HARRISBURG MEDICAL CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- HARRISBURG MEDICAL CENTER INC (EIN 23-7426289)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-04-30
- IRS object ID
- 201821209349300507
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-04-30T08:17:00-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 WASHINGTON AVENUE SUITE 1800 | AddressLine1Txt |
| City | ST LOUIS | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237426289 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARR | BusinessNameControlTxt |
| Phone | 6182537671 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DRIVE | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUNE HAYES | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 6182537671 | PhoneNum |
| Signature | 2018-04-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFF PARKER | PreparerPersonNm |
| PTIN | P00970069 | PTIN |
| Phone | 3149254300 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-04-26 | IPDt |
| IP Tm | 12:08:10 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 5C592A38642564D958275A63599AC7915113978F | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 4264D1B680993024C276DC83B894831CF63E241F | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JUNE HAYES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DRIVE | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $69,657,888 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HARRISBURGMC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1975 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF HARRISBURG MEDICAL CENTER IS TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 654 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $150 | PYContributionsGrantsAmt |
| CY Contributions Grants | $51,927 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $52,393,269 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $61,465,955 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$8,300 | PYInvestmentIncomeAmt |
| CY Investment Income | -$58,666 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $228,263 | CYOtherRevenueAmt |
| PY Total Revenue | $52,385,119 | PYTotalRevenueAmt |
| CY Total Revenue | $61,687,479 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,712 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $33,988,212 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $34,489,329 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,886,898 | PYOtherExpensesAmt |
| CY Other Expenses | $26,880,697 | CYOtherExpensesAmt |
| PY Total Expenses | $56,875,110 | PYTotalExpensesAmt |
| CY Total Expenses | $61,378,738 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,489,991 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $308,741 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $41,815,143 | TotalAssetsBOYAmt |
| Total Assets EOY | $45,443,478 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,512,539 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $19,599,394 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,302,604 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $25,844,084 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF HARRISBURG MEDICAL CENTER IS TO MAINTAIN AND IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $54,909,560 | ExpenseAmt |
| Grant | $8,712 | GrantAmt |
| Revenue | $61,465,955 | RevenueAmt |
| Desc | IN SUPPORT OF ITS MISSION, THE HOSPITAL PROVIDES CARE TO PATIENTS AT LESS THAN ITS ESTABLISHED CHARGES FOR PATIENTS THAT MEET THE HOSPITAL'SFINANCIAL ASSISTANCE CRITERIA. BECAUSE THE HOSPITAL DOES NOT PURSUECOLLECTION 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 $3,294,000 FOR 2017. 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 MANY TIMES THE PAYMENTS ARE LESS THAN THE COST OF RENDERING CARE. | Desc |
| Total Program Service Expenses | $54,909,560 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 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 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 55 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 654 | 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 | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUNE HAYES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6182537671 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DR | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| STEVE LEDBETTER | ||||||||
| BOARD CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DENNIS MURPHY | ||||||||
| VICE-CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TOM DAVIS | ||||||||
| SECRETARY/TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LARRY JONES | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| HAROLD WILSON | ||||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| JOAN HARPER | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY SUE EWING | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| BENNA DAUGHERTY | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID EDMISTER | ||||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| KOLBY SMITHPETERS | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MIKE WILLIAMS | ||||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL TISON | ||||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| JIM HAYES | ||||||||
| PAST BOARD CHAIRPERSON | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID DISNEY | ||||||||
| PAST BOARD CHAIRPERSON | 4.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES C HENSON | ||||||||
| PAST BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RODNEY SMITH | ||||||||
| PRESIDENT/CEO | 39.00 | Yes (X) | $290,063 | $0 | $23,831 | 1.00 | ||
| THERESA JUNE HAYES | ||||||||
| VICE-PRESIDENT/CFO | 40.00 | Yes (X) | $178,477 | $0 | $16,087 | |||
| CINDY FORD | ||||||||
| VICE-PRESIDENT/CNO | 40.00 | Yes (X) | $127,956 | $0 | $5,811 | |||
| DANIEL LAMPLEY | ||||||||
| VICE-PRESIDENT/COO | 40.00 | Yes (X) | $180,586 | $0 | $13,203 | |||
| JAMES ALEXANDER | ||||||||
| PHYSICIAN | 40.00 | $570,673 | $0 | $14,121 | Yes (X) | |||
| THOMAS BUCINSKI | ||||||||
| PHYSICIAN | 36.00 | $331,252 | $0 | $17,078 | Yes (X) | |||
| SAMIR ABDO | ||||||||
| PHYSICIAN | 36.00 | $284,730 | $0 | $17,546 | Yes (X) | |||
| CLAYTON FORD | ||||||||
| PHYSICIAN | 40.00 | $280,112 | $0 | $16,299 | Yes (X) | |||
| KIMBALL EWELL | ||||||||
| PHYSICIAN | 40.00 | $271,977 | $0 | $17,473 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,515,826 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $141,449 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | 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 |
|---|---|---|---|---|---|
| MORTHLAND COLLEGE HEALTH SERVICES | |||||
| 309 WEST ST LOUIS STREET SUITE B | WEST FRANKFORT | IL | 62896 | HOSPITALISTS AND ER PHYSICIANS | $2,349,676 |
| MORTHLAND COLLEGE SPECIALTY PHYSICIANS | |||||
| 11057 COUNTRY CLUB ROAD | WEST FRANKFORT | IL | 62896 | SPECIALTY PHYSICIANS | $527,543 |
| HORIZON MENTAL HEALTH MANAGEMENT | |||||
| PO BOX 840839 | DALLAS | TX | 752840839 | MANAGEMENT COMPANY FOR BEHAVIORAL HEALTH | $344,229 |
| SELECT PSYCHIATRIC MGMT GROUP | |||||
| 112 AIRWAY DRIVE | MARION | IL | 62959 | MEDICAL DIRECTORSHIP/CALL COVERAGE PSYCH | $307,365 |
| BARTON ASSOCIATES | |||||
| 300 JUBILEE DRIVE | PEABODY | MA | 01960 | MEDICAL STAFFING | $302,269 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $50,000 | RelatedOrganizationsAmt |
| All Other Contributions | $1,927 | AllOtherContributionsAmt |
| Total Contributions | $51,927 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624110 | $61,337,152 | $61,337,152 |
| RENT REVENUE | 624100 | $128,803 | $128,803 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $61,465,955 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,159 | TotalRevenueColumnAmt |
| Exclusion | $45,159 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,866,584 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,937,906 | SecuritiesAmt |
| Other | $32,503 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$71,322 | SecuritiesAmt |
| Other | -$32,503 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$103,825 | TotalRevenueColumnAmt |
| Exclusion | -$103,825 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 624110 | $112,547 | $112,547 |
| OTHER MISCELLANEOUS | 624100 | $105,645 | $105,645 |
| COIN MACHINES & TV | 624100 | $5,196 | $5,196 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,875 | TotalRevenueColumnAmt |
| Exclusion | $4,875 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $228,263 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $61,687,479 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $61,465,955 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $169,597 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,712 | TotalAmt |
| Program Services | $8,712 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $886,661 | TotalAmt |
| Management And General | $886,661 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,811,161 | TotalAmt |
| Program Services | $23,175,459 | ProgramServicesAmt |
| Management And General | $1,635,702 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $747,027 | TotalAmt |
| Program Services | $673,703 | ProgramServicesAmt |
| Management And General | $73,324 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,290,918 | TotalAmt |
| Program Services | $5,673,435 | ProgramServicesAmt |
| Management And General | $617,483 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,753,562 | TotalAmt |
| Program Services | $1,581,442 | ProgramServicesAmt |
| Management And General | $172,120 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,750 | TotalAmt |
| Management And General | $49,750 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,741,837 | TotalAmt |
| Program Services | $6,939,344 | ProgramServicesAmt |
| Management And General | $802,493 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,710 | TotalAmt |
| Program Services | $460 | ProgramServicesAmt |
| Management And General | $354,250 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,269,913 | TotalAmt |
| Program Services | $3,506,101 | ProgramServicesAmt |
| Management And General | $763,812 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $672,137 | TotalAmt |
| Program Services | $665,358 | ProgramServicesAmt |
| Management And General | $6,779 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,960 | TotalAmt |
| Program Services | $142,038 | ProgramServicesAmt |
| Management And General | $24,922 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,058 | TotalAmt |
| Program Services | $24,158 | ProgramServicesAmt |
| Management And General | $10,900 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $454,814 | TotalAmt |
| Program Services | $453,014 | ProgramServicesAmt |
| Management And General | $1,800 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,643,257 | TotalAmt |
| Program Services | $2,643,257 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $888,375 | TotalAmt |
| Management And General | $888,375 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,115,124 | $3,115,124 | $0 |
| BAD DEBT EXPENSE | $2,763,200 | $2,763,200 | $0 |
| PHARMACY SUPPLIES | $2,756,250 | $2,756,250 | $0 |
| FOOD & DIETARY | $335,029 | $329,454 | $5,575 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $634,283 | TotalAmt |
| Program Services | $459,051 | ProgramServicesAmt |
| Management And General | $175,232 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,378,738 | TotalAmt |
| Program Services | $54,909,560 | ProgramServicesAmt |
| Management And General | $6,469,178 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,076,858 | BOYAmt |
| EOY | $49,361 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $501,387 | BOYAmt |
| EOY | $1,307,852 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,838,076 | BOYAmt |
| EOY | $13,066,859 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,572 | BOYAmt |
| EOY | $59,351 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,116 | BOYAmt |
| EOY | $261,523 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,212,919 | BOYAmt |
| EOY | $1,434,511 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $932,545 | BOYAmt |
| EOY | $897,410 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $50,064,602 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $24,363,738 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,672,998 | BOYAmt |
| EOY | $25,700,864 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,984,064 | BOYAmt |
| EOY | $2,619,843 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,625 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,983 | BOYAmt |
| EOY | $45,904 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,815,143 | BOYAmt |
| EOY | $45,443,478 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,420,240 | BOYAmt |
| EOY | $5,869,551 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $12,455,120 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,092,299 | BOYAmt |
| EOY | $1,274,723 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,512,539 | BOYAmt |
| EOY | $19,599,394 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,302,604 | BOYAmt |
| EOY | $25,844,084 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,302,604 | BOYAmt |
| EOY | $25,844,084 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,815,143 | BOYAmt |
| EOY | $45,443,478 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $308,741 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $232,739 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $18,791 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $18,791 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | THE HOSPITAL PAYS MEMBERSHIP DUES TO THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION (IHA) AND THE AMERICAN HOSPITAL ASSOCIATION (AHA), A PERCENTAGE OF THESE DUES IS SPENT ON LOBBYING ACTIVITIES BY THESE ASSOCIATIONS. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $810,438 | OtherCostOrOtherBasisAmt |
| Book Value | $810,438 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $27,222,357 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,962,502 | DepreciationAmt |
| Book Value | $14,259,855 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $882,870 | OtherCostOrOtherBasisAmt |
| Depreciation | $533,431 | DepreciationAmt |
| Book Value | $349,439 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,042,650 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,867,805 | DepreciationAmt |
| Book Value | $5,174,845 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,106,287 | OtherCostOrOtherBasisAmt |
| Book Value | $5,106,287 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,700,864 | 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 | THE ORGANIZATION APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION DOES NOT CURRENTLY INCLUDE AN INCOME TAX PROVISION IN THE CONSOLIDATED FINANCIAL STATEMENTS. MANAGEMENT MONITORS THE REPORTING OF UNCERTAIN TAX POSITIONS, WHICH COULD RESULT IN RECORDING OF AN INCOME TAX PROVISION IN THE FUTURE. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,123,582 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $1,123,582 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01830 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $19,068,412 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,488,591 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,579,821 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15610 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,191,994 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,488,591 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,703,403 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17440 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $20,191,994 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,488,591 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $10,703,403 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.17440 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $2,763,200 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $921,067 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $12,732,806 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $20,503,705 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$7,770,899 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DRIVE | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.HARRISBURGMC.COM | WebsiteAddressTxt |
| State License | 521 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, PAGE 8 | OwnWebsiteURLTxt |
| 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 | SEE PART V, PAGE 8 | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Provided Nonprofit Contact | Yes (X) | ProvidedNonprofitContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | SEE FOLLOWING NOTE FOR FULL URL FOR FINANCIAL ASSISTANCE POLICY | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | SEE FOLLOWING NOTE FOR FULL URL FOR FAP APPLICATION | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | SEE FOLLOWING NOTE FOR FULL URL FOR FAP PLAIN LANGUAGE SUMMARY | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| HARRISBURG MEDICAL CENTER | PART V, SECTION B, LINE 5: A SURVEY OF COMMUNITY MEMBERS WAS DEVELOPED THAT ASKED SEVERAL QUESTIONS RELATED TO INDIVIDUAL HEALTH AND ACCESS TO CARE, HEALTH SERVICES CHALLENGES AND RISK FACTORS. THE ORGANIZATION ASKED AREA PHYSICIANS ABOUT THEIR THOUGHTS, CONCERNS AND IDEAS ABOUT THE HEALTH OF THE COMMUNITY AND THEIR PATIENTS VIA HARD COPY SURVEY. HMC ALSO FACILITATED A FOCUS GROUP MEETING WITH KEY COMMUNITY MEMBERS REPRESENTING BROAD INTERESTS OF THE COMMUNITY. INVITATION WAS BASED ON THE INDIVIDUAL'S KNOWLEDGE OF AND INTEREST IN COMMUNITY HEALTH ISSUES AFFECTING THE ORGANIZATION'S PRIMARY SERVICE AREA. HMC ALSO ANALYZED DATA FROM OTHER AREA AGENCIES' COMMUNITY ASSESSMENTS. |
| HARRISBURG MEDICAL CENTER | PART V, SECTION B, LINE 11: THE TOP THREE PRIORITY HEALTH NEEDS IDENTIFIED FOR HARRISBURG MEDICAL CENTER THAT ARE ADDRESSED IN THE IMPLEMENTATION PLAN ARE:1) MENTAL HEALTH:FOCUS ON ACCESS TO AND TREATMENT OF INDIVIDUALS HAVING MENTAL HEALTH ISSUES OTHER THAN THE EMERGENCY ROOM.2) CHRONIC DISEASES:ENCOURAGE HEALTHY LIFESTYLES AND PROVIDE EDUCATIONAL ACTIVITIES TO ELEMENTARY SCHOOL AGE CHILDREN TO HELP PREVENT CONGESTIVE HEART FAILURE (CHF) AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD), DIABETES, AND OBESITY IN LATER LIFE.3) SUBSTANCE ABUSE: FOCUS ON THE DEVELOPMENT OF A HOSPITAL PROVIDED INPATIENT MEDICAL STABILIZATION RELATED WITHDRAWAL FROM SUBSTANCE ABUSE/ADDICTION AND A STRONG OUTPATIENT NETWORK OF PROGRAMS AND PROVIDERS FOR TREATMENT OF PATIENTS WITH SUBSTANCE ABUSE/ADDICTION RELATED TO DRUGS AND ALCOHOL. |
| HARRISBURG MEDICAL CENTER | PART V, SECTION B, LINE 13H: IF A PATIENT MEETS THE PRESUMPTIVE ELIGIBILITY CATEGORIES LISTED BELOW, THE PATIENT SHALL NOT BE REQUIRED TO COMPLETE THE FINANCIAL ASSISTANCE APPLICATION AND SHALL BE DEEMED TO RECEIVE A 100% ALLOWANCE. PRESUMPTIVE ELIGIBILITY CATEGORIES:1. HOMELESSNESS-WHICH IS 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 (I.E. HOSPITAL INPATIENT CO-PAYS, NONCOVERED DAYS, NON-COVERED CHARGES AND SPENDDOWN AMOUNTS. NOTE: THIS DOES NOT INCLUDE OFFICE CO-PAY AMOUNTS).6. INCARCERATION IN A PENAL INSTITUTION. |
| SCHEDULE H, PART V, SECTION B, LINE 16A | THE FAP WAS WIDELY AVAILABLE AT:HTTP://WWW.HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2018/02/FINANCIAL-ASSISTANCE-POLICY-AND-GUIDELINES.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 16B | THE FAP APPLICATION WAS WIDELY AVAILABLE AT:HTTP://WWW.HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2017/05/FAP-SUMMARY_APP-4-1-17.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 16C | THE FAP PLAIN LANGUAGE SUMMARY WAS WIDELY AVAILABLE AT:HTTP://WWW.HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2017/05/FAP-SUMMARY_APP-4-1-17.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 7A | THE ORGANIZATION'S MOST RECENT CHNA REPORT CAN BE FOUND AT:WWW.HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2016/11/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF |
| SCHEDULE H, PART V, SECTION B, LINE 10A | THE ORGANIZATION'S MOST RECENTLY ADOPTED IMPLEMENTATION STRATEGY CAN BE FOUND WITH ITS CHNA REPORT AT:WWW.HARRISBURGMC.COM/WP-CONTENT/UPLOADS/2016/11/COMMUNITY-HEALTH-NEEDS-ASSESSMENT.PDF |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| 1 - HMC CLINIC AT HARRISBURG | ||||
| 901 S COMMERCIAL | HARRISBURG | IL | 62946 | PRIMARY CARE CLINIC |
| 2 - ELDORADO PRIMARY CARE | ||||
| 1007 US HIGHWAY 45 | ELDORADO | IL | 62930 | PROVIDER BASED RURAL HEALTH CLINIC |
| 3 - EQUALITY FAMILY PRACTICE | ||||
| 183 WEST LANE | EQUALITY | IL | 62934 | PROVIDER BASED RURAL HEALTH CLINIC |
| 4 - HMC CLINIC AT MARION | ||||
| 3106 OUTER DRIVE | MARION | IL | 62959 | PRIMARY CARE CLINIC |
| 5 - GALATIA PRIMARY CARE | ||||
| 124 EAST MAIN | GALATIA | IL | 62935 | PROVIDER BASED RURAL HEALTH CLINIC |
| 6 - MACH MINE CLINIC | ||||
| 16468 LIBERTY SCHOOL ROAD | MARION | IL | 62959 | PRIMARY CARE CLINIC |
| 7 - VIKING MINE CLINIC | ||||
| 13643 NORTH THOMPSONVILLE ROAD | MACEDONIA | IL | 62860 | PRIMARY CARE CLINIC |
| 8 - HMC SPECIALTY CLINIC | ||||
| 20 DR WARREN TUTTLE DRIVE | HARRISBURG | IL | 62946 | SPECIALTY MEDICINE CLINIC |
| 9 - HMC ORTHOPAEDIC CLINIC | ||||
| 50 DR WARREN TUTTLE DRIVE | HARRISBURG | IL | 62946 | ORTHOPAEDIC MEDICINE CLINIC |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | HOMELESSNESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION WITH NO REPRESENTATIVE, MEDICAID ELIGIBLE BUT NOT ON DATE OF SERVICE, MEDICAID ELIGIBLE ON DATE OF SERVICE, BUT SERVICE IS NON-COVERED, AND INCARCERATION IN A PENAL INSTITUTION QUALIFY A PATIENT UNDER THE PRESUMPTIVE ELIGIBILITY RULES FOR FINANCIAL ASSISTANCE. |
| PART I, LINE 7: | THE ORGANIZATION USED A COST-TO-CHARGE RATIO AS CALCULATED UTILIZING DATA FROM INTERNAL ACCOUNTING RECORDS AND USING A METHODOLOGY CONSISTENT WITH SCHEDULE H INSTRUCTIONS TO DETERMINE AMOUNTS ON LINES 7A AND 7B OF PART I SCHEDULE H. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2,763,200. |
| PART III, LINE 2: | THE HOSPITAL CALCULATED BAD DEBT EXPENSE AT COST USING THE COST-TO-CHARGE RATIO, AS CALCULATED USING WORKSHEET 2 OF THE SCHEDULE H INSTRUCTIONS. PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT ONLY AFTER ALL COLLECTION PROCEDURES HAVE BEEN EXHAUSTED AND AFTER ALL DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED. |
| PART III, LINE 3: | BASED ON THE HOSPITAL'S EXPERIENCE WITH ALL ITS PATIENTS, THE ORGANIZATION ESTIMATES THAT IT IS LIKELY THAT UP TO ONE-THIRD OF ACCOUNTS WRITTEN OFF TO BAD DEBT MAY HAVE QUALIFIED FOR FINANCIAL ASSISTANCE, BUT THE PATIENT CHOSE NOT TO APPLY. THEREFORE, 33.333% OF THE BAD DEBT ADJUSTMENTS ARE INCLUDED ON PART III, LINE 3 AT COST. |
| PART III, LINE 4: | THE ORGANIZATION'S BAD DEBT EXPENSE IS EXPLAINED IN NOTE 1 OF ITS AUDITED FINANCIAL STATEMENTS:--PATIENT ACCOUNTS RECEIVABLE--THE HOSPITAL PROVIDES AN ALLOWANCE FOR BAD DEBTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. PATIENT SERVICES ARE PROVIDED ON AN UNSECURED BASIS. PAYMENT IS REQUIRED UPON RECEIPT OF THE INVOICE. THE HOSPITAL BILLS THIRD-PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED. ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. AN ESTIMATED ALLOWANCE OF APPROXIMATELY $5,314,000 AND $3,893,000 WAS RECORDED AT JUNE 30, 2017 AND 2016, RESPECTIVELY. THE HOSPITAL'S ALLOWANCE FOR DOUBTFUL ACCOUNTS FOR SELF-PAY PATIENTS WAS AN AVERAGE OF 70% AND 78% OF SELF-PAY ACCOUNTS RECEIVABLE AT JUNE 30, 2017 AND 2016, RESPECTIVELY. DURING THE YEARS ENDING JUNE 30, 2017 AND 2016, THE HOSPITAL WROTE OFF APPROXIMATELY $2,763,000 AND $3,090,000, RESPECTIVELY. |
| PART III, LINE 8: | UNPAID COST OF MEDICARE REPRESENTS THE COST (DETERMINED USING THE OVERALL COST TO CHARGE RATIO) 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 HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. |
| PART III, LINE 9B: | THE ORGANIZATION APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS, BOTH FAP-ELIGIBLE AND FAP NON-ELIGIBLE PATIENTS. THE PROCEDURES FOR COLLECTION ON PATIENT ACCOUNTS ARE AS FOLLOWS:A.SELF-PAY PATIENTS RECEIVE THEIR FIRST STATEMENT WITHIN TEN DAYS OF DISCHARGE. TWO WEEKS AFTER THE FIRST STATEMENT, A FOLLOW-UP TELEPHONE CALL WILL BE MADE AND THE PATIENT WILL RECEIVE STATEMENTS AND LETTERS. ANY BALANCE REMAINING ON AN ACCOUNT AFTER INSURANCE HAS PAID IS HANDLED IN THE SAME WAY.B.FOLLOW UP TELEPHONE CALLS WILL BE MADE ONCE PER MONTH.C.IF A PAYMENT PLAN IS ESTABLISHED PER THE PAYMENT PLAN POLICY, THEN THE ACCOUNT WILL BE MONITORED ACCORDING TO THE TERMS OF THE PAYMENT PLAN.D.THE HOSPITAL OFFERS PATIENTS SEVERAL PAYMENT ALTERNATIVES:1.CASH/CHECK FOR THE FULL PAYMENT2.MASTERCARD, VISA, AMERICAN EXPRESS AND DISCOVER CREDIT CARDS3.FINANCIAL ASSISTANCE - HOSPITAL PERSONNEL ARE AVAILABLE TO ANSWER QUESTIONS AND ASSIST PATIENTS WITH GATHERING INFORMATION AND DOCUMENTATION TO QUALIFY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY.4.HOSPITAL SHORT TERM FINANCING - THE HOSPITAL WILL ACCEPT MONTHLY PAYMENT ARRANGEMENTS IN THOSE CIRCUMSTANCES WHERE FINANCIAL NEED IS VERIFIED BY THE BUSINESS OFFICE STAFF. THE MINIMUM MONTHLY PAYMENT AMOUNT FOR HOSPITAL ACCOUNTS IS $100 OR 1/25THOF THE ACCOUNT BALANCE, WHICHEVER IS GREATER. THE MINIMUM MONTHLY PAYMENT AMOUNT FOR CLINIC ACCOUNTS IS $25 OR 1/12TH OF THE ACCOUNT BALANCE, WHICHEVER IS GREATER. ANY VARIATIONS FROM THIS POLICY MUST BE APPROVED BY THE DIRECTOR OF PATIENT FINANCIAL SERVICES.E.AN ACCOUNT IS CONSIDERED DELINQUENT WHEN:1.NO PERSONAL PAYMENT OR REASONABLE PAYMENT ARRANGEMENTS ARE RECEIVED WITHIN 30 DAYS OF SERVICE OR 30 DAYS OF FINAL INSURANCE PAYMENT.2.THERE IS A FAILURE TO RESPOND TO PHONE CALLS AND/OR CORRESPONDENCE FOR 30 DAYS OR MORE.3.FAILURE TO COMPLY WITH THE TERMS OF A REASONABLE PAYMENT PLAN.4.STATEMENTS ARE RETURNED VIA US MAIL AND BUSINESS OFFICE IS UNABLE TO OBTAIN NEW ADDRESS INFORMATION.F.ONCE AN ACCOUNT HAS BEEN DETERMINED DELINQUENT:1.A FINAL NOTICE IS SENT TO THE PATIENT VIA US MAIL AND THE PATIENT HAS 14 DAYS TO RESPOND.2.IN THOSE CASES WHERE THE PATIENT FINANCIAL SERVICES STAFF HAS EXHAUSTED ALL REASONABLE EFFORTS TO COLLECT THE BALANCES DUE TO THE HOSPITAL, THE ACCOUNT(S) WILL BE REFERRED TO A LICENSED COLLECTION AGENCY FOR ADJUDICATION.FOR PATIENTS SPECIFICALLY SEEKING FINANCIAL ASSISTANCE THE PROCEDURES ARE AS FOLLOWS: DURING THE APPLICATION PERIOD (PRIOR TO SERVICE THOUGH THE 240TH DAY AFTER THE BILLING STATEMENT IS PROVIDED) ALL COLLECTIONS EFFORTS ARE SUSPENDED AND DOCUMENTED IN THE PATIENT'S ACCOUNT, PENDING DETERMINATION OF ELIGIBILITY. IF THE ACCOUNT HAS BEEN PLACED WITH AN OUTSIDE COLLECTION AGENCY, THE AGENCY IS NOTIFIED BY THE FINANCIAL COUNSELOR TO SUSPEND COLLECTION EFFORTS UNTIL A DETERMINATION IS MADE. THE NOTIFICATION IS ALSO DOCUMENTED IN THE PATIENT'S ACCOUNT. ALL EXTRAORDINARY COLLECTION ACTIONS ARE ALSO SUSPENDED, INCLUDING REPORTING TO CREDIT AGENCIES, SELLING THE DEBT TO A THIRD PARTY, AND COMMENCING CIVIL ACTION AGAINST THE INDIVIDUAL. |
| PART VI, LINE 2: | HOSPITAL ASSESSES HEALTHCARE NEEDS OF COMMUNITY AND HOW THE HOSPITAL MIGHTADDRESS THOSE NEEDS BY PARTICIPATING IN STRATEGIC PLANNING SESSIONS THAT INCLUDES COMMUNITY BOARD MEMBERS, PHYSICIANS AND STAFF. CEO ALSO PARTICIPATES IN STRATEGIC PLANNING SESSIONS WITH NEARBY REGIONAL HOSPITAL.CEO MEETS WITH LOCAL PROVIDERS AND ADMINISTRATORS FROM NURSING HOMES ANDOTHER LOCAL HOSPITALS TO DETERMINE HOW STRATEGIC ALLIANCES CAN BEST SERVICE OUR REGION'S PATIENTS. HOSPITAL DATA IS REVIEWED TO DETERMINE NEEDS OF PATIENTS BY ANALYZING TOP DIAGNOSES AS WELL AS RE-ADMISSION RATES AND RELATED DIAGNOSES. ALONG WITH STAFF FROM THE EMERGENCY MANAGEMENT AGENCY AND PERSONNEL FROM THE COUNTY HEALTH, LAW ENFORCEMENT, AND FIRE DEPARTMENTS, HOSPITAL STAFF PARTICIPATES IN ANNUAL REGIONAL HAZARD VULNERABILITY ASSESSMENTS TO ASSESS COMMUNITY READINESS FOR DISASTERS SUCH AS MINING ACCIDENTS, EARTHQUAKES AND TORNADOS. |
| PART VI, LINE 3: | ALL PATIENTS THAT ARE WITHOUT THIRD PARTY COVERAGE, I.E. "SELF PAY", RECEIVE A HANDOUT DURING REGISTRATION THAT DETAILS THE FINANCIAL ASSISTANCE PROGRAM. ALL PATIENT BILLING STATEMENTS FOR THE HOSPITAL INCLUDE A STATEMENT REGARDING HOW A PATIENT MAY APPLY FOR CONSIDERATION UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. SIGNAGE IS DISPLAYED IN REGISTRATION, PATIENT CARE AND BUSINESS OFFICE AREAS THAT ANNOUNCES FINANCIAL HELP WITH PATIENT BILLS FOR THOSE WHO QUALIFY. IF A PATIENT CONTACTS THE BUSINESS OFFICE WITH AN INABILITY TO MAKE PAYMENT ISSUE, HOSPITAL PERSONNEL INFORM THE PATIENT OF THE FINANCIAL ASSISTANCE PROGRAM. ONE FULL-TIME EMPLOYEE SERVES AS A FINANCIAL COUNSELOR TO HELP THE ORGANIZATION'S PATIENTS APPLY FOR GOVERNMENT FUNDED MEDICAL COVERAGE OR FOR THE HOSPITAL'S OWN FINANCIAL ASSISTANCE PROGRAM. |
| PART VI, LINE 4: | THE COMMUNITIES SERVED BY HARRISBURG MEDICAL CENTER ARE SALINE, GALLATIN, HARDIN, POPE AND WHITE COUNTIES. IN THE FIVE COUNTIES, THERE IS A TOTAL POPULATION OF ROUGHLY 52,000, WITH ABOUT 20% OF THE TOTAL OVER THE AGE OF 65. THIS AREA HAS EXPERIENCED DECLINING POPULATION BETWEEN 2014 AND 2016. THE RESIDENTS IN THE COUNTIES SERVED ARE PREDOMINANTLY WHITE AND THE MEDIAN INCOME RANGES FROM $39,243 IN POPE COUNTY TO A HIGH OF $43,678 IN WHITE COUNTY. AROUND 20% OF THE POPULATION LIVES IN POVERTY. UNEMPLOYMENT RATES RANGE FROM 4.4% TO 6.4%, HIGHER THAN THE NATIONAL AVERAGE OF 3.9%. THE MOST COMMON EMPLOYMENT SECTORS FOR THOSE WHO LIVE IN SALINE COUNTY ARE HEALTHCARE AND SOCIAL ASSISTANCE, RETAIL TRADE AND EDUCATIONAL SERVICES. HARRISBURG MEDICAL CENTER'S ENTIRE SERVICE AREA IS CONSIDERED A FEDERALLY DESIGNATED MEDICALLY UNDERSERVED AREA. |
| PART VI, LINE 5: | HARRISBURG MEDICAL CENTER REGULARY PROVIDES FREE OR LOW-COST HEALTH SCREENINGS AND HEALTH EDUCATION PROGRAMS TO THE GENERAL PUBLIC ON A VARIETY OF TOPICS, INCLUDING ARTHRITIS, MENTAL HEALTH, CANCER AND NUTRITION. HMC PROVIDES OTHER SERVICES AT NO COST TO PROMOTE THE HEALTH OF OUR COMMUNITY , SUCH AS CAREGIVER SUPPORT GROUPS, EARLY CHILDHOOLD NUTRITION COUNSELING, TEDDY BEAR FAIRS FOR CHILDREN, AND SUPPORT GROUPS FOR PATIENTS WITH CONGESTIVE HEART FAILURE AND DIABETES. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ILLINOIS HOSPITAL RESEARCH & EDUCATIONAL FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1151 E WARRENVILLE RD PO BOX 3015 | AddressLine1Txt |
| City | NAPERVILLE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60566 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 237421930 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $8,712 | CashGrantAmt |
| Purpose Of Grant | GENERAL ASSISTANCE | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION CURRENTLY PROVIDES GRANTS TO A SINGLE RECEIPIENT, THE ILLINOIS HOSPITAL RESEARCH & EDUCATIONAL FOUNDATION (IHREF). PER ITS PUBLICLY DISCLOSED FORM 990 ON GUIDESTAR.ORG, IHREF'S MISSION IS TO PROMOTE THE CONTINUING EDUCATION OF HOSPITAL AND AND OTHER HEALTHCARE PERSONNEL, TO PROVIDE SCHOLARSHIPS TO PERSONS PURSUING HEALTHCARE CAREERS, AND TO PROVIDE GRANTS TO HOSPITALS WHICH WILL ASSIST IN THE IMPROVEMENT OF HEALTHCARE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 | Yes (1) | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RODNEY SMITH | ||||||||||||||
| PRESIDENT/CEO | $253,161 | $0 | $11,702 | $0 | $25,200 | $0 | $10,600 | $0 | $13,231 | $0 | $313,894 | $0 | $0 | $0 |
| THERESA JUNE HAYES | ||||||||||||||
| VICE-PRESIDENT/CFO | $162,554 | $0 | $0 | $0 | $15,923 | $0 | $7,127 | $0 | $8,960 | $0 | $194,564 | $0 | $0 | $0 |
| DANIEL LAMPLEY | ||||||||||||||
| VICE-PRESIDENT/COO | $162,586 | $0 | $0 | $0 | $18,000 | $0 | $6,810 | $0 | $6,393 | $0 | $193,789 | $0 | $0 | $0 |
| JAMES ALEXANDER | ||||||||||||||
| PHYSICIAN | $304,673 | $0 | $248,000 | $0 | $18,000 | $0 | $12,414 | $0 | $1,707 | $0 | $584,794 | $0 | $0 | $0 |
| THOMAS BUCINSKI | ||||||||||||||
| PHYSICIAN | $289,919 | $0 | $23,333 | $0 | $18,000 | $0 | $13,960 | $0 | $3,118 | $0 | $348,330 | $0 | $0 | $0 |
| SAMIR ABDO | ||||||||||||||
| PHYSICIAN | $284,730 | $0 | $0 | $0 | $0 | $0 | $14,728 | $0 | $2,818 | $0 | $302,276 | $0 | $0 | $0 |
| CLAYTON FORD | ||||||||||||||
| PHYSICIAN | $179,633 | $0 | $100,479 | $0 | $0 | $0 | $14,490 | $0 | $1,809 | $0 | $296,411 | $0 | $0 | $0 |
| KIMBALL EWELL | ||||||||||||||
| PHYSICIAN | $199,285 | $0 | $72,692 | $0 | $0 | $0 | $13,960 | $0 | $3,513 | $0 | $289,450 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | RODNEY SMITH, NON-QUALIFIED RETIREMENT PLAN PAYMENTS: $14,197 THE NON-QUALIFIED RETIREMENT PLAN ARRANGEMENT USES A SPECIALLY DESIGNED LIFE INSURANCE CONTRACT AS THE FUNDING VEHICLE. WHILE THE CONTRACT IS JOINTLY OWNED BY BOTH RODNEY SMITH AND HARRISBURG MEDICAL CENTER, THE ARRANGEMENT IS TREATED AS A HARRISBURG MEDICAL CENTER LOAN TO RODNEY SMITH FOR TAX PURPOSES. HARRISBURG MEDICAL CENTER PAID POLICY PREMIUM CONSTITUTES THE "LOAN" UPON WHICH RODNEY SMITH MUST REPORT THE INTEREST AS INCOME. THIS INTEREST PLUS RODNEY SMITH "EQUITY TRANSFER", IF ANY, OF THE LOAN PREMIUM IS GENERALLY PAID BY HIM/HER VIA COMPENSATION BONUS. HARRISBURG MEDICAL CENTER'S NET LOAN REMAINS AN ASSET ON ITS BALANCE SHEET. THE PLAN VALUES OWNED BY RODNEY SMITH ARE MINIMAL IN THE EARLY PLAN YEARS. HOWEVER, AS RODNEY SMITH APPROACHES RETIREMENT, HARRISBURG MEDICAL CENTER GENERALLY BEGINS A SERIES OF SECONDARY COMPENSATION BONUSES THAT ENABLE RODNEY SMITH TO REDUCE THE BALANCE OF THE OUTSTANDING LOAN THROUGH EQUITY TRANSFER. THROUGH THIS PROCESS, RODNEY SMITH CAN RETIRE WITH FULL AND UNENCUMBERED OWNERSHIP OF THE POLICY. IF RODNEY SMITH LEAVES PRIOR TO RETIREMENT, HARRISBURG MEDICAL CENTER MAINTAINS A FINANCIAL INTEREST IN THE PLAN TO THE EXTENT OF THE LOAN NOT YET RELEASED TO RODNEY SMITH. | ExplanationTxt |
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 | ILLINOIS FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 861091967 | BondIssuerEIN |
| CUSIP | 45204ETA6 | CUSIPNum |
| Bond Issued | 2017-03-14 | BondIssuedDt |
| Issue Price | $19,500,000 | IssuePriceAmt |
| Purpose | REFUND MORTGAGE NOTE AND FUND EXPANSION PROJECT | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $19,500,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $382,353 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $3,394,967 | CapitalExpendituresAmt |
| Other Spent Proceeds | $9,056,277 | OtherSpentProceedsAmt |
| Unspent | $6,666,403 | UnspentAmt |
| Substantial Completion | 2018 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | 0 | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | 0 | 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 | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | 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 | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | 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 | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE K, PAGE 1, PART II LINE 17 | FormAndLineReferenceDesc |
| Explanation | ONCE THE ORGANIZATION MAKES A FINAL ALLOCATION OF PROCEEDS, THEY WILL HAVE BOOKS AND RECORDS TO SUPPORT SUCH AN ALLOCATION. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan From OrganizationLoanFromOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| DR JAMES ALEXANDER | |||||||
| EMPLOYEE | PRACTICE WINDUP | Yes (X) | $55,259 | $15,423 | Yes (1) | 0 | Yes (1) |
| RODNEY SMITH | |||||||
| EMPLOYEE | LIFECOMP DOLLARFLEX PLAN | Yes (X) | $43,928 | $43,928 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $59,351 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KRISTIN WILSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | EMPLOYEE | RelationshipDescriptionTxt |
| Transaction | $25,807 | TransactionAmt |
| Transaction | WAGES | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV, LINE 1 | FormAndLineReferenceDesc |
| Explanation | HMC EMPLOYEE KRISTIN WILSON IS A FAMILY MEMBER OF BOARD MEMBER HAROLD WILSON. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | DRAFT COPIES OF THE RETURN WILL BE DISTRIBUTED TO ALL BOARD MEMBERS WITH ADEQUATE TIME TO REVIEW. SPECIFIC ITEMS AND QUESTIONS WILL BE ADDRESSED FIRST WITH THE FINANCE COMMITTEE DURING A FINANCE COMMITTEE MEETING AND AGAIN WITH THE FULL BOARD AT A MONTHLY BOARD MEETING. REVISIONS WILL BE MADE AS REQUESTED AND FINAL COPY WILL BE APPROVED BY THE FULL BOARD AFTER FINANCE COMMITTEE REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | A CONFLICT OF INTEREST FORM IS COMPLETED AND REVIEWED ANNUALLY TO DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS, WITH ASSISTANCE FROM THE DIRECTOR OF HUMAN RESOURCES, REVIEWS THE ILLINOIS HOSPITAL ASSOCIATION (IHA) EXECUTIVE COMPENSATION SURVEY, ALONG WITH THE TOP DATA PAY AND BENEFIT SURVEY TO DETERMINE THE SALARY OF CEO. THE SURVEYS ARE USED EACH YEAR TO ENSURE THAT ANNUAL INCREASES HOLD THE CEO'S COMPENSATION WITHIN THE SALARY RANGE OF CEOS OF SIMILAR SIZED HOSPITALS. THIS PROCESS OF DELIBERATION AND DECISION WAS DOCUMENTED IN BOARD MEETING MINUTES AND WAS MOST RECENTLY COMPLETED IN 2017. THE CHIEF EXECUTIVE OFFICE DETERMINES THE PROPOSED COMPENSATION OF THE CHIEF FINANCIAL OFFICER, CHIEF NURSING OFFICER, AND CHIEF EXECUTIVE OFFICER BY REVIEWING THE IHA EXECUTIVE SALARY SURVEY. COMPARISONS ARE MADE BETWEEN HMC AND HOSPITAL OF SIMILAR SIZE, REVENUE AND NUMBER OF EMPLOYEES. THE PROPOSED COMPENSATIONS ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. THE SURVEY IS REVIEWED EACH YEAR TO ENSURE THAT ANNUAL INCREASES HOLD THE COMPENSATION WITHIN THE SALARY RANGE OF OFFICERS OF SIMILAR SIZED HOSPITALS. THIS PROCESS OF DELIBERATION AND DECISION WAS DOCUMENTED IN BOARD MEETING MINUTES AND WAS MOST RECENTLY COMPLETED IN 2017. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 6,939,344. MANAGEMENT AND GENERAL EXPENSES 709,633. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,648,977. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 91,897. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 91,897. OTHER MISCELLANEOUS FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 963. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 963. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT AND SELECTION PROCESSES DURING THE YEAR. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER CLINIC SERVICES LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 DR WARREN TUTTLE DRIVE | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 452945162 | EIN |
| Primary Activities | HEALTHCARE | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Total Income | $2,586,540 | TotalIncomeAmt |
| End Of Year Assets | $2,847,321 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 EAST CLARK STREET | AddressLine1Txt |
| City | HARRISBURG | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62946 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371411984 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISBURG MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | 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 | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | 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 | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |