HOSPITAL & MEDICAL FOUNDATION OF PARIS INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- HOSPITAL & MEDICAL FOUNDATION OF PARIS INC (EIN 37-0860281)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-10-03
- IRS object ID
- 201822769349301107
- 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 D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-10-03T12:00:35-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 430352985 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kerber Eck & Braeckel LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1116 West Main | AddressLine1Txt |
| City | Carbondale | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 629012335 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370860281 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPITAL & MEDICAL FOUNDATION | BusinessNameLine1Txt |
| Business Name Line2 | OF PARIS INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 2174654141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 721 EAST COURT STREET | AddressLine1Txt |
| City | PARIS | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61944 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | OLIVER M SMITH | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2174654141 | PhoneNum |
| Signature | 2018-09-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Anna Guetersloh | PreparerPersonNm |
| PTIN | P01315485 | PTIN |
| Phone | 6185291040 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | OLIVER M SMITH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 721 EAST COURT STREET | AddressLine1Txt |
| City | PARIS | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61944 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $45,256,199 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | MYHORIZONHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1958 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | OPERATION OF HOSPITAL - INPATIENT DAYS PLUS EMERGENCY, ANCILLARY AND OUTPATIENT SERVICES FOR RESIDENTS IN PARIS, EDGAR COUNTY AND EAST CENTRAL ILLINOIS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 457 | TotalEmployeeCnt |
| Total Volunteers | 46 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $177,639 | PYContributionsGrantsAmt |
| CY Contributions Grants | $52,179 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $51,150,596 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $42,605,479 | CYProgramServiceRevenueAmt |
| PY Investment Income | $38,004 | PYInvestmentIncomeAmt |
| CY Investment Income | $71,139 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,528,945 | PYOtherRevenueAmt |
| CY Other Revenue | $2,527,402 | CYOtherRevenueAmt |
| PY Total Revenue | $52,895,184 | PYTotalRevenueAmt |
| CY Total Revenue | $45,256,199 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $28,900,257 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $30,198,485 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,456,738 | PYOtherExpensesAmt |
| CY Other Expenses | $16,938,929 | CYOtherExpensesAmt |
| PY Total Expenses | $51,356,995 | PYTotalExpensesAmt |
| CY Total Expenses | $47,137,414 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,538,189 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,881,215 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $37,565,072 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,060,032 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,202,708 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,189,810 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $30,362,364 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $28,870,222 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OPERATION OF HOSPITAL AND MEDICAL CLINIC - 3,017 INPATIENT DAYS (INCLUDING SWING) PLUS EMERGENCY, ANCILLARY AND OUTPATIENT SERVICES FOR RESIDENTS IN PARIS, EDGAR COUNTY, AND EAST CENTRAL ILLINOIS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $45,953,683 | ExpenseAmt |
| Revenue | $45,184,056 | RevenueAmt |
| Desc | OPERATION OF HOSPITAL AND MEDICAL CLINIC - 3,017 INPATIENT DAYS (INCLUDING SWING) PLUS EMERGENCY, ANCILLARY AND OUTPATIENT SERVICES FOR RESIDENTS IN PARIS, EDGAR COUNTY, AND EAST CENTRAL ILLINOIS. | Desc |
| Total Program Service Expenses | $45,953,683 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 457 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARTIN D ADAMS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2174654141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 721 E COURT ST | AddressLine1Txt |
| City | PARIS | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61944 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| NOLAN LONGEST | ||||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY LIZ WRIGHT | ||||||||
| BOARD VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RENEE CRAIG | ||||||||
| BOARD TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN BLAIR | ||||||||
| BOARD SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVE FRISSE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | 1.00 | ||
| TOM HEBERMEHL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SCOTT HOGAN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAIME HOULIHAN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NED JENISON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DARRIN JOHNSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MANDY NEAL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DOUG SMITTKAMP | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CRAIG SMITH | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DR LELAND PHIPPS | ||||||||
| CHIEF OF MEDICAL STAFF | 40.00 | Yes (X) | $308,614 | $0 | $16,949 | |||
| DR REID SUTTON MD | ||||||||
| CHIEF OF MEDICAL STAFF | 40.00 | Yes (X) | $295,689 | $0 | $30,636 | |||
| BRUCE YOUNG | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BARBARA DICK | ||||||||
| BOARD SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KEITH PERRY | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARTIN D ADAMS | ||||||||
| CFO | 40.00 | $180,183 | $0 | $25,022 | 1.00 | Yes (X) | ||
| OLIVER M SMITH | ||||||||
| CEO | 40.00 | $284,308 | $0 | $29,832 | 1.00 | Yes (X) | ||
| SUSAN LIVVIX | ||||||||
| VP OF NURSING & PROFESSIONAL SERVICES | 40.00 | $160,391 | $0 | $24,535 | Yes (X) | |||
| DR BRUCE J HOULE | ||||||||
| PHYSICIAN | 40.00 | $472,966 | $0 | $9,183 | Yes (X) | |||
| DR RAHAT HAMEED SHEIKH | ||||||||
| PHYSICIAN | 40.00 | $411,926 | $0 | $31,982 | Yes (X) | |||
| DR JUHUI LI | ||||||||
| PHYSICIAN | 40.00 | $405,207 | $0 | $32,836 | Yes (X) | |||
| DR JOHN P NADEAU | ||||||||
| PHYSICIAN | 40.00 | $385,703 | $0 | $24,953 | Yes (X) | |||
| DR ARTURO MENCHACA | ||||||||
| PHYSICIAN | 40.00 | $332,919 | $0 | $24,143 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,237,906 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $250,071 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 40 | 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 |
|---|---|---|---|---|---|
| MIDWEST EMERGENCY | |||||
| 320 EAST HIGHWAY 50 | OFALLON | IL | 62269 | ER PHYSICIAN SERVICES | $2,061,410 |
| HERITAGE BUILDERS | |||||
| 1016 SOUTH WILLOW | EFFINGHAM | IL | 62401 | CONSTRUCTION MANAGEMENT/GENERAL CONTRACT | $993,866 |
| ULTRA GROUP | |||||
| 651 E 4TH ST SUITE 100 | CHATTANOOGA | TN | 37403 | PROFESSIONAL STAFFING & MANAGEMENT SERVI | $455,351 |
| LABORATORY CORP OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LAB WORK | $353,594 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 72633 | LUCUM TENENS/PHYSICIAN STAFFING | $188,623 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $50,281 | GovernmentGrantsAmt |
| All Other Contributions | $1,898 | AllOtherContributionsAmt |
| Total Contributions | $52,179 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $42,605,479 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $42,605,479 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $42,605,479 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,139 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $71,139 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,964 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,964 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,964 | TotalRevenueColumnAmt |
| Exclusion | $19,964 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| 340B Revenue | $1,454,150 | $1,454,150 |
| Other Operating Revenue | $980,300 | $980,300 |
| Cafeteria Income | $72,988 | $72,988 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,507,438 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,256,199 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $45,184,056 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $19,964 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $624,882 | TotalAmt |
| Management And General | $624,882 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,364,774 | TotalAmt |
| Program Services | $23,364,774 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $470,936 | TotalAmt |
| Program Services | $470,936 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,199,540 | TotalAmt |
| Program Services | $4,120,151 | ProgramServicesAmt |
| Management And General | $79,389 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,538,353 | TotalAmt |
| Program Services | $1,538,353 | ProgramServicesAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $479,460 | TotalAmt |
| Management And General | $479,460 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,388 | TotalAmt |
| Program Services | $82,388 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,455 | TotalAmt |
| Program Services | $45,455 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $197,942 | TotalAmt |
| Program Services | $197,942 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,059 | TotalAmt |
| Program Services | $131,059 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $715,826 | TotalAmt |
| Program Services | $715,826 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,766 | TotalAmt |
| Program Services | $274,766 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,097 | TotalAmt |
| Program Services | $91,097 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,343,005 | TotalAmt |
| Program Services | $2,343,005 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $736,474 | TotalAmt |
| Program Services | $736,474 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Supplies | $4,644,425 | $4,644,425 |
| Outside Services | $3,079,403 | $3,079,403 |
| Physician Fees | $2,960,086 | $2,960,086 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,157,543 | TotalAmt |
| Program Services | $1,157,543 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,137,414 | TotalAmt |
| Program Services | $45,953,683 | ProgramServicesAmt |
| Management And General | $1,183,731 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,450 | BOYAmt |
| EOY | $9,864,711 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,116,972 | BOYAmt |
| EOY | $364,094 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,495 | BOYAmt |
| EOY | $100,498 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,675,077 | BOYAmt |
| EOY | $7,369,675 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $910,321 | BOYAmt |
| EOY | $48,122 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,367,713 | BOYAmt |
| EOY | $1,277,683 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $609,824 | BOYAmt |
| EOY | $392,805 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $46,291,132 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,235,145 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,465,911 | BOYAmt |
| EOY | $15,055,987 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,683 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,626 | BOYAmt |
| EOY | $586,457 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,565,072 | BOYAmt |
| EOY | $35,060,032 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,586,683 | BOYAmt |
| EOY | $3,931,351 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,616,025 | BOYAmt |
| EOY | $2,258,459 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,202,708 | BOYAmt |
| EOY | $6,189,810 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,114,559 | BOYAmt |
| EOY | $28,284,052 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $247,805 | BOYAmt |
| EOY | $586,170 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,362,364 | BOYAmt |
| EOY | $28,870,222 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,565,072 | BOYAmt |
| EOY | $35,060,032 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,881,215 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $389,073 | OtherChangesInNetAssetsAmt |
| 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $403,842 | OtherCostOrOtherBasisAmt |
| Book Value | $403,842 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $24,822,186 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,625,476 | DepreciationAmt |
| Book Value | $8,196,710 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $74,744 | OtherCostOrOtherBasisAmt |
| Depreciation | $62,286 | DepreciationAmt |
| Book Value | $12,458 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $17,113,271 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,917,955 | DepreciationAmt |
| Book Value | $4,195,316 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,877,089 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,629,428 | DepreciationAmt |
| Book Value | $2,247,661 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $15,055,987 | TotalBookValueLandBuildingsAmt |
| 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 | There were no uncertain tax benefits or liabilities identified and recorded as of December 31, 2017. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent250 | Yes (X) | Percent250Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $345,608 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $345,608 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00730 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,102,890 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,717,169 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,385,721 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09300 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,448,498 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,717,169 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,731,329 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10030 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $3,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,451,498 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,717,169 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $4,734,329 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.10040 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,167 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $88,167 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $88,167 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $88,167 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00190 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense | $2,135,831 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $640,750 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $15,350,079 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $18,009,037 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,658,958 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | PARIS COMMUNITY HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 721 E COURT ST | AddressLine1Txt |
| City | PARIS | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 61944 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | FAMILY MEDICAL CENTER | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARIS COMMUNITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 16 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | www.myhorizonhealth.org/community-resources/community-health-needs/ | OwnWebsiteURLTxt |
| Other Website URL | www.myhorizonhealth.org/community-resources/community-health-needs/ | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 16 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | www.myhorizonhealth.org/community-resources/community-health-needs/ | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 250.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | 0 | IncludesPublicityMeasuresInd |
| FAP Actions On Nonpayment | 0 | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| 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 (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PARIS COMMUNITY HOSPITAL | Part V, Section B, Line 5: A CONSULTANT LED AN INTERNAL WORKING GROUP TO CONDUCT THREE FOCUS GROUPS COMPRISED OF AREA HEALTH CARE PROFESSIONALS/PARTNERS AND LOCAL OFFICIALS/COMMUNITY LEADERS. |
| PARIS COMMUNITY HOSPITAL | Part V, Section B, Line 11: AN IMPLEMENTATION STRATEGY WAS DEVELOPED IN THE FOURTH QUARTER OF 2016 AND EXECUTION OF THE STRATEGY BEGAN IN 2017. THE IMPLEMENTATION STRATEGY ADDRESSES ALL SIGNIFICANT NEEDS IDENTIFIED IN THE CHNA CONDUCTED IN 2016. THE HOSPITAL IS EXECUTING STRATEGIES AS THEY BECOME FINANCIALLY FEASIBLE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 5 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - FAMILY MEDICAL CENTER | ||||
| 727 E COURT STREET | PARIS | IL | 61944 | RURAL HEALTH CLINIC |
| 2 - FAMILY MEDICAL CENTER | ||||
| 112 W MADISON AVENUE | CHRISMAN | IL | 61924 | RURAL HEALTH CLINIC |
| 3 - SENOIR CARE | ||||
| 15323 US HIGHWAY 150 | PARIS | IL | 61944 | CLINIC |
| 4 - FAMILY MEDICAL CENTER | ||||
| 5 S WALNUT ST | OAKLAND | IL | 61943 | RURAL HEALTH CLINIC |
| 5 - WALK-IN CLINIC EZ CARE | ||||
| 1 PHIPPS LANE | PARIS | IL | 61944 | CLINIC |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 7: | THE ORGANIZATION USED AN OVERALL COST TO CHARGE RATIO TO DETERMINE THE AMOUNTS ON PARIT I OF THE SCHEDULE H. |
| Part II, Community Building Activities: | THE ORGANIZATION EXPENDED FUNDS TO RECRUIT ADDITIONAL PHYSICIANS TO THE COMMUNITY WHICH IS MEDICALLY UNDERSERVED. |
| Part III, Line 2: | IT IS ESTIMATED THAT 30% OF BAD DEBTS WOULD BE ELIGIBLE FOR FINANCIAL ASSISTANCE IF THE PATIENTS APPLIED AND PROVIDED FAMILY INCOME INFORMATION. THIS PORTION OF BAD DEBT SHOULD BE INCLUDED IN COMMUNITY BENEFIT AS THE PATIENTS ARE UNINSURED AND PRESUMED TO BE NEEDY AND UNABLE TO PAY FOR THE SERVICES. |
| Part III, Line 8: | THE SAME COST TO CHARGE RATIO CALCULATED TO DETERMINE COMMUNITY BENEFIT EXPENSES IN PART I WAS APPLIED TO MEDICARE CHARGES TO DETERMINE ESTIMATED COST. UNPAID COST OF MEDICARE REPRESENTS THE COST OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM, IN EXCESS OF PAYMENTS FOR THOSE SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT 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. |
| Part III, Line 9b: | PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE IDENTIFIED AT REGISTRATION WITH A UNIQUE FINANCIAL CLASS CODE. IF THEY QUALIFY FOR 100% ASSISTANCE, THEIR ACCOUNT IS ADJUSTED TO ZERO AND NO BILL IS SENT. IF THEY QUALIFY FOR PARTIAL ASSISTANCE, THEIR ACCOUNT IS ADJUSTED ACCORDINGLY BEFORE A BILL IS SENT FOR THE BALANCE DUE. |
| Part VI, Line 2: | ON A BI-ANNUAL BASIS THE HOSPITAL'S MANAGEMENT COMPANY, ALONG WITH ADMINISTRATIVE STAFF, MEET IN A RETREAT WITH THE BOARD OF DIRECTORS AND MEDICAL STAFF TO ASSESS AND PLAN FOR THE NEEDS OF THE COMMUNITY. A PHONE SURVEY OF 375 RESIDENTS OF THE HOSPITAL'S SERVICE ARE IS PERFORMED TO GET COMMUNITY INPUT. |
| Part VI, Line 3: | NOTICES OF THE AVAILABILITY OF FINANCIAL ASSISTANCE ARE POSTED IN ADMISSIONS AREA OF THE HOSPITAL AND MEDICAL CENTER AND IN THE EMERGENCY ROOM. UNINSURED PATIENTS NOT ALREADY IN THE PROGRAM ARE GIVEN A BROCHURE THAT EXPLAINS THE PROGRAM ALONG WITH AN APPLICATION WHEN THEY ARE ADMITTED OR REGISTERED. A BROCHURE IS INCLUDED IN THE INFORMATION PACKET GIVEN TO ALL INPATIENTS. INFORMATION IS ALSO POSTED ON THE HOSPITAL'S WEBSITE. THE FINANCIAL ASSISTANCE CORRDINATOR FOLLOW UP WITH PATIENTS TO ANSWER QUESTIONS AND PROVIDE ASSISTANCE IN APPLYING. ALL BILLS SENT TO THE HOSPITAL PATIENTS INCLUDE A MESSAGE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND WHO TO CONTACT TO APPLY. PATIENTS ARE SCREENED FOR STATE PROGRAMS AND ASSITED WITH APPLICATIONS. |
| Part VI, Line 4: | THE ORGANIZATION'S CRITICAL ACCESS HOSPITAL (CAH) AND RURAL HEALTH CENTERS SERVE PRIMARILY THE RURAL EDGAR COUNTY, ILLINOIS THAT IS DESIGNATED BY THE STATE AS A MEDICALLY UNDERSERVED AREA. ABOUT HALF OF THE 18,000 POPULATION LIVE IN SMALL CITIES AND THE REST LIVE IN RURAL AREAS. THE LATEST CENSUS INFORMATION SHOWS THE MEAN PER CAPITA HOUSEHOLD INCOME TO BE $25,017 AND 17.1% OF EDGAR COUNTY FAMILIES HAVE INCOME BELOW THE POVERTY LEVEL. APPROXIMATELY 26.23% OF THE POPULATION IS ENROLLED IN THE STATE MEDICAID PROGRAM AND 19.34% OF THE RESIDENTS ARE 65 YEARS AND OLDER. |
| Part VI, Line 5: | THE ORGANIZATION CONDUCTS HEALTH FAIRS IN THE COMMUNITY THROUGHOUT THE YEAR AND PROVIDES VARIOUS HEALTH SCREENINGS FOR INDUSTRY WORKERS AND THE PUBLIC IN GENERAL. A MONTHLY NEWSLETTER IS DEVOTED TO INFORMING THE PUBLIC ABOUT TIMELY HEALTH ISSUES AND THE AVAILABILITY OF THE LOCAL HEALTH SERVICES. THE VOLUNTEER GOVERNING BODY IS COMPRISED MOSTLY OF PEOPLE WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OR ALL OF ITS DEPARTMENTS. ALL SURPLUS FUNDS ARE USED TO IMPROVE FACILITIES AND TO REPLACE OR UPGRADE EQUIPMENT TO PROVIDE THE HIGHEST QUALITY OF PATIENT CARE POSSIBLE. CONTINUOUS MEDICAL EDUCATION IS PROVIDED TO PHYSICIANS AND STAFF. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR LELAND PHIPPS | ||||||||||||||
| CHIEF OF MEDICAL STAFF | $226,053 | $0 | $82,561 | $0 | $0 | $0 | $12,150 | $0 | $4,799 | $0 | $325,563 | $0 | $0 | $0 |
| DR REID SUTTON MD | ||||||||||||||
| CHIEF OF MEDICAL STAFF | $295,689 | $0 | $0 | $0 | $0 | $0 | $12,611 | $0 | $18,025 | $0 | $326,325 | $0 | $0 | $0 |
| MARTIN D ADAMS | ||||||||||||||
| CFO | $180,183 | $0 | $0 | $0 | $0 | $0 | $6,306 | $0 | $18,716 | $0 | $205,205 | $0 | $0 | $0 |
| OLIVER M SMITH | ||||||||||||||
| CEO | $256,308 | $0 | $28,000 | $0 | $0 | $0 | $11,792 | $0 | $18,040 | $0 | $314,140 | $0 | $0 | $0 |
| SUSAN LIVVIX | ||||||||||||||
| VP OF NURSING & PROFESSIONAL SERVICE | $160,391 | $0 | $0 | $0 | $0 | $0 | $7,218 | $0 | $17,317 | $0 | $184,926 | $0 | $0 | $0 |
| DR BRUCE J HOULE | ||||||||||||||
| PHYSICIAN | $472,966 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,183 | $0 | $482,149 | $0 | $0 | $0 |
| DR RAHAT HAMEED SHEIKH | ||||||||||||||
| PHYSICIAN | $328,002 | $0 | $83,924 | $0 | $0 | $0 | $12,698 | $0 | $19,284 | $0 | $443,908 | $0 | $0 | $0 |
| DR JUHUI LI | ||||||||||||||
| PHYSICIAN | $405,207 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $32,836 | $0 | $438,043 | $0 | $0 | $0 |
| DR JOHN P NADEAU | ||||||||||||||
| PHYSICIAN | $385,703 | $0 | $0 | $0 | $0 | $0 | $7,059 | $0 | $17,894 | $0 | $410,656 | $0 | $0 | $0 |
| DR ARTURO MENCHACA | ||||||||||||||
| PHYSICIAN | $332,919 | $0 | $0 | $0 | $0 | $0 | $4,803 | $0 | $19,340 | $0 | $357,062 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF PARIS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 376000744 | BondIssuerEIN |
| Bond Issued | 2003-12-01 | BondIssuedDt |
| Issue Price | $6,060,000 | IssuePriceAmt |
| Purpose | CONSTRUCTION OF ADDITIONAL FACILITIES | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | Yes (1) | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $6,060,000 | TotalProceedsAmt |
| Refunding Escrow | $989,995 | RefundingEscrowAmt |
| Issuance Costs From Proceeds | $60,000 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $5,010,005 | CapitalExpendituresAmt |
| Current Refunding | 0 | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00800 | PrivateBusUseByOthersPct |
| Total Private Business Use | 0.00800 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| PARIS CLINIC PHARMACY | |||
| OWNER IS A DIRECTOR | $14,631 | LEASE OF PHARMACY SPACE | 0 |
| MAIN STREET CAFE | |||
| OWNER IS A SPOUSE OF A DIRECTOR | $29,001 | CATERING/MEALS | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 3 | THE HOSPITAL HAS A CONSULTING AGREEMENT WITH BLUE MANAGEMENT SERVICES, LLC d/b/a ALLIANT MANAGEMENT SERVICES TO ADVISE ON HOSPITAL OPERATIONS. |
| Form 990, Part VI, Section A, line 6 | MEMBERSHIP IS BY VIRTUE OF ACHIEVING CERTAIN LEVELS OF DONATION TO THE ORGANIZATION. |
| Form 990, Part VI, Section A, line 7a | THE ORGANIZATION HAS MEMBERS AND THEY HAVE CERTAIN RIGHTS INCLUDING THE RIGHT TO VOTE ON MEMBERS OF THE BOARD. MEMBERSHIP OF THE ORGANIZATION IS BY VIRTURE OF ACHIEVING CERTAIN LEVEL OF DONATION TO THE ORGANIZATION. OTHER RIGHTS INCLUDE THE RIGHT TO RECEIVE AN ANNUAL REPORT AND TO ATTEND THE ANNUAL MEETING AT WHICH TIME NOMINATIONS FOR MEMBERS OF THE BOARD MAY BE MADE AND MEMBERS OF THE BOARD ARE ELECTED OR RE-ELECTED BY VOTE OF MEMBERS. |
| Form 990, Part VI, Section B, line 11b | THE ORGANIZATION POSTS THE FORM 990 TO THE HOSPITAL'S INTRANET AND EACH MEMBER OF THE BOARD OF DIRECTORS, CEO AND CFO ARE ASKED TO REVIEW BEFORE THE FINAL 990 IS FILED. |
| Form 990, Part VI, Section B, line 12c | CONFLICT OF INTEREST STATEMENTS ARE GIVEN TO THE BOARD MEMBERS YEARLY AND ARE ACCUMULATED BY THE PRESIDENT/CEO'S SECRETARY WHO MONITORS THAT ALL ARE RETURNED. |
| Form 990, Part VI, Section B, line 15 | CEO/CFO REVIEW PROCESS - EACH BOARD MEMBER IS ASKED TO COMPLETE A SURVEY THAT SCORES THE CEO/CFO IN SEVERAL AREAS OF JOB PERFORMACE ADN COMMUNITY INVOLVEMENT. THE EXECUTIVE COMMITTEE OF THE BOARD TOGETHER WITH A REPRESENTATIVE FROM ALLIANT MANAGEMENT SERVICES REVIEWS THE SURVEY RESULTS AND REVIEWS SALARY SURVEY DATA FOR THE SAME POSITIONS IN COMPARABLE ORGANIZATIONS. PHYSICIAN EMPLOYEE REVIEW PROCESS - PHYSICIANS ARE REVIEWED BY THE RECRUITMENT AND RETENTION COMMITTEE OF THE BOARD AND THE CEO PRESENTS THEM WITH MARKET BENCHMARK DATA THAT COMPARES THEIR PRODUCTION AND SALARY LEVEL AND THE CEO MAKES A RECOMMENDATION. NON-PHYSICIAN REVIEW PROCESS - NON-PHYSICIAN EMPLOYEES ARE EVALUATED BY THE CEO AND MARKET BENCHMARK DATA IS OBTAINED FOR REVIEW IN MAKING A DECISION ON SALARY CHANGES. COST OF LIVING ADJUSTMENTS ARE APPROVED BY THE BOARD. |
| Form 990, Part VI, Section C, line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST FROM ADMINISTRATION. |
| Form 990, Part XI, line 9: | Changes for Foundation Net Assets 389,073. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARIS COMMUNITY HOSPITAL FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 721 EAST COURT ST | AddressLine1Txt |
| City | PARIS | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 619442460 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473034746 | EIN |
| Primary Activities | FOUNDATION - SUPPORTING ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501C | ExemptCodeSectionTxt |
| Public Charity Status | Line 12a, I | PublicCharityStatusTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| 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 | 0 | 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 | Yes (1) | 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 | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |