS INITIATIVE HAS BEEN TREMENDOUSLY IMPACTED DUE TO COVID. THE HOSPITAL HAS HAD THE WELLNESS CENTER CLOSED DOWN TO THESE TYPE OF OPERATIONS SINCE MARCH.2. PREVALENCE OF DIABETES IN THE COMMUNITY AND THE NEED FOR PHYSICAL, HEALTH, AND NUTRITION EDUCATION FOR YOUTH AND ADULTS, AND FOR ACCESS TO REASONABLY PRICED INSULIN AND OTHER DIABETES MEDICATIONS FOR THE UNDERINSURED AND UNINSURED.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED:A) EXPAND THE PRITIKEN CARDIAC PROGRAM:THE PROGRAM WAS CLOSED DOWN FOR CLOSE TO 2 MONTHS, DUE TO COVID, AND HAS TAKEN SOME TIME TO BUILD BACK UP. WE ARE STILL STRUGGLING TO GROW THIS SERVICE, AS PATIENTS SEEM TO HAVE A LESSENED INTEREST IN THE EDUCATIONAL PIECE DURING THIS PANDEMIC, AND THE REFERRALS HAVE BEEN LOWER AS WELL.B) EXPAND MERIT-BASED INCENTIVE PAYMENT SYSTEM ADDRESSING A1C MEASURESC) CONTINUE TO SUPPORT CONNECTIONS CLINIC:THE HOSPITAL DONATES $5,000 MONTHLY TO THE HEALTH & WELLNESS CONNECTION OF FULTON COUNTY. THE HEALTH & WELLNESS CONNECTION OF FULTON COUNTY (HWCFC) IS A CASE MANAGEMENT FACILITY STAFFED BY DEDICATED VOLUNTEERS AND PROFESSIONALS. OUR MISSION IS TO HELP LOCAL PROVIDERS WITH QUALITY PRIMARY HEALTHCARE FOR THE UNDERINSURED PATIENTS AND UNDERSERVED RESIDENTS OF FULTON COUNTY. SERVICES INCLUDE: HELP WITH MEDICATION COSTS; HELP WITH DIABETIC SUPPLIES; HELP WITH VISION CARE COST; HELP WITH DENTAL CARE COSTS; COUNSELING; HELP WITH CERTAIN HEALTH RELATED TRANSPORTATION COSTS; FLU SHOTSD) CONTINUE SUPPORT OF BIO-MED CLASSROOM AND EDUCATION PROGRAMS AT CANTON HIGH SCHOOL:THE HOSPITAL DONATED $25,000 TO CANTON HIGH SCHOOL TO HELP BUILD A STATE OF THE ART BIO-MED CLASSROOM THAT WILL BE USED TO HOUSE THE FOLLOWING COURSES: PRINCIPLES OF BIOMEDICAL SCIENCE, BIOLOGY, BIOLOGY 11, AND HUMAN BODY SYSTEMS. MORE INFORMATION ON THIS PROJECT CAN BE FOUND HERE: HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/NEWS/2018/10/GRAHAM-HEALTH-SYSTEM-BIOMEDICAL-LAB3. THE THIRD PRIORITIZED NEED WAS MENTAL HEALTH, INCLUDING:A) RESOURCES TO ADDRESS SUICIDEB) LOCAL ACCESS TO MENTAL HEALTH PROVIDERS AT ALL LEVELSC) LOCAL MENTAL HEALTH SUPPORT SERVICESD) LOCAL ACCESS TO DETOXIFICATION, REHABILITATION, AND RECOVERY FOR PERSONS FACING SUBSTANCE USE DISORDERS4. THE GROUP NEXT IDENTIFIED THE NEED TO ADDRESS THE NUMBER OF LOCAL TEEN BIRTHS.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED:A) EXPLORE FACE-TO-FACE EDUCATION BETWEEN MEDICAL STAFF AND STUDENTSB) PROVIDE SUPPORT FOR THE FULTON COUNTY HEALTH DEPARTMENT IN ITS EFFORTS TO ADDRESS THIS ISSUEDURING THE 2020 CALENDAR YEAR, THE HOSPITAL HAS BEEN ACTIVELY WORKING ON A DEDICATED BEHAVIORAL HEALTH PROGRAM TO BRING INTO OUR CLINICS. THE PROGRAM IS SET TO KICK OFF AT THE BEGINNING OF CALENDAR YEAR 2021. THE BEHAVIORAL HEALTH SPECIALIST WILL COVER THE FOLLOWING:- ANXIETY, DEPRESSION, ADJUSTMENT DISORDERS, AND OTHER BEHAVIORAL HEALTH DIAGNOSES - SMOKING CESSATION; STRESS MANAGEMENT- BEHAVIORAL INTERVENTIONS FOR WEIGHT LOSS AND HEALTHY LIFESTYLE CHANGES- RELATIONSHIP ISSUES AND/OR DOMESTIC VIOLENCE CONCERNS- CHRONIC PAIN AND PAIN MANAGEMENT- PSYCHOTROPIC MEDICATIONS - GRIEF AND BEREAVEMENT ISSUES- CAREGIVER BURDEN- SUBSTANCE MISUSE OR ABUSE (OR SUSPECTED)- TRAUMA (BRIEF TREATMENT THEN MOST LIKELY TRIAGE)- SOMATIC SYMPTOMS; NON-ADHERENCE TO TREATMENT PLAN- MENTAL HEALTH CRISIS (PANIC ATTACKS, SUICIDAL OR HOMICIDAL IDEATION, SUSPECTED PHYSICAL OR MENTAL ABUSE)- MONITORING OF DISCHARGED PATIENTS FROM PSYCHIATRIC IN-PATIENT UNTIL A HIGHER LEVEL OF CARE CAN BE ESTABLISHED5. THE GROUP'S FINAL IDENTIFIED NEED WAS ACCESS TO INCREASE LOCAL ACCESS TO DENTISTS FOR UNDERINSURED AND UNINSURED COMMUNITY MEMBERS.ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED:A) GRAHAM HOSPITAL WILL CONTINUE TO PROVIDE FINANCIAL SUPPORT FOR DENTAL SERVICES AT THE CONNECTIONS CLINICB) GRAHAM HOSPITAL WILL SUPPORT, AS REASONABLY POSSIBLE, EFFORTS BY THE FULTON COUNTY HEALTH DEPARTMENT TO PROVIDE DENTAL SERVICES |
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 16J: THE FAP AND FAP SUMMARY ARE ONLY PROVIDED IN ENGLISH. GRAHAM HOSPITAL ASSOCIATION IS NOT REQUIRED TO PROVIDE THE FAP AND FAP SUMMARY IN LANGUAGES THAT ARE SPOKEN BY LEP POPULATIONS. |
| PART V, LINE 16A, FAP WEBSITE: | HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE |
| PART V, LINE 16B, FAP APPLICATION WEBSITE: | HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE |
| PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: | HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE |
| SCHEDULE H, PART V, LINE 10: | HTTP://WWW.GRAHAMHEALTHSYSTEM.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 10 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (10 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - GRAHAM MEDICAL GROUP | ||||
| 180 SOUTH MAIN STREET | CANTON | IL | 61520 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| 2 - GRAHAM HOSPITAL EXTENDED CARE UNIT | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | SKILLED NURSING & LONG TERM CARE UNITS |
| 3 - GHA HOME MEDICAL EQUIPMENT STORE | ||||
| 101 SOUTH MAIN STREET | CANTON | IL | 61520 | HOME MEDICAL EQUIPMENT RETAIL STORE |
| 4 - GRAHAM MEDICAL GROUP - FARMINGTON | ||||
| 601 EAST FORT STREET | FARMINGTONGG | IL | 64531 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| 5 - GRAHAM MEDICAL GROUP - LEWISTOWN | ||||
| 408 SOUTH MAIN STREET | LEWISTOWN | IL | 61542 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| 6 - GRAHAM MEDICAL GROUP - ELMWOOD | ||||
| 1024 N MAGNOLIA STREET | ELMWOOD | IL | 61529 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| 7 - GRAHAM CARDIAC REHABILITATION | ||||
| 235 WEST WALNUT | CANTON | IL | 61520 | CARDIAC REHAB SERVICES |
| 8 - GRAHAM HOSPITAL SCHOOL OF NURSING | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | SCHOOL OF NURSING |
| 9 - GRAHAM HOSPITAL PHARMACY | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | PHARMACY FOR PATIENTS & RETAIL FOR EMPLOYEES |
| 10 - GRAHAM MEDICAL GROUP - AVON | ||||
| 1800 23RD AVENUE | AVON | IL | 61415 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 6A: | NOT APPLICABLE |
| PART I, LINE 7: | THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDING BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | A DONATION OF $5,000 WAS MADE TO THE SPOON RIVER PARTNERSHIP FOR ECONOMIC DEVELOPMENT. THIS ORGANIZATION FOCUSES ON BUILDING IN THE LOCAL COMMUNITY THROUGH ECONOMIC GROWTH, WHICH IMPROVES OPPORTUNITIES FOR JOBS AND INSURANCE WITHIN THE COMMUNITY. THIS DONATION HELPED SUPPORT THE LOCAL ECONOMY BY HELPING A SMALL BUSINESS. A DONATION OF $10,000 WAS MADE TO THE UNIVERSITY OF ILLINOIS FAMILY MEDICINE RURAL STUDENT PHYSICIAN PROGRAM. THIS DONATION WILL HELP GIVE OPPORTUNITY TO PHYSICIANS WHO WANT TO WORK IN RURAL HOSPITALS LIKE GRAHAM. A MONTHLY DONATION OF $5,000 WAS MADE TO THE HEALTH & WELLNESS CONNECTION OF FULTON COUNTY (HWCFC). THIS CLINIC IS CONSISTENT WITH AND SUPPORTIVE OF GRAHAM'S MISSION OF PROVIDING CHARITY CARE AND HEALTH IMPROVEMENT SERVICES TO THOSE IN NEED. A $5,000 DONATION TOWARDS THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK BUILDING FUND WAS ALSO PROVIDED. |
| PART III, LINE 2: | PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. |
| PART III, LINE 3: | PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. THE HOSPITAL DOES NOT CHARGE INTEREST ON RECEIVABLES. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED PAST DUE WHEN AN AMOUNT IS PAST DUE ACCORDING TO THE PAYOR'S AGREED-UPON TERMS. PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. |
| PART III, LINE 8: | THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFITS EXPENSE BECAUSE PROVIDING MEDICAL CARE AT A SHORTFALL IMPACTS THE HOSPITAL'S OPERATIONS AND GROWTH. THE CARE IS PROVIDED BECAUSE THERE IS A NEED AND A DESIRE TO PROVIDE MEDICAL CARE IN THIS COMMUNITY.THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: | THE COLLECTION POLICY DESCRIBES THE STEPS TAKEN TO COLLECT SELF PAY BALANCES OUTSTANDING INCLUDING NOTIFICATIONS TO THE PATIENT THROUGH STATEMENTS, FOLLOW-UP PHONE CALLS, VERIFICATION OF INSURANCE ELIGIBILITY AND ULTIMATELY AT WHAT POINT THE UNPAID BALANCE IS WRITTEN OFF AS UNCOLLECTIBLE. IN PRACTICE, WHEN A PATIENT IS IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, A SEARCH OF ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE IS DONE AND THOSE ACCOUNTS ARE REPROCESSED. |
| PART VI, LINE 2: | IN ADDITION TO THE CHNA, A PHYSICIAN NEEDS ASSESSMENT IS DONE TO IDENTIFY NEEDS FOR SPECIFIC SPECIALTY SERVICES BASED ON THE SIZE OF THE CATCHMENT AREA. DATA IS ANALYZED TO IDENTIFY SERVICES THAT ARE PROVIDED TO COUNTY RESIDENTS BY OTHER FACILITIES THAT WOULD BE MORE ACCESSIBLE TO PATIENTS IF PROVIDED AT GRAHAM HEALTH SYSTEM. INPUT IS GAINED FROM PHYSICIANS AND OTHER HEALTHCARE WORKERS PROVIDING SERVICE IN THE AREA ALONG WITH INPUT PROVIDED BY THE BOARD OF DIRECTORS WHO REPRESENT THE COMMUNITY AND PROVIDE A COMMUNICATION LINK BETWEEN GRAHAM HEALTH SYSTEM AND THE COMMUNITIES WE SERVE. |
| PART VI, LINE 3: | THE CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM IS MADE AVAILABLE TO PATIENTS UPON REGISTRATION. FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE TO PATIENTS UPON REGISTRATION OR TO ANYONE REQUESTING THE APPLICATION. THE APPLICATIONS ARE ALSO AVAILABLE ON GRAHAM HEALTH SYSTEM'S WEBSITE AT WWW.GRAHAMHEALTHSYSTEM.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE. APPOINTMENTS MAY BE MADE WITH A FINANCIAL ADVOCATE IF ASSISTANCE IS NEEDED. MEDICAID SERVICES APPLICATION ASSISTANCE IS AVAILABLE. |
| PART VI, LINE 4: | THE GRAHAM HEALTH SYSTEM PRIMARY CATCHMENT AREA IS LOCATED PRIMARILY IN FULTON COUNTY AND INCLUDES ALL OR PORTIONS OF THE TOWNS OF CANTON, LEWISTOWN, CUBA, ELMWOOD, FARMINGTON, HAVANA, ST. DAVID, ASTORIA, DUNFERMLINE AND BRYANT. THE RACE AND ETHNICITY MAKEUP ARE TYPICAL OF RURAL ILLINOIS BASED ON US CENSUS BUREAU DATA AND INCLUDES 91.6% WHITE, 4.0% BLACK, 3.1% HISPANIC ORIGIN, AND 1.3% OTHER. ACCORDING TO THE US CENSUS BUREAU MEDIAN HOUSEHOLD INCOME 2016 WAS $46,183. FULTON COUNTY'S AUGUST 2019 UNEMPLOYMENT RATE WAS 5.7%. |
| PART VI, LINE 5: | DURING EACH FISCAL YEAR VARIOUS COMMUNITY HEALTH IMPROVEMENT SERVICES ARE HELD AT A FACILITY OWNED BY GRAHAM HEALTH SYSTEM OR ITS EMPLOYEES ASSIST WITH SERVICES HELD AT VARIOUS LOCATIONS WITHIN THE CATCHMENT AREA. EXAMPLES OF THESE ACTIVITIES INCLUDE ANNUAL SPONSORSHIP OF A COMMUNITY TALK AND DINNER THAT IS FREE TO THE PUBLIC COVERING HEALTH TOPICS; FREE BLOOD PRESSURE CLINICS OFFERED ON A REGULAR BASIS; PROVIDING SPACE FOR OPERATION OF AN OUTPATIENT CLINIC THAT PROVIDES FREE HEALTHCARE SERVICES TO FULTON COUNTY RESIDENTS. CLINIC SERVICES ARE PROVIDED BY COMMUNITY VOLUNTEERS. |
| PART VI, LINE 6: | N/A |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IL |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| FULTON COUNTY FREE HEALTH AND WELLNESS CLINIC | ||||||||
| 103A S MAIN STREET | CANTON | IL | 61520 | 272753264 | 501(C)(3) | $60,000 | PROVIDE SUPPORT TO ORGANIZATION | |
| UNIVERSITY OF ILLINOIS FOUNDATION | ||||||||
| HARKER HALL MC 386 1305 WEST GREEN | URBANA | IL | 61801 | 376006007 | 501(C)(3) | $10,000 | PROVIDE SUPPORT TO ORGANIZATION | STREET |
| ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK | ||||||||
| 1945 VANS WAY | PRINCETON | IL | 61356 | 550809159 | 501(C)(3) | $5,000 | PROVIDE SUPPORT TO ORGANIZATION - BUILDING FUND DONATION | |
| SPOON RIVER PARTNERSHIP FOR ECONOMIC DEVELOPMENT | ||||||||
| 209 EAST CHESTNUT SUITE 2 | CANTON | IL | 61520 | 050633175 | 501(C)(3) | $5,000 | PROVIDE SUPPORT TO ORGANIZATION | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 4 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRENT PARRY DPM | ||||||||||||||
| PODIATRIST | $388,884 | $0 | $0 | $0 | $80,400 | $0 | $8,400 | $0 | $35,906 | $0 | $513,590 | $0 | $0 | $0 |
| JULIO RAMOS MD | ||||||||||||||
| PHYSICIAN | $339,888 | $0 | $48,710 | $0 | $19,513 | $0 | $8,400 | $0 | $11,666 | $0 | $428,177 | $0 | $0 | $0 |
| DEVASHISH AGARWAL MD | ||||||||||||||
| PHYSICIAN | $306,114 | $0 | $44,980 | $0 | $24,519 | $0 | $8,400 | $0 | $36,823 | $0 | $420,836 | $0 | $0 | $0 |
| JEFFREY HEMP MD | ||||||||||||||
| PHYSICIAN | $256,557 | $0 | $35,000 | $0 | $3,946 | $0 | $8,400 | $0 | $34,207 | $0 | $338,110 | $0 | $0 | $0 |
| JOHN QUINONES DO | ||||||||||||||
| PHYSICIAN | $0 | $0 | $0 | $0 | $234,179 | $0 | $0 | $0 | $0 | $0 | $234,179 | $0 | $0 | $0 |
| KEITH IFFT MD | ||||||||||||||
| ANESTHESIOLOGIST MEDICAL DIRECTOR | $402,766 | $0 | $0 | $0 | $26,386 | $0 | $8,400 | $0 | $52,633 | $0 | $490,185 | $0 | $0 | $0 |
| DWAYNE BERNARD MD | ||||||||||||||
| MEDICAL DIRECTOR | $323,685 | $0 | $61,834 | $0 | $29,793 | $0 | $8,400 | $0 | $40,166 | $0 | $463,878 | $0 | $0 | $0 |
| ANDREW ROUDEBUSH DO | ||||||||||||||
| WOUND CLINIC DIRECTOR | $196,431 | $0 | $56,814 | $0 | $35,042 | $0 | $8,400 | $0 | $33,427 | $0 | $330,114 | $0 | $0 | $0 |
| ROBERT SENNEFF | ||||||||||||||
| PRESIDENT/CEO | $396,460 | $0 | $88,397 | $0 | $193,067 | $0 | $76,216 | $0 | $12,228 | $0 | $766,368 | $0 | $0 | $0 |
| JULIE REEDER | ||||||||||||||
| VP FINANCE/CFO | $141,846 | $0 | $35,775 | $0 | $28,741 | $0 | $24,071 | $0 | $26,711 | $0 | $257,144 | $0 | $0 | $0 |
| HOLLY HENLINE | ||||||||||||||
| VP ANCILLARY/CCO | $136,336 | $0 | $33,788 | $0 | $26,336 | $0 | $21,554 | $0 | $46,228 | $0 | $264,242 | $0 | $0 | $0 |
| JAMES SCHREINER | ||||||||||||||
| VP INFO SERVICES | $164,521 | $0 | $34,069 | $0 | $23,865 | $0 | $25,635 | $0 | $10,564 | $0 | $258,654 | $0 | $0 | $0 |
| TERESA MCCONKEY | ||||||||||||||
| VP PATIENT SERVICES | $161,331 | $0 | $31,636 | $0 | $27,743 | $0 | $25,854 | $0 | $11,820 | $0 | $258,384 | $0 | $0 | $0 |
| ALLISON SOURS | ||||||||||||||
| VP QUALITY | $121,912 | $0 | $26,647 | $0 | $16,574 | $0 | $17,108 | $0 | $10,514 | $0 | $192,755 | $0 | $0 | $0 |
| MICHELLE DALY | ||||||||||||||
| VP CLINIC SERVICES | $115,920 | $0 | $15,957 | $0 | $9,889 | $0 | $16,810 | $0 | $14,003 | $0 | $172,579 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) PLAN IN 2019 SPONSORED BY GRAHAM HOSPITAL ASSOCIATION: ROBERT SENNEFF - $67,816, TERESA MCCONKEY - $19,139, JAMES SCHREINER - $18,893, HOLLY HENLINE - $15,500, JULIE REEDER - $17,654, ALLISON SOURS - $13,981, MICHELLE DAY - $12,385. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY GRAHAM HOSPITAL ASSOCIATION ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2019. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|
| CITY OF CANTON IL | |||||||
| A | 376000876 | 2015-11-04 | $48,540,000 | REFUND PRIOR ISSUE AND FUND BUILDING PROJECTS | 0 | 0 | 0 |
| CITY OF CANTON IL | |||||||
| B | 376000876 | 2020-06-18 | $17,000,000 | FUND BUILDING PROJECTS AND EQUIPMENT | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Refunding EscrowRefundingEscrowAmt | Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt | Capital ExpendituresCapitalExpendituresAmt | Substantial CompletionSubstantialCompletionYr | Refunding Tax Exempt BondsRefundingTaxExemptBondsInd | Refunding Taxable BondsRefundingTaxableBondsInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd | Other Spent ProceedsOtherSpentProceedsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | $5,415,001 | $48,540,000 | $26,755,000 | $488,550 | $21,296,450 | 2017 | Yes (1) | 0 | Yes (1) | Yes (1) | |
| B | $17,000,000 | $207,600 | $1,245,613 | 0 | 0 | 0 | Yes (1) | $15,546,787 |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0.15000 | 0.15000 | Yes (1) | 0 | Yes (1) |
| B | 0 | 0 | 0 | 0 | Yes (1) | 0 | Yes (1) |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Business Name Line2HedgeProviderName/BusinessNameLine2Txt | Term Of HedgeTermOfHedgePct | Superintegrated HedgeSuperintegratedHedgeInd | Hedge TerminatedHedgeTerminatedInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MORGAN STANLEY & | |||||||||||||
| A | Yes (1) | Yes (1) | Yes (1) | BMO | 25.000000000000 | 0 | 0 | 0 | 0 | 0 | |||
| (no name) | |||||||||||||
| B | 0 | Yes (1) | 0 | 0 | 0 | 0 | Yes (1) | 0 | 0 | ||||
Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | 0 |
| B | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE PREPARED FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES, CEO, CFO, DIRECTOR OF ACCOUNTING, AND SENIOR ACCOUNTANT BEFORE FILING WITH THE IRS. BEFORE FILING, THE CFO PRESENTS THE FORM 990 TO THE ORGANIZATION'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | GRAHAM HOSPITAL REQUIRES THAT ALL TRUSTEES AND ADMINISTRATIVE OFFICERS KEEP THE BOARD OF TRUSTEES INFORMED OF POTENTIAL CONFLICTS OF INTEREST, AND THAT EACH PERSON MAKE AN ANNUAL DECLARATION OF SUCH INTEREST. A CONFLICT OF INTEREST MIGHT EXIST WHEN ORGANIZATIONS IN WHICH TRUSTEES OR OFFICERS HAVE A MATERIAL FINANCIAL INTEREST ARE EITHER DOING BUSINESS WITH, COMPETING WITH, OR HAVE A FINANCIAL INTEREST IN GRAHAM HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE ADMINISTRATIVE OFFICERS IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE ORGANIZATION UTILIZES AN OUTSIDE FIRM, SULLIVAN, COTTER AND ASSOCIATES, INC. TO PROVIDE OUTSIDE EXECUTIVE COMPENSATION INFORMATION. THE LAST REVIEW WAS COMPLETED IN JANUARY 2020. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OUTSIDE CONTRACTORS: PROGRAM SERVICE EXPENSES 601,954. MANAGEMENT AND GENERAL EXPENSES 478,876. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,080,830. PHYSICIANS: PROGRAM SERVICE EXPENSES 10,724,431. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,724,431. SERVICE AGREEMENT: PROGRAM SERVICE EXPENSES 1,998,815. MANAGEMENT AND GENERAL EXPENSES 33,957. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,032,772. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 1,427,575. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,427,575. REPAIR AND MAINTENANCE : PROGRAM SERVICE EXPENSES 64,446. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 64,446. OTHER FEES: PROGRAM SERVICE EXPENSES 4,004,641. MANAGEMENT AND GENERAL EXPENSES 678,781. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,683,422. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 26,088. CHANGE IN BENEFICAL INTEREST IN PERPETUAL TRUSTS 177,578. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -1,409,896. |