GRAHAM HOSPITAL ASSOCIATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- GRAHAM HOSPITAL ASSOCIATION (EIN 37-0673506)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-03-26
- IRS object ID
- 202000869349300735
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-03-26T11:04:22-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370673506 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAH | BusinessNameControlTxt |
| Phone | 3096475240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 W WALNUT | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61520 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT G SENNEFF | PersonNm |
| Person Title | PRESIDENT AND CEO | PersonTitleTxt |
| Phone | 3096475240 | PhoneNum |
| Signature | 2020-02-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2020-02-25 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.54.158.12 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-02-28 | IPDt |
| IP Tm | 13:29:53 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | E4255D669FE7A429B540D12C0E645A16D05D3497 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 05365E77D662BDC17E2AAA2C6021CC7EC3235B8D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT G SENNEFF | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 W WALNUT | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61520 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $103,028,100 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GRAHAMHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES, IN A RESPONSIBLE AND CHARITABLE MANNER, TO THE PEOPLE AND COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 818 | TotalEmployeeCnt |
| Total Volunteers | 77 | TotalVolunteersCnt |
| Total Gross UBI | $319,193 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $647,708 | PYContributionsGrantsAmt |
| CY Contributions Grants | $399,717 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $84,072,982 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $85,089,299 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,149,854 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,397,555 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,444,683 | PYOtherRevenueAmt |
| CY Other Revenue | $929,030 | CYOtherRevenueAmt |
| PY Total Revenue | $104,315,227 | PYTotalRevenueAmt |
| CY Total Revenue | $89,815,601 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $40,276,740 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $44,648,460 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $44,711,134 | PYOtherExpensesAmt |
| CY Other Expenses | $43,680,585 | CYOtherExpensesAmt |
| PY Total Expenses | $84,987,874 | PYTotalExpensesAmt |
| CY Total Expenses | $88,329,045 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $19,327,353 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,486,556 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $193,875,235 | TotalAssetsBOYAmt |
| Total Assets EOY | $194,646,676 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $61,832,768 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $61,596,588 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $132,042,467 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $133,050,088 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES, IN A RESPONSIBLE AND CHARITABLE MANNER, TO THE PEOPLE AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $39,983,827 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $46,205,148 | RevenueAmt |
| Desc | GRAHAM HOSPITAL IS A PROVIDER OF HEALTHCARE SERVICES IN FULTON COUNTY AND SURROUNDING AREAS. DURING THIS REPORTING PERIOD, 2,516 ADULTS AND CHILDREN WERE ADMITTED AND 217 BABIES WERE BORN. THEY RECEIVED INPATIENT SERVICES IN THE ACUTE CARE FACILITY. 244 PATIENTS WERE ADMITTED FOR 9,690 DAYS OF SERVICE IN THE EXTENDED CARE FACILITY. 103,852 OUTPATIENT SERVICES WERE PROVIDED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,497,332 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $12,130,674 | RevenueAmt |
| Desc | GRAHAM MEDICAL GROUP WHICH PROVIDES PHYSICIAN AND PROFESSIONAL HEALTH CARE SERVICES TO THE PATIENTS IN FULTON COUNTY, ILLINOIS. THIS INCLUDES CHARITY CARE TO QUALIFIED INDIVIDUALS AND 91,316 OFFICE VISITS AND 10,406 NURSING HOME AND HOSPITAL VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $10,995,023 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $12,705,804 | RevenueAmt |
| Desc | SURGICAL SERVICES - THE HOSPITAL PERFORMED 556 INPATIENT SURGERIES AND 3,144 OUTPATIENT SURGERIES IN FISCAL YEAR 2019. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $5,954,015 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,880,436 | RevenueAmt |
| Desc | THE HOSPITAL OPERATES A 24 HOUR EMERGENCY DEPARTMENT WHICH HAD 14,383 PATIENTS REGISTERED TO THE EMERGENCY DEPARTMENT IN FISCAL YEAR 2019. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $5,954,015 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $6,880,436 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $67,430,197 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 68 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 818 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBERT G SENNEFF | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3096475240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 W WALNUT | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61520 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BILL CARLBERG | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| BROOKE DENNISTON | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| PAULA GRIGSBY | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DONALD HACKETT | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ELIZABETH JAMES | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KENNETH KROCK MD | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARION KUZNIAR | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KEVIN MEADE | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JOSHUA MILLER | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| TERRY MOSS | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK RENICK MD | ||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MIKE RENNER | ||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ROBERT BOBELL OD | ||||||||
| VICE CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JANIS BLOUT | ||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ROBERT SENNEFF | ||||||||
| PRESIDENT/CEO | 40.00 | Yes (X) | $534,264 | $0 | $88,043 | Yes (X) | ||
| HOLLY HENLINE | ||||||||
| VP ANCILLARY/CCO | 40.00 | $187,234 | $0 | $41,846 | Yes (X) | |||
| CAROLYN JACOBUS | ||||||||
| VP CLINIC SERVICES (THRU JULY) | 40.00 | $134,711 | $0 | $16,362 | Yes (X) | |||
| TERESA MCCONKEY | ||||||||
| VP PATIENT SERVICES | 40.00 | $250,513 | $0 | $35,248 | Yes (X) | |||
| JULIE REEDER | ||||||||
| VP FINANCE/CFO | 40.00 | $183,668 | $0 | $41,655 | Yes (X) | |||
| JAMES SCHREINER | ||||||||
| VP INFO SERVICES | 40.00 | $251,165 | $0 | $32,255 | Yes (X) | |||
| ALLISON SOURS | ||||||||
| VP QUALITY | 40.00 | $84,049 | $0 | $14,890 | Yes (X) | |||
| ANDREW ROUDEBUSH DO | ||||||||
| WOUND CLINIC DIRECTOR | 36.00 | $270,033 | $0 | $33,654 | Yes (X) | |||
| DWAYNE BERNARD MD | ||||||||
| MEDICAL DIRECTOR | 36.00 | $420,599 | $0 | $42,870 | Yes (X) | |||
| DEVASHISH AGARWAL MD | ||||||||
| PHYSICIAN | 36.00 | $410,297 | $0 | $42,120 | Yes (X) | |||
| JEFFREY HEMP MD | ||||||||
| PHYSICIAN | 36.00 | $331,848 | $0 | $33,920 | Yes (X) | |||
| MATTHEW MCMILLIN MD | ||||||||
| PHYSICIAN | 24.00 | $240,909 | $0 | $3,223 | Yes (X) | |||
| BRENT PARRY DPM | ||||||||
| PODIATRIST | 36.00 | $407,753 | $0 | $36,157 | Yes (X) | |||
| JULIO RAMOS MD | ||||||||
| PHYSICIAN | 36.00 | $403,364 | $0 | $16,644 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,110,407 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $478,887 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COLEMAN MEDICAL ASSOCIATES | |||||
| 180 SOUTH MAIN STREET | CANTON | IL | 61520 | PHYSICIAN SERVICES | $7,815,523 |
| PJ HOERR INC | |||||
| 107 W COMMERCE | PEORIA | IL | 61604 | CONSTRUCTION | $2,536,106 |
| ENDURACARE ACUTE CARE SERVICES | |||||
| PO BOX 654072 | DALLAS | TX | 75265 | REHAB SERVICES | $1,981,839 |
| MIDWEST MOBILE ANESTHESIA | |||||
| 4128 W STONEWATER DRIVE | PEORIA | IL | 61615 | ANESTHESIA SERVICES | $1,006,302 |
| PEORIA SURGICAL GROUP LTD | |||||
| 1001 MAIN ST SUITE 300 | PEORIA | IL | 61606 | SURGICAL SERVICES | $707,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 28 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $399,717 | AllOtherContributionsAmt |
| Total Contributions | $399,717 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICES | 621110 | $77,922,062 | $77,922,062 | |
| 340(B) REVENUE | 446110 | $6,026,919 | $6,026,919 | |
| SCHOOL OF NURSING | 611600 | $450,335 | $450,335 | |
| LABORATORY SERVICES | 621500 | $199,196 | $199,196 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $490,787 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $370,790 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $119,997 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $85,089,299 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,855,886 | TotalRevenueColumnAmt |
| Exclusion | $2,855,886 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $390,809 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $240,578 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $150,231 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $150,231 | TotalRevenueColumnAmt |
| Exclusion | $150,231 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $13,513,590 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $12,519,974 | SecuritiesAmt |
| Other | $451,947 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $993,616 | SecuritiesAmt |
| Other | -$451,947 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $541,669 | TotalRevenueColumnAmt |
| Exclusion | $541,669 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA | 722210 | $647,861 | $647,861 |
| EMPLOYEE PHARMACY | 446110 | $130,938 | $130,938 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $778,799 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $89,815,601 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $85,548,905 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $319,193 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,547,786 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,519,823 | TotalAmt |
| Program Services | $1,213,883 | ProgramServicesAmt |
| Management And General | $1,305,940 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,570,005 | TotalAmt |
| Program Services | $25,183,258 | ProgramServicesAmt |
| Management And General | $6,386,747 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $695,913 | TotalAmt |
| Program Services | $602,255 | ProgramServicesAmt |
| Management And General | $93,658 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,519,425 | TotalAmt |
| Program Services | $6,333,041 | ProgramServicesAmt |
| Management And General | $1,186,384 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,343,294 | TotalAmt |
| Program Services | $1,961,930 | ProgramServicesAmt |
| Management And General | $381,364 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363,904 | TotalAmt |
| Management And General | $363,904 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,269 | TotalAmt |
| Management And General | $36,269 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,090 | TotalAmt |
| Management And General | $72,090 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $369,880 | TotalAmt |
| Management And General | $369,880 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,955,618 | TotalAmt |
| Program Services | $13,343,574 | ProgramServicesAmt |
| Management And General | $3,612,044 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,985 | TotalAmt |
| Program Services | $8,349 | ProgramServicesAmt |
| Management And General | $289,636 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $426,985 | TotalAmt |
| Program Services | $185,107 | ProgramServicesAmt |
| Management And General | $241,878 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,880,627 | TotalAmt |
| Program Services | $117,712 | ProgramServicesAmt |
| Management And General | $1,762,915 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,632,769 | TotalAmt |
| Program Services | $1,365,200 | ProgramServicesAmt |
| Management And General | $267,569 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,037 | TotalAmt |
| Program Services | $17,029 | ProgramServicesAmt |
| Management And General | $37,008 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,212 | TotalAmt |
| Program Services | $10,226 | ProgramServicesAmt |
| Management And General | $2,986 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,552,394 | TotalAmt |
| Program Services | $1,347,451 | ProgramServicesAmt |
| Management And General | $204,943 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,260,793 | TotalAmt |
| Program Services | $4,550,190 | ProgramServicesAmt |
| Management And General | $710,603 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $547,497 | TotalAmt |
| Management And General | $547,497 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $9,955,973 | $9,665,377 | $290,596 |
| MEDICAID ASSESSMENT | $2,307,692 | $2,307,692 | |
| DIETARY | $742,628 | $721,366 | $21,262 |
| REPAIRS AND MAINTENANCE | $578,009 | $437,445 | $140,564 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $632,223 | TotalAmt |
| Program Services | $366,804 | ProgramServicesAmt |
| Management And General | $265,419 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,329,045 | TotalAmt |
| Program Services | $67,430,197 | ProgramServicesAmt |
| Management And General | $20,898,848 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,191,164 | BOYAmt |
| EOY | $702,413 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,024,737 | BOYAmt |
| EOY | $3,572,625 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,578,992 | BOYAmt |
| EOY | $11,329,607 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,200,664 | BOYAmt |
| EOY | $2,932,186 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,873,940 | BOYAmt |
| EOY | $1,846,830 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,977,716 | BOYAmt |
| EOY | $1,700,920 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $138,199,794 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $63,610,920 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,684,711 | BOYAmt |
| EOY | $74,588,874 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,084,256 | BOYAmt |
| EOY | $86,868,947 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,666,367 | BOYAmt |
| EOY | $8,764,595 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,592,688 | BOYAmt |
| EOY | $2,339,679 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,875,235 | BOYAmt |
| EOY | $194,646,676 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,319,528 | BOYAmt |
| EOY | $6,915,782 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,378,239 | BOYAmt |
| EOY | $44,069,585 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,135,001 | BOYAmt |
| EOY | $10,611,221 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,832,768 | BOYAmt |
| EOY | $61,596,588 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,376,100 | BOYAmt |
| EOY | $124,285,493 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $320,008 | BOYAmt |
| EOY | $362,678 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,346,359 | BOYAmt |
| EOY | $8,401,917 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,042,467 | BOYAmt |
| EOY | $133,050,088 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,875,235 | BOYAmt |
| EOY | $194,646,676 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,486,556 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $347,786 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$826,721 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $23,011 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $23,011 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED: 37% OF MEMBERSHIP DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION, OR $13,749; 37% OF MEMBERSHIP DUES PAID TO THE AMERICAN HOSPITAL ASSOCIATION, OR $8,550; 28.42% OF MEMBERSHIP DUES PAID TO THE ILLINOIS HEALTH CARE ASSOCIATION, OR $712. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $91,454,034 | BeginningYearBalanceAmt |
| Contributions | $860,760 | ContributionsAmt |
| Investment Earnings Or Losses | $3,919,679 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $12,300 | GrantsOrScholarshipsAmt |
| Other Expenditures | $256,453 | OtherExpendituresAmt |
| Administrative Expenses | $1,463,034 | AdministrativeExpensesAmt |
| End Year Balance | $94,502,686 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $81,121,870 | BeginningYearBalanceAmt |
| Contributions | $621,102 | ContributionsAmt |
| Investment Earnings Or Losses | $5,169,957 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $13,150 | GrantsOrScholarshipsAmt |
| Other Expenditures | -$5,143,522 | OtherExpendituresAmt |
| Administrative Expenses | $589,245 | AdministrativeExpensesAmt |
| End Year Balance | $91,454,056 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $76,601,005 | BeginningYearBalanceAmt |
| Contributions | $131,055 | ContributionsAmt |
| Investment Earnings Or Losses | $8,619,102 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $10,550 | GrantsOrScholarshipsAmt |
| Other Expenditures | $302,248 | OtherExpendituresAmt |
| Administrative Expenses | $916,494 | AdministrativeExpensesAmt |
| End Year Balance | $84,121,870 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $74,358,133 | BeginningYearBalanceAmt |
| Contributions | $292,468 | ContributionsAmt |
| Investment Earnings Or Losses | -$235,443 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $8,445 | GrantsOrScholarshipsAmt |
| Other Expenditures | $12,750 | OtherExpendituresAmt |
| Administrative Expenses | $792,958 | AdministrativeExpensesAmt |
| End Year Balance | $73,601,005 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $70,323,226 | BeginningYearBalanceAmt |
| Contributions | $2,730,813 | ContributionsAmt |
| Investment Earnings Or Losses | $1,877,809 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,050 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $570,665 | AdministrativeExpensesAmt |
| End Year Balance | $74,358,133 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.90730 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.09000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00270 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,145,860 | OtherCostOrOtherBasisAmt |
| Book Value | $3,145,860 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $87,475,197 | OtherCostOrOtherBasisAmt |
| Depreciation | $31,633,094 | DepreciationAmt |
| Book Value | $55,842,103 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,442,446 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,992,795 | DepreciationAmt |
| Book Value | $14,449,651 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,136,291 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,985,031 | DepreciationAmt |
| Book Value | $1,151,260 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $74,588,874 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (6 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTY PAYORS | $2,861,958 |
| ESTIMATED SELF INSURANCE COSTS | $2,727,275 |
| ASSET RETIREMENT OBLIGATION | $266,162 |
| DEFERRED COMP PLAN OBLIGATIONS | $1,130,856 |
| FMV OF SWAP OPTIONS | $3,485,359 |
| RECOURSE LIABILITY | $139,611 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $10,611,221 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $89,384,317 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $347,786 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$779,070 | OtherRevenueAmt |
| Revenue Not Reported | -$431,284 | RevenueNotReportedAmt |
| Revenue Subtotal | $89,815,601 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $89,815,601 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $88,569,623 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $240,578 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $240,578 | ExpensesNotReportedAmt |
| Expenses Subtotal | $88,329,045 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $88,329,045 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE INTENDED USE OF THE ORGANIZATION'S ENDOWMENT FUNDS IS TO PROVIDE SCHOLARSHIPS BASED ON STUDENT NEEDS FROM THE INCOME OF THE DONOR-RESTRICTED ENDOWMENT FUNDS. THE PERMANENT ENDOWMENT IS USED FOR THE PURCHASE OF PROPERTY AND EQUIPMENT. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENT EXPENSES 240,578. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -1,019,648. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENT EXPENSES 240,578. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 180.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | 0 | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,787,649 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,787,649 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02020 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $16,718,869 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,343,571 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,375,298 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03820 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,506,518 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,343,571 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,162,947 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.05840 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $60,506 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,282 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $59,224 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00070 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $212,342 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $212,342 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $272,848 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,282 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $271,566 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00310 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,779,366 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $13,344,853 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,434,513 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.06150 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,336 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,336 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,550 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,550 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,886 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,886 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,687,051 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $21,495,646 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $24,138,166 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,642,520 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT STREET | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61520 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.GRAHAMHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| State License | 0000869 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 18 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE SUPPLEMENTAL INFORMATION | OwnWebsiteURLTxt |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE SUPPLEMENTAL INFORMATION | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 180.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE PART V, PAGE 8 | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE PART V, PAGE 8 | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE PART V, PAGE 8 | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| Other Publicity | Yes (X) | OtherPublicityInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 5: FOCUS GROUP 1 COMMUNITY LEADERS AND REPRESENTATIVES: RUSTY MELHOUSE - FINANCIAL ADVISOR EDWARD D. JONES TRYGVE MEADE - ATTORNEY/PROPRIETOR MEADE LAW OFFICE JEFF STANDARD SHERIFF - FULTON COUNTY SHERIFF'S DEPARTMENT AMANDA ATCHLEY - EXECUTIVE DIRECTOR CANTON AREA CHAMBER OF COMMERCE AARON AND VEANNA THUM - OWNERS CRAWFORD'S HOME FURNISHINGS KATHY EDWARDS - PRESIDENT GRAHAM HOSPITAL SERVICE LEAGUE ROLF SILVERSTEIN - SUPERINTENDENT CANTON UNION SCHOOL DISTRICT #66 BROOKE DENNISTON - EXECUTIVE DIRECTOR CANTON YWCA JAY SHEPLER - REPRESENTATIVE ST. MARY'S FOOD PANTRY REV. KEVIN VAN TINE - PASTOR COVENANT COMMUNITY FELLOWSHIP, CANTON KENT MCDOWELL - MAYOR CITY OF CANTON DICK FAIRBURN - PUBLIC SAFETY DIRECTOR CITY OF CANTONIDENTIFICATION AND PRIORITIZATION GROUP AMANDA ATCHLEY - EXECUTIVE DIRECTOR CANTON AREA CHAMBER OF COMMERCE KENT MCDOWELL - MAYOR CITY OF CANTON KATIE LYNN - ADMINISTRATOR FULTON COUNTY HEALTH DEPARTMENT MISSY KOLOWSKI - ADMINISTRATOR HEALTH & WELLNESS CONNECTION OF FULTON COUNTY MICHELLE LOCKE - CLINICAL SOCIAL WORKER GRAHAM HOSPITAL SUE LIVINGSTON - DIRECTOR GRAHAM SCHOOL OF NURSING JEFF HOWD - ADMINISTRATOR THE LOFT REHAB & NURSING CENTER, CANTONFOCUS GROUP 2 - MEDICAL PROFESSIONALS AND PARTNERS KATIE LYNN - ADMINISTRATOR FULTON COUNTY HEALTH DEPARTMENT LIZ UTSINGER - HEALTH PROFESSIONAL/HEALTH EDUCATOR FULTON COUNTY HEALTH DEPARTMENT MISSY KOLOWKI - ADMINISTRATOR HEALTH & WELLNESS CONNECTION OF FULTON COUNTY |
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 7D: HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 11: 1. PREVALENCE OF OBESITY AMONG YOUTH AND ADULTS IN THE COMMUNITY, AND THE NEED FOR NUTRITION EDUCATION FOR THE COMMUNITY AND ACCESS TO HEALTHY FOODS. ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: A. EXPAND THE PRITIKIN CARDIAC PROGRAM B. CREATE A COMMUNITY BIKE SHARE PROGRAM C. COLLABORATE WITH THE YMCA TO PRESENT A HEALTHY KIDS DAY D. GROW PROGRAMS FOR BUSINESS AT THE COMMUNITY WELLNESS CENTER E. CREATE WELLNESS CHECK PROGRAMS G. IMPROVE PATIENT BMI THROUGH TRACKING AND EDUCATION AT CLINICS AND THE WELLNESS CENTER2. PREVALENCE OF DIABETES IN THE COMMUNITY AND THE NEED FOR PHYSICAL, HEALTH, AND NUTRITION EDUCATION FOR YOUTH AND ADULTS, AND FOR ACCESS TO REASONABLY PRICED INSULIN AND OTHER DIABETES MEDICATIONS FOR THE UNDERINSURED AND UNINSURED. ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: A. EXPAND THE PRITIKIN CARDIAC PROGRAM B. EXPAND MERIT-BASED INCENTIVE PAYMENT SYSTEM ADDRESSING A1C MEASURES C. CONTINUE TO SUPPORT CONNECTIONS CLINIC D. CONTINUE SUPPORT OF BIO-MED CLASSROOM AND EDUCATION PROGRAMS AT CANTON HIGH SCHOOL3. THE THIRD PRIORITIZED NEED WAS MENTAL HEALTH, INCLUDING: A. RESOURCES TO ADDRESS SUICIDE B. LOCAL ACCESS TO MENTAL HEALTH PROVIDERS AT ALL LEVELS C. LOCAL MENTAL HEALTH SUPPORT SERVICES D. LOCAL ACCESS TO DETOXIFICATION, REHABILITATION, AND RECOVERY FOR PERSONS FACING SUBSTANCE USE DISORDERS4. THE GROUP NEXT IDENTIFIED THE NEED TO ADDRESS THE NUMBER OF LOCAL TEEN BIRTHS. ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: A. EXPLORE FACE-TO-FACE EDUCATION BETWEEN MEDICAL STAFF AND STUDENTS B. PROVIDE SUPPORT FOR THE FULTON COUNTY HEALTH DEPARTMENT IN ITS EFFORTS TO ADDRESS THIS ISSUE5. THE GROUP'S FINAL IDENTIFIED NEED ACCESSED WAS TO INCREASE LOCAL ACCESS TO DENTISTS FOR UNDERINSURED AND UNINSURED COMMUNITY MEMBERS. ACTIONS THE HOSPITAL INTENDS TO TAKE TO ADDRESS THE HEALTH NEED: A. GRAHAM HOSPITAL WILL CONTINUE TO PROVIDE FINANCIAL SUPPORT FOR DENTAL SERVICES AT THE CONNECTIONS CLINIC B. GRAHAM HOSPITAL WILL SUPPORT, AS REASONABLY POSSIBLE, EFFORTS BY THE FULTON COUNTY HEALTH DEPARTMENT TO PROVIDE DENTAL SERVICES |
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 16J: THE FAP AND FAP SUMMARY ARE ONLY PROVIDED IN ENGLISH. GRAHAM HOSPTIAL ASSOCIATION IS NOT REQUIRED TO PROVIDE THE FAP AND FAP SUMMARY IN LANGUAGES THAT ARE SPOKEN BY LEP POPULATIONS. |
| PART V, LINE 16A, FAP WEBSITE: | HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE |
| PART V, LINE 16B, FAP APPLICATION WEBSITE: | HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE |
| PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE: | HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE/FINANCIAL-ASSISTANCE |
| SCHEDULE H, PART V, LINE 10: | HTTPS://WWW.GRAHAMHEALTHSYSTEM.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 8 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - GRAHAM MEDICAL GROUP | ||||
| 180 SOUTH MAIN STREET | CANTON | IL | 61520 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| 2 - GRAHAM HOSPITAL PHARMACY | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | PHARMACY FOR PATIENTS & RETAIL FOR EMPLOYEES |
| 3 - GRAHAM MEDICAL GROUP - LEWISTOWN | ||||
| 408 SOUTH MAIN STREET | LEWISTOWN | IL | 61542 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| 4 - GRAHAM MEDICAL GROUP - FARMINGTON | ||||
| 601 EAST FORT STREET | FARMINGTON | IL | 64531 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| 5 - GRAHAM HOSPITAL EXTENDED CARE UNIT | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | SKILLED NURSING & LONG TERM CARE UNITS |
| 6 - GHA HOME MEDICAL EQUIPMENT STORE | ||||
| 101 SOUTH MAIN STREET | CANTON | IL | 61520 | HOME MEDICAL EQUIPMENT RETAIL STORE |
| 7 - GRAHAM HOSPITAL SCHOOL OF NURSING | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | SCHOOL OF NURSING |
| 8 - GRAHAM CARDIAC REHABILITATION | ||||
| 235 WEST WALNUT | CANTON | IL | 61520 | CARDIAC REHAB SERVICES |
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | NOT APPLICABLE |
| PART I, LINE 6A: | NOT APPLICABLE |
| PART I, LINE 7: | THE COSTING METHOD USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBTS DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | A DONATION OF $5,000 WAS MADE TO THE SPOON RIVER PARTNERSHIP FOR ECONOMIC DEVELOPMENT. THIS ORGANIZATION FOCUSES ON BUILDING IN THE LOCAL COMMUNITY THROUGH ECONOMIC GROWTH, WHICH IMPROVES OPPORTUNITIES FOR JOBS AND INSURANCE WITHIN THE COMMUNITY. THIS DONATION HELPED SUPPORT THE LOCAL ECONOMY BY HELPING A SMALL BUSINESS. A DONATION OF $5,000 WAS MADE TO THE UNIVERSITY OF ILLINOIS FAMILY MEDICINE RURAL STUDENT PHYSICIAN PROGRAM. THIS DONATION WILL HELP GIVE OPPORTUNITY TO PHYSICIANS WHO WANT TO WORK IN RURAL HOSPITALS LIKE GRAHAM. A MONTHLY DONATION OF $5,000 WAS MADE TO THE FULTON COUNTY FREE HEALTH AND WELLNESS CLINIC. THIS CLINIC IS CONSISTENT WITH AND SUPPORTIVE OF GRAHAM'S MISSION OF PROVIDING CHARITY CARE AND HEALTH IMPROVEMENT SERVICES TO THOSE IN NEED. A DONATION OF $2,500 WAS GIVEN TO THE AMERICAN HEART ASSOCIATION. A DONATION OF $9,339.50 WAS MADE TO THE CITY OF ELMWOOD FOUNDATION FOR FEASIBILITY RESEARCH FOR A YMCA COMMUNITY CENTER. A TOTAL OF $8,557.55 WORTH OF MEDICAL SUPPLIES WERE ASSEMBLED INTO KITS AND DONATED TO AREA SCHOOL DISTRICTS. |
| PART III, LINE 2: | PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. |
| PART III, LINE 3: | PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. THE HOSPITAL DOES NOT CHARGE INTEREST ON RECEIVABLES. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED PAST DUE WHEN AN AMOUNT IS PAST DUE ACCORDING TO THE PAYOR'S AGREED-UPON TERMS. PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. |
| PART III, LINE 8: | THE SHORTFALL SHOULD BE TREATED AS A COMMUNITY BENEFITS EXPENSE BECAUSE PROVIDING MEDICAL CARE AT A SHORTFALL IMPACTS THE HOSPITAL'S OPERATIONS AND GROWTH. THE CARE IS PROVIDED BECAUSE THERE IS A NEED AND A DESIRE TO PROVIDE MEDICAL CARE IN THIS COMMUNITY.THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUE (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN SERVICES AND THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: | THE COLLECTION POLICY DESCRIBES THE STEPS TAKEN TO COLLECT SELF PAY BALANCES OUTSTANDING INCLUDING NOTIFICATIONS TO THE PATIENT THROUGH STATEMENTS, FOLLOW-UP PHONE CALLS, VERIFICATION OF INSURANCE ELIGIBILITY AND ULTIMATELY AT WHAT POINT THE UNPAID BALANCE IS WRITTEN OFF AS UNCOLLECTIBLE. IN PRACTICE, WHEN A PATIENT IS IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, A SEARCH OF ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE IS DONE AND THOSE ACCOUNTS ARE REPROCESSED. |
| PART VI, LINE 2: | IN ADDITION TO THE CHNA, A PHYSICIAN NEEDS ASSESSMENT IS DONE TO IDENTIFY NEEDS FOR SPECIFIC SPECIALTY SERVICES BASED ON THE SIZE OF THE CATCHMENT AREA. DATA IS ANALYZED TO IDENTIFY SERVICES THAT ARE PROVIDED TO COUNTY RESIDENTS BY OTHER FACILITIES THAT WOULD BE MORE ACCESSIBLE TO PATIENTS IF PROVIDED AT GRAHAM HEALTH SYSTEM. INPUT IS GAINED FROM PHYSICIANS AND OTHER HEALTHCARE WORKERS PROVIDING SERVICE IN THE AREA ALONG WITH INPUT PROVIDED BY THE BOARD OF DIRECTORS WHO REPRESENT THE COMMUNITY AND PROVIDE A COMMUNICATION LINK BETWEEN GRAHAM HEALTH SYSTEM AND THE COMMUNITIES WE SERVE. |
| PART VI, LINE 3: | THE CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM IS MADE AVAILABLE TO PATIENTS UPON REGISTRATION. FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE TO PATIENTS UPON REGISTRATION OR TO ANYONE REQUESTING THE APPLICATION. THE APPLICATIONS ARE ALSO AVAILABLE ON GRAHAM HEALTH SYSTEM'S WEBSITE AT WWW.GRAHAMHEALTHSYSTEM.ORG/PATIENTS-VISITORS/BILLING-FINANCIAL-ASSISTANCE. APPOINTMENTS MAY BE MADE WITH A FINANCIAL ADVOCATE IF ASSISTANCE IS NEEDED. MEDICAID SERVICES APPLICATION ASSISTANCE IS AVAILABLE. |
| PART VI, LINE 4: | THE GRAHAM HEALTH SYSTEM PRIMARY CATCHMENT AREA IS LOCATED PRIMARILY IN FULTON COUNTY AND INCLUDES ALL OR PORTIONS OF THE TOWNS OF CANTON, LEWISTOWN, CUBA, ELMWOOD, FARMINGTON, HAVANA, ST. DAVID, ASTORIA, DUNFERMLINE AND BRYANT. THE RACE AND ETHNICITY MAKEUP ARE TYPICAL OF RURAL ILLINOIS BASED ON US CENSUS BUREAU DATA AND INCLUDES 91.6% WHITE, 4.0% BLACK, 3.1% HISPANIC ORIGIN, AND 1.3% OTHER. ACCORDING TO THE US CENSUS BUREAU MEDIAN HOUSEHOLD INCOME 2016 WAS $46,183. FULTON COUNTY'S AUGUST 2019 UNEMPLOYMENT RATE WAS 5.7%. |
| PART VI, LINE 5: | DURING EACH FISCAL YEAR VARIOUS COMMUNITY HEALTH IMPROVEMENT SERVICES ARE HELD AT A FACILITY OWNED BY GRAHAM HEALTH SYSTEM OR ITS EMPLOYEES ASSIST WITH SERVICES HELD AT VARIOUS LOCATIONS WITHIN THE CATCHMENT AREA. EXAMPLES OF THESE ACTIVITIES INCLUDE ANNUAL SPONSORSHIP OF A COMMUNITY TALK AND DINNER THAT IS FREE TO THE PUBLIC COVERING HEALTH TOPICS; FREE BLOOD PRESSURE CLINICS OFFERED ON A REGULAR BASIS; PROVIDING SPACE FOR OPERATION OF AN OUTPATIENT CLINIC THAT PROVIDES FREE HEALTHCARE SERVICES TO FULTON COUNTY RESIDENTS. CLINIC SERVICES ARE PROVIDED BY COMMUNITY VOLUNTEERS. |
| PART VI, LINE 6: | NOT APPLICABLE. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT SENNEFF | ||||||||||||||
| PRESIDENT/CEO | $438,149 | $0 | $77,725 | $0 | $18,390 | $0 | $73,899 | $0 | $14,144 | $0 | $622,307 | $0 | $0 | $0 |
| HOLLY HENLINE | ||||||||||||||
| VP ANCILLARY/CCO | $146,959 | $0 | $27,900 | $0 | $12,375 | $0 | $20,892 | $0 | $20,954 | $0 | $229,080 | $0 | $0 | $0 |
| CAROLYN JACOBUS | ||||||||||||||
| VP CLINIC SERVICES (THRU JULY) | $117,500 | $0 | $15,302 | $0 | $1,909 | $0 | $3,692 | $0 | $12,670 | $0 | $151,073 | $0 | $0 | $0 |
| TERESA MCCONKEY | ||||||||||||||
| VP PATIENT SERVICES | $181,958 | $0 | $27,300 | $0 | $41,255 | $0 | $26,854 | $0 | $8,394 | $0 | $285,761 | $0 | $35,374 | $0 |
| JULIE REEDER | ||||||||||||||
| VP FINANCE/CFO | $153,478 | $0 | $29,700 | $0 | $490 | $0 | $22,001 | $0 | $19,654 | $0 | $225,323 | $0 | $0 | $0 |
| JAMES SCHREINER | ||||||||||||||
| VP INFO SERVICES | $180,273 | $0 | $27,000 | $0 | $43,892 | $0 | $26,121 | $0 | $6,134 | $0 | $283,420 | $0 | $34,017 | $0 |
| ANDREW ROUDEBUSH DO | ||||||||||||||
| WOUND CLINIC DIRECTOR | $245,201 | $0 | $24,034 | $0 | $798 | $0 | $7,984 | $0 | $25,670 | $0 | $303,687 | $0 | $0 | $0 |
| DWAYNE BERNARD MD | ||||||||||||||
| MEDICAL DIRECTOR | $407,759 | $0 | $11,034 | $0 | $1,806 | $0 | $8,250 | $0 | $34,620 | $0 | $463,469 | $0 | $0 | $0 |
| DEVASHISH AGARWAL MD | ||||||||||||||
| PHYSICIAN | $409,772 | $0 | $0 | $0 | $525 | $0 | $8,250 | $0 | $33,870 | $0 | $452,417 | $0 | $0 | $0 |
| JEFFREY HEMP MD | ||||||||||||||
| PHYSICIAN | $329,076 | $0 | $0 | $0 | $2,772 | $0 | $8,250 | $0 | $25,670 | $0 | $365,768 | $0 | $0 | $0 |
| MATTHEW MCMILLIN MD | ||||||||||||||
| PHYSICIAN | $240,909 | $0 | $0 | $0 | $0 | $0 | $3,223 | $0 | $0 | $0 | $244,132 | $0 | $0 | $0 |
| BRENT PARRY DPM | ||||||||||||||
| PODIATRIST | $391,946 | $0 | $0 | $0 | $15,807 | $0 | $8,250 | $0 | $27,907 | $0 | $443,910 | $0 | $0 | $0 |
| JULIO RAMOS MD | ||||||||||||||
| PHYSICIAN | $399,106 | $0 | $0 | $0 | $4,258 | $0 | $8,250 | $0 | $8,394 | $0 | $420,008 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) PLAN IN 2018 SPONSORED BY GRAHAM HOSPITAL ASSOCIATION: ROBERT SENNEFF - $65,649, TERESA MCCONKEY - $19,247, JAMES SCHREINER - $18,493, HOLLY HENLINE - $15,135, JULIE REEDER - $16,212. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY GRAHAM HOSPITAL ASSOCIATION ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2018. THIS INFORMATION IS INCLUDED IN DEFERRED COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) PLAN IN 2018 SPONSORED BY GRAHAM HOSPITAL ASSOCIATION: TERESA MCCONKEY - $40,289, ALISON SOURS - $8,500 AND JAMES SCHREINER - $36,474. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR DISTRIBUTION FROM THE PLAN IN 2018. THIS INFORMATION IS INCLUDED IN REPORTABLE COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF CANTON IL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 376000876 | BondIssuerEIN |
| Bond Issued | 2015-11-04 | BondIssuedDt |
| Issue Price | $48,540,000 | IssuePriceAmt |
| Purpose | REFUND PRIOR ISSUE AND FUND BUILDING PROJECTS | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $4,040,001 | RetiredAmt |
| Total Proceeds | $48,540,000 | TotalProceedsAmt |
| Refunding Escrow | $26,755,000 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $488,550 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $21,296,450 | CapitalExpendituresAmt |
| Substantial Completion | 2017 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | Yes (1) | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | Yes (1) | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.15000 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.15000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | Yes (1) | Form8038TFiledInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORGAN STANLEY & | BusinessNameLine1Txt |
| Business Name Line2 | BMO | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 25.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE PREPARED FORM 990 IS REVIEWED BY THE BOARD OF TRUSTEES, CEO, CFO, DIRECTOR OF ACCOUNTING, AND SENIOR ACCOUNTANT BEFORE FILING WITH THE IRS. BEFORE FILING, THE INDEPENDENT ACCOUNTANT PRESENTS THE FORM 990 TO THE ORGANIZATION'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | GRAHAM HOSPITAL REQUIRES THAT ALL TRUSTEES AND ADMINISTRATIVE OFFICERS KEEP THE BOARD OF TRUSTEES INFORMED OF POTENTIAL CONFLICTS OF INTEREST, AND THAT EACH PERSON MAKE AN ANNUAL DECLARATION OF SUCH INTEREST. A CONFLICT OF INTEREST MIGHT EXIST WHEN ORGANIZATIONS IN WHICH TRUSTEES OR OFFICERS HAVE A MATERIAL FINANCIAL INTEREST ARE EITHER DOING BUSINESS WITH, COMPETING WITH, OR HAVE A FINANCIAL INTEREST IN GRAHAM HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE ADMINISTRATIVE OFFICERS IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE ORGANIZATION UTILIZES AN OUTSIDE FIRM, SULLIVAN, COTTER AND ASSOCIATES, INC. TO PROVIDE OUTSIDE EXECUTIVE COMPENSATION INFORMATION. THE LAST REVIEW WAS COMPLETED IN MAY 2019. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | REPAIRS AND MAINTENANCE: PROGRAM SERVICE EXPENSES 37,246. MANAGEMENT AND GENERAL EXPENSES 1,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,246. PHYSICIANS: PROGRAM SERVICE EXPENSES 9,859,498. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,859,498. SERVICE AGREEMENT: PROGRAM SERVICE EXPENSES 961,415. MANAGEMENT AND GENERAL EXPENSES 28,688. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 990,103. OUTSIDE CONTRACTORS: PROGRAM SERVICE EXPENSES 556,456. MANAGEMENT AND GENERAL EXPENSES 119,416. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 675,872. MISCELLANEOUS: PROGRAM SERVICE EXPENSES 322,715. MANAGEMENT AND GENERAL EXPENSES 3,462,940. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,785,655. PHYSICAL THERAPY: PROGRAM SERVICE EXPENSES 1,606,244. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,606,244. |
| FORM 990, PART XI, LINE 9: | CHANGE IN INTEREST IN NET ASSETS OF FOUNDATION 137,368. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS 55,559. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -1,019,648. |