2016-11-07T11:44:23-06:00 2015-12-31 BKD LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 631022733 990 2015-01-01 370662561 SOUTHWESTERN ILLINOIS HEALTH FACILITIES INC % MICHAEL MARSHALL SOUT 6183916400 6800 STATE ROUTE 162 MARYVILLE IL 62062 MIKE MARSHALL CFO 6183916400 2016-11-04 true Donna J Larson P00043751 3142315544 2016-10-17 2015 2017-02-10 21:41:12Z ANDERSON HOSPITAL KEITH PAGE 6800 STATE ROUTE 162 MARYVILLE IL 62062 179861515 false X WWW.ANDERSONHOSPITAL.ORG X 1977 IL OUR COMMUNITY TURNS TO ANDERSON FIRST FOR ALL HEALTHCARE NEEDS. 20 19 1448 200 209526 0 0 144442968 152849780 5816948 1743186 5719292 3132914 155979208 157725880 15235 29966 0 0 59383065 62908436 0 0 0 75436149 82071930 134834449 145010332 21144759 12715548 185652752 191133162 82140652 76789140 103512100 114344022 TO EXCEED EXPECTATIONS IN PROVIDING PERSONAL, CONVENIENT, QUALITY HEALTHCARE. false false 117863364 29966 153059306 NURSING AND ANCILLARY SERVICES FOR 29,263 INPATIENT DAYS, 98,181 OUTPATIENT VISITS, 9,157 OUTPATIENT SURGERIES AND 37,662 EMERGENCY VISITS 117863364 true false false true false false false false false false true false false false true false false true false false false false false false false false true true true false true true false false false false false true false false false true false false false false true true true true false false true 62 0 true 1448 true true true false false false false false false false false false X 20 19 false false false false false false false true true false false false true true true true true true false false IL X MICHAEL MARSHALL 6183916402 6800 STATE ROUTE 162 MARYVILLE IL 62062 X MARK SHASHEK CHAIRPERSON 1.08 2.0 X X 0 0 0 FRANK FLANIGAN VICE CHAIRPERSON 0.65 0.0 X X 0 0 0 ROBERT CIUFERI TREASURER 0.27 0.0 X X 0 0 0 MILLIE BELOBRAYDIC SECRETARY 0.44 0.0 X X 0 0 0 KAY WERNER ASST SECRETARY 0.27 0.0 X X 0 0 0 JOSEPH SMITH TRUSTEE 0.62 0.0 X 0 0 0 RICHARD DAWDY TRUSTEE 0.57 0.0 X 0 0 0 LENDELL PHELPS JR TRUSTEE 0.31 2.0 X 0 0 0 K MAX EAKIN MD TRUSTEE 0.31 2.0 X 0 0 0 JOSEPH HAGERTY TRUSTEE 0.42 0.0 X 0 0 0 GARY CERETTO TRUSTEE 0.23 0.0 X 0 0 0 PATRICK ZIMMERMANN MD TRUSTEE 0.25 0.0 X 0 0 0 GREGORY COFFEY TRUSTEE 0.42 0.0 X 0 0 0 LAURA BERNAIX MD TRUSTEE 0.16 0.0 X 0 0 0 REV MARK MAYNARD TRUSTEE 0.27 0.0 X 0 0 0 JEFFREY PARRES MD TRUSTEE 0.29 0.0 X 0 0 0 DALE SAUER TRUSTEE 0.16 0.0 X 0 0 0 NANCY THOMAS TRUSTEE 0.22 0.0 X 0 0 0 GINGER TRUCANO TRUSTEE 0.25 0.0 X 0 0 0 JUDY WIEMANN TRUSTEE 0.29 0.0 X 0 0 0 KEITH PAGE PRESIDENT 40.0 5.0 X 382667 0 75130 MICHAEL MARSHALL CFO 40.0 5.0 X 238330 0 39662 PHILLIP GREENE PHYSICIAN 40.0 0.0 X 204943 0 19483 RAFE HENG PHYSICIAN 40.0 0.0 X 213942 0 10490 SUSAN REYNOLDS PHYSICIAN 40.0 0.0 X 197050 0 20382 ANITA SANDHU PHYSICIAN 40.0 0.0 X 276726 0 0 JEAN SWEARINGEN PHYSICIAN 40.0 0.0 X 210769 0 6088 1724427 0 171235 31 false true false CENTER FOR ADVANCED ORTHO 6800 STATE ROUTE 162 STE 123 MARYVILLE IL 62062 PHYSICIAN SERVICES 1611648 GENERAL LAPARSCOPIC SURGERY ASSOC 6800 STATE ROUTE 162 STE 121 MARYVILLE IL 62062 PHYSICIAN SERVICES 1431800 FAMILY CARE SPECIALISTS PROFESSIONAL PARK MARYVILLE IL 62062 PHYSICIAN SERVICES 1166410 NEXTGEN HEALTHCARE INFO SYSTEMS 18111 VON KARMAN AVE IRVINE CA 92612 SOFTWARE SERVICES 976323 QUEST DIAGNOSTICS 12436 COLLECTION CENTER DR CHICAGO IL 60693 LAB SERVICES 965918 48 X 0 NET PATIENT REVENUE 621110 152849780 152849780 152849780 2045147 2045147 0 0 2022815 2022815 0 2022815 2022815 21833674 0 21773020 362615 60654 -362615 -301961 -301961 0 0 0 MEDICAL INFORMAITON RELEASE FEES 561000 119108 119108 SISHA CONTRACT 624310 209526 209526 SICHA BONUS REVENUE 561000 48027 48027 733438 733438 1110099 157725880 152849780 209526 4666574 X 29966 29966 0 0 0 735789 735789 0 0 52087015 44037393 8049622 1429296 1268291 161005 5028802 4288812 739990 3627534 3066928 560606 0 1010991 1010991 186803 186803 0 0 0 24076157 15812837 8263320 339420 16964 322456 25485276 21844353 3640923 0 0 8132617 7507840 624777 161315 121408 39907 0 0 2058754 2058754 0 6845431 6748518 96913 2941046 507576 2433470 Bad Debt Expense 4865504 4865504 Taxes 5582836 5582836 Dues and Subscriptions 311362 87450 223912 EDUCATION 74418 17934 56484 145010332 117863364 27146968 0 2870246 2348314 6956302 3652844 0 0 18829415 19642054 0 0 0 0 0 0 2318571 2280466 1488553 1447636 156948320 74851638 79353770 82096682 69868373 76461048 0 0 0 0 0 0 3967522 3204118 185652752 191133162 12784258 9883869 0 0 0 0 42427622 40514268 0 0 0 0 2501492 2235125 0 0 24427280 24155878 82140652 76789140 X 103512100 114344022 0 0 0 0 103512100 114344022 185652752 191133162 12715548 -1883626 X false true X true false X false false false false false true 44724 false false false 44724 false PART II-B, LINE F GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES THE AMOUNT REPRESENTS THE PORTION OF DUES PAID TO PROFESSIONAL ORGANIZATIONS THAT IS ALLOCATED TO THE LOBBYING ACTIVITIES OF THOSE ORGANIZATIONS. 0 3170811 3170811 0 105202135 39264396 65937739 0 624593 534504 90089 0 44572705 32799301 11773404 0 3378076 2253437 1124639 82096682 0 Due to Third Party Payers 4590878 Estimated Self-Insurance Costs 19565000 24155878 PART V, LINE 4 ENDOWMENT FUNDS THE FUNDS ARE DESIGNATED FOR CAPITAL IMPROVEMENTS, TO PROVIDE SELF-INSURANCE COVERAGE, TO MEET BOND REQUIREMENTS, AND TO PROVIDE FUNDS FOR HEALTH CARE PROGRAMS. HOWEVER, NONE OF THE FUNDS MEETS THE DEFINITION OF AN ENDOWMENT FUND UNDER SFAS 117, THEREFORE, PART V HAS NOT BEEN COMPLETED. PART X, LINE 2 UNCERTAIN TAX POSITIONS UNDER FIN 48 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 TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. true true true X true X 600. true true false true true 1266500 1266500 0.00900 28165817 17003611 11162206 0.08000 29432317 17003611 12428706 0.08900 657860 657860 0.00500 1649509 1649509 0.01200 29966 29966 2337335 2337335 0.01700 31769652 17003611 14766041 0.10600 true 4865504 30701823 35125735 -4423912 X true true 1 1 ANDERSON HOSPITAL 6800 STATE ROUTE 162 MARYVLLE IL 62062 WWW.ANDERSONHOSPITAL.ORG 0004119 X X X ANDERSON HOSPITAL 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 X true 15 true SEE PART V, SECTION C false false true X 200. 600. X X X X X true true X 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 true false X X X true X false false SCHEDULE H, PART V, SECTION B, LINE 5 IN CONDUCTING THE MOST RECENT CHNA, ANDERSON HOSPITAL ELICITED INPUT FROM THE COMMUNITY MEMBERS THROUGH A VARIETY OF METHODS. WE PARTNERED WITH THE MADISON COUNTY HEALTH DEPARTMENT TO HOLD FOCUS GROUPS, CONDUCT A COMMUNITY HEALTH SURVEY, AND ORGANIZE MEETINGS TO SET TOP HEALTH PRIORITIES. THE STAKEHOLDER FOCUS GROUPS ALLOWED US TO OBTAIN PERTINENT INFORMATION FROM OUR COMMUNITY LEADERS AND STAFF MEMBERS TO ESTABLISH KEY HEALTH CONCERNS. EIGHT TOTAL FOCUS GROUPS WERE HELD THROUGHOUT THE COMMUNITY IN MADISON COUNTY, WITH ONE BEING HELD AT ANDERSON HOSPITAL. THE ATTENDEES OF THE STAKEHOLDER FOCUS GROUPS WERE INDIVIDUALS WHO ARE INVOLVED WITH THE HEALTH OF THE COMMUNITY THROUGH THEIR PROFESSION OR PERSONAL INTEREST IN HEALTH AND WELLNESS. EXAMPLES INCLUDED HEALTH EDUCATORS AND ADMINISTRATORS FROM HOSPITALS AND ASSISTED LIVING FACILITIES IN THE AREA, FACULTY FROM LOCAL UNIVERSITIES AND COLLEGES, PHARMACISTS, HEALTH EDUCATORS FROM THE MADISON COUNTY HEALTH DEPARTMENT, COLLEAGUES THAT WORK WITH SPECIFIC POPULATIONS AND PERSONS WITH DISABILITIES, AND STAFF FROM ORGANIZATIONS THAT FOCUS ON THE HEALTH AND WELLBEING OF THE COMMUNITY. THE FOCUS GROUP QUESTIONS TARGETED WHAT IS IMPORTANT TO THE HEALTH OF OUR COMMUNITY, WHAT ARE THE MOST URGENT HEALTH CONCERNS, WHAT ARE THE CAUSES OF THESE PROBLEMS, WHAT ARE THE STRENGTHS OF THE SERVICES IN THE COMMUNITY, AND WHAT ARE THE GREATEST OBSTACLES. PARTICIPANTS WERE ASKED FOR FURTHER INVOLVEMENT IN PROMOTING COMPLETION OF THE COMMUNITY HEALTH SURVEY. THE COMMUNITY HEALTH SURVEY WAS DISSEMINATED ELECTRONICALLY THROUGH EMAIL AND THROUGH PAPER SURVEYS THAT WERE PLACED AROUND THE COMMUNITY AND AT ANDERSON HOSPITAL. THE SURVEY YIELDED 389 RESPONSES FROM OUR PRIMARY SERVICE AREA. QUESTIONS FOCUSED ON WHAT ARE THE MOST URGENT HEALTH CONCERNS, WHAT KEEPS PEOPLE FROM BEING HEALTHY, WHY PEOPLE DO NOT GET NEEDED HEALTH CARE, AND RATE HEALTH ISSUES ON A SCALE OF MOST URGENT TO NOT A PROBLEM. FROM THE SURVEY RESULTS, TEN TOP HEALTH CONCERNS WERE IDENTIFIED. ANDERSON HOSPITAL PARTICIPATED IN THE MADISON COUNTY HEALTH DEPARTMENT MEETINGS TO IDENTIFY THEIR TOP CONCERNS TO GAIN INSIGHT, THEN MET WITH OUR INTERNAL TEAM TO DETERMINE WHAT THE TOP CONCERNS WERE FOR OUR SPECIFIC SERVICE AREA. ANDERSON HOSPITAL'S HEALTH EDUCATION PLANNING COMMITTEE MET AND MEMBERS INDIVIDUALLY CHOSE THEIR TOP CONCERNS, AND THEN DISCUSSED EACH TOPIC AS A COMMITTEE TO ULTIMATELY DETERMINE OUR TOP 4 PRIORITY TOPICS. THE TOPICS INCLUDED CANCER, POVERTY, OBESITY, AND SUBSTANCE ABUSE. SCHEDULE H, PART V, SECTION B, LINE 7A & 7D CHNA WEBSITE: HTTP://WWW.ANDERSONHOSPITAL.ORG/ABOUT_US/COMMUNITY_HEALTH_NEEDS_ASSESSMENT .ASPX AVAILABILITY OF CHNA THE CHNA IS AVAILABLE ON THE HOSPITAL'S WEBSITE, UPON REQUEST VIA PHONE OR IN PERSON, AND HARDCOPIES ARE AVAILABLE IN LOBBY AREA AT THE HOSPITAL. THE ORGANIZATION'S IMPLEMENTATION STRATEGY IS INCLUDED WITH THE CHNA THAT IS AVAILABLE ON THE HOSPITAL'S WEBSITE. PART V, SECTION B, 10A IMPLEMENTATION STRATEGY WEBSITE: HTTP://WWW.ANDERSONHOSPITAL.ORG/ABOUT_US/COMMUNITY_HEALTH_NEEDS_ASSESSMENT .ASPX SCHEDULE H, PART V, SECTION B, LINE 22D SELF PAY ACCOUNTS WERE DISCOUNTED AS REQUIRED BY GUIDELINES PROVIDED BY THE STATE OF ILLINOIS. WE GIVE ALL UNINSURED PATIENTS A 50% DISCOUNT OFF CHARGES, THEN BASED ON THEIR FPL%, THEY MAY BE ELIGIBLE FOR ADDITIONAL FINANCIAL ASSISTANCE. NO UNINSURED PATIENT PAYS MORE THAN 25% OF TOTAL CHARGES. SCHEDULE H, PART V, SECTION B, LINE 11 ANDERSON HOSPITAL'S HEALTH EDUCATION PLANNING COMMITTEE FACILITATES AND MAINTAINS AN ANNUAL DASHBOARD FOCUSED ON THE TOP HEALTH PRIORITIES FOR 2016-2018 THAT WERE IDENTIFIED IN OUR COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS CONDUCTED IN 2015. ANDERSON CHOSE A TOTAL OF FOUR INTERNAL AND EXTERNAL HEALTH PRIORITIES BASED ON TOP HEALTH CONCERNS IN OUR SERVICE AREA. EACH HEALTH PRIORITY HAS A LIST OF OBJECTIVES THAT WERE THE PRIMARY FOCUS OVER THE LAST THREE YEARS. ANDERSON WORKED CLOSELY WITH OUR COMMUNITY PARTNERS TO MEET THESE OBJECTIVES. ALTHOUGH THERE WERE MANY HEALTH CONCERNS IN OUR COMMUNITY THAT NEEDED TO BE ADDRESSED, WE PRIORITIZED ON THE TOP FOUR WITH THE BEST INTEREST OF IMPROVING THESE CONCERNS OVER THE THREE YEAR TIME PERIOD. THE HEALTH EDUCATION PLANNING COMMITTEE MEETS AT LEAST QUARTERLY TO UPDATE THE DASHBOARD WITH THE OBJECTIVES THAT HAVE BEEN MET, AS WELL AS DOCUMENT IF A PARTICULAR OBJECTIVE COULD NOT BE MET AND WHY. ADDITIONALLY, WE RECORD AND MAINTAIN ALL COMMUNITY BENEFIT DATA FOR ANDERSON HOSPITAL IN THE CIBSA DATABASE. WITH THIS INFORMATION, WE CAN IDENTIFY HOW WE HAVE MET OUR GOALS AND OBJECTIVES, AND FOCUS ON AREAS OF GROWTH IN THE FUTURE. SCHEDULE H, PART V, SECTION B, LINE 16A, 16B & 16C WEBSITE URL FOR FAP: THE FAP, FAP APPLICATION FORM, AND PLAIN LANGUAGE SUMMARY OF THE FAP ARE ALL FOUND AT THE FOLLOWING LINK: HTTP://WWW.ANDERSONHOSPITAL.ORG/PATIENTS_VISITORS/FINANCIAL_ASSISTANCE.ASP X 13 ANDERSON REHAB SERVICES 2928 NORTH CENTER MARYVILLE IL 62062 REHAB SERVICES SOUTHERN ILLINOIS SPECIALIZED HEALTH 53 EAST ELM ALTON IL 62002 REHAB SERVICES MARYVILLE IMAGING 2023 VADALABENE DR MARYVILLE IL 62062 IMAGING SERVICES ANDERSON SLEEP CENTER 2809 NORTH CENTER MARYVILLE IL 62062 SLEEP STUDY COLLINSVILLE EXPRESS CARE 1103 BELT LINE RD COLLINSVILLE IL 62234 ER - OTHER GLEN CARBON EXPRESS CARE 17 GINGER CREEK GLEN CARBON IL 62034 ER - OTHER HIGHLAND EXPRESS CARE 2504 COMMERCE LN HIGHLAND IL 62249 ER - OTHER WELLNESS CENTER 2133 VADALABENE DR MARYVILLE IL 62062 ER - OTHER ANDERSON HOME HEALTH 6800 STATE ROUTE 162 MARYVILLE IL 62062 HOME HEALTH SERVICES BETHALTO EXPRESS CARE 159 E MCARTHUR BETHALTO IL 62010 ER - OTHER ANDERSON CANCER CENTER 2227 VADALABENE MARYVILLE IL 62062 CANCER TREATMENT ANDERSON PEDIATRIC CENTER 6820 STATE ROUTE 162 MARYVILLE IL 62062 PEDIATRIC SERVICES ONCOLOGY TREATMENT CENTER 6836 STATE ROUTE 162 MARYVILLE IL 62062 CANCER TREATMENT SCHEDULE H, PART III, SECTION A, LINE 2 & LINE 4 BAD DEBTS ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYER SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYER SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYER HAS NOT YET PAID, OR FOR PAYERS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED OR PROVIDED BY POLICY) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. SCHEDULE H, PART III, SECTION B, LINE 8 MEDICARE COSTING METHODOLOGY IS BASED ON COST-TO-CHARGE RATIOS. MEDICARE SHORTFALLS SHOULD BE RECORDED AS COMMUNITY BENEFIT AS RATES ARE SET BY THE GOVERNMENT AT LEVELS SIGNIFICANTLY BELOW COSTS. 30% OR MORE OF ANDERSON'S TOTAL BUSINESS IS PATIENTS IN OUR COMMUNITY WITH MEDICARE COVERAGE. SCHEDULE H, PART III, SECTION C, LINE 9B COLLECTION PRACTICES ALL BILLING AND COLLECTION POLICIES AND PRACTICES WILL REFLECT THE MISSION AND VALUES OF ANDERSON HOSPITAL, INCLUDING OUR SPECIAL CONCERN FOR PEOPLE WHO ARE POOR AND VULNERABLE. ANDERSON HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE BY ESTABLISHING SOUND BUSINESS PRACTICES. ANDERSON HOSPITAL'S BILLING AND COLLECTION PRACTICES WILL BE FAIR AND CONSISTENTLY APPLIED WITHIN EACH ENTITY. PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE PROVIDED THAT ASSISTANCE AND THEIR ACCOUNTS ARE WRITTEN OFF AND NO FURTHER COLLECTION ACTIVITY OCCURS ON THE PORTION OF THE BILL THAT QUALIFIES FOR CHARITY. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT THE COMMUNITY BENEFIT PLAN IDENTIFIES COMMUNITY HEALTH NEEDS AND GAPS THROUGH COMMUNITY, EMPLOYEE, AND VOLUNTEER SURVEYS, PERIOD MEETINGS WITH THE LOCAL MAYOR, AND COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT AND ALIGNS THOSE WITH THE HOSPITAL'S INITIATIVES. THE PLAN IS DEVELOPED BY THE HEALTH EDUCATION PLANNING COMMITTEE IN COLLABORATION WITH THE MADISON COUNTY PARTNERSHIP FOR COMMUNITY HEALTH AND COMMUNITY LEADERS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE FINANCIAL COUNSELORS ASSIST PATIENTS WITH THEIR HEALTH INSURANCE OR FINANCIAL ASSISTANCE NEEDS. DURING THE BILLING CYCLE, PATIENT FINANCIAL SERVICES WORKS WITH PATIENTS WHO NEED ASSISTANCE OR PAYMENT PLANS. FINANCIAL ASSISTANCE INFORMATION IS POSTED ON THE ANDERSON HOSPITAL WEBSITE. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION ANDERSON HOSPITAL SERVES PATIENTS IN MADISON COUNTY, AND THE ILLINOIS CITIES OF TROY, MARYVILLE, EDWARDSVILLE, GLEN CARBON, GRANITE CITY, AND HIGHLAND. THE COMMUNITY IS MOSTLY A WHITE COLLAR COMMUNITY WITH LITTLE INDUSTRY. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH TO CONTINUE MCPCH INVOLVEMENT WITH COMMITTEE REPRESENTATION FROM ANDERSON HOSPITAL, INCLUDING: MOTOR VEHICLE COMMITTEE, ADDICTIVE BEHAVIOR COMMITTEE, SEXUAL RISK BEHAVIORS COMMITTEE, CANCER COMMITTEE, CARDIOVASCULAR COMMITTEE, AND MCPCH COMMITTEE MEMBERS TO REPORT AT HEPC. TO CONTINUE TO INCREASE AWARENESS OF DISASTER PREPAREDNESS IN THE COMMUNITY BY: AUGMENTING MCPCH COMMUNITY DISASTER PLANS AND PRESENTING TO LOCAL BUSINESSES. TO EDUCATE AND DISSEMINATE INFORMATION TO THE COMMUNITY REGARDING INFECTION CONTROL, TARGETING MRSA, INFLUENZA A, H1N1, AND PREVENTATIVE PRACTICES AND EDUCATION OF THESE TO LOCAL SCHOOLS. TO MAINTAIN PARTNERSHIP WITH LOCAL BUSINESSES AND PUBLIC SERVICES TO MEET THEIR EMPLOYEES' SPECIFIC HEALTHCARE NEEDS. TO EXPAND HEALTH AND WELLNESS EXPOSURE AT ANDERSON HOSPITAL. TO INCREASE COMMUNITY AWARENESS RELATED TO CONGESTIVE HEART FAILURE. IN COLLABORATION WITH COMMUNITY LEADERS, ANDERSON'S COMMUNITY INCLUDES SEMI-ANNUAL MEETINGS WITH THE LOCAL MAYORS TO DISCUSS THE STRATEGIC PLAN OF THE HOSPITAL, PROVIDE UPDATES ON PLANNED CAPITAL SPENDING, DISCUSS NEW SERVICES, AND TO RECEIVE FEEDBACK FROM THE COMMUNITY REGARDING CURRENT SERVICES OR THE NEEDS FOR ADDITIONAL SERVICES. SCHEDULE H, PART VI, LINE 6 OTHER INFORMATION ANDERSON HOSPITAL WILL PROVIDE QUALITY HEALTH CARE SERVICES TO ALL PERSONS IN NEED REGARDLESS OF THEIR ABILITY TO PAY. EACH PERSON WILL BE TREATED AS AN INDIVIDUAL WITH SPECIFIC NEEDS FOR ASSISTANCE WITHOUT REGARD TO PAYMENT. ANDERSON HOSPITAL EMBRACES ITS RESPONSIBILITY TO SERVE THE COMMUNITIES IN WHICH WE PARTICIPATE AND STRIVES TO INCREASE ACCESS TO CARE FOR ALL MEMBERS OF THE COMMUNITY. ANDERSON HOSPITAL IS AN EMS RESOURCE HOSPITAL PROVIDING TRAINING AND EDUCATION TO LOCAL EMS PERSONNEL. SCHEDULE H, PART VI, LINE 7 STATE FILING OF COMMUNITY BENEFIT REPORT ILLINOIS SCHEDULE H, PART I, LINE 7 FINANCIAL ASSISTANCE & OTHER COMMUNITY BENEFITS THE COSTS REPORTED IN THE TABLE IN PART I, LINE 7, USED A RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM INSTRUCTIONS. THIS METHODOLOGY WAS USED FOR ALL PATIENT SEGMENTS. SCHEDULE H, PART I, LINE 7, COLUMN F FINANCIAL ASSISTANCE & OTHER COMMUNITY BENEFITS - PERCENT OF TOTAL EXPENSE THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $4,865,504 REPORTED ON PART IX, LINE 25, HOWEVER, IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. SCHEDULE H, PART I, LINE 3C FACTORS OTHER THAN FPG IN ADDITION TO FPG, THE ORGANIZATION USES THE FOLLOWING FACTORS TO DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE: ASSET LEVEL, MEDICAL INDIGENCY, INSURANCE STATUS, UNDERINSURANCE STATUS, AND RESIDENCY. true SCHEDULE I, PART I, LINE 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS IN THE UNITED STATES THE ORGANIZATION ONLY MAKES GRANTS TO PRE-SELECTED CHARITABLE ORGANIZATIONS. DURING 2015, NO RECIPIENT RECEIVED MORE THAN $5,000. X X X X false true false false false false false false false KEITH PAGE PRESIDENT 358587 0 0 0 24080 0 53148 0 21982 0 457797 0 0 0 MICHAEL MARSHALL CFO 236833 0 0 0 1497 0 17679 0 21983 0 277992 0 0 0 PHILLIP GREENE PHYSICIAN 186133 0 0 0 18810 0 0 0 19483 0 224426 0 0 0 RAFE HENG PHYSICIAN 205849 0 0 0 8093 0 0 0 10490 0 224432 0 0 0 SUSAN REYNOLDS PHYSICIAN 170852 0 0 0 26198 0 0 0 20382 0 217432 0 0 0 ANITA SANDHU PHYSICIAN 257923 0 0 0 18803 0 0 0 0 0 276726 0 0 0 JEAN SWEARINGEN PHYSICIAN 199800 0 0 0 10969 0 0 0 6088 0 216857 0 0 0 SCHEDULE J, PART I, LINE 4C KEITH PAGE PARTICIPATES IN A SEC. 457(F) PLAN. A CONTRIBUTION IN THE AMOUNT OF $34,161 WAS ACCRUED FOR 2015. A SW IL DEV AUTHORITY SERIES 2006 311234684 84552YFG1 2006-12-15 14373967 REFINANCE CLINICAL BLDG RENOVATIO false false false B SW IL DEVELOPMENT AUTHORITY SERIES 2011A & 2011B 311234684 2011-12-29 18438921 CURRENT REFUNDING OF SER 1999 BOND false false false C VILLAGE OF MARYVILLE ILLINOIS SERIES 2011 370922463 2011-08-04 10000000 CONSTRUCT MEDICAL OFFICE BLDG false false false D VILLAGE OF MARYVILLE ILLINOIS SERIES 2012 370922463 2012-02-17 6000000 CONSTRUCT MEDICAL OFFICE BLDG false false false A 2195000 0 14373967 912756 777164 0 287479 0 0 12396568 0 0 2008 false false true true B 3703602 0 18438921 0 0 18175745 263176 0 0 0 0 0 2011 true false true true C 1430726 0 10000000 0 0 0 125000 0 0 9875000 0 0 2012 false false true true D 758706 0 6000000 0 0 0 56500 0 0 5943500 0 0 2012 false false true true A false true false false 0.00800 0.00000 0.00800 false false 0.00000 false true B 0.00000 0.00000 0.00000 0.00000 C false true false false 0.00000 0.00000 0.00000 false false 0.00000 false true D false true false false 0.00000 0.00000 0.00000 false false 0.00000 false true A true false false 0 true WACHOVIA BANK 29. true false true B false false true false false false 0 false 0 false true C false false true false false false 0 false 0 false true D false false true false false false 0 false 0 false true A true B true C true D true BANK OF EDWARDSVILLE SEE PART V X 3000000 2235125 false true true BANK OF EDWARDSVILLE SEE PART V X 60895 30642 false true true 2265767 BANK OF EDWARDSVILLE > 35% OWNED BY DIRECTOR 532847 PAID INTEREST false BANK OF EDWARDSVILLE > 35% OWNED BY DIRECTOR 1412983 EARNED INTEREST false BANK OF EDWARDSVILLE > 35% OWNED BY DIRECTOR 225623 TRUSTEE FEES false PART II LOANS TO/FROM INTERESTED PERSONS THE BANK OF EDWARDSVILLE IS OVER 35% CONTROLLED BY MARK SHASHEK. THE PURPOSE OF THE LOAN LISTED ON LINE (1) IS TO PURCHASE REAL ESTATE. THE PURPOSE OF THE LOAN LISTED ON LINE (2) IS TO PURCHASE EQUIPMENT. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990 THE FORM 990 IS REVIEWED BY THE CEO, CFO, AND CONTROLLER. INFORMATION FOR THE RETURN IS GATHERED BY THE HOSPITAL'S FINANCE DEPARTMENT AND GIVEN TO AN INDEPENDENT AUDITOR FOR FILING PREPARATION. A COPY OF THE FORM 990 IS MADE AVAILABLE TO THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION B, LINE 12C PROCESS FOR MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY THE COMPLIANCE OFFICER REVIEWS AND MONITORS THE POLICY ANNUALLY. PERSONS COVERED UNDER THE POLICY INCLUDE TRUSTEES/DIRECTORS/MANAGERS, OFFICERS AND COMMITTEE MEMBERS OF THE ANDERSON ENTITIES; DEPARTMENT DIRECTORS, ADMINISTRATIVE DIRECTORS, ASSISTANT DIRECTORS, MEMBERS OF SENIOR MANAGEMENT AND MEDICAL STAFF LEADERS OF ANDERSON, MEDICAL STAFF MEMBERS AND NON-MANAGEMENT STAFF. CONFLICTS ARE REVIEWED, IDENTIFIED AND MAINTAINED BY THE COMPLIANCE OFFICER. EXPLANATION OF ANY RESTRICTIONS IMPOSED ON PERSONS WITH A CONFLICT: THE COVERED INDIVIDUAL PROMPTLY AND FULLY DISCLOSES THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AT THE FOLLOWING TIMES: A. WHEN THE COVERED INDIVIDUAL FIRST BECOMES A COVERED INDIVIDUAL AND AT EVERY ANNUAL MEETING OF THE ANDERSON ENTITY THEREAFTER THROUGH THE SUBMISSION OF A CONFLICT DISCLOSURE STATEMENT AFFIRMING THAT THE COVERED INDIVIDUAL (I) RECEIVED A COPY OF THIS POLICY, (II) READ AND UNDERSTOOD THIS POLICY, AND (III) AGREES TO COMPLY WITH THIS POLICY; B. UPON ANY CHANGES IN CIRCUMSTANCES WHICH GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; AND C. WHEN THE COVERED INDIVIDUAL HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A TRANSACTION OR ARRANGEMENT BEING CONSIDERED AT A BOARD OR COMMITTEE MEETING. FOR MANAGERS AND MEDICAL STAFF LEADERS: THE COVERED INDIVIDUAL PROMPTLY AND FULLY DISCLOSES THE EXISTENCE OF ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST TO THE COMPLIANCE OFFICER AT THE FOLLOWING TIMES: A. WHEN THE COVERED INDIVIDUAL FIRST BECOMES A COVERED INDIVIDUAL AND ANNUALLY THEREAFTER THROUGH THE SUBMISSION OF A CONFLICT DISCLOSURE STATEMENT AFFIRMING THAT THE COVERED INDIVIDUAL (I) RECEIVED A COPY OF THIS POLICY, (II) READ AND UNDERSTOOD THIS POLICY, AND (III) AGREES TO COMPLY WITH THIS POLICY; AND B. UPON ANY CHANGES IN CIRCUMSTANCES WHICH GIVE RISE TO AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; C. WHEN A COVERED INDIVIDUAL HAS AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST WITH RESPECT TO A TRANSACTION OR ARRANGEMENT BEING CONSIDERED ON BEHALF OF ANDERSON AND THE COVERED INDIVIDUAL IS IN A POSITION TO INFLUENCE THE OUTCOME OF THE CONSIDERATION. DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST MADE AT THE MEETING AT WHICH THE TRANSACTION OR ARRANGEMENT IS BEING CONSIDERED SHALL BE MADE TO ALL INDIVIDUALS PRESENT AT THE MEETING. FOR OTHER MEDICAL STAFF MEMBERS: DISCLOSURE OCCURS AT APPOINTMENT AND REAPPOINTMENT UNLESS THEY ARE BOARD MEMBERS - THESE PHYSICIANS FOLLOW THE BOARD OF TRUSTEE REQUIREMENTS. EMPLOYEES NOT IN MANAGEMENT POSITIONS: AT TIME OF HIRE AND AT EACH ANNUAL EMPLOYEE EVALUATION. FORM 990, PART VI, SECTION B, LINE 15A REVIEW OF CEO OR TOP MANAGEMENT OFFICIAL COMPENSATION THE CEO SALARY AND BONUS STRUCTURE IS DETERMINED ON AN ANNUAL BASIS BY THE HUMAN RESOURCES COMMITTEE OF THE BOARD OF TRUSTEES, AND APPROVED BY THE FULL BOARD BASED ON AN EVALUATION DONE BY THE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 15B REVIEW OF OTHER OFFICER OR KEY EMPLOYEE COMPENSATION THE ADMINISTRATIVE DIRECTOR SALARY STRUCTURE IS DETERMINED BY A REVIEW AND MARKET COMPENSATION STUDY BASED ON OFFICIAL SURVEYS BY SUCH COMPANIES AS TOWERS, PERRIN AND MERCER. RECOMMENDATIONS ARE MADE TO THE CEO BY HUMAN RESOURCES, AND ARE APPROVED BY THE CEO BASED ON PERFORMANCE EVALUATION. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:SURGERY CONTRACT SERVICES TOTAL FEES:546722 FORM 990 PART IX LINE 11G DESCRIPTION:REFERENCE LAB CONTRACT SERVICE TOTAL FEES:701333 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER MEDICAL SERVICES TOTAL FEES:3378100 FORM 990 PART IX LINE 11G DESCRIPTION:ADMIN & OTHER FACILITY SERVICE TOTAL FEES:8140205 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN SERVICES TOTAL FEES:11309797 MARYVILLE MEDICAL SERVICES LLC 6800 STATE ROUTE 162 MARYVILLE IL 62062 200654708 PHYS SERVICES IL 517893 272711 Y MARYVILLE PHYSICIAN SERVICES LLC 6800 STATE ROUTE 162 MARYVILLE IL 62062 200802394 PHYS SERVICES IL 12534853 2093081 Y MARYVILLE IMAGING LLC 6800 STATE ROUTE 162 MARYVILLE IL 62062 452588783 IMAGING SERV IL 3346655 1672604 Y ANDERSON REAL ESTATE LLC 6800 STATE ROUTE 162 MARYVILLE IL 62062 452681347 REAL ESTATE IL 649955 9334720 Y AUXILIARY OF ANDERSON HOSPITAL 6800 STATE ROUTE 162 MARYVILLE IL 62062 376080063 SUPPORT ORG IL 501(C)(3) 11, III-O NA false ANDERSON HOSPITAL FOUNDATION 6800 STATE ROUTE 162 MARYVILLE IL 62062 274548522 SUPPORT ORG IL 501(C)(3) 7 SW IL HEALTH true false false false false false false false false false false false false false false true false false false false ANDERSON HOSPITAL FOUNDATION O 61417 BOOK VALUE