2025-11-15T14:32:46+00:00 2024-12-31 346565596 ERNST & YOUNG US LLP 835 N COLLEGE AVENUE INDIANAPOLIS IN 46202 990 2024-01-01 371363001 RICHLAND MEMORIAL HOSPITAL RICH 2173833311 611 W Park Street Urbana IL 61801 DENNIS HESCH EXEC VP & CFO 6183952131 2025-11-15 true true Jennifer D Rhoderick P00395735 3176817000 2025-11-13 2024 2025-03-06 01:10:19Z Carle Richland Memorial Hospital DENNIS HESCH EXEC VP & CFO 611 W Park Street Urbana IL 61801 76636192 false X www.carle.org X 1953 IL TO BE THE TRUSTED PARTNER IN ALL HEALTHCARE DECISIONS AND TO IMPROVE HEALTH BY PROVIDING HIGHLY ACCESSIBLE, WORLD-CLASS CARE AND SERVICES. 10 7 508 43 546915 0 160537 113409 62991249 73796704 24892 -129202 870075 1354032 64046753 75134943 50396 24345 0 41811150 45425580 0 0 32162008 34362993 74023554 79812918 -9976801 -4677975 24883089 27398423 12852522 14303314 12030567 13095109 TO BE THE TRUSTED PARTNER IN ALL HEALTHCARE DECISIONS AND TO IMPROVE HEALTH BY PROVIDING HIGHLY ACCESSIBLE, WORLD-CLASS CARE AND SERVICES. false false 70497344 24345 74347780 Richland Memorial Hospital, Inc., DBA Carle Richland Memorial Hospital (RMH) is a tax-exempt Illinois not-for-profit corporation established for the purpose of operating a hospital and conducting patient care related activities. Richland is a 25 bed hospital providing a range of ancillary and support services. iN 2024, cARLE RICHLAND MEMORIAL HOSPITAL TRANSITIONED from AN ACUTE CARE HOSPITAL TO A CRITICAL ACCESS HOSPITAL. for 2024, the hospital admitted 2,005 patients, is fully accredited by dnv, has an Emergent Stroke Ready Designation and a Level II Nursery Designation by the Illinois Department of Public Health, and is a clinical hub site for Southern Illinois University Physician Assistant Program. carle richland memorial hospital operates a 20-bed extended care wing for private-pay patients, which is part of the same legal entity, hospital tax identification number, and illinois department of public health hospital license. the extended care wing is not part of the medicare-enrolled critical access hospital. in 2024, RMH recorded 11,359 patient days. in addition to the hospital, the organization has tWO rural health clinics: -Carle Olney is located at 363 N. West Street, Olney, IL, 1.3 miles from the hospital, which offers behavioral health, convenient care, and family medicine services 8 a.m. - 8 p.m. seven days per week. -Carle West Salem is located at 100 S. Main Street, West Salem, IL, and offers family medicine services Monday through Friday, 8 a.m. to 5 p.m. In addition to the rural health clinics, RMH provides services under the following: -RMH Professional Services located at 605 E. Main Street, Olney, IL one-half mile from the hospital and offers general surgery and wound care services. -The Apothecary Shoppe, located at 108 S. Main Street, West Salem, IL, offers retail pharmacy services Monday through Friday from 9 a.m. to 12:45 p.m. AND 1:15 p.m. TO 5:30 P.M. -Carle Bridgeport is located at 100 Industry Road, Bridgeport, IL, and offers family medicine services Monday through Friday, 8 a.m. to 5 p.m. rmh provides quality medical healthcare regardless of race, creed, gender, national origin, disability, age, or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of the hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. The mission of RMH is to serve our community with respect in providing healthcare services and healthcare education. Therefore, in keeping with the commitment to serve all members of the community, we offer: -free care to qualified individuals under the Carle Rural health financial assistance Program -care provided to persons covered by governmental programs at below cost; and -health activities and programs to support and educate the community. These activities include wellness programs, community education programs, professional education programs, and a variety of broad community support activities. RMH provides care to persons covered by governmental programs at below cost. The hospital also provides care to persons covered by commercial insurance at below cost. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. To the extent reimbursement is below cost, the hospital recognizes these amounts as cost incurred in meeting its mission to the entire community. Financial assistance was also provided through the Carle Rural Health financial assistance policy offered in 2024. 70497344 true true false true false false false false false false true false false false true true false true false false false false false false false false true true true false true false false false false false false false false true false false false false false false true true true false false true 38 0 true 508 true true true false false false false false false false false false false false X 10 7 true false false false true true true true true false false false true true true true true true false false false false IL X X DENNIS HESCH EXEC VP & CFO 2173833311 611 W PARK STREET URBANA IL 61801 GARY HOUCHIN SECRETARY/TREASURER 1.0 0.1 X X 0 0 0 JENNIFER CUMMINS-ZUBER CHAIR 1.2 0.1 X X 0 0 0 PATRICIA KESSLER-BOOKHOUT DDS VICE CHAIR 1.0 0.1 X X 0 0 0 BERNARD BRAUER BOARD MEMBER 1.1 0.1 X 0 0 0 BRIAN ATWOOD MD BOARD MEMBER 4.0 0.1 X 0 0 0 LARRY DUNN BOARD MEMBER 0.9 0.1 X 0 0 0 RAYMOND FISHER MD BOARD MEMBER // PHYSICIAN 39.9 0.1 X 0 653825 41107 SHERRY GEIER BOARD MEMBER 1.2 0.1 X 0 0 0 STEVE THOMSON BOARD MEMBER 1.2 0.1 X 0 0 0 TANNER MILLER MD BOARD MEMBER // PHYSICIAN 39.9 0.1 X 0 587008 57945 DENNIS HESCH OFFICER - EVP, CHIEF FINANCE & STRATEGY OFFICER 2.0 38.0 X 0 1175111 332566 JAMES C LEONARD MD OFFICER - PRESIDENT & CEO 0.5 39.5 X 0 2298226 50256 MATTHEW KOLB JD MHA EX OFFICIO, NON-VOTING // OFFICER - PRESIDENT, CARLE HEALTH REGIONS // EVP, COO 1.0 39.0 X 0 1418629 333703 NAPOLEON KNIGHT MD MBA OFFICER - EVP, CHIEF MEDICAL OFFICER 1.0 39.0 X 0 1091552 41194 REGINA THOMAS DNP MBA EX OFFICIO, NON-VOTING // OFFICER - PRESIDENT, CARLE HEALTH - SOUTH REGION 39.9 0.1 X 0 303634 66999 BROOK FISHER DIRECTOR, REVENUE CYCLE DENIALS 3.0 37.0 X 0 172634 43126 CALEB MILLER SVP, SURGICAL SERVICES & AMBULATORY CARE 1.0 39.0 X 0 540975 87261 LAUREN SCHMID MBA EVP, CHIEF HUMAN RESOURCES OFFICER 1.0 39.0 X 0 878588 105168 NICHOLAS CROMPTON VP, CONSTRUCTION & FACILITY SERVICES 1.0 39.0 X 0 303209 84556 ANDREW SHAJARI MD PHYSICIAN - GENERAL SURGERY 40.0 0.0 X 626496 0 7490 HARRY GARRETT MD PHYSICIAN - FAMILY MEDICINE 40.0 0.0 X 658259 0 50545 JUSTIN ORENICH DO PHYSICIAN - GENERAL SURGERY 40.0 0.0 X 720070 0 48812 PARTH PATEL DO PHYSICIAN - PAIN CLINIC 40.0 0.0 X 602377 0 24440 YEKATERINA FAYN MD PHYSICIAN - CARDIOLOGY 40.0 0.0 X 645487 0 38014 KENNETH ARONSON MD FORMER KEY EMPLOYEE 0.0 0.0 X 0 718772 50376 3252689 10142163 1463558 76 true true false PIVOT POINT CONSULTING 5501 VIRGINIA WAY 120 BRENTWOOD TN 37027 CONSULTING SERVICES 644111 SENTRY DATA SYSTEMS INC 800 FAIRWAY DR STE 400 DEERFIELD BEACH FL 33441 PHARMACY SOFTWARE MAINTENANCE 175749 ARUP LABORATORIES 500 CHIPETA WAY SALT LAKE CITY UT 84108 MEDICAL LABORATORY SERVICES 136210 SIEMENS MEDICAL SOLUTIONS USA 2501 BARRINGTON RD HOFFMAN ESTATES IL 60192 LABORATORY TESTING 120577 4 76381 37028 15404 113409 NET PATIENT SERVICE REVENUE 622110 73561772 73561772 INTERNAL MEDICAL DIRECTOR REVENUE 622110 225078 225078 RENT FROM RELATED ORGS 523000 9731 9731 ALL OTHER PROGRAM SERVICE REVENUE 900099 123 123 0 0 0 0 73796704 20572 20572 0 0 149774 0 -149774 -149774 -149774 1877309 1351475 525834 525834 ACCRETION FOR EXCESS COSTS 990009 528674 528674 CAFETERIA SERVICES 722331 235573 235573 CATERING REVENUE 722320 10785 10785 53166 22402 10296 20468 828198 75134943 74347780 546915 126839 24345 24345 110551 110551 36764465 32461702 4302763 1945849 1707729 238120 4125468 3488678 636790 2479247 2048852 430395 15936 15936 2291521 1848673 442848 0 3080 1260 1820 1426531 809152 617379 230900 194955 35945 1040377 864223 176154 58391 42929 15462 74560 70425 4135 172276 148606 23670 2102456 909375 1193081 538153 433600 104553 Internal Management Fees 15478097 14593194 884903 Patient Care Supplies 7534600 7534600 Provider Assessment Tax 3020390 3020390 DUES AND MEMBERSHIPS 46541 14248 32293 329184 169857 159327 0 79812918 70497344 9315574 0 2232803 1363873 3183933 6654678 0 0 0 0 64183 396215 835852 938109 223229 161635 67768586 50024620 18258680 17743966 0 0 84409 139947 24883089 27398423 4610864 5274103 0 0 0 4263600 4413376 3978058 4615835 12852522 14303314 X 12030567 13095109 12030567 13095109 24883089 27398423 X -4677975 5742517 X false true true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 15936 15936 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY DUES & MEMBERSHIP FEES WERE PAID TO THE FOLLOWING ORGANIZATIONS A PORTION OF WHICH WAS ALLOCATED TO LOBBYING. ILLINOIS HEALTH & HOSPITAL ASSOCATION - $15,642 AMERICAN SOCIETY OF HEALTH-SYSTEM PHARMACISTS - $75 ILLINOIS PHARMACIST'S ASSOCIATION - $50 AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS - $100 ACADEMY OF NUTRITION AND DIETETICS - $32 NATIONAL ASSOCIATION OF PEDIATRIC NURSE PRACTITIONERS - $22 AMERICAN ASSOCIATION OF NURSE PRACTITIONERS - $15 1024913 1024913 33595969 23685773 9910196 32220210 25615261 6604949 927494 723586 203908 17743966 Federal Income Taxes ASSET RETIREMENT OBLIGATION 3007357 DUE TO BLUE CROSS 1608478 4615835 X 0 0 0 0 0 0 0 0 0 0 0 0 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2024, AND 2023. true true X true X true X 1134409 1134409 0.01421 18089981 13960736 4129245 0.05174 0 0.0 0 0 19224390 13960736 5263654 0.06595 13572 13572 0.00017 171611 171611 0.00215 4355788 4355788 0.05457 0 0.0 14777 14777 0.00019 0 0 4555748 0 4555748 0.05708 0 0 23780138 13960736 9819402 0.12303 0 0.0 2602 2602 0.00003 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0.0 0 0 2602 0 2602 0.00003 true 3332898 1666449 29768216 36803778 -7035562 X true true 1 1 Carle Richland Memorial Hospital 800 East Locust Street Olney IL 62450 https://carle.org/locations/carle-richland-memorial-hospital 0004200 X X X X Carle Richland Memorial Hospital 1 false false true X X X X X X X X X 24 true false true true X https://carle.org/about-us/community-health-needs-assessments X true 24 true https://carle.org/about-us/community-health-needs-assessments false true X 200.0 400.0 X true true X X X true X SEE SCHEDULE H PART VI X SEE SCHEDULE H PART VI X SEE SCHEDULE H PART VI X X X X X X true X false X X X X true X false false Schedule H, Part V, Section B, Line 3E THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA. Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - RICHLAND MEMORIAL HOSPITAL. Provisions in the Affordable Care Act (ACA) require charitable hospitals to conduct a Community Health Needs Assessment (CHNA). The CHNA is a systematic process involving the community to identify and analyze community health needs as well as community assets and resources in order to plan and act upon priority community health needs. This assessment process results in a CHNA report which assists the hospital in planning, implementing, and evaluating hospital strategies and community benefit activities. The Community Health Needs Assessment was developed and conducted, in partnership with representatives from the community, by a consultant provided through the Illinois Critical Access Hospital Network (ICAHN). ICAHN is a not-for-profit 501(c)(3) corporation established in 2003 for the purposes of sharing resources, education, promoting operational efficiencies, and improving healthcare services for member critical access and rural hospitals and their communities. ICAHN, with 60 member hospitals, is an independent network governed by a nine-member board of directors, with standing and project development committees facilitating the overall activities of the network. ICAHN continually strives to strengthen the capacity and viability of its members and rural health providers. This Community Health Needs Assessment will serve as a guide for planning and implementation of healthcare initiatives that will allow the hospital and its partners to best serve the emerging health needs of Olney and the surrounding area. Three focus groups met to discuss the state of overall health and wellness in the Richland Memorial Hospital service area and to identify health concerns and needs in the delivery of healthcare and health services to improve wellness and reduce chronic illness for all residents. The focus groups included representation of healthcare providers, community leaders, community services providers, schools, faith-based organizations, local elected officials, public health, and others. Several members of these groups provided services to underserved and unserved persons as all or part of their roles. A community survey was also conducted to assess the needs of the larger population of the CRMH service area. The focus groups' findings, along with secondary data analyzed by the consultant, were presented to a focused group to identify and prioritize the community's significant health needs. The group consisted of representatives of public health, community leaders, healthcare providers, and community services providers. Schedule H, Part V, Section B, Line 6b Facility , 1 Facility , 1 - RICHLAND MEMORIAL HOSPITAL. THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS DEVELOPED AND CONDUCTED, IN PARTNERSHIP WITH THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK . Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - RICHLAND MEMORIAL HOSPITAL. The Implementation Strategy was developed through a facilitated meeting involving key administrative staff at Richland Memorial Hospital in April 2024. The group reviewed the needs assessment process completed to that point and considered the prioritized significant needs and supporting documents. They discussed steps taken to address the previous Community Health Needs Assessment. They also considered the potential internal and external resources available to address the prioritized needs. The group then considered each of the prioritized needs. For each of the three priority areas, the actions the hospital intends to take were identified along with their anticipated impact, the resources the hospital intends to commit to, and the external collaborators the hospital plans to cooperate with to address the need. The plan will be evaluated by periodic review of measurable outcome indicators with annual review and reporting. Health Needs Selected: PRIORITY #1: Access to Care The priority under Access to Care is focused on the goal that everyone in the region has access to the resources and providers they need to improve their health, including primary and specialty care for physical and mental health needs. 86.21% of CHNA survey respondents identified access to providers in the community as the top choice in "things that help make us healthier." Chronic disease/management was identified by 71.92% of the community survey participants as one of the community's most important health concerns. Access to healthcare was identified as very important by 86.21% of the survey participants when asked about the importance of community resources. Over 90% of the survey participants stated they had someone they considered their provider, and 95% stated they had seen their primary care provider within the last year. 44% of participants stated they had not participated in any cancer screenings within the last 12 months. Carle Implementation Plan - Anticipated Impact & Plan to Evaluate: Carle Richland Memorial Hospital will pursue these initiatives to increase access to care: 1. Increase screening opportunities with a primary focus on common cancers and chronic diseases. 2. Develop targeted education that shows the incidence, risks, and available screenings for cancer and chronic diseases. 3. Develop additional support groups exploring the need for chronic disease and cancer support groups. 4. Continue to support the Jasper and Lawrence County Health Departments in their efforts to address mental health needs. 5. Continue the efforts to recruit social workers to improve access to mental health resources. 6. Ensure we are leveraging the Carle Health resources to assist with these actions. Evaluation of Prior Impact: According to 2024 County Health Rankings, Richland County has 1,720:1 primary care providers, which is higher than the state and national average, but 190:1 mental health providers, 3,830:1 dentists, which are lower than the state and national averages. Richland County has a lower uninsured rate at 7% than the state and national averages. However, there is still work to do in this area, and this was prioritized. In response, Carle Richland Memorial Hospital took the following actions in 2024: -Carle Richland Memorial Hospital's existence as a Critical Access Hospital in a rural community is a key contributor to access to healthcare. -In 2024, CRMH offered a charity care program and promoted the availability of the program. Recruited primary and specialty care providers, increasing access in the region. CRMH added a new Convenient Care APP in 2024. -In 2024, RMH worked to expand Healthfest, which focuses on access, screenings, vaccinations, and more for the community. In 2024, there were 40 exhibitor booths offering information about health services serving 277 attendees. -In 2024, RMH provided 85 patients with low-cost labs, and 396 total lab tests as part of Healthfest. -RMH continues to partner with the Lawrence County Health Department which offers crisis screenings. -RMH promoted prescription affordability as a 340B provider, increasing access to patients in the region. PRIORITY #2: Addressing Social Service Needs and Gaps The priority under Addressing Social Service Needs and Gaps is focused on the goal that everyone in the region will easily find help and access to agencies and providers to meet their social needs. 9% of CHNA survey participants have sought and used a food pantry in the past while another 7% state they needed that help but for some reason did not receive it. 2.41% of participants sought and received treatment in mental health/behavioral programs and another 23.4% needed this help but did not receive it. 59.59% of participants identified Basic needs: food, clothing, and transportation as one of the community's most important health issues. Carle Implementation Plan - Anticipated Impact & Plan to Evaluate: Carle Richland Memorial Hospital will pursue these initiatives to address social service needs and gaps: 1. Continue to develop the scope of the Community Health Initiatives Committee. This group includes both the board and leaders. The goal will be to create awareness of community health concerns and appropriation of resources accordingly. 2. Investigate ways to improve social service access for our employees. A daily pay option is available. Investigate ways to provide food from the Cafe for food-insecure employees (at a low cost). 3. Support local agencies that address social service needs, like Giving Hope Food Pantry. Investigate budgeting dollars for this and leveraging social media channels to raise awareness of these agencies and solicit potential donors. 4. Continue to support one-time assistance for needs (prescriptions, transportation, etc.) for patients. 5. Leverage the 340B program to assist uninsured patients with high-cost medications. 6. Carle Health will continue to recruit mental health providers to ensure resources are available for telehealth coverage. Evaluation of Prior Impact: According to 2024 County Health Rankings, 3% of the population has limited access to healthy foods, but 14% deals with food insecurity. Teen births are 27/1,000, which is significantly higher than the state average of 13 and national average of 16. The median household income is 57,000, well below state and national averages, and there is a reliance on social services. In response, Carle Richland Memorial Hospital took the following actions: -In 2024, RMH continued to utilize the hospital's current social worker to address SDOH and connect patients to resources to support care needs. RMH has an open position for an additional LCSW and will continue to recruit for the position. -In 2024, RMH expanded HealthFest, offering various health screening and reduced cost labs to increase access in the community and to share information on various social services in the community. -In 2024, RMH partnered with the National Kidney Foundation of Illinois to offer 70 Kidney screenings for patients in the region. -RMH continues to offer Sports Physicals to the local schools, which is an opportunity for increased access to social services and health discussions. -RMH continued to support one-time assistance for needs (prescriptions, transportation, etc.) for patients in 2024. -RMH designated a RIDES route around the hospital to assist the community in accessing health care. PRIORITY #3: Improved Health Knowledge and Literacy The priority under Improved Health Knowledge and Literacy is that community members will have better personal knowledge about the tools and tactics for healthier living. They will also have improved knowledge of the resources available within the community, including those internal to Carle Richland and other community partners. In CHNA Survey data, almost 25% of participants stated they needed help with their health insurance over the past year. Chronic disease management was noted as one of the top five most important community health issues by 71.92% of participants. In numerous categories of social service needs, participants reported they needed help or tried to find help for their need but could not find it. Obesity and lack of exercise opportunities were identified as the top six community health issues. Prevention services - such as violence and abuse prevention - were identified as very important community health resources. Carle Implementation Plan - Anticipated Impact & Plan to Evaluate: Carle Richland Memorial Hospital will pursue these initiatives to improve health knowledge and literacy: Schedule H, Part V, Section B, Line 11 Facility , 2 Facility , 2 - RICHLAND MEMORIAL HOSPITAL (CONTINUED). 1. QR codes are being added to patient educational documents that take them to additional videos explaining their condition, care, and treatment. This is starting in med/surg and ED. Investigate other areas where this could be beneficial. Educate nursing staff to ensure the importance of this additional education is reinforced with patients. 2. Investigate partnerships with Managed Care Organizations (MCO) to educate their covered lives on disease conditions, health improvement/prevention strategies, and the benefits available to them for completing health screenings. 3. Leverage the Healthfest, held annually in October, to provide educational materials and free or low-cost screenings for chronic diseases and cancer. 4. Investigate a partnership with local schools utilizing employees to provide students with education on the benefits of diet and exercise, strategies to improve their physical and mental health, chronic diseases, and management, as well as exposure to health careers and job opportunities at Carle Richland Memorial Hospital. 5. Support and participate in the inter agency group meeting in the community to ensure agencies understand what each does and the priorities they are working on. This will potentially reduce duplication of services and allow more agency collaboration. The group recommends the development of a resource guide that would assist agencies and patients/residents in finding needed resources. Evaluation of Prior Impact: According to 2024 County Health Rankings, Richland County adults had 4.5 poor physical health days per month, and 5.6 poor mental health days per month, both of which are higher than the respective state and national averages. According to 2024 County Health Rankings, Adult Obesity is roughly 37%, which is also higher than state and national averages. 11.39% of the community does not have access to a computer (higher than the state and nation) and only 80.43% of the community has high-speed internet access which is significantly lower than the state and national average. 18.4% of households report no or slow internet. A larger than state or national percentage of the population is a tobacco user/current smoker (18.5%). Teen birth rates were significantly higher than the state or national norms. In response, Carle Richland Memorial Hospital took the following actions: -In 2024, RMH began offering outpatient dietary consultants and Diabetes Self Management Education and Support, to help patients learn practical skills, medication management, and monitoring education. -In 2024, RMH hosted monthly 'Dine with a Doc' opportunities, a monthly event organized by CRMH and hosted at the Olney Senior Center. CRMH provides a lunch meal and rotates providers through who provide education in their area of expertise (Cardiology- Heart Failure, Podiatry- diabetic foot exam, Primary Care- vaccination, etc. for educational purposes for the community and region. -In 2024, RMH added QR codes to patient educational documents, which take patients to additional videos explaining their condition, care, and treatment. Needs Not Addressed: There are no health needs prioritized by the CHNA that Carle Richland Memorial Hospital is not working to address. 5 CARLE OLNEY PRIMARY CARE 363 N WEST ST OLNEY IL 62450 RURAL HEALTH CLINIC CARLE (OLNEY) SURGICAL SERVICES 605 E MAIN ST OLNEY IL 62450 SURGICAL SERVICES CARLE WEST SALEM 100 S MAIN ST WEST SALEM IL 62476 RURAL HEALTH CLINIC CARLE BRIDGEPORT 101 INDUSTRY RD BRIDGEPORT IL 624172242 OUTPATIENT CLINIC RMH PROFESSIONAL SERVICES 605 E Main Street Olney IL 62450 GENERAL SURGERY AND PODIATRY SERVICES Schedule H, Part I, Line 7 OTHER COMMUNITY BENEFITS / COMMUNITY BUILDING Cash and In-kind: A large portion of Carle's community-building activities focused on economic development, including cash, in-kind donations and budgeted expenditures for the city, business associations and other programs in Richland County. In addition to the more than $7,000 in cash donations, leadership provided in-kind support of over $10,000 by serving on numerous community boards and committees. Schedule H, Part I, Line 3 FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA PATIENTS MAY REQUEST AND COMPLETE A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME, INCLUDING BEFORE CARE IS RECEIVED. PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE ON MULTIPLE OCCASIONS THROUGHOUT THE COLLECTION PROCESS. IN ADDITION TO PATIENTS COMPLETING APPLICATIONS FOR OUR FINANCIAL ASSISTANCE PROGRAM, WE HAVE ROBUST PRESUMPTIVE ELIGIBILITY PROCESSES IN PLACE. WE HAVE PARTNERED WITH EXPERIAN INFORMATION SOLUTIONS, INC. TO HELP US IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON KEY FINANCIAL INDICATORS. THESE PATIENTS MAY BE APPROVED WITHOUT EVER COMPLETING AN APPLICATION OR EXPRESSING A NEED FOR FINANCIAL ASSISTANCE. IN ADDITION, WE PRESUME ELIGIBILITY FOR PATIENTS WHO ARE VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTALLY INCAPACITATED, ELIGIBLE FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) OR WOMEN, INFANTS, AND CHILDREN NUTRITION PROGRAM (WIC), TOWNSHIP ASSISTANCE, LOW INCOME ENERGY ASSISTANCE PROGRAM (LIHEAP), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM OR COVERED BY ILLINOIS MEDICAID. Schedule H, Part V, Section B, Line 16a FAP AVAILABLE WEBSITE HTTPS://CARLE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE HTTPS://DEV-CMS.CARLE.ORG/GETMEDIA/ADCADB9A-2903-478C-A4A7-06BCF9DB10BC/358-0123- CFAPAPPLICATION.PDF Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE HTTPS://CARLE.ORG/GETMEDIA/F7608F63-CB1C-4EB5-8F0B-02F00EAFEC74/X0873-0223-CFAP-PLAIN-LANGUAGE-SUMMARY.PDF Schedule H, Part VI, Line 7 STATE FILING OF COMMUNITY BENEFITS REPORT AS A CRITICAL ACCESS HOSPITAL, RICHLAND MEMORIAL HOSPITAL IS NOT REQUIRED TO FILE A STATE COMMUNITY BENEFIT REPORT WITH THE ILLINOIS ATTORNEY GENERAL. Schedule H, Part I, Line 7g Subsidized Health Services SUBSIDIZED HEALTH SERVICES ARE NET COSTS FOR BILLED SERVICES THAT ARE SUBSIDIZED BY THE HOSPITAL. THESE INCLUDE SERVICES OFFERED DESPITE A FINANCIAL LOSS BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND EITHER OTHER PROVIDERS ARE UNWILLING TO PROVIDE THESE SERVICES OR THE SERVICES WOULD OTHERWISE NOT BE AVAILABLE IN A SUFFICIENT AMOUNT. WE INCLUDED AS UNREIMBURSED COSTS OF SUBSIDIZED CONTINUING CARE, $4,261,848 AND HOSPITAL OUTPATIENT SERVICES, $93,940. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance SEE NARRATIVE FOR SCHEDULE H, PART III, LINE 2 Schedule H, Part II Community Building Activities VOLUNTEER SERVICES: Non-employee: In 2024, non-employee volunteers put in more than 6,032 hours at the hospital, receiving no payment but contributing to Carle's mission. At a minimum wage of $14/hour, this equated to more than $85,000 of potential wages that Carle saved by having such a strong volunteer program. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS, AND BAD DEBT CHARGES TO COST; A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER COMMUNITY BENEFITS COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCUR. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUAL'S FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. THIS NARRATIVE ALSO PERTAINS TO SCHEDULE H, PART I, LINE 7 - EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology CARLE RICHLAND MEMORIAL HOSPITAL USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote AS A RESULT OF ADOPTING ASU 2014-09, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0. PLEASE SEE SCHEDULE H, PART III, LINE 2 METHODOLOGY USED TO ESTIMATE BAD DEBT FOR 990 REPORTING PURPOSES. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID, AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE INTENDED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. ILLINOIS LAW DEFINES GOVERNMENTAL-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID, AND OTHER FEDERAL, STATE, OR LOCAL INDIGENT CARE PROGRAMS. WHEN THERE IS A SHORTFALL, WE DO BELIEVE THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE STEPPING UP TO CARRY THE BURDEN OF THE GOVERNMENT, ASSURING CARE TO SENIORS, AND THOSE LESS FORTUNATE DEMOGRAPHICS THAT HAVE EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance THE CARLE FINANCIAL ASSISTANCE PROGRAM (CFAP) PROVIDES DISCOUNTED OR FREE CARE TO THOSE WHO NEED IT WITHIN THE CARLE HEALTH SYSTEM, INCLUDING THIS HOSPITAL. NOT ONLY DOES THIS RESULT IN A MORE TIMELY APPLICATION PROCESS, BUT MOST IMPORTANTLY, IT MEANS PATIENTS RECEIVE THE SAME DISCOUNT AT THE HOSPITAL AND CLINICS IF THEY MIGHT NEED AN ADDITIONAL LEVEL OF SPECIALTY OR HOSPITAL CARE. WITH THIS PROGRAM, THE HOSPITAL HAS A ROBUST PRESUMPTIVE ELIGIBILITY PROCESS. WE PRESUME ELIGIBILITY FOR VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION, RECIPIENTS OF WIC (WOMEN, INFANTS AND CHILDREN NUTRITION PROGRAM), SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM), LIHEAP (LOW INCOME HOME ENERGY ASSISTANCE PROGRAM), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM, RECEIPT OF GRANT ASSISTANCE FOR MEDICAL SERVICE, FEDERALLY QUALIFIED HEALTH CLINIC (FQHC) DISCOUNT REFERRALS, MEDICAID TITLE XIX, XXI, AND IN-NETWORK MEDICAID MANAGED CARE PLANS. IN ADDITION, WE UTILIZE A VENDOR, EXPERIAN INFORMATION SOLUTIONS, INC., TO PROACTIVELY IDENTIFY PATIENTS WHO MAY BE PRESUMPTIVELY-QUALIFIED FOR ASSISTANCE - NOT ONLY FOR PUBLIC PROGRAMS LIKE MEDICAID, BUT ALSO BASED ON A NUMBER OF KEY FINANCIAL INDICATORS, INCLUDING CREDIT HISTORY, DEMOGRAPHICS AND GROSS INCOME. IDENTIFIED PATIENTS MAY BE PRESUMED ELIGIBLE AND AUTOMATICALLY ENROLLED IN THE PROGRAM, OR THEY MAY BE CONTACTED AND ENCOURAGED TO APPLY FOR ASSISTANCE. PATIENTS WHO ARE NOT DEEMED PRESUMPTIVELY ELIGIBLE WOULD NEED TO REQUEST AND COMPLETE AN APPLICATION. IF THE PATIENT DOES NOT REQUEST OR COMPLETE AND RETURN THE APPLICATION, THEN THE BALANCE IS DEEMED THEIR RESPONSIBILITY TO PAY. FOR PATIENTS THAT DO NOT QUALIFY FOR CARLE FINANCIAL ASSISTANCE AND WHO MAY BE UNINSURED OR UNDERINSURED, THE HOSPITAL HAS OTHER DISCOUNT OPTIONS AVAILABLE, SUCH AS PROMPT PAY, ILLINOIS UNINSURED DISCOUNT, AND CAPPED DISCOUNT - WHERE A PATIENT'S OUT-OF-POCKET MEDICAL EXPENSES ARE LIMITED TO 40% OF THEIR ANNUAL GROSS INCOME IF THEY EARN AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL. ONCE ALL APPLICABLE DISCOUNTS HAVE BEEN APPLIED, WE MAKE EVERY ATTEMPT TO WORK WITH THE PATIENT AND SET UP PAYMENT ARRANGEMENTS ON THE REMAINING BALANCE DUE. THE CURRENT MINIMUM IS 5% OF THE TOTAL BALANCE DUE OR $25.00 A MONTH. IF THEY CANNOT MEET THESE GUIDELINES, OUR IN-HOUSE BILLING STAFF MEMBERS WORK WITH THEM TO SET UP A TEMPORARY/SHORT TERM PAYMENT ARRANGEMENT UNTIL THEY CAN MAKE THE MINIMUM PAYMENT. IF THEY ARE UNABLE TO MAKE PAYMENT ON THE BALANCE DUE, THEN THE BALANCE MAY BE LISTED WITH AN OUTSIDE COLLECTION AGENCY. WHEN THE ACCOUNT IS STILL IN-HOUSE, THE MINIMUM NOTIFICATION IS MONTHLY ITEMIZED STATEMENTS. IF A PATIENT DOES NOT RESPOND, THE ACCOUNT IS GIVEN A FINAL NOTICE, EITHER BY LETTER OR PHONE, AND SENT TO AN OUTSIDE COLLECTION AGENCY. THE HOSPITAL WILL NOT FILE COLLECTION SUIT LIENS ON A PRIMARY RESIDENCE, NOR DO WE AUTHORIZE AN AGENCY TO USE SO-CALLED "BODY ATTACHMENTS". THE AGENCIES ARE AWARE OF OUR CFAP AND HAVE BEEN ADVISED TO REFER THE PATIENTS BACK TO CARLE IF THEY DEEM THE PATIENT IS UNABLE TO PAY. BILLING STAFF WILL THEN MAKE ONE MORE ATTEMPT TO WORK WITH THE PATIENT TO SEE IF HELP IS AVAILABLE. IF STAFF DETERMINES THAT THE PATIENT MIGHT QUALIFY, WE SEND THE PATIENT A CFAP APPLICATION AND INSTRUCT THE AGENCY TO PUT A HOLD ON THE ACCOUNT; THE AVERAGE HOLD IS 60 DAYS. IF THE PATIENT IS THEN APPROVED FOR DISCOUNTS AT 100% FOR FINANCIAL ASSISTANCE, THE BALANCE IS ADJUSTED AND THE ACCOUNT IS CLOSED WITH THE AGENCY. IF THE PATIENT IS APPROVED FOR LESS THAN 100%, THE ADJUSTMENTS ARE REPORTED TO THE AGENCY AND THE AGENCY WILL BEGIN COLLECTION EFFORTS ON ANY REMAINING BALANCE. Schedule H, Part V, Section B, Line 16a FAP website - Carle Richland Memorial Hospital: Line 16a URL: SEE SCHEDULE H PART VI; Schedule H, Part V, Section B, Line 16b FAP Application website - Carle Richland Memorial Hospital: Line 16b URL: SEE SCHEDULE H PART VI; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Carle Richland Memorial Hospital: Line 16c URL: SEE SCHEDULE H PART VI; Schedule H, Part VI, Line 2 Needs assessment AS A TAX-EXEMPT ORGANIZATION, CARLE RICHLAND MEMORIAL HOSPITAL PROVIDES CARE TO PATIENTS REGARDLESS OF THE ABILITY TO PAY. CARLE'S GENEROUS FINANCIAL ASSISTANCE PROGRAM HAS RESULTED IN OUR ABILITY TO REACH MANY PEOPLE OVER THE YEARS. TO ENSURE WE ARE ADDRESSING THE NEEDS OF THE COMMUNITY, THE FINANCE AND QUALITY COMMITTEES OF THE CARLE BOARD OF TRUSTEES REVIEW AND EVALUATE CHARITY CARE FIGURES ANNUALLY. WE DO NOT LIMIT THE AMOUNT OF FINANCIAL ASSISTANCE WE PROVIDE, AT THIS TIME. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance Our practice is to look at each patient's financial status in relation to our Carle Financial Assistance Program and the criteria of the Uninsured Patient Discount Act, and to provide the patient with the deepest discount available. By expanding the presumptive eligibility screening processes and determining the financial status of patients up-front, we have been able to pinpoint those needing assistance early in the process, minimizing bad debt and optimizing our ability to help. Staff is also diligent in following up with patients during hospitalization and after discharge if there's any reason to believe the patient could benefit from financial assistance, and we auto-qualify certain patient populations for Carle Financial Assistance Program, such as the homeless, WIC, SNAP (Supplemental Nutrition Assistance Program), Medicaid, Low Income Home Energy Assistance Program (LIHEAP), and Township Assistance recipients. Communicating that Financial Assistance is Available Carle Foundation Hospital has made a concerted, continuous effort to be sure that people have access to information that will help them with their medical bills. These include: -Advertising Carle Financial Assistance Program; continued presence in appropriate community publications; and on-site via displays throughout the hospital and clinics -Simplified application form, including a version in Spanish and French, that contains information regarding the Carle Financial Assistance Program -Publication of a Plain Language Summary and all other financial assistance-related information on Carle.org/FinancialAssistance -Information about the Carle Financial Assistance Program on all statements, collection letters and Hospital admission packets -Carle Financial Assistance Program information and applications at all registration points, Hospital main lobby and carle.org -Meetings with local legislators to help them assist constituents with healthcare needs, including financial assistance Schedule H, Part VI, Line 4 Community information Carle Richland Memorial Hospital has defined its primary service area and populations as the general population within the geographic area in and surrounding Richland County. The hospital's patient population includes all who receive care without regard to insurance coverage or eligibility for assistance. A total of 106,132 people live in the 3,298 square mile report area defined for this assessment according to the U.S. Census Bureau American Community Survey 201020 10year estimates. The population density for this area, estimated at 32 persons per square mile, is less than the national average population density of 92 persons per square mile. The average household size of the area, at 2.3, is lower than both Illinois and the U.S. The median age is 43.7 years, which is higher than Illinois and the U.S. median ages. The largest education segment is high school graduates followed by those with some college. 10.2% of the population has no high school diploma or GED and 34.7% of the community's population have only a high school degree. Unemployment at the time of writing was 3.7%, roughly equivalent to the averages of the unemployment rate in Illinois and the United States. Employment in this community is 48.3% white collar, 33.6% blue collar, and 17.4% service sector. According to 2020 data from the Illinois Primary Healthcare Association, Carle Richland Memorial Hospital is the only hospital in Richland County; there is 1 hospital in Crawford County, Clay County, Lawrence County, Wayne County, and Wabash County; there are no hospitals in Jasper County or Wayne County. As is the case in much of rural Illinois, the median household income in the service area, $56,055, is lower than the statewide or national average. Schedule H, Part VI, Line 5 Promotion of community health RMH has an open medical staff and is governed by a community board that serves on a volunteer basis. Surplus funds are reinvested into the organization for technology replacement and advancement, clinical service expansion and quality improvement. Funds are also invested into our communities to meet identified health needs which contribute to the overall well-being of the residents of the communities we serve. Schedule H, Part VI, Line 6 Affiliated health care system RMH is a 25 bed critical access hospital, not-for-profit healthcare facility located in Olney, IL and became part of the Carle Health System on April 1, 2017. As part of the Carle Health System, it currently serves eight Southeastern Illinois counties, with a total population of more than 107,000 individuals. The integration of Carle and RMH allows for expanded access to healthcare in the region. RMH also operates a 20-bed extended care wing for private-pay patients, which is part of the same legal entity, hospital tax identification number, and Illinois department of public health hospital license. the extended care wing is not part of the Medicare-enrolled critical access hospital. Though RMH falls under the umbrella of The Carle Foundation, it maintains a separate board of directors and senior leadership. While RMH's CHNA and community benefit reporting is separate from the Carle Foundation Hospital, it follows the same guidelines and principles as Carle. RMH staff is involved in the CHNA and implementation plan, and serve on human services agency boards and committees to provide support to help address identified community health needs. true CITY OF OLNEY 300 S WHITTLE AVE OLNEY IL 62450 376001911 GOVERNMENT 12000 PROGRAM SERVICES RICHLAND COUNTY HIGH SCHOOL 1200 EAST LAUREL STREET OLNEY IL 62450 376004449 GOVERNMENT 9075 SPONSORSHIP 2 0 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds ANY CHARITABLE ORGANIZATION WISHING TO REQUEST FUNDS IS ASKED TO SUBMIT THE REQUEST IN WRITING. EMAILED REQUESTS ARE ACCEPTABLE. THE REQUEST MUST INCLUDE A DESCRIPTION OF THE PURPOSE OF THE CONTRIBUTION AND OTHER RELEVANT INFORMATION SUCH AS THE REQUESTOR'S NAME, AND AMOUNT OF THE REQUEST. THE REQUESTS ARE REVIEWED, EVALUATED, AND ADMINISTERED BY THE PUBLIC RELATIONS DIRECTOR WHO MAY SEEK ADDITIONAL INFORMATION FROM THE REQUESTOR AS NEEDED AS WELL AS INPUT FROM ANY APPROPRIATE CARLE ADMINISTRATOR OR DIRECTOR. A SET OF ESTABLISHED GUIDELINES DRIVE THESE DECISIONS. MOST ARE MADE TO IMPROVE HEALTHCARE/ACCESS TO HEALTHCARE OR ARE CONSISTENT WITH THE ORGANIZATION'S ROLE AS A CORPORATE CITIZEN. ASSESSED NEED IS A COMMON CRITERIA. WRITTEN AGREEMENTS ARE IN PLACE AND THERE IS REGULAR CONTACT WITH ORGANIZATIONS, SUCH AS COLLEGES AND UNIVERSITIES, RECEIVING $5,000 OR MORE TO ENSURE THAT THE DONATIONS ARE BEING USED AS AGREED UPON. THE RECORDS ARE MAINTAINED IN ADMINISTRATION OR PUBLIC RELATIONS. false true false false false false false false false RAYMOND FISHER MD BOARD MEMBER // PHYSICIAN 0 628948 0 0 0 24877 0 27678 0 13429 0 694932 0 0 TANNER MILLER MD BOARD MEMBER // PHYSICIAN 0 549735 0 35070 0 2203 0 27678 0 30267 0 644953 0 0 DENNIS HESCH OFFICER - EVP, CHIEF FINANCE & STRATEGY OFFICER 0 1145424 0 0 0 29687 0 306265 0 26301 0 1507677 0 0 JAMES C LEONARD MD OFFICER - PRESIDENT & CEO 0 1805832 0 0 0 492394 0 27678 0 22578 0 2348482 0 462357 MATTHEW KOLB JD MHA EX OFFICIO, NON-VOTING // OFFICER - PRESIDENT, CARLE HEALTH REGIONS // EVP, COO 0 1119849 0 0 0 298780 0 302587 0 31116 0 1752332 0 269019 NAPOLEON KNIGHT MD MBA OFFICER - EVP, CHIEF MEDICAL OFFICER 0 832803 0 0 0 258749 0 27678 0 13516 0 1132746 0 229062 REGINA THOMAS DNP MBA EX OFFICIO, NON-VOTING // OFFICER - PRESIDENT, CARLE HEALTH - SOUTH REGION 0 301284 0 0 0 2350 0 49189 0 17810 0 370633 0 0 KENNETH ARONSON MD FORMER KEY EMPLOYEE 0 634032 0 58303 0 26437 0 27678 0 22698 0 769148 0 0 BROOK FISHER DIRECTOR, REVENUE CYCLE DENIALS 0 165259 0 0 0 7375 0 10854 0 32272 0 215760 0 0 CALEB MILLER SVP, SURGICAL SERVICES & AMBULATORY CARE 0 438377 0 0 0 102598 0 56043 0 31218 0 628236 0 74056 LAUREN SCHMID MBA EVP, CHIEF HUMAN RESOURCES OFFICER 0 711410 0 0 0 167178 0 74631 0 30537 0 983756 0 137552 NICHOLAS CROMPTON VP, CONSTRUCTION & FACILITY SERVICES 0 299356 0 0 0 3853 0 50322 0 34234 0 387765 0 0 ANDREW SHAJARI MD PHYSICIAN - GENERAL SURGERY 622957 0 0 0 3539 0 0 0 7490 0 633986 0 0 0 HARRY GARRETT MD PHYSICIAN - FAMILY MEDICINE 594113 0 38933 0 25213 0 27678 0 22867 0 708804 0 0 0 JUSTIN ORENICH DO PHYSICIAN - GENERAL SURGERY 682857 0 35000 0 2213 0 27678 0 21134 0 768882 0 0 0 PARTH PATEL DO PHYSICIAN - PAIN CLINIC 600164 0 0 0 2213 0 0 0 24440 0 626817 0 0 0 YEKATERINA FAYN MD PHYSICIAN - CARDIOLOGY 620274 0 0 0 25213 0 27678 0 10336 0 683501 0 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE GOVERNING BOARD OF THE CARLE FOUNDATION, THE SYSTEM PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY. - THE COMMITTEE IS COMPRISED OF MEMBERS OF THE GOVERNING BOARD WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED, AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. - THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. - THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. - THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR, WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan THE 2024 PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE SYSTEM PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, LISTED ON FORM 990 PART VII INCLUDE MATTHEW KOLB, JD, MHA, DENNIS HESCH, JAMES C. LEONARD, MD, RAYMOND FISHER, MD, HARRY GARRETT, MD, YEKATERINA FAYN, MD, KENNETH ARONSON, MD, LAUREN SCHMID, MBA, NAPOLEON KNIGHT, MD, MBA, AND CALEB MILLER. IN 2024, PAYMENTS FROM THE 457(F) PLAN WERE MADE TO JAMES LEONARD, MD ($462,357), MATTHEW KOLB, JD, MHA ($269,019), NAPOLEON KNIGHT, MD, MBA ($229,062), LAUREN SCHMID, MBA $137,552), AND CALEB MILLER ($74,056). Whitley Houchin FAMILY MEMBER OF BOARD MEMBER 110551 EMPLOYMENT false Schedule L, Part V FAMILY RELATIONSHIPS WHITLEY HOUCHIN IS AN EMPLOYEE OF RICHLAND MEMORIAL HOSPITAL INC. AND HAS A FAMILY RELATIONSHIP WITH GARY HOUCHIN (SECRETARY AND TREASURER OF BOARD). Form 990, Part VI, Line 2 Family/business relationships amongst interested persons James C. Leonard, MD (Officer), Matthew Kolb, JD, MHA (Officer), AND Napoleon Knight, MD, MBA (Officer) - Business relationship, James C. Leonard, MD (Officer) and Napoleon Knight, MD, MBA (Officer) - Business relationship, James C. Leonard, MD (Officer), Dennis Hesch (Officer), and Lauren Schmid, MBA (Key Employee) - Business relationship, Dennis Hesch (Officer), Matthew Kolb, JD, MHA (Officer), and Nicholas Crompton (Key Employee) - Business relationship Form 990, Part VI, Line 6 Classes of members or stockholders CARLE HEALTH - SOUTH REGION, A TAX-EXEMPT ILLINOIS NOT-FOR-PROFIT CORPORATION, IS THE SOLE MEMBER. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body RICHLAND MEMORIAL HOSPITAL'S SOLE MEMBER, CARLE HEALTH - SOUTH REGION, ACTING THROUGH ITS GOVERNING BOARD, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE BOARD MEMBERS AS WELL AS FILL VACANCIES. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders RICHLAND MEMORIAL HOSPITAL MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, CARLE HEALTH - SOUTH REGION, THROUGH ITS GOVERNING BOARD, WHEN VOTING ON MATTERS INCLUDING AMENDING GOVERNING DOCUMENTS, RECOMMENDING THE PRESIDENT TO THE BOARD, APPROVING ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGETS, APPROVING PAYMENT TO THE MEMBERS OF THE RICHLAND GOVERNING BOARD FOR THEIR EXPENSES OR COMPENSATION, APPROVING ANY NEW, LONG-TERM OR MASTER INSTITUTIONAL PLAN OR CHANGES TO SUCH PLANS, APPROVING THE ADDITION OF ANY NEW MEMBER AND ANY DISSOLUTION, MERGER, CONSOLIDATION, OR SALE OR OTHER DISPOSITION OR ENCUMBRANCE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION OR ANY DISPOSITION OF REAL PROPERTY OR RELOCATION OF THE HOSPITAL AND/OR CLINIC, APPROVING ANY ORGANIZATION OR ACQUISITION OF A SUBSIDIARY OR AFFILIATE, APPROVING ANY INITIATIVE REQUIRING CERTIFICATE OF NEED APPROVAL, APPROVING ANY PLEDGE OF ALL OR ANY PART OF THE CORPORATION'S ASSETS AS SECURITY FOR A DEBT, LIABILITY OR OTHER OBLIGATION, APPROVING ANY LOAN TO OR FOR THE CORPORATION OR ANY OTHER INDEBTEDNESS, AND APPROVING NON-BUDGETED EXPENDITURES OR SALE EXCEEDING THE PRESIDENT'S AUTHORIZED SPENDING AUTHORITY. Form 990, Part VI, Line 11b Review of form 990 by governing body FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY BY POSTING TO THE ORGANIZATION'S DIRECTOR COMMUNICATION PORTAL. ALSO, BEFORE FILING, EACH BOARD MEMBER RECEIVED NOTIFICATION THAT THE FORM 990 WAS POSTED AND AVAILABLE FOR REVIEW AT HIS/HER DISCRETION. EACH BOARD MEMBER HAS THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS. Form 990, Part VI, Line 12c Conflict of interest policy THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, MEMBERS OF THE GOVERNING BOARD, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE COMPLIANCE DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO AND ADDRESSED BY THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF MEMBERS OF THE GOVERNING BOARD AND MEMBERS OF THE BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD, ABSENT THE SUBJECT BOARD OR COMMITTEE MEMBER DETERMINES WHETHER A CONFLICT EXISTS. BOARD MEMBERS AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM DELIBERATING AND VOTING ON MATTERS THAT MAY PRESENT A CONFLICT. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH ACTUAL AND/OR POTENTIAL CONFLICTS OF INTEREST. Form 990, Part VI, Line 19 Required documents available to the public THE CARLE FOUNDATION, THE SYSTEM PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, PUBLISHES THROUGH WWW.DACBOND.COM AND https://emma.msrb.org/ ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, ANNUAL AUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THESE WEBSITES. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE OR BY SEARCHING AT HTTPS://EMMA.MSRB.ORG/. IN ADDITION, FORMS 990 OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND. QUARTERLY FINANCIAL STATEMENTS ARE ALSO AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. Form 990, Part VII, Section A COLUMN B THE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40-HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK. Form 990, Part VIII, Line 11d Other Miscellaneous Revenue ALL OTHER REVENUE - Total Revenue: 42870, Related or Exempt Function Revenue: 22402, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 20468; LAUNDRY SERVICES - Total Revenue: 10296, Related or Exempt Function Revenue: , Unrelated Business Revenue: 10296, Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances INTERCOMPANY RECEIVABLE/PAYABLE SETTLEMENTS - 5742517; Total - 5742517; Form 990, Part XII, Line 2c Change of Oversight Process or Selection Process FORM 990 PART XII, QUESTION 2A, B, C AND PART IV, LINES 12, 12A THE FINANCIAL STATEMENTS FOR RICHLAND MEMORIAL HOSPITAL, WERE AUDITED ON A CONSOLIDATED BASIS. THE CARLE FOUNDATION HAS AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT OR AUDITOR. Form 990, Part VI, Line 15 15A & 15B - Procces to establish compensation of top management official RICHLAND MEMORIAL HOSPITAL DOES NOT COMPENSATE ITS OFFICERS. EMPLOYEE COMPENSATION FOR THESE INDIVIDUALS IS PAID BY THE SYSTEM PARENT ORGANIZATION, THE CARLE FOUNDATION. THE GOVERNING BOARD OF THE CARLE FOUNDATION, THE SYSTEM PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: - THE COMMITTEE IS COMPRISED OF MEMBERS OF THE GOVERNING BOARD; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. - THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. - THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. - THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR, WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE. CARLE BROMENN MEDICAL CENTER 611 W PARK STREET URBANA IL 61801 850682363 HOSPITAL SERVICES IL 501(c)(3) 3 CHCR true CARLE COMMUNITY HEALTH CORPORATION 611 W PARK STREET URBANA IL 61801 364458371 FNDN MISSION IL 501(c)(3) Type I CDF true CARLE DEVELOPMENT FOUNDATION 611 W PARK STREET URBANA IL 61801 371159978 FUNDRAISING IL 501(c)(3) 7 TCF true CARLE EUREKA HOSPITAL 611 W PARK STREET URBANA IL 61801 850688306 HOSPITAL SERVICES IL 501(c)(3) 3 CHCR true CARLE HEALTH - CENTRAL REGION 611 W PARK STREET URBANA IL 61801 990548510 GOVERNANCE/OVERSIGHT IL 501(c)(3) Type III-FI TCF true CARLE HEALTH - EAST REGION 611 W PARK STREET URBANA IL 61801 990582680 GOVERNANCE/OVERSIGHT IL 501(c)(3) Type III-FI TCF true CARLE HEALTH - SOUTH REGION 611 W PARK STREET URBANA IL 61801 990614340 GOVERNANCE/OVERSIGHT IL 501(c)(3) Type III-FI TCF true CARLE HEALTH - WEST REGION 611 W PARK STREET URBANA IL 61801 371111135 GOVERNANCE/OVERSIGHT IL 501(c)(3) Type III-FI TCF true CARLE HEALTH CARE INCORPORATED 611 W PARK STREET URBANA IL 61801 371140016 VARIOUS MEDICAL SERVICES IL 501(c)(3) 10 TCF true CARLE RETIREMENT CENTERS INC 611 W PARK STREET URBANA IL 61801 371160033 RETIREMENT LIVING IL 501(c)(3) 10 TCF true CARLE WEST PHYSICIAN GROUP INC 611 W PARK STREET URBANA IL 61801 850703768 PHYSICIAN SERVICES IL 501(c)(3) 10 CHCI true CRIS HEALTHY AGING 611 W PARK STREET URBANA IL 61801 370948852 SENIOR CITIZEN SERVICES IL 501(c)(3) 7 CHCI true HOOPESTON COMMUNITY MEMORIAL HOSPITAL 611 W PARK STREET URBANA IL 61801 363637465 HOSPITAL SERVICES IL 501(c)(3) 3 CHER true HULT CENTER FOR HEALTHY LIVING INC 611 W PARK STREET URBANA IL 61801 363510390 WELLNESS SERVICES IL 501(c)(3) 7 PH true HUMAN SERVICE CENTER 611 W PARK STREET URBANA IL 61801 371004882 BEHAVIORAL HEALTH SERVICES IL 501(c)(3) 7 TP true METHODIST MEDICAL CENTER FOUNDATION 611 W PARK STREET URBANA IL 61801 510186460 FUNDRAISING IL 501(c)(3) 7 CHWR true METHODIST MEDICAL CENTER OF ILLINOIS 611 W PARK STREET URBANA IL 61801 370661223 HOSPITAL SERVICES IL 501(c)(3) 3 CHWR true METHODIST SERVICES INC 611 W PARK STREET URBANA IL 61801 371111134 PROPERTY HOLDING CO. IL 501(c)(3) PF CHWR true PARK COURT LIMITED 611 W PARK STREET URBANA IL 61801 371178386 PROPERTY HOLDING CO. IL 501(c)(3) Type II CHWR true PEKIN MEMORIAL HOSPITAL 611 W PARK STREET URBANA IL 61801 370692351 HOSPITAL SERVICES IL 501(c)(3) 3 CHWR true PRAIRIE VIEW VILLAS NO 1 611 W PARK STREET URBANA IL 61801 261755679 HOUSING SERVICES IL 501(c)(3) 7 TMHC true PROCTOR HEALTH SYSTEMS 611 W PARK STREET URBANA IL 61801 364147437 PHYSICIAN SERVICES IL 501(c)(3) 3 CHWR true PROCTOR HOSPITAL 611 W PARK STREET URBANA IL 61801 370681540 HOSPITAL SERVICES IL 501(c)(3) 3 CHWR true TAZWOOD MENTAL HEALTH CENTER INC 611 W PARK STREET URBANA IL 61801 371278969 BEHAVIORAL HEALTH SERVICES IL 501(c)(3) 7 TP true THE CARLE FOUNDATION 611 W PARK STREET URBANA IL 61801 370673465 PARENT/INV MGMT IL 501(c)(3) Type III-FI NA false THE CARLE FOUNDATION HOSPITAL 611 W PARK STREET URBANA IL 61801 371119538 HOSPITAL SERVICES IL 501(c)(3) 3 CHER true THE METHODIST MEDICAL CENTER OF ILLINOIS SELF INSURANCE TRUST AGREEMENT 611 W PARK STREET URBANA IL 61801 376181831 SELF INSURANCE IL 501(c)(3) Type I MMCI true TRILLIUM PLACE 611 W PARK STREET URBANA IL 61801 834051901 BEHAVIORAL HEALTH SERVICES IL 501(c)(3) Type II CHWR true CENTRAL ILLINOIS ENDOSCOPY CENTER LLC 611 W PARK STREET URBANA IL 61801 208243285 MEDICAL SERVICES IL NA N/A CHAMPAIGN SURGICENTER LLC 611 W PARK STREET URBANA IL 61801 201915925 SURGICAL CENTER IL NA N/A MOUPH LLC 611 W PARK STREET URBANA IL 61801 921791534 OUTPATIENT ORTHOPEDIC SERVICES IL NA N/A RAVEN EVERGREEN CREDIT OFFSHORE FUND II LP 75 SPRING STREET 6TH FLOOR NEW YORK NY 10012 981747373 INVESTMENTS NA N/A REHABILITATION THERAPY SERVICES LLC 416 ST MARKS CT 110 PEORIA IL 61603 810584193 REHABILITATION THERAPY IL NA N/A THE CENTER FOR ORTHOPEDIC MEDICINE LLC RECOVERY CARE CENTER 2502B E EMPIRE ST BLOOMINGTON IL 61704 270934895 OUTPATIENT ORTHOPEDIC SERVICES IL NA N/A THE CENTER FOR ORTHOPEDIC MEDICINE LLC SURGERY CENTER 2502B E EMPIRE ST BLOOMINGTON IL 61704 371356453 OUTPATIENT ORTHOPEDIC SERVICES IL NA N/A BELCREST SERVICES LTD 611 W PARK STREET URBANA IL 61801 371196307 MEDICAL SERVICES IL NA C Corporation true CARLE HEALTH JUNCTION MEDICAL LLC 611 W PARK STREET URBANA IL 61801 814609769 CARE COORDINATION IL NA C Corporation true CARLE HEALTH PHYSICIAN PARTNERS INC 611 W PARK STREET URBANA IL 61801 850718392 PHYSICIAN SERVICES IL NA C Corporation true CARLE HOLDING COMPANY INC 611 W PARK STREET URBANA IL 61801 371188284 HOLDING CO. IL NA C Corporation true CARLE RESEARCH PRODUCTS INC 611 W PARK STREET URBANA IL 61801 999999999 MEDICAL RESEARCH - INACTIVE IL NA C Corporation true CARLE RISK MANAGEMENT COMPANY 611 W PARK STREET URBANA IL 61801 371217973 RISK MANAGEMENT IL NA C Corporation true CARLE VENTURES INC 611 W PARK STREET URBANA IL 61801 371313150 HEALTH CARE PARTNERSHIPS IL NA C Corporation true CHA HOLDING INC 3310 SOUTH FIELDS DR CHAMPAIGN IL 61822 471854275 HOLDING CO. IL NA C Corporation true FIRSTCAROLINACARE INSURANCE COMPANY 42 MEMORIAL DR PINEHURST NC 28374 331160597 INSURANCE IL NA C Corporation true HEALTH ALLIANCE CONNECT INC 3310 SOUTH FIELDS DR CHAMPAIGN IL 61822 464796891 HEALTH CARE COORDINATION IL NA C Corporation true HEALTH ALLIANCE MEDICAL PLANS INC 3310 SOUTH FIELDS DR CHAMPAIGN IL 61822 371260731 HEALTH COVERAGE IL NA C Corporation true HEALTH ALLIANCE MIDWEST INC 3310 SOUTH FIELDS DR CHAMPAIGN IL 61822 371354502 HEALTH COVERAGE IL NA C Corporation true HEALTH ALLIANCE NORTHWEST HEALTH PLAN 820 N CHELAN AVE WENATCHEE WA 98801 461966323 HEALTH COVERAGE WA NA C Corporation true HEALTH ALLIANCE NORTHWEST HOLDING 820 N CHELAN AVE WENATCHEE WA 98801 461717578 HOLDING CO. WA NA C Corporation true HEALTH PLUS INC 611 W PARK STREET URBANA IL 61801 371295532 CONTRACTING IL NA C Corporation true HEALTH SYSTEMS INSURANCE LIMITED GOVERNORS SQUARE 2ND FLOOR BLDG 3 23 LIME TREE BAY AVE GRAND CAYMAN CJ KY11102 980638449 INSURANCE CJ NA C Corporation true METHODIST HEALTH VENTURES INC 611 W PARK STREET URBANA IL 61801 371140939 HOLDING CO. IL NA C Corporation true OPTIMUM HEALTH SOLUTIONS INC 611 W PARK STREET URBANA IL 61801 205430137 CARE COORDINATION - INACTIVE IL NA C Corporation true PEKIN PROHEALTH INC 611 W PARK STREET URBANA IL 61801 371117052 CLINICAL OPERATIONS IL NA C Corporation true PROVIDER RESOURCE MANAGEMENT INC 611 W PARK STREET URBANA IL 61801 371223550 PHYSICIAN SERVICES IL NA C Corporation true true false true false false false false false false false true true true false false true true true true CARLE HEALTH CARE INCORPORATED A 9600 BOOK Health Alliance Medical Plans A 131 BOOK CARLE DEVELOPMENT FOUNDATION C 76789 BOOK Health Alliance Connect Inc L 895233 BOOK Health Alliance Medical Plans L 2428378 BOOK HEALTH SYSTEMS INSURANCE LIMITED M 532313 BOOK HOOPESTON COMMUNITY MEMORIAL HOSPITAL S 250000 BOOK THE CARLE FOUNDATION HOSPITAL S 116049 BOOK