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St Margaret's Health-Peru: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
St Margaret's Health-Peru (EIN 36-2852553)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-05-17
IRS object ID
202141379349310704
Schema version
2019v5.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-05-17T18:25:38-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN470714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14650 E 53RD STREETAddressLine1Txt
CityDAVENPORTCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52807ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362852553EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS VALLEY COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlILLIBusinessNameControlTxt
Phone8152233300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 WEST STREETAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLISA LYCNHPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone8152233300PhoneNum
Signature2021-05-17SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENIFER L CHASEPreparerPersonNm
PTINP01306883PTIN
Phone5638884000PhoneNum
Preparation2021-05-17PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTOMMY HOBBSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 WEST STREETAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$89,589,521GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.IVCH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1978FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee698TotalEmployeeCnt
Total Volunteers152TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$615,399PYContributionsGrantsAmt
CY Contributions Grants$12,336,464CYContributionsGrantsAmt
PY Program Service Revenue$80,345,895PYProgramServiceRevenueAmt
CY Program Service Revenue$68,493,879CYProgramServiceRevenueAmt
PY Investment Income$846,203PYInvestmentIncomeAmt
CY Investment Income$904,827CYInvestmentIncomeAmt
PY Other Revenue$1,475,612PYOtherRevenueAmt
CY Other Revenue-$2,320,765CYOtherRevenueAmt
PY Total Revenue$83,283,109PYTotalRevenueAmt
CY Total Revenue$79,414,405CYTotalRevenueAmt
PY Grants And Similar Paid$19,900PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$13,350CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$43,976,887PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$40,280,134CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$42,126,386PYOtherExpensesAmt
CY Other Expenses$40,170,670CYOtherExpensesAmt
PY Total Expenses$86,123,173PYTotalExpensesAmt
CY Total Expenses$80,464,154CYTotalExpensesAmt
PY Revenues Less Expenses-$2,840,064PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,049,749CYRevenuesLessExpensesAmt
Total Assets BOY$60,770,856TotalAssetsBOYAmt
Total Assets EOY$68,370,653TotalAssetsEOYAmt
Total Liabilities BOY$46,654,217TotalLiabilitiesBOYAmt
Total Liabilities EOY$52,310,389TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$14,116,639NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$16,060,264NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$69,383,816ExpenseAmt
Grant$13,350GrantAmt
Revenue$66,352,814RevenueAmt
DescILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) IS A SMALL, INTEGRATED COMMUNITY HEALTH CARE DELIVERY SYSTEM. SERVICES RANGE FROM EMPLOYED PHYSICIANS AND MID-LEVELS IN THE SPECIALTIES OF FAMILY MEDICINE, INTERNAL MEDICINE, OBSTETRICS/GYNECOLOGY, ORTHOPEDICS, OTORHINOLARYNGOLOGY, AND SLEEP MEDICINE. IN ADDITION TO THESE PHYSICIAN PRACTICES, IVCH ALSO OFFERS THE CARE TODAY CLINIC WHICH PROVIDES A LOWER-COST, CONVENIENT ALTERNATIVE TO EMERGENCY ROOM CARE. CONTRACTED PHYSICIAN SERVICES ARE PROVIDED FOR EMERGENCY MEDICINE, ANESTHESIOLOGY, AND HOSPITALISTS SERVICES. INPATIENT HOSPITAL SERVICES PROVIDED BY IVCH INCLUDE MEDICAL AND SURGICAL SERVICES, ICU, OBSTETRICS, SWING BEDS, DIAGNOSTIC, REHAB AND TREATMENT SERVICES. OUTPATIENT SERVICES INCLUDE SURGERY, EMERGENCY ROOM, LABORATORY, DIAGNOSTIC IMAGING, REHAB SERVICES, PAIN MANAGEMENT, SLEEP THERAPY, WOUND MANAGEMENT, RESPIRATORY CARE, EKG, OTHER DIAGNOSTIC AND THERAPEUTIC SERVICES HOSPICE AND ADULT DAY CARE SERVICES ARE ALSO PROVIDED. IVCH IS A MEDICARE DEPENDENT HOSPITAL AND QUALIFIES FOR DISPROPORTIONATE SHARE PAYMENTS. IVCH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY OF HEALTH SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR FINANCIAL STATUS OR ABILITY TO PAY. IVCH SUBSIDIZES THE COST OF TREATING PATIENTS WHO ARE UNABLE TO PAY AND THOSE WHO RECEIVE GOVERNMENT ASSISTANCE WHERE REIMBURSEMENT IS LIMITED. STATISTICS:- INPATIENT ADMISSIONS: 1,868- INPATIENT DAYS: 5,283- NEWBORN DELIVERIES: 370- INPATIENT SURGERIES: 450 - OUTPATIENT SURGERIES: 3,355 - OUTPATIENT VISITS: 65,289 - EMERGENCY ROOM VISITS: 11,309 - CLINIC VISITS: 51,257Desc
Total Program Service Expenses$69,383,816TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document81IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee698EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LISA LYNCHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8157803574PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 WEST STREETAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
ROBERT MITCHELL DO
PHYSICIAN40.00Yes (X)$732,732$0$30,305
MARIO COTE MD
PHYSICIAN40.00Yes (X)$600,260$0$52,907
PETER MEIER MD
FORMER PHYSICIAN40.00Yes (X)$600,086$0$21,354
IOANNIS KARKATZOUNIS MD
PHYSICIAN40.00Yes (X)$537,548$0$34,095
MAHER YOUNES MD
PHYSICIAN40.00Yes (X)$518,406$0$11,039
TOMMY HOBBS
CHIEF EXECUTIVE OFFICER36.00$286,418$0$39,4234.00Yes (X)
LISA LYNCH
CHIEF FINANCIAL OFFICER36.00$151,631$0$38,4224.00Yes (X)
JAMES CLINARD
VICE PRESIDENT1.00$0$0$01.00Yes (X)Yes (X)
JOSEPH HOGAN
DIRECTOR1.00$0$0$02.00Yes (X)
CINDY KURKOWSKI
DIRECTOR1.00$0$0$01.00Yes (X)
JOEL LEIFHEIT MD
DIRECTOR1.00$0$0$01.00Yes (X)
JAMES LOVELAND
PRESIDENT1.00$0$0$01.00Yes (X)Yes (X)
RICHARD MARTUZZO
SECRETARY1.00$0$0$02.00Yes (X)Yes (X)
KRISTINE PAUL
DIRECTOR1.00$0$0$03.00Yes (X)
MICHAEL ROONEY OD
DIRECTOR1.00$0$0$01.00Yes (X)
DAVID SICKLEY
TREASURER1.00$0$0$01.00Yes (X)Yes (X)
WILLIAM VLASTNIK
DIRECTOR1.00$0$0$03.00Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,427,081TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$227,545TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K44IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PERU EMERGENCY PHYSICIANS LLP
PO BOX 677979DALLASTX75267PHYSICIAN SERVICES$3,006,030
SODEXO INC & AFFILIATES
PO BOX 360170PITTSBURGHPA15251DIETARY & ENVIRONMENTAL SERVICES$2,819,996
VALLEY ANESTHESIA SERVICES LLC
23273-2525 EAST STREETPRINCETONIL61356ANESTHESIA SERVICES$1,332,250
SAINT FRANCIS MEDICAL CENTER
7074 SOLUTIONS CENTERCHICAGOIL60677LABORATORY SERVICES$814,749
DIVERSIFIED CLINICAL SERVICES
28525 NETWORK PLACECHICAGOIL60673WOUND CARE & HYPERBARIC OXYGEN$697,287
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K24CntrctRcvdGreaterThan100KCnt
Related Organizations$182,489RelatedOrganizationsAmt
Government Grants$11,752,679GovernmentGrantsAmt
All Other Contributions$401,296AllOtherContributionsAmt
Total Contributions$12,336,464TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business621110BusinessCd
Total Revenue Column$68,493,879TotalRevenueColumnAmt
Related Or Exempt Func Income$68,493,879RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$68,493,879TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$263,737TotalRevenueColumnAmt
Exclusion$263,737ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$403,107RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$582,807RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$179,700RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$179,700TotalRevenueColumnAmt
Exclusion-$179,700ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$10,233,399SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$9,592,309SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$641,090SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$641,090TotalRevenueColumnAmt
Exclusion$641,090ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
TRANSPORT VEHICLE REVENUE900009$330,372$330,372
MANAGEMENT FEES541610$60,000$60,000
CAFETERIA REVENUE721000$51,783$51,783

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column-$2,583,220TotalRevenueColumnAmt
Related Or Exempt Func Income-$2,583,220RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total-$2,141,065OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$79,414,405TotalRevenueColumnAmt
Related Or Exempt Func Income$66,352,814RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$725,127ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$13,350TotalAmt
Program Services$13,350ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$441,772TotalAmt
Management And General$441,772ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$31,298,571TotalAmt
Program Services$27,599,351ProgramServicesAmt
Management And General$3,699,220ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,267,307TotalAmt
Program Services$1,101,968ProgramServicesAmt
Management And General$165,339ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,347,669TotalAmt
Program Services$4,649,987ProgramServicesAmt
Management And General$697,682ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,924,815TotalAmt
Program Services$1,673,695ProgramServicesAmt
Management And General$251,120ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$656,149TotalAmt
Management And General$656,149ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$123,705TotalAmt
Management And General$123,705ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$22,477TotalAmt
Management And General$22,477ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,591,281TotalAmt
Program Services$4,591,281ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$438,753TotalAmt
Program Services$134,089ProgramServicesAmt
Management And General$304,664ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$339,984TotalAmt
Program Services$196,007ProgramServicesAmt
Management And General$143,977ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,364,542TotalAmt
Program Services$1,008,639ProgramServicesAmt
Management And General$355,903ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,028,583TotalAmt
Program Services$1,988,582ProgramServicesAmt
Management And General$40,001ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$84,151TotalAmt
Program Services$82,982ProgramServicesAmt
Management And General$1,169ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$592,851TotalAmt
Program Services$480,209ProgramServicesAmt
Management And General$112,642ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,424,883TotalAmt
Program Services$1,964,155ProgramServicesAmt
Management And General$460,728ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$709,222TotalAmt
Program Services$805,886ProgramServicesAmt
Management And General-$96,664ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PURCHASE SERVICES$10,664,510$7,449,967$3,214,543
SUPPLIES AND EQUIPMENT$10,444,267$10,219,298$224,969
HOSPITAL ASSESSMENT PAY$2,690,047$2,690,047
REPAIRS AND MAINTENANCE$1,836,769$1,726,573$110,196

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,158,496TotalAmt
Program Services$1,007,750ProgramServicesAmt
Management And General$150,746ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$80,464,154TotalAmt
Program Services$69,383,816ProgramServicesAmt
Management And General$11,080,338ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$924,502BOYAmt
EOY$15,762,599EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$10,619,069BOYAmt
EOY$7,227,591EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,408,993BOYAmt
EOY$2,084,685EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$981,200BOYAmt
EOY$907,307EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$117,343,726LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$92,566,110LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$26,954,898BOYAmt
EOY$24,777,616EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$11,939,707BOYAmt
EOY$8,590,919EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$326,106BOYAmt
EOY$302,427EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$6,616,381BOYAmt
EOY$8,717,509EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$60,770,856BOYAmt
EOY$68,370,653EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$15,242,907BOYAmt
EOY$12,801,697EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,263BOYAmt
EOY$6,263EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$16,748,447BOYAmt
EOY$15,813,402EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,136,499BOYAmt
EOY$11,869,215EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$13,520,101BOYAmt
EOY$11,819,812EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$46,654,217BOYAmt
EOY$52,310,389EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,844,097BOYAmt
EOY$14,787,467EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,272,542BOYAmt
EOY$1,272,797EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,116,639BOYAmt
EOY$16,060,264EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$60,770,856BOYAmt
EOY$68,370,653EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$1,049,749ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$385,997NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$3,379,371OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$22,477OtherActivitiesAmt
Total Lobbying Expenditures$22,477TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationALLOCATED PORTION OF MEMBERSHIP DUES WITH ILLINOIS HOSPITAL ASSOCATION, AMERICAN HOSPITAL ASSOCATION, AND MEDICARE DEPENDENT RURAL HOSPITAL COALITION.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,476,235OtherCostOrOtherBasisAmt
Book Value$1,476,235BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$53,756,101OtherCostOrOtherBasisAmt
Depreciation$37,161,269DepreciationAmt
Book Value$16,594,832BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$325,067OtherCostOrOtherBasisAmt
Depreciation$270,249DepreciationAmt
Book Value$54,818BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$60,251,705OtherCostOrOtherBasisAmt
Depreciation$53,937,001DepreciationAmt
Book Value$6,314,704BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,534,618OtherCostOrOtherBasisAmt
Depreciation$1,197,591DepreciationAmt
Book Value$337,027BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$24,777,616TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$5,048,534
INTEREST IN ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION$1,272,797
OTHER ASSETS$2,396,178
FieldValueIRS element (for citing)
Total Book Value Other Assets$8,717,509TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
PENSION OBLIGATION$3,684,416
ESTIMATED THIRD PARTY PAYOR SETTLEMENTS$2,413,393
ESTIMATED SELF-INSURANCE COSTS$3,660,902
DUE TO AFFILIATES$2,061,101
FieldValueIRS element (for citing)
Total Liability$11,819,812TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationIV HEALTH CORP, INC., ILLINOIS VALLEY COMMUNITY HOSPITAL, ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION AND HYGIENIC INSTITUTE OF LASALLE, PERU, AND OGLESBY ARE NONPROFIT CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. HOWEVER, THEY ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. VALLEY HEALTH ENTERPRISES IS SUBJECT TO INCOME TAXATION AS A LIMITED LIABILITY COMPANY THAT IS TAXED AS A PARTNERSHIP. IV HEALTH CORP, INC., ILLINOIS VALLEY COMMUNITY HOSPITAL, ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION AND HYGIENIC INSTITUTE OF LASALLE, PERU, AND OGLESBY FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO NONPROFIT ORGANIZATIONS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF EACH ENTITY AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). UBI IS REPORTED ON FORM 990-T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESS, IF ANY. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2020 AND 2019, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY. TAX RETURNS FILED ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN.ExplanationTxt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent150Yes (X)Percent150Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent300Yes (X)Percent300Ind
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$222,704TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$222,704NetCommunityBenefitExpnsAmt
Total Expense0.00280TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$12,830,950TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,318,694DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,512,256NetCommunityBenefitExpnsAmt
Total Expense0.11820TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,053,654TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$3,318,694DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,734,960NetCommunityBenefitExpnsAmt
Total Expense0.12100TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$479,495TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$384,356DirectOffsettingRevenueAmt
Net Community Benefit Expns$95,139NetCommunityBenefitExpnsAmt
Total Expense0.00120TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$18,003TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$18,003NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$942,372TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$520,168DirectOffsettingRevenueAmt
Net Community Benefit Expns$422,204NetCommunityBenefitExpnsAmt
Total Expense0.00520TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$13,350TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$13,350NetCommunityBenefitExpnsAmt
Total Expense0.00020TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$1,453,220TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$904,524DirectOffsettingRevenueAmt
Net Community Benefit Expns$548,696NetCommunityBenefitExpnsAmt
Total Expense0.00680TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$14,506,874TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,223,218DirectOffsettingRevenueAmt
Net Community Benefit Expns$10,283,656NetCommunityBenefitExpnsAmt
Total Expense0.12780TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$4,529,107BadDebtExpenseAmt
Bad Debt Expense Attributable$452,911BadDebtExpenseAttributableAmt
Reimbursed By Medicare$17,711,412ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$18,762,821CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$1,051,409MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS VALLEY COMMUNITY HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1925 WEST STREETAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.IVCH.ORGWebsiteAddressTxt
State License0003418StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherVARIOUS PHYSICIAN CLINICS & OUTPATIENT SERVICESOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS VALLEY COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
OtherYes (X)OtherInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLSEE PART V, PAGE 8OwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLSEE PART V, PAGE 8StrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care150.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care300.000000000000FPGFamilyIncmLmtDscntCarePct
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLHTTPS://WWW.IVCH.ORG/PATIENTS-VISITORS/PATIENT/FINANCIAL-ASSISTANCE/FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLHTTPS://WWW.IVCH.ORG/PATIENTS-VISITORS/PATIENT/FINANCIAL-ASSISTANCE/FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLHTTPS://WWW.IVCH.ORG/PATIENTS-VISITORS/PATIENT/FINANCIAL-ASSISTANCE/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ILLINOIS VALLEY COMMUNITY HOSPITALPART V, SECTION B, LINE 3J: INDUSTRY DATA RELATED TO PROJECTED GROWTH IN NEED FOR VARIOUS SERVICES SPECIFIC TO THE POPULATION OF THIS AREA.
ILLINOIS VALLEY COMMUNITY HOSPITALPART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) STAKEHOLDERS WORKING GROUP, COMPRISED OF MEMBERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED, WAS RESPONSIBLE FOR THE CHNA PROCESS. THE STAKEHOLDER GROUP INCLUDED MEMBERS FROM IVCH, IVCH MEDICAL GROUP, LA SALLE COUNTY HEALTH DEPT, ALTERNATIVES FOR THE OLDER ADULT, NORTH CENTRAL BEHAVIORAL HEALTH SERVICES, OGLESBY PUBLIC SCHOOLS AND ILLINOIS VALLEY UNITED WAY. THE WORKING GROUP DEVELOPED A SURVEY INSTRUMENT, EVALUATED SURVEY RESPONSES, COLLECTED AND EVALUATED SECONDARY DATA, SYNTHESIZED THE PRIMARY AND SECONDARY DATA, AND IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS. PRIMARY DATA FOR THIS ASSESSMENT CAME FROM A SURVEY DEVELOPED, DISTRIBUTED AND ANALYZED BY THE STAKEHOLDERS WORKING GROUP SPECIFICALLY FOR CHNA.
ILLINOIS VALLEY COMMUNITY HOSPITALPART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES A DESCRIPTION OF THE ACTIONS TAKEN TO MEET NEEDS THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE AREAS OF CONCERN THAT HAVE BEEN IDENTIFIED IN THE NEW 2018 COMMUNITY HEALTH NEEDS ASSESSMENT, RELATE TO COST AND QUALITY OF HEALTHCARE, ACCESS TO SPECIALISTS AND SPECIALIZED TREATMENTS, AND MENTAL HEALTH AND SUBSTANCE ABUSE. REGARDING COST AND QUALITY OF CARE, ILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) HAS IMPLEMENTED A PALLIATIVE CARE PROGRAM TO REDUCE PATIENT AND OVERAL COST OF CARE WHILE ENHANCING CARE AND SERVICE TO PATIENTS; PROMOTED AND PROVIDED ANNUAL WELLNESS VISITS TO PROACTIVELY MANAGE THE HEALTH OF PATIENTS; AND EDUCATED AND ASSISTED PATIENTS TO UNDERSTAND AVAILABLE INSURANCE AND COVERAGES PROVIDED BY MEDICARE AND MEDICAID. REGARDING ACCESS TO SPECIALISTS AND SPECIALIZED CARE, IVCH CONDUCTED ANALYSIS TO DETERMINE MORE SPECIFICALLY WHAT THE COMMUNITY IS SEEKING, AND AUGMENTED A MEDICAL STAFF DEVELOPMENT PLAN TO RECRUIT ORTHOPEDIC SURGEON, OB/GYN PHYSICIANS AND NEUROLOGIST. REGARDING MENTAL HEALTH AND SUBSTANCE ABUSE, IVCH HAS INCREASED ACCESS TO MENTAL HEALTH TREATMENT BY PROVIDING TELEPSYCHIATRY SERVICES IN PRIMARY CARE CLINICS; CONTINUED FOCUS ON PEDIATRIC MENTAL HEALTH THROUGH SERVICES OFFERED AT THE HYGIENIC INSTITUTE; AND INCREASED AWARENESS OF CURRENT MEDICATION ASSISTED THERAPY TREATMENT OPTIONS OFFERED THROUGH THE IVCH MEDICAL GROUP.
FORM 990, SCHEDULE H, PART V, LINE 7A, CHNA WEBSITE:HTTPS://WWW.IVCH.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
FORM 990, SCHEDULE H, PART V, LINE 10A, IMPLEMENTATION STRATEGY WEBSITE:HTTPS://WWW.IVCH.ORG/DOCUMENTS/CHNA-2018-IMPLEMENTATION-STRATEGYV3.PDF
FieldValueIRS element (for citing)
Facility3FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - CENTER FOR PHYSICAL REHABILITATION
300 WALNUT STREETPERUIL61354OUTPATIENT PHYSICAL REHABILITATION
2 - IVCH WOUND & HYPERBARIC CENTER
1403 6TH STREETPERUIL61354WOUND AND HYPERBARIC THERAPY
4 - IVCH CARE TODAY
300 WALNUT STREETPERUIL61354URGENT CARE ALTERNATIVE TO ER

Supplemental Information Detail SupplementalInformationDetail (17 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3C:NOT APPLICABLE
PART I, LINE 6A:NOT APPLICABLE
PART I, LINE 7:THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7 USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS.
PART I, LINE 7G:THE AMOUNTS REPORTED ON ROW 7G DO NOT CONTAIN COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
PART I, LN 7 COL(F):THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $4,529,107. BAD DEBT EXPENSE WAS NOT INCLUDED IN THE DENOMINATOR BECAUSE IT WAS REPORTED ON LINE 2D OF PART VIII, STATEMENT OF REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES IS 18.03%. THIS PERCENTAGE INCREASES TO 41.35% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN THE TOTAL COMMUNTY BENEFIT EXPENSE.
PART II, COMMUNITY BUILDING ACTIVITIES:NOT APPLICABLE
PART III, LINE 2:THE ORGANIZATION RECORDS CONTRACTUAL DISCOUNTS AT THE TIME OF THE POSTING OF THE PAYMENT FOR SERVICES FROM THIRD PARTY PAYORS. BAD DEBT IS RECORDED AT THE TIME THE ACCOUNT IS EITHER PRESUMED UNCOLLECTIBLE OR TURNED OVER TO COLLECTION. FURTHER, THE ORGANIZATION RECORDS APPROPRIATE ALLOWANCES FOR CONTRACTUAL DISCOUNTS AND BAD DEBT/CHARITY CARE IN ORDER TO REFLECT ACCOUNTS RECEIVABLE AT THE EXPECTED COLLECTIBLE AMOUNT.CONTRACTUAL DISCOUNTS/MEDICARE/MEDICAID: MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYORS IN EVALUATING THE REASONABLE ESTIMATE OF THE ALLOWANCE FOR CONTRACTUAL DISCOUNTS. FOR SERVICES PROVIDED TO PATIENTS THAT HAVE THIRD PARTY COVERAGE, THE CORPORATION ANALYZES THE DISCOUNT RATES FOR EACH MAJOR PAYOR. THE DIFFERENCE BETWEEN THE NEGOTIATED RATES FOR THE MEDICARE/MEDICAID STANDARD RATES ARE USED TO DETERMINE THE ALLOWANCE FOR CONTRACTUAL DISCOUNTS.SELF-PAY ACCOUNTS RECEIVABLE INCLUDE THE PATIENT RESPONSIBILITY FOR SERVICES AFTER THE THIRD PARTY COVERAGE HAS BEEN APPLIED TO THE PATIENT ACCOUNT AS WELL AS THE UNINSURED. AN ALLOWANCE FOR BAD DEBT IS ESTIMATED BASED ON PAST EXPERIENCE AS WELL AS THE AGE OF THE ACCOUNTS. THE ORGANIZATION HAS A COLLECTIONS PRACTICES POLICY THAT IS USED TO SET GUIDELINES ON THE APPROACH AND TIMELINE TO MAKE REASONABLE COLLECTION EFFORTS BEFORE ANY ACCOUNTS ARE TURNED OVER TO A COLLECTION AGENCY. THE ORGANIZATION HAD BAD DEBT EXPENSE TOTALING $4,529,107. THIS REFLECTS THE COMBINED IMPACT OF WRITE-OFFS OF UNCOLLECTIBLE ACCOUNTS, PROVISIONS RECORDED TO ESTIMATE BAD DEBT ON ACCOUNTS RECEIVABLE.DURING FISCAL 2020, THERE WERE NO CHANGES IN THE ORGANIZATION'S POLICIES OR PRACTICES.
PART III, LINE 3:10% OF BAD DEBT IS ASSUMED TO BE PROVIDED INCLUDE AMOUNTS WRITTEN OFF FOR PATIENTS THAT WOULD HAVE QUALIFIED FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE RATIONALE FOR THE PERCENTAGE BEING THIS IS BECAUSE OF THE SIGNIFICANT STEPS TAKEN WITH PATIENTS TO FACILITATE MEDICAID OR FINANCIAL ASSISTANCE QUALIFICATION.
PART III, LINE 4:ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITALS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 79 PERCENT AT JUNE 30, 2020.
PART III, LINE 8:IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NON PROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE AMOUNTS REPORTED ON LINE 6 WERE OBTAINED FROM WORKSHEET D OF THE FISCAL YEAR 2020 MEDICARE COST REPORT.
PART III, LINE 9B:WHEN A PATIENT IS IN THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE THE ACCOUNT IS PLACED ON HOLD AND NO FURTHER COLLECTION EFFORTS ARE MADE UNTIL THE REQUEST FOR ASSISTANCE HAS BEEN RESOLVED. THE APPLICATION PROCESS INCLUDES FACILITATING THE PATIENT'S APPLICATION FOR VARIOUS ASSISTANCE PROGRAMS, AND IDENTIFYING WHERE THE PATIENT FALLS IN THE DISCOUNT SCALE OF THE ORGANIZATION BASED ON INCOME LEVEL AND SIZE OF FAMILY. IF THERE IS A BALANCE REMAINING AFTER CHARITY CARE OR OTHER FINANCIAL ASSISTANCE HAS BEEN APPLIED, A MUTUALLY AGREED UPON PAYMENT PLAN IS DEVELOPED AND THE ACCOUNT FOLLOWS THE SAME COLLECTION PROCEDURES AS ALL OTHER SELF-PAY ACCOUNTS. MONTHLY PAYMENTS ARE REQUIRED AND BALANCES ARE TYPICALLY EXPECTED TO BE PAID IN FULL WITHIN ONE YEAR. EXTENSIONS MAY BE APPROVED FOR UNEXPECTED CHANGES IN ABILITY TO MEET THE PAYMENT SCHEDULE. COLLECTION PROCEDURES INCLUDE STATEMENTS, PAST DUE NOTICES, PHONE CALLS AND, IF AGREED UPON PAYMENT ARRANGEMENTS CAN NOT BE MET, THE ACCOUNT IS REFERRED TO A COLLECTION AGENCY.
PART VI, LINE 2:THE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY ILLINOIS VALLEY COMMUNITY HOSPITAL IS BASED ON A COMBINATION OF THE FOLLOWING FACTORS: EXISTENCE OR NON-EXISTENCE OF APPROPRIATE SERVICES, DEMONSTRATED NEED, VOICE OF THE CUSTOMER, COLLABORATION WITH COMMUNITY ORGANIZATIONS, GOVERNMENT AGENCIES AND OTHER HEALTH CARE PROVIDERS, BENCHMARKING MARKET RESEARCH, CUSTOMER SURVEYS, PHYSICIAN INPUT AND MONITORING OF STATE AND FEDERAL GUIDELINES. THIS INFORMATION IS REVIEWED AND ANALYZED BY THE HOSPITAL'S ADMINISTRATIVE TEAM AND INCORPORATED INTO THE HOSPITAL'S STRATEGIC PLANNING PROCESS.
PART VI, LINE 3:DOCUMENTATION IS PROVIDED AT THE TIME OF REGISTRATION INFORMING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDING CONTACT INFORMATION FOR THE PATIENT FINANCIAL SERVICES DEPARTMENT. BASIC INFORMATION AND CONTACT INFORMATION IS ALSO AVAILABLE AT WWW.IVCH.ORG BY SELECTING THE HOME PAGE'S FINANCIAL ASSISTANCE BUTTON. WHEN CONTACTED BY A PATIENT, FINANCIAL COUNSELORS WORK INDIVIDUALLY WITH EACH APPLICANT TO DETERMINE ELIGIBILITY FOR CHARITY OR FINANCIAL ASSISTANCE. NOTICES ABOUT FINANCIAL ASSISTANCE PROGRAMS ARE POSTED IN THE REGISTRATION AREAS AND INFORMATION IS ALSO INCLUDED ON THE PATIENT STATEMENTS. THE SOCIAL SERVICES DEPARTMENT NOTIFIES EACH INPATIENT OF FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT ILLINOIS VALLEY COMMUNITY HOSPITAL AS WELL AS LOCAL, STATE, AND FEDERAL PROGRAMS THEY MAY BE ELIGIBLE FOR.
PART VI, LINE 4:ILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) SERVES THE RESIDENTS OF RURAL COMMUNITIES LOCATED IN LASALLE, BUREAU AND PUTNAM COUNTIES, IN NORTH CENTRAL ILLINOIS. THE HOSPITAL IS LOCATED NEAR THE JUNCTION OF INTERSTATES 80 AND 39 AND IS 62 MILES WEST OF JOLIET AND 64 MILES NORTH OF BLOOMINGTON. THE PRIMARY SERVICE AREA OF THE HOSPITAL HAS A POPULATION OF ABOUT 35,000 PEOPLE. NO POPULATION GROWTH IS PROJECTED FOR THE AREA. THE LARGEST AREA EMPLOYERS ARE INVOLVED IN TRANSPORTATION, WAREHOUSING, AGRICULTURE, LIGHT INDUSTRY, AND RETAIL SERVICES. THE SERVICE AREA RACE AND ETHNICITY IS COMPOSED OF 85% WHITE, 3% AFRICAN AMERICAN, 10% HISPANIC AND 1% ASIAN. ACCORDING TO THE ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY, THE 2020 UNEMPLOYMENT RATE IN LASALLE COUNTY WAS 9.4%, WHICH WAS SLIGHTLY LOWER THAN THE STATE OF ILLINOIS (9.5%) AND HIGHER THAN THE UNITED STATES (8.1%). THE MEDIAN HOUSEHOLD INCOME IN LASALLE ($58,142), BUREAU ($57,436) AND PUTNAM ($63,638) COUNTIES WERE BELOW THE STATE OF ILLINOIS FIGURE OF $65,886. THE PROPORTION OF LASALLE COUNTY RESIDENTS LIVING BELOW THE FEDERAL POVERTY LEVEL OF 12.2% IS MORE THAN THE STATE AVERAGE OF 11.5%. IVCH SERVES PATIENTS WITHOUT REGARD TO AGE, GENDER, INCOME, ETHNIC ORIGIN, INSURANCE COVERAGE, OR ABILITY TO PAY. APPROXIMATELY 65% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE WAS FROM PARTICIPATION IN THE MEDICARE AND MEDICAID PROGRAMS FOR THE YEAR ENDING JUNE 30, 2020.
PART VI, LINE 5:THE BOARD OF DIRECTORS OF ILLINOIS VALLY COMMUNITY HOSPITAL (IVCH) IS COMPOSED OF 10 COMMUNITY MEMBERS RESIDING IN OUR SERVICE AREA. THESE BOARD MEMBERS HAVE REGULAR INPUT ON STRATEGIC PLANNING, NEW SERVICES, TECHNOLOGY, AND PHYSICIAN RECRUITMENT. IVCH MAINTAINS AN OPEN MEDICAL STAFF AND IS CONSTANTLY RECRUITING NEW PHYSICIANS TO MEET IDENTIFIED NEEDS. ALL AVAILABLE CASH FLOW GENERATED BY THE ORGANIZATION IS REINVESTED BACK INTO THE HOSPITAL THROUGH THE PURCHASE OF PROPERTY AND EQUIPMENT TO PROVIDE SERVICES THAT MEET THE NEEDS OF THE SERVICE AREA. THE COMMUNITY OUTREACH DEPARTMENT OFFERS A WIDE VARIETY OF HEALTH AND WELLNESS PROGRAMMING, INCLUDING TAI CHI CLASSES, FREE BLOOD PRESSURE AND GLUCOSE SCREENINGS, HEMOGLOBIN A1C SCREENINGS, LIPID PROFILE SCREENINGS, HEALTHY HEART SCREENINGS, PROSTATE CANCER SCREENINGS, SMOKING CESSATION CLASSES, BABYSITTING CLINICS, CPR INSTRUCTION, AND FIRST AID.
PART VI, LINE 6:NOT APPLICABLE
PART VI, LINE 7, REPORTS FILED WITH STATESIL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT MITCHELL DO
PHYSICIAN$617,748$0$71,148$0$43,836$0$7,075$0$23,230$0$763,037$0$0$0
MARIO COTE MD
PHYSICIAN$337,653$0$259,019$0$3,588$0$18,500$0$34,407$0$653,167$0$0$0
PETER MEIER MD
FORMER PHYSICIAN$418,072$0$100,000$0$82,014$0$0$0$21,354$0$621,440$0$0$0
IOANNIS KARKATZOUNIS MD
PHYSICIAN$446,335$0$2,687$0$88,526$0$0$0$34,095$0$571,643$0$0$0
MAHER YOUNES MD
PHYSICIAN$477,885$0$0$0$40,521$0$0$0$11,039$0$529,445$0$0$0
TOMMY HOBBS
CHIEF EXECUTIVE OFFICER$284,519$0$0$0$1,899$0$14,000$0$25,423$0$325,841$0$0$0
LISA LYNCH
CHIEF FINANCIAL OFFICER$150,667$0$0$0$964$0$7,854$0$30,568$0$190,053$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationEMPLOYED PHYSICIANS OF THE ORGANIZATION RECEIVE A BASE SALARY BASED ON THE MARKET FOR PHYSICIANS IN THEIR MEDICAL SPECIALTY. EACH PHYSICIAN HAS AN EMPLOYMENT CONTRACT WHICH MAY INCLUDE A COMPONENT OF INCENTIVE COMPENSATION. INCENTIVE COMPENSATION IS BASED ON THEIR INDIVIDUAL PROFESSIONAL PRODUCTION, PROVIDING AN OPPORTUNITY TO EARN ABOVE THE BASE SALARY LEVEL. THE BASE SALARY IS RECONCILED WITH THE PHYSICIAN'S PROFESSIONAL PRODUCTION ON A QUARTERLY AND ANNUAL BASIS. ANY AMOUNTS DUE TO THE PHYSICIANS FOR INCENTIVE COMPENSATION ARE PAID WITHIN 30 DAYS OF THE END OF THE PERIOD.ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ILLINOIS FINANCING AUTHORITY
A86109196745203HK352014-12-15$10,000,000RE-FINANCING OF EXISTING DEBT000
ILLINOIS FINANCING AUTHORITY
B86109196745203HK432014-12-15$8,000,000RE-FINANCING OF EXISTING DEBT000
ILLINOIS FINANCING AUTHORITY
C86109196745203HK602014-12-15$3,160,000RE-FINANCING OF EXISTING DEBT000

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$1,943,000$10,000,000$200,000$9,800,0002015Yes (1)0Yes (1)Yes (1)
B$1,553,000$8,000,000$160,000$7,840,0002015Yes (1)0Yes (1)Yes (1)
C$613,000$3,160,000$63,200$3,096,8002015Yes (1)0Yes (1)Yes (1)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctPrivate Bus Concerning UBIPrivateBusConcerningUBIPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A0Yes (1)000.010000.000000.0100000Yes (1)
B0Yes (1)000.010000.000000.0100000Yes (1)
C0Yes (1)000.010000.000000.0100000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A0Yes (1)00Yes (1)000Yes (1)
B0Yes (1)00Yes (1)000Yes (1)
C0Yes (1)00Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6ILLINOIS VALLEY COMMUNITY HOSPITAL IS A SUBSIDIARY OF ITS SOLE CORPORATE MEMBER, IV HEALTH CORP, INC.
FORM 990, PART VI, SECTION A, LINE 7AMEMBERS OF THE BOARD OF DIRECTORS OF THE PARENT COMPANY, IV HEALTH CORP, INC., ACTING ON BEHALF OF THE PARENT, HAVE RESERVED POWERS TO, AS IT RELATES TO THE OPERATIONS OF ILLINOIS VALLEY COMMUNITY HOSPITAL TO APPOINT AND REMOVE DIRECTORS AND TO RATIFY AND REMOVE OFFICERS.
FORM 990, PART VI, SECTION A, LINE 7BMEMBERS OF THE BOARD OF DIRECTORS OF THE PARENT COMPANY, IV HEALTH CORP, INC., ACTING ON BEHALF OF THE PARENT, HAVE RESERVED POWERS TO, AS IT RELATES TO THE OPERATIONS OF ILLINOIS VALLEY COMMUNITY HOSPITAL TO ADOPT, AMEND, OR REPEAL THE ARTICLES OF INCORPORATION AND/OR BY-LAWS, ADOPT A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION, APPROVE THE PURCHASE, SALE, TRANSFER, LEASE ENCUMBRANCE OF PROPERTY, APPROVE BORROWING WITH A TERM GREATER THAN A ONE YEAR TERM OR WHICH REQUIRES A MORTGAGE OF REAL PROPERTY, AND SELECTION OR MODIFICATION OF THE BUSINESS/LEGAL NAME OF THE ENTITY.
FORM 990, PART VI, SECTION B, LINE 11BTHE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER REVIEW THE FORM 990 PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. THE FINAL VERSION OF THE FORM 990 IS E-MAILED OR HAND DELIVERED TO EACH BOARD MEMBER FOR THEIR REVIEW AND TO ANSWER QUESTIONS REGARDING THE 990.
FORM 990, PART VI, SECTION B, LINE 12CTHE OFFICERS AND DIRECTORS OF ILLINOIS VALLEY COMMUNITY HOSPITAL ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY AND HAVE A DUTY TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST. ALL PERSONS COVERED UNDER THE POLICY ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSE ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS. TRANSACTIONS WITH COVERED PERSONS, OR ENTITIES IN WHICH A COVERED PERSON HAS ANY TYPE OF INTEREST, MUST BE AN ARMS LENGTH TRANSACTION. THE BOARD OF DIRECTORS WILL REVIEW ANY TRANSACTIONS IN QUESTION AND DETERMINE IF A CONFLICT EXISTS. THE INTERESTED PERSON MAY MAKE A PRESENTATION, BUT MUST LEAVE THE MEETING DURING DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION. IF A CONFLICT OF INTEREST EXISTS, THE BOARD OF DIRECTORS MAY APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION, DETERMINE IF THERE'S A MORE ADVANTAGEOUS TRANSACTION THAT WOULD NOT GIVE RISE TO A CONFLICT, OR VOTE TO DETERMINE IF THE TRANSACTION IS IN THE HOSPITAL'S BEST INTEREST AND WHETHER IT IS FAIR AND REASONABLE. IF THE BOARD OF DIRECTORS HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE A POSSIBLE CONFLICT OF INTEREST, THE BOARD WILL INFORM THE MEMBER OF THE BASIS OF SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN. FURTHER INVESTIGATION MAY BE WARRANTED, AND THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION AS NEEDED.
FORM 990, PART VI, SECTION B, LINE 15AAN ADHOC COMMITTEE OF THE BOARD OF DIRECTORS (INCLUDING THE BOARD PRESIDENT, CHAIRPERSON OF THE PERSONNEL COMMITTEE, AND AT LEAST ONE OTHER MEMBER) CONDUCT AN ANNUAL PERFORMANCE REVIEW OF THE CHIEF EXECUTIVE OFFICER AND DETERMINE ANY CHANGE/INCREASE IN THE COMPENSATION, IF ANY, BASED UPON BENCHMARK COMPENSATION SURVEYS AND AREA NORMS. THE CHIEF EXECUTIVE OFFICER HAS A WRITTEN EMPLOYMENT CONTRACT RENEWAL OF THE CONTRACT OR INCREASE IN COMPENSATION MUST BE APPROVED BY A MAJORITY OF THE BOARD OF DIRECTORS. THIS COMPENSATION REVIEW WAS COMPLETED IN 2020.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 9:CHANGE IN UNRECOGNIZED FUNDED STATUS OF PENSION PLAN 3,379,116. CHANGE IN INTEREST OF ILLINOIS VALLEY COMMUNITY FOUNDATION 255.
FORM 990, PART XII, LINE 2C:THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
IV HEALTH CORP INC
925 WEST STREETPERUIL61354371211890PARENTIL501(C)(3)LINE 12B, IIN/A0
HYGIENIC INSTITUTE FOR LASALLE PERU AND OGLESBY
925 WEST STREETPERUIL61354362167742PRIMARY CAREIL501(C)(3)LINE 10Yes (1)IV HEALTH CORP INC
ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION
925 WEST STREETPERUIL61354371211780FUNDRAISING FOR ILLINOIS VALLEY COMMUNITY HOSPITALIL501(C)(3)LINE 12A, IYes (1)IV HEALTH CORP INC

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1VALLEY REGIONAL HEALTH SERVICESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14391 VENTURE DRIVEAddressLine1Txt
CityPERUCityNm
State AbbreviationILStateAbbreviationCd
ZIP61354ZIPCd
FieldValueIRS element (for citing)
EIN273891281EIN
Primary ActivitiesCANCER CAREPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1ILLINOIS VALLEY COMMUNITY HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$23,678ShareOfTotalIncomeAmt
Share Of EOY Assets$604,818ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.50000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctControlled OrganizationControlledOrganizationInd
VALLEY HEALTH ENTERPRISES
925 WEST STREETPERUIL61354363476877DMEILILLINOIS VALLEY COMMUNITY HOSPITALC$429,441$3,514,2241.00000Yes (1)
ILLINOIS VALLEY HEALTH SERVICES INC
925 WEST STREETPERUIL61354364050682INACTIVEILILLINOIS VALLEY COMMUNITY HOSPITALC1.00000Yes (1)
ILLINOIS VALLEY PHO
925 WEST STREETPERUIL61354363978381PPO CONTRACTINGILILLINOIS VALLEY COMMUNITY HOSPITALC-$2,113$98,3740.500000
IVCH GENERAL PROFESSIONAL LIAB LOSS FUND
925 WEST STREETPERUIL61354366673231INACTIVEILILLINOIS VALLEY COMMUNITY HOSPITALT1.00000Yes (1)
HEALTH CARE BUILDING CORP
925 WEST STREETPERUIL61354363306917INACTIVEILILLINOIS VALLEY COMMUNITY HOSPITALC1.00000Yes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION
C$182,489FAIR MARKET VALUE
HYGIENIC INSTITUTE OF LASALLE PERU AND OGELSBY
O$130,028FAIR MARKET VALUE
HYGIENIC INSTITUTE OF LASALLE PERU AND OGELSBY
R$295,414FAIR MARKET VALUE
HYGIENIC INSTITUTE OF LASALLE PERU AND OGELSBY
S$177,206FAIR MARKET VALUE
VALLEY HEALTH ENTERPRISES
R$301,941FAIR MARKET VALUE