2016-08-09T08:28:54-05:00 2015-12-31 990 2015-01-01 362181997 FREEPORT MEMORIAL HOSPITAL FREE 8155996209 1045 W STEPHENSON ST FREEPORT IL 61032 MICHAEL C CLARK CHIEF FINANCIAL OFFICER 8155996361 2016-08-09 0 2015 2016-12-15 16:53:06Z MICHAEL R PERRY MD PRES 1045 W STEPHENSON ST FREEPORT IL 61032 136557614 0 X WWW.FHN.ORG X 1964 IL OUR MISSION IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES, WORKING TOGETHER WITH THOSE WE SERVE. 9 8 1353 327 9307 -852 208225 125594 138964364 136151353 297798 224384 0 0 139470387 136501331 0 0 0 0 39981312 40978194 0 0 0 70830125 69157491 110811437 110135685 28658950 26365646 80290021 87094468 33469876 39429984 46820145 47664484 X SEE SCHEDULE O 0 0 43443903 94543965 FREEPORT MEMORIAL HOSPITAL PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO PATIENTS IN FIVE NORTHWESTERN ILLINOIS COUNTIES. THE HOSPITAL ENSURES CONTINIUED ACCESS TO CARE BY SERVING PATIENTS IN MEDICALLY UNDERSERVED AREAS. THE HOSPITAL QUALIFIES AS A MEDICARE DISPROPORTIONATE SHARE HOSPITAL BECAUSE IT SERVES A DISPROPORTIONATELY HIGH NUMBER OF LOW-INCOME PATIENTS. 60035881 41598081 OTHER UNCOMPENSATED CARE: THE HOSPITAL IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELLY 72% OF ITS' PATIENT BASE QUALIFYING FOR AT LEAST ONE OF THESE PROGRAMS. AT PRESENT THE REIMBURSEMENT RATES OF THESE PROGRAMS DO NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THE ESTIMATED UNFUNDED COST OF SERVICE FOR MEDICARE PATIENTS WAS APPROXIMATELY $8,861,864 AND MEDICAID PATIENTS WAS APPROXIMATELY $9,575,936 FOR THE YEAR ENDING 12/31/2015. 891072 0 CHARITY CARE: THE HOSPITAL PROVIDED CHARITY CARE BENEFITS FOR PATIENTS WHOSE INCOME WAS UP TO 300% OF THE FEDERALLY DETERMINED PROVERTY LEVEL. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO APPROXIMATELY $3,661,645 IN 2015. ESTIMATED COSTS OF PROVIDING THESE SERVICES AMOUNTED TO APPROXIMATELY $891,072 IN 2015. OTHER COMMUNITY BENEFITS: THE HOSPITAL OPERATES AND SUPPORTS A NUMBER OF COMMUNITY BENEFIT PROGRAMS THAT INCLUDE BUT ARE NOT LIMITED TO COMMUNITY HEALTH EDUCATION, HEALTH CARE SUPPORT SERVICES AND HEALTH PROFESSIONAL EDUCATION. 104370856 1 0 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 64 0 1 1353 1 1 1 0 0 0 0 0 0 0 0 0 X 9 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X AMY RUNGREN 8155996940 1045 W STEPEHNSON ST FREEPORT IL 61032 CAROL SCHUSTER CHAIRMAN 0.50 X 0 0 0 STEVEN KNEUBUEHL VICE CHAIRMAN 0.50 X 0 0 0 ELLEN POPPEN TREASURER 0.50 X 0 0 0 LARRY MAIN SECRETARY 0.50 X 0 0 0 GARY FONTANA BOARD MEMBER 0.50 X 0 0 0 HEATHER MCPHERSON BOARD MEMBER 0.50 X 0 0 0 REBECCA PEDERSON MD BOARD MEMBER 0.50 X 0 300957 49883 NEAL RICHARDSON BOARD MEMBER 0.50 X 0 0 0 MARK WRIGHT BOARD MEMBER 0.50 X 0 0 0 MICHAEL MERRY MD CHAIR PHYSICIANS COUNCEL 0.50 X 0 0 0 KEVIN DRAXINGER MD PRESIDENT MEDICAL STAFF 0.50 X 0 0 0 MICHAEL PERRY MD PRESIDENT/CEO 25.00 15.00 X 348108 204443 80549 MICHAEL C CLARK EXECUTIVE VP/CFO 25.00 15.00 X 185111 108717 80392 MARK S GRIDLEY EXECUTIVE VP/COO 25.00 15.00 X 166060 97525 59727 LEONARD CARTER HUMAN RESOURCES 25.00 15.00 X 134010 78703 28949 ROBERT GELLER MD VP OF MEDICAL AFFAIRS 1.00 40.00 X 0 310635 74784 NANCY V CUTLER VP OF NURSING CNO 40.00 X 171445 0 17074 ALAN ESKER MD PHYSICIAN 40.00 X 279382 0 56441 ROBIN SCALISE IMAGING DIRECTOR 40.00 X 153949 0 31977 BETH KALNINS MD MEDICAL STAFF 40.00 X 233716 0 31904 CLARENCE PARKS MD HOSPITALIST 40.00 X 310211 0 37502 HYO JIN KIM HOSPITALIST 40.00 X 212320 0 26778 WILLIAM SPANGLER ASST. VP FINANCE 40.00 X 140474 0 52299 MICHAEL G WEAVER PHARMACY DIRECTOR 40.00 X 153074 0 43925 WILLIAM PALMQUIST FORMER PHARMACIST 40.00 X 128430 0 41180 2616290 1100980 713364 25 1 1 0 MEA-FREEPORT LLC PO BOX 634850 CINCINNATI OH 45263 EMERGENCY DEPT 5457715 CAMOLOT RADIOLOGY 3849 N PERRYVBILLE RD ROCKFORD IL 61108 RADIOLOGY PHYSICIANS 2370624 LOCUM CONNECTIONS 16000 N DALLAS PARKWAY DALLAS TX 75248 PHYSICIAN SERVICES 464266 MEDICAL STAFFING NETWORK PO BOX 840292 DALLAS TX 75284 PHYSICIAN SERVICES 418689 EXCALIBUR DDPM PO BOX 635 NEW CASTLE CO 81647 COLLECTIONS SERVICE 379507 11 21230 104364 125594 PATIENT SERV. REVENUE 621400 127015769 127006462 9307 PROVIDER TAX REVENUE 621400 6258087 6258087 GOVERNMENT PAYMENT 621400 1721182 1721182 EHR INCENTIVE PAYMENT 621400 580606 580606 CAFETERIA REVENUE 621400 508853 508853 66856 66856 136151353 269506 269506 11161 56283 0 -56283 11161 -45122 -45122 136501331 136142046 9307 224384 990544 990544 30570863 29151200 1419663 710987 665032 45955 6475711 6475711 2230089 2051100 178989 50000 50000 9372920 9134580 238340 4928269 4686688 241581 79674 69352 10322 210737 79992 130745 3128951 3073632 55319 1964957 1964957 CONTRACTED SERVICES 11278083 9975282 1302801 CORPORATE ALLOCATION 11224165 11224165 MEDICAL SPECIALIST 10609042 10598470 10572 BAD DEBTS 5794209 5794209 10516484 9426486 1089998 110135685 104370856 5764829 0 30696208 34813903 22133541 20339505 1693810 1454580 1731629 1946195 3086882 2344004 79371736 62368709 17690597 17003027 1679505 1621461 1577849 7571793 80290021 87094468 17651298 20911308 15818578 18518676 33469876 39429984 X 45809944 46669347 1010201 995137 46820145 47664484 80290021 87094468 X 26365646 -118162 -25403145 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 43266 43266 0 PART II-B, LINE 1: PORTION OF 2015 ILLINOIS HOSPITAL ASSOCIATION DUES USED FOR LOBBYING - $27,578. PORTION OF 2015 AMERICAN HOSPITAL ASSOCIATION DUES USED FOR LOBBYING - $5,938. PORTION OF 2015 MDH COALITION USED FOR LOBBYING - $9,750. 944945 944945 49287572 38422030 10865542 26946642 23238891 3707751 2192577 707788 1484789 17003027 OTHER ASSETS 9304 DUE FROM RESITRICTED FUND 29367 MEDICIAD ASSESSMENT RECEIVABLE 1056994 FHM CLAIMS INSURANCE RECEIVABLE 6476128 7571793 PENSION LIABILITY 10100201 ACCRUED MALPRACTICE LIABILITY 111929 ASSET RETIREMENT OBLIGATION 1685777 MALPRACTICE LIABILITY LONG TERM 6620769 18518676 1 1 1 X 1 X 1 1 0 1 1 879893 0 879893 0.00800 24764126 15188190 9575936 0.09220 25644019 15188190 10455829 0.10020 330460 5700 324760 0.00310 366560 0 366560 0.00350 172408 0 172408 0.00170 66115 0 66115 0.00060 935543 5700 929843 0.00890 26579562 15193890 11385672 0.10910 47871 47871 0.00040 47871 47871 0.00040 1 1392348 0 26409891 35271755 -8861864 X 1 1 1 1 FREEPORT MEMORIAL HOSPITAL 1045 WEST STEPHENSON STREET FREEPORT IL 61032 X X X FREEPORT MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 13 1 0 0 1 X WWW.FHN.ORG X 1 13 1 WWW.FHN.ORG 0 0 1 X 125.000000000000 300.000000000000 X X X X X X 1 1 X X X 1 X WWW.FHN.ORG X WWW.FHN.ORG X WWW.FHN.ORG X X X X X 1 X X 1 X X X X X 1 X 0 0 FREEPORT MEMORIAL HOSPITAL PART V, SECTION B, LINE 22D: HOSPITAL USED AVERAGE AMOUNTS GENERALLY BILLED TO INDIVIDUALS WHO HAVE INSURANCE. PART I, LINE 7: SCHEDULE H PART I LINE 7 COLUMN(F): OUR TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN(A) WAS $110,135,685. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $5,794,209. THIS LEFT US WITH A TOTAL EXPENSE OF $104,341,476 FOR PURPOSES OF CALCULATING LINE 7, COLUMN(F). PART I, LN 7 COL(F): SCHEDULE H PART I LINE 7: OUR TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN(A) $110,135,685. THE BAD DEBT EXPENSES INCLUDED IN THIS AMOUNT WAS $5,794,209. THIS LEFT US A TOTAL EXPENSES OF $104,341,476 FOR THE PURPOSES OF CALCULATING LINE 7, COLUMN(F). PART III, LINE 4: LINE #2: THE RATIO OF PATIENT CARE COST TO CHARGES AS DETERMINED ON WORKSHEET 2 IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2.LINE # 3: NO BAD DEBT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE POLICY. PART III, LINE 8: COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING THE MEDICARE COST-TO-CHARGE RATIO FROM OUR FILED 12/31/15 MEDICARE COST REPORT.COMMUNITY BENEFIT: WE BELIEVE THAT ALL OF THE 8,861 MILLION SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE OF THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORDED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 50% OF HOSPITAL REVENUES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST OF MEDICARE BENEFICIARIES.0 PART III, LINE 9B: INDIVIDUALS APPROVED FOR ASSISTED CARE ARE GIVEN A CARD WHICH IS TYPICALLY VALID FOR 6 MONTHS. THEY PRESENT THE CARD WHEN THEY RECEIVE SERVICES. INDIVIDUALS APPROVED FOR ASSISTED CARE WILL BE ASKED TO MAKE A MODEST CO-PAY AT THE TIME OF SERVICE, BASED ON THE FOLLOWING SCHEDULE:HOSPITAL INPATIENT SERVICES: $50HOSPITAL EMERGENCY DEPARTMENT: $35HOSPITAL OUTPATIENT SERVICES: $25OUR COLLECTION POLICIES ARE THE SAME FOR ALL OF OUR PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, AN APPLICATION FOR ASSISTED CARE IS SENT TO THE PATIENT. AFTER A PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS EITHER PARTIALLY OR ENTIRELY WRITTEN OFF. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE EXISTING DEBT COLLECTION POLICY. COVERAGE FOR THE ASSISTED CARE PROGRAM IS FOR 6 MONTHS AFTER WHICH TIME PATIENTS CAN REAPPLY IF THEY CONTINUE TO MEET THE GUIDELINES ESTABLISHED. PART VI, LINE 7, REPORTS FILED WITH STATES IL SCHEDULE H PART I LINE 6A: ANNUAL COMMUNITY BENEFIT REPORT - OUR ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR THE FHN NETWORK AS A WHOLE AND IS INCLUDED AS A NON-AUDITED SCHEDULE ON THE AUDITED FINANCIAL STATEMENTS. X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 REBECCA PEDERSON MD BOARD MEMBER 0 283271 0 13308 0 4378 0 25000 0 24883 0 350840 0 0 MICHAEL PERRY MD PRESIDENT/CEO 262985 154451 31751 18647 53372 31345 30870 18130 19876 11673 398854 234246 0 0 MICHAEL C CLARK EXECUTIVE VP/CFO 153962 90422 15218 8938 15931 9357 30870 18130 19777 11615 235758 138462 0 0 MARK S GRIDLEY EXECUTIVE VP/COO 142272 83556 12899 7574 10889 6395 15750 9250 21878 12849 203688 119624 0 0 LEONARD CARTER HUMAN RESOURCES 118090 69354 10479 6154 5441 3195 0 0 18238 10711 152248 89414 0 0 ROBERT GELLER MD VP OF MEDICAL AFFAIRS 0 260414 0 24407 0 25814 0 38950 0 35834 0 385419 0 0 NANCY V CUTLER VP OF NURSING CNO 146214 0 18486 0 6745 0 11295 0 5779 0 188519 0 0 0 ALAN ESKER MD PHYSICIAN 268467 0 6125 0 4790 0 31000 0 25441 0 335823 0 0 0 ROBIN SCALISE IMAGING DIRECTOR 151618 0 2000 0 331 0 29372 0 2605 0 185926 0 0 0 BETH KALNINS MD MEDICAL STAFF 225462 0 5750 0 2504 0 0 0 31904 0 265620 0 0 0 CLARENCE PARKS MD HOSPITALIST 300834 0 8250 0 1127 0 25000 0 12502 0 347713 0 0 0 HYO JIN KIM HOSPITALIST 208813 0 3125 0 382 0 15989 0 10789 0 239098 0 0 0 WILLIAM SPANGLER ASST. VP FINANCE 126942 0 12128 0 1404 0 24148 0 28151 0 192773 0 0 0 MICHAEL G WEAVER PHARMACY DIRECTOR 148800 0 2000 0 2274 0 29454 0 14471 0 196999 0 0 0 WILLIAM PALMQUIST FORMER PHARMACIST 125140 0 50 0 3240 0 28519 0 12661 0 169610 0 0 0 PART I, LINE 1A FREEPORT MEMORIAL HOSPITAL REIMBURSED A DIRECTOR/TRUSTEE FOR BUSINESS TRAVEL EXPENSES INCLUDING TRAVEL EXPENSES FOR A SPOUSE. FORM 990, PART III, LINE 1 FHN IS REGIONAL HEALTHCARE SYSTEM COMMITTED TO THE HEALTH AND WELL-BEING OF THE PEOPLE OF NORTHWEST ILLINOIS AND SOUTHERN WISCONSIN. WE HAVE SERVICES FOR ALL AGES, SO EVERY MEMBER OF YOUR FAMILY CAN RECEIVE CARING, PERSONAL, PROFESSIONAL HEALTHCARE. AN AVERAGE OF 1,400 PEOPLE VISIT FHN EACH DAY FOR THEIR HEALTHCARE NEEDS (THAT'S MORE THAN 525,000 PATIENTS PER YEAR). FHN IS THE ONLY HEALTHCARE PROVIDER IN OUR SERVICE AREA THAT OFFERS AFFILIATIONS WITH THREE MAJOR HOSPITALS IN ROCKFORD, ILLINOIS, AS WELL AS WITH THE UNIVERSITY OF WISCONSIN HOSPITAL AND CLINICS IN MADISON, WISCONSIN. WE SEE EACH PATIENT INTERACTION AS A SERIOUS RESPONSIBILITY THAT REQUIRES CLINICAL EXPERTISE, ACCESS TO THE LATEST IN MEDICAL TECHNOLOGY AND A LEVEL OF TRUST AND COMMITMENT THAT IS EARNED BY OUR PEOPLE, OUR PRODUCTS AND OUR PROCESS. ABOUT FHN MEMORIAL HOSPITAL: 146 LICENSED BED. 24-HOUR EMERGENCY CARE. EICU UNIT, LINKING OUR EXPERIENCED, CARING STAFF ROUND-THE-CLOCK WITH THE UNIVERSITY OF WISCONSIN E-CARE TEAM OF PROFESSIONAL INTENSIVISTS AND CRITICAL CARE NURSES. SATELLITE EDUCATION CENTER FOR THE ILLINOIS POISON CONTROL CENTER (ONE OF ONLY 12 IN THE STATE OF ILLINOIS). OVER 75 PHYSICIANS ON THE ACTIVE AND ASSOCIATED MEDICAL STAFF - 100% ARE BOARD-CERTIFIED OR BOARD-ELIGIBLE. UP-TO-THE-MINUTE EQUIPMENT AND SERVICES, INCLUDING A CARDIOVASCULAR CENTER. SURGERY CAPABILITIES FOR PROCEDURES RANGING FROM A SIMPLE TONSILLECTOMY TO SOPHISTICATED VASCULAR SURGERY. SPECIALTY SERVICE AREAS SUCH AS SLEEP CENTER, PAIN CLINIC, SPINE CENTER AND FAMILY BIRTHING CENTER. AS PART OF YOUR COMMUNITY, WE WILL PROVIDE PERSONAL, PROFESSIONAL AND CARING HEALTHCARE FOR YOUR ENTIRE FAMILY. WE WILL PROVIDE OR FIND SERVICES YOU NEED TO MAKE YOUR LIFE BETTER. WE WILL FOLLOW THROUGH AND MAKE SURE YOU ARE SATISFIED. WE ARE COMMITTED TO EXCELLENCE AND YOUR WELL-BEING IS THE REASON FOR OUR EXISTENCE. WE ARE PART OF YOUR COMMUNITY. AND WE WANT TO KEEP IT HEALTHY, BOTH ECONOMICALLY AND PHYSICALLY, AT WORK, AT PLAY, ON THE FARM, AT SCHOOL AND AT HOME. IN 2006, WE FORMED A PARTNERSHIP WITH THE STEPHENSON COUNTY HEALTH DEPARTMENT TO PROVIDE HEALTHCARE SERVICES FOR THE UNINSURED, UNDERINSURED AND MEDICALLY INDIGENT AT THE FHN COMMUNITY HEALTHCARE CENTER, LOCATED AT THE FORMER CRUSADER COMMUNITY CLINIC INSIDE THE HEALTH DEPARTMENT BUILDING. AND IN SUPPORT OF THE LOCAL UNITED WAY, EACH YEAR OUR EMPLOYEES MAKE THEIR PERSONAL CONTRIBUTIONS, AVERAGING OVER $40,000, AND ALSO SERVE IN LEADERSHIP POSITIONS FOR MANY COMMUNITY ORGANIZATIONS AND BOARDS. FHN IS A COMMUNITY HEALTHCARE SYSTEM, COMPRISED OF LOCAL EXPERTS, INSPIRED BY GLOBAL INNOVATION AND GROUNDED BY ETHICAL LEADERSHIP. FREEPORT MEMORIAL HOSPITAL COORDINATES AND INTEGRATES MEDICAL CARE SERVICES AND PROVIDES INDIVIDUALS IMPARTIAL ACCESS TO MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR SOURCE OF PAYMENT. THE HOSPITAL PROVIDES MEDICALLY NECESSARY CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL QUALIFIES AS A MEDICARE DISPROPORTIONATE SHARE HOSPITAL BECAUSE IT SERVES A DISPROPORTIONATELY HIGH NUMBER OF LOW INCOME PATIENTS. INSURED AND UNDERINSURED PATIENTS, WHO MEET CERTAIN FEDERAL POVERTY GUIDELINES AND/OR OTHER UNIQUE CIRCUMSTANCES, ARE PROVIDED FREE OR DISCOUNTED CARE AFTER A NOMINAL CO-PAYMENT. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. DURING 2015, THE CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THE HOSPITAL'S CHARITY CARE POLICY WAS $3,661,645 AT A COST OF $891,072 . FREEPORT MEMORIAL HOSPITAL IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELY 72% OF ITS PATIENT BASE QUALIFYING FOR AT LEAST ONE OF THESE PROGRAMS. AT PRESENT, THE REIMBURSEMENT RATES FOR BOTH PROGRAMS DO NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THE ESTIMATED UNFUNDED COSTS OF SERVICES FOR MEDICAID PATIENTS WERE APPROXIMATELY $9,575,936 FOR THE YEAR ENDING 12/31/2015. MEDICARE PAYMENTS WERE APPROXIMATELY $8,861,864 LESS THAN THE HOSPITAL'S COST TO PROVIDE CARE DURING THE SAME PERIOD. IN ADDITION, THE COST OF CARE PROVIDED TO PEOPLE WHO DID NOT PAY WAS $1,392,348 IN 2015. FREEPORT MEMORIAL HOSPITAL PROVIDES DISCOUNTS TO UNINSURED PATIENTS WITHOUT REGARD TO THEIR INCOME. FOR 2015 THESE DISCOUNTS TOTALED $717,469 . THE ESTIMATED COSTS ATTRIBUTABLE TO THE DISCOUNTED PORTION OF THESE SERVICES WERE $172,408 FOR 2014. FREEPORT MEMORIAL HOSPITAL AND ITS RELATED ORGANIZATIONS SUPPORT AND PARTICIPATE IN MANY COMMUNITY SERVICES AND OUTREACH PROGRAMS, INCLUDING SUPPORT FOR COMMUNITY HEALTH EDUCATION PROGRAMS, COMMUNITY-BASED CLINICAL SERVICES, HEALTH PROFESSIONAL EDUCATION, RESEARCH, SPONSORSHIP OF COMMUNITY EVENTS, AND COMMUNITY-BUILDING ACTIVITIES. THE HOSPITAL CONTRIBUTED $802,314 TOWARDS THESE PROGRAMS IN 2015. PROGRAM SERVICE EXPENSES: $110,135,685 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE FORM 990 BEFORE THE TAX RETURN IS FILED. QUESTIONS AND EXPLANATIONS ARE ANSWERED BY THE FINANCE DEPARTMENT TO THE BOARD'S SATSIFACTION. THE BOARD REVIEWS ALL TRANSACTIONS THAT AFFECT THE FILING OF THE ORGANIZATION'S FORM 990 AND EQUIVALENT STATE RETURNS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A DEDICATED CORPORATE COMPLIANCE OFFICER. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE. THESE DOCUMENTS ARE REVIEWED BY THE CCO TO DETERMINE IF ANY INDIVIDUAL HAS A CONFLICT OF INTEREST THAT NEEDS TO BE ADDRESSED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT REVIEWS THE CEO, TOP MANAGEMENT AND EXECUTIVE DIRECTORS COMPENSATION. THE COMMITTEE RELIES ON INTERNAL AND EXTERNAL INFORMATION TO DETERMINE THE APPROPRIATE COMPENSATION AND EMPLOYS AN INDEPENDENT THIRD PARTY TO CONDUCT THE ANNUAL EXECUTIVE COMPENSATION ANALYSIS. THIS ANALYSIS IS USED TO DETERMINE IF THE BOARD'S WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY HAS BEEN MET. THE EXECUTIVE COMPENSATION COMMITTEE ALSO RECEIVES A REASONABLENESS LETTER FROM THE THIRD PARTY. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN MINIMUM PENSION LIABILITY 1,290,996. TRANSFERS TO AFFILIATE -26,679,078. NET ASSETS RELEASED FROM RESTRICTION -162,249. CONTRIBUTIONS TEMPORARY RESTRICTED 147,186. FREEPORT REGIONAL HEALTH CARE FOUNDATION 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363994636 HEALTH CARE IL 501(C)(3) LINE 11 N/A 0 FREEPORT REGIONAL HEALTHCARE SERVICES 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363967303 HEALTH CARE IL 501(C)(3) LINE 3 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 FREEPORT REGIONAL MANAGEMENT SERVICES 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363994636 HEALTH CARE IL 501(C)(3) LINE 3 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 JANE ADDAMS INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 362879689 HEALTH CARE IL 501(C)(3) LINE 7 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 JANE ADDAMS HEALTHCARE SERVICES INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363677357 HEALTH CARE IL 501(C)(3) LINE 11 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 MEMORIAL ENTERPRISES INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363353871 HEALTH CARE IL FREEPORT REGIONAL HEALTH CARE FOUNDATION C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0