2025-02-04T12:06:46+00:00 2024-03-31 350921680 CROWE LLP 9600 Brownsboro Road Suite 400 Louisville KY 402413902 990 2023-04-01 237426289 Harrisburg Medical Center Inc HARR 6182537671 100 Dr Warren Tuttle Drive Harrisburg IL 62946 Warren Ladner CFO 6184575200 2025-02-04 true Kim Scifres P01316095 5023263996 2025-02-04 2023 2025-03-06 01:10:19Z JOHN ANTES 100 Dr Warren Tuttle Drive Harrisburg IL 62946 48635696 false X WWW.HARRISBURGMC.COM X 1975 IL WE ARE DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL THE PEOPLE IN THE COMMUNITIES WE SERVE. 11 9 581 19 0 0 283088 615587 49353843 47871764 -93174 2821 136607 94723 49680364 48584895 16558 0 0 0 28158437 26668034 0 0 0 27802340 33844352 55977335 60512386 -6296971 -11927491 34937063 31196981 24998764 33186173 9938299 -1989192 HARRISBURG MEDICAL CENTER AND SOUTHERN ILLINOIS HEALTHCARE IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL THE PEOPLE IN THE COMMUNITIES WE SERVE. false false 54616666 0 44214997 IN SUPPORT OF ITS MISSION, THE HOSPITAL PROVIDES CARE TO PATIENTS AT LESS THAN ITS ESTABLISHED CHARGES FOR PATIENTS THAT MEET THE HOSPITAL'S FINANCIAL ASSISTANCE CRITERIA. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE, THEY ARE NOT REPORTED IN NET PATIENT SERVICE REVENUE. CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY (FAP) WERE APPROXIMATELY $1,140,000 FOR FISCAL YEAR 2024. 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 THE PAYMENTS ARE LESS THAN THE COST OF RENDERING CARE. MULBERRY CENTER AT HARRISBURG OFFERS PATIENT-CENTERED PSYCHIATRIC CARE IN AN ENVIRONMENT WHERE COMPREHENSIVE MEDICAL CARE IS AVAILABLE. THROUGH INTERACTIVE EXPERIENCES, PATIENTS LEARN TO BETTER UNDERSTAND THEIR SYMPTOMS AND LEARN HOW TO MANAGE THEM AFTER DISCHARGE. THE INPATIENT UNIT IS DIVIDED INTO TWO WINGS. ONE IS A GENERAL ADULT UNIT, HOUSING INDIVIDUALS WITH PSYCHIATRIC DISORDERS WHICH DO NOT INVOLVE DEMENTIA. THE SECOND WING IS A GEROPSYCHIATRIC UNIT WHICH TREATS PATIENTS WHOSE ILLNESS IS COMPLICATED BY DEMENTIA AND EMPHASIS IS PLACED ON MANAGING COGNITIVE DEFICITS ASSOCIATED WITH DEMENTIA. IN BOTH WINGS, PATIENTS RECEIVE SERVICES FROM A MULTI-DISCIPLINARY TEAM UNDER THE DIRECTION OF PSYCHIATRISTS. THE MULBERRY CENTER PROVIDES FOR 24/7 EMERGENCY ADMISSIONS. 4542596 0 3668829 HARRISBURG MEDICAL CENTER OPERATES PHYSICIAN PRACTICES TO PROVIDE CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR APPLICTED ON A NOT-FOR PROFIT BASIS. THESE PRACTICES ARE LOCATED IN VARIOUS COMMUNITIES IN OUR SERVICE AREA. BOTH PRIMARY CARE AND SPECIALIZED MEDICAL CARE ARE PROVIDED INCLUDING PEDIATRICS, BEHAVIORAL HEALTH, AND FAMILY MEDICINE. THESE PHYSICIAN PRACTICES PROVIDE QUALITY HEALTH SERVICES THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. THESE PHYSICIANS PROVIDED UNCOMPENSATED CARE THROUGH PARTICIPATION IN THE GOVERNMENT SPONSORED MEDIARE AND MEDIICAID PROGRAMS AND THE HMC INDIGENT FINANCIAL ASSISTANCE PROGRAM. 59159262 true false false true false false false false false true false false false true true false true false false false false false false false false true true false false true true false false false false false false false false true false false false false false false true true false false false true 44 0 true 581 true false false false false false false false false false false false false X 11 9 false false false false true true true true true false false true true true true true true true true false IL X WARREN LADNER 6182537671 100 DR WARREN TUTTLE DR Harrisburg IL 62946 Dennis Murphy Board Chair 2.0 0 X X 0 0 0 John Antes President/CEO/Trustee 10.0 45.0 X X 0 920791 128446 John B Millstead SR VP/COO 10.0 35.0 X X 0 747377 231822 Matt Businaro Board Vice Chair 2.0 0 X X 0 0 0 Michael Williams Secretary/Treasurer 2.0 0 X X 0 0 0 Angela Rowe Trustee 1.0 1.0 X 0 0 0 Benna Daugherty Trustee 1.0 0 X 0 0 0 Gina Sirach Trustee 1.0 1.0 X 0 0 0 Jacqueline Scott Trustee 1.0 0 X 0 0 0 Matthew Winkleman Trustee 1.0 40.0 X 0 538989 70353 Michael Tison Trustee 1.0 2.0 X 0 300 0 Denao Ruttino VP/Innovation Technology 10.0 45.0 X 0 400282 56078 Donald Hutson VP/Administrator (Partial Year) 40.0 0.0 X 490750 0 43860 Jennifer Harre VP/CNO 10.0 45.0 X 0 334011 76263 John Daly VP/General Counsel 10.0 45.0 X 0 408966 43448 Marci L Moore-Connelley MD SR VP/CMO 10.0 45.0 X 0 587343 91618 Pam Henderson VP/HR (Partial Year) 10.0 35.0 X 0 236848 89163 Rodney Smith VP/Administrator 20.0 35.0 X 0 463234 91205 Shelly Pierce VP/Quality 10.0 45.0 X 0 364791 71501 Warren Ladner Sr VP/CFO/Treasurer 10.0 45.0 X 0 483458 91347 Andrea Miller Physician 40.0 0 X 290543 0 49172 Deborah Gajewski RN Supervisor 40.0 0 X 239083 0 14448 J Cody Sandusky Pharmacist 40.0 1.0 X 208852 0 20052 Kasey Harner Advanced Practice Provider 40.0 0 X 229578 0 19336 Stephanie Franklin Advanced Practice Provider 40.0 0 X 206880 0 20855 Rex Budde Former President/CEO/Trustee 0.0 0.0 X 0 536649 1688 1665686 6023039 1210655 27 true true false CROSS COUNTRY STAFFING 6551 PARK OF COMMERCE BLVD BOCA RATON FL 33487 MEDICAL STAFFING 2540484 INTEGRITAS TRINITY MEDICAL STAFF 2250 NORTH ILLINOIS AVENUE CARBONDALE IL 62901 MEDICAL STAFFING 1506058 INTEGRITAS STATERA HEALTH CARE 2250 NORTH ILLINOIS AVENUE CARBONDALE IL 62901 MEDICAL STAFFING 1467422 COMPHEALTH PO BOX 972651 DALLAS TX 75234 MEDICAL STAFFING 1054055 RLH UROLOGY LOCUM SERVICES LLC 3401 HEARTLAND ST MARION IL 62959 MEDICAL STAFFING 120900 6 615587 615587 PATIENT SERVICE REVENUE 622100 47621612 47621612 0 0 LEASEHOLD REVENUE FROM RELATED ORGANIZATIONS 531120 210657 210657 0 0 MISCELLANEOUS DEPARTMENTAL REVENUE 900099 39495 39495 0 0 0 0 0 0 47871764 2622 0 0 2622 199 0 0 199 53475 50801 2674 0 2674 0 0 2674 0 0 CAFETERIA REVENUE 722310 79987 0 0 79987 MEDICAL RECORDS 621300 12062 12062 0 0 0 0 0 0 92049 48584895 47883826 0 85482 X 0 0 0 0 0 0 0 0 563677 0 563677 0 63508 63508 0 0 19459295 19102126 357169 0 668430 660829 7601 0 4490787 4435041 55746 0 1422337 1395306 27031 0 0 0 0 0 0 0 0 0 60391 46310 14081 0 15841 0 15841 0 0 0 0 0 0 0 17114218 17034657 79561 0 125 125 0 0 1714114 1705529 8585 0 22814 15768 7046 0 0 0 0 0 1368581 1368581 0 0 59578 57122 2456 0 0 0 0 0 14941 14941 0 0 393361 393361 0 0 0 0 0 0 2408462 2206685 201777 0 206220 206220 0 0 MEDICAL SUPPLIES 4869178 4869178 0 0 PROVIDER TAX 3765185 3765185 0 0 EQUIPMENT RENTAL 1528620 1515908 12712 0 LOSS ON ASSET DISPOSAL 162925 162925 0 0 139798 139957 -159 0 60512386 59159262 1353124 0 502263 4036 4113659 208040 0 0 5217687 8043563 0 0 0 0 10626 803 1373336 473390 313680 122210 28060941 6163913 23044532 21897028 0 0 0 0 361280 447911 34937063 31196981 4445513 4048967 0 0 0 0 17462616 16862928 0 0 0 0 0 0 626670 384483 2463965 11889795 24998764 33186173 X 9938299 -1989192 9938299 -1989192 34937063 31196981 -11927491 0 X false true X true false X false false false false false false false false true 15841 15841 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY A PORTION OF DUES PAID TO ILLINOIS HOSPITAL ASSOCIATION IS USED FOR LOBBYING BY THAT ASSOCIATION IN THE AMOUNT OF $15,841. 772443 772443 21234258 3380173 17854085 0 0 0 5335045 2708249 2626796 719195 75491 643704 21897028 DUE TO AFFILIATES 11768429 THIRD PARTY SETTLEMENTS -143246 MEDICAL LIABILITY INSURANCE 228481 ACCRUED INTEREST 33344 EXECUTIVE BENEFIT PLAN 2787 11889795 X Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The organization is included in consolidated financial statements. Below is the FIN 48 (ASC 740) footnote from those financial statements: SIHE and its affiliated organizations, with the exception of the Captive, Harrisburg Medical Center Clinic Services LLC, HSSI and PSC, are exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. The Corporation realized certain income which the Internal Revenue Service considers to be unrelated business income subject to income tax. For the years ended March 31, 2024 and 2023, a minimal amount of tax was due related to these operations. The Captive is incorporated under the laws of the Cayman Islands, which imposes no tax on income or capital gains. However, the Captive is subject to U.S. federal corporate taxation to the extent that it generates income that is effectively connected with a U.S. trade or business. The Captive is not engaged in any such trade or business in the U.S. PSC is a pass-through entity and its members separately account for their share of PSC's net income or loss which is allocated to the members based on the ownership percentage. Accordingly, income taxes are not provided for in the accompanying consolidated financial statements. When tax returns are filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would be ultimately sustained. Examples of tax positions common to health systems include matters such as the tax- exempt entity taking a tax position that an organization is tax exempt without observing corresponding proof of tax exemption from federal and state taxing authorities and there is material net income generated by the entity or egregious compensation paid to insiders that could result in revocation of exempt status (outside the scope of intermediate sanctions excise tax penalties). The tax position is to consider that these compensatory arrangements do not jeopardize tax exemption. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions taken are not offset or aggregated with other positions. 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 of being realized upon settlement with the applicable taxing authority. There were no uncertain tax benefits identified and recorded at March 31, 2024 and 2023. The Corporation does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. The Corporation would recognize interest and/or penalties related to income tax matters in miscellaneous expenses. There was no interest and/or penalties related to income tax matters identified and recorded for the years ended March 31, 2024 and 2023. Tax returns filed by the Corporation are subject to examination by the Internal Revenue Service (IRS) up to three years from the extended due date of each return. Tax returns filed by the Corporation are no longer subject to examination for the years ended March 31, 2020 and prior. true true X true X true X 600 true true false true true 465505 0 465505 0.0077 20445251 16243019 4202232 0.0694 0 0.0 0 0 20910756 16243019 4667737 0.0771 276 0 276 0.0000 0 0 0 0.0 49134 0 49134 0.0008 0 0 0 0.0 0 0 0 0.0 0 0 49410 0 49410 0.0008 0 0 20960166 16243019 4717147 0.0780 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 0 0 0 0.0 true 970549 182463 8820981 13840932 -5019951 X true true 1 1 HARRISBURG MEDICAL CENTER 100 DR WARREN TUTTLE DRIVE HARRISBURG IL 62946 WWW.HARRISBURGMC.COM 521 X X X HARRISBURG MEDICAL CENTER 1 false false true X X X X X X X X X 21 true true false true X https://www.sih.net/giving-back/sih-in-the-community-community-benefit--programs/communiyt-health-ne X true 21 true https://www.sih.net/giving-back/sih-in-the-community-community-benefit--programs/communiyt-health-ne false true X 200.0 600.0 X X X X X true true X X X true X https;//www.sih.net/patients-and-visitors/financial-resources/healthcare-assistance-program X https://www.sih.net/patients-and-visitors/financial-resources/healthcare-assistance-program X https://www.sih.net/patients-and-visitors/financial-resources/healthcare-assistance-program X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E The significant health needs of the community are identified through the CHNA. These needs were prioritized based on overall impact, magnitude of the problem, severity and ability and interest of the community. CHNA advisory team members discussed and voted on the top issues. The following areas were identified as the top 3 priority needs: 1 - Social Determinants of Health (poverty, hunger/food access, housing, access to care) 2 - Behavioral Health (mental health and substance misuse) 3 - Chronic Disease Prevention, Management and Treatment Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - HARRISBURG MEDICAL CENTER. THE CHNA AND DEVELOPMENT OF ITS IMPLEMENTATION PLAN IS A WAY FOR THE HOSPITAL'S CORPORATE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES (SIH), AND COMMUNITY PARTNERS TO WORK COLLABORATIVELY TO IMPROVE THE HEALTH AND WELL-BEING OF ALL THE PEOPLE IN THE COMMUNITIES SERVED. IN ORDER TO DEVELOP A BROAD UNDERSTANDING OF COMMUNITY HEALTH NEEDS IN THE ELEVEN COUNTY SERVICE AREA. A COMMUNITY SURVEY WAS CONDUCTED BETWEEN AUGUST 30, 2021 AND SEPTEMBER 22, 2021. A SURVEY LINK WAS DISTRIBUTED VIA E-MAIL, SOCIAL MEDIA, FLYER DISTRIBUTION AND WORD OF MOUTH TO THE COMMUNITY AT-LARGE. SEE APPENDIX 1 OF THE CHNA FOR REFERENCE. THE BROAD INTERESTS OF THE COMMUNITY WE SERVE WERE INCORPORATED BY INCLUDING INPUT FROM RESIDENTS, PATIENT GROUPS, HEALTH CARE PRACTITIONERS, LOCAL HEALTH DEPARTMENTS, SOCIAL SERVICES PROVIDERS AND OTHER COMMUNITY ORGANIZATIONS AND PARTNERS. A SURVEY OF 637 COMMUNITY MEMBERS AND PARTNERS AND 17 HEALTHCARE PROVIDERS WAS CONDUCTED TO GAIN INPUT REGARDING OVERALL HEALTH ISSUES TO BE ADDRESSED. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED TO INCORPORATE FOUR HOSPITALS WITHIN THE SOUTHERN ILLINOIS HEALTHCARE SYSTEM AS THE COMMUNITY IS DEFINED AS THE SAME SURROUNDING AREA. ONE OF THESE HOSPITALS, HARRISBURG MEDICAL CENTER IS REPORTED ON THIS SEPARATE 990 RETURN, WHILE THE REMAINING THREE HOSPITALS ARE INCLUDED ON THE SOUTHERN ILLINOIS HOSPITAL SERVICES 990 RETURN. VULNERABLE AND UNDER-REPRESENTED POPULATIONS IN OUR AREA ARE CHARACTERIZED BY THE FOLLOWING HEALTH DISPARITIES: - HOMELESSNESS - FOOD INSECURITIES - LIMITED ACCESS TO MEDICAL SCREENINGS AND TREATMENT THE ABOVE ISSUES ARE SUPPORTED BY THE FOLLOWING STATISTICS: - 48.7% OF HOUSEHOLDS WITH CHILDREN ARE AT OR BELOW 20% OF POVERTY LEVEL - 46.1% OF WORKING AGE POPULATION ARE UNEMPLOYED - 57.1% OF STUDENTS ARE ELIGIBLE FOR FREE LUNCH 17.9% OF HOUSEHOLDS RECEIVE SNAP BENEFITS - 16.2% OF ADUCTS ARE UNABLE TO FILL PRESCRIPTIONS DUE TO COST SIH CHNA ADVISORY TEAM THE 53-MEMBER TEAM REVIEWED THE DATA, PROVIDED INPUT AND SHARED THEIR PERCEPTIONS OF OVERALL IMPACT, MAGNITUDE OF THE PROBLEM, SEVERITY, AND ABILITY AND INTEREST OF THE COMMUNITY TO ADDRESS THE ISSUES, AND VOTED ON THE TOP PRIORITY HEALTH ISSUES. MANY OF THE INDIVIDUALS INVITED TO PARTICIPATE IN THE SURVEY ARE OR PROVIDE SERVICES TO THOSE WHO ARE MEDICALLY UNDERSERVED, LOW-INCOME OR MINORITY POPULATONS. IT WAS REQUESTED THAT THESE INDIVIDUALS PROMOTE THE SURVEY AMONG THOSE THEY SERVE. THIS INCLUDED FEDERALLY QUALIFIED HEALTH CENTERS STAFF AND HEALTHY COMMUNITY COALITION MEMBERS THAT SERVE OUR MOST VULNERABLE POPULATIONS - LOW INCOME FAMILIES AND THOSE LIVING IN POVERTY, UNINSURED AND UNDER-INSURED, ELDERLY, TEENS, THOSE WITH BEHAVIORAL HEALTH ISSUES, ETC. AN INVITATION EMAIL WITH A SURVEY MONKEY LINK WAS SENT TO OVER 4,000 INDIVIDUALS. THE SURVEY WAS ALSO PROMOTED VIA FACEBOOK, ALL RESPONSES WERE COLLECTED ANONYMOUSLY. Schedule H, Part V, Section B, Line 6a Facility , 1 Facility , 1 - HARRISBURG MEDICAL CENTER. A joint CHNA was conducted with the hospitals listed below. MEMORIAL HOSPITAL OF CARBONDALE, CARBONDALE, IL HERRIN HOSPITAL, HERRIN, IL ST JOSEPH MEMORIAL HOSPITAL, MURPHYSBORO, IL Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - HARRISBURG MEDICAL CENTER. THE MOST RECENTLY CONDUCTED CHNA WAS COMPLETED IN MARCH 2022 FOR WHICH AN IMPLEMENTATION STRATEGY WAS DEVELOPED FOR THE NEXT THREE YEARS BEGINNING APRIL 1, 2022 AND ENDING MARCH 31, 2025. THE INFORMATION BELOW DESCRIBES HOW THE HOSPITAL IS ADDRESSING THE NEEDS IDENTIFIED IN THE MOST RECENT CHNA. THREE IMPLEMENTATION PLAN TEAMS WERE DEVELOPED IN ORDER TO BRING EXPERTS TOGETHER WITH EXPERTISE AND INTEREST IN EACH OF THE CHOSEN AREAS. KEY ISSUES AND NEEDS WERE IDENTIFIED AND INTERVENTION STRATEGIES WERE DEVELOPED. THE COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN WAS REVIEWED AND ADOPTED BY THE SIH BOARD OF TRUSTEES IN MARCH 2022. THE PRIORITY AREAS THROUGH THIS NEEDS ASSESSMENT WILL BE USED TO FOCUS COMMUNITY BENEFITS DEPARTMENT PLANNING FOR THE NEXT THREE YEARS. THE PRIORITY HEALTH ISSUES THAT THE FOUR HOSPITALS WILL ADDRESS FROM 2022 - 2025 ARE: SOCIAL DETERMINANTS OF HEALTH (ACCESS TO CARE, HUNGER/FOOD ACCESS, HOUSING, AND POVERTY), BEHAVIORAL HEALTH (MENTAL HEALTH AND SUBSTANCE MISUSE), AND CHRONIC DISEASE PREVENTION, MANAGEMENT. AND TREATMENT (FOCUSING ON CARDIOVASCULAR DISEASE, STROKE AND DIABETES). THE FOCUS WILL BE ADDRESSING THESE PRIORITIZED NEEDS. HOWEVER OTHER AREAS IDENTIFIED AS COMMUNITY NEEDS, THAT WERE DETERMINED TO BE LOWER PRIORITY WERE ACCESS TO CARE (TELEHEALTH), LACK OF CANCER AND PREVENTATIVE SCREENINGS AND PEDIATRIC DENTAL CARE. THESE LOWER PRIORITY ITEMS WILL BE ADDRESSED IN THE FUTURE IF FUNDING IS AVAILABLE. Schedule H, Part V, Section B, Line 13 Facility , 1 Facility , 1 - HARRISBURG MEDICAL CENTER. IF A PATIENT MEETS CERTAIN PRESUMPTIVE ELIGIBILITY CRITERIA, THE PATIENT SHALL NOT BE REQUIRED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND SHALL BE DEEMED TO RECEIVE A 100% ALLOWANCE. PRESUMPTIVE ELIGIBILITY CATEGORIES ARE: 1) HOMELESSNESS, DEFINED AS AN INDIVIDUAL WITHOUT PERMANENT HOUSING WHO MAY LIVE ON THE STREETS, STAY IN A SHELTER, MISSION, SINGLE ROOM OCCUPANCY FACILITIES, ABANDONED BUILDING OR VEHICLE, OR IN ANY OTHER UNSTABLE OR NON-PERMANENT SITUATION; 2) DECEASED WITH NO ESTATE; 3) MENTAL INCAPACITATION WITH NO REPRESENTATIVE; 4) MEDICAID ELIGIBLE BUT NOT ON DATE OF SERVICE; 5) MEDICAID ELIGIBLE ON DATE OF SERVICE, BUT THE SERVICE IS NON-COVERED, AND 6) INCARCERATION IN A PENAL INSTITUTION. 4 HMC CLINIC AT MARION 3106 OUTER DRIVE MARION IL 62959 PROVIDER BASED RURAL HEALTH CLINIC ELDORADO PRIMARY CARE 1007 US HIGHWAY 45 ELDORADO IL 62930 PROVIDER BASED RURAL HEALTH CLINIC MACH MINE CLINIC 16468 LIBERTY SCHOOL ROAD MARION IL 62959 PRIMARY CARE CLINIC VIKING MINE CLINIC 13643 NORTH THOMPSONVILLE ROAD MACEDONIA IL 62860 PRIMARY CARE CLINIC Schedule H, Part I, Line 6a Community benefit report prepared by related organization SOUTHERN ILLINOIS HOSPITAL SERVICES Schedule H, Part I, Line 7g Subsidized Health Services NONE OF THE COSTS ARE ATTRIBUTABLE TO A PHYSICIAN CLINIC Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE IRS PROVIDED WORKSHEETS WERE UTILIZED TO CALCULATE FINANCIAL ASSISTANCE AND MEDICAID COST BASED ON COST TO CHRGE RATIOS FROM THE COST REPORT INFOMRATION. ACTUAL COST IS USED FOR REPORTING OTHER BENEFIT COST AS TRACKED THROUGH OUT THE YEAR IN THE GENERAL LEDGER PROCESS. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, SOUTHERN ILLINOIS HOSPITAL SERVICES HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE ON IRS FORM 990, PART IX. THE AMOUNT REPORTED ON PART III, LINE 3 IS THE ESTIMATED BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS OF ACCOUNTS RECEIVABLE CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. Schedule H, Part III, Line 3 Bad Debt Expense Methodology BASED ON THE HOSPITAL'S EXPERIENCE WITH ALL ITS PATIENTS AND THE REGION POVERTY RATE, THE ORGANIZATION ESTIMATES THAT APPROXIMATELY 18.80% OF ACCOUNTS WRITTEN OFF TO BAD DEBT MAY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE, BUT THE PATIENT CHOSE NOT TO APPLY. THEREFORE, 18.80% OF THE BAD DEBT ADJUSTMENTS ARE INCLUDED ON PART III, LINE 3 AT COST. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote THE FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE CAN BE FOUND ON PAGES 12-13 OF SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES, INC CONSOLIDATED FINANCIAL REPORT WITH SUPPLEMENTARY INFORMATION MARCH 31, 2024, AND 2023. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE EXPENSES FROM THE AUDITED FINANCIAL STATEMENTS ARE ADJUSTED PER MEDICARE REGULATIONS. OVERHEADS ARE ALLOCATED BASED ON THE STEP-DOWN METHOD BY USING MEDICARE APPROVED STATISTICS. MEDICARE COST ARE DETERMINED BY MULTIPLYING THE DAYS OR CHARGES TIMES THE PER DIEM AMOUNT OR THE COST TO CHARGE RATIO APPLICABLE TO THE DEPARTMENT. HOME OFFICE EXPENSE IS ALLOCATED TO THE FACILITIES BASED ON THE HOME OFFICE COST REPORT STATISTICS USED ON THE HOME OFFICE COST REPORT. STATISTICS USED ON THE HOME OFFICE COST REPORT ARE APPROVED BY THE MEDICARE INTERMEDIARY. ONE HUNDRED PERCENT OF THE SHORTFALL OF MEDICARE ALLOWABLE COSTS OVER MEDICARE REVENUE IS CONSIDERED TO BE A COMMUNITY BENEFIT. BY CONTINUING TO TREAT PATIENTS ELIGIBLE FOR MEDICARE, HOSPITALS ALLEVIATE THE FEDERAL GOVERNMENT'S BURDEN FOR DIRECTLY PROVIDING MEDICAL SERVICES. THE IRS HAS ACKNOWLEDGED THAT LESSENING THE GOVERNMENT BURDEN ASSOCIATED WITH PROVIDING MEDICARE BENEFITS IS A CHARITABLE PURPOSE. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE HOSPITAL'S COLLECTION POLICY AND FINANCIAL ASSISTANCE POLICY (FAP) CONTAIN PROVISIONS FOR COLLECTION PRACTICES FOR PATIENTS WHO ARE KNOWN TO BE ELIGIBLE FOR FINANCIAL ASSISTANCE. THESE PRACTICES ALSO APPLY BROADLY TO ALL TYPES OF PATIENTS. HOSPITAL WILL PROVIDE PATIENTS WITH A PLAIN LANGUAGE SUMMARY OF THE FAP. HOSPITAL WILL MAKE A REASONABLE EFFORT TO ORALLY NOTIFY THE INDIVIDUAL ABOUT THE FAP AND ABOUT HOW THE INDIVIDUAL MAY OBTAIN ASSISTANCE WITH THE FAP APPLICATION. IF HOSPITAL DETERMINES THE INDIVIDUAL IS ELIGIBLE FOR FINANCIAL ASSISTANCE, HOSPITAL WILL: A) PROVIDE THE INDIVIDUAL WITH A BILLING STATEMENT THAT INDICATES THE AMOUNT HE OR SHE OWES FOR THE CARE RECEIVED, ASSUMING THE INDIVIDUAL IS ELIGIBLE FOR ASSISTANCE OTHER THAN FREE CARE AND HOW THAT AMOUNT WAS DETERMINED, B) REFUND TO THE INDIVIDUAL ANY AMOUNT HE OR SHE HAS PAID THAT EXCEEDS THE AMOUNT THE INDIVIDUAL IS DETERMINED TO BE PERSONALLY RESPONSIBLE FOR PAYING, C) TAKE ALL REASONABLE AVAILABLE MEASURES TO REVERSE ANY EXTRAORDINARY COLLECTION ACTIONS ("ECAS") TAKEN AGAINST THE INDIVIDUAL. FOR ALL TYPES OF PATIENTS, HOSPITAL TAKES THE FOLLOWING ACTIONS AT LEAST 30 DAYS BEFORE INITIATING ECA TO OBTAIN PAYMENT FOR CARE: A) PROVIDE THE INDIVIDUAL WITH A WRITTEN NOTICE THAT INDICATES FINANCIAL ASSISTANCE IS AVAILABLE FOR ELIGIBLE INDIVIDUALS, B) IDENTIFIES THE ECA(S) THAT HOSPITAL (OR OTHER AUTHORIZED PARTY) INTENDS TO INITIATE TO OBTAIN PAYMENT FOR THE CARE AND C) STATES A DEADLINE AFTER WHICH SUCH ECAS MAY BE INITIATED THAT IS NO EARLIER THAN 30 DAYS AFTER THE DATE THAT THE WRITTEN NOTICE IS PROVIDED. Schedule H, Part V, Section B, Line 16a FAP website - HARRISBURG MEDICAL CENTER: Line 16a URL: https;//www.sih.net/patients-and-visitors/financial-resources/healthcare-assistance-program; Schedule H, Part V, Section B, Line 16b FAP Application website - HARRISBURG MEDICAL CENTER: Line 16b URL: https://www.sih.net/patients-and-visitors/financial-resources/healthcare-assistance-program; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - HARRISBURG MEDICAL CENTER: Line 16c URL: https://www.sih.net/patients-and-visitors/financial-resources/healthcare-assistance-program; Schedule H, Part VI, Line 2 Needs assessment THE HOSPITAL ASSESSES THE HEALTHCARE NEEDS OF THE COMMUNITY AND THEY MIGHT BE ADDRESSED BY PARTICIPATING IN STRATEGIC AND OPERATIONAL PLANNING SESSIONS THAT INCLUDE THE BOARD OF DIRECTORS, STATE LEGISLATORS, OFFICIALS FROM THE LOCAL COMMUNITY COLLEGE AND LOCAL CLERGY. THE CEO PARTICIPATES IN STRATEGIC PLANNING MEETINGS WITH LEADERSHIP OF HOSPITAL'S CORPORATE MEMBER. HOSPITAL LEADERSHIP MEETS WITH LEADERSHIP FROM LOCAL HEALTH DEPARTMENTS, AREA HOSPITALS, AREA LONG TERM CARE FACILITIES AND EMERGENCY PLANNERS ON AN ONGOING BASIS. THE PRESIDENT OF THE MEDICAL STAFF MEETS REGULARLY WITH PRIMARY BEHAVIORAL HEALTH CLINIC LEADERS AS WELL AS REPRESENTATIVES FROM COMMUNITY BEHAVIORAL HEALTH AND SUPPORT ORGANIZATIONS TO ASCERTAIN NEEDS AND ASSESS MEETING OF THE NEEDS. HOSPITAL DATA IS REVIEWED TO DETERMINE PATIENTS' NEEDS BY ANALYZING DIAGNOSIS, READMISSION RATES AND THE MEDICARE CASE MIX INDEX. THE HOSPITAL PARTICIPATES IN REGIONAL HAZARD ASSESSMENTS AND DRILLS. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance ALL PATIENTS WITHOUT THIRD PARTY COVERAGE, I.E., CONSIDERED "SELF-PAY," RECEIVE A COPY OF THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM (FAP) PLAIN LANGUAGE SUMMARY DURING REGISTRATION THAT DETAILS THE FAP. HOSPITAL PATIENT BILLING STATEMENTS INCLUDE A STATEMENT EXPLAINING HOW A PATIENT MAY APPLY FOR CONDSIDERATION UNDER THE HOSPITAL'S FAP. SIGNAGE IS DISPLAYED IN REGISTRATION, PATIENT CARE, AND BUSINESS OFFICE AREAS THAT ANNOUNCES FINANCIAL HELP WITH BILLS FOR THOSE PATIENTS WHO QUALIFY. IF A PATIENT CONTACTS THE BUSINESS OFFICE REGARDING DIFFICULTY IN MAKING PAYMENTS, HOSPITAL PERSONNEL INFORMS THE PATIENT OF THE FAP. ONE FULL-TIME FINANCIAL COUNSELOR ASSISTS THE HOSPITAL'S PATIENTS IN APPLYING FOR GOVERNMENT FUNDED MEDICAL COVERAGE. Schedule H, Part VI, Line 4 Community information WHILE EACH OF THE ELEVEN COUNTIES IN THE HOSPITAL SYSTEM SERVICE AREA IS UNIQUE, ALL SHARE SIMILAR CHALLENGES. ALL HAVE ISOLATED HOUSEHOLDS, RESIDENTS WITH LOW INCOME AND LOW EDUCATIONAL LEVELS, AND HIGH RATES OF POVERTY, ILLNESS, AND MORTALITY. ALL HAVE A LARGE NUMBER OF MEDICALLY UNDERSERVED RESIDENTS. IN GENERAL, SOUTHERN ILLINOIS RESIDENTS ARE MORE PRONE TO HAVE HIGHER BMI, HIGHER BLOOD PRESSURE, INCREASED RISK FOR DIABETES AND ARE MORE APT TO SMOKE AND BE SEDENTARY THAN ALL OTHER ILLINOISANS. IMPROVEMENTS ARE NEEDED IN AREAS SUCH AS PREVENTATIVE SCREENINGS, HEALTHY EATING, AND PHYSICAL ACTIVITY. RESIDENTS FACE CONSIDERABLE BARRIERS TO ACCESS, DEMONSTRATED BY UNMET OR MISSED PRIMARY CARE APPOINTMENTS AND HIGH EMERGENCY DEPARTMENT UTILIZATION. UNEMPLOYMENT, POVERTY, FOOD INSECURITY, ACCESS TO CARE AND LACK OF TRANSPORTATION SERVE AS BARRIERS TO HEALTH AND HEALTHCARE. HARRISBURG MEDICAL CENTER PREDOMINATELY SERVES A RURAL FIVE-COUNTY AREA INCLUDING SALINE, GALLATIN, HARDIN, POPE, AND WHITE COUNTIES. POVERTY RATES RANGE FROM A LOW OF 12.3% TO A HIGH OF 20.5% IN THESE COUNTIES. THE OVERALL AVERAGE FOR THE FIVE COUNTIES IS 18.34%. EACH OF THE COUNTIES IS FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA. THE POPULATION OF THE FIVE COUNTIES IS APPROXIMATELY 50,000 AND THE POPULATION HAS SHOWN A DECLINING TREND FOR AT LEAST THE PAST TWENTY YEARS. APPROXIMATELY 17% OF THE POPULATION IS 65 YEARS OLD OR OLDER AS COMPARED TO 12% OF ALL ILLINOISANS. 87% OF THE POPULATION HAVE A HIGH SCHOOL DIPLOMA WHILE ONLY 16% OF THE POPULATION OVER 25 YEARS OLD HAVE EARNED A BACHELOR'S DEGREE OR HIGHER. INCOME PER CAPITAL IS $26,500 FOR THE POPULATION WHICH IS 26% LESS THAN THE INCOME PER CAPITAL OF THE STATE OF ILLINOIS AND 22% LESS THAN OF THE U.S.. THE PERCENTAGE OF INDIVIDUALS IN THIS AREA LIVING IN POVERTY EXCEEDS THE PERCENTAGE FOR THE STATE OF ILLINOIS AND FOR THE UNITED STATES OF AMERICA. 32% OF THE SERVICE AREA RECEIVES MEDICAID AS COMPARED TO 21% OF ILLINOISANS AND 22% OF THE U.S. POPULATION. 59% OF CHILDREN LIVING IN THE 5-COUNTY SERVICE AREA ARE ELIGIBLE FOR FREE OR REDUCED-PRICE SCHOOL LUNCHES. EIGHT NON-SIH HOSPITALS EXIST WITH THE ELEVEN COUNTY PRIMARY MARKET AREA. THE MARION VA MEDICAL CENTER AND HEARTLAND REGIONAL MEDICAL CENTER ARE BOTH LOCATED IN WILLIAMSON COUNTY. THE REMAINING FACILITIES ARE 25-BED CRITICAL ACCESS HOSPITALS: FERRELL HOSPITAL IN SALINE COUNTY, FRANKLIN HOSPITAL IN FRANKLIN COUNTY, MARSHALL BROWNING HOSPITAL IN PERRY COUNTY, PINCKNEYVILLE COMMUNITY HOSPITAL IN PERRY COUNTY, UNION COUNTY HOSPITAL IN UNION COUNTY, AND HARDIN COUNTY HOSPITAL IN HARDIN COUNTY. THREE SIH HOSPITALS, MEMORIAL HOSPITAL OF CARBONDALE, HERRIN HOSPITAL OF HERRIN AND ST JOSEPH HOSPITAL OF MURPHYSBORO ALSO SERVE THE AREA. EACH OF THE ELEVEN COUNTIES WITHIN THE PRIMARY MARKET AREA HAS BEEN FEDERALLY DESIGNATED AS A HEALTH PROFESSIONAL SHORTAGE AREA, AND AT LEAST A PORTION OF EACH COUNTY HAS BEEN FEDERALLY DESIGNATED AS A MEDICALLY UNDERSERVED AREA OR HAVING A MEDICALLY UNDERSERVED POPULATION. Schedule H, Part VI, Line 5 Promotion of community health HMC IS PASSIONATE ABOUT THE HEALTH AND WELL-BEING OF THE COMMUNITIES SERVED. HMC PROVIDES QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT THE SERVICE AREA REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. HMC IS A COMMUNITY HOSPITAL THAT PROVIDES ACUTE AND BEHAVIORAL HEALTH CARE. A FULL-TIME EMERGENCY ROOM ENSURES NO ONE IS DENIED CARE OR TREATMENT WITHIN THE HOSPITAL. MEDICAL STAFF PRIVILEGES ARE AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. CONSISTENT WITH THE SERVICES PROVIDED AT THE FACILITY, THE BOARD OF TRUSTEES IS COMPRISED OF ELEVEN MEMEBERS. THESE MEMBERS ARE COMPRISED OF LOCAL COMMUNITY LEADERS, PHYSICIANS AND THE CEO AND COO OF SOUTHERN ILLINOIS HEALTHCARE. THE MAJORITY OF THE BOARD IS COMPRISED OF PERSONS WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION OR FAMILY MEMBERS THEREOF. HMC INVESTS EXCESS FUNDS FROM OPERATIONS INTO THE EXPANSION AND REPLACEMENT OF EXISTING FACILITIES AND EQUIPMENT, REPAYMENT OF DEBT AND IMPROVEMENT IN PATIENT CARE. OPERATING FUNDS ARE ALLOCATED ANNUALLY TO BRING HEALTH RELATED PROGRAMS TO THE AREA. OUR GOAL IS TO RESPOND TO COMMUNITY HEALTH NEEDS, INCREASE ACCESS TO CARE AND IMPROVE THE OVERALL HEALTH STATUS OF THOSE IN THE COMMUNITIES SERVED BY HMC. HMC PARTICIPATES IN MANY COMMUNITY EVENTS TO PROMOTE THE HEALTH AND WELL-BEING OF THE COMMUNITY. HMC SUPPORTS AND PROVIDES OUTREACH FOR OUR COMMUNITY. HMC PARTICIPATES IN MANY COMMUNITY ORGANIZATIONS EVENTS TO PROMOTE HEALTH SUCH AS HEALTH FAIRS AT THE COMMUNITY COLLEGE, LOCAL PARADES, SALINE COUNTY CHAMBER OF COMMERCE, SALINE COUNTY CHAMBER GOLF TOURNAMENT. THE HOSPITAL ACTIVELY SUPPORTS AND WORKS WITH OTHER HEALTH-RELATED ORGANIZATIONS SUCH AS HOSPICE OF SOUTHERN ILLINOIS AND EGYPTIAN HEALTH DEPARTMENT, AS WELL AS OTHER AREA HOSPITALS, AND NURSING HOMES. HMC HOSTS SEMI-ANNUAL BLOOD DRIVES FOR THE AMERICAN RED CROSS AT THE HOSPITAL. HMC CLINICS ALSO PROVIDED FOOD BASKETS TO LOCAL FAMILIES AT THANKSGIVING AND CHRISTMAS AND ALSO PURCHASED GIFTS FOR THE SCHOOLS UNDERPRIVILEGED STUDENTS. HMC IS ACTIVE WITH THE GOLDEN CIRCLE SENIOR CITIZENS ORGANIZATION IN HARRISBURG. HMC'S REGISTERED DIETICIANS REVIEW AND APPROVE THEIR MENU EVERY MONTH AT NO CHARGE. OUR REGISTERED DIETICIANS ALSO PROVIDE NUTRITIONAL CONSULTS AT NO CHARGE IN THE CLINICS. HMC PROVIDES AN ATHLETIC TRAINER AND DRUG SCREENING TESTS AT NO CHARGE TO THE HARRISBURG HIGH SCHOOL. Schedule H, Part VI, Line 6 Affiliated health care system THE HOSPITAL IS PART OF A LARGER SYSTEM, SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS), THAT PROVIDES HEALTH SERVICES TO THE POPULATION OF SOUTHERN ILLINOIS. SIHS PROVIDES CARE THROUGH ITS FOUR HOSPITALS AND A COMMUNITY HEALTH CENTER. THREE OF THE HOSPITALS ARE REPORTED AS SOUTHERN ILLINOIS HOSPITAL SERVICES AND ONE IS REPORTED AS HARRISBURG MEDICAL CENTER. HARRISBURG MEDICAL CENTER ALSO PROVIDES CARE THROUGH TWO RURAL HEALTH CLINICS. SOUTHERN ILLINOIS MEDICAL SERVICES (SIMS) PROVIDES CARE THROUGH PHYSICIAN PRACTICES. THESE PRACTICES ARE COMPRISED OF THE CENTER FOR MEDICAL ARTS, LOGAN PRIMARY CARE, PHYSICIAN CARE GROUP, INDIVIDUAL PHYSICIAN PRACTICES, HOSPITAL PHYSICIAN AND EMERGENCY ROOM PHYSICIANS. SIHS AND SIMS WORK TOGETHER IN PROVIDING CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED. BOTH PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. Schedule H, Part VI, Line 7 State filing of community benefit report IL true true false false false false false false false John B Millstead SR VP/COO 0 549157 0 0 0 198220 0 186117 0 45705 0 979199 0 158407 John Antes President/CEO/Trustee 0 798918 0 75000 0 46873 0 102450 0 25996 0 1049237 0 0 Matthew Winkleman Trustee 0 390496 0 130331 0 18162 0 27869 0 42484 0 609342 0 17182 Rex Budde Former President/CEO/Trustee 0 12543 0 0 0 524106 0 349 0 1339 0 538337 0 99595 John Daly VP/General Counsel 0 347665 0 0 0 61301 0 39310 0 4138 0 452414 0 25987 Warren Ladner Sr VP/CFO/Treasurer 0 449931 0 0 0 33527 0 58200 0 33147 0 574805 0 0 Donald Hutson VP/Administrator (Partial Year) 106801 0 0 0 383949 0 3498 0 40362 0 534610 0 61258 0 Jennifer Harre VP/CNO 0 274936 0 0 0 59075 0 31466 0 44797 0 410274 0 17990 Pam Henderson VP/HR (Partial Year) 0 122683 0 0 0 114165 0 82611 0 6552 0 326011 0 70038 Marci L Moore-Connelley MD SR VP/CMO 0 497863 0 0 0 89480 0 65540 0 26078 0 678961 0 54892 Shelly Pierce VP/Quality 0 283155 0 0 0 81636 0 54472 0 17029 0 436292 0 45508 Denao Ruttino VP/Innovation Technology 0 366409 0 0 0 33873 0 40554 0 15524 0 456360 0 0 Rodney Smith VP/Administrator 0 395533 0 0 0 67701 0 48685 0 42520 0 554439 0 31825 J Cody Sandusky Pharmacist 187579 0 0 0 21273 0 6380 0 13672 0 228904 0 0 0 Kasey Harner Advanced Practice Provider 155379 0 53396 0 20803 0 6252 0 13084 0 248914 0 0 0 Stephanie Franklin Advanced Practice Provider 143295 0 42373 0 21212 0 5894 0 14961 0 227735 0 0 0 Deborah Gajewski RN Supervisor 179269 0 37489 0 22325 0 2182 0 12266 0 253531 0 0 0 Andrea Miller Physician 234791 0 4803 0 50949 0 9248 0 39924 0 339715 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation Compensation for the organization's President is paid by Southern Illinois Hospital Services, Inc. (SIHS), a related tax-exempt organization. SIHS uses the following methods to determine the President's compensation: -Compensation committee -Independent compensation consultant -Compensation survey or study -Approval by the board or compensation committee Schedule J, Part I, Line 4a Severance or change-of-control payment DONALD HUTSON RECEIVED SEVERANCE OF $186,996 Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan COMPENSATION FOR THE ORGANIZATION'S OFFICERS IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES INC, A RELATED TAX-EXEMPT ORGANIZATION. THE FOLLOWING SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS/CONTRIBUTIONS WERE MADE: JOHN ANTES - NO PAYMENT RECEIVED, $97,500 DEFERRED COMPENSATION REX BUDDE - $99,595 PAYMENT RECEIVED, NO DEFERRED COMPENSATION WARREN LADNER - NO PAYMENT RECEIVED, $45,000 DEFERRED COMPENSATION JOHN DALY - $25,987 PAYMENT RECEIVED, $29,345 DEFERRED COMPENSATION BART MILLSTEAD - $158,407 PAYMENT RECEIVED, $172,917 DEFERRED COMPENSATION MARCI MOORE-CONNELLEY - $54,892 PAYMENT RECEIVED, $52,340 DEFERRED COMPENSATION DENAO RUTTINO - NO PAYMENT RECEIVED, $32,250 DEFERRED COMPENSATION SHELLY PIERCE - $45,508 PAYMENT RECEIVED, $42,979 DEFERRED COMPENSATION JENNIFER HARRE - $17,990 PAYMENT RECEIVED, $20,022 DEFERRED COMPENSATION PAM HENDERSON - $70,038 PAYMENT RECEIVED, $79,773 DEFERRED COMPENSATION RODNEY SMITH - $31,825 PAYMENT RECEIVED, $35,485 DEFERRED COMPENSATION DONALD HUTSON - $61,258 PAYMENT RECEIVED, NO DEFERRED COMPENSATION Matthew Winkleman - $17,182 payment received, $14,669 deferred compensation A ILLINOIS FINANCE AUTHORITY 861091967 000000000 2021-12-01 18565000 REFUND TAX-EXEMPT SERIES 2017 BONDS (ISSUED 3/14/17) false false false A 1355000 0 18565000 0 0 0 337239 0 0 0 18227761 0 2017 true false false true A false false false false 0.0 0.0 0.0 false false true A false true false false true false false false true A true Schedule K, Part II, Line 17 ADEQUATE BOOKS AND RECORDS WILL BE AVAILABLE TO SUPPORT THE FINAL ALLOCATION OF PROCEEDS ONCE THEY ARE MADE. Schedule K, Part V Different Procedures to Undertake Corrective Action Issuer name: ILLINOIS FINANCE AUTHORITY N/A TIFFANY BUSINARO EMPLOYEE - WIFE OF BOARD MEMBER MATT BUSINARO 63508 WAGES false Form 990, Part VI, Line 1a Delegate broad authority to a committee THE EXECUTIVE COMMITTEE, COMPRISED OF THE 3 BOARD OFFICERS AND 3 TRUSTEES, SHALL HAVE THE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE HOSPITAL DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD OF DIRECTORS, SUBJECT TO ANY PRIOR LIMITATION IMPOSED IN THE BYLAWS. Form 990, Part VI, Line 6 Classes of members or stockholders THE ORGANIZATION'S SOLE MEMBER IS SOUTHERN ILLINOIS HOSPITAL SERVICES, A RELATED TAX-EXEMPT ORGANIZATION. THE MEMBER HAS THE RIGHT TO ELECT MEMBERS TO THE BOARD OF TRUSTEES AND APPROVE SOME DECISIONS OF THE BOARD. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES, INC., HAS THE EXCLUSIVE RIGHT TO ELECT TRUSTEES TO THE ORGANIZATION'S BOARD OF TRUSTEES. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES (CORPORATE MEMBER), HAS RESERVED POWERS FOUND IN THE ORGANIZATION'S BYLAWS THE FOLLOWING MATTERS REQUIRE THE APPROVAL OF THE CORPORATE MEMBER: 1. APPROVAL AND REMOVAL OF THE MEMBERS OF THE BOARD OF TRUSTEES; 2. APPROVAL OF ANY CHANGE TO THE STATEMENT OF MISSION, PHILOSOPHY, ROLE AND PURPOSE OF THE CORPORATION; 3. APPROVAL OF CAPITAL EXPENDITURES IN EXCESS OF $50,000; 4. APPROVAL OF THE BUYING, SELLING, LEASING, MORTGAGING OR DISPOSING OF PROPERTY; 5. APPROVAL OF STRATEGIC PLANS; 6. APPROVAL OF THE CREATION OR DISSOLUTION OF ANY CORPORATION, THE SOLE MEMBER OR MAJORITY STOCKHOLDER OF WHICH IS THE CORPORATION; 7. APPROVAL OF MERGER, DISSOLUTION, CONSOLIDATION OR REORGANIZATION OF THE CORPORATION; 8. APPROVAL OF JOINT VENTURES OR AFFILIATIONS; 9. APPROVAL OF THE INCURRENCE OF ANY INDEBTEDNESS; 10. APPROVAL OF SUCH OTHER MATTERS AS MAY BE REQUIRED BY LAW OR BY THE CORPORATION'S ARTICLES OF INCORPORATION, OR BY THE BYLAWS TO BE SUBMITTED TO THE CORPORATE MEMBER; 11. APPROVAL OF ANY AMENDMENT TO THE ARTICLES OF INCORPORATION OR BYLAWS OF THE CORPORATION; AND 12. SELECTION AND TERMINATION OF THE ADMINISTRATOR OF THE CORPORATION, FOLLOWING CONSULTATION WITH THE BOARD. Form 990, Part VI, Line 11b Review of form 990 by governing body A DRAFT OF THE FORM 990 AND SUPPLEMENTAL SCHEDULES WAS DISTRIBUTED TO THE CEO, CFO AND CERTAIN VICE-PRESIDENTS OF THE CORPORATION FOR THEIR REVIEW AND COMMENTS. A DRAFT COPY WAS PRESENTED TO THE FINANCE COMMITTEE BY THE CFO AND THE ORGANIZATION'S TAX ADVISORS FOR REVIEW AND COMMENTS. AFTER THE REVIEW AND COMMENT PERIOD, ALL SUGGESTIONS AND COMMENTS WERE CONSIDERED AND THE FORM 990 WAS UPDATED AS APPROPRIATE. THE FINALIZED FORM 990 AND SUPPLEMENTAL SCHEDULES WAS THEN PRESENTED TO THE BOARD OF TRUSTEES AND A COPY OF THE RETURN WAS MADE AVAILABLE TO EVERY MEMBER OF THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. Form 990, Part VI, Line 12c Conflict of interest policy NNUALLY, THE GENERAL COUNSEL SENDS OUT A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH TRUSTEE, DIRECTOR, OFFICER, MANAGER AND KEY EMPLOYEE TO COMPLETE AND RETURN. THE GENERAL COUNSEL THEN REVIEWS THESE QUESTIONNAIRES TO DETERMINE WHAT CONFLICTS, REAL OR PERCEIVED, EXIST. DURING EVERY BOARD MEETING, THE GENERAL COUNSEL REMINDS THE TRUSTEES THAT THE BOARD HAS A CONFLICT OF INTEREST POLICY, THAT THE GENERAL COUNSEL HAS REVIEWED THE AGENDA FOR ANY CONFLICTS, BUT THAT THE TRUSTEES ARE OBLIGATED TO GIVE NOTICE IF A CONFLICT HAS BEEN OVER-LOOKED OR IF A DISCUSSION OR ACTION COMES BEFORE THE BOARD WHICH MAY INVOLVE OR CREATE A CONFLICT OF INTEREST FOR SOMEONE. IF A TRUSTEE HAS A CONFLICT OF INTEREST, THE TRUSTEE OR THE GENERAL COUNSEL DISCLOSES THE CONFLICT. THE TRUSTEE WITH THE CONFLICT IS ALLOWED TO REMAIN IN THE MEETING TO ANSWER ANY QUESTION THE TRUSTEE MAY NEED TO ANSWER AND THEN THE CONFLICTED TRUSTEE IS EXCUSED FROM THE MEETING. THE REMAINING TRUSTEES THEN DISCUSS THE MATTER FURTHER AND ACTION IS TAKEN ON THE MATTER. FINALLY, THE CONFLICTED TRUSTEE IS THEN INVITED BACK INTO THE MEETING. INTERESTED PERSONS MAY ALSO BE ASKED, IN RARE SITUATIONS, TO RESIGN THEIR POSITION ON THE BOARD. Form 990, Part VI, Line 15a Process to establish compensation of top management official COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER OFFICERS IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF THE PRESIDENT/CEO FOR THE FULL BOARD. ONLY THE FULL BOARD HAS THE AUTHORITY TO APPROVE THE COMPENSATION OF THE PRESIDENT/CEO. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2023. Form 990, Part VI, Line 15b Process to establish compensation of other employees The Board of Trustees sets the executive compensation policy and is responsible for approval of the compensation. The Governance Committee is designated by the Board to act as the Compensation Committee for matters concerning executive compensation. Each member of the Committee, while considering executive compensation issues, must be an independent director, free from any conflict of interest. The Committee seeks out and contracts the services of an outside, independent executive compensation consultant to advise the Committee in matters of market values of comparable executive positions. The Committee annually reviews all comparability data and prepares a recommendation as to the compensation package of all officers for the full Board. Only the Committee will have the authority to approve the compensation of the senior management team and will report it's actions to the Board. The decisions and deliberations are documented in the governance committee minutes. This process was last undertaken in June 2023. Form 990, Part VI, Line 19 Required documents available to the public THE ORGANIZATION MAKES ITS CONFLICT-OF-INTEREST POLICY AVAILABLE TO THE PUBLIC ON ITS WEBSITE AND UPON REQUEST. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104 THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. Form 990, Part IX, Line 11g Other Fees PHYSICIAN FEES - Total Expense: 4745736, Program Service Expense: 4745736, Management and General Expenses: 0, Fundraising Expenses: 0; CLINICAL SERVICE FEES - Total Expense: 135771, Program Service Expense: 135771, Management and General Expenses: 0, Fundraising Expenses: 0; CONSULTING FEES - Total Expense: 160125, Program Service Expense: 160125, Management and General Expenses: 0, Fundraising Expenses: 0; OTHER PROFESSIONAL FEES - Total Expense: 9462049, Program Service Expense: 9462049, Management and General Expenses: , Fundraising Expenses: ; RECRUITMENT FEES - Total Expense: 4670, Program Service Expense: 5000, Management and General Expenses: -330, Fundraising Expenses: 0; ENGINEERING FEES - Total Expense: 50644, Program Service Expense: 50644, Management and General Expenses: 0, Fundraising Expenses: 0; CREDIT & COLLECTION FEES - Total Expense: 3052, Program Service Expense: 3052, Management and General Expenses: 0, Fundraising Expenses: 0; PURCHASED SERVICES - Total Expense: 2546392, Program Service Expense: 2466501, Management and General Expenses: 79891, Fundraising Expenses: 0; ARCHITIECT FEES - Total Expense: 5779, Program Service Expense: 5779, Management and General Expenses: 0, Fundraising Expenses: 0; HARRISBURG MEDICAL CENTER FOUNDATION 540 N COMMERCIAL HARRISBURG IL 62946 371411984 FUNDRAISING IL 501(c)(3) Type I HARRISBURG MEDICAL CENTER true SOUTHERN ILLINOIS HOSPITAL SERVICES PO BOX 3988 CARBONDALE IL 62902 370618939 HEALTHCARE IL 501(c)(3) 3 SOUTHERN ILLINOIS HOSPITAL ENTERPRISES INC false SOUTHERN ILLINOIS HOSPITAL ENTERPRISES INC PO BOX 3988 CARBONDALE IL 62902 371136788 HEALTHCARE IL 501(c)(3) Type II NA false SOUTHERN ILLINOIS MEDICAL SERVICES NFP 1239 EAST MAIN STREET CARBONDALE IL 62901 205521741 HEALTHCARE IL 501(c)(3) 3 SOUTHERN ILLINOIS HOSPITAL SERVICES false SIH FOUNDATION NFP 1239 EAST MAIN STREET CARBONDALE IL 62901 271933790 FUNDRAISING IL 501(c)(3) Type I SOUTHERN ILLINOIS HOSPITAL SERVICES false SIH CAYMAN SPC GROUP LTD 980611605 FINANCING CJ SOUTHERN ILLINOIS HOSPITAL SERVICES C Corporation true HEALTH SERVICES OF SOUTHERN ILLINOIS PO BOX 3988 CARBONDALE IL 62902 371115061 HEALTHCARE IL SOUTHERN ILLINOIS HOSPITAL SERVICES C Corporation false false false false true true false false false false true false false false true true true false false false