2020-05-14T08:06:40-05:00 2019-06-30 430352985 KERBER ECK & BRAECKEL LLP 3200 ROBBINS ROAD STE 200A SPRINGFIELD IL 62704 990 2018-07-01 364143823 SIU PHYSICIANS & SURGEONS INC SIUP 2175458850 PO BOX 19639 SPRINGFIELD IL 62794 J ALAN NERONE CHIEF FINANCIAL OFFICER 2175458850 2020-05-07 1 DANIELLE M HUNT P00343541 2177890960 2020-05-07 50.234.166.214 2020-05-07 13:40:54 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6E79AD4D72D5696956193634B49D777D91EF8B4B 2018 2020-09-23 17:36:50Z SIU HEALTHCARE J ALAN NERONE 201 E MADISON STE 300 SPRINGFIELD IL 62702 119186262 0 X WWW.SIUMED.ORG X 1997 IL ASSIST SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE'S MEDICAL EDUCATION ACTIVITIES THROUGH PROVIDING PATIENT CARE. 11 3 281 0 0 0 0 0 98458945 115831726 1037447 1136263 0 0 99496392 116967989 0 0 0 0 33821582 31889341 0 0 0 72078282 74275936 105899864 106165277 -6403472 10802712 49978831 62040034 8095877 9038523 41882954 53001511 TO BE A LEADER IN QUALITY HEALTH CARE TO ALL PEOPLE OF CENTRAL AND SOUTHERN ILLINOIS IN SUPPORT OF THE MISSION OF THE SOUTHERN ILLINOIS UNIVERSITY SCHOOL OF MEDICINE. 0 0 91539268 115831726 HEALTH CARE DELIVERY: PHYSICIANS AND OTHER HEALTHCARE PROVIDERS OF SIU PHYSICIANS AND SURGEONS, INC. ASSISTED IN THE TRAINING OF 293 UNDERGRADUATE MEDICAL STUDENTS AND 356 MEDICAL RESIDENTS AND FELLOWS WHILE PROVIDING MEDICAL SERVICES IN THE COMMUNITIES WE SERVE. (OVER 623,000 PATIENT VISITS) 91539268 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 64 0 1 281 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 3 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X SIU SCHOOL OF MEDICINE 2175452227 801 N RUTLEDGE STREET SPRINGFIELD IL 62702 BATTON MD BEAU TREASURER 24.50 25.50 X X 183156 235710 62599 CARLSON MD DOUGLAS FACULTY BOARD MEMBER 24.50 25.50 X 9635 485582 37624 FLACK MD JOHN FACULTY BOARD MEMBER 24.50 25.50 X 32058 557942 47490 KRUSE MD JERRY DEAN AND CEO 24.50 25.50 X X 357330 353366 142791 MINER MD MICHELLE FACULTY BOARD MEMBER 24.50 25.50 X 106353 80275 40716 O'KEEFE DWIGHT BOARD MEMBER 2.00 X 0 0 0 SMITH JR HD CHAIR 2.00 X X 0 0 0 ETTEMA MD SANDRA SECRETARY 24.50 25.50 X X 199224 245782 66157 KHAN MD AZIZ FACULTY BOARD MEMBER 24.50 25.50 X 111500 494264 59643 WOLF MD KARI VICE CHAIR 24.50 25.50 X X 31869 451625 43182 FRAZIER PAMELA BOARD MEMBER 2.00 X 0 0 0 COX-LARGENT WENDY CFO 25.00 25.00 X 87800 233555 53089 WEICHOLD NELSON COO 50.00 X 199195 144551 64361 COLLIER MARY ELIZABETH CFO 15.00 30.00 X 8500 52947 0 ABRAMS MD ROBERT PHYSICIAN 24.50 25.50 X 440000 497506 90465 CALDER MD KEVIN PHYSICIAN 24.50 25.50 X 243387 463459 66030 CRABTREE MD TRAVES PHYSICIAN 24.50 25.50 X 319500 371391 75715 SCHWARTZ MD BRADLEY PHYSICIAN 24.50 25.50 X 268573 435439 69392 STEVENS MD WILLIAM PHYSICIAN 24.50 25.50 X 462447 251254 73919 ALBERS MD JANET FORMER FACULTY BOARD MEMBE 2.00 48.00 X 0 369218 33129 BUESCHER MD LUCINDA FORMER FACULTY BOARD MEMBE 24.50 25.50 X 139646 156678 48660 DECKARD MD ALAN FORMER FACULTY BOARD MEMBE 24.50 25.50 X 40240 201718 35342 DORSEY MD PHD J KEVIN FORMER FACULTY BOARD MEMBE 5.00 45.00 X 0 314873 11758 GILCHRIST MD JAMES FORMER FACULTY BOARD MEMBE 24.50 25.50 X 47447 373103 39199 HAZELRIGG MD STEPHEN FORMER FACULTY BOARD MEMBER 24.50 25.50 X 359904 503242 83445 HODGSON KIM FORMER FACULTY BOARD MEMBE 24.50 25.50 X 115954 501211 56122 LORET DE MOLA MD RICARDO FORMER BOARD MEMBER 24.50 25.50 X 396269 530940 96372 NEUMEISTER MD MICHAEL FORMER FACULTY BOARD MEMBE 24.50 25.50 X 277149 747402 98934 4437136 9053033 1496134 109 1 1 0 WEATHERBY LOCUMS INCORPORATED PO BOX 972633 DALLAS TX 75397 CLINICAL SERVICES 2123312 ANTHELIO HEALTHCARE SOLUTIONS ONE LINCOLN CENTRE 5400 LBJ FREEWA DALLAS TX 75240 CONSULTING SERVICES 1046924 MEMORIAL MEDICAL CENTER 701 N FIRST ST SPRINGFIELD IL 62702 REFERENCE LAB/CATERING/RESEARCH SUPPORT 502796 GE MEDICAL SYSTEMS ULTRASOUND & PRIMARY PO BOX 96483 CHICAGO IL 60693 EQUIPMENT RENTAL/ REPAIR & MAINTENANCE 277650 MEYER CAPEL A PROFESSIONAL CORPORATION PO BOX 6750 CHAMPAIGN IL 61826 LEGAL SERVICES 271998 13 MEDICAL FEES 621110 104841805 104841805 CONTRACTUAL SERVICES 621110 7044260 7044260 MEANINGFUL USE/MGMT & PROVIDER SV 621110 2474787 2474787 TRAUMA/ON CALL FEES 621110 1470874 1470874 115831726 1186937 1186937 2167599 2218273 -50674 -50674 -50674 116967989 115831726 0 1136263 1325646 766411 559235 28927087 16777710 12149377 1636608 949099 687509 43725 43725 3741213 3741213 365530 365530 3902073 3316762 585311 1809343 1809343 183815 183815 66730 66730 19511 19511 343380 291873 51507 509770 509770 UNIVERSITY OVERHEAD 41953676 41953676 PHARMACEUTICALS 12418341 12418341 ACADEMIC DEVELOPMENT 8418057 8418057 MISCELLANEOUS 500772 500772 106165277 91539268 14626009 0 1523681 8159620 14198019 16287047 1755515 1406066 25466 0 4436998 3548835 1031748 888163 21463214 22844999 9981188 12454139 49978831 62040034 5174938 5832262 2920939 3206261 8095877 9038523 X 40851206 52113348 1031748 888163 0 0 41882954 53001511 49978831 62040034 X 10802712 444888 -129043 X X 0 1 X 1 0 X X 1 BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY 376005961 6 1 50371733 0 1 50371733 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 X SCHEDULE A SECTION E1C THE ORGANIZATION OPERATES AS A MULTI-SPECIALTY PHYSICIAN GROUP WHICH BOTH AIDS IN THE TRAINING OF MEDICAL STUDENTS AND RESIDENTS AND PROVIDES CLINICAL SERVICES. THE REVENUES RECEIVED BY SIUHC ARE IN PART USED TO SUPPORT RESEARCH AND EDUCATIONAL ACTIVITIES OF THE SCHOOL OF MEDICINE, WHICH IN TURN, SUPPORTS THE OVERALL EDUCATIONAL MISSION OF THE BOARD OF TRUSTEES OF SOUTHERN ILLINOIS UNIVERSITY. 4417093 3531120 885973 19905 17715 2190 888163 DEPOSITS WITH SOUTHERN ILLINOIS UNIVERSITY 12172446 ACCRUED INTEREST RECEIVABLE 281693 12454139 DUE TO SOUTHERN ILLINOIS UNIVERSITY 3206261 3206261 117283834 444888 444888 116838946 129043 129043 116967989 106165277 0 106165277 0 106165277 PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON EQUITY INVESTMENT: $129,043 PART X, LINE 2 SIU PHYSICIANS AND SURGEONS OWES SOUTHERN ILLINOIS UNIVERSITY FOR SERVICES PERFORMED ON OUR BEHALF. THESE SERVICES INCLUDE STAFF, SUPPLIES, AND FACILITIES EXPENSES. X X X X 0 0 0 0 0 0 0 0 0 BATTON MD BEAU TREASURER 183156 235710 0 0 0 0 27384 0 2086 33129 212626 268839 0 0 CARLSON MD DOUGLAS FACULTY BOARD MEMBER 9635 485582 0 0 0 0 2409 0 2086 33129 14130 518711 0 0 FLACK MD JOHN FACULTY BOARD MEMBER 32058 557942 0 0 0 0 7910 0 2086 37494 42054 595436 0 0 KRUSE MD JERRY DEAN AND CEO 286499 353366 70831 0 0 0 58274 57158 2086 25273 417690 435797 0 0 MINER MD MICHELLE FACULTY BOARD MEMBER 106353 80275 0 0 0 0 10634 0 1153 28929 118140 109204 0 0 ETTEMA MD SANDRA SECRETARY 199224 245782 0 0 0 0 38098 0 2086 25973 239408 271755 0 0 KHAN MD AZIZ FACULTY BOARD MEMBER 111500 494264 0 0 0 0 20063 0 2086 37494 133649 531758 0 0 WOLF MD KARI VICE CHAIR 31869 451625 0 0 0 0 7967 0 2086 33129 41922 484754 0 0 COX-LARGENT WENDY CFO 27800 233555 60000 0 0 0 19200 0 760 33129 107760 266684 0 0 WEICHOLD NELSON COO 133975 144551 65220 0 0 0 29735 0 1497 33129 230427 177680 0 0 ABRAMS MD ROBERT PHYSICIAN 440000 497506 0 0 0 0 55250 0 2086 33129 497336 530635 0 0 CALDER MD KEVIN PHYSICIAN 243387 463459 0 0 0 0 33512 0 1906 30612 278805 494071 0 0 CRABTREE MD TRAVES PHYSICIAN 319500 371391 0 0 0 0 40500 0 2086 33129 362086 404520 0 0 SCHWARTZ MD BRADLEY PHYSICIAN 268573 435439 0 0 0 0 36517 0 2086 30789 307176 466228 0 0 STEVENS MD WILLIAM PHYSICIAN 462447 251254 0 0 0 0 34339 0 2086 37494 498872 288748 0 0 ALBERS MD JANET FORMER FACULTY BOARD MEMBE 0 369218 0 0 0 0 0 0 0 33129 0 402347 0 0 BUESCHER MD LUCINDA FORMER FACULTY BOARD MEMBE 139646 156678 0 0 0 0 13963 0 1568 33129 155177 189807 0 0 DECKARD MD ALAN FORMER FACULTY BOARD MEMBE 40240 201718 0 0 0 0 7241 0 1187 26914 48668 228632 0 0 DORSEY MD PHD J KEVIN FORMER FACULTY BOARD MEMBE 0 314873 0 0 0 0 0 0 0 11758 0 326631 0 0 GILCHRIST MD JAMES FORMER FACULTY BOARD MEMBE 47447 373103 0 0 0 0 11840 0 2086 25273 61373 398376 0 0 HAZELRIGG MD STEPHEN FORMER FACULTY BOARD MEMBER 359904 503242 0 0 0 0 43865 0 2086 37494 405855 540736 0 0 HODGSON KIM FORMER FACULTY BOARD MEMBE 115954 501211 0 0 0 0 28763 0 2086 25273 146803 526484 0 0 LORET DE MOLA MD RICARDO FORMER BOARD MEMBER 396269 530940 0 0 0 0 59640 0 2086 34646 457995 565586 0 0 NEUMEISTER MD MICHAEL FORMER FACULTY BOARD MEMBE 277149 747402 0 0 0 0 59354 0 2086 37494 338589 784896 0 0 FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS MEMBERS AS DESCRIBED IN THE ORGANIZATIONAL BYLAWS. THESE BYLAWS LAY OUT THE SPECIFIC REQUIREMENT FOR MEMBERSHIP. FORM 990, PART VI, SECTION A, LINE 7A FOUR DIRECTORS ARE ELECTED BY THE MEMBERSHIP REPRESENTING EACH OF THE MAJOR PRIMARY CARE OR SPECIALTY DEPARTMENTS AND 1 MEMBER-AT-LARGE. A NOMINATING COMMITTEE IS APPOINTED BY THE BOARD OF DIRECTORS WHO SOLICITS NOMINATIONS FROM THE MEMBERSHIP. THE MEMBERS THEN VOTE IN ONE OF THE CATEGORIES FOR A DIRECTOR. EACH DIRECTOR IS ELECTED TO A THREE YEAR TERM AND CAN SERVE NO MORE THAN TWO CONSECUTIVE TERMS. FORM 990, PART VI, SECTION A, LINE 7B THE ONLY DECISION OF THE GOVERNING BOARD THAT IS SUBJECT TO THE MEMBERSHIP IS A CHANGE IN THE BYLAWS. A BYLAWS CHANGE REQUIRES A SIMPLE MAJORITY OF THE VOTING MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS INITIALLY REVIEWED BY THE CHIEF FINANCIAL OFFICER. A COPY IS PROVIDED TO THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW AND RECOMMENDATION TO THE BOARD FOR APPROVAL. ANY QUESTIONS OR CHANGES ARE ADDRESSED BY THE CFO. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE SUBMITTED ANNUALLY TO THE CORPORATE COMPLIANCE OFFICER WHO REVIEWS FOR POTENTIAL CONFLICTS. AT BOARD OF DIRECTORS MEETINGS, THE DIRECTORS ARE ASKED AT EACH MEETING OF ANY POTENTIAL CONFLICTS RELATED TO THE MEETING AGENDA. POTENTIAL CONFLICTS ARE DISCUSSED AND WHEN THEY EXIST, BOARD MEMBERS EITHER RECUSE THEMSELVES FROM DISCUSSION,VOTING, OR THE MEETING AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15 EXTERNAL COMPENSATION DATA IS USED FOR ALL DIRECTORS AND OFFICERS. DATA TYPICALLY USED WOULD INCLUDE NATIONAL TRADE ASSOCIATION DATA SUCH AS MGMA OR AAMC. COMPENSATION CAPS ARE SET FROM MEDIUM TO NO GREATER THAN THE 90 PERCENTILE. ONCE AN EMPLOYEE EXCEEDS THE ABSOLUTE COMPENSATION CAP, NO ADDITIONAL INCOME CAN BE EARNED. THE COMPENSATION COMMITTEE, WHICH CONSISTS OF INDEPENDENT VOTING MEMBERS OF THE BOARD OF DIRECTORS, REVIEWS THE RECOMMENDATIONS AND MAKE CHANGES OR APPROVE. THIS PROCESS OCCURS ANNUALLY. FORM 990, PART VI, SECTION C, LINE 19 SIU PHYSICIANS AND SURGEONS MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE ON ITS PUBLIC WEBSITE. EACH BOARD MEETING STARTS WITH A REQUEST FOR DISCLOSURE OF CONFLICTS OF INTEREST FOR THE MEETING AGENDA. BYLAWS, BOARD MEETING MINUTES, AND FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: LOSS ON EQUITY INVESTMENT -129,043. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR YEAR. SOUTHERN ILLINOIS UNIVERSITY 1263 LINCOLN DRIVE CARBONDALE IL 629016899 376005961 HIGHER EDUCATION IL 170(B)(1)(A)(V) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 SOUTHERN ILLINOIS UNIVERSITY P 41953676 CASH SOUTHERN ILLINOIS UNIVERSITY R 8418057 CASH