St Margaret's Health-Peru: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- St Margaret's Health-Peru (EIN 36-2852553)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-22
- IRS object ID
- 201941429349301124
- 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 C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-22T13:37:49-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 N HARRISON STREET SUITE 300 | AddressLine1Txt |
| City | DAVENPORT | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 528011999 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362852553 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS VALLEY COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ILLI | BusinessNameControlTxt |
| Phone | 8152233300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 925 WEST STREET | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TOMMY HOBBS | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 8152233300 | PhoneNum |
| Signature | 2019-05-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JENIFER L CHASE | PreparerPersonNm |
| PTIN | P01306883 | PTIN |
| Phone | 5638884000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 108.171.131.186 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-22 | IPDt |
| IP Tm | 12:38:55 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | CE3CED47DB4F0A9B1081F73FA9E2E0877120914F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 4C1D0D315BE423A46ED40DD100972F4F7F99666A | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TOMMY HOBBS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 925 WEST STREET | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $84,980,462 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.IVCH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | ILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 747 | TotalEmployeeCnt |
| Total Volunteers | 181 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $16,607 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $65,842 | PYContributionsGrantsAmt |
| CY Contributions Grants | $103,741 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $85,248,108 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $82,438,616 | CYProgramServiceRevenueAmt |
| PY Investment Income | $663,776 | PYInvestmentIncomeAmt |
| CY Investment Income | $533,708 | CYInvestmentIncomeAmt |
| PY Other Revenue | $418,551 | PYOtherRevenueAmt |
| CY Other Revenue | $581,296 | CYOtherRevenueAmt |
| PY Total Revenue | $86,396,277 | PYTotalRevenueAmt |
| CY Total Revenue | $83,657,361 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $36,310 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $40,751 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $41,032,636 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $43,847,000 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $46,586,576 | PYOtherExpensesAmt |
| CY Other Expenses | $44,801,272 | CYOtherExpensesAmt |
| PY Total Expenses | $87,655,522 | PYTotalExpensesAmt |
| CY Total Expenses | $88,689,023 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,259,245 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$5,031,662 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $69,614,943 | TotalAssetsBOYAmt |
| Total Assets EOY | $63,945,771 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $48,473,043 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $44,799,713 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,141,900 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,146,058 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $73,667,686 | ExpenseAmt |
| Grant | $40,751 | GrantAmt |
| Revenue | $83,205,446 | RevenueAmt |
| Desc | ILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) IS A SMALL, INTEGRATED COMMUNITY HEALTH CARE DELIVERY SYSTEM. SERVICES RANGE FROM EMPLOYED PHYSICIANS AND MID-LEVELS IN THE SPECIALTIES OF FAMILY MEDICINE, INTERNAL MEDICINE, OBSTETRICS/GYNECOLOGY, ORTHOPEDICS, OTORHINOLARYNGOLOGY, AND SLEEP MEDICINE. IN ADDITION TO THESE PHYSICIAN PRACTICES, IVCH ALSO OFFERS THE CARE TODAY CLINIC WHICH PROVIDES A LOWER-COST, CONVENIENT ALTERNATIVE TO EMERGENCY ROOM CARE. CONTRACTED PHYSICIAN SERVICES ARE PROVIDED FOR EMERGENCY MEDICINE, ANESTHESIOLOGY, AND HOSPITALISTS SERVICES. INPATIENT HOSPITAL SERVICES PROVIDED BY IVCH INCLUDE MEDICAL AND SURGICAL SERVICES, ICU, OBSTETRICS, SWING BEDS, DIAGNOSTIC, REHAB AND TREATMENT SERVICES. OUTPATIENT SERVICES INCLUDE SURGERY, EMERGENCY ROOM, LABORATORY, DIAGNOSTIC IMAGING, REHAB SERVICES, PAIN MANAGEMENT, SLEEP THERAPY, WOUND MANAGEMENT, RESPIRATORY CARE, EKG, OTHER DIAGNOSTIC AND THERAPEUTIC SERVICES HOSPICE AND ADULT DAY CARE SERVICES ARE ALSO PROVIDED. IVCH IS A MEDICARE DEPENDENT HOSPITAL AND QUALIFIES FOR DISPROPORTIONATE SHARE PAYMENTS. IVCH IS COMMITTED TO PROVIDING THE HIGHEST QUALITY OF HEALTH SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR FINANCIAL STATUS OR ABILITY TO PAY. IVCH SUBSIDIZES THE COST OF TREATING PATIENTS WHO ARE UNABLE TO PAY AND THOSE WHO RECEIVE GOVERNMENT ASSISTANCE WHERE REIMBURSEMENT IS LIMITED. STATISTICS:- INPATIENT ADMISSIONS: 2,235 - INPATIENT DAYS: 6,339- NEWBORN DELIVERIES: 3,974 - INPATIENT SURGERIES: 694 - OUTPATIENT SURGERIES: 4,743 - OUTPATIENT VISITS: 72,355 - EMERGENCY ROOM VISITS: 13,807 - CLINIC VISITS: 60,659 | Desc |
| Total Program Service Expenses | $73,667,686 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 80 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 747 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 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 | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LISA LYNCH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8157803574 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 925 WEST STREET | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 |
|---|---|---|---|---|---|---|---|---|
| JAMES CLINARD | ||||||||
| VICE PRESIDENT | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOSEPH HOGAN | ||||||||
| DIRECTOR | 1.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CINDY KURKOWSKI | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOEL LEIFHEIT MD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES LOVELAND | ||||||||
| PRESIDENT | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RICHARD MARTUZZO | ||||||||
| SECRETARY | 1.00 | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KRISTINE PAUL | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL ROONEY OD | ||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID SICKLEY | ||||||||
| TREASURER | 1.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WILLIAM VLASTNIK | ||||||||
| DIRECTOR | 1.00 | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| TOMMY HOBBS | ||||||||
| CHIEF EXECUTIVE OFFICER | 36.00 | 4.00 | Yes (X) | $274,627 | $0 | $38,149 | ||
| BRADLEY REACH | ||||||||
| CHIEF FINANCIAL OFFICER | 36.00 | 4.00 | Yes (X) | $138,312 | $0 | $14,805 | ||
| MARIO COTE MD | ||||||||
| PHYSICIAN | 40.00 | $690,219 | $0 | $52,171 | Yes (X) | |||
| PETER MEIER MD | ||||||||
| PHYSICIAN | 40.00 | $703,026 | $0 | $40,103 | Yes (X) | |||
| ROBERT MITCHELL DO | ||||||||
| PHYSICIAN | 40.00 | $506,945 | $0 | $38,580 | Yes (X) | |||
| JAMES MURPHY MD | ||||||||
| PHYSICIAN | 40.00 | $599,633 | $0 | $31,825 | Yes (X) | |||
| BRANDON MUSGRAVE MD | ||||||||
| PHYSICIAN | 40.00 | $650,021 | $0 | $37,027 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,562,783 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $252,660 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | 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 |
|---|---|---|---|---|---|
| PERU EMERGENCY PHYSICIANS LLP | |||||
| PO BOX 674579 | DETROIT | MI | 48267 | PHYSICIAN SERVICES | $3,550,095 |
| SODEXO INC & AFFILIATES | |||||
| PO BOX 360170 | PITTSBURGH | PA | 15251 | DIETARY & ENVIRONMENTAL SERVICES | $2,173,214 |
| IVAA | |||||
| 925 WEST STREET | PERU | IL | 61354 | ANESTHESIA SERVICES | $1,357,250 |
| DIVERSIFIED CLINICAL SERVICES | |||||
| 28525 NETWORK PLACE | CHICAGO | IL | 60673 | WOUND CARE & HYPERBARIC OXYGEN | $706,077 |
| FIDELITY ON CALL | |||||
| 9006 N INDUSTRIAL ROAD | PEORIA | IL | 61615 | NURSING SERVICES | $618,658 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 19 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $70,535 | RelatedOrganizationsAmt |
| All Other Contributions | $33,206 | AllOtherContributionsAmt |
| Total Contributions | $103,741 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $82,438,616 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,438,616 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $82,438,616 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $225,832 | TotalRevenueColumnAmt |
| Exclusion | $225,832 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $423,110 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $608,644 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$185,534 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$185,534 | TotalRevenueColumnAmt |
| Exclusion | -$185,534 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,022,333 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $714,457 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $307,876 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $307,876 | TotalRevenueColumnAmt |
| Exclusion | $307,876 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISCELLANEOUS REVENUE | 900009 | $428,014 | $428,014 |
| TRANSPORT VEHICLE REVENUE | 900009 | $198,630 | $198,630 |
| CAFETERIA REVENUE | 721000 | $80,186 | $80,186 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $60,000 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $60,000 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $766,830 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $83,657,361 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $83,205,446 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $348,174 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,751 | TotalAmt |
| Program Services | $40,751 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $435,775 | TotalAmt |
| Management And General | $435,775 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,548,656 | TotalAmt |
| Program Services | $31,693,478 | ProgramServicesAmt |
| Management And General | $3,855,178 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $882,614 | TotalAmt |
| Program Services | $732,570 | ProgramServicesAmt |
| Management And General | $150,044 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,688,803 | TotalAmt |
| Program Services | $3,891,706 | ProgramServicesAmt |
| Management And General | $797,097 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,291,152 | TotalAmt |
| Program Services | $1,901,656 | ProgramServicesAmt |
| Management And General | $389,496 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,029 | TotalAmt |
| Management And General | $153,029 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,991 | TotalAmt |
| Management And General | $16,991 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,132 | TotalAmt |
| Management And General | $25,132 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,097,051 | TotalAmt |
| Program Services | $4,097,051 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $556,087 | TotalAmt |
| Program Services | $194,630 | ProgramServicesAmt |
| Management And General | $361,457 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,419 | TotalAmt |
| Program Services | $403,493 | ProgramServicesAmt |
| Management And General | $172,926 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,897,786 | TotalAmt |
| Program Services | $1,271,517 | ProgramServicesAmt |
| Management And General | $626,269 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,079,534 | TotalAmt |
| Program Services | $1,838,308 | ProgramServicesAmt |
| Management And General | $241,226 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,438 | TotalAmt |
| Program Services | $33,178 | ProgramServicesAmt |
| Management And General | $9,260 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,530 | TotalAmt |
| Program Services | $103,301 | ProgramServicesAmt |
| Management And General | $18,229 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $671,563 | TotalAmt |
| Program Services | $570,829 | ProgramServicesAmt |
| Management And General | $100,734 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,489,528 | TotalAmt |
| Program Services | $2,791,622 | ProgramServicesAmt |
| Management And General | $697,906 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $860,469 | TotalAmt |
| Program Services | $688,375 | ProgramServicesAmt |
| Management And General | $172,094 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES AND EQUIPMENT | $13,254,334 | $9,278,034 | $3,976,300 |
| PURCHASE SERVICES | $11,393,645 | $9,684,598 | $1,709,047 |
| HOSPITAL ASSESSMENT PAY | $3,175,120 | $2,540,096 | $635,024 |
| REPAIRS AND MAINTENANCE | $1,813,881 | $1,451,105 | $362,776 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $576,735 | TotalAmt |
| Program Services | $461,388 | ProgramServicesAmt |
| Management And General | $115,347 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,689,023 | TotalAmt |
| Program Services | $73,667,686 | ProgramServicesAmt |
| Management And General | $15,021,337 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,338,280 | BOYAmt |
| EOY | $716,504 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,859,171 | BOYAmt |
| EOY | $12,739,876 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,456,056 | BOYAmt |
| EOY | $2,427,242 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,410,045 | BOYAmt |
| EOY | $981,933 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $117,147,798 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $87,827,993 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,873,841 | BOYAmt |
| EOY | $29,319,805 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,191,724 | BOYAmt |
| EOY | $10,287,745 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $370,187 | BOYAmt |
| EOY | $335,250 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,115,639 | BOYAmt |
| EOY | $7,137,416 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,614,943 | BOYAmt |
| EOY | $63,945,771 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,099,113 | BOYAmt |
| EOY | $14,007,608 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $6,263 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,769,916 | BOYAmt |
| EOY | $17,659,238 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $713,394 | BOYAmt |
| EOY | $1,415,479 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,890,620 | BOYAmt |
| EOY | $11,711,125 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,473,043 | BOYAmt |
| EOY | $44,799,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,888,754 | BOYAmt |
| EOY | $17,821,320 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,253,146 | BOYAmt |
| EOY | $1,324,738 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,141,900 | BOYAmt |
| EOY | $19,146,058 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,614,943 | BOYAmt |
| EOY | $63,945,771 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$5,031,662 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$33,547 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $3,069,367 | 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 | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $25,132 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $25,132 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | ALLOCATED PORTION OF MEMBERSHIP DUES WITH ILLINOIS HOSPITAL ASSOCATION, AMERICAN HOSPITAL ASSOCATION, AND MEDICARE DEPENDENT RURAL HOSPITAL COALITION. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,476,235 | OtherCostOrOtherBasisAmt |
| Book Value | $1,476,235 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,478,373 | OtherCostOrOtherBasisAmt |
| Depreciation | $34,510,629 | DepreciationAmt |
| Book Value | $18,967,744 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $325,067 | OtherCostOrOtherBasisAmt |
| Depreciation | $241,512 | DepreciationAmt |
| Book Value | $83,555 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $60,395,161 | OtherCostOrOtherBasisAmt |
| Depreciation | $51,931,296 | DepreciationAmt |
| Book Value | $8,463,865 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,472,962 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,144,556 | DepreciationAmt |
| Book Value | $328,406 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $29,319,805 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATES | $4,216,855 |
| INTEREST IN ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION | $1,324,738 |
| OTHER ASSETS | $1,595,823 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $7,137,416 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| PENSION OBLIGATION | $2,892,111 |
| ESTIMATED THIRD PARTY PAYOR SE | $3,076,192 |
| ESTIMATED SELF-INSURANCE COSTS | $3,726,648 |
| DUE TO AFFILIATES | $2,016,174 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,711,125 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | IV HEALTH CORP, INC., ILLINOIS VALLEY COMMUNITY HOSPITAL, ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION AND HYGIENIC INSTITUTE OF LASALLE, PERU, AND OGLESBY ARE NONPROFIT CORPORATIONS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE INTERNAL REVENUE CODE. HOWEVER, THEY ARE SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. VALLEY HEALTH ENTERPRISES IS SUBJECT TO INCOME TAXATION AS A LIMITED LIABILITY COMPANY THAT IS TAXED AS A PARTNERSHIP. IV HEALTH CORP, INC., ILLINOIS VALLEY COMMUNITY HOSPITAL, ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION AND HYGIENIC INSTITUTE OF LASALLE, PERU, AND OGLESBY FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO NONPROFIT ORGANIZATIONS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF EACH ENTITY AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). UBI IS REPORTED ON FORM 990-T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESS, IF ANY. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2018 AND 2017, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY. TAX RETURNS FILED ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. | ExplanationTxt |
Schedule H IRS990ScheduleH
| 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 |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| 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) |
|---|---|---|
| Total Community Benefit Expns | $342,942 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $342,942 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00400 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,640,815 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,056,173 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,584,642 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08940 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $12,983,757 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,056,173 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,927,584 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09340 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $685,571 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $256,567 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $429,004 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,775 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,775 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00020 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,104,393 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $773,108 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $331,285 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00390 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $40,751 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $40,751 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,848,490 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,029,675 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $818,815 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00970 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $14,832,247 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $6,085,848 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,746,399 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10310 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $3,858,353 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $386,000 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $21,235,085 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $20,936,328 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $298,757 | 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 | ILLINOIS VALLEY COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 925 WEST STREET | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.IVCH.ORG | WebsiteAddressTxt |
| State License | 0003418 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | VARIOUS PHYSICIAN CLINICS & OUTPATIENT SERVICES | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS VALLEY COMMUNITY 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 |
| Other | Yes (X) | OtherInd |
| 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 | SEE PART V, PAGE 8 | 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 | SEE PART V, PAGE 8 | 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 | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://WWW.IVCH.ORG/PATIENTS-VISITORS/PATIENT/FINANCIAL-ASSISTANCE/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://WWW.IVCH.ORG/PATIENTS-VISITORS/PATIENT/FINANCIAL-ASSISTANCE/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://WWW.IVCH.ORG/PATIENTS-VISITORS/PATIENT/FINANCIAL-ASSISTANCE/ | 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 |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| 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 Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| ILLINOIS VALLEY COMMUNITY HOSPITAL | PART V, SECTION B, LINE 3J: INDUSTRY DATA RELATED TO PROJECTED GROWTH IN NEED FOR VARIOUS SERVICES SPECIFIC TO THE POPULATION OF THIS AREA. |
| ILLINOIS VALLEY COMMUNITY HOSPITAL | PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) STAKEHOLDERS WORKING GROUP, COMPRISED OF MEMBERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED, WAS RESPONSIBLE FOR THE CHNA PROCESS. THE STAKEHOLDER GROUP INCLUDED MEMBERS FROM ILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH), IVCH MEDICAL GROUP, LASALLE COUNTY HEALTH DEPARTMENT, ALTERNATIVES FOR THE OLDER ADULT, YOUTH SERVICE BUREAU, NORTH CENTRAL BEHAVIORAL HEALTH SERVICES, HYGIENIC INSTITUTE, OGLESBY PUBLIC SCHOOLS AND ILLINOIS VALLEY UNITED WAY. THE WORKING GROUP DEVELOPED A SURVEY INSTRUMENT, EVALUATED SURVEY RESPONSES, COLLECTED AND EVALUATED SECONDARY DATA, SYNTHESIZED THE PRIMARY AND SECONDARY DATA, AND IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS. PRIMARY DATA FOR THIS ASSESSMENT CAME FROM TWO SOURCES, A COMMUNITY STUDY PERFORMED FOR IVCH BY LEEDE RESEARCH IN 2008 AND A SURVEY DEVELOPED, DISTRIBUTED AND ANALYZED BY THE STAKEHOLDERS WORKING GROUP SPECIFICALLY FOR THE CHNA. |
| ILLINOIS VALLEY COMMUNITY HOSPITAL | PART V, SECTION B, LINE 11: THE COMMUNITY HEALTH NEEDS ASSESSMENT INCLUDES A DESCRIPTION OF THE ACTIONS TAKEN TO MEET NEEDS THAT WERE IDENTIFIED IN THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE AREAS OF CONCERN THAT HAVE BEEN IDENTIFIED HISTORICALLY, AND WERE FURTHER ELEVATED IN THE NEW 2015 COMMUNITY HEALTH NEEDS ASSESSMENT, RELATE TO MENTAL HEALTH/ADDICTION SERVICES AND DENTAL CARE. REGARDING DENTAL CARE, ILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) HAS DEVELOPED A LISTING OF SERVICES AVAILABLE IN THE AREA WHICH IS PROVIDED TO PATIENTS. THE MOST SIGNIFICANT NEED IS THE MENTAL HEALTH AND ADDICTION SERVICES. IN ADDITION TO THE ALREADY IDENTIFIED NEED, A SIGNIFICANT MENTAL HEALTH AGENCY IN THE SERVICE AREA HAS GREATLY REDUCED ITS SERVICES DUE TO THE REDUCTION IN ITS GRANT FUNDING. THIS IS CURRENTLY SIGNIFICANTLY IMPACTING ACCESS TO MENTAL HEALTH CARE. INADEQUATE AVAILABILE MENTAL HEALTH INPATIENT CARE IS RESULTING IN A BACKUP OF PATIENTS IN EMERGENCY CARE. IVCH IS EXPLORING PSYCHIATRY TELEHEALTH SERVICES AS WELL AS A POTENTIAL JOINT VENTURE OF PSYCHIATRY SERVICES WITH A HOSPITAL IN THE ADJACENT SERVICE AREA. |
| PART V, LINE 7A, CHNA WEBSITE: | HTTPS://WWW.IVCH.ORG/DOCUMENTS/CHNA-FINAL-2015.PDF |
| PART V, LINE 10A, IMPLEMENTATION STRATEGY WEBSITE: | HTTPS://WWW.IVCH.ORG/DOCUMENTS/IVCH-IMPLEMTATION-STRATAGY-2015V2.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 4 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - CENTER FOR PHYSICAL REHABILITATION | ||||
| 300 WALNUT STREET | PERU | IL | 61354 | OUTPATIENT PHYSICAL REHABILITATION |
| 2 - IVCH WOUND & HYPERBARIC CENTER | ||||
| 1403 6TH STREET | PERU | IL | 61354 | WOUND AND HYPERBARIC THERAPY |
| 3 - ILLINOIS VALLEY ADULT DAY CENTER | ||||
| 1040 SECOND STREET | LASALLE | IL | 61301 | ADULT DAY CARE |
| 4 - IVCH CARE TODAY | ||||
| 300 WALNUT STREET | PERU | IL | 61354 | URGENT CARE ALTERNATIVE TO ER |
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | NOT APPLICABLE |
| PART I, LINE 6A: | NOT APPLICABLE |
| PART I, LINE 7: | THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7 USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS. |
| PART I, LINE 7G: | THE AMOUNTS REPORTED ON ROW 7G DO NOT CONTAIN COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. |
| PART I, LN 7 COL(F): | THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $3,858,353. BAD DEBT EXPENSE WAS NOT INCLUDED IN THE DENOMINATOR BECAUSE IT WAS REPORTED ON LINE 2D OF PART VIII, STATEMENT OF REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES IS 16.72%. THIS PERCENTAGE INCREASES TO 40.33% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN THE TOTAL COMMUNTY BENEFIT EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | NOT APPLICABLE |
| PART III, LINE 2: | THE ORGANIZATION RECORDS CONTRACTUAL DISCOUNTS AT THE TIME OF THE POSTING OF THE PAYMENT FOR SERVICES FROM THIRD PARTY PAYORS. BAD DEBT IS RECORDED AT THE TIME THE ACCOUNT IS EITHER PRESUMED UNCOLLECTIBLE OR TURNED OVER TO COLLECTION. FURTHER, THE ORGANIZATION RECORDS APPROPRIATE ALLOWANCES FOR CONTRACTUAL DISCOUNTS AND BAD DEBT/CHARITY CARE IN ORDER TO REFLECT ACCOUNTS RECEIVABLE AT THE EXPECTED COLLECTIBLE AMOUNT.CONTRACTUAL DISCOUNTS/MEDICARE/MEDICAID: MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYORS IN EVALUATING THE REASONABLE ESTIMATE OF THE ALLOWANCE FOR CONTRACTUAL DISCOUNTS. FOR SERVICES PROVIDED TO PATIENTS THAT HAVE THIRD PARTY COVERAGE, THE CORPORATION ANALYZES THE DISCOUNT RATES FOR EACH MAJOR PAYOR. THE DIFFERENCE BETWEEN THE NEGOTIATED RATES FOR THE MEDICARE/MEDICAID STANDARD RATES ARE USED TO DETERMINE THE ALLOWANCE FOR CONTRACTUAL DISCOUNTS.SELF-PAY ACCOUNTS RECEIVABLE INCLUDE THE PATIENT RESPONSIBILITY FOR SERVICES AFTER THE THIRD PARTY COVERAGE HAS BEEN APPLIED TO THE PATIENT ACCOUNT AS WELL AS THE UNINSURED. AN ALLOWANCE FOR BAD DEBT IS ESTIMATED BASED ON PAST EXPERIENCE AS WELL AS THE AGE OF THE ACCOUNTS. THE ORGANIZATION HAS A COLLECTIONS PRACTICES POLICY THAT IS USED TO SET GUIDELINES ON THE APPROACH AND TIMELINE TO MAKE REASONABLE COLLECTION EFFORTS BEFORE ANY ACCOUNTS ARE TURNED OVER TO A COLLECTION AGENCY. THE ORGANIZATION HAD BAD DEBT EXPENSE TOTALING $3,858,353. THIS REFLECTS THE COMBINED IMPACT OF WRITE-OFFS OF UNCOLLECTIBLE ACCOUNTS, PROVISIONS RECORDED TO ESTIMATE BAD DEBT ON ACCOUNTS RECEIVABLE.DURING FISCAL 2018, THERE WERE NO CHANGES IN THE ORGANIZATION'S POLICIES OR PRACTICES. |
| PART III, LINE 3: | 10% OF BAD DEBT IS ASSUMED TO BE PROVIDED INCLUDE AMOUNTS WRITTEN OFF FOR PATIENTS THAT WOULD HAVE QUALIFIED FOR THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. THE RATIONALE FOR THE PERCENTAGE BEING THIS IS BECAUSE OF THE SIGNIFICANT STEPS TAKEN WITH PATIENTS TO FACILITATE MEDICAID OR FINANCIAL ASSISTANCE QUALIFICATION. |
| PART III, LINE 4: | ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS.FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY).FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRDPARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE HOSPITALS ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS 78 PERCENT AT JUNE 30, 2018. |
| PART III, LINE 8: | IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NON PROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE AMOUNTS REPORTED ON LINE 6 WERE OBTAINED FROM WORKSHEET D OF THE FISCAL YEAR 2018 MEDICARE COST REPORT. |
| PART III, LINE 9B: | WHEN A PATIENT IS IN THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE THE ACCOUNT IS PLACED ON HOLD AND NO FURTHER COLLECTION EFFORTS ARE MADE UNTIL THE REQUEST FOR ASSISTANCE HAS BEEN RESOLVED. THE APPLICATION PROCESS INCLUDES FACILITATING THE PATIENT'S APPLICATION FOR VARIOUS ASSISTANCE PROGRAMS, AND IDENTIFYING WHERE THE PATIENT FALLS IN THE DISCOUNT SCALE OF THE ORGANIZATION BASED ON INCOME LEVEL AND SIZE OF FAMILY. IF THERE IS A BALANCE REMAINING AFTER CHARITY CARE OR OTHER FINANCIAL ASSISTANCE HAS BEEN APPLIED, A MUTUALLY AGREED UPON PAYMENT PLAN IS DEVELOPED AND THE ACCOUNT FOLLOWS THE SAME COLLECTION PROCEDURES AS ALL OTHER SELF-PAY ACCOUNTS. MONTHLY PAYMENTS ARE REQUIRED AND BALANCES ARE TYPICALLY EXPECTED TO BE PAID IN FULL WITHIN ONE YEAR. EXTENSIONS MAY BE APPROVED FOR UNEXPECTED CHANGES IN ABILITY TO MEET THE PAYMENT SCHEDULE. COLLECTION PROCEDURES INCLUDE STATEMENTS, PAST DUE NOTICES, PHONE CALLS AND, IF AGREED UPON PAYMENT ARRANGEMENTS CAN NOT BE MET, THE ACCOUNT IS REFERRED TO A COLLECTION AGENCY. |
| PART VI, LINE 2: | THE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY ILLINOIS VALLEY COMMUNITY HOSPITAL IS BASED ON A COMBINATION OF THE FOLLOWING FACTORS: EXISTENCE OR NON-EXISTENCE OF APPROPRIATE SERVICES, DEMONSTRATED NEED, VOICE OF THE CUSTOMER, COLLABORATION WITH COMMUNITY ORGANIZATIONS, GOVERNMENT AGENCIES AND OTHER HEALTH CARE PROVIDERS, BENCHMARKING MARKET RESEARCH, CUSTOMER SURVEYS, PHYSICIAN INPUT AND MONITORING OF STATE AND FEDERAL GUIDELINES. THIS INFORMATION IS REVIEWED AND ANALYZED BY THE HOSPITAL'S ADMINISTRATIVE TEAM AND INCORPORATED INTO THE HOSPITAL'S STRATEGIC PLANNING PROCESS. |
| PART VI, LINE 3: | DOCUMENTATION IS PROVIDED AT THE TIME OF REGISTRATION INFORMING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDING CONTACT INFORMATION FOR THE PATIENT FINANCIAL SERVICES DEPARTMENT. BASIC INFORMATION AND CONTACT INFORMATION IS ALSO AVAILABLE AT WWW.IVCH.ORG BY SELECTING THE HOME PAGE'S FINANCIAL ASSISTANCE BUTTON. WHEN CONTACTED BY A PATIENT, FINANCIAL COUNSELORS WORK INDIVIDUALLY WITH EACH APPLICANT TO DETERMINE ELIGIBILITY FOR CHARITY OR FINANCIAL ASSISTANCE. NOTICES ABOUT FINANCIAL ASSISTANCE PROGRAMS ARE POSTED IN THE REGISTRATION AREAS AND INFORMATION IS ALSO INCLUDED ON THE PATIENT STATEMENTS. THE SOCIAL SERVICES DEPARTMENT NOTIFIES EACH INPATIENT OF FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT ILLINOIS VALLEY COMMUNITY HOSPITAL AS WELL AS LOCAL, STATE, AND FEDERAL PROGRAMS THEY MAY BE ELIGIBLE FOR. |
| PART VI, LINE 4: | ILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) SERVES THE RESIDENTS OF RURAL COMMUNITIES LOCATED IN LASALLE, BUREAU AND PUTNAM COUNTIES, IN NORTH CENTRAL ILLINOIS. THE HOSPITAL IS LOCATED NEAR THE JUNCTION OF INTERSTATES 80 AND 39 AND IS 62 MILES WEST OF JOLIET AND 64 MILES NORTH OF BLOOMINGTON. THE PRIMARY SERVICE AREA OF THE HOSPITAL HAS A POPULATION OF ABOUT 35,000 PEOPLE. NO POPULATION GROWTH IS PROJECTED FOR THE AREA. THE LARGEST AREA EMPLOYERS ARE INVOLVED IN TRANSPORTATION, WAREHOUSING, AGRICULTURE, LIGHT INDUSTRY, AND RETAIL SERVICES. THE SERVICE AREA RACE AND ETHNICITY IS COMPOSED OF 85% WHITE, 3% AFRICAN AMERICAN, 10% HISPANIC AND 1% ASIAN. ACCORDING TO THE ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY, THE 2017 UNEMPLOYMENT RATE IN LASALLE COUNTY WAS 5.5%, WHICH WAS HIGHER THAN THE STATE OF ILLINOIS (5.0%) AND THE UNITED STATES (4.4%). THE MEDIAN HOUSEHOLD INCOME IN LASALLE ($51,684) AND BUREAU ($51,425) COUNTIES WERE ALL BELOW THE STATE OF ILLINOIS FIGURE OF $61,229. THE MEDIAN HOUSEHOLD INCOME IN PUTNAM COUNTY WAS $64,485. THE PROPORTION OF LASALLE COUNTY RESIDENTS LIVING BELOW THE FEDERAL POVERTY LEVEL (13.9%) IS SLIGHTLY LESS THAN THE STATE AVERAGE OF 14.0%. IVCH SERVES PATIENTS WITHOUT REGARD TO AGE, GENDER, INCOME, ETHNIC ORIGIN, INSURANCE COVERAGE, OR ABILITY TO PAY. APPROXIMATELY 64% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE WAS FROM PARTICIPATION IN THE MEDICARE AND MEDICAID PROGRAMS FOR THE YEAR ENDING JUNE 30, 2018. |
| PART VI, LINE 5: | THE BOARD OF DIRECTORS OF ILLINOIS VALLY COMMUNITY HOSPITAL (IVCH) IS COMPOSED OF 10 COMMUNITY MEMBERS RESIDING IN OUR SERVICE AREA. THESE BOARD MEMBERS HAVE REGULAR INPUT ON STRATEGIC PLANNING, NEW SERVICES, TECHNOLOGY, AND PHYSICIAN RECRUITMENT. IVCH MAINTAINS AN OPEN MEDICAL STAFF AND IS CONSTANTLY RECRUITING NEW PHYSICIANS TO MEET IDENTIFIED NEEDS. ALL AVAILABLE CASH FLOW GENERATED BY THE ORGANIZATION IS REINVESTED BACK INTO THE HOSPITAL THROUGH THE PURCHASE OF PROPERTY AND EQUIPMENT TO PROVIDE SERVICES THAT MEET THE NEEDS OF THE SERVICE AREA. THE COMMUNITY OUTREACH DEPARTMENT OFFERS A WIDE VARIETY OF HEALTH AND WELLNESS PROGRAMMING, INCLUDING TAI CHI CLASSES, FREE BLOOD PRESSURE AND GLUCOSE SCREENINGS, HEMOGLOBIN A1C SCREENINGS, LIPID PROFILE SCREENINGS, HEALTHY HEART SCREENINGS, PROSTATE CANCER SCREENINGS, SMOKING CESSATION CLASSES, BABYSITTING CLINICS, CPR INSTRUCTION, AND FIRST AID. |
| PART VI, LINE 6: | NOT APPLICABLE |
| PART VI, LINE 7, REPORTS FILED WITH STATES | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TOMMY HOBBS | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $274,627 | $0 | $0 | $0 | $0 | $0 | $13,500 | $0 | $24,649 | $0 | $312,776 | $0 | $0 | $0 |
| BRADLEY REACH | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $138,312 | $0 | $0 | $0 | $0 | $0 | $3,184 | $0 | $11,621 | $0 | $153,117 | $0 | $0 | $0 |
| MARIO COTE MD | ||||||||||||||
| PHYSICIAN | $256,491 | $0 | $392,939 | $0 | $40,789 | $0 | $13,500 | $0 | $38,671 | $0 | $742,390 | $0 | $0 | $0 |
| PETER MEIER MD | ||||||||||||||
| PHYSICIAN | $600,891 | $0 | $75,000 | $0 | $27,135 | $0 | $13,500 | $0 | $26,603 | $0 | $743,129 | $0 | $0 | $0 |
| ROBERT MITCHELL DO | ||||||||||||||
| PHYSICIAN | $407,592 | $0 | $54,000 | $0 | $45,353 | $0 | $13,500 | $0 | $25,080 | $0 | $545,525 | $0 | $0 | $0 |
| JAMES MURPHY MD | ||||||||||||||
| PHYSICIAN | $596,922 | $0 | $0 | $0 | $2,711 | $0 | $13,500 | $0 | $18,325 | $0 | $631,458 | $0 | $0 | $0 |
| BRANDON MUSGRAVE MD | ||||||||||||||
| PHYSICIAN | $476,429 | $0 | $173,325 | $0 | $267 | $0 | $13,500 | $0 | $23,527 | $0 | $687,048 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | EMPLOYED PHYSICIANS OF THE ORGANIZATION RECEIVE A BASE SALARY BASED ON THE MARKET FOR PHYSICIANS IN THEIR MEDICAL SPECIALTY. EACH PHYSICIAN HAS AN EMPLOYMENT CONTRACT WHICH MAY INCLUDE A COMPONENT OF INCENTIVE COMPENSATION. INCENTIVE COMPENSATION IS BASED ON THEIR INDIVIDUAL PROFESSIONAL PRODUCTION, PROVIDING AN OPPORTUNITY TO EARN ABOVE THE BASE SALARY LEVEL. THE BASE SALARY IS RECONCILED WITH THE PHYSICIAN'S PROFESSIONAL PRODUCTION ON A QUARTERLY AND ANNUAL BASIS. ANY AMOUNTS DUE TO THE PHYSICIANS FOR INCENTIVE COMPENSATION ARE PAID WITHIN 30 DAYS OF THE END OF THE PERIOD. | ExplanationTxt |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (3 entries)
| Bond ReferenceBondReferenceCd | Bond Issuer EINBondIssuerEIN | CUSIPCUSIPNum | Bond IssuedBondIssuedDt | Issue PriceIssuePriceAmt | PurposePurposeDesc | DefeasedDefeasedInd | On Behalf Of IssuerOnBehalfOfIssuerInd | Pool FinancingPoolFinancingInd |
|---|---|---|---|---|---|---|---|---|
| ILLINOIS FINANCING AUTHORITY | ||||||||
| A | 861091967 | 45203HK35 | 2014-12-15 | $10,000,000 | RE-FINANCING OF EXISTING DEBT | 0 | 0 | 0 |
| ILLINOIS FINANCING AUTHORITY | ||||||||
| B | 861091967 | 45203HK43 | 2014-12-15 | $8,000,000 | RE-FINANCING OF EXISTING DEBT | 0 | 0 | 0 |
| ILLINOIS FINANCING AUTHORITY | ||||||||
| C | 861091967 | 45203HK60 | 2014-12-15 | $3,160,000 | RE-FINANCING OF EXISTING DEBT | 0 | 0 | 0 |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (3 entries)
| Bond ReferenceBondReferenceCd | RetiredRetiredAmt | Total ProceedsTotalProceedsAmt | Refunding EscrowRefundingEscrowAmt | Substantial CompletionSubstantialCompletionYr | Current RefundingCurrentRefundingInd | Advance RefundingAdvanceRefundingInd | Final Allocation MadeFinalAllocationMadeInd | Adequate Books And Rec MaintAdequateBooksAndRecMaintInd |
|---|---|---|---|---|---|---|---|---|
| A | $1,078,000 | $10,000,000 | $10,000,000 | 2015 | Yes (1) | 0 | Yes (1) | Yes (1) |
| B | $861,000 | $8,000,000 | $8,000,000 | 2015 | Yes (1) | 0 | Yes (1) | Yes (1) |
| C | $341,000 | $3,160,000 | $3,160,000 | 2015 | Yes (1) | 0 | Yes (1) | Yes (1) |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedPropertyInd | Any Lease ArrangementsAnyLeaseArrangementsInd | Mgmt Contract Bond Fincd PropMgmtContractBondFincdPropInd | Any Research AgreementsAnyResearchAgreementsInd | Private Bus Use By OthersPrivateBusUseByOthersPct | Private Bus Concerning UBIPrivateBusConcerningUBIPct | Total Private Business UseTotalPrivateBusinessUsePct | Bond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestInd | Change In Use Bond Financed PropChangeInUseBondFinancedPropInd | Procs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd |
|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | 0.01000 | 0.00000 | 0.01000 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | 0.01000 | 0.00000 | 0.01000 | 0 | 0 | 0 |
| C | 0 | Yes (1) | 0 | 0 | 0.01000 | 0.00000 | 0.01000 | 0 | 0 | 0 |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiledInd | Rebate Not Due YetRebateNotDueYetInd | Exception To RebateExceptionToRebateInd | No Rebate DueNoRebateDueInd | Variable Rate IssueVariableRateIssueInd | Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd | Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd | Gross Proceeds InvestedGrossProceedsInvestedInd | Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| B | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
| C | 0 | Yes (1) | 0 | 0 | Yes (1) | 0 | 0 | 0 | Yes (1) |
Procedures Corrective Action ProceduresCorrectiveActionGrp (3 entries)
| Bond ReferenceBondReferenceCd | Procedures Corrective ActionProceduresCorrectiveActionInd |
|---|---|
| A | Yes (1) |
| B | Yes (1) |
| C | Yes (1) |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ILLINOIS VALLEY COMMUNITY HOSPITAL IS A SUBSIDIARY OF ITS SOLE CORPORATE MEMBER, IV HEALTH CORP, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | MEMBERS OF THE BOARD OF DIRECTORS OF THE PARENT COMPANY, IV HEALTH CORP, INC., ACTING ON BEHALF OF THE PARENT, HAVE RESERVED POWERS TO, AS IT RELATES TO THE OPERATIONS OF ILLINOIS VALLEY COMMUNITY HOSPITAL TO APPOINT AND REMOVE DIRECTORS AND TO RATIFY AND REMOVE OFFICERS. |
| FORM 990, PART VI, SECTION A, LINE 7B | MEMBERS OF THE BOARD OF DIRECTORS OF THE PARENT COMPANY, IV HEALTH CORP, INC., ACTING ON BEHALF OF THE PARENT, HAVE RESERVED POWERS TO, AS IT RELATES TO THE OPERATIONS OF ILLINOIS VALLEY COMMUNITY HOSPITAL TO ADOPT, AMEND, OR REPEAL THE ARTICLES OF INCORPORATION AND/OR BY-LAWS, ADOPT A PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION, APPROVE THE PURCHASE, SALE, TRANSFER, LEASE ENCUMBRANCE OF PROPERTY, APPROVE BORROWING WITH A TERM GREATER THAN A ONE YEAR TERM OR WHICH REQUIRES A MORTGAGE OF REAL PROPERTY, AND SELECTION OR MODIFICATION OF THE BUSINESS/LEGAL NAME OF THE ENTITY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CHIEF EXECUTIVE OFFICER AND CHIEF FINANCIAL OFFICER REVIEW THE FORM 990 PRIOR TO SUBMISSION TO THE INTERNAL REVENUE SERVICE. THE FINAL VERSION OF THE FORM 990 IS E-MAILED OR HAND DELIVERED TO EACH BOARD MEMBER FOR THEIR REVIEW, AND A BOARD MEETING IS HELD TO REVIEW AND ANSWER QUESTIONS REGARDING THE 990 PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE OFFICERS AND DIRECTORS OF ILLINOIS VALLEY COMMUNITY HOSPITAL ARE COVERED UNDER THE POLICY AND HAVE A DUTY TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST. ALL PERSONS COVERED UNDER THE POLICY ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSE ANY INTEREST THAT COULD GIVE RISE TO CONFLICTS. ANY TRANSACTIONS WITH COVERED PERSONS, OR ENTITIES IN WHICH A COVERED PERSON HAS ANY TYPE OF INTEREST, MUST BE AN ARM'S LENGTH TRANSACTION. THE DIRECTORS WILL REVIEW ANY TRANSACTIONS IN QUESTION AND DETERMINE IF A CONFLICT EXISTS. IF A CONFLICT EXISTS, THE INTERESTED PERSON MAY MAKE A PRESENTATION, BUT MUST LEAVE THE MEETING DURING DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15A | AN ADHOC COMMITTEE OF THE BOARD OF DIRECTORS (INCLUDING THE BOARD PRESIDENT, CHAIRPERSON OF THE PERSONNEL COMMITTEE, AND AT LEAST ONE OTHER MEMBER) CONDUCT AN ANNUAL PERFORMANCE REVIEW OF THE CHIEF EXECUTIVE OFFICER AND DETERMINE ANY CHANGE/INCREASE IN THE COMPENSATION, IF ANY, BASED UPON BENCHMARK COMPENSATION SURVEYS AND AREA NORMS. THE CHIEF EXECUTIVE OFFICER HAS A WRITTEN EMPLOYMENT CONTRACT RENEWAL OF THE CONTRACT OR INCREASE IN COMPENSATION MUST BE APPROVED BY A MAJORITY OF THE BOARD OF DIRECTORS. THIS COMPENSATION REVIEW WAS COMPLETED IN 2018. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL, STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN UNRECOGNIZED FUNDED STATUS OF PENSION PLAN 2,997,775. CHANGE IN INTEREST OF ILLINOIS VALLEY COMMUNITY FOUNDATION 71,592. |
| FORM 990, PART XII, LINE 2C: | THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/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 |
|---|---|---|---|---|---|---|---|---|---|---|
| IV HEALTH CORP INC | ||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 371211890 | PARENT | IL | 501(C)(3) | LINE 12B, II | IV HEALTH CORP INC | Yes (1) |
| HYGIENIC INSTITUTE FOR LASALLE PERU AND OGLESBY | ||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 362167742 | PRIMARY CARE | IL | 501(C)(3) | LINE 10 | IV HEALTH CORP INC | Yes (1) |
| ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION | ||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 371211780 | FUNDRAISING FOR ILLINOIS VALLEY COMMUNITY HOSPITAL | IL | 501(C)(3) | LINE 12A, I | IV HEALTH CORP INC | Yes (1) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VALLEY REGIONAL HEALTH SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4391 VENTURE DRIVE | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61354 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273891281 | EIN |
| Primary Activities | CANCER CARE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS VALLEY COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | RELATED | PredominantIncomeTypeTxt |
| Share Of Total Income | -$34,937 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $584,472 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.50000 | OwnershipPct |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VALLEY HEALTH ENTERPRISES | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 363476877 | DME | IL | ILLINOIS VALLEY COMMUNITY HOSPITAL | C | $51,929 | $3,003,049 | 1.00000 | Yes (1) |
| ILLINOIS VALLEY HEALTH SERVICES INC | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 364050682 | INACTIVE | IL | ILLINOIS VALLEY COMMUNITY HOSPITAL | C | 1.00000 | Yes (1) | ||
| ILLINOIS VALLEY PHO | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 363978381 | PPO CONTRACTING | IL | ILLINOIS VALLEY COMMUNITY HOSPITAL | C | $23,401 | $71,661 | 0.50000 | 0 |
| IVCH GENERAL PROFESSIONAL LIAB LOSS FUND | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 366673231 | INACTIVE | IL | ILLINOIS VALLEY COMMUNITY HOSPITAL | T | 1.00000 | Yes (1) | ||
| HEALTH CARE BUILDING CORP | ||||||||||||
| 925 WEST STREET | PERU | IL | 61354 | 363306917 | INACTIVE | IL | ILLINOIS VALLEY COMMUNITY HOSPITAL | C | 1.00000 | Yes (1) | ||
| 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 | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| ILLINOIS VALLEY COMMUNITY HOSPITAL FOUNDATION | ||
| C | $70,535 | FAIR MARKET VALUE |
| HYGIENIC INSTITUTE OF LASALLE PERU AND OGELSBY | ||
| O | $187,500 | FAIR MARKET VALUE |
| HYGIENIC INSTITUTE OF LASALLE PERU AND OGELSBY | ||
| R | $161,339 | FAIR MARKET VALUE |
| HYGIENIC INSTITUTE OF LASALLE PERU AND OGELSBY | ||
| S | $208,785 | FAIR MARKET VALUE |
| VALLEY HEALTH ENTERPRISES | ||
| S | $512,355 | FAIR MARKET VALUE |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | LATE FILED RETURN DUE TO CCH SOFTWARE OUTAGE | ExplanationTxt |