ST MARGARETS HEALTH SPRING VALLEY: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- ST MARGARETS HEALTH SPRING VALLEY (EIN 36-2167884)
- Tax period
- 2017-10-01 to 2018-09-30
- Filed
- 2019-08-14
- IRS object ID
- 201922269349301852
- Schema version
- 2017v2.3
- 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 D
- Schedule H
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-08-14T12:35:46-05:00 | ReturnTs |
| Tax Period End | 2018-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 450250958 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Eide Bailly LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 800 Nicollet Mall Ste 1300 | AddressLine1Txt |
| City | Minneapolis | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 554027033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362167884 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Margaret's Hospital | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 8156642700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 East First Street | AddressLine1Txt |
| City | Spring Valley | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61362 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Timothy Muntz | PersonNm |
| Person Title | President/CEO | PersonTitleTxt |
| Phone | 8156642700 | PhoneNum |
| Signature | 2019-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Hunwardsen CPA | PreparerPersonNm |
| PTIN | P00484560 | PTIN |
| Phone | 6122536500 | PhoneNum |
| Preparation | 2019-08-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 216.147.181.47 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-08-13 | IPDt |
| IP Tm | 14:02:38 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | B602D594AFD2B0B327E07A06F36CA6A7E42546D0 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 330E77A2EC15986A2DC713C7FDB26B906589BB96 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Margaret's Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Timothy Muntz | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 East First Street | AddressLine1Txt |
| City | Spring Valley | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61362 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $90,163,288 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Group Exemption | 0928 | GroupExemptionNum |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.aboutsmh.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1903 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | Provide health care services to improve the health of the people in the community | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 847 | TotalEmployeeCnt |
| Total Volunteers | 119 | TotalVolunteersCnt |
| Total Gross UBI | $20,659 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $403,644 | PYContributionsGrantsAmt |
| CY Contributions Grants | $386,199 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $85,731,969 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $88,635,636 | CYProgramServiceRevenueAmt |
| PY Investment Income | $807,586 | PYInvestmentIncomeAmt |
| CY Investment Income | $972,730 | CYInvestmentIncomeAmt |
| PY Other Revenue | $51,476 | PYOtherRevenueAmt |
| CY Other Revenue | $72,804 | CYOtherRevenueAmt |
| PY Total Revenue | $86,994,675 | PYTotalRevenueAmt |
| CY Total Revenue | $90,067,369 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $49,725 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $51,150 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $41,576,853 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $44,747,110 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $42,012,641 | PYOtherExpensesAmt |
| CY Other Expenses | $47,642,582 | CYOtherExpensesAmt |
| PY Total Expenses | $83,639,219 | PYTotalExpensesAmt |
| CY Total Expenses | $92,440,842 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,355,456 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,373,473 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $97,007,727 | TotalAssetsBOYAmt |
| Total Assets EOY | $99,398,411 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $36,297,396 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $40,041,201 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $60,710,331 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $59,357,210 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | St. Margaret's Health, in union with the Sisters of Mary of the Presentation, is committed to the values of Catholic health care in caring for the needs of our patients and their families, the community and one another. Through our belief in God and our respect for life, we provide holistic quality health care with dignity and compassion. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $80,939,519 | ExpenseAmt |
| Grant | $51,150 | GrantAmt |
| Revenue | $88,635,636 | RevenueAmt |
| Desc | St. Margaret's Health has a tradition of serving the poor and others in the area surrounding Spring Valley for over 100 years. Following in the footsteps of Jesus Christ, St. Margaret's Hospital is reaching out to the poor and those most in need. The presence of St. Margaret's Hospital means much more than dollars and cents. The value of services to those in need has been more than a financial sheet can describe, because sometimes the smaller programs do the most good and because the organization cannot possibly count up all the services. St. Margaret's Hospital has been a leader in the community, helping others to see the need to respond to the needs of the poor.St. Margaret's Hospital had 7,131 patient days in fiscal year 2018 with 2,272 admissions and 2,278 discharges. Total Clinic visits were 141,679 and outpatient visits were 158,296.The Hospital provides care to patients who meet certain criteria under its charity care policy without charge or at amounts less than established rates. Because the Hospital does not pursue collection of amounts determined to qualify as charity care, they are not reported as revenue. The amounts of charges foregone for services provided under the Hospital's charity care policy were $2,782,404 for the year ended September 30, 2018. Total direct and indirect costs related to these foregone charges, by using methodology of the Catholic Health Association of the United States for the year ended September 30, 2018 were approximately $1,012,000. In addition, the Hospital provides services to other medically indigent patients under certain government reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Hospital also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable. | Desc |
| Total Program Service Expenses | $80,939,519 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| 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 | Yes (1) | 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 | Yes (1) | 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 | 124 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 847 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kim Santman | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8156641328 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 East First Street | AddressLine1Txt |
| City | Spring Valley | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61362 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Joyce McCullough | ||||||||
| Chairperson | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| James A Andreoni | ||||||||
| Vice Chairperson | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Aaron K Alton | ||||||||
| Director-President SMP Health | 1.00 | 42.00 | Yes (X) | Yes (X) | $0 | $755,218 | $53,895 | |
| Dr Richard Twanow | ||||||||
| Director | 40.00 | 0.00 | Yes (X) | $204,848 | $0 | $29,934 | ||
| Sr Anne Germaine Picard | ||||||||
| Director | 0.50 | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| Dr John McCormick | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Sr Dorothy Bertsch | ||||||||
| Director | 0.50 | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| Harold Read | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Christian Cyr | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Dr Geetha DoddaDirector | ||||||||
| Medical Staff Pres (thru July) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Dr Eric SantosDirector | ||||||||
| Medical Staff Pres (as of August) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Timothy Muntz | ||||||||
| President/CEO | 40.00 | 0.20 | Yes (X) | Yes (X) | $0 | $404,352 | $48,584 | |
| Kim Santman | ||||||||
| VP of Finance | 40.00 | 0.00 | Yes (X) | $0 | $233,340 | $40,877 | ||
| Dr Paul Perona | ||||||||
| Physician | 40.00 | 0.00 | $1,236,659 | $0 | $58,080 | Yes (X) | ||
| Dr Dale Chilson | ||||||||
| Physician | 40.00 | 0.00 | $1,160,321 | $0 | $40,376 | Yes (X) | ||
| Dr Michael Shin | ||||||||
| Physician | 40.00 | 0.00 | $1,202,654 | $0 | $58,247 | Yes (X) | ||
| Dr Ramon Inciong | ||||||||
| Physician | 40.00 | 0.00 | $514,428 | $0 | $40,376 | Yes (X) | ||
| Dr Thaw Tun | ||||||||
| Physician | 40.00 | 0.00 | $493,315 | $0 | $37,142 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,812,225 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,392,910 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $407,511 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 54 | 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 |
|---|---|---|---|---|---|
| SMP Health Systems | |||||
| 1202 Page Drive SW | Fargo | ND | 58106 | Administrative services | $3,002,417 |
| EPSS North Regions LLC | |||||
| 12528 SR 78 | Havana | IL | 62644 | Contract emergency physicians | $1,265,377 |
| Anesthesia Associates LTD | |||||
| 2540 Hanford Lane | Aurora | IL | 60502 | Contract anesthesia services | $1,231,000 |
| 1033 Ambulance Serivce LTD | |||||
| 3 Wolfer Industrial Park | Spring Valley | IL | 61362 | Ambulance services | $850,186 |
| Quest Diagnostics | |||||
| 506 East State Parkway | Schaumburg | IL | 60173 | Contract lab testing | $381,302 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 33 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $107,607 | RelatedOrganizationsAmt |
| Government Grants | $16,474 | GovernmentGrantsAmt |
| All Other Contributions | $262,118 | AllOtherContributionsAmt |
| Total Contributions | $386,199 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient service revenue | 622110 | $87,625,423 | $87,625,423 |
| Employee retail pharmacy | 446110 | $244,614 | $244,614 |
| Congregate Living | 900099 | $152,016 | $152,016 |
| Medicare meaningful use | 900099 | $80,001 | $80,001 |
| Change in value of Foundation | 900099 | -$24,161 | -$24,161 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $557,743 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $557,743 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $88,635,636 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $971,224 | TotalRevenueColumnAmt |
| Exclusion | $971,224 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $168,723 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $95,919 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $72,804 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $72,804 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $20,659 | UnrelatedBusinessRevenueAmt |
| Exclusion | $52,145 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,506 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,506 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,506 | TotalRevenueColumnAmt |
| Exclusion | $1,506 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $90,067,369 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $88,635,636 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $20,659 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,024,875 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,150 | TotalAmt |
| Program Services | $51,150 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,538 | TotalAmt |
| Program Services | $217,538 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,322 | TotalAmt |
| Program Services | $23,322 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,305,825 | TotalAmt |
| Program Services | $34,094,636 | ProgramServicesAmt |
| Management And General | $3,211,189 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $831,649 | TotalAmt |
| Program Services | $760,016 | ProgramServicesAmt |
| Management And General | $71,633 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,906,906 | TotalAmt |
| Program Services | $3,571,362 | ProgramServicesAmt |
| Management And General | $335,544 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,461,870 | TotalAmt |
| Program Services | $2,251,207 | ProgramServicesAmt |
| Management And General | $210,663 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,566 | TotalAmt |
| Management And General | $119,566 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,175 | TotalAmt |
| Management And General | $58,175 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,529,943 | TotalAmt |
| Program Services | $11,671,339 | ProgramServicesAmt |
| Management And General | $2,858,604 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,501,283 | TotalAmt |
| Program Services | $800 | ProgramServicesAmt |
| Management And General | $1,500,483 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,221,550 | TotalAmt |
| Program Services | $3,519,457 | ProgramServicesAmt |
| Management And General | $702,093 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,182,584 | TotalAmt |
| Program Services | $1,169,782 | ProgramServicesAmt |
| Management And General | $12,802 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,772 | TotalAmt |
| Program Services | $79,253 | ProgramServicesAmt |
| Management And General | $37,519 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,961 | TotalAmt |
| Program Services | $133,467 | ProgramServicesAmt |
| Management And General | $30,494 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $965,103 | TotalAmt |
| Program Services | $965,103 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,221,220 | TotalAmt |
| Program Services | $6,221,220 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,708,473 | TotalAmt |
| Program Services | $612,533 | ProgramServicesAmt |
| Management And General | $1,095,940 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical supplies | $10,215,807 | $10,215,807 | |
| Repairs and maintenance | $3,488,398 | $2,325,146 | $1,163,252 |
| Bad debt expense | $2,948,477 | $2,948,477 | |
| Dues & memberships | $201,270 | $107,904 | $93,366 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,440,842 | TotalAmt |
| Program Services | $80,939,519 | ProgramServicesAmt |
| Management And General | $11,501,323 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,021,019 | BOYAmt |
| EOY | $2,900,796 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,895 | BOYAmt |
| EOY | $168,895 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,939,356 | BOYAmt |
| EOY | $13,838,930 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,393 | BOYAmt |
| EOY | $63,777 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,214,033 | BOYAmt |
| EOY | $2,121,512 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $512,383 | BOYAmt |
| EOY | $662,115 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $111,124,088 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $65,501,197 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,674,905 | BOYAmt |
| EOY | $45,622,891 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,903,788 | BOYAmt |
| EOY | $2,096,128 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,403,498 | BOYAmt |
| EOY | $30,845,033 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $409,841 | BOYAmt |
| EOY | $388,356 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $644,616 | BOYAmt |
| EOY | $689,978 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,007,727 | BOYAmt |
| EOY | $99,398,411 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,547,384 | BOYAmt |
| EOY | $7,118,414 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,108,088 | BOYAmt |
| EOY | $26,388,061 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,641,924 | BOYAmt |
| EOY | $6,534,726 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,297,396 | BOYAmt |
| EOY | $40,041,201 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,167,285 | BOYAmt |
| EOY | $58,636,022 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $505,046 | BOYAmt |
| EOY | $683,188 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,000 | BOYAmt |
| EOY | $38,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,710,331 | BOYAmt |
| EOY | $59,357,210 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,007,727 | BOYAmt |
| EOY | $99,398,411 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,373,473 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,458,786 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$438,434 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $385,690 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $2,841,557 | OtherCostOrOtherBasisAmt |
| Book Value | $3,227,247 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,258,509 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $70,245,827 | OtherCostOrOtherBasisAmt |
| Depreciation | $39,350,664 | DepreciationAmt |
| Book Value | $32,153,672 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $5,775 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $31,955,484 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,703,910 | DepreciationAmt |
| Book Value | $8,257,349 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $85,526 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $4,345,720 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,446,623 | DepreciationAmt |
| Book Value | $1,984,623 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $45,622,891 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SMPHS pooled investment funds | Desc |
| Book Value | $30,845,033 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $30,845,033 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Deferred compensation obligation | $1,992,155 |
| Estimated health claims | $751,207 |
| Estimated third-party payor settlements | $3,581,000 |
| Construction accounts payable | $210,364 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,534,726 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $88,303,584 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,458,786 | NetUnrealizedGainsInvstAmt |
| Other Revenue | -$2,969,962 | OtherRevenueAmt |
| Revenue Not Reported | -$1,511,176 | RevenueNotReportedAmt |
| Revenue Subtotal | $89,814,760 | RevenueSubtotalAmt |
| Other Revenues Not Included | $252,609 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $252,609 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $90,067,369 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $89,510,942 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $18,577 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $18,577 | ExpensesNotReportedAmt |
| Expenses Subtotal | $89,492,365 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $2,948,477 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $2,948,477 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $92,440,842 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Hospital is organized as an Illinois nonprofit corporation and has been recognized by the Internal Revenue Service (IRS) as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The Hospital is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, the Hospital is subject to income tax on net income that is derived from business activities that are unrelated to its exempt purpose. The Hospital files an Exempt Organization Business Income Tax Return (Form 990-T) with the IRS to report its unrelated business taxable income. The Hospital believes that it has appropriate support for any tax positions taken affecting its annual filing requirements, and as such, does not have any uncertain tax positions that are material to the financial statements. The Hospital would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. The Hospital's Form 990-T and other income tax filings required by state, local, or non-U.S. tax authorities are no longer subject to tax examination for the years before 2015. |
| Part XI, Line 2d - Other Adjustments: | Change in equity in gains of investees included in income per financial stmt -21,485. Provision for bad debts included in expenses for Form 990 -2,948,477. |
| Part XI, Line 4b - Other Adjustments: | Contributions for long-lived assets included in revenue for Form 990 101,217. Temporarily restricted contributions included in revenue for Form 990 194,130. Rental expenses included in revenue for Form 990 -18,577. Change in value of Foundation included in revenue for Form 990 -24,161. |
| Part XII, Line 2d - Other Adjustments: | Rental expenses included in revenue for Form 990 18,577. |
| Part XII, Line 4b - Other Adjustments: | Provision for bad debts included in expenses for Form 990 2,948,477. |
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 |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| 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 | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 2166 | PersonsServedCnt |
| Total Community Benefit Expns | $980,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $980,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Persons Served | 9685 | PersonsServedCnt |
| Total Community Benefit Expns | $13,745,330 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,994,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,750,651 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07540 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 11851 | PersonsServedCnt |
| Total Community Benefit Expns | $14,725,330 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,994,679 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,730,651 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08640 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 242 | ActivitiesOrProgramsCnt |
| Persons Served | 13493 | PersonsServedCnt |
| Total Community Benefit Expns | $114,497 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,640 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $112,857 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 1 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $8,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $8,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 2 | ActivitiesOrProgramsCnt |
| Persons Served | 209 | PersonsServedCnt |
| Total Community Benefit Expns | $63,797 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,750 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $57,047 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00060 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 43 | ActivitiesOrProgramsCnt |
| Persons Served | 1839 | PersonsServedCnt |
| Total Community Benefit Expns | $21,984 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $21,984 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 288 | ActivitiesOrProgramsCnt |
| Persons Served | 15541 | PersonsServedCnt |
| Total Community Benefit Expns | $208,278 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $8,390 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $199,888 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00220 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 290 | ActivitiesOrProgramsCnt |
| Persons Served | 27392 | PersonsServedCnt |
| Total Community Benefit Expns | $14,933,608 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $7,003,069 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,930,539 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08860 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $14,520 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,520 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 11 | ActivitiesOrProgramsCnt |
| Total Community Benefit Expns | $14,520 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $14,520 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,948,477 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $395,096 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $19,250,533 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $24,919,019 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$5,668,486 | 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 | St Margaret's Hospital | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 East First Street | AddressLine1Txt |
| City | Spring Valley | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61362 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.aboutsmh.org | WebsiteAddressTxt |
| State License | 0002576 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | 12 Provider based clinics | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Margaret's Hospital | 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 | 15 | 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 | www.aboutsmh.org/assessments/ | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 15 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.aboutsmh.org/assessments/ | 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 | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| 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 |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | www.aboutsmh.org/financialassistance.html | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | www.aboutsmh.org/financialassistance.html | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | www.aboutsmh.org/financialassistance.html | 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 | Yes (1) | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| St. Margaret's Hospital | Part V, Section B, Line 5: In order to engage the entire community in the CHNA process, a collaborative team of health professional experts and key community advocates were included in the survey process, and were selected to ensure representation of the broad interests of the community. Specifically, team members included representatives from St. Margaret's Health, members of the Bureau, Marshall, and Putnam County Health Departments, and administrators from key community partner organizations. Engagement occurred throughout the entire process, resulting in shared ownership of the assessment. Specifically, members of the collaborative team consisted of individuals with special knowledge of and expertise in the healthcare of the community. |
| St. Margaret's Hospital | Part V, Section B, Line 11: The following needs continue to be addressed throughout FY2018.Nutrition, Physical Activity and Obesity1. New Year/New You Program: include topics addressing exercise, dietary health for general wellness, prevention of heart disease, diabetes and other health conditions2. Heart Program - cover healthy behaviors (including nutrition and exercise) related to heart disease3. Provide education for healthy behaviors for cancer prevention, wellness during cancer treatment, sustaining healthy behaviors to prevent recurrence to Pink Ribbon Club (breast Cancer Support Group)4. Children's Programs - will include education on exercise, nutrition and healthy behaviors for ages Kindergarten through 8th grade to help prevent obesity and related diseases5. Kid Camp - (In partnership with Illinois Valley Community College and University of Illinois Extension Service ) Girl Talk Boys Will Be Boys6. Attend area health fairs and provide information on healthy life style, nutrition, activity for prevention of obesity, diabetes, heart disease for a variety of focus groups including young adults, work force, and seniors7. Business/Community Group presentations on healthy life style, exercise, nutrition8. School Physicals provide individual counseling for students who were overweight or obese9. Program to Special needs classes on personal health and healthy choices10. Babysitting class cover activity and nutrition for children BP/BS screenings with personal counseling on activity, nutrition and healthy lifestyles11. Cholesterol screenings with personal counseling on activity, nutrition and healthy lifestyles12. Health races provide sponsorship and educational materials about healthy lifestyles, exercise and nutritionMental Health and Substance Abuse1. Community Partnership Against Substance Abuse (CPASA) alcohol and drug awareness programs, prevention programs for general public, P2D2 take back prescription drug program to keep off the streets, Hidden in Plain sight program to help parents be more aware of signs of potential drug abuse in teens, work with school officials for programs on drug awareness and prevention, supported and attended community town meetings concerning heroin problems arising in our community.2. Support Tar Wars (with Bureau, Marshall and Putnam County Health Department ) and Dare programs (with local police departments)3. Partner with area health departments and community organizations in a drug screening program at local high schools to help identify students who may need assistance with a prevention and avoidance program for at-risk students4. Implement Depression Screening for all scheduled appointments at St. Margaret's clinics5. Suicide Prevention walks provide educational materials on warning signs and options for treatment of depression6. Assist with drug screenings at North Central Behavioral Health System (NCBHS)for their clients in treatment programs7. Provide representation on Area- wide Community Coalition on Drug Abuse8. Add Physician Assistant to Family Practice/Psychiatrist practice to increase access for mental health visits |
| St. Margaret's Hospital | Part V, Section B, Line 15e: St. Margaret's Hospital posts a summary of its charity care policy in the admissions/registration areas, waiting rooms, emergency rooms, and other areas the organization finds beneficial to patients. The policy and contact information on financial assistance is provided and discussed during the admission and discharge process. Each patient bill includes an explanation on how to inquire about financial assistance or an uninsured discount. |
| St. Margaret's Hospital | Part V, Section B, Line 16j: Brochures are displayed at points of registration discussing availability of Financial Assistance. Upon notification from Registration regarding Self Pay Admissions, Patient Account clerk or staff member from another department tries to contact the patient to discuss availability of financial assistance. Utilization Review distributes applications when financial assistance is requested from nursing or the patient, or upon admission in the a nursing unit when possible. Clinic Clerks distribute applications when requested by the patient, or if the patient informs them of problems in paying their bills. Bills, letters regarding balances, and statements sent to the patient explain how to inquire about financial assistance or an uninsured discount. Qualified patients seeking help or options in paying bills for St. Margaret's Health services, will be offered financial assistance as an option. If a patient chooses to apply for financial assistance, they are given an "Application for Financial Assistance" which is to be completed according to directions on application and returned to the Patient Accounts Center. |
| St. Margaret's Hospital | Part V, Section B, Line 24: All individuals eligible under the Hospital's financial assistance policy are provided a discount for emergency and other medically necessary care. FAP-eligible patients without insurance may be charged gross charges on elective procedures. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | 1 - St Margaret's DME | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 East First Street | AddressLine1Txt |
| City | Spring Valley | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61362 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | Durable medical equipment | FacilityTxt |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 3c: | In addition to using FPG for purposes of determining charity care, St. Margaret's Hospital makes special provisions for certain patients. Patients eligible for Illinois Medicaid who receive services not covered by the program may be granted 100% financial assistance on non-covered services. Homeless patients are granted 100% financial assistance upon verification of homelessness. |
| Part I, Line 6a: | The community benefit report is available to the public upon request. |
| Part I, Line 7: | Charity care expense was converted to cost on line 7a based on an overall cost to charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, line 7e, health professions education, line 7f, and cash and in-kind donations, line 7i were reported from actual expenses and revenues recorded in the general ledger. Subsidized health services reported on line 7g were calculated using a cost to charge ratio derived from Worksheet 2. |
| Part I, Ln 7 Col(f): | The amount of bad debt expense removed from total expenses to determine the percentage was $2,948,477. |
| Part II, Community Building Activities: | The Hospital worked with EMS services in the area to help coordinate services and worked with the county health department to help with emergency preparedness and disaster drills. |
| Part III, Line 2: | St. Margaret's Hospital determines bad debt expense by estimating what may not be collectible from patient balances after taking into account appropriate discounts and payments (uninsured discount, eligible charity care discounts/adjustments, and payments received and expected to be received). Payments on accounts that were written off as bad debt reduces bad debt expense.Bad debt expense on line 2 is reported at charges as presented on the financial statements. |
| Part III, Line 3: | The estimated amount of the Organization's bad debt expense attributable to patients eligible under the Organization's charity care policy is based on 13.4% of individuals living below the federal poverty level. The amount on line 3 is an estimated amount that could reasonably be attributable to patients who likely would have qualified for financial assistance under the charity care program if sufficient information had been obtained to make a determination of their eligibility. |
| Part III, Line 4: | The footnote to the Organization's financial statements can be found on page 9 of the attached audited financial statements. |
| Part III, Line 8: | The Medicare program does not cover all the costs of caring for these patients. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit. The Organization reported only those allowable costs and Medicare reimbursements reported in the Medicare Cost Report for the year.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report. The Medicare Cost Report is completed based on the rules and regulations set forth by the Centers for Medicare and Medicaid Services. |
| Part III, Line 9b: | Homeless patients and Illinois Medicaid patients will not be subject to any collection efforts. When a patient is in the process of applying for financial assistance there will be no collection efforts. After a determination of financial assistance, any personal portion due follows the same collection procedures as other accounts. Collection procedures include past due notices and phone calls and then the account is referred to a collection agency. |
| Part VI, Line 2: | St. Margaret's Hospital identifies unmet community health needs by participating in community coalitions, partnerships, boards, committees, commissions, advisory groups, and panels. For example, Hospital representatives met with the local health department to jointly evaluate the needs of the community. In particular, Hospital staff met with local mental health service providers to discuss unmet mental health needs in the community. On a monthly basis, the Hospital reviews its internal patient surveys. On a tri-annual basis, the Board meets with select medical staff members and Hospital staff to develop a strategic plan, which addresses the demographics of the communities served. The Hospital provides health education and outreach at various locations out in the community, where participants are educated on the importance of disease preventions and early detection. The Hospital supports a local free clinic by providing free lab services. This allows employed physicians to donate their services and provide financial assistance. |
| Part VI, Line 3: | St. Margaret's Hospital posts a summary of its charity care policy in the admissions/registration areas, waiting rooms, emergency rooms, and other areas the organization finds beneficial to patients. The policy and contact information on financial assistance is provided and discussed during the admission and discharge process. Upon notification from Registration regarding self-pay admissions, the Patient Account clerk or staff member from another department tries to contact the patient to discuss availability of financial assistance. Also, information on other programs, such as government benefits, Medicaid or state programs, are discussed with patients. Assistance is also provided for individuals applying for government benefits. Patients are encouraged to explore their options and use our resources to obtain assistance with their bills. Each patient bill includes an explanation on how to inquire about financial assistance or an uninsured discount. |
| Part VI, Line 4: | St. Margaret's Hospital is a 44-bed acute care hospital located in Spring Valley, IL. Spring Valley, IL is a city situated on the Illinois river in the southeastern corner of Bureau County, IL. Bureau County is located in the Northcentral region of Illinois. The population is approximately 5,365 people. Spring Valley is part of the "Illinois Valley Micropolitan" (La Salle, Peru, and Spring Valley) which total approximately 25,000 people. Wal-Mart is the largest employer and has a labor force from over 100 different zip codes that easily commute to Spring Valley. Other common industries are manufacturing, retail trade, construction and transportation and warehousing. The median household income was $43,636 and the unemployment rate was 4.9%. Medicare and public aid make up 60% of our total patient service revenue. The nearest city with a population greater than 50,000 is Peoria, IL located 47 miles SW of Spring Valley. |
| Part VI, Line 5: | St. Margaret's Hospital Board is comprised of 11 members: Timothy Muntz, CEO, two sisters from the Sisters of Mary of the Presentation, one Hospital physician, the President of the Sisters of Mary of the Presentation Health Corporation, a related, controlling organization, and six community members which includes one Medical Staff President. To meet the needs of our community, the Hospital extends privileges to medical staff that are qualified and licensed. Our organization is committed to be involved and helpful to the community. Our employees serve on several committees working to improve the health and lives of the community. The emergency room is open 24 hours a day and everyone is treated regardless of their ability to pay. The Hospital operates a separate Foundation which conducts fundraising activities and solicits funds that are utilized to further the exempt purpose of the Hospital. The Foundation makes regular contributions to the Hospital for items that directly improve patient care. Surplus funds are reinvested in patient care and facility upgrades.During the past year, we provided 2,166 patients with free or reduced charity care, including free lab services for patients treated at Bureau County Health & Wellness, a free clinic in Princeton. In addition to our charity care, we also saw $2.9 million in Hospital bills go unpaid. This amount was written off as bad debt. These figures show that despite our nation's complex system of paying for health care through the government, insurance companies, and third-party payors, there are still many who are not covered by these programs. They are the poor who are ineligible for governmental support, the unemployed, and those employed by companies that don't offer adequate medical insurance.We are committed to improving the health of the people in our communities. Some of the services we provide to the community at a reduced price or free of charge include the following:* We participate in various health fairs throughout the area, providing information on health issues.* To help in the early detection of illness, we provide a number of health screenings at no cost or at prices less than our cost for services, such as blood pressure, blood sugar, and cholesterol screenings.* We provide various education programs for items such as diabetes, joint replacements, arthritis, babysitting, healthy eating and physical fitness. As an extension of these programs, we also provide numerous support groups for our patients suffering from chronic illness, all offered free to the public.* We provide flu shots in the community at prices less than our costs.* We provide skilled nursing care in a Swing Bed setting, even though the reimbursement from federal programs does not justify its existence.* We donate to various healthcare organizations, including Abigail Women's Clinic and American Cancer Society. We provide free food to the homeless shelter. |
| Part VI, Line 6: | We are an affiliate of the Sisters of Mary of the Presentation Health Corporation. St. Margaret's Hospital operates in accordance with the mission, vision, and values of the Sisters of Mary of the Presentation Health Corporation. Our annual budgeting process includes an assessment of how our budget demonstrates a commitment to the values of the system and the system works to ensure we are always mindful of our duty to care for the poor and those in need. St. Margaret's Hospital has a Strategic Plan developed from themes set forth by the Health System for all affiliates. The strategic plan is an active document which St. Margaret's Hospital works on continuously and reports back to the Health System on our progress toward established goals which again, align with the mission, vision, and values of the organization. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| LaSalle Business Association | |||||||
| PO Box 182 | LaSalle | IL | 61301 | 262000923 | City of Spring Vly | $9,000 | Jazz/Blues Festival Sponsor |
| Perfectly Flawed Foundation | |||||||
| 240 1st Street | LaSalle | IL | 61301 | 820596153 | 501(c)(3) | $5,500 | Sponsor |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 2: | FormAndLineReferenceDesc |
| Explanation | St. Margaret's Hospital provides donations and sponsorships to local organizations. Organization's make requests and the board makes a determination of funding. Each organization provides documentation of what the funding was used for. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Travel For Companions | Yes (X) | TravelForCompanionsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Aaron K Alton | ||||||||||||||
| Director-President SMP Health | $0 | $621,590 | $0 | $65,206 | $0 | $68,422 | $0 | $28,386 | $0 | $31,883 | $0 | $815,487 | $0 | $0 |
| Dr Richard Twanow | ||||||||||||||
| Director | $169,956 | $0 | $7,294 | $0 | $27,598 | $0 | $15,300 | $0 | $19,401 | $0 | $239,549 | $0 | $0 | $0 |
| Timothy Muntz | ||||||||||||||
| President/CEO | $0 | $344,640 | $0 | $31,327 | $0 | $28,385 | $0 | $28,653 | $0 | $23,174 | $0 | $456,179 | $0 | $0 |
| Kim Santman | ||||||||||||||
| VP of Finance | $0 | $214,040 | $0 | $10,390 | $0 | $8,910 | $0 | $14,475 | $0 | $29,130 | $0 | $276,945 | $0 | $0 |
| Dr Paul Perona | ||||||||||||||
| Physician | $786,506 | $0 | $439,228 | $0 | $10,925 | $0 | $22,800 | $0 | $36,005 | $0 | $1,295,464 | $0 | $0 | $0 |
| Dr Dale Chilson | ||||||||||||||
| Physician | $286,229 | $0 | $860,150 | $0 | $13,942 | $0 | $4,800 | $0 | $37,823 | $0 | $1,202,944 | $0 | $0 | $0 |
| Dr Michael Shin | ||||||||||||||
| Physician | $651,916 | $0 | $533,112 | $0 | $17,626 | $0 | $22,800 | $0 | $36,674 | $0 | $1,262,128 | $0 | $0 | $0 |
| Dr Ramon Inciong | ||||||||||||||
| Physician | $233,710 | $0 | $98,996 | $0 | $181,722 | $0 | $4,800 | $0 | $37,923 | $0 | $557,151 | $0 | $0 | $0 |
| Dr Thaw Tun | ||||||||||||||
| Physician | $164,434 | $0 | $93,174 | $0 | $235,707 | $0 | $4,800 | $0 | $34,589 | $0 | $532,704 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | St. Margaret's Hospital provides travel for Board Member companions in the years Board Members are required to attend a retreat. The retreat is intended for education on ethics, finance and healthcare. Spousal travel is not taxed. |
| Part I, Line 3 | St. Margaret's Hospital does not pay compensation to Timothy Muntz, President/CEO. This individual is compensated by Sisters of Mary of the Presentation Health System, a related organization, for his services at the Hospital. Sisters of Mary of the Presentation Health System uses one or more of the methods on Part I, question 3 to determine his compensation. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Emily Santman | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Daughter to VP of Finance, Kim Santman | RelationshipDescriptionTxt |
| Transaction | $23,322 | TransactionAmt |
| Transaction | Compensation and benefits as an employee | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 2 | Timothy Muntz, Kim Santman, and Aaron Alton have a business relationship. |
| Form 990, Part VI, Section A, line 6 | The sole member of the organization is the Sisters of Mary of the Presentation Health System. |
| Form 990, Part VI, Section A, line 7a | The member is entitled to vote in the election of Directors and to cast one vote for each Director to be elected. The member is also entitled to one vote on every other matter to be voted on by the member. Votes cast on behalf of the member are cast by the Chief Executive Officer of Sisters of Mary of the Presentation Health System. |
| Form 990, Part VI, Section A, line 7b | The authority to act on the following matters is exclusively vested in the member of the organization: 1. any change in the philosophy, objectives and purposes of the organization; 2. amendment of the articles of incorporation and bylaws; 3. the election or removal of the Directors; 4. merger or consolidation with any other organization; 5. dissolution of the organization or the sale, lease or exchange of all or substantially all of its property or assets; 6. the sale, lease, transfer or encumbrance of any land, buildings or other assets owned by the organization or in which the organization has or will have equitable or legal title; 7. approval of the annual operating and capital budgets; 8. appointment of the Chief Executive Officer. |
| Form 990, Part VI, Section A, line 8b | The organization does not have committees with authority to act on behalf of the governing body. |
| Form 990, Part VI, Section B, line 11b | The Form 990 is made available to the Board of Directors. The President and Vice President of Finance review the Form 990. |
| Form 990, Part VI, Section B, line 12c | Each Director and officer must submit in writing to the Chairperson of the Board and the CEO a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chairperson of the Board reviews the statements of the Directors and the Vice Chairperson of the Board reviews the statement filed by the Chairperson. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chairperson of the Board as authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chairperson, the Vice Chairperson has authority to require the Chairperson remove himself in the same matter. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he/she will not participate in the deliberations or vote on it. |
| Form 990, Part VI, Section B, line 15 | The Organization's President/CEO, other officers, and key employees are compensated by Sisters of Mary of the Presentation Health System, a related organization. The compensation process is determined by Sisters of Mary of the Presentation Health System. The Sisters of Mary of the Presentation Health System Board of Trustees directly engages a nationally recognized independent compensation consulting firm to review the total compensation arrangements of the officers and key employees. The Sisters of Mary of the Presentation Health System Board of Trustees approves all compensation based on comparable data and documents their decision in the meeting minutes. |
| Form 990, Part VI, Section C, line 19 | The Organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990. |
| Form 990, Part IX, line 11g | Purchased services: Program service expenses 10,275,541. Management and general expenses 830,194. Fundraising expenses 0. Total expenses 11,105,735. Professional fees: Program service expenses 65,372. Management and general expenses 2,009,814. Fundraising expenses 0. Total expenses 2,075,186. Consulting fees: Program service expenses 107,831. Management and general expenses 0. Fundraising expenses 0. Total expenses 107,831. Contract Labor: Program service expenses 1,222,595. Management and general expenses 18,596. Fundraising expenses 0. Total expenses 1,241,191. |
| Form 990, Part XI, line 9: | Change in equity of investment in St. Margaret's Health Organization 1,170. Equity transfer to Sisters of Mary of the Presentation Health System -50,122. Equity transfer to SMP Enterprises Illinois Inc. -375,000. Change in equity in investment of Valley Regional Health Services -22,655. Change in beneficial interests in assets held by others 8,173. |
| Form 990, Part XII, Line 2c: | The governing Board of Sisters of Mary of the Presentation Health System assumes responsibility for oversight of the audit for St. Margaret's Hospital. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Sisters of Mary of the Presentation Health System | ||||||||||
| 1202 Page Drive SW | Fargo | ND | 58103 | 450359620 | Facilitates management and operations of ten related facilities | ND | 501(c)(3) | Line 12a, I | SMP Health Ministry | 0 |
| St Margaret's Hospital Foundation | ||||||||||
| 600 East First Street | Spring Valley | IL | 61362 | 364042262 | Provide support to St. Margaret's Hospital | IL | 501(c)(3) | Line 12a, I | SMP Health System | 0 |
| Prairieland Home Care | ||||||||||
| 1102 Page Drive SW | Fargo | ND | 581060007 | 450391192 | Home health and supportive services | ND | 501(c)(3) | Line 10 | SMP Health System | 0 |
| Presentation Medical Center | ||||||||||
| 213 2nd Avenue NE | Rolla | ND | 583670759 | 450227391 | Acute care hospital | ND | 501(c)(3) | Line 3 | SMP Health System | 0 |
| St Aloisius Hospital | ||||||||||
| 325 East Brewster Street | Harvey | ND | 58341 | 450226729 | Provision of health care services | ND | 501(c)(3) | Line 3 | SMP Health System | 0 |
| St Andrew's Hospital | ||||||||||
| 316 Ohmer Street | Bottineau | ND | 58318 | 450226426 | Acute care critical access hospital | ND | 501(c)(3) | Line 3 | SMP Health System | 0 |
| St Andrew's Hospital Foundation | ||||||||||
| 316 Ohmer Street | Bottineau | ND | 58318 | 450413201 | Provide support to St. Andrew's Hospital | ND | 501(c)(3) | Line 12a, I | SMP Health System | 0 |
| Sisters of Mary of the Presentation Long Term Care | ||||||||||
| 1202 Page Dr SW | Fargo | ND | 58103 | 752999939 | Provide extended care and medically related services | ND | 501(c)(3) | Line 10 | SMP Health System | 0 |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| St Andrew's Bottineau Clinic LLC | ||||||||||||||
| 316 Ohmer Street | Bottineau | ND | 58318 | 450451306 | Provision of health care services | ND | N/A | |||||||
| Valley Regional Health Services L3C | ||||||||||||||
| 4391 Venture Drive | Peru | IL | 613541014 | 273891281 | Outpatient oncology services | IL | St Margaret's Hospital | Related | $252,000 | $495,030 | 0 | Yes (1) | 0.50000 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SMP Enterprises | |||||||||
| PO Box 10007 | Fargo | ND | 581060007 | 363486506 | Collection Agency | ND | N/A | C | 0 |
| SMP Enterprises - IL | |||||||||
| 600 East 1st Street | Spring Valley | IL | 61362 | 363456566 | Healthcare Management | IL | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |