2021-11-09T13:13:31-06:00 2020-12-31 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2020-01-01 370684691 Memorial Hospital Association MEMO 2173573131 PO Box 160 Carthage IL 62321 Teresa Smith CFO 2173573131 2021-10-11 1 Teresa Smith 999009999 Kim Hunwardsen CPA P00484560 6122536500 2021-10-11 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z Ada Bair PO Box 160 Carthage IL 62321 34273213 0 X www.mhtlc.org X 1947 IL Memorial Hospital provides clinical care, diagnostic, treatment, and wellness services 14 12 296 25 0 0 491662 612856 29416095 32468683 256725 162204 23933 62306 30188415 33306049 0 0 0 0 15414780 16853716 0 0 128331 15104150 15192547 30518930 32046263 -330515 1259786 35871886 44299401 24594339 31468371 11277547 12831030 X Memorial Hospital is committed to improving health by providing education and wellness programs and innovative services at all the stages of life. 1 0 26450672 32468683 Memorial Hospital is dedicated to maintaining and improving the health of all people in the Hancock County area. Governed by a Board of Directors, we serve as a vital safety net, serving our communities with access to quality healthcare services. Memorial Hospital provides many types of community benefit care. Community benefit care includes charity care, community health fairs, lectures, and free health screenings, demonstrating our commitment to improving the overall health of the residents of the Hancock County area.In 2020 the Hospital had 2,671 patient days with 682 admissions and 679 discharges. (Continued on Schedule O)There were 4,037 emergency room visits, 1,688 provider-based physician clinic visits, 3,455 independent physician visits and 27,722 rural health physician clinic visits.We are always committed to providing compassionate care to every member of our community regardless of their ability to pay.To fulfill its mission of community service, the Organization provides care to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than its established rates. Revenue from services to these patients and residents is recorded in the accounting system at the established rates, but the Organization does not pursue collection of the amounts. The resulting adjustments are recorded as adjustments to patient and resident service revenue, depending on the timing of the charity determination.The Illinois legislature passed a bill titled the "Hospital Uninsured Patient Discount Act." Effective April 1, 2009, this Act requires hospitals to provide certain mandated discounts from charges to the uninsured in Illinois. Charges are to be discounted at 135% of cost. Furthermore, a hospital may not collect more than 25% of an uninsured family's gross income in any one year.The Organization provides health care services to patients and residents who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Since the Organization does not pursue collection of these amounts, they are not reported as patient and resident service revenue. The estimated cost of providing these services was $408,000 for the year ended December 31, 2020, calculated by multiplying the ratio of cost to gross charges for the Organization by the gross uncompensated charges associated with providing charity care to its patients and residents.In addition, the Organization provides services to other medically indigent patients under certain government-reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Organization also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable. 26450672 1 1 0 1 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 52 0 1 296 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 IL X Kim Byers 2173576571 PO Box 160 Carthage IL 62321 Dan Asbury President 3.00 1.00 X X 0 0 0 LuAnn Haas Vice President 3.00 1.00 X X 0 0 0 Dennis Rankin Secretary/Treasurer 3.00 1.00 X X 0 0 0 Terry Pope Director 3.00 1.00 X 0 0 0 Doug Groth DVM Director 3.00 1.00 X 0 0 0 Debbie Simon Director 3.00 1.00 X 0 0 0 Larry McClintock Director 3.00 1.00 X 0 0 0 Christopher Jones MD Director 40.00 1.00 X 407578 0 37148 Sharon Morrison Director until August 3.00 1.00 X 0 0 0 Angela Pollock Director 3.00 1.00 X 0 0 0 Charles Gilbert Director 3.00 1.00 X 0 0 0 Robert Barlow Director 3.00 1.00 X 0 0 0 Joe Zumwalt Director 3.00 1.00 X 0 0 0 Katie Pearson Director as of September 3.00 1.00 X 0 0 0 Brenda Young Director as of September 3.00 1.00 X 0 0 0 Ada Bair CEO 40.00 3.00 X 239355 0 13973 Teresa Smith CFO 40.00 3.00 X 159089 0 23428 Nileshwa Senthe MD Pediatrician 40.00 0.00 X 436519 0 27732 Victoria Popela DO Family Practice Physician 40.00 0.00 X 351215 0 12778 Rosalinda Campos MD Family Practice Physician 40.00 0.00 X 338483 0 11973 Edward McKenney DO Family Practice Physician 40.00 0.00 X 315768 0 12579 Douglas Heighton MD Family Practice Physician 40.00 0.00 X 278568 0 38874 2526575 0 178485 24 0 1 0 Aimes of Carthage LLC 8657 Wedgewood Dr Burr Ridget IL 60527 ER physician service 1905613 Quincy Medical Group 1025 Maine Street Quincy IL 62301 Physician services 700507 Shared Medical Services Inc 209 Limestone Pass Cottage WI 53527 MRI services 178540 Fusion Medical Staffing LLC PO Box 82674 Lincoln NE 685012674 Temporary Staffing Personnel 165247 Aramark Services Inc 27310 Network Pl Chicago IL 606731273 Dietary Operations 160508 9 558861 53995 612856 Patient & resident service revenu 621110 30673613 30673613 Pharmacy revenue 900099 1614800 1614800 Equity in Advance Phys Therapy 900099 40326 40326 Equity in Sherrick Home Health 900099 4114 4114 135830 135830 32468683 127163 127163 65586 1000 4280 0 61306 1000 62306 62306 991125 6800 948228 14656 42897 -7856 35041 35041 33306049 32468683 0 224510 X 863575 450057 413518 74871 74871 12767221 10947734 1725734 93753 156465 136942 19523 2112440 1774082 338358 879144 738244 140900 96662 96662 64622 64622 8210 8210 5873730 4879899 988653 5178 186125 30559 139903 15663 847762 579914 255501 12347 545325 504314 41011 51521 37472 13430 619 60549 56023 4526 794063 553767 240296 2006729 1409080 597649 225425 141605 83820 Medical supplies 3061075 3061075 Provider tax 623931 623931 Repairs and maintenance 387537 386797 740 Dues, Fees, and Subscri 323568 42688 280880 35713 13408 21534 771 32046263 26450672 5467260 128331 5211540 13332920 18100 4872552 6273798 15064 24244 340491 415028 188320 248003 37570844 22724944 16125936 14845900 7218067 7545928 66300 66300 441070 138554 1374446 1408726 35871886 44299401 3384903 2605571 4257148 16415000 15705000 4394436 5159852 2625800 400000 1115000 24594339 31468371 X 11091592 12511136 185955 319894 11277547 12831030 35871886 44299401 X 1259786 159760 133937 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 8210 8210 0 Part II-B, Line 1: Memorial Hospital is a member of the Illinois Health & Hospital Association (IHA) and 37% of their dues are used for lobbying expenses which totaled $8,210 in 2020. 4257525 291901 -40935 4590361 3951916 592682 287073 4257525 4185386 -84735 148735 3951916 4105493 345604 265711 4185386 3987871 374801 257179 4105493 0.99491 0.00509 0.00000 0 0 499957 499957 24950077 14215123 10734954 23098 23098 0 10498416 7911206 2587210 1599296 575517 1023779 14845900 Estimated health claims 400000 Estimated third-party payor settlements 715000 1115000 X 33470089 159760 159760 33310329 -4280 -4280 33306049 32050543 4280 4280 32046263 0 32046263 Part V, Line 4: An endowment fund with the income to be used for the benefit of Memorial Hospital Association. Permanently restricted funds are required to be retained permanently, either by explicit donor stipulation or by UPMIFA. Board designated funds are to be used for facility and equipment upgrades. Part X, Line 2: The Hospital believes they have appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 4b - Other Adjustments: Rent expenses included in revenue for Form 990 -4,280. Part XII, Line 2d - Other Adjustments: Rent expenses included in revenue for Form 990 4,280. 1 1 X 1 X 1 X 0 1 1 0 1 1 408000 408000 0.01270 6671913 4650017 2021896 0.06310 7079913 4650017 2429896 0.07580 11137234 6950104 4187130 0.13070 11137234 6950104 4187130 0.13070 18217147 11600121 6617026 0.20650 1 1634740 201073 7715280 7686643 28637 X 1 1 1 1 Memorial Hospital Association 1454 North County Road 2050 Carthage IL 62321 www.mhtlc.org 0005611 X X X X 6 Rural Health Clinics Memorial Hospital Association 1 0 0 1 X X X X X X X X X 18 1 0 1 1 X www.mhtlc.org/about-us/community-reports/ X 1 18 1 http://www.mhtlc.org/about-us/community-reports/ 0 1 X 150.000000000000 300.000000000000 X X X 1 1 X X X X 1 X http://www.mhtlc.org/patients-visitors/financial-assistance/ X http://www.mhtlc.org/patients-visitors/financial-assistance/ X http://www.mhtlc.org/patients-visitors/financial-assistance/ X X X X X 1 X 0 X X X X 1 X 0 1 Memorial Hospital Association Part V, Section B, Line 5: Data collection came from multiple sources for analysis. Some of the sources identified were the IPLAN data system, CDC, Behavioral Risk Factor Surveys, local mental health agency, local hospital as well as Comp Data which is an Illinois repository for hospital discharge data and demographics. As the process progressed, data from local law enforcement as well as a Hancock County Economic Development Survey was included in the analysis by this group. Memorial Hospital Association Part V, Section B, Line 6b: Hancock County Health Department Memorial Hospital Association Part V, Section B, Line 11: The top 3 priority areas of focus from the 2018 Community Health Needs Assessment are diabetes and cardiovascular disease, lung cancer, and drug abuse and alcohol dependency. The same needs carried over from the 2015 CHNA. Below are the 2020 accomplishments.Cardio Vascular-We were unable to provide blood pressures checks or screening events due to Covid. -Quarterly social media posts with educational tips on hypertension appeared on the Hancock County Health Department and Memorial Hospital sites. -We were unable to offer a county wide physical activity challenge due to Covid.Intervention Strategies for Diabetes -We were unable to offer diabetes screening events due to Covid.-Hancock County providers received education on the Diabetes Health & Wellness Center resources annually.-We were unable to offer diabetes education days to residents due to Covid.-Residents hospitalized locally with elevated glucose levels received consultation prior to discharge. Dietician recommended referral to physicians while on rounds. In 2020 there were 23 referrals.-All diagnosed prediabetes and diabetics received an auto referral to the Diabetes Health and Wellness Center from Memorial Hospital provider offices. In 2020 there were 123 patients referred who took advantage of the services.Intervention Strategies for Lung Cancer-Annual updates on resources and QUITLINE for 100% of health care providers in Hancock County. Providers have information on Quitline and updates are sent if there are changes. Smoking cessation discussion is a measure that is tracked on the provider dashboard and improvements are reviewed.-We were unable to provide an educational program due to Covid.-Quarterly social media posts on Hancock County Health Department and Memorial Hospital sites with resources for tobacco cessation. -Education was provided to all expectant mothers in Memorial Hospital clinic settings as documented by medical records and in the WIC clinic at Hancock County Health Department. This is part of the new OB intake process.The Hospital will not address drug abuse and alcohol dependency as a separate task force was developed to address these needs. Memorial Hospital Association Part V, Section B, Line 13h: PRESUMPTIVE ELIGIBILITY: A patient may appear eligible for charity care discounts but there is no financial assistance form and a lack of supporting documentation. Often there is adequate information provided by the patient through other sources which could provide sufficient evidence to provide the patient with charity care assistance.In the event there is no evidence to support a patient's eligibility for charity care, Memorial Hospital and Memorial Medical Clinics could use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potential discount amounts.Presumptive eligibility may be determined on the basis of individual life circumstance. In these situations, a patient is deemed to be eligible for 100% write off. A patient in this situation is presumed to be eligible and therefore does not need to complete a financial assistance applicationif they can provide proof that they meet one of the following criteria:a. Patient states that he/she is homeless. The due diligence efforts must be documented.b. Patient is deceased with no known estate.c. Patient is mentally incapacitated with no one to act on their behalf.d. Patient is currently eligible for Medicaid, but was not eligible on a prior date of service or for non-covered services. Instead of making the patient duplicate the required paperwork Memorial Hospital will rely on the financial assistance determination process from Medicaid.e. Accounts deemed uncollectible by a contracted collection agency.f. In the event of "special" circumstances where the income exceeds the poverty guidelines but medical bills are high, the Patient Account Director and/or Chief Financial Officer may determine partial or full eligibility provided proper documentation is available.PROPENSITY TO PAY: Propensity to pay may be determined by obtaining a healthcare score from an outside vendor. Memorial Hospital Association Part V, Section B, Line 24: All individuals eligible under the hospital financial assistance policy are provided a discount for emergency and other medically necessary care. The financial assistance policy does not apply to elective procedures. Therefore, FAP-eligible patients without insurance may be charged gross charges on elective procedures. 2 1 - Advance Physical Therapy 620 Wabash Street Carthage IL 62321 Physical therapy rehabilitation 3 - Memorial Medical Clinic Hamilton 1471 Keokuk Street Hamilton IL 62341 Physician clinic Part I, Line 3c: PRESUMPTIVE ELIGIBILITY: A patient may appear eligible for charity care discounts but there is no financial assistance form and a lack of supporting documentation. Often there is adequate information provided by the patient through other sources which could provide sufficient evidence to provide the patient with charity care assistance.In the event there is no evidence to support a patient's eligibility for charity care, Memorial Hospital and Memorial Medical Clinics could use outside agencies in determining estimated income amounts for the basis of determining charity care eligibility and potential discount amounts.Presumptive eligibility may be determined on the basis of individual life circumstance. In these situations, a patient is deemed to be eligible for 100% write off. A patient in this situation is presumed to be eligible and therefore does not need to complete a financial assistance applicationif they can provide proof that they meet one of the following criteria:a. Patient states that he/she is homeless. The due diligence efforts must be documented.b. Patient is deceased with no known estate.c. Patient is mentally incapacitated with no one to act on their behalf.d. Patient is currently eligible for Medicaid, but was not eligible on a prior date of service or for non-covered services. Instead of making the patient duplicate the required paperwork Memorial Hospital will rely on the financial assistance determination process from Medicaid.e. Accounts deemed uncollectible by a contracted collection agency.f. In the event of "special" circumstances where the income exceeds the poverty guidelines but medical bills are high, the Patient Account Director and/or Chief Financial Officer may determine partial or full eligibility provided proper documentation is available.PROPENSITY TO PAY: Propensity to pay may be determined by obtaining a healthcare score from an outside vendor. Part I, Line 6a: The community benefit report information is shared in Memorial Hospital's annual report and available on their website www.mhtlc.org. Part I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost to charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Part I, Line 7g: A physician clinic included as a subsidized service on the 990. Direct and indirect costs were $1,058,556. Part III, Line 2: The amount on line 2 represents implicit price concessions. The Organization determines its estimate of implicit price concession based on its historical collection experience with this class of patients. Part III, Line 3: The estimated amount of the Organization's implicit price concessions attributable to patients eligible under the Organization's charity care policy is calculated based on an approximate 12.3% of individuals living below the poverty level in the service area. Part III, Line 4: The initial estimate of the transaction price is determined by reducing the standard charge by any contractualadjustments, discounts and implicit price concessions based on historical collection experience. Subsequentchanges to the estimate of the transaction price are generally recorded as adjustments to patient and residentservice revenue in the period of the change. The ability to estimate the collectability of uninsured and other selfpaypatients is contingent on the patient's ability or willingness to pay for the services provided. Subsequentchanges that are determined to be the result of an adverse change in the patient's and resident's ability to payare recorded as bad debt expense. Bad debt expense for the years ended December 31, 2020 and 2019 was notsignificant. Part III, Line 8: Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by Centers for Medicare and Medicaid Services. These amounts do not include fee schedule amounts.If costs related to amounts reimbursed on a fee schedule were included there would have been a Medicare Shortage. Total revenue received from Medicare based on a fee schedule 315,024Medicare estimated costs of care relating to payments (1,205,187)Net Shortage (89,163) Part III, Line 9b: Memorial Hospital does not pursue collection activities for patients that qualify for charity care or patients that have set up payment arrangements for their accounts. The Hospital will not pursue extraordinary collection activities on patients for at least 120 days from the date of the first statement and provides patients 240 days to apply for assistance. Memorial Hospital does not charge interest on patients with payment arrangements. Also, extraordinary collection activities are not pursued for patients waiting for approval or denial from public aid. Any personal portion due after financial assistance is established would follow normal collection procedures. Part VI, Line 2: Memorial Hospital, based on its mission, wants to ensure that the health care needs of the community it serves are met. The Hospital has medical clinics located throughout Hancock County to improve access to health care services to our patients. The Board also has four committees; Finance, Planning, Quality and Community Health, and Marketing Committees that have community representation to ensure that input is obtained from the community when considering the health care needs of those we serve. Community input on desired services is obtained through patient satisfaction surveys that are initiated by the inpatient unit, emergency department, and medical clinics that provide a line of communication to identify additional health care services that community desires. The second Community Health Needs Assessment is completed and posted to our website at www.mhtlc.com. Part VI, Line 3: Memorial Hospital strives to provide a rewarding and healing process to our patients, plus an affordable, comfortable process to meet their financial obligations. Memorial Hospital informs their patients individually upon admission about the eligibility for assistance under federal, state or local government programs, and provides the patient with information regarding the Organization's charity care policy.The Collection and Financial Assistance Policies and applications are on our website. We also provide financial counseling to any patient. We post our Charity Care Policy and information regarding federal, state, and local programs at all our registration areas. Brochures are distributed regarding financial assistance with all admission packages.Billing statements have financial assistance support telephone numbers at the bottom of each statement. Our third party billing service provides counseling to our patients regarding available financial assistance if there is a need. Part VI, Line 4: Memorial Hospital Association is an 18-bed critical access hospital located in Carthage, IL. Carthage is a city in Hancock County, Illinois. It is located in western Illinois along the Mississippi River. The nearest city with a population > 50,000 is Peoria, IL. Its primary service area from its most recently completed community health needs assessment is defined as Hancock County, with Colchester, Lomax, Keokuk, Tennessee and Blandinsville as the secondary service area. The 2020 population is approximately 32,573. The 2020 median household income is approximately $52,561, significantly lower than the state of Illinois. The unemployment rate was 3.8%, lower than the rate for the state of Illinois.The most common industries are manufacturing, agriculture, construction and health care. The nearest hospital is Keokuk Area Hospital about 15 miles away on the Iowa side of the Mississippi River. Part VI, Line 5: Memorial Hospital is dedicated to improving health by providing education and wellness programs and innovative services at all the stages of life for residents of Hancock County. The Hospital is governed by a 13-member, volunteer Board of Directors that represent key areas within Hancock County as well as the medical staff. As a critical access hospital, Memorial Hospital is an 18-bed facility that provides general medical, surgical services along with obstetrics and an array of outpatient services for the community. Specialty clinics are also provided locally in the areas of cardiology, dermatology, oncology, neurology, ophthalmology, podiatry, orthopedic, pulmonology, urology, ENT, rheumatology, bariatric, and sleep apnea so that our patients don't have to travel far to receive needed health care services. These specialty physicians are members of the Hospital's medical staff along with other providers that desire to serve members of our service area. The Hospital extends medical staff privileges to all qualified physicians in the community. With the support of the community, Memorial Hospital built a new 18-bed hospital that was occupied in August 2009. The facility provides up-to-date, diagnostic equipment and services with a capital budget also presented and approved on an annual basis to ensure that needed equipment is obtained to meet the expectations of our patients. Memorial Hospital operates an emergency room available to all regardless of ability to pay.The Hospital also participates in several health care events throughout the year providing free services as well as a listing of services that are offered through the Hospital, clinics, and specialty clinics. This includes, but is not limited to, health fairs, blood pressure screenings, and diabetic education. Memorial Hospital sponsors the bloodmobile and provides language assistance services. X X X 0 0 0 0 0 0 0 0 0 Nileshwa Senthe MD Pediatrician 435715 0 0 0 804 0 0 0 27792 0 464311 0 0 0 Christopher Jones MD Director 407148 0 0 0 430 0 0 0 37208 0 444786 0 0 0 Victoria Popela DO Family Practice Physician 349981 0 0 0 1234 0 0 0 12838 0 364053 0 0 0 Rosalinda Campos MD Family Practice Physician 338296 0 0 0 187 0 0 0 12033 0 350516 0 0 0 Edward McKenney DO Family Practice Physician 314484 0 0 0 1284 0 0 0 12639 0 328407 0 0 0 Douglas Heighton MD Family Practice Physician 276236 0 0 0 2332 0 0 0 38934 0 317502 0 0 0 Ada Bair CEO 228071 0 10000 0 1284 0 0 0 14033 0 253388 0 0 0 Teresa Smith CFO 158659 0 0 0 430 0 0 0 23488 0 182577 0 0 0 A Western Illinois Economic Development Authority 352256539 958362BL8 2016-07-21 18659314 Refund Revenue Bond Series 2016 issued 9/16/2008 0 0 0 A 2954314 18659314 344284 18315030 0 1 1 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 0 0 0 0 0 0 0 1 A 1 Roxanne Rankin Family member to Dennis Rankin, Secretary/Treasurer of board 36029 Employee compensation 0 Shelley Smith Family member to Teresa Smith, Officer 38842 Employee compensation 0 Form 990, Part III, line 2 Urology, ENT, Rheumatology & Bariatric services are being provided in a Specialty Clinic setting in our Carthage Clinic and physicians are provided by Quincy Medical Group. Form 990, Part VI, Section A, line 1 The Executive Committee consists of the President, Vice President, Secretary-Treasurer, additional members as the Board appoints, the Chief Executive Officer and any other leadership team members deemed appropriate by the officers of the Board. The Chief Executive Officer and any Leadership Team members do not have the right to vote upon any action being taken. The Executive Committee meets only in the event that the Board is unable to take necessary action, has an agenda for each meeting, keeps minutes of its meetings, and mails a copy of the minutes of each meeting to each member of the Board of Directors within twenty-four (24) hours of the adjournment of the meeting. The primary purpose of the Executive Committee is to carry out critical tasks for effective Board functioning, including, but not limited to, Chief Executive Officer Management performance, management company performance, if applicable, and providing assistance to the Board in situations requiring action when it is impossible or impractical to convene a full Board meeting. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the Finance Committee and then by the Board of Directors before it is filed. The final return is reviewed and signed by the CFO. Form 990, Part VI, Section B, line 12c Officers, Board members, and key employees are required to sign a conflict of interest statement upon hiring or becoming a Board member. The disclosure is updated at the annual meeting. Any possible conflict of interest is disclosed to the other Board members and made a matter of record through an annual procedure and also when the interest becomes a matter of Board action. Disclosures are reviewed by the Board of Directors and any Member for whom conflicts have been identified leaves and abstains from voting. Appropriate documentation of the handling of the conflict is kept to protect the interested party and Memorial Hospital Association. Additionally, the Compliance Officer meets with the Compliance Committee of the board. Any issues identified are logged and followed up by the Compliance Officer. Form 990, Part VI, Section B, line 15a Salary surveys are reviewed annually to ensure all positions individually are within the market rate. The Executive Committee determines the salary for the CEO. Each Board member does an independent performance review of the CEO, which is compiled and used by the Executive Committee. The Executive Committee uses the Illinois Hospital Association salary survey as a guide for compensation using the high, middle, and low ranges for similar size organizations. Measures such as revenue, performance of the CEO, and budgetary constraints are all factors that are considered when reviewing the CEO's salary. The salary for the CFO is determined by the CEO using the CAH Compensation Survey sponsored by Integrated Healthcare Strategies as a guide for similar organizations. The most recent review of salary occurred in 2019. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available to the public upon request. The financial statements are also required to be attached to the Form 990. Form 990, Part IX, line 11g Purchased services: Program service expenses 4,576,361. Management and general expenses 863,946. Fundraising expenses 5,178. Total expenses 5,445,485. Professional fees: Program service expenses 303,538. Management and general expenses 124,707. Fundraising expenses 0. Total expenses 428,245. Form 990, Part XI, line 9: Change in interest in net assets of Memorial Hospital Foundation 133,937. Hancock County Senior Services PO Box 160 Carthage IL 62321 370902248 Caring for the elderly IL 501(c)(3) Line 3 Memorial Hospital Association 1 Advance Physical Therapy of Hancock County 620 Wabash Street Carthage IL 62321 113655886 Physical therapy rehabilitation IL Memorial Hospital Association Related 18275 65175 0 1 0.50000 Hancock County SLF LLP 403 S Adams Carthage IL 62321 204445121 Assisted living facility IL N/A 0 0 HGV Foundation Inc 400 S Adams St Carthage IL 62321 450609346 Supporting living IL N/A C 0 0 0 0 0 0 0 0 0 0 1 1 1 0 1 1 1 0 0 1 Hancock County Senior Services P 218615 General Ledger Advance Physical Therapy of Hancock County S 65000 Amount on K-1