GRAHAM HOSPITAL ASSOCIATION: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- GRAHAM HOSPITAL ASSOCIATION (EIN 37-0673506)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-15
- IRS object ID
- 201521359349306227
- Schema version
- 2013v4.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule L
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-15T14:46:26-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 N HARRISON STREET SUITE 300 | AddressLine1 |
| City | DAVENPORT | City |
| State | IA | State |
| ZIP Code | 528011999 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370673506 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAH | BusinessNameControlTxt |
| Phone | 3096475240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT | AddressLine1 |
| City | CANTON | City |
| State | IL | State |
| ZIP Code | 615202444 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT G SENNEFF | PersonNm |
| Person Title | PRESIDENT AND CEO | PersonTitleTxt |
| Phone | 3096475240 | PhoneNum |
| Signature | 2015-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN J ROMANO | PreparerPersonNm |
| PTIN | P00227323 | PTIN |
| Phone | 5638884000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT G SENNEFF | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT | AddressLine1 |
| City | CANTON | City |
| State | IL | State |
| ZIP Code | 615202444 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $94,391,626 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GRAHAMHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1905 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES, IN A RESPONSIBLE AND CHARITABLE MANNER, TO THE PEOPLE AND COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 851 | TotalEmployeeCnt |
| Total Volunteers | 119 | TotalVolunteersCnt |
| Total Gross UBI | $111,364 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$94,171 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $683,103 | PYContributionsGrantsAmt |
| CY Contributions Grants | $486,448 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $69,768,423 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $69,683,192 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,657,877 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,585,297 | CYInvestmentIncomeAmt |
| PY Other Revenue | $998,110 | PYOtherRevenueAmt |
| CY Other Revenue | $807,873 | CYOtherRevenueAmt |
| PY Total Revenue | $78,107,513 | PYTotalRevenueAmt |
| CY Total Revenue | $74,562,810 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,950 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,300 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $36,700,431 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $35,275,610 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $33,409,038 | PYOtherExpensesAmt |
| CY Other Expenses | $36,296,898 | CYOtherExpensesAmt |
| PY Total Expenses | $70,114,419 | PYTotalExpensesAmt |
| CY Total Expenses | $71,576,808 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $7,993,094 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,986,002 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $136,551,074 | TotalAssetsBOYAmt |
| Total Assets EOY | $142,209,447 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $45,354,081 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $43,000,174 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $91,196,993 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $99,209,273 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES, IN A RESPONSIBLE AND CHARITABLE MANNER, TO THE PEOPLE AND COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $31,839,517 | ExpenseAmt |
| Grant | $4,300 | GrantAmt |
| Revenue | $37,014,481 | RevenueAmt |
| Desc | GRAHAM HOSPITAL IS A PROVIDER OF HEALTHCARE SERVICES IN FULTON COUNTY AND SURROUNDING AREAS. DURING THIS REPORTING PERIOD, 2,118 ADULTS AND CHILDREN WERE ADMITTED AND 241 BABIES WERE BORN. THEY RECEIVED INPATIENT SERVICES IN THE ACUTE CARE FACILITY. 308 PATIENTS WERE ADMITTED FOR 11,286 DAYS OF SERVICE IN THE EXTENDED CARE FACILITY. 66,241 OUTPATIENT SERVICES WERE PROVIDED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $12,297,892 | ExpenseAmt |
| Revenue | $14,296,702 | RevenueAmt |
| Desc | GRAHAM MEDICAL GROUP WHICH PROVIDES PHYSICIAN AND PROFESSIONAL HEALTH CARE SERVICES TO THE PATIENTS IN FULTON COUNTY, ILLINOIS. THIS INCLUDES CHARITY CARE TO QUALIFIED INDIVIDUALS AND 83,916 OFFICE VISITS AND 10,245 NURSING HOME AND HOSPITAL VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $8,762,710 | ExpenseAmt |
| Revenue | $10,186,937 | RevenueAmt |
| Desc | SURGICAL SERVICES - THE HOSPITAL PERFORMED 739 INPATIENT SURGERIES AND 2,480 OUTPATIENT SURGERIES IN FISCAL YEAR 2014. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,533,620 | ExpenseAmt |
| Revenue | $8,758,079 | RevenueAmt |
| Desc | THE HOSPITAL OPERATES A 24 HOUR EMERGENCY DEPARTMENT WHICH HAD 15,036 PATIENTS REGISTERED TO THE ED IN FISCAL YEAR 2014. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $7,533,620 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $8,758,079 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $60,433,739 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| 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 | Yes (1) | 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 | 0 | 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 | 123 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 851 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | 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 | ROBERT G SENNEFF | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3096475240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT | AddressLine1 |
| City | CANTON | City |
| State | IL | State |
| ZIP Code | 61520 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| BRAD ANDERSON | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| ROBERT BOBELL OD | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| BILL CARLBERG | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| ALAN DILTS | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| PAULA GRIGSBY | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| GORDON JAMES | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JEFF JOCHUMS | |||||||||
| VICE CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| KENNETH KROCK MD | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| JULIE MELLERT | |||||||||
| FORMER TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| MARK PIRTLE | |||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| PATRICK RENICK MD | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| MIKE RENNER | |||||||||
| TRUSTEE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| KATHY TABER | |||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| MIKE WALTERS | |||||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |||
| WARREN WOLF | |||||||||
| MEMBER AT LARGE | 2.00 | Yes (X) | $0 | $0 | $0 | ||||
| ERIC FRANZ | |||||||||
| VP FINANCE/CFO | 40.00 | $0 | $0 | $0 | Yes (X) | ||||
| CAROLYN JACOBUS | |||||||||
| VP CLINIC SERVICES | 40.00 | $139,932 | $0 | $29,387 | Yes (X) | ||||
| TERESA MCCONKEY | |||||||||
| VP PATIENT SERVICES | 40.00 | $142,240 | $0 | $31,979 | Yes (X) | ||||
| JIM SCHREINER | |||||||||
| VP INFO SERVICES | 40.00 | $151,239 | $0 | $17,003 | Yes (X) | ||||
| ROBERT G SENNEFF | |||||||||
| PRESIDENT AND CEO | 40.00 | $574,442 | $0 | $69,682 | Yes (X) | ||||
| JAMES T STRATTON | |||||||||
| FORMER VP FINANCE/CFO | 40.00 | $424,364 | $0 | $50,136 | Yes (X) | ||||
| JOHN QUINONES DO | |||||||||
| MEDICAL DIRECTOR ED | 45.00 | $312,321 | $0 | $30,449 | Yes (X) | ||||
| DWAYNE BERNARD MD | |||||||||
| PHYSICIAN | 45.00 | $414,950 | $0 | $45,204 | Yes (X) | ||||
| JEFFREY HEMP MD | |||||||||
| PHYSICIAN | 45.00 | $359,952 | $0 | $46,417 | Yes (X) | ||||
| DAVID LLOYD CRNA | |||||||||
| CRNA | 65.00 | $234,292 | $0 | $28,917 | Yes (X) | ||||
| JULIO ANTONIO RAMOS MD | |||||||||
| PHYSICIAN | 45.00 | $365,688 | $0 | $21,829 | Yes (X) | ||||
| JOHN ZYGIEL MD | |||||||||
| PHYSICIAN | 45.00 | $345,793 | $0 | $18,788 | Yes (X) | ||||
| SARA KIMBLE | |||||||||
| FORMER VP PATIENT SERVICES | 40.00 | $113,477 | $0 | $4,784 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,578,690 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $394,575 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COLEMAN MEDICAL ASSOCIATES | |||||
| 180 SOUTH MAIN STREET | CANTON | IL | 61520 | PHYSICIAN SERVICES | $6,815,918 |
| ENDURACARE ACUTE CARE SERVICES LLC | |||||
| 3765 GOVERNMENT BLVD | MOBILE | AL | 36693 | REHAB SERVICES | $1,335,388 |
| PJ HOERR INC | |||||
| 107 W COMMERCE | PEORIA | IL | 61604 | CONSTRUCTION CONTRACTOR | $665,029 |
| PEORIA SURGICAL GROUP LTD | |||||
| 1001 MAIN ST SUITE 300 | PEORIA | IL | 61606 | PHYSICIAN SURGERY SERVICES | $623,850 |
| MEDICAL INFORMATION TECHNOLOGY | |||||
| N MAIN ST | CANTON | IL | 61520 | INFORMATION SERVICES | $331,187 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $486,448 | AllOtherContributionsAmt |
| Total Contributions | $486,448 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| PATIENT SERVICES | 621110 | $71,159,226 | $71,159,226 | |
| OTHER PROGRAM SERVICE | 900099 | $1,787,130 | $1,787,130 | |
| SCHOOL OF NURSING | 611600 | $850,650 | $850,650 | |
| LABORATORY SERVICES | 621500 | $204,234 | $116,259 | $87,975 |
| LESS: PROVISION FOR UNCOLLECTIBLE | 900009 | -$4,318,048 | -$4,318,048 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $69,683,192 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,707,245 | TotalRevenueColumnAmt |
| Exclusion | $1,707,245 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $319,346 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $195,844 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $123,502 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $123,502 | TotalRevenueColumnAmt |
| Exclusion | $123,502 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $21,508,974 | SecuritiesAmt |
| Other | $2,050 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $19,472,265 | SecuritiesAmt |
| Other | $160,707 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,036,709 | SecuritiesAmt |
| Other | -$158,657 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,878,052 | TotalRevenueColumnAmt |
| Exclusion | $1,878,052 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| CAFETERIA | 722210 | $428,647 | $428,647 | |
| EMPLOYEE PHARMACY | 446110 | $232,335 | $232,335 | |
| DURABLE EQUIPMENT | 446199 | $23,389 | $23,389 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $684,371 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $74,562,810 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $70,256,199 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $111,364 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,708,799 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,300 | TotalAmt |
| Program Services | $4,300 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,913,941 | TotalAmt |
| Program Services | $598,225 | ProgramServicesAmt |
| Management And General | $1,315,716 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,060,687 | TotalAmt |
| Program Services | $23,223,841 | ProgramServicesAmt |
| Management And General | $2,836,846 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $594,616 | TotalAmt |
| Program Services | $502,897 | ProgramServicesAmt |
| Management And General | $91,719 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,761,510 | TotalAmt |
| Program Services | $4,027,050 | ProgramServicesAmt |
| Management And General | $734,460 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,944,856 | TotalAmt |
| Program Services | $1,644,863 | ProgramServicesAmt |
| Management And General | $299,993 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,226 | TotalAmt |
| Management And General | $22,226 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,702 | TotalAmt |
| Management And General | $125,702 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,695 | TotalAmt |
| Management And General | $34,695 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,853,088 | TotalAmt |
| Program Services | $8,334,039 | ProgramServicesAmt |
| Management And General | $519,049 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,574 | TotalAmt |
| Program Services | $5,838 | ProgramServicesAmt |
| Management And General | $230,736 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,107,777 | TotalAmt |
| Program Services | $8,015,122 | ProgramServicesAmt |
| Management And General | $1,092,655 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $509,505 | TotalAmt |
| Program Services | $54,506 | ProgramServicesAmt |
| Management And General | $454,999 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,115,070 | TotalAmt |
| Program Services | $937,224 | ProgramServicesAmt |
| Management And General | $177,846 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,176 | TotalAmt |
| Program Services | $38,389 | ProgramServicesAmt |
| Management And General | $7,787 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,235,794 | TotalAmt |
| Program Services | $1,045,174 | ProgramServicesAmt |
| Management And General | $190,620 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,128,068 | TotalAmt |
| Program Services | $4,319,827 | ProgramServicesAmt |
| Management And General | $808,241 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $772,044 | TotalAmt |
| Management And General | $772,044 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $5,607,802 | $4,444,880 | $1,162,922 |
| MEDICAID ASSESSMENT | $2,617,685 | $2,617,685 | |
| MISCELLANEOUS EXPENSES | $494,544 | $494,544 | |
| DUES & SUBSCRIPTIONS | $142,150 | $59,880 | $82,270 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,998 | TotalAmt |
| Program Services | $65,455 | ProgramServicesAmt |
| Management And General | $182,543 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,576,808 | TotalAmt |
| Program Services | $60,433,739 | ProgramServicesAmt |
| Management And General | $11,143,069 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,605,896 | BOYAmt |
| EOY | $1,342,310 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,371,311 | BOYAmt |
| EOY | $1,552,325 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,508,853 | BOYAmt |
| EOY | $9,311,856 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,429,932 | BOYAmt |
| EOY | $1,308,769 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $687,852 | BOYAmt |
| EOY | $865,258 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $113,944,118 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $58,722,974 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,253,414 | BOYAmt |
| EOY | $55,221,144 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,131,608 | BOYAmt |
| EOY | $61,532,278 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,772,631 | BOYAmt |
| EOY | $10,913,061 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $789,577 | BOYAmt |
| EOY | $162,446 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,551,074 | BOYAmt |
| EOY | $142,209,447 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,358,603 | BOYAmt |
| EOY | $7,224,091 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,345,000 | BOYAmt |
| EOY | $27,570,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,650,478 | BOYAmt |
| EOY | $8,206,083 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $45,354,081 | BOYAmt |
| EOY | $43,000,174 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,008,228 | BOYAmt |
| EOY | $90,377,983 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,954 | BOYAmt |
| EOY | $257,012 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,985,811 | BOYAmt |
| EOY | $8,574,278 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,196,993 | BOYAmt |
| EOY | $99,209,273 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $136,551,074 | BOYAmt |
| EOY | $142,209,447 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,986,002 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,433,355 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $592,923 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $34,695 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $34,695 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED: 39% OF MEMBERSHIP DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION, OR $32,461; 38.39% OF MEMBERSHIP DUES PAID TO THE ILLINOIS HEALTH CARE ASSOCIATION, OR $1,007; 39% OF MEMBERSHIP DUES PAID TO THE ILLINOIS HOME CARE & HOSPICE COUNCIL, OR $1,227. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $63,277,262 | BeginningYearBalanceAmt |
| Contributions | $252,307 | ContributionsAmt |
| Investment Earnings Or Losses | $8,455,919 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,300 | GrantsOrScholarshipsAmt |
| Other Expenditures | $501,000 | OtherExpendituresAmt |
| Administrative Expenses | $1,157,962 | AdministrativeExpensesAmt |
| End Year Balance | $70,323,226 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $54,282,312 | BeginningYearBalanceAmt |
| Contributions | $6,002,000 | ContributionsAmt |
| Investment Earnings Or Losses | $4,507,261 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,950 | GrantsOrScholarshipsAmt |
| Other Expenditures | $1,200,000 | OtherExpendituresAmt |
| Administrative Expenses | $309,361 | AdministrativeExpensesAmt |
| End Year Balance | $63,277,262 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $55,402,455 | BeginningYearBalanceAmt |
| Contributions | $5,002,957 | ContributionsAmt |
| Investment Earnings Or Losses | $1,395,193 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,950 | GrantsOrScholarshipsAmt |
| Other Expenditures | $7,513,343 | OtherExpendituresAmt |
| End Year Balance | $54,282,312 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $54,498,646 | BeginningYearBalanceAmt |
| Contributions | $2,368,195 | ContributionsAmt |
| Investment Earnings Or Losses | $8,389,005 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $4,450 | GrantsOrScholarshipsAmt |
| Other Expenditures | $9,848,941 | OtherExpendituresAmt |
| End Year Balance | $55,402,455 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $56,079,016 | BeginningYearBalanceAmt |
| Contributions | $2,547,372 | ContributionsAmt |
| Investment Earnings Or Losses | $4,063,090 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $3,885 | GrantsOrScholarshipsAmt |
| Other Expenditures | $8,186,947 | OtherExpendituresAmt |
| End Year Balance | $54,498,646 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.87500 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.12500 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,579,803 | OtherCostOrOtherBasisAmt |
| Book Value | $2,579,803 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $64,596,219 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,318,189 | DepreciationAmt |
| Book Value | $39,278,030 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $44,581,976 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,006,366 | DepreciationAmt |
| Book Value | $12,575,610 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,186,120 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,398,419 | DepreciationAmt |
| Book Value | $787,701 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $55,221,144 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (4 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| PERPETUAL TRUSTS | $8,790,944 | C |
| DEFERRED FINANCING COSTS | $188,076 | C |
| LONG TERM NOTES RECEIVABLE | $1,754,886 | C |
| DUE FROM MEDICARE | $179,155 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $10,913,061 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED SELF-INSURANCE COSTS | $3,178,803 |
| ASSET RETIREMENT OBLIGATION | $266,162 |
| FAIR MARKET VALUE OF SWAP OPTION | $3,789,524 |
| DUE TO THIRD PARTY PAYORS | $971,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,206,083 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $79,784,932 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,433,355 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $592,923 | OtherRevenueAmt |
| Revenue Not Reported | $5,026,278 | RevenueNotReportedAmt |
| Revenue Subtotal | $74,758,654 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$195,844 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$195,844 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $74,562,810 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $71,772,652 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $195,844 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $195,844 | ExpensesNotReportedAmt |
| Expenses Subtotal | $71,576,808 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $71,576,808 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | PROVIDE SCHOLARSHIPS BASED ON STUDENT NEEDS FROM THE INCOME OF THE DONOR-RESTRICTED ENDOWMENT FUNDS. THE PERMANENT ENDOWMENT IS USED FOR THE PURCHASE OF PROPERTY AND EQUIPMENT. |
| PART X, LINE 2: | THE HOSPITAL IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE HOSPITAL FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO NONPROFIT ORGANIZATIONS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF EACH ENTITY AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS INCOME (UBI). UBI IS REPORTED ON FORM 990-T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESS, IF ANY. TAX POSITIONS ARE OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF JUNE 30, 2014 AND 2013, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY. FORMS 990 FILED BY THE HOSPITAL ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 FILED BY THE HOSPITAL ARE GENERALLY NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED JUNE 30, 2010 AND PRIOR. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN FAIR VALUE OF INTEREST RATE SWAP AGREEMENT -52,369. CHANGE IN INTEREST IN NET ASSETS OF THE FOUNDATION 56,825. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS 588,467. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES INCLUDED WITH REVENUE ON RETURN -195,844. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES INCLUDED WITH REVENUE ON RETURN 195,844. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
Free Care Oth Percentage FreeCareOthPercentageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Free Care Other | 180.000000000000 | FreeCareOtherPct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,228,264 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,228,264 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.03110 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,945,812 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,850,782 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,095,030 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.04320 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,174,076 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,850,782 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,323,294 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07430 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $178,981 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,185 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $169,796 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00240 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,054 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $23,054 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00030 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $202,035 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $9,185 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $192,850 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00270 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $18,376,111 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $12,859,967 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,516,144 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.07700 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $5,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $5,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00010 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $4,318,048 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $0 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $16,949,000 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,814,025 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$865,025 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | Yes (X) | OtherInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | 0 | 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 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 210 WEST WALNUT STREET | AddressLine1 |
| City | CANTON | City |
| State | IL | State |
| ZIP Code | 61520 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.GRAHMHOSPITAL.ORG | WebsiteAddressTxt |
| State License | 0000869 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAHAM HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| 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 |
| Information Gaps | Yes (X) | InformationGapsInd |
| CHNA Conducted | 12 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.GRAHAMHOSPITAL.ORG | OwnWebsiteURLTxt |
| Rpt Available Upon Request | Yes (X) | RptAvailableUponRequestInd |
| Adopt Implementation Strategy | Yes (X) | AdoptImplementationStrategyInd |
| Exec Implementation Strategy | Yes (X) | ExecImplementationStrategyInd |
| Include Operational Plan | Yes (X) | IncludeOperationalPlanInd |
| Prioritize Health Needs | Yes (X) | PrioritizeHealthNeedsInd |
| Prioritize Services | Yes (X) | PrioritizeServicesInd |
| All Needs Addressed | Yes (1) | AllNeedsAddressedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Used Deter Elig Free Care | Yes (1) | FPGUsedDeterEligFreeCareInd |
| FPG Family Incm Lmt Free Care | 180.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Used Determ Elig Dscnt Care | Yes (1) | FPGUsedDetermEligDscntCareInd |
| FPG Family Incm Lmt Dscnt Care | 300.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| Income Level | Yes (X) | IncomeLevelInd |
| Asset Level | Yes (X) | AssetLevelInd |
| Medical Indigency | Yes (X) | MedicalIndigencyInd |
| Insurance Status | Yes (X) | InsuranceStatusInd |
| Uninsured Discount | Yes (X) | UninsuredDiscountInd |
| Medicaid Medicare | Yes (X) | MedicaidMedicareInd |
| State Regulation | Yes (X) | StateRegulationInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| Posted On Website | Yes (X) | PostedOnWebsiteInd |
| Attached To Invoice | Yes (X) | AttachedToInvoiceInd |
| Posted In Emergency Room | Yes (X) | PostedInEmergencyRoomInd |
| Posted In Admission Office | Yes (X) | PostedInAdmissionOfficeInd |
| Available On Request | Yes (X) | AvailableOnRequestInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| 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 (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 3: GRAHAM HOSPITAL ASSOCIATION CREATED THE FOLLOWING FOCUS GROUPS TO GATHER INPUT FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT:FOCUS GROUP #1 INCLUDED THE FULTON COUNTY SHERIFF, THE CANTON FIRE CHIEF, A SCHOOL SUPERINTENDENT, A BANK EXECUTIVE, THE DIRECTOR OF A FOOD PANTRY, A LOCAL BUSINESS LEADER, THE DIRECTOR OF THE YMCA, A LIBRARIAN AND A COMMUNITY VOLUNTEER. THEY MET ON MAY 15, 2012.FOCUS GROUP #2 INCLUDED THE MAYOR OF CANTON, A VICE-PRESIDENT AT SPOON RIVER COLLEGE, A SCHOOL SUPERINTENDENT, A RETIRED PHYSICIAN, THE EXECUTIVE DIRECTOR OF THE YWCA AND THE PRESIDENT OF GRAHAM HOSPITAL SERVICE LEAGUE. THIS GROUP ALSO MET ON MAY 15, 2012.FOCUS GROUP #3 INCLUDED THE ADMINISTRATOR OF THE FULTON COUNTY HEALTH DEPARTMENT, THE DIRECTOR OF THE NURSING SCHOOL, THE ADMINISTRATOR OF A NURSING HOME, A PEDIATRIC PHYSICIAN, A PATHOLOGIST, A CHIROPRACTOR, A GENERAL SURGEON, NURSING HOME REPRESENTATIVES AND PHARMACISTS. THIS GROUP ALSO MET ON MAY 15, 2012. |
| GRAHAM HOSPITAL ASSOCIATION | PART V, SECTION B, LINE 20D: GRAHAM HOSPITAL FOLLOWS THE ILLINOIS HOSPITAL UNINSURED PATIENT DISCOUNT ACT THAT REQUIRES ILLINOIS HOSPITALS TO PROVIDE DISCOUNTS TO UNINSURED PATIENTS MEETING CERTAIN ELIGIBILITY CRITERIA. THE DISCOUNTS MUST RESULT IN BILLS OF NO MORE THAN 135% OF COST AND THE MAXIMUM COLLECTIBLE AMOUNT IS 25% OF THE ANNUAL FAMILY INCOME FOR THOSE WHO MEET THE ELIGIBILITY CRITERIA AND DO NOT HAVE SIGNIFICANT ASSETS. COST IS DETERMINED BY USING THE COST TO CHARGE RATIO FROM THE MOST RECENTLY FILED MEDICARE COST REPORT. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 9 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (9 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | FacilityFacilityTxt |
|---|---|---|---|---|
| GRAHAM HOSPITAL PHARMACY | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | PHARMACY FOR PATIENTS & RETAIL FOR EMPLOYEES |
| GRAHAM MEDICAL GROUP | ||||
| 180 SOUTH MAIN STREET | CANTON | IL | 61520 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| GRAHAM HOSPITAL EXTENDED CARE UNIT | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | SKILLED NURSING & LONG TERM CARE UNITS |
| GRAHAM HOSPITAL HOME HEALTHHOSPICE | ||||
| 225 WEST WALNUT | CANTON | IL | 61520 | HOME HEALTH AND HOSPICE PROVIDER |
| GHA HOME MEDICAL EQUIPMENT STORE | ||||
| 101 SOUTH MAIN STREET | CANTON | IL | 61520 | HOME MEDICAL EQUIPMENT RETAIL STORE |
| GRAHAM MEDICAL GROUP - FARMINGTON | ||||
| 601 EAST FORT STREET | FARMINGTON | IL | 61531 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| GRAHAM HOSPITAL SCHOOL OF NURSING | ||||
| 210 WEST WALNUT STREET | CANTON | IL | 61520 | SCHOOL OF NURSING |
| GRAHAM MEDICAL GROUP - LEWISTOWN | ||||
| 2001 NORTH MAIN STREET | LEWISTOWN | IL | 61542 | MULTI-SPECIALTY OUTPATIENT PHYSICIAN CLINIC |
| GRAHAM MEDICAL GROUP - CUBA | ||||
| 114 SOUTH 4TH STREET | CUBA | IL | 61427 | OUTPATIENT PHYSICIAN CLINIC |
Supplemental Information Detail SupplementalInformationDetail (16 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3C: | NOT APPLICABLE |
| PART I, LINE 6A: | NOT APPLICABLE |
| PART I, LINE 7: | GRAHAM HOSPITAL ASSOCIATION UTILIZED WORKSHEET 2 TO CALCULATE ITS COST-TO-CHARGE RATIO. TOTAL EXPENSES REPORTED IN THE FINANCIAL REPORT FOR THE YEAR ENDED 06/30/14 LESS NONPATIENT CARE ACTIVITIES OF $1,628,029, THE MEDICAID ASSESSMENT PROVIDER TAX OF $2,617,685 AND THE COMMUNITY BENEFIT EXPENSES FOR VARIOUS PROGRAMS OF $202,035 AND $5,000 ARE DIVIDED BY GROSS PATIENT CHARGES OF $175,056,378 TO REACH A COST TO CHARGE RATIO OF 38.46%.DURING EACH FISCAL YEAR VARIOUS COMMUNITY HEALTH IMPROVEMENT SERVICES ARE HELD AT A FACILITY OWNED BY GRAHAM HOSPITAL ASSOCIATION OR GRAHAM HOSPITAL ASSOCIATION EMPLOYEES ASSIST WITH SERVICES HELD AT VARIOUS LOCATIONS WITHIN THE CATCHMENT AREA. AN ACTUAL COUNT OF COMMUNITY MEMBERS SERVED IS RECORDED IF AVAILABLE OR ESTIMATED IF NOT AVAILABLE. COST FOR EACH ACTIVITY IS RECORDED AT THE ACTUAL COST OF SUPPLIES, AND STAFF TIME IS CALCULATED USING ACTUAL TIME SPENT MULTIPLIED BY AVERAGE WAGES FOR THE EMPLOYEES INVOLVED. ANY OFFSETTING REVENUE IS SUBTRACTED FROM THE COST OF THE ACTIVITY TO REACH A NET COST OF EACH EVENT. WHEN COMMUNITY GROUPS USE A ROOM IN ONE OF THE GRAHAM HOSPITAL ASSOCIATION FACILITIES, THERE IS NO CHARGE FOR THE COMMUNITY GROUP AND THE COST OF THE ROOM USE IS ESTIMATED AT A NOMINAL FLAT RATE FEE AND RECORDED HERE AS AN IN-KIND CONTRIBUTION. THESE ACTIVITES REPRESNT THE COMMUNITY BENEFIT EXPENSES NOTED ABOVE. |
| PART I, LINE 7G: | NOT APPLICABLE |
| PART I, LN 7 COL(F): | NO BAD DEBT EXPENSE WAS INCLUDED IN THE DENOMINATOR BECAUSE BAD DEBT WAS REPORTED IN LINE 2E OF PART VIII, STATEMENT OF REVENUE. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES IS 25.67%, AND THE PERCENTAGE INCREASES TO 50.56% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN TOTAL COMMUNTY BENEFIT EXPENSE. |
| PART II, COMMUNITY BUILDING ACTIVITIES: | NOT APPLICABLE |
| PART III, LINE 2: | PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. |
| PART III, LINE 3: | NOT APPLICABLE |
| PART III, LINE 4: | PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. THE HOSPITAL DOES NOT CHARGE INTEREST ON RECEIVABLES. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED PAST DUE WHEN AN AMOUNT IS PAST DUE ACCORDING TO THE PAYOR'S AGREED-UPON TERMS. PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. |
| PART III, LINE 8: | MEDICARE ALLOWABLE COSTS ARE TAKEN FROM WORKSHEET D-1 AS REPORTED IN THE FILED MEDICARE COST REPORT FOR THE YEAR ENDED 6/30/2014. |
| PART III, LINE 9B: | THE COLLECTION POLICY DESCRIBES THE STEPS TAKEN TO COLLECT SELF PAY BALANCES OUTSTANDING INCLUDING NOTIFICATIONS TO THE PATIENT THROUGH STATEMENTS, FOLLOW-UP PHONE CALLS, VERIFICATION OF INSURANCE ELIGIBILITY AND ULTIMATELY AT WHAT POINT THE UNPAID BALANCE IS WRITTEN OFF AS UNCOLLECTIBLE. IN PRACTICE, WHEN A PATIENT IS IDENTIFIED AS QUALIFYING FOR FINANCIAL ASSISTANCE, A SEARCH OF ACCOUNTS WRITTEN OFF AS UNCOLLECTIBLE IS DONE AND THOSE ACCOUNTS ARE REPROCESSED. |
| PART VI, LINE 2: | IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT IMPLEMENTED DURING 2012, A PHYSICIAN NEEDS ASSESSMENT IS DONE TO IDENTIFY NEEDS FOR SPECIFIC SPECIALTY SERVICES BASED ON THE SIZE OF THE CATCHMENT AREA, DATA IS ANALYZED TO IDENTIFY SERVICES THAT ARE PROVIDED TO COUNTY RESIDENTS BY OTHER FACILITIES THAT WOULD BE MORE ACCESSIBLE TO PATIENTS IF PROVIDED AT GRAHAM HOSPITAL. INPUT IS GAINED FROM PHYSICIANS AND OTHER HEALTHCARE WORKERS PROVIDING SERVICE IN THE AREA ALONG WITH INPUT PROVIDED BY THE BOARD OF DIRECTORS WHO REPRESENT THE COMMUNITY AND PROVIDE A COMMUNICATION LINK BETWEEN GRAHAM HOSPITAL AND THE COMMUNITIES WE SERVE. |
| PART VI, LINE 3: | THE CHARITY CARE/FINANCIAL ASSISTANCE PROGRAM IS MADE AVAILABLE TO PATIENTS UPON REGISTRATION. FINANCIAL ASSISTANCE APPLICATIONS ARE AVAILABLE TO PATIENTS UPON REGISTRATION OR TO ANYONE REQUESTING THE APPLICATION AT ANYTIME FOR CLAIMS EXCEEDING $300. THE APPLICATIONS ARE AVAILABLE ON GRAHAM HEALTH SYSTEM'S WEBSITE AT HTTP://WWW.GRAHAMHOSPITAL.ORG/FINANCIALASSISTANCE. APPOINTMENTS MAY BE MADE WITH A FINANCIAL COUNSELOR IF ASSISTANCE IS NEEDED. MEDICAID SERVICES APPLICATION ASSISTANCE IS AVAILABLE. |
| PART VI, LINE 4: | THE GRAHAM HOSPITAL ASSOCIATION PRIMARY CATCHMENT AREA IS LOCATED PRIMARILY IN FULTON COUNTY AND INCLUDES ALL OR PORTIONS OF THE TOWNS OF CANTON, LEWISTOWN, CUBA, FARMINGTON, HAVANA, ST. DAVID, ASTORIA, DUNFERMLINE AND BRYANT. THE RACE AND ETHNICITY MAKEUP ARE TYPICAL OF RURAL ILLINOIS BASED ON US CENSUS BUREAU DATA AND INCLUDES 92.5% WHITE, 3.7% BLACK, 2.6% HISPANIC ORIGIN, AND 1.2% OTHER. ACCORDING TO THE US CENSUS BUREAU MEDIAN HOUSEHOLD INCOME 2012 WAS $41,899. FULTON COUNTY'S NOV 2014 UNEMPLOYMENT RATE WAS 7.3%. |
| PART VI, LINE 5: | DURING EACH FISCAL YEAR VARIOUS COMMUNITY HEALTH IMPROVEMENT SERVICES ARE HELD AT A FACILITY OWNED BY GRAHAM HOSPITAL ASSOCIATION OR GRAHAM HOSPITAL ASSOCIATION EMPLOYEES ASSIST WITH SERVIES HELD AT VARIOUS LOCATIONS WITHIN THE CATCHMENT AREA. EXAMPLES OF THESE ACTIVITIES INCLUDE SPONSORSHIP OF AN ANNUAL WOMEN'S HEALTH FAIR HELD IN THE HOSPITAL LOBBY THAT IS OPEN TO THE PUBLIC WHERE EDUCATIONAL BOOTHS, FREE HEALTH SCREENINGS, HEALTHY LUNCHES, PRESENTATIONS BY LOCAL PHYSICIANS ARE AVAILABLE TO ATTENDEES DURING THE DAY; ANNUAL SPONSORSHIP OF A COMMUNITY TALK AND DINNER THAT IS FREE TO THE PUBLIC COVERING HEART HEALTH; FREE BLOOD PRESSURE CLINICS OFFERED THROUGHOUT THE COUNTY ON A REGULAR BASIS. GRAHAM HOSPITAL PROVIDES THE SPACE FOR OPERATION OF AN OUTPATIENT CLINIC THAT PROVIDES FREE HEALTHCARE SERVICES TO FULTON COUNTY RESIDENTS. CLINIC SERVICES ARE PROVIDED BY COMMUNITY VOLUNTEERS. |
| PART VI, LINE 6: | NOT APPLICABLE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CAROLYN JACOBUS | ||||||||||||||
| VP CLINIC SERVICES | $119,864 | $0 | $18,683 | $0 | $1,385 | $0 | $16,488 | $0 | $12,899 | $0 | $169,319 | $0 | $0 | $0 |
| TERESA MCCONKEY | ||||||||||||||
| VP PATIENT SERVICES | $126,297 | $0 | $15,589 | $0 | $354 | $0 | $16,807 | $0 | $15,172 | $0 | $174,219 | $0 | $0 | $0 |
| JIM SCHREINER | ||||||||||||||
| VP INFO SERVICES | $98,702 | $0 | $48,934 | $0 | $3,603 | $0 | $9,531 | $0 | $7,472 | $0 | $168,242 | $0 | $0 | $0 |
| ROBERT G SENNEFF | ||||||||||||||
| PRESIDENT AND CEO | $390,330 | $0 | $58,989 | $0 | $125,123 | $0 | $63,791 | $0 | $5,891 | $0 | $644,124 | $0 | $90,173 | $0 |
| JAMES T STRATTON | ||||||||||||||
| FORMER VP FINANCE/CFO | $165,298 | $0 | $38,499 | $0 | $220,567 | $0 | $28,105 | $0 | $22,031 | $0 | $474,500 | $0 | $30,034 | $0 |
| JOHN QUINONES DO | ||||||||||||||
| MEDICAL DIRECTOR ED | $305,093 | $0 | $2,476 | $0 | $4,752 | $0 | $7,500 | $0 | $22,949 | $0 | $342,770 | $0 | $0 | $0 |
| DWAYNE BERNARD MD | ||||||||||||||
| PHYSICIAN | $413,384 | $0 | $600 | $0 | $966 | $0 | $7,500 | $0 | $37,704 | $0 | $460,154 | $0 | $0 | $0 |
| JEFFREY HEMP MD | ||||||||||||||
| PHYSICIAN | $356,901 | $0 | $600 | $0 | $2,451 | $0 | $7,500 | $0 | $38,917 | $0 | $406,369 | $0 | $0 | $0 |
| DAVID LLOYD CRNA | ||||||||||||||
| CRNA | $233,152 | $0 | $600 | $0 | $540 | $0 | $7,192 | $0 | $21,725 | $0 | $263,209 | $0 | $0 | $0 |
| JULIO ANTONIO RAMOS MD | ||||||||||||||
| PHYSICIAN | $362,712 | $0 | $600 | $0 | $2,376 | $0 | $7,500 | $0 | $14,329 | $0 | $387,517 | $0 | $0 | $0 |
| JOHN ZYGIEL MD | ||||||||||||||
| PHYSICIAN | $330,781 | $0 | $600 | $0 | $14,412 | $0 | $7,500 | $0 | $11,288 | $0 | $364,581 | $0 | $0 | $0 |
| SARA KIMBLE | ||||||||||||||
| FORMER VP PATIENT SERVICES | -$909 | $0 | $0 | $0 | $114,386 | $0 | $0 | $0 | $4,784 | $0 | $118,261 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINES 4A-B | THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT FROM THE ORGANIZATION IN 2013: SARA KIMBLE - $113,575. THIS AMOUNT IS INCLUDED IN REPORTABLE COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) PLAN IN 2013 SPONSORED BY GRAHAM HOSPITAL ASSOCIATION: CAROLYN JACOBUS - $12,205, TERESA MCCONKEY - $12,386, JIM SCHREINER - $4,930, ROBERT G. SENNEFF - $56,291 AND JAMES T. STRATTON - $20,605. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY GRAHAM HOSPITAL ASSOCIATION ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2013. THIS INFORMATION IS INCLUDED IN DEFERRED COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A 457(F) PLAN IN 2013 SPONSORED BY GRAHAM HOSPITAL ASSOCIATION: ROBERT SENNEFF - $123,881 AND JAMES T. STRATTON - $44,496. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR DISTRIBUTION FROM THE PLAN IN 2013. THIS INFORMATION IS INCLUDED IN REPORTABLE COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. |
| PART I, LINE 7 | INCENTIVE AWARDS ARE BASED ON THE ATTAINMENT OF HOSPITAL AND INDIVIDUAL TARGETS AND ARE CALCULATED AS A PERCENTAGE OF WAGES. PAYMENT OF INCENTIVE AWARDS IS DEPENDENT ON THE ACHIEVEMENT OF ORGANIZATIONAL KEY INDICATORS. |
| FORM 990, SCHEDULE J, PART II, COLUMN F: | THE FOLLOWING INDIVIDUAL ALSO PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN IN 2009, 2010, 2011, 2012 AND 2013 SPONSORED BY GRAHAM HOSPITAL ASSOCIATION: ROBERT G. SENNEFF - $90,173 AND JAMES T. STRATTON - $30,034. THE DOLLAR AMOUNT REPRESENTS PRIOR YEAR CONTRIBUTIONS MADE BY GRAHAM HOSPITAL ASSOCIATION ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2009, 2010, 2011 AND 2012. THIS INFORMATION WAS INCLUDED IN DEFERRED COMPENSATION ON THE PRIOR YEARS' FORM 990, PART VII AND SCHEDULE J, PART II. THESE INDIVIDUALS REACHED A SPECIFIED LEVEL OF VESTING IN 2013, SO THE DOLLAR AMOUNT IS NOW INCLUDED IN REPORTABLE COMPENSATION ON THE CURRENT YEAR FORM 990, PART VII AND SCHEDULE J, PART II. THE DOLLAR AMOUNT IS ALSO LISTED AS COMPENSATION REPORTED IN A PRIOR FORM 990 ON THE CURRENT YEAR FORM 990, SCHEDULE J, PART II. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITY OF CANTON IL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 376000876 | BondIssuerEIN |
| CUSIP | 138206AA5 | CUSIPNum |
| Bond Issued | 2009-06-30 | BondIssuedDt |
| Issue Price | $31,085,000 | IssuePriceAmt |
| Purpose | PHYSICIAN CLINIC & FARMINGTON CLINIC CONSTRUCTION, OB RENOVATION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $31,085,000 | TotalProceedsAmt |
| Issuance Costs From Proceeds | $476,622 | IssuanceCostsFromProceedsAmt |
| Working Capital Expenditures | $30,608,378 | WorkingCapitalExpendituresAmt |
| Substantial Completion | 2011 | SubstantialCompletionYr |
| Current Refunding | Yes (1) | CurrentRefundingInd |
| Advance Refunding | 0 | AdvanceRefundingInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.15000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.15000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | Yes (1) | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | Yes (1) | HedgeIdentifiedInBksAndRecInd |
Hedge Provider Name HedgeProviderName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MORGAN STANLEY & | BusinessNameLine1 |
| Business Name Line2 | HARRIS NA | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 25.000000000000 | TermOfHedgePct |
| Superintegrated Hedge | 0 | SuperintegratedHedgeInd |
| Hedge Terminated | 0 | HedgeTerminatedInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| MIDAMERICA NATIONAL BANK | |||
| SEE BELOW FOR DESCRIPTION OF RELATIONSHIP | $70,875 | INTEREST, DIVIDENDS, AND REALIZED GAINS EARNED ON THE ORGANIZATION'S INVESTMENTS WITH MIDAMERICA NATIONAL BANK. | 0 |
| MIDAMERICA NATIONAL BANK | |||
| SEE BELOW FOR DESCRIPTION OF RELATIONSHIP | $19,556 | BANK FEES PAID BY THE ORGANIZATION TO MIDAMERICA NATIONAL BANK | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE L, PART IV | FormAndLineReferenceDesc |
| Explanation | RELATIONSHIP BETWEEN INTEREST PERSON AND THE ORGANIZATION:WARREN WOLF, A TRUSTEE OF GRAHAM HOSPITAL ASSOCIATION, IS A DIRECTOR ON THE BOARD OF MIDAMERICA NATIONAL BANK. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6: | THE GRAHAM HOPSITAL SERVICE LEAGUE VOLUNTEERS OPERATE AND MANAGE THEIR OWN GIFT SHOP WHICH IS LOCATED WITHIN GRAHAM HOSPITAL. A PORTION OF THE PROCEEDS FROM THE GIFT SHOP AND ALL OTHER FUND-RAISING EVENTS IS GIVEN TO THE HOSPITAL ANNUALLY TO PROVIDE FOR MUCH NEEDED EQUIPMENT. VOLUNTEERS ALSO PERFORM VARIOUS OTHER SERVICES WITHIN THE HOSPITAL; PATIENT ESCORT, SURGERY HOSTESS, PHARMACY, AND THE RED CROSS INFORMATION DESK. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE PREPARED FORM 990 IS REVIEWED BY THE CFO, DIRECTOR OF ACCOUNTING, AND SENIOR ACCOUNTANT BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | GRAHAM HOSPITAL REQUIRES THAT ALL TRUSTEES AND ADMINISTRATIVE OFFICERS KEEP THE BOARD OF TRUSTEES INFORMED OF POTENTIAL CONFLICTS OF INTEREST, AND THAT EACH PERSON MAKE AN ANNUAL DECLARATION OF SUCH INTEREST. A CONFLICT OF INTEREST MIGHT EXIST WHEN ORGANIZATIONS IN WHICH TRUSTEES OR OFFICERS HAVE A MATERIAL FINANCIAL INTEREST ARE EITHER DOING BUSINESS WITH, COMPETING WITH, OR HAVE A FINANCIAL INTEREST IN GRAHAM HOSPITAL. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE ADMINISTRATIVE OFFICERS IS REVIEWED ANNUALLY BY THE EXECUTIVE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES. THE ORGANIZATION UTILIZES AN OUTSIDE FIRM, SULLIVAN, COTTER AND ASSOCIATES, INC. TO PROVIDE OUTSIDE EXECUTIVE COMPENSATION INFORMATION. THE LAST REVIEW WAS COMPLETED IN JUNE, 2013. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | OTHER FEES: PROGRAM SERVICE EXPENSES 8,334,039. MANAGEMENT AND GENERAL EXPENSES 519,049. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8,853,088. |
| FORM 990, PART XI, LINE 9: | CHANGE IN FAIR VALUE OF SWAP OPTION -52,369. CHANGE IN NET ASSETS OF GRAHAM HOSPITAL FOUNDATION 56,825. CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUSTS 588,467. |
| FORM 990, PART XII, LINE 2C | THE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR. |