MERCY HARVARD HOSPITAL INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HARVARD HOSPITAL INC (EIN 31-1551871)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-05-10
- IRS object ID
- 201601319349302665
- Schema version
- 2014v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-10T14:41:55-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 MIDLAND COURT PO BOX 8130 | AddressLine1Txt |
| City | JANESVILLE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 535478130 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 311551871 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HARVARD HOSPITAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARV | BusinessNameControlTxt |
| Phone | 8159435431 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 GRANT STREET | AddressLine1Txt |
| City | HARVARD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60033 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN COOK | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8159435431 | PhoneNum |
| Signature | 2016-05-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRADLEY S MCGUIRE CPA | PreparerPersonNm |
| PTIN | P00643763 | PTIN |
| Phone | 6087525835 | PhoneNum |
| Preparation | 2016-05-09 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN COOK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 GRANT STREET | AddressLine1Txt |
| City | HARVARD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,824,009 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCYHEALTHSYSTEM.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTH CARE TO THE HARVARD COMMUNITY AND SURROUNDING AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 7 | VotingMembersIndependentCnt |
| Total Employee | 224 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $50,632 | PYContributionsGrantsAmt |
| CY Contributions Grants | $28,917 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $25,115,249 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,681,655 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,106 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,214 | CYInvestmentIncomeAmt |
| PY Other Revenue | $135,788 | PYOtherRevenueAmt |
| CY Other Revenue | $109,223 | CYOtherRevenueAmt |
| PY Total Revenue | $25,307,775 | PYTotalRevenueAmt |
| CY Total Revenue | $23,824,009 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,375,562 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,500,067 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,496,499 | PYOtherExpensesAmt |
| CY Other Expenses | $13,581,617 | CYOtherExpensesAmt |
| PY Total Expenses | $24,872,061 | PYTotalExpensesAmt |
| CY Total Expenses | $24,081,684 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $435,714 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$257,675 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $19,527,397 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,875,899 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $17,442,490 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,048,667 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,084,907 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,827,232 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE QUALITY HEALTH CARE TO THE HARVARD COMMUNITY AND SURROUNDING AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,439,101 | ExpenseAmt |
| Revenue | $23,699,791 | RevenueAmt |
| Desc | HOSPITAL DISCHARGES 412, EMERGENCY VISITS 6,311, OUTPATIENT SURGERY CASES 1,810, NURSING HOME DISCHARGES 142 | Desc |
| Total Program Service Expenses | $18,439,101 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 37 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 224 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 7 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOHN COOK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6087566642 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 MINERAL POINT | AddressLine1Txt |
| City | JANESVILLE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 535475003 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| KATHERINE SCHACK | ||||||||
| CHAIRPERSON & DIRECTOR | 1.00 | Yes (X) | Yes (X) | $664 | $0 | $0 | ||
| WESLEY JOST | ||||||||
| VICE-CHAIR & DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| P CASEY VORIS | ||||||||
| SECRETARY/TREAS & DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER HALLATT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $240,824 | $41,637 | 55.00 | ||
| RON KIERAS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CARLOS AREVALO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAY SCHULZ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $716 | $0 | $0 | |||
| ALLEN CASTILLO | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN COOK | ||||||||
| CFO | 1.00 | Yes (X) | $0 | $414,941 | $39,695 | 55.00 | ||
| WENDI AUBRY | ||||||||
| PHARMACIST TEAM LEAD | 41.50 | $159,497 | $0 | $17,475 | Yes (X) | |||
| CYNTHIA BANGERT | ||||||||
| DIRECTOR | 41.50 | $132,214 | $0 | $24,387 | Yes (X) | |||
| ELIZABETH AGGACID | ||||||||
| RN UNIT SUPERVISOR/HIB | 42.30 | $121,474 | $0 | $7,236 | Yes (X) | |||
| LAURA LEAHEY | ||||||||
| RN/HIB | 47.50 | $141,067 | $0 | $11,206 | Yes (X) | |||
| KHRISTINE SCHRADER | ||||||||
| SHIFT COORD | 52.00 | $163,407 | $0 | $21,760 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $719,039 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $655,765 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $163,396 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PRN HEALTH SERVICES | |||||
| 740 FORD STREET STE A | KIMBERLY | WI | 54136 | CONTRACT NURSING | $135,371 |
| MAGILL CONSTRUCTION COMPANY | |||||
| 977 KOOPMAN LN | ELKHORN | WI | 53121 | CONSTRUCTION | $134,411 |
| UNITED SHOCKWAVE SERVICES LTD | |||||
| PO BOX 2178 | DES PLAINES | IL | 600172178 | LITHOTRIPSY | $106,085 |
| PER MAR SECURITY SERVICES | |||||
| PO BOX 1101 | DAVENPORT | IA | 528051101 | SECURITY SERVICES | $104,881 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $28,917 | GovernmentGrantsAmt |
| Total Contributions | $28,917 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $23,596,593 | $23,596,593 | |
| CAFETERIA | 722210 | $85,062 | $85,062 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,681,655 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,214 | TotalRevenueColumnAmt |
| Exclusion | $4,214 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $103,198 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $103,198 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $103,198 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $103,198 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $6,025 | TotalRevenueColumnAmt |
| Exclusion | $6,025 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,025 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,824,009 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,699,791 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $95,301 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,380 | TotalAmt |
| Management And General | $1,380 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,304,611 | TotalAmt |
| Program Services | $6,334,328 | ProgramServicesAmt |
| Management And General | $1,970,283 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $272,648 | TotalAmt |
| Program Services | $197,861 | ProgramServicesAmt |
| Management And General | $74,787 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,327,330 | TotalAmt |
| Program Services | $955,961 | ProgramServicesAmt |
| Management And General | $371,369 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,098 | TotalAmt |
| Program Services | $452,517 | ProgramServicesAmt |
| Management And General | $141,581 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,200 | TotalAmt |
| Management And General | $5,200 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,874,603 | TotalAmt |
| Program Services | $3,403,163 | ProgramServicesAmt |
| Management And General | $471,440 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,628 | TotalAmt |
| Program Services | $1,049 | ProgramServicesAmt |
| Management And General | $103,579 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,543,212 | TotalAmt |
| Program Services | $2,244,631 | ProgramServicesAmt |
| Management And General | $298,581 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,411 | TotalAmt |
| Management And General | $106,411 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $462,086 | TotalAmt |
| Program Services | $378,689 | ProgramServicesAmt |
| Management And General | $83,397 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,593 | TotalAmt |
| Program Services | $12,511 | ProgramServicesAmt |
| Management And General | $12,082 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,218 | TotalAmt |
| Program Services | $13,509 | ProgramServicesAmt |
| Management And General | $11,709 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $568,874 | TotalAmt |
| Program Services | $466,204 | ProgramServicesAmt |
| Management And General | $102,670 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,697,952 | TotalAmt |
| Program Services | $1,391,506 | ProgramServicesAmt |
| Management And General | $306,446 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,527 | TotalAmt |
| Program Services | $187,908 | ProgramServicesAmt |
| Management And General | $65,619 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBTS | $1,608,564 | $1,608,564 | $0 |
| INTERCOMPANY EXPENSES | $1,096,422 | $208,972 | $887,450 |
| OTHER TAXES | $529,195 | $65,081 | $464,114 |
| MAINTENANCE AND REPAIRS | $476,085 | $415,288 | $60,797 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,047 | TotalAmt |
| Program Services | $101,359 | ProgramServicesAmt |
| Management And General | $103,688 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,081,684 | TotalAmt |
| Program Services | $18,439,101 | ProgramServicesAmt |
| Management And General | $5,642,583 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $896,201 | BOYAmt |
| EOY | $970,773 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,562,209 | BOYAmt |
| EOY | $3,671,170 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $568,271 | BOYAmt |
| EOY | $589,647 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,724 | BOYAmt |
| EOY | $260,525 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $35,653,920 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $23,499,783 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,811,818 | BOYAmt |
| EOY | $12,154,137 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $504,174 | BOYAmt |
| EOY | $229,647 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,527,397 | BOYAmt |
| EOY | $17,875,899 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,140,691 | BOYAmt |
| EOY | $1,919,041 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,301,799 | BOYAmt |
| EOY | $14,129,626 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,442,490 | BOYAmt |
| EOY | $16,048,667 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,084,907 | BOYAmt |
| EOY | $1,827,232 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,084,907 | BOYAmt |
| EOY | $1,827,232 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,527,397 | BOYAmt |
| EOY | $17,875,899 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$257,675 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $222,604 | OtherCostOrOtherBasisAmt |
| Book Value | $222,604 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,394,664 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,570,588 | DepreciationAmt |
| Book Value | $7,824,076 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,308,071 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,379,707 | DepreciationAmt |
| Book Value | $3,928,364 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $728,581 | OtherCostOrOtherBasisAmt |
| Depreciation | $549,488 | DepreciationAmt |
| Book Value | $179,093 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,154,137 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED PARTIES | $13,844,216 |
| LONG-TERM CAPITAL LEASE | $2,413 |
| THIRD-PARTY PAYABLES | $282,997 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $14,129,626 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent150 | Yes (X) | Percent150Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent300 | Yes (X) | Percent300Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | 0 | ExpensesExceedBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $114,644 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $114,644 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00510 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,765,447 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,823,852 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,941,595 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.08640 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $6,575 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $3,992 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,583 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,886,666 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,827,844 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,058,822 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.09160 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $32,309 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $32,309 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00140 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,433,208 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,798,662 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,634,546 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07270 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Total Expense | 0.00000 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,251 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $18,251 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,483,768 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,798,662 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,685,106 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07490 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,370,434 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $5,626,506 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,743,928 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.16650 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $533,558 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $101,803 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $2,978,110 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $5,208,542 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,230,432 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HARVARD HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 901 GRANT STREET | AddressLine1Txt |
| City | HARVARD | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60033 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HARVARD HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 13 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | MERCYHEALTHSYSTEM.ORG/LOCATION/MERCY-HARVARD-HOSPITAL | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | MERCYHEALTHSYSTEM.ORG | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | MERCYHEALTHSYSTEM.ORG/LOCATION/MERCY-HARVARD-HOSPITAL | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 150.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | MERCYHEALTHSYSTEM.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | MERCYHEALTHSYSTEM.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | MERCYHEALTHSYSTEM.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| MERCY HARVARD HOSPITAL | PART V, SECTION B, LINE 5: MERCY HEALTH SYSTEM SET OUT TO GATHER INFORMATION ON THE COMMUNITY OF HARVARD, ILLINOIS AS WELL AS MCHENRY COUNTY AS A WHOLE. DATA WAS GATHERED THROUGH HOUSEHOLD SURVEYS AND SECONDARY DATA SOURCES.MERCY HEALTH SYSTEM DISTRIBUTED HEALTH QUESTIONNAIRES TO A RANDOM SAMPLE OF MCHENRY COUNTY RESIDENTS. THE FIFTY QUESTION SURVEY WAS DISTRIBUTED TO 1,245 MEMBERS OF THE COMMUNITY AND COVERED VARIOUS TOPICS, INCLUDING ACCESS TO CARE, QUALITY OF LIFE, CHRONIC ILLNESSES, AND LIFESTYLE FACTORS. A RESPONSE WAS RECEIVED FROM 10.04% OF HOUSEHOLDS THAT RECEIVED THE SURVEY. IN ADDITION TO THE DATA GATHERED FROM HOUSEHOLD SURVEYS AND FOCUS GROUPS, MERCY HEALTH SYSTEM ANALYZED HEALTH-RELATED DATA FROM A VARIETY OF EXISTING SOURCES, INCLUDING THE UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTES COUNTY HEALTH RANKINGS, ILLINOIS DEPARTMENT OF PUBLIC HEALTH, THE UNITED STATES CENSUS BUREAU, AND THE KAISER FAMILY FOUNDATION STATE HEALTH FACTS. SECONDARY SOURCE DATA, WHEN COMBINED WITH THE INFORMATION GATHERED FROM THE HOUSEHOLD SURVEYS, PROVIDED A PICTURE OF WHAT IS WORKING WELL IN ADDITION TO IDENTIFYING OPPORTUNITIES FOR IMPROVEMENT FOR THE HEALTHCARE INFRASTRUCTURE OF MCHENRY COUNTY AND SPECIFICALLY, THE HARVARD, ILLINOIS COMMUNITY. |
| MERCY HARVARD HOSPITAL | PART V, SECTION B, LINE 6B: MERCY HARVARD HOSPITAL WORKED WITH ITS AFFILIATED ORGANIZATION: MERCY HEALTH SYSTEM CORPORATION. MERCY HEALTH SYSTEM HAS CLINIC FACILITIES IN AND AROUND MCHENRY COUNTY. |
| MERCY HARVARD HOSPITAL | PART V, SECTION B, LINE 11: CONSISTENT WITH THE MCHENRY COUNTY AND HARVARD AREA COMMUNITY NEEDS ASSESSMENT ACTION PLANS, MERCY CONTINUES TO ROLL OUT ITS IMPLEMENTATION PLANS. PROMOTING OBESITY EDUCATION, HYPERTENSION AWARENESS, BREAST CANCER AWARENESS, COLORECTAL CANCER SCREENING EDUCATION, INCREASING ACCESS TO PRIMARY CARE AND INCREASING INFLUENZA VACCINATIONS ARE PRIORITIES IN THE CITY OF HARVARD AREA AND MCHENRY COUNTY.MERCY PARTNERS WITH MULTIPLE COMMUNITY BASED ORGANIZATIONS IN THE HARVARD AREA AND THROUGHOUT MCHENRY COUNTY TO ACCOMPLISH SUCCESSFUL IMPLEMENTATION OF THESE STRATEGIES. DURING THE COURSE OF TAX YEAR 2014 (FISCAL YEAR JULY 1, 2014 - JUNE 30, 2015), MERCY PARTICIPATED IN NUMEROUS COMMUNITY HEALTH FAIRS, PROVIDED FREE SCREENINGS AT OUR CLINICS AND IN CONJUNCTION WITH COMMUNITY BASED ORGANIZATIONS OFFERED SCREENING AT TWO FREE PRIMARY CARE CLINICS, SCHOOL DISTRICTS IN AREA, AND AT THE COUNTY PUBLIC HEALTH DEPARTMENT. MERCY ALSO PROVIDES FINANCIAL INCENTIVES FOR THEIR EMPLOYEES TO PARTICIPATE IN SMOKING CESSATION PROGRAMS. ALL OF THESE EFFORTS ARE SUPPORTED THROUGH BROAD BASED MARKETING AND ADVERTISING PROGRAMS DIRECTED TO AUDIENCES IN BOTH COUNTIES PROMOTING THESE PROGRAMS.FINALLY IN THE AREA OF SCREENINGS, MERCY PARTNERS WITH COMMUNITY AGENCIES AND MERCY STAFF TO OFFER SCREENINGS AT HEALTH FAIRS, MERCY SPONSORED EVENTS, AND THROUGH FREE AND SLIDING FEE SCALE PRIMARY CLINICS IN MCHENRY COUNTY. |
| MERCY HARVARD HOSPITAL | PART V, SECTION B, LINE 16I: AVAILABLE THROUGH PATIENT FINANCIAL COUNSELORS WHO DO PRE- OR POST-FOLLOW UP WITH SELF-PAY PATIENTS. |
| MERCY HARVARD HOSPITAL | PART V, SECTION B, LINE 22D: THE HOSPITAL FACILITY USED THE AVERAGE COMMERCIAL CHARGE. |
| PART V, SECTION B, LINE 16 | FINANCIAL ASSISTANCE POLICY WEBSITE AVAILABILITY |
| MERCY HARVARD HOSPITAL PART V, SECTION B, LINE 16A WEBSITE: | MERCYHEALTHSYSTEM.ORG |
| MERCY HARVARD HOSPITAL PART V, SECTION B, LINE 16B WEBSITE: | MERCYHEALTHSYSTEM.ORG |
| MERCY HARVARD HOSPITAL PART V, SECTION B, LINE 16C WEBSITE: | MERCYHEALTHSYSTEM.ORG |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 3 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| MERCY HARVARD CARE CENTER | ||||
| 901 HAYES STREET | HARVARD | IL | 60033 | NURSING HOME FACILITY |
| MERCY HARVARD HOSPITAL CLINIC | ||||
| 1001 GRANT STREET | HARVARD | IL | 60033 | PHYSICIAN CLINIC |
| MERCY HARVARD REHABILITATION AND FITNESS | ||||
| 1000 HAYES STREET | HARVARD | IL | 60033 | REHABILITATION CENTER |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | THE HOSPITAL OFFERS A 20% SELF-PAY DISCOUNT TO ALL UNINSURED PATIENTS ON ALL MEDICALLY NECESSARY SERVICES. ELIGIBILITY FOR FINANCIAL ASSISTANCE IS BASED ON THE FOLLOWING: INDIVIDUAL OR HOUSEHOLD INCOME, INDIVIDUAL OR HOUSEHOLD ASSETS, HOUSEHOLD SIZE, AND OTHER SOURCES OF PAYMENT FOR SERVICES. THE AMOUNT OF ASSISTANCE IS BASED ON THE PATIENT'S ABILITY TO PAY AND THE SIZE OF THEIR OUTSTANDING BALANCE. IF PATIENT INCOME AND HOUSEHOLD ASSETS ARE LESS THAN 150% OF THE FEDERAL POVERTY GUIDELINES, THEN MERCY WILL COVER 100% OF THEIR OUTSTANDING BALANCE. IF THE PATIENT'S INCOME AND HOUSEHOLD ASSETS FALL BETWEEN 150% AND 300% OF THE FEDERAL POVERTY GUIDELINES, THEN A PATIENT'S REMAINING BALANCE CAN BE REDUCED AS MUCH AS 90% AND PAYMENT ARRANGEMENTS CAN BE EXTENDED FOR AS LONG AS TWENTY-FOUR (24) MONTHS OR LONGER IF THERE ARE EXTENUATING CIRCUMSTANCES. THIS FORMULA ALLOWS FOR PATIENTS WITH A MODERATE INCOME, BUT DIAGNOSED WITH CATASTROPHIC ILLNESSES, TO QUALIFY FOR ASSISTANCE. |
| PART I, LINE 6A: | MERCY HEALTH SYSTEM CORP, A RELATED ORGANIZATION OF MERCY HARVARD HOSPITAL, INC, PREPARED A COMMUNITY BENEFIT REPORT. |
| PART I, LINE 7: | A COST-TO-CHARGE RATIO METHODOLOGY WAS USED TO DETERMINE COSTS ASSOCIATED WITH CHARITY CARE, UNREIMBURSED MEDICAID, AND OTHER MEANS TESTED GOVERNMENT PROGRAMS. THE COST-TO-CHARGE RATIO WAS DERIVED FROM IRS WORKSHEET 2: RATIO OF PATIENT CARE COST-TO-CHARGE. THE COST OF THE OTHER BENEFITS REFERENCED IN THE TABLE OF LINE 7 (COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS; SUBSIDIZED HEALTH SERVICES; CASH AND IN-KIND CONTRIBUTIONS) WERE DETERMINED USING ACTUAL DEPARTMENT/SERVICE SPECIFIC DATA AND/OR COST ACCOUNTING DERIVED DATA. |
| PART I, LINE 7G: | N/A |
| PART I, LN 7 COL(F): | BAD DEBT EXPENSE OF $1,608,564 INCLUDED ON FORM 990, PART IX, LINE 25, WAS EXCLUDED FROM EXPENSES WHEN CALCULATING THE PERCENTAGE IN THIS COLUMN. |
| PART III, LINE 2: | THE COST OF BAD DEBT EXPENSE WAS DETERMINED BY APPLYING THE COST-TO-CHARGE RATIO TO THOSE CHARGES ESTIMATED AND EXPENSED AS UNCOLLECTIBLE. |
| PART III, LINE 3: | THE ESTIMATE OF BAD DEBT DOLLARS THAT MAY HAVE BEEN COVERED THROUGH MERCY HARVARD HOSPITAL'S FINANCIAL ASSISTANCE/CHARITY CARE POLICY (HAD THE PROPER PAPER WORK BEEN COMPLETED BY THE INDIVIDUAL NEEDING ASSISTANCE) IS ESTIMATED AT 19.08%. THIS FIGURE WAS BASED ON THE PERCENT OF BAD DEBT ACCOUNT DOLLARS THAT ARE RECLASSIFIED FOR CHARITY AND/OR BANKRUPTCY PURPOSES. |
| PART III, LINE 4: | BAD DEBT EXPENSE IS ACCOUNTED FOR IN THE FOLLOWING MANNER (AS DETAILED IN NOTE 1 OF THE AUDITED FINANCIAL STATEMENTS OF MERCY ALLIANCE, INC AND AFFILIATES - MERCY ALLIANCE, INC IS THE PARENT COMPANY OF MERCY HARVARD HOSPITAL, INC). PATIENT ACCOUNTS RECEIVABLE ARE RECORDED . . . NET OF CONTRACTUAL ADJUSTMENTS AND ALLOWANCE FOR DOUBTFUL ACCOUNTS, WHICH REFLECTS MANAGEMENT'S BEST ESTIMATE OF THE AMOUNTS THAT WILL NOT BE COLLECTED . . . IN EVALUATING THE COLLECTIBILITY OF PATIENT ACCOUNTS RECEIVABLE, ALLIANCE ANALYZES HISTORICAL LOSS EXPERIENCE ON REVENUE FOR ALL PAYORS. USING THE LOSS EXPERIENCE RATE, ALLIANCE ESTIMATES THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND PROVISION FOR BAD DEBTS. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. |
| PART III, LINE 8: | DATA FOR LINES 5 & 6 OF PART III AND THE MEDICARE SHORTFALL IS BASED ON MERCY HARVARD HOSPITAL'S MEDICARE COST REPORT. |
| PART III, LINE 9B: | PATIENTS WHO ARE SELF-PAY, REGARDLESS OF WHETHER THEY QUALIFY FOR MERCY HARVARD HOSPITAL'S (MHH) COMMUNITY CARE PROGRAM, WILL RECEIVE A 20% DISCOUNT FROM MHH'S STANDARD FEE SCHEDULE. ALL SELF-PAY PATIENTS MEET WITH PATIENT FINANCIAL COUNSELORS AND DISCUSS PAYMENT OPTIONS INCLUDING MHH'S COMMUNITY CARE PROGRAM. PATIENTS MUST APPLY FOR COMMUNITY CARE AND SUPPLY MERCY WITH THE NECESSARY FINANCIAL AND OTHER INFORMATION REQUIRED. PATIENTS WHO QUALIFY FOR COMMUNITY CARE BENEFITS WILL RECEIVE A REDUCTION IN THE BALANCE OWED, EXTENDED PAYMENT TERMS, OR BOTH. THE AMOUNT OF THE COMMUNITY CARE BENEFIT WILL BE BASED ON THE PATIENT'S ABILITY TO PAY AND THE SIZE OF THE OUTSTANDING BALANCE. |
| PART VI, LINE 2: | COMMUNITY NEEDS ASSESSMENTS ARE CONDUCTED EVERY 18 MONTHS. MERCY HARVARD HOSPITAL, INC (MHH) AND ITS SISTER ORGANIZATION, MERCY HEALTH SYSTEM CORP (MHS) WORK IN CONJUNCTION WITH THE PUBLIC HEALTH DEPARTMENTS OF WALWORTH (WI), ROCK (WI), AND MCHENCY (IL) COUNTIES TO COMPLETE. MHH COMPLETES AN ANNUAL CRITICAL ACCESS HOSPITAL ASSESSMENT. NEEDS ASSESSMENT SURVEYS ARE COMPLETED AS REQUIRED BY THE STATE OF ILLINOIS.MHS HAS DEDICATED STAFF THAT WORKS WITH VARIOUS AGENCIES/PROGRAMS TO ASSESS HEALTH NEEDS IN THE COMMUNITIES THAT MHH AND MHS SERVE. COLLABORATIVE EXAMPLES OF MERCY AND MERCY'S RELATED ENTITIES INCLUDE: I)THE COMMUNITY HEALTH CENTER AT MERCY CLINIC SOUTH: PARTNERSHIP WITH THE COMMUNITY HEALTH CENTER, INC OF BELOIT, WI IN 2006. MERCY PARTNERED WITH COMMUNITY HEALTH CENTER, INC TO OPEN THIS CLINIC IN JANESVILLE. IT PROVIDES FREE AND LOW-COST CARE TO LOW-INCOME, UNINSURED AND UNDERINSURED PATIENTS. THIS FIRST-OF-ITS-KIND PARTNERSHIP IS THE RESULT OF YEARS OF WORK WITH LOCAL PARTNERS AND THE FEDERAL GOVERNMENT TO DESIGN AND DEBUT A NEW MODEL OF CAR FOR THE UNDERSERVED. THE CLINIC SEES OVER 200 NEW PATIENTS EACH MONTH, HAS SIGNIFICANTLY IMPROVED PATIENT OUTCOMES, AND HAS SAVED MILLION IN UNNECESSARY EMERGENCY DEPARTMENT COSTS. II)HEALTHNET FREE CLINIC IN JANESVILLE: MERCY PHYSICIANS VOLUNTEER THEIR SERVICES. MERCY ALSO DONATES LAB, RADIOLOGY AND OTHER ANCILLARY SERVICES TO PATIENTS. III)FAMILY HEALTH PARTNERSHIP CLINIC AND WELL CHILD CLINIC IN WOODSTOCK, IL AND HARVARD FREE CLINIC IN MCHENRY COUNTY, IL: MERCY PHYSICIANS VOLUNTEER THEIR SERVICES. IV)FAMILY HEALTH PARTNERSHIP CLINIC: MCHENRY COUNTY DEPARTMENT OF HEALTH COLLABORATION TO PROVIDE MAMMOGRAMS AT MERCY FACILITIES FOR WOMEN WHO CANNOT OTHERWISE AFFORD THE SERVICE. V)ROCK COUNTY HEALTH DEPARTMENT: BIOTERRORISM READINESS PROJECT. VI)RED CROSS: BLOOD DRIVE AND COOPERATIVE VOLUNTEER EFFORTS. VII)UNITED WAY: FUND RAISING CAMPAIGN AND ROCK COUNTY NEEDS ASSESSMENT SURVEY CONTRIBUTOR VIII)AREA POLICE AND FIRE DEPARTMENTS: PROVIDE PORTABLE DEFIBRILLATORS FOR POLICE VEHICLES AND FREE OR REDUCED-COST PARAMEDIC/EMT EDUCATIONAL OPPORTUNITIES. IX)COMMUNITY ACTION, INC.: MERCY LEADERSHIP SERVES ON STRATEGIC PLANNING COMMITTEE AND COMMUNITY ACTION DEVELOPMENT BOARD. |
| PART VI, LINE 3: | ALL UNINSURED PATIENTS ARE NOTIFIED OF MERCY'S FINANCIAL AIDE POLICY UPON REGISTRATION. INFORMATION IS ALSO AVAILABLE AT THE HEALTH SYSTEM'S WEBSITE, IN OUR EMERGENCY ROOMS, FINANCIAL SERVICES OFFICES, AND WITH THE PATIENT FINANCIAL COUNSELORS. APPROPRIATE PERSONNEL HAVE BEEN TRAINED ON HOW TO INTERACT WITH PATIENTS ABOUT FINANCIAL AID AVAILABILITY, AND HOW TO DIRECT PATIENTS TO APPROPRIATE FINANCIAL AID STAFF. THE HOSPITALS HAVE TRANSLATION SERVICES AVAILABLE AS NEEDED. |
| PART VI, LINE 4: | MERCY HARVARD HOSPITAL, IS LOCATED IN MCHENRY COUNTY, ILLINOIS. IT IS A LICENSED FOR 25 ACUTE AND 45 LONG TERM CARE BEDS. IT IS A CRITICAL ACCESS HOSPITAL WITH 24/7 EMERGENCY SERVICES AND OUTPATIENT SURGERY. SINCE 2003, AND ITS AFFILIATION WITH MERCY HEALTH SYSTEM CORP., MHH HAS BEEN ABLE TO PROVIDE A NEW LEVEL OF CARE AND MORE MEDICAL SPECIALTIES. MEDIAN HOUSEHOLD INCOME IN HARVARD IS $45,991 (2010), WHICH IS LOWER THAN BOTH THE COUNTY AND STATE MEDIANS OF $76,482 AND $55,735, RESPECTIVELY. IN 2010 HARVARD HAD A GREATER PROPORTION OF RESIDENTS WHO WERE UNEMPLOYED, COMPARED TO THE COUNTY AND STATE RATES. MCHENRY COUNTY HAD AN UNEMPLOYMENT RATE OF 8.4% (2012) COMPARED TO ILLINOIS' 8.9% AND US RATE OF 8.1%.APPROXIMATELY 20% OF HARVARD RESIDENTS HAD EARNINGS BELOW THE POVERTY LEVEL IN 2010. THIS PROPORTION EXCEEDS BOTH THE COUNTY (4.2%) AND STATE (9.2%) RATES. ONE IN FOUR HARVARD FAMILIES LIVE IN POVERTY. SLIGHTLY MORE THAN TWO PERCENT OF FAMILIES IN THE HARVARD COMMUNITY RECEIVE CASH PUBLIC ASSISTANCE, COMPARED TO 1.2% ACROSS MCHENRY COUNTY AND 2.0% ACROSS ILLINOIS. SIMILARLY, 12.9% OF FAMILIES RECEIVED FOOD STAMP BENEFITS IN 2010, WHICH IS GREATER THAN BOTH THE MCHENRY COUNTY AND ILLINOIS RATES OF 3.8% AND 9.1%, RESPECTIVELY.THE HOSPITALS' PAYOR DEMOGRAPHICS INCLUDE 33.5% MEDICARE, AND 22.35% MEDICAID FOR THE FISCAL YEAR OF JULY 1, 2014 - JUNE 30, 2015 (AS DETERMINED BY CHARGES BILLED). |
| PART VI, LINE 5: | MERCY HARVARD HOSPITAL HAS AN OPEN MEDICAL STAFF WITH PRIVILEGES AVAILABLE TO ALL QUALIFIED PHYSICIANS IN THE AREA. MERCY HARVARD HOSPITAL HAS A GOVERNING BODY IN WHICH INDEPENDENT PERSONS REPRESENTATIVE OF THE COMMUNITY COMPRISE A MAJORITY. |
| PART VI, LINE 6: | MERCY HARVARD HOSPITAL PROVIDES ACUTE CARE SERVICES IN MCHENRY COUNTY ILLINOIS. IT IS PART OF A LARGER INTEGRATED HEALTHCARE SYSTEM AND IS AFFILIATED WITH OTHER SEPARATELY REPORTED ORGANIZATIONS. MERCY ALLIANCE INC. IS THE PARENT COMPANY OF MERCY HEALTH SYSTEM CORPORATION, MERCY ASSISTED CARE INC, AND MERCY HARVARD HOSPITAL INC. MERCY HEALTH SYSTEM CORPORATION OPERATES TWO HOSPITALS AND HAS COMMUNITY CLINICS LOCATED THROUGHOUT SIX COUNTIES OF WISCONSIN AND ILLINOIS. MERCY ASSISTED CARE PROVIDES HOME HEALTH SERVICES AND DME (DURABLE MEDICAL EQUIPMENT) SERVICES; THUS PROVIDING CONTINUATION OF CARE TO MERCY HEALTH SYSTEM PATIENTS AND THE COMMUNITY AS A WHOLE. MERCY HEALTH SYSTEM CORP. WORKS WITH THE MERCY FOUNDATION, INC. TO OPERATE A HOMELESS SHELTER IN JANESVILLE, WI: THE HOUSE OF MERCY HOMELESS CENTER PROVIDES SHELTER, SUPPORT, AND TRAINING TO WOMEN, CHILDREN, AND FAMILIES TO HELP FIGHT HOMELESSNESS. IT OPENED IN 1996, AND NOW SHELTERS AN AVERAGE OF 290 INDIVIDUALS/YEAR THE LAST THREE YEARS.MERCY HOSPITAL ASSOCIATION OF VOLUNTEERS, INC. IS THE ORGANIZATION/TAX ENTITY OF MERCY'S VOLUNTEERS. VOLUNTEERS NUMBERED 1,431 IN CALENDAR YEAR 2014. THIS ORGANIZATION NOT ONLY SUPPORTS MERCY'S SERVICES, BUT PROVIDES BENEFITS TO THE COMMUNITY AS A WHOLE. IN CONJUNCTION WITH MERCY HEALTH SYSTEM'S MEAL PREPARATION, THE VOLUNTEERS PARTICIPATE IN AND OVERSEE A MEALS ON WHEELS PROGRAM: PARTICIPANT/NUTRITION SPECIFIC MEALS ARE PREPARED AND DELIVERED TO THE ELDERLY NEEDING ASSISTANCE IN JANESVILLE. THE VOLUNTEER ASSOCIATION RUNS A HOSPITALITY HOUSE IN WHICH FAMILY MEMBERS OF PATIENTS ARE OFFERED FREE HOUSING DURING THEIR LOVED ONES EXTENDED HOSPITAL STAY AND REHABILITATION. |
| PART VI, LINE 7, REPORTS FILED WITH STATES | WI,IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JENNIFER HALLATT | ||||||||||||||
| DIRECTOR | $0 | $152,798 | $0 | $83,905 | $0 | $4,121 | $0 | $16,082 | $0 | $25,555 | $0 | $282,461 | $0 | $0 |
| JOHN COOK | ||||||||||||||
| CFO | $0 | $268,004 | $0 | $140,656 | $0 | $6,281 | $0 | $17,160 | $0 | $22,535 | $0 | $454,636 | $0 | $0 |
| WENDI AUBRY | ||||||||||||||
| PHARMACIST TEAM LEAD | $159,364 | $0 | $0 | $0 | $133 | $0 | $9,178 | $0 | $8,297 | $0 | $176,972 | $0 | $0 | $0 |
| CYNTHIA BANGERT | ||||||||||||||
| DIRECTOR | $131,662 | $0 | $0 | $0 | $552 | $0 | $7,568 | $0 | $16,819 | $0 | $156,601 | $0 | $0 | $0 |
| LAURA LEAHEY | ||||||||||||||
| RN/HIB | $140,972 | $0 | $0 | $0 | $95 | $0 | $7,881 | $0 | $3,325 | $0 | $152,273 | $0 | $0 | $0 |
| KHRISTINE SCHRADER | ||||||||||||||
| SHIFT COORD | $163,122 | $0 | $0 | $0 | $285 | $0 | $9,115 | $0 | $12,645 | $0 | $185,167 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | MANAGEMENT REVIEWS THE FORM 990 BEFORE FILING AND IT IS AVAILABLE TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS, AND KEY EMPLOYEES ARE REQUIRED TO REPORT ALL CONFLICTS OF INTEREST. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR INVESTIGATING ALL CONFLICTS AND REPORTING TO THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY & FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER FEES FOR SERVICE: PROGRAM SERVICE EXPENSES 3,403,163. MANAGEMENT AND GENERAL EXPENSES 471,440. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,874,603. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (13 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MERCY ALLIANCE INC | |||||||||||
| 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 391679859 | SUPPORT OF HEALTHCARE | WI | 501(C)(3) | LINE 11A, I | MERCYROCKFORD HEALTH SYSTEM CORPORATION | 0 | |
| MERCY FOUNDATION INC | |||||||||||
| 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 237275336 | SUPPORT OF HEALTHCARE | WI | 501(C)(3) | LINE 11A, I | MERCY HEALTH SYSTEM CORPORATION | 0 | |
| MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS | |||||||||||
| 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 390912682 | SUPPORT OF HEALTHCARE | WI | 501(C)(3) | LINE 11C, III-FI | MERCY HEALTH SYSTEM CORPORATION | 0 | |
| MERCY ASSISTED CARE INC | |||||||||||
| 901 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 391035110 | HEALTHCARE | WI | 501(C)(3) | LINE 9 | MERCY ALLIANCE INC | 0 | |
| MERCY HEALTH SYSTEM CORPORATION | |||||||||||
| 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 390816848 | HEALTHCARE | WI | 501(C)(3) | LINE 3 | MERCY ALLIANCE INC | 0 | |
| HARVARD MEMORIAL HOSPITAL FOUNDATION | |||||||||||
| 901 GRANT STREET | HARVARD | IL | 60033 | 364308662 | SUPPORT OF HEALTHCARE | IL | 501(C)(3) | LINE 11A, I | MERCY HARVARD HOSPITAL INC | 0 | |
| MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER | |||||||||||
| 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 201673011 | NONE | IL | 501(C)(3) | LINE 3 | MERCY ALLIANCE INC | 0 | |
| MERCYROCKFORD HEALTH SYSTEM CORPORATION | |||||||||||
| 2400 N ROCKTON AVE | ROCKFORD | IL | 61103 | 472158680 | SUPPORT OF HEALTHCARE | IL | 501(C)(3) | LINE 11A, I | 0 | N/A | |
| ROCKFORD MEMORIAL HOSPITAL | |||||||||||
| 2400 N ROCKTON AVE | ROCKFORD | IL | 61103 | 362167847 | HEALTHCARE | IL | 501(C)(3) | LINE 3 | ROCKFORD HEALTH SYSTEM | 0 | |
| ROCKFORD HEALTH SYSTEM | |||||||||||
| 2400 N ROCKTON AVE | ROCKFORD | IL | 61103 | 363197915 | SUPPORT OF HEALTHCARE | IL | 501(C)(3) | LINE 11C, III-FI | MERCYROCKFORD HEALTH SYSTEM CORPORATION | 0 | |
| ROCKFORD MEMORIAL DEVELOPMENT FOUNDATION | |||||||||||
| 2400 N ROCKTON AVE | ROCKFORD | IL | 61103 | 363197918 | SUPPORT OF HEALTHCARE | IL | 501(C)(3) | LINE 11A, I | ROCKFORD HEALTH SYSTEM | 0 | |
| VISITING NURSES ASSN OF THE ROCKFORD AREA | |||||||||||
| 4223 E STATE STREET | ROCKFORD | IL | 61108 | 362167945 | HEALTHCARE | IL | 501(C)(3) | LINE 9 | ROCKFORD HEALTH SYSTEM | 0 | |
| ROCKFORD HEALTH PHYSICIANS | |||||||||||
| 2300 N ROCKTON AVE | ROCKFORD | IL | 61103 | 363097436 | HEALTHCARE | IL | 501(C)(3) | LINE 3 | ROCKFORD HEALTH SYSTEM | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JANESVILLE MEDICAL CENTER INC | |||||||||||||
| 1000 MINERAL POINT AVE | JANESVILLE | WI | 53548 | 391520130 | MANAGEMENT OF UNION EMPLOYEES | WI | N/A | C | 0 | ||||
| MERCYCARE INSURANCE COMPANY | |||||||||||||
| 580 N WASHINGTON ST | JANESVILLE | WI | 53546 | 391768192 | INSURANCE | WI | N/A | C | 0 | ||||
| MERCYCARE HMO INC - CONSOLIDATED WITH MERCYCARE INSURANCE CO | |||||||||||||
| 580 N WASHINGTON ST | JANESVILLE | WI | 53546 | 201482553 | INSURANCE | WI | N/A | C | 0 | ||||
| ROCKFORD HEALTH INSURANCE LTD | |||||||||||||
| INSURANCE | N/A | C | 0 | WELLESLEY HOUSE SO 2ND FL | PEMBROOKE, HM | BD | BD | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |