2017-05-04T13:05:05-05:00 2016-06-30 BKD LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 631022733 990 2015-07-01 237098532 Sarah Bush Lincoln Health Center % DENNIS J PLUARD CPA SARA 2172582514 PO BOX 372 Mattoon IL 61938 DENNIS PLUARD VP FINANCE & OPS 2172582102 2017-05-03 true Donna J Larson P00043751 3142315544 2017-04-01 2015 2021-01-29 14:40:06Z JERRY ESKER 1000 HEALTH CENTER DRIVE MATTOON IL 61938 407317236 false X www.sarahbush.org X 1977 IL THE MISSION OF SARAH BUSH LINCOLN HEALTH CENTER IS TO PROVIDE EXCEPTIONAL CARE FOR ALL AND CREATE HEALTHY COMMUNITIES. 29 21 2500 236 5120510 524606 543208 261119722 275791473 9229291 3582280 17948054 20282117 288821673 300199078 53990 70055 0 0 153930826 165832941 0 0 0 94036126 103015367 248020942 268918363 40800731 31280715 426721690 474947748 127769617 152916497 298952073 322031251 X THE MISSION OF SARAH BUSH LINCOLN HEALTH CENTER IS TO PROVIDE EXCEPTIONAL CARE FOR ALL AND CREATE HEALTHY COMMUNITIES. 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0 0 53186830 51464289 127769617 152916497 X 298952073 322031251 0 0 0 0 298952073 322031251 426721690 474947748 31280715 -8201537 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false true 34695 false false false 34695 false SCHEDULE C, PART II-B, LINE 1F LOBBYING ACTIVITIES: THIS IS THE PORTION OF THE IHA/AHA DUES THAT IS OFFSET AND ALLOCATED TO LOBBYING PURPOSES. THE LOBBYING PERCENTAGE THAT WAS PUBLISHED BY THE AMERICAN HOSPITAL ASSOCIATION WAS DETERMINED TO BE 22.12% OF THE ANNUAL MEMBERSHIP DUES AND THE PERCENTAGE BY IHA WAS DETERMINED TO BE 34.0% OF THEIR DUES. 3938638 10493 -379135 3569996 3873031 43737 21870 3938638 3440394 15359 417278 3873031 3157288 10 283096 3440394 65660868 6860 8519 62518959 3157288 0.01280 0.71630 0.27090 false true true 3553346 3553346 138366558 48400443 89966115 543828 374370 169458 103512435 70346321 33166114 43089394 4622612 38466782 165321815 SUPPLEMENTAL PENSION 29686812 F DEFERRED COMPENSATION 12827782 F HEDGE FUNDS 40770931 F 83285525 0 SUPPLEMENTAL PENSION 29792141 DEFERRED COMPENSATION 12827783 EST PROFESSIONAL LIABILITY CLA 8844365 51464289 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS: ALL FUNDS ARE HELD BY A RELATED ORGANIZATION, SARAH BUSH LINCOLN HEALTH FOUNDATION. PER THE DONORS SPECIFIED INTENTIONS, PERMANENT AND TEMPORARY ENDOWMENT FUNDS MAY BE USED FOR CHARITABLE, BENEVOLENT, EDUCATIONAL, AND SCIENTIFIC PURPOSES TO SUPPORT SARAH BUSH LINCOLN HEALTH CENTER. THE PURPOSE OF THE BOARD DESIGNATED FUNDS IS TO PROVIDE FINANCIAL SUPPORT FOR ACTIVITIES OF THE SARAH BUSH LINCOLN HEALTH SYSTEM OR EXPENSES ASSOCIATED WITH MANAGING THE FOUNDATION. SCHEDULE D, PART X, LINE 2 FIN 48 FOOTNOTE: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. Central America and the Caribbean Investments 29342677 Central America and the Caribbean Investments 85944 29428621 29428621 true false true true false false SCHEDULE F, PART I, COLUMN F INVESTMENTS & EXPENDITURES: INVESTMENTS IN REGION: $ 29,342,677 EXPENDITURES IN REGION: 85,944 --------------- $ 29,428,621 true true true X 130. true X true true true false true true 3338188 3338188 0.01240 61854460 50200601 11653859 0.04330 65192648 50200601 14992047 0.05570 1027201 1027201 0.00380 314728 314728 0.00120 1341929 1341929 0.00500 66534577 50200601 16333976 0.06070 67745 67745 0.00040 67745 67745 0.00040 true 3338188 47889017 80611422 -32722405 X true true 1 1 SARAH BUSH LINCOLN HEALTH CENTER 1000 HEALTH CENTER DRIVE MATTOON IL 61938 HTTP://WWW.SARAHBUSH.ORG 0003392 X SARAH BUSH LINCOLN HEALTH CENTER 1 false false true X X X X X X X X X 15 true false false true X SEE PART V, SECTION C X SEE PART V, SECTION C X true 15 false + true false true X 130. 400. X X X true true X X X true X SEE PART V, SECTION C X SEE PART V, SECTION C X SEE PART V, SECTION C X X X X true X false X X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN THE SUMMER OF 2015. COMMUNITY INPUT WAS PROVIDED THROUGH 25 KEY INFORMANTS, INCLUDING REPRESENTATIVES OF PUBLIC HEALTH, PHYSICIANS AND OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. SPECIFIC NAMES/TITLES OF THOSE PARTICIPATING ARE AVAILABLE UPON REQUEST. SCHEDULE H, PART V, SECTION B, LINE 7B CHNA REPORT: THE CHNA REPORT FOR TAX YEAR 2012 IS POSTED AT: HTTP://MATTOON.HEALTHFORECAST.NET/REPORT.PDF SCHEDULE H, PART V, SECTION B, LINE 11 NEEDS NOT BEING ADDRESSED: (1) MENTAL HEALTH: SBLHC HAS LIMITED RESOURCES AND SERVICES AVAILABLE TO ADDRESS MENTAL HEALTH. OTHER COMMUNITY RESOURCES, SUCH AS THE REGIONAL BEHAVIOR HEALTH NETWORK, HAVE THE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER SUPPORT THIS HEALTH NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. (2) HEALTH KNOWLEDGE AND EDUCATION: SBLHC EMPLOYS A COMMUNITY OUTREACH REPRESENTATIVE THAT IS ACTIVE AT HEALTH FAIRS, SYMPOSIUMS AND COMMUNITY EVENTS TO PROVIDE HEALTH EDUCATION TO COMMUNITY RESIDENTS. IN ADDITION, SBL HAS NUMEROUS EDUCATIONAL PROGRAMS AND SUPPORT GROUPS FOCUSED ON SPECIFIC HEALTH NEEDS AND EDUCATION. NEEDS BEING ADDRESSED: MAXIMIZE ACCESS TO CARE - FY 14 - BUILT WALK-IN CLINIC LOCATION IN CHARLESTON, IL. FY 15 - ACQUIRED PRIMARY CARE CLINICS IN SHELBYVILLE, IL AND NEWTON, IL. FY 16 - BUILT WALK-IN/PRIMARY CARE CLINIC IN TUSCOLA, IL. HIRED 7 FAMILY MEDICINE PRIMARY CARE PROVIDERS, 1 PEDIATRICIAN, 2 CARDIOLOGISTS, 3 RADIOLOGISTS, 1 DERMATOLOGIST, 1 NEUROLOGIST, 1 PSYCHIATRIST, 1 UROLOGIST, 2 GASTROENTEROLOGISTS. IMPLEMENTED A HOSPITALIST PROGRAM WHICH ALLOWS THE PRIMARY CARE PROVIDERS TO SPEND MORE TIME IN THEIR OFFICE PRACTICES. ACTIVATE HEALTHY CHOICES AMONG ADULTS: SBLHC BUILT THE CENTER FOR HEALTHY LIVING IN FY 2015; THERE ARE 857 MEMBERS AS OF JUNE 30,2016. SBLHC WORKS WITH PATIENTS TO FIND COMMUNITY-BASED CENTERS TO CONTINUE EXCERCISE ROUTINES. CANCER CARE - WORKED WITH ONCOLOGY SOLUTIONS (CONSULTANT) TO DEVELOP AN ENVIRONMENTAL ASSESSMENT AND NEEDS ASSESSMENT FOR THE CANCER CENTER. DEVELOPED CAPITAL AND OPERATIONAL PLAN FOR THE CANCER CENTER: INCLUDES CONSTRUCTION OF A NEW FREESTANDING BUILDING ON SBL CAMPUS, HIRING OF PATIENT NAVIGATORS TO ASSIST PATIENTS AND A CLINICAL RESEARCH COORDINATOR. HIGHLIGHTED CANCER CARE AWARENESS IN SBL HEALTH STYLES MAGAZINE THAT IS SENT TO HOMES THROUGHOUT OUR 7-COUNTY SERVICE AREA. TOBACCO USE - FY 16: ENROLLED 43 PEOPLE IN THE SMOKING CESSATION CLASSES. 55-60% QUIT RATE. NON-TOBACCO HIRING POLICY BEGAN IN 2015. ONGOING FOCUS ON SBL EMPLOYEE HEALTH INITIATIVES. CREATED HEALTH & WELLNESS PLAN INTEGRATOR TO ASSIST WITH WELLNESS INITIATIVES AND HEALTH PREVENTION FOR SBL EMPLOYEES (GOAL IS TO REDUCE EMPLOYEE HEALTH COSTS WHILE EVOLVING TO A HEALTHIER WORKFORCE). ORAL HEALTH- WE PARTNER WITH 70 SCHOOLS IN OUR 9 COUNTY SERVICE AREA TO BRING DENTAL SERVICES TO CHILDREN WITH NEED. FY16 = 7,988 TOTAL DENTAL TREATMENTS PERFORMED. WE PARTNER WITH 7 COMMUNITY DENTISTS WHO VOLUNTEER THEIR TIME AND OFFICE SPACE TO PROVIDE RESTORATIVE DENTAL CARE TO KIDS IN NEED. WE PARTNER WITH AREA SCHOOLS TO PROVIDE ORAL HEALTH EDUCATION TO STUDENTS. WE HAVE A FT ORAL HEALTH EDUCATOR THAT PERFORMS THESE PRESENTATIONS. IN ADDITION, WE ARE ACTIVELY INVOLVED AT HEALTH FAIRS AND OTHER COMMUNITY EVENTS TO PROMOTE THE IMPORTANCE OF PROPER ORAL HYGIENE. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B, & 16C FAP, FAP APPLICATION, AND FAP PLAIN LANGUAGE SUMMARY: HTTPS://WWW.SARAHBUSH.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE/ SCHEDULE H, PART V, SECTION B, LINE 22D PATIENTS WITHOUT INSURANCE AND WHO QUALIFY FOR FINANCIAL ASSISTANCE (OR HAVE PREVIOUSLY QUALIFIED FOR FINANCIAL ASSISTANCE) ARE GIVEN A DISCOUNT IN ACCORDANCE WITH HOSPITAL POLICY. AMOUNT GENERALLY BILLED (AGB) TEST: ANY PATIENT ELIGIBLE FOR FINANCIAL ASSISTANCE WILL BE BILLED NO MORE THAN AN AMOUNT DETERMINED BY MULTIPLYING THE GROSS CHARGES FOR ALL EMERGENCY MEDICAL CARE AND MEDICALLY NECESSARY SERVICES PROVIDED TO SUCH INDIVIDUAL BY THE AMOUNT GENERALLY BILLED (AGB) PERCENTAGE. GUARANTORS WITH FAMILY INCOME LESS THAN 400% OF THE FEDERAL POVERTY GUIDELINES ARE ELIGIBLE FOR THE AGB DISCOUNT. THE AGB PERCENTAGE MEANS THE PERCENT CALCULATED ANNUALLY WHICH IS EQUAL TO (I) THE AGGREGATE DOLLAR AMOUNT OF CLAIMS PAID FOR ALL EMERGENCY MEDICAL CARE AND OTHER MEDICALLY NECESSARY SERVICES DURING THE TWELVE (12) MONTH PERIOD ENDED DECEMBER OF EACH YEAR BY BOTH MEDICARE AND ALL PRIVATE HEALTH INSURERS AS PRIMARY PAYERS, TOGETHER WITH ANY ASSOCIATED PORTIONS OF THOSE CLAIMS DUE FROM MEDICARE BENEFICIARIES OR INSURED PERSONS FOR CO-PAYMENTS, CO-INSURANCE OR DEDUCTIBLES PLUS ANY LUMP SUM OR ADJUSTMENT PAYMENTS RELATED TO THE CARE OF PATIENTS BY MEDICARE OR OTHER PAYERS DIVIDED BY (II) THE GROSS CHARGES APPLICABLE TO ALL CLAIMS INCLUDED IN CALCULATING THE AMOUNT UNDER CLAUSE (I). THE AGB PERCENTAGE SHALL BE APPLIED TO ALL ELIGIBLE APPLICANT'S ACCOUNTS EFFECTIVE THIRTY (30) DAYS FOLLOWING THE END OF THE TWELVE (12) MONTH PERIOD USED IN DETERMINING THE AGB PERCENTAGE. ONLY EMERGENCY OR MEDICALLY NECESSARY SERVICES WILL BE ELIGIBLE FOR CONSIDERATION IN THIS CALCULATION. SCHEDULE H, PART V, SECTION B, LINE 7A CHNA REPORT: https://www.sarahbush.org/media/filer_public/10/24/1024c90d-e620-4e78-9ebf -408aed615a49/chna_report.pdf 16 SBL ARCOLA CLINIC 241 W SPRINGFIELD RD ARCOLA IL 61920 CLINIC SBL ARTHUR CLINIC 211 S WALNUT ARTHUR IL 61911 CLINIC SBL CASEY CLINIC 412 NW 3RD ST CASEY IL 62420 CLINIC SBL CHARLESTON FAMILY PRACTICE 116 WEST BUCHANAN AVE CHARLESTON IL 61920 CLINIC SBL FAMILY MEDICAL CENTER 200 RICHMOND AVE MATTOON IL 61928 CLINIC SBL NEOGA CLINIC 650 OAK AVE PO BOX 640 NEGOA IL 62447 CLINIC SBL SULLIVAN CLINIC 7 HAWTHORNE LANE SULLIVAN IL 61951 CLINIC SBL TOLEDO CLINIC 168 COURTHOUSE SQUARE PO BOX 99 TOLEDO IL 62468 CLINIC SBL EFFINGHAM CLINIC 905 N MAPLE EFFINGHAM IL 62401 CLINIC SBL MATTOON WALK-IN CLINIC 144 DETTRO DRIVE MATTOON IL 61938 CLINIC SBL NEWTON CLINIC 910 SOUTH BUREN ST NEWTON IL 62448 CLINIC SBL CHARLESTON WALK-IN CLINIC 2040 EAST LINCOLN CHARLESTON IL 61920 CLINIC SBL ALTAMONT CLINIC 8 NORTH THIRD ST ALTAMONT IL 62411 CLINIC SBL SHELBYVILLE CLINIC 207 S PINE ST SUITE 10 SHELBYVILLE IL 62565 CLINIC SBL TUSCOLA CLINIC 1100 TUSCOLA BLVD TUSCOLA IL 61953 CLINIC SBL MARTINSVILLE CLINIC 890 RIDGELAWN ROAD MARTINSVILLE IL 62442 CLINIC SCHEDULE H, PART I, LINE 6A IT IS PUBLISHED ON OUR WEBSITE (WWW.SARAHBUSH.ORG). SCHEDULE H, PART I, LINE 7, COLUMN F THE ORGANIZATION INCURRED BAD DEBT EXPENSE IN THE AMOUNT OF $9,574,566, HOWEVER, IT HAS BEEN DISREGARDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. SCHEDULE H, PART I, LINE 7 THE COSTING METHODOLOGY THAT WAS USED TO CALCULATE THESE AMOUNTS WAS THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2 OF THE WORKING PAPERS. SCHEDULE H, PART II COLES TOGETHER, IS A NOT-FOR-PROFIT CORPORATION FOUNDED FOR AND TO PROMOTE ECONOMIC DEVELOPMENT FOR NEW AND EXISTING INDUSTRY IN OUR COUNTY, COLES COUNTY, ILLINOIS. OUR HOSPITAL BOARD HAS MADE A COMMITMENT TO SUPPORT THIS ORGANIZATION WHOSE COMMUNITY DEVELOPMENT EFFORTS BENEFIT OUR ORGANIZATION AS WELL AS OTHER ORGANIZATIONS IN OUR COMMUNITY THAT WOULD ULTIMATELY IMPACT AND KEEP OUR HOSPITAL A VIABLE ORGANIZATION. SUPPORT IS PROVIDED FINANCIALLY AND THROUGH PARTICIPATION ON THEIR BOARD. ADDITIONALLY, DONATIONS WERE MADE TO A VARIETY OF NON-PROFIT GROUPS TO HELP OUR COMMUNITY WITH ECONOMIC DEVELOPMENT. SCHEDULE H, PART III, LINE 2 USED THE RATIO OF PATIENT CARE COST TO CHARGES (0.3487) AS COMPUTED ON WORKSHEET 2 OF THE ACCOUNTING WORK PAPERS CALCULATE THE BAD DEBT EXPENSE (9,574,566) AT COST (3,338,188). WE REDUCE BAD DEBT EXPENSE BY THE DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS. SCHEDULE H, PART III, LINE 4 SEE THE PATIENT ACCOUNTS RECEIVABLE NOTE ON PAGE 8 OF THE ATTACHED FINANCIAL STATEMENTS. SCHEDULE H, PART III, LINE 8 ALTHOUGH SBL DOES NOT TREAT SHORTFALL FOR MEDICARE AS A COMMUNITY BENEFIT, THERE COULD BE A CASE MADE THAT NOT BEING FULLY REIMBURSED FOR TREATING THE ELDERLY IS CONSIDERED TO BE THE PROVISION OF A BENEFIT TO THE COMMUNITY. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6, WAS THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2 AND ALSO DETAILED ON WORKSHEET C OF THE WORKING PAPERS. SCHEDULE H, PART III, LINE 9B ACCOUNTS WRITTEN OFF AS A BAD DEBT AND REFERRED TO A COLLECTION AGENCY BUT LATER DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE WILL BE PLACED ON HOLD AT THE COLLECTION AGENCY AND ADDED TO THE BALANCES CONSIDERED FOR FINANCIAL ASSISTANCE. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT EVERY THREE YEARS, SARAH BUSH LINCOLN ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT. THIS ASSESSMENT INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (COMMUNITY HEALTH SURVEY THAT IS BASED LARGELY ON THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH A SERIES OF KEY INFORMANT FOCUS GROUPS. BASED ON THE RESULTS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, SBL DETERMINED TO FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE ACCESS TO HEALTH SERVICES, ACTIVATE HEALTHY CHOICES AMONG ADULTS, CANCER, TOBACCO USE AND ORAL HEALTH. SCHEDULE H, PART VI, LN 3. PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE WHEN A PATIENT IS PRIVATE PAY (OR SHOWS CONCERN ABOUT PAYING THE BILL) OUR REGISTRATION CLERK INFORMS THEM OF OUR FINANCIAL ASSISTANCE POLICY AT THE TIME OF REGISTRATION. ALL STAFF ARE ORIENTED AS TO HOW THE PROGRAM WORKS DURING NEW EMPLOYEE ORIENTATION. WE ALSO HAVE FINANCIAL ASSISTANCE REPRESENTATIVES AVAILABLE DURING NORMAL BUSINESS HOURS TO SPEAK WITH THE PATIENT IF THERE ARE QUESTIONS BEYOND THE REGISTRATION CLERK'S KNOWLEDGE. PATIENTS ARE INFORMED (NOT NECESSARILY AT REGISTRATION) THEY NEED TO APPLY FOR MEDICAID SHOULD THEY HAVE ANY PRE-QUALIFIERS FOR THE PROGRAM (IE: BLIND, DISABLED, DEPENDENT CHILDREN IN THE HOME, ETC). THIS INFORMATION IS IN THE FINANCIAL ASSISTANCE BROCHURE WITH THE APPLICATION AS WELL. IF A PATIENT NEEDS TO APPLY FOR MEDICAID PRIOR TO FINANCIAL ASSISTANCE, WE PROVIDE THEM THE INFORMATION AND ASSISTANCE TO APPLY AT THE PUBLIC AID OFFICE. ADDITIONALLY, OUR SBL FINANCIAL ASSISTANCE PROGRAM BROCHURES ARE IN EVERY DEPARTMENT AND CLINIC IN THE SYSTEM AND WIDELY AVAILABLE THROUGHOUT THE FACILITY. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE (INCLUDING APPLICATIONS) WITH A DEDICATED PHONE NUMBER. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION SARAH BUSH LINCOLN (SBL) SERVES RURAL COMMUNITIES IN EAST CENTRAL ILLINOIS. SBL'S MARKET AREA ENCOMPASSES 7 COUNTIES INCLUDING: CLARK, COLES, CUMBERLAND, DOUGLAS, EDGAR, MOULTRIE, AND SHELBY. THE POPULATION OF THE HOSPITAL'S SERVICE AREA IS ESTIMATED AT 157,198 PEOPLE. THE REGION IS PREDOMINANTLY WHITE, WITH FEWER THAN 4 PERCENT OF THE POPULATION IDENTIFYING THEMSELVES AS MEMBERS OF RACIAL MINORITY GROUPS. THE REGION IS RURAL, WITH MORE THAN 53 PERCENT OF THE POPULATION LIVING IN COMMUNITIES OF LESS THAN 2,500. THE MEDIAN AGE IN EACH COUNTY, EXCEPT COLES, IS HIGHER THAN THE ILLINOIS MEDIAN OF 36.2 YEARS. TWELVE PERCENT OF THE POPULATION HAS INCOMES BELOW THE FEDERAL POVERTY LEVEL. AN ESTIMATED 13.5 PERCENT OF ADULT POPULATION UNDER AGE 65 IS WITHOUT HEALTHCARE INSURANCE. ALTHOUGH SBL HAS HAD A POSITIVE IMPACT ON THE PHYSICIAN-TO-POPULATION RATIOS OF THE REGION, THE AREA IS MEDICALLY UNDERSERVED AS DETERMINED BY BOTH FEDERAL AND STATE GUIDELINES. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH SARAH BUSH LINCOLN HEALTH CENTER HAS AN OPEN MEDICAL STAFF AS WELL AS A COMMUNITY BOARD. SCHEDULE H, PART I, LINE 3C SEE PART V, LINE 13 FOR OTHER CRITERIA USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. true COLES TOGETHER 400 AIRPORT ROAD MATTOON IL 61938 371243664 501(C)(6) 37500 SEE PART IV COLES COUNTY COUNCIL ON AGING 11021 E CO RD 800N CHARLESTON IL 619208632 237414779 501(C)(3) 10000 SEE PART IV 1 1 SCHEDULE I, PART II, COLUMN H PURPOSE OF GRANT OR ASSISTANCE: COLES TOGETHER IS A NOT-FOR-PROFIT CORPORATION FOUNDED FOR AND TO PROMOTE COLES ECONOMIC DEVELOPMENT FOR NEW AND EXISTING INDUSTRY IN OUR COUNTY, COLES COUNTY, ILLINOIS. OUR HOSPITAL BOARD HAS MADE A COMMITMENT TO SUPPORT THIS ORGANIZATION WHOSE COMMUNITY DEVELOPMENT EFFORTS BENEFIT OUR ORGANIZATION AS WELL AS OTHER ORGANIZATIONS IN OUR COMMUNITY THAT WOULD ULTIMATELY IMPACT THE UTILIZATION AND VIABILITY OF OUR HOSPITAL ORGANIZATION. COLES COUNTY COUNCIL ON AGING IS A NOT-FOR-PROFIT CORPORATION FOUNDED TO ENHANCE THE QUALITY OF LIFE FOR OLDER ADULTS AND PEOPLE OF ALL AGES AND ABILITIES. OUR HOSPITAL BOARD HAS MADE A COMMITMENT TO SUPPORT THIS ORGANIZATION WHOSE COMMUNITY DEVELOPMENT EFFORTS ARE COMMITTED TO THE PROVISION OF EXCELLENCE IN SERVICE TO THE ELDERLY POPULATION OF COLES COUNTY AND THE GENERAL PUBLIC. X X true true X X X X X false true false false false false false true false DR GARY MIKEL COMMITTEE COMMUNITY MEMBER 253498 0 53203 0 47121 0 9000 0 20086 0 382908 0 0 0 DR SHERYL ARTMANN DIRECTOR 314379 0 1600 0 51440 0 9000 0 22613 0 399032 0 0 0 DR KIRAN JOAG PHYSICIAN OFFICER 383340 0 148394 0 12596 0 9000 0 18329 0 571659 0 0 0 DR JOHN LAUER DIRECTOR 295047 0 119321 0 48482 0 9000 0 24107 0 495957 0 0 0 AARON C EUBANKS MD PHYSICIAN 795585 0 779613 0 117166 0 9000 0 21602 0 1722966 0 0 0 LOUIS B MENDELLA MD PHYSICIAN 844408 0 572835 0 123955 0 9000 0 24175 0 1574373 0 0 0 MATTHEW D JONES MD PHYSICIAN 594341 0 561233 0 42078 0 9000 0 21112 0 1227764 0 0 0 CHARLY T NGUYEN MD PHYSICIAN 801011 0 223057 0 122076 0 9000 0 25499 0 1180643 0 0 0 MR TIMOTHY A OLS PRESIDENT & CEO 355086 0 190730 0 112292 0 9000 0 24409 0 691517 0 0 0 MR DENNIS J PLUARD VP FINANCE & OPERATIONS 251110 0 87456 0 55778 0 9000 0 20814 0 424158 0 0 0 MR JERRY J ESKER VP PRACTICE MANAGEMENT 240276 0 95464 0 42667 0 9000 0 14316 0 401723 0 0 0 MS MARY LOU WILD VP PATIENT CARE 165192 0 82910 0 103919 0 9000 0 10081 0 371102 0 0 0 DR JAMES HILDEBRANDT VP MEDICAL AFFAIRS 292937 0 108464 0 69672 0 9000 0 21504 0 501577 0 0 0 MR ERIC G BENSON VP HUMAN RESOURCES 182729 0 71295 0 36673 0 7580 0 21249 0 319526 0 0 0 MS KIMBERLY A UPHOFF VP DEVELOPMENT & FOUNDATION 173633 0 62972 0 26424 0 7249 0 20054 0 290332 0 0 0 MS MARGARETT A RATLIFF VP INFORMATION SYSTEMS 190335 0 67627 0 16097 0 8049 0 14891 0 296999 0 0 0 AZIZ S AHMED MD PHYSICIAN 578891 0 494789 0 37359 0 4846 0 1009 0 1116894 0 0 0 DR JOSHUA W GARRETT COMMITTEE COMMUNITY MEMBER 572643 0 604184 0 42629 0 9000 0 8095 0 1236551 0 0 0 DR LORI L CUDONE DIRECTOR 421596 0 166269 0 37121 0 9000 0 17057 0 651043 0 0 0 SCHEDULE J, PART I, LINE 7 COMPENSATION INFORMATION: ADDITIONAL COMPENSATION TO OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE DEPENDENT ON SPECIFIC ORGANIZATIONAL AND INDIVIDUAL GOALS. THESE GOALS INCLUDE FINANCIAL, QUALITY, CUSTOMER SERVICE, AND OTHER GOALS RELATED TO THE ORGANIZATION'S STRATEGIC PLAN. SCHEDULE J, PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES AND COMPANION TRAVEL: COUNTRY CLUB DUES ARE REPORTED AS TAXABLE COMPENSATION FOR OUR PRESIDENT AND CEO, MR. TIMOTHY A OLS. TRAVEL FOR COMPANIONS IS PROVIDED PER THE EMPLOYMENT AGREEMENT WITH THE PRESIDENT & CEO, TIM OLS. ANY PERSONAL ITEMS, EXTRA DAYS, AND MEALS FOR BOTH ARE PAID FOR USING HIS PERSONAL CREDIT CARD. SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: SARAH BUSH LINCOLN HEALTH CENTER CURRENTLY MAINTAINS A NONQUALIFIED, UNFUNDED, DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, ON BEHALF OF CERTAIN DESIGNATED MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THE PLAN IS INTENDED TO BE AN UNFUNDED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES, AS DESCRIBED IN THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). THE FOLLOWING PERSONS LISTED IN FORM 990, PART VII ARE PARTICIPANTS IN THE PLAN: GARY MIKEL, MD KIRAN JOAG, MD SHERYL ARTMANN, MD JOHN LAUER, MD AARON EUBANKS, MD LOUIS MENDELLA, MD CHARLEY NGUYEN, MD TIMOTHY A OLS DENNIS J PLUARD ERIC BENSON JERRY ESKER MARY LOU WILD KIMBERLY UPHOFF JAMES HILDEBRANDT MARGARETT RATLIFF AZIZ AHMED, MD JOSHUA GARRETT, MD LORI CUDONE, MD MATT JONES, MD THERE WERE NO DISTRIBUTIONS FROM THE PLAN DURING THE TAX YEAR BY THESE PARTICIPANTS. A ILLINOIS FINANCE AUTHORITY 861091967 2011-03-18 45000000 SEE PART VI false true false B ILLINOIS FINANCE AUTHORITY 861091967 2015-11-01 30000000 SEE PART VI false true false A 12880000 0 45000000 0 0 0 517777 0 0 26444431 18037792 0 2014 true false false true B 0 0 30000000 0 0 0 0 0 0 13462013 0 16537987 false false false true A false false false false 0 false false false true B false false false false 0 false false false true A true true false 0 false 0 false true B true true false 0 false 0 false true A true B true SCHEDULE K, PART I, LINE A, COLUMN F DESCRIPTION OF PURPOSE: REFINANCE OLD BONDS AND CONSTRUCTION OF MASTER FACILITY PLAN SCHEDULE K, PART I, LINE B, COLUMN F THE 2015 REVENUE BONDS, SERIES 2015, ALLOWS BORROWING UP TO $30,000,000 WHICH BEAR A VARIABLE INTEREST RATE OF 68 PERCENT OF ONE MONTH LIBOR PLUS 45 BASIS POINTS PER ANNUM. BONDS BORROWED FOR REIMBURSING THE HEALTH CENTER FOR ACQUIRING, CONSTRUCTING, RENOVATING, EXPANDING AND EQUIPPING CERTAIN FACILITIES IN THE HOSPITAL. LAURIE E MOONEY WIFE OF TIM MOONEY 136069 L MOONEY EMPLOYED BY HLTH CTR false MORGAN E DAVIS DAUGHTER OF DON DAVIS 11431 M DAVIS EMPLOYED BY HLTH CTR false ROBERT CUDONE HUSBAND OF LORI CUDONE 120611 R CUDONE EMPLOYED BY HLTH CTR false FORM 990, PART III, LINE 4A SEE ATTACHED SOCIAL ACCOUNTABILITY STATEMENT FORM 990, PART VI, SECTION A, LINE 2 BUSINESS RELATIONSHIPS: Scott Wilson, Tina Stovall, Jim Littleford, and John Lauer have business relationships with each other as a result of all serving as board members of Sarah Bush Lincoln Health Management Services, a for-profit affiliate of the organization. All members of the Health Center Board have dual membership with the Health System Board. JANET GROVE AND TIMOTHY GOVER HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 MEMBERS: THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS SARAH BUSH LINCOLN HEALTH SYSTEM. PART VI, SECTION A, LINE 7A ELECTION OF GOVERNING BODY: BOARD MEMBERS WILL AID IN THE SELECTION FOR THE NOMINATION OF NEW BOARD MEMBERS WHEN VACANCIES OCCUR OR WHEN TERMS WILL EXPIRE, BUT THE FINAL APPROVAL OF THE CANDIDATES IS MADE BY THE SOLE MEMBER OF THE CORPORATION, SARAH BUSH LINCOLN HEALTH SYSTEM. PART VI, SECTION A, LINE 7B DECISIONS OF THE GOVERNING BODY: THE SARAH BUSH LINCOLN HEALTH SYSTEM BOARD, THE SOLE MEMBER OF THE HEALTH CENTER BOARD, RETAINS CERTAIN RESERVED POWERS INCLUDING; AMENDING ARTICLES OF INCORPORATION OR BYLAWS, APPROVING THE ANNUAL OPERATING BUDGET AND LONG RANGE STRATEGIC PLAN, APPROVAL OF ANY TRANSACTIONS REQUIRING A CERTIFICATE OF NEED, APPROVAL OF THE BORROWING OF FUNDS AND INCURRING DEBT, APPROVAL OF MERGERS, CONSOLIDATIONS, SALE, OF ALL OR SUBSTANTIALLY ALL ASSETS, SELECTING AUDITORS, CREATING OR ACQUIRING SUBSIDIARY OR AFFILIATE CORPORATIONS, DISSOLVING THE CORPORATION, APPOINTING, EVALUATING AND REMOVAL OF PRESIDENT/CEO, AND ELECTING BOARD MEMBERS. FORM 990 PART VI, SECTION B, LINE 11A FORM 990 REVIEW: THE SENIOR ACCOUNTING STAFF REVIEWS ALL ELEMENTS OF THE 990 BASED ON PRIOR KNOWLEDGE AND INTERVIEWS WITH OTHER INDIVIDUALS IN THE ORGANIZATION. IN ADDITION, BOARD MEMBERS SUBMIT DETAILED QUESTIONNAIRES WITH REGARDS TO THEIR RELATIONSHIPS WITH THE ORGANIZATION. THE FINAL FORM 990 IS MADE AVAILABLE TO THEM ONLINE VIA A WEB PORTAL AND AT THEIR BOARD MEETING FOR REVIEW AND QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12A-C CONFLICT OF INTEREST POLICY: MEMBERS OF THE BOARD OF DIRECTORS ANNUALLY COMPLETE A CERTIFICATION STATEMENT WHICH IDENTIFIES POSSIBLE CONFLICTS OF INTEREST RELATED TO THEIR PROFESSIONAL AND PERSONAL LIVES. DURING DELIBERATIONS AND DECISIONS ON WHICH THERE APPEARS TO BE A CONFLICT OF INTEREST, THE BOARD MEMBER IS EXCUSED FROM THE DISCUSSION AND DELIBERATION, SHALL NOT VOTE ON, NOR USE HIS PERSONAL INFLUENCE ON OR BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM IN RESPECT TO THE TRANSACTION OR CONTRACT. FORM 990, PART VI, SECTION B, LINES 15A & 15B PROCESS FOR DETERMINING COMPENSATION: COMPENSATION IS DETERMINED FOR THE PRESIDENT & CEO, VP MEDICAL AFFAIRS, VP FINANCE & OPERATIONS, VP PRACTICE MANAGEMENT, VP PATIENT CARE SERVICES, VP INFORMATION SERVICES, VP HUMAN RESOURCES, AND THE VP DEVELOPMENT & FOUNDATION BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE SBL BOARD. AN INDEPENDENT CONSULTANT, HAY GROUP, INC., REVIEWED CURRENT COMPENSATION FOR EACH POSITION AND COMPARED IT TO SIMILAR POSITIONS IN LIKE ORGANIZATIONS. THE COMMITTEE APPROVED COMPENSATION CONSISTENT WITH THE BOARD-APPROVED EXECUTIVE COMPENSATION PHILOSOPHY. THIS PROCESS IS DONE ANNUALLY, BETWEEN JUNE AND AUGUST, FOR ALL THE LISTED POSITIONS. FORM 990, PART VI, SECTION C, LINE 19 PUBLIC DISCLOSURE: CURRENTLY, SARAH BUSH LINCOLN HEALTH CENTER POSTS THEIR COMMUNITY BENEFITS STATEMENT ON OUR PUBLIC WEB-SITE. NO OTHER GOVERNING DOCUMENTS ARE ROUTINELY MADE AVAILABLE. FORM 990, PART XII A FEDERAL AWARD WAS GRANTED AND AN A-133 AUDIT REQUIRED. THE A-133 AUDIT WAS PERFORMED IN CONJUNCTION WITH THE HOSPITAL'S ROUTINE AUDIT. SARAH BUSH LINCOLN HEALTH SYSTEM 1000 HEALTH CENTER DRIVE MATTOON IL 61938 371136714 PARENT CO IL 501(C)(3) 11-I NA false SARAH BUSH LINCOLN HEALTH CTR FOUNDATION 1000 HEALTH CENTER DRIVE MATTOON IL 61938 371136713 FUNDRAISING IL 501(C)(3) 11-I SBLHS true SARAH BUSH LINCOLN HEALTH MGMT SERVICES 1000 HEALTH CENTER DRIVE MATTOON IL 61938 371136614 RETAIL DME/RX IL SBLHS C CORP 0 0 true SARAH BUSH LINCOLN CAPTIVE INSURANCE LTD PO BOX 69 GRAND CAYMAN CJ KY1-1102 INSURANCE CJ SBLHS C CORP 0 0 true true false true false false false false false true false true false false false false false false false SARAH BUSH LINCOLN HEALTH CENTER FOUNDATION C 272600 BOOK VALUE SARAH BUSH LINCOLN HEALTH MANAGEMENT SERVICES A 236384 CONTRACTED RATE SARAH BUSH LINCOLN HEALTH MANAGEMENT SERVICES L 2698989 BOOK VALUE