2015-05-15T10:01:21-05:00 2014-06-30 BKD LLP 211 N BROADWAY SUITE 600 ST LOUIS MO 631022733 990 2013-07-01 362852553 Illinois Valley Community Hospital % TOMMY HOBBS ILLI 8152233300 925 WEST STREET Suite PERU IL 61354 TOMMY HOBBS CEO CEO 8152233300 2015-05-11 true Troy A Lindsey P01041237 8152233300 2013 2016-03-07 17:11:31Z TOMMY HOBBS 925 WEST STREET PERU IL 61354 85303224 false X WWW.IVCH.ORG X 1978 IL ILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY. 12 7 741 115 0 443207 439388 77592250 83035966 609754 649191 572105 644437 79217316 84768982 34852 43695 0 0 35534346 37944930 0 0 0 41934557 46264933 77503755 84253558 1713561 515424 77728094 76014036 43248475 39971042 34479619 36042994 X ILLINOIS VALLEY COMMUNITY HOSPITAL IS DEDICATED TO PROVIDING EXCEPTIONAL CARE THROUGH A COMMITMENT TO CLINICAL EXCELLENCE AND COMPASSION FOR EVERY PATIENT, EVERY DAY. false false 66535066 43695 83035966 HOSPITAL PATIENT CARE SERVICES: INPATIENT SERVICES PROVIDED BY ILLINOIS VALLEY COMMUNITY HOSPITAL (IVCH) INCLUDE MEDICAL AND SURGICAL SERVICES, ICU, OBSTETRICS, SWING BEDS, DIAGNOSTIC, REHAB AND TREATMENT SERVICES. OUTPATIENT SERVICES INCLUDE SURGERY, EMERGENCY ROOM, LABORATORY, DIAGNOSTIC IMAGING, REHAB SERVICES, HOSPICE, PAIN MANAGEMENT, SLEEP THERAPY, RESPIRATORY CARE, EKG, OTHER DIAGNOSTIC AND THERAPEUTIC SERVICES AND PHYSICIAN CLINICS. IVCH IS A MEDICARE DEPENDENT HOSPITAL, A DISPROPORTIONATE SHARE HOSPITAL AND IS COMMITTED TO PROVIDING THE HIGHEST QUALITY OF HEALTH SERVICES TO ALL PATIENTS, REGARDLESS OF THEIR FINANCIAL STATUS OR ABILITY TO PAY. IVCH SUBSIDIZES THE COST OF TREATING PATIENTS WHO ARE UNABLE TO PAY AND THOSE WHO RECEIVE GOVERNMENT ASSISTANCE WHERE REIMBURSEMENT IS LIMITED. IN FY 2014 THE COST OF FINANCIAL ASSISTANCE AND MEANS TESTED GOVERNMENT PROGRAMS PROVIDED BY IVCH WAS $6,798,890. STATISTICS: INPATIENT ADMISSIONS: 2,653 INPATIENT DAYS: 7,708 NEWBORN DELIVERIES: 500 INPATIENT SURGERIES: 806 OUTPATIENT SURGERIES: 4,810 OUTPATIENT VISITS: 85,435 EMERGENCY ROOM VISITS: 15,187 CLINIC VISITS: 61,907 66535066 true true false true false false false false false false true false false true true true false true false false false false false false false false true true true false true true false false false false false false false false false true false false false false false true true true false false true 69 0 true 741 true false false false false false false false false false false X 12 7 true false false false true true true true true false false true true true true true true true false false IL X TOMMY HOBBS 8152233300 925 WEST STREET PERU IL 61354 X KRISTINE PAUL PRESIDENT 1.0 2.25 X X 0 0 0 JAMES LOVELAND VICE-PRESIDENT 1.0 1.5 X X 0 0 0 RICHARD MARTUZZO SECRETARY 1.0 1.75 X X 0 0 0 DAVID SICKLEY TREASURER 1.0 1.5 X X 0 0 0 GEORGE BUCKMAN DIRECTOR 1.0 2.0 X 0 0 0 JAMES CLINARD DIRECTOR 1.0 1.0 X 0 0 0 GEETHA DODDA MD DIRECTOR 1.0 1.0 X 0 0 0 WILLIAM ETZENBACH DIRECTOR 1.0 1.5 X 0 0 0 JOSEPH HOGAN DIRECTOR 1.0 2.0 X 0 0 0 CINDY KURKOWSKY DIRECTOR 1.0 1.0 X 0 0 0 MICHAEL ROONEY OD DIRECTOR 1.0 1.0 X 0 0 0 WILLIAM VLASTNIK DIRECTOR 1.0 2.75 X 0 0 0 TOMMY HOBBS CEO / NONVOTING DIRECTOR 40.0 4.25 X 220005 0 38338 STEPHEN DAVIS CFO 40.0 4.25 X 130504 0 32202 PETER MEIER MD ORTHOPEDIC SURGEON 40.0 0.0 X 602898 0 35240 ROBERT MITCHELL MD ORTHOPEDIC SURGEON 40.0 0.0 X 500762 0 29617 ANDREW GUZMAN MD OB/GYN PHYSICIAN 40.0 0.0 X 514674 0 29589 MARIO COTE MD INT. MED. PHYSICIAN 40.0 X 452934 0 37400 SCOTT MILLINGTON MD ANESTHESIOLOGIST 40.0 0.0 X 400056 0 33364 2821833 0 235750 28 false true false PERU EMERGENCY PHYSICIANS LLP PO BOX 674579 DETROIT MI 48267 CONTRACT PHYSICIANS 3454932 ILLINOIS VALLEY ANESTHESIA ASSOC 925 WEST STREET PERU IL 61354 CONTRACT CRNA'S 1007250 EUGENE BECKER MD 14637 RIVER OAKS DR LINCOLNSHIRE IL 61704 ANESTHESIA SERVICES 450750 DOWNSTATE SCHOCKWAVE THERAPIES 405 BRONCO DR BLOOMINGTON IL 61704 LITHO/LASER SERVICES 289322 COMPHEALTH PO BOX 97651 DALLAS TX 75397 LOCUMS 189029 11 413293 26095 439388 NET PATIENT SERVICE REVENUE 621110 81878382 81878382 EHR INCENTIVE REVENUE 621110 1157584 1157584 83035966 646714 646714 0 0 450749 530119 -79370 0 -79370 -79370 6600 4123 2477 2477 2477 0 0 0 CAFETERIA REVENUE 721000 271579 271579 MANAGEMENT FEES 541610 39287 39287 TRANSPORT VEHICLE REVENUE 900099 254484 254484 158457 158457 723807 84768982 83035966 1293628 43695 43695 0 0 0 421049 0 421049 0 24030 24030 28097666 22579847 5517819 1027853 830056 197797 6347610 5052287 1295323 2026722 1601110 425612 0 228149 228149 53164 53164 43435 43435 0 0 5495165 5495165 662324 139325 522999 812728 576332 236396 1209662 806440 403222 0 1631840 1328207 303633 19224 18405 819 0 134975 109827 25148 568297 500101 68196 0 4192022 3416498 775524 1877911 1051630 826281 SUPPLIES 11070324 11070324 0 PURCHASED SERVICES 6747248 4608057 2139191 BAD DEBT EXPENSE 4920589 4920589 0 PROVIDER TAX 3612336 0 3612336 2985540 2387171 598369 84253558 66535066 17718492 0 2088744 1682073 100706 100807 0 0 12434413 11254591 0 0 0 0 0 0 2757971 2927763 1126314 1130385 110173896 71192810 39989265 38981086 13666563 14377346 444578 436084 0 0 0 0 5119540 5123901 77728094 76014036 7631870 8190488 0 0 0 0 21939750 21559750 0 0 0 0 1629365 2210865 0 0 12047490 8009939 43248475 39971042 X 32984688 34832432 1494931 1210562 0 0 34479619 36042994 77728094 76014036 X 515424 839439 208512 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false true 100 false false false false true 43335 43435 false SCHEDULE C, PART II-B, QUESTION 1I ALLOCATED PORTION OF MEMBERSHIP DUES WITH ILLINOIS HOSPITAL ASSOCIATION, AMERICAN HOSPITAL ASSOCIATION AND MEDICARE DEPENDENT RURAL HOSPITAL COALITION. 1476235 1476235 51407504 28352986 23054518 304038 163473 140565 55019016 41650779 13368237 1967103 1025572 941531 38981086 DUE FROM AFFILIATES 1962618 INTEREST IN IVCH FOUNDATION 1210562 OTHER ASSETS 1950721 5123901 0 PENSION OBLIGATION 2266901 DERIVATIVE FINANCIAL INSTRUMENT 0 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS 1005513 ACCRUED PROFESSIONAL AND GENERAL LIABILITY 4728492 DUE TO AFFILIATES 9033 8009939 X SCHEDULE D, PART X, LINE 2 FIN 48 DISCLOSURE: THE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES UNDER THE AUTHORITATIVE GUIDANCE ISSUED BY THE CODIFICATION. THE CORPORATION USES A THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION TO ACCOUNT FOR UNCERTAINTY IN INCOME TAXES. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS NOT BEEN MET. THIS GUIDANCE ALSO ADDRESSES DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE AND TRANSITION. THE CORPORATION CONDUCTS BUSINESS SOLELY IN THE U.S. AND, AS A RESULT, FILES FEDERAL AND ILLINOIS TAX RETURNS. IN THE NORMAL COURSE OF BUSINESS THE CORPORATION IS SUBJECT TO EXAMINATION BY TAXING AUTHORITIES. true true true X true X true true true false true true 988802 988802 0.01250 11491731 7303909 4187822 0.05280 12480533 7303909 5176624 0.06530 807062 332353 474709 0.00600 17217 17217 0.00020 966850 621550 345300 0.00160 47695 47695 0.00060 1838824 953903 884921 0.00840 14319357 8257812 6061545 0.07370 false 4920589 492000 21904676 21478349 426327 X true true 1 1 ILLINOIS VALLEY COMMUNITY HOSPITAL 925 WEST STREET PERU IL 61354 www.ivch.org 0003418 X X X ILLINOIS VALLEY COMMUNITY HOSPITAL 1 true X X X X X X X X 13 true false true X http://www.ivch.org/pdfs/IVCH-CHNA.pdf X X X X X X false false true true 150. true 300. true X X X X X X X true true X X X X X X true false X X X X true X false false SCHEDULE H, PART V, SECTION B, QUESTION 3 COMMUNITY INPUT FOR CHNA: THE CHNA STAKEHOLDERS WORKING GROUP, COMPRISED OF MEMBERS REPRESENTING THE BROAD INTERESTS OF THE COMMUNITIES SERVED, WAS RESPONSIBLE FOR THE CHNA PROCESS. THE STAKEHOLDER GROUP INCLUDED MEMBERS FROM : IVCH, IVCH MEDICAL GROUP, LA SALLE COUNTY HEALTH DEPT., ALTERNATIVES FOR THE OLDER ADULT, YOUTH SERVICE BUREAU, NORTH CENTRAL BEHAVIORAL HEALTH SERVICES, HYGIENIC INSTITUTE, OGLESBY PUBLIC SCHOOLS AND ILLINOIS VALLEY UNITED WAY. THE WORKING GROUP DEVELOPED A SURVEY INSTRUMENT, EVALUATED SURVEY RESPONSES, COLLECTED AND EVALUATED SECONDARY DATA, SYNTHESIZED THE PRIMARY AND SECONDARY DATA, AND IDENTIFIED AND PRIORITIZED COMMUNITY HEALTH NEEDS. PRIMARY DATA FOR THIS ASSESSMENT CAME FROM TWO SOURCES, A COMMUNITY STUDY PERFORMED FOR IVCH BY LEEDE RESEARCH IN 2008 AND A SURVEY DEVELOPED, DISTRIBUTED AND ANALYZED BY THE STAKEHOLDERS WORKING GROUP SPECIFICALLY FOR THE CHNA. SCHEDULE H, PART V, SECTION B, QUESTION 7 CHNA INDENTIFIED NEEDS NOT ADDRESSED BY HOSPITAL FACILITY: THE IMPLEMENTATION STRATEGY CAN BE ACCESSED AT: http://www.ivch.org/pdfs/IVCH-CHNA.pdf THE ORGANIZATION HAS NOT YET BEEN ABLE TO ADEQUATELY ADDRESS THE EXPANSION OF ACCESS TO AFFORDABLE CARE FOR MENTAL HEALTH AND SUBSTANCE ABUSE ISSUES. THIS IS DUE IN LARGE PART TO CONTINUED CUTS FROM STATE AND FEDERAL GOVERNMENT FUNDING FOR TREATMENT OF MENTAL HEALTH AND SUBSTANCE ABUSE. FOR EXAMPLE, RECENTLY THE PARTNERSHIP WITH THE LOCAL OUTPATIENT BEHAVIORAL HEALTH PROVIDER, NORTH CENTRAL BEHAVIORAL HEALTH (NCBH), WAS TERMINATED DUE TO CUTS IN THEIR REIMBURSEMENT. THE CUTS TO AN ALREADY INADEQUATE REIMBURSEMENT STRUCTURE WOULDN'T ALLOW NCBH TO CONTINUE THE SERVICE. WE ARE WORKING WITH ANOTHER PROVIDER TO PROVIDE TELEHEALTH SERVICES, HOWEVER, ADDITIONAL EFFORTS ARE UNDERWAY TO ENHANCE OUR CAPABILITIES. FINALLY, INITIAL CONVERSATIONS HAVE BEGUN TO DEVELOP A COMMUNITY BASED CENTER FOR MENTAL HEALTH PATIENTS. THIS IS IN THE EARLY STAGES OF DISCUSSION, HOWEVER, IT IS PART OF ADDITIONAL EFFORTS TO IMPLEMENT STRATEGIES TO ADDRESS THE GROWING MENTAL HEALTH PROBLEM. 5 CENTER FOR PHYSICAL REHABILITATION 300 WALNUT ST PERU IL 61354 OUTPATIENT PHYSICAL REHAB IVCH WOUND & HYPERBARIC CENTER 1403 6TH ST PERU IL 61354 WOUND CARE & HYPERBARIC THPY. ILLINOIS VALLEY ADULT DAY CENTER 1040 SECOND ST LA SALLE IL 61301 ADULT DAY CARE IVCH CARE TODAY 300 WALNUT ST PERU IL 61354 URGENT CARE IVCH FAST CARE 5307 ST ROUTE 251 PERU IL 63154 RETAIL CLINIC AT PERU WALMART SCHEDULE H, PART I, LINE 7, COLUMN F COMMUNITY BENEFIT PERCENTAGE OF TOTAL COST: THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF $4,920,589 REPORTED ON FORM 990, PART IX, LINE 25, HOWEVER, THIS EXPENSE HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN. SCHEDULE H, PART I, LINE 7 COMMUNITY BENEFIT COST: 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 7G SUBSIDIZED HEALTH SERVICES: THE AMOUNTS REPORTED ON ROW 7G DO NOT CONTAIN COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC. SCHEDULE H, PART III, LINE 2, 3 & 4 BAD DEBT EXPENSE: LINE 2: THE AMOUNT OF BAD DEBT EXPENSE REPORTED ON THE ORGANIZATION'S FY 2014 AUDITED FINANCIAL STATEMENTS WAS $4,920,589, WHICH IS VALUED AT CHARGES. LINE 3: THIS PORTION OF BAD DEBT (APPROXIMATELY 10%) IS RELATED TO ACCOUNTS THAT MAY HAVE QUALIFIED FOR THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY BASED ON HISTORICAL INFORMATION. THIS AMOUNT WOULD HAVE BEEN INCLUDED IN CHARITY CARE HAD THE PATIENT SUBMITTED THE FA APPLICATION AND PROVIDED THE NECESSARY DOCUMENTATION. LINE 4: THE CORPORATION'S ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE CORPORATION ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR DOUBTFUL ACCOUNTS, PROVISION FOR BAD DEBTS AND PROVISION FOR CHARITY. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR 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 CORPORATION ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS, PROVISION FOR BAD DEBTS AND CHARITY FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND CO-INSURANCES. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, THE CORPORATION RECORDS A PROVISION FOR BAD DEBTS AND CHARITY IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES 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) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. THE CORPORATION'S ALLOWANCE FOR DOUBTFUL ACCOUNTS INCREASED BY 8% IN FISCAL YEAR 2014 FROM FISCAL YEAR 2013. THIS INCREASE IS THE RESULT OF A HISTORICAL COLLECTION PERCENTAGE MONITORING AS WELL AS THE AGING OF THESE ACCOUNTS. ADDITIONALLY, THE CORPORATION MADE PROVISIONS FOR UNCOLLECTIBLE ACCOUNTS OF APPROXIMATELY $5,750,000 AND HAD RECOVERIES ON ACCOUNTS WRITTEN OFF OF $750,000. THE CORPORATION HAS NOT CHANGED ITS CHARITY CARE OR UNINSURED DISCOUNT POLICIES DURING FISCAL YEARS 2014 OR 2013. SCHEDULE H, PART III, LINE 8 MEDICARE: IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NON-PROFIT HOSPITALS, STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. THE AMOUNT REPORTED ON LINE 6 WAS OBTAINED FROM WORKSHEET D OF THE FY 2014 MEDICARE COST REPORT. SCHEDULE H, PART III, LINE 9 COLLECTION PRACTICES: WHEN A PATIENT IS IN THE PROCESS OF APPLYING FOR FINANCIAL ASSISTANCE, THE ACCOUNT IS PLACED ON HOLD AND THERE WILL BE NO COLLECTION EFFORTS DURING THIS TIME. IF THERE IS A BALANCE AFTER CHARITY CARE OR FINANCIAL ASSISTANCE HAS BEEN APPLIED, A MUTUALLY AGREED UPON PAYMENT PLAN IS DEVELOPED AND THE ACCOUNT FOLLOWS THE SAME COLLECTION PROCEDURES AS ALL OTHER SELF-PAY ACCOUNTS. MONTHLY PAYMENTS ARE REQUIRED AND BALANCES ARE TYPICALLY EXPECTED TO BE PAID IN FULL WITHIN ONE YEAR. EXTENSIONS MAY BE APPROVED FOR EXTENUATING CIRCUMSTANCES. COLLECTION PROCEDURES INCLUDE STATEMENTS, PAST DUE NOTICES, PHONE CALLS AND IF AGREED UPON PAYMENT ARRANGEMENTS CANNOT BE FULFILLED, THE ACCOUNT IS REFERRED TO A COLLECTION AGENCY. SCHEDULE H, PART VI, LINE 2 NEEDS ASSESSMENT: THE DETERMINATION OF CURRENT AND FUTURE HEALTH CARE NEEDS OF THE COMMUNITIES SERVED BY IVCH IS BASED ON A COMBINATION OF THE FOLLOWING FACTORS: EXISTENCE OR NON-EXISTENCE OF APPROPRIATE SERVICES, DEMONSTRATED NEED, VOICE OF THE CUSTOMER, COLLABORATION WITH COMMUNITY ORGANIZATIONS, GOVERNMENT AGENCIES AND OTHER HEALTH CARE PROVIDERS, BENCHMARKING, MARKET RESEARCH, CUSTOMER SURVEYS, PHYSICIAN INPUT AND MONITORING OF STATE AND FEDERAL GUIDELINES. THIS INFORMATION IS REVIEWED AND ANALYZED BY THE HOSPITAL'S ADMINISTRATIVE TEAM AND INCORPORATED INTO THE HOSPITAL'S STRATEGIC PLANNING PROCESS. SCHEDULE H, PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE: DOCUMENTATION IS PROVIDED AT THE TIME OF REGISTRATION INFORMING PATIENTS THAT FINANCIAL ASSISTANCE IS AVAILABLE AND PROVIDING CONTACT INFORMATION FOR THE PATIENT FINANCIAL SERVICES DEPT. WHEN CONTACTED BY A PATIENT, OUR FINANCIAL COUNSELORS WORK INDIVIDUALLY WITH EACH APPLICANT TO DETERMINE ELIGIBILITY FOR CHARITY OR FINANCIAL ASSISTANCE. NOTICES ABOUT FINANCIAL ASSISTANCE PROGRAMS ARE POSTED IN THE REGISTRATION AREAS AND INFORMATION IS ALSO INCLUDED ON THE PATIENT STATEMENTS AND IVCH WEBSITE. THE SOCIAL SERVICES DEPARTMENT NOTIFIES EACH INPATIENT OF FINANCIAL ASSISTANCE PROGRAMS AVAILABLE AT IVCH AS WELL AS LOCAL, STATE AND FEDERAL PROGRAMS THEY MAY BE ELIGIBLE FOR. SCHEDULE H, PART VI, LINE 4 COMMUNITY INFORMATION: ILLINOIS VALLEY COMMUNITY HOSPITAL SERVES THE RESIDENTS OF RURAL COMMUNITIES LOCATED IN LA SALLE, BUREAU AND PUTNAM COUNTIES, IN NORTH CENTRAL ILLINOIS. THE HOSPITAL IS LOCATED NEAR THE JUNCTION OF INTERSTATES 80 AND 39 AND IS 62 MILES WEST OF JOLIET AND 64 MILES NORTH OF BLOOMINGTON. THE PRIMARY SERVICE AREA OF THE HOSPITAL HAS A POPULATION OF ABOUT 35,000. NO POPULATION GROWTH IS PROJECTED FOR THE AREA. THE LARGEST AREA EMPLOYERS ARE INVOLVED IN TRANSPORTATION, WAREHOUSING, AGRICULTURE, LIGHT INDUSTRY AND RETAIL SERVICES. THE SERVICE AREA RACE AND ETHNICITY IS COMPOSED OF 89% WHITE, 2% AFRICAN AMERICAN, 8% HISPANIC AND 1% ASIAN. ACCORDING TO THE ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY, THE DECEMBER 2012 UNEMPLOYMENT RATE IN LA SALLE COUNTY WAS 10.8%, WHICH WAS HIGHER THAN THE STATE OF ILLINOIS (8.6%) AND THE UNITED STATES (7.6%). THE MEDIAN HOUSEHOLD INCOME IN LA SALLE ($49,414), BUREAU ($45,580) AND PUTNAM ($52,564) COUNTIES WERE ALL BELOW THE STATE OF ILLINOIS FIGURE OF $52,967. THE PROPORTION OF LA SALLE COUNTY RESIDENTS LIVING BELOW THE FEDERAL POVERTY LEVEL (13.2%) IS SLIGHTLY LESS THAN THE STATE AVERAGE OF 13.8%. IVCH SERVES PATIENTS WITHOUT REGARD TO AGE, GENDER, INCOME, ETHNIC ORIGIN, INSURANCE COVERAGE OR ABILITY TO PAY. APPROXIMATELY 61% OF THE HOSPITAL'S GROSS PATIENT SERVICE REVENUE WAS FROM PARTICIPATION IN THE MEDICARE AND MEDICAID PROGRAMS FOR THE YEAR ENDING JUNE 30, 2014. SCHEDULE H, PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH: THE BOARD OF DIRECTORS OF IVCH IS COMPOSED OF 13 COMMUNITY MEMBERS RESIDING IN OUR SERVICE AREA. THESE BOARD MEMBERS HAVE REGULAR INPUT ON STRATEGIC PLANNING, NEW SERVICES, TECHNOLOGY, AND PHYSICIAN RECRUITMENT. IVCH MAINTAINS AN OPEN MEDICAL STAFF AND IS CONSTANTLY RECRUITING NEW PHYSICIANS TO MEET IDENTIFIED NEEDS. ANY SURPLUS FUNDS ARE REINVESTED BACK INTO THE HOSPITAL THROUGH THE PURCHASE OF PROPERTY AND EQUIPMENT TO PROVIDE SERVICES THAT MEET THE NEEDS OF THE SERVICE AREA. OUR COMMUNITY OUTREACH DEPT. OFFERS A WIDE VARIETY OF HEALTH AND WELLNESS PROGRAMMING, INCLUDING TAI CHI CLASSES, FREE BLOOD PRESSURE AND GLUCOSE SCREENINGS, HEMOGLOBIN A1C SCREENINGS, LIPID PROFILE SCREENINGS, HEALTHY HEART SCREENINGS, PROSTATE CANCER SCREENINGS, SMOKING CESSATION CLASSES, BABYSITTING CLINICS, CPR INSTRUCTION AND FIRST AID. SCHEDULE H, PART VI, LINE 6 AFFILIATED HEALTH CARE SYSTEM: NOT APPLICABLE SCHEDULE H, PART VI, LINE 8 STATE FILING OF COMMUNITY BENEFIT REPORT: NOT APPLICABLE true MARCH OF DIMES 425 FIRST ST LA SALLE IL 61301 131846366 501(C)(3) 12000 DONATION 1 SCHEDULE I, PART I, QUESTION 2 PROCEDURE FOR MONITORING THE USE OF GRANT FUNDS: IVCH GRANTS FUNDS TO OTHER ORGANIZATIONS AND COMMUNITY BENEFIT PROJECTS AROUND THEIR COMMUNITY TO IMPROVE THE HEALTH AND WELLNESS OF RESIDENTS. ALL RECIPIENTS WHO RECEIVED OVER $5,000 DURING THE YEAR ARE REPORTED ON PART II. X X X X false false false false false false false false false TOMMY HOBBS CEO / NONVOTING DIRECTOR 217948 0 0 0 2057 0 14300 0 24038 0 258343 0 0 0 STEPHEN DAVIS CFO 126930 0 0 0 3574 0 8550 0 23652 0 162706 0 0 0 PETER MEIER MD ORTHOPEDIC SURGEON 602898 0 0 0 0 0 7650 0 27590 0 638138 0 0 0 ROBERT MITCHELL MD ORTHOPEDIC SURGEON 500762 0 0 0 0 0 7650 0 21967 0 530379 0 0 0 ANDREW GUZMAN MD OB/GYN PHYSICIAN 514674 0 0 0 0 0 7650 0 21939 0 544263 0 0 0 MARIO COTE MD INT. MED. PHYSICIAN 452934 0 0 0 0 0 7650 0 29750 0 490334 0 0 0 SCOTT MILLINGTON MD ANESTHESIOLOGIST 400056 0 0 0 0 0 7650 0 25714 0 433420 0 0 0 A ILLINOIS FINANCE AUTHORITY 861091967 45200FG60 2009-12-17 22955000 REFUNDING AND NEW CONSTRUCTION false false false A 1395250 0 22955000 0 0 0 430102 141572 0 13517821 8865505 0 2011 true false true true A false false false false 0.00000 0.00000 0.00000 false false 0.00000 false true A false true false false true false 0 false 0 false false A false VALLEY HEALTH ENTERPRISES SEE PART V 682731 SALARIES & BENEFITS false VALLEY HEALTH ENTERPRISES SEE PART V 39287 MANAGEMENT FEES false VALLEY HEALTH ENTERPRISES SEE PART V 70913 OTHER EXPENSE REIMBURSEMENT false VALLEY HEALTH ENTERPRISES SEE PART V 22176 RENT false VALLEY HEALTH ENTERPRISES SEE PART V 787386 PAYMENTS TO IVCH false VALLEY REGIONAL HEALTH SERVICES SEE PART V 180907 SALARIES & BENEFITS false VALLEY REGIONAL HEALTH SERVICES SEE PART V 1953 OTHER EXPENSE REIMBURSEMENT false VALLEY REGIONAL HEALTH SERVICES SEE PART V 620537 PURCHASE OF CT, PET, & LAB SRV false VALLEY REGIONAL HEALTH SERVICES SEE PART V 127626 PAYMENTS TO IVCH false DIANE DAVIS SPOUSE OF OFFICER 24030 EMPLOYMENT false DAVID SICKLEY DIRECTOR 415543 CONSTRUCTION WORK false SCHEDULE L, PART IV ENTITY RELATIONSHIPS: THE FOLLOWING INDIVIDUALS WHO SERVED AS AN OFFICER / BOARD MEMBER ON THE ORGANIZATION ALSO SERVED AS AN OFFICER / BOARD MEMBER OF VALLEY HEALTH ENTERPRISES, WHICH IS A WHOLLY OWNED TAXABLE SUBSIDIARY OF IV HEALTH CORP, INC. James Loveland, BOARD MEMBER Richard Martuzzo, BOARD MEMBER William Vlastnik, BOARD MEMBER David Sickley, BOARD MEMBER William Etzenbach, BOARD MEMBER Tommy Hobbs, OFFICER Stephen Davis, OFFICER THE FOLLOWING INDIVIDUALS WHO SERVED AS AN OFFICER ON THE ORGANIZATION ALSO SERVED AS AN OFFICER OF VALLEY REGIONAL HEALTH SERVICES, WHICH IS TAXED AS A PARTNERSHIP AND IS 50% OWNED BY THE ORGANIZATION. Tommy Hobbs, OFFICER Stephen Davis, OFFICER FORM 990, PART VI, LINE 2 FAMILY AND BUSINESS RELATIONSHIPS: WILLIAM ETZENBACH, BOARD MEMBER, AND JAMES CLINARD, BOARD MEMBER, HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, LINE 6 MEMBERS OR STOCKHOLDERS: MEMBERS OF THE ORGANIZATION ARE THE BOARD OF DIRECTORS OF IV HEALTHCORP, INC. (PARENT CORPORATION OF IVCH). FORM 990, PART VI, LINE 7A POWER TO APPOINT AND REMOVE DIRECTORS: MEMBERS HAVE THE EXCLUSIVE POWER TO APPOINT AND REMOVE DIRECTORS OF IVCH. FORM 990, PART VI, LINE 7B RESERVED POWERS OF MEMBERS: MEMBERS RATIFY NOMINATION OF OFFICERS AND REMOVE OFFICERS; ADOPT, AMEND AND REPEAL ARTICLES OF INCORPORATION AND BYLAWS; ADOPT ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION; APPROVE PURCHASES, TRANSFERS, LEASES OR ENCUMBRANCES OF PROPERTY BY THE HOSPITAL, BORROWING IN EXCESS OF ONE YEAR OR SECURED BY A MORTGAGE AND ANY CHANGE IN BUSINESS NAME OR LOGO. FORM 990, PART VI, LINE 11B REVIEW OF FORM 990: THE CEO AND CFO REVIEW THE FORM 990 PRIOR TO SUBMISSION TO THE IRS. THE FINAL VERSION OF THE FORM 990 IS E-MAILED OR HAND DELIVERED TO EACH BOARD MEMBER FOR THEIR REVIEW AND COMMENT PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, LINE 12C CONFLICT OF INTEREST POLICY: ALL BOARD MEMBERS AND MANAGEMENT STAFF OF IVCH ARE COVERED UNDER THE POLICY AND HAVE A DUTY TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST. ALL PERSONS COVERED UNDER THE POLICY ARE REQUIRED TO ANNUALLY COMPLETE A CONFLICT OF INTEREST QUESTIONNAIRE AND DISCLOSE ANY INTERESTS THAT COULD GIVE RISE TO CONFLICTS. ANY TRANSACTIONS WITH COVERED PERSONS OR ENTITIES IN WHICH A COVERED PERSON HAS ANY TYPE OF INTEREST, MUST BE AN ARM'S LENGTH TRANSACTION. THE BOARD MEMBERS WILL REVIEW ANY TRANSACTIONS IN QUESTION AND DETERMINE IF A CONFLICT EXISTS. IF A CONFLICT EXISTS, THE INTERESTED PERSON MAY MAKE A PRESENTATION, BUT MUST LEAVE THE MEETING DURING DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION. FORM 990, PART VI, LINE 15A PROCESS FOR DETERMINING COMPENSATION: AN ADHOC COMMITTEE OF THE BOARD MEMBERS OF THE PARENT (INCLUDING THE BOARD PRESIDENT, CHAIRPERSON OF THE PERSONNEL COMMITTEE AND AT LEAST ONE OTHER MEMBER) CONDUCT AN ANNUAL PERFORMANCE REVIEW OF THE CEO AND DECIDE THE INCREASE IN COMPENSATION, IF ANY, BASED UPON BENCHMARK COMPENSATION SURVEYS AND AREA NORMS. THE CEO HAS A WRITTEN EMPLOYMENT CONTRACT. RENEWAL OF THE CONTRACT OR INCREASE IN COMPENSATION MUST BE APPROVED BY A MAJORITY OF THE PARENT BOARD. FORM 990, PART VI, LINE 19 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 XI, LINE 9 OTHER CHANGES IN NET ASSETS: PENSION EQUITY ADJUSTMENT $526,175 CHANGES DUE TO FOUNDATION CONTRIBUTIONS (317,663) ----------- TOTAL $208,512 HYGIENIC INSTITUTE 925 WEST STREET PERU IL 61354 362167742 HEALTH CARE IL 501(C)(3) 7 IVHC true IVCH FOUNDATION 925 WEST STREET PERU IL 61354 371211780 FUNDRAISING IL 501(C)(3) 11A IVHC true IV HEALTH CORP INC 925 WEST STREET PERU IL 61354 371211890 PARENT IL 501(C)(3) 11B IVHC true VALLEY RG HLTH SRVC 4391 VENTURE DR PERU IL 61354 273891281 HEALTH CARE IL IVCH RELATED -25193 574102 false true 0.50000 VALLEY HEALTH ENTERPRISES 925 WEST STREET PERU IL 61354 363476877 PHARMACY & DME IL NA C CORP true IV HEALTH SERVICES INC 925 WEST STREET PERU IL 61354 364050682 DORMANT IL NA C CORP true ILLINOIS VALLEY PHO 925 WEST STREET PERU IL 61354 363978381 PPO CONTRACTING IL IVCH C CORP 3817 57203 0.50000 false IVCH GENERAL PROF LIABILITY LOSS FUND 925 WEST STREET PERU IL 61354 366673231 DORMANT IL NA TRUST true HEALTH CARE BUILDING CORP 925 WEST STREET PERU IL 61354 363306917 DORMANT IL NA C CORP true true false true false true false false false false false false false false true true true true true true IVCH FOUNDATION C 413293 CASH HYGIENIC INSTITUTE R 492146 CASH HYGIENIC INSTITUTE S 360000 CASH IV HEALTH CORP E 380000 CASH IV HEALTH CORP P 394455 CASH VALLEY HEALTH ENTERPRISES O 682731 CASH VALLEY HEALTH ENTERPRISES Q 70913 CASH VALLEY HEALTH ENTERPRISES A 22176 CASH VALLEY HEALTH ENTERPRISES S 787386 CASH