HOOPESTON COMMUNITY MEMORIAL HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: HOOPESTON COMMUNITY MEMORIAL HOSPITAL (EIN 36-3637465)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-11-13
IRS object ID: 201533179349306188
Schema version: 2014v5.0
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 C
Schedule D
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-11-13T13:55:48-06:00	ReturnTs
Tax Period End	2014-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ERNST & YOUNG US LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	111 MONUMENT CIRCLE SUITE 4000	AddressLine1Txt
City	INDIANAPOLIS	CityNm
State Abbreviation	IN	StateAbbreviationCd
ZIP	46204	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	363637465	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Hoopeston Community Memorial Hospital	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% DENNIS HESCH EXEC VP & CFO	InCareOfNm
Business Name Control	HOOP	BusinessNameControlTxt
Phone	2172835531	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 E Orange Street	AddressLine1Txt
City	Hoopeston	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60942	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DENNIS HESCH	PersonNm
Person Title	EXEC VP & CFO	PersonTitleTxt
Phone	2712835531	PhoneNum
Signature	2015-11-13	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JENNIFER RHODERICK	PreparerPersonNm
PTIN	P00395735	PTIN
Phone	3176817000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-04-25 22:37:26Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	CARLE HOOPESTON REGIONAL HEALTH CTR	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	DENNIS HESCH EXEC VP CFO	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	611 W PARK ST	AddressLine1Txt
City	URBANA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61801	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$35,661,148	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.carle.org/hoopeston	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1956	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE QUALITY HEALTH CARE AND OTHER MEDICALLY RELATED SERVICES AND EDUCATION TO THE COMMUNITY THROUGH THE OPERATION OF A CRITICAL ACCESS HOSPITAL and rural health clinics.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	2	VotingMembersIndependentCnt
Total Employee	362	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$24,863	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$3,116	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$38,867	PYContributionsGrantsAmt
CY Contributions Grants	$28,016	CYContributionsGrantsAmt
PY Program Service Revenue	$25,964,439	PYProgramServiceRevenueAmt
CY Program Service Revenue	$35,348,183	CYProgramServiceRevenueAmt
PY Investment Income	$18,422	PYInvestmentIncomeAmt
CY Investment Income	$10,053	CYInvestmentIncomeAmt
PY Other Revenue	$602,558	PYOtherRevenueAmt
CY Other Revenue	$242,009	CYOtherRevenueAmt
PY Total Revenue	$26,624,286	PYTotalRevenueAmt
CY Total Revenue	$35,628,261	CYTotalRevenueAmt
PY Grants And Similar Paid	$33,528	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$28,586	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$12,873,555	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$16,779,900	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$16,126,714	PYOtherExpensesAmt
CY Other Expenses	$22,343,549	CYOtherExpensesAmt
PY Total Expenses	$29,033,797	PYTotalExpensesAmt
CY Total Expenses	$39,152,035	CYTotalExpensesAmt
PY Revenues Less Expenses	-$2,409,511	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$3,523,774	CYRevenuesLessExpensesAmt
Total Assets BOY	$34,747,313	TotalAssetsBOYAmt
Total Assets EOY	$36,308,585	TotalAssetsEOYAmt
Total Liabilities BOY	$31,271,627	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$36,283,096	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$3,475,686	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$25,489	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	MISSION STATEMENT SECTION 1. GENERAL PURPOSES. THE CORPORATION IS ORGANIZED AND SHALL BE EXCLUSIVELY OPERATED AS A NOT-FOR-PROFIT CORPORATION FOR CHARITABLE, BENEVOLENT, SCIENTIFIC AND EDUCATIONAL PURPOSES WITHIN THE MEANING OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE OF 1986, AS AMENDED, OR THE CORRESPONDING PROVISIONS OF ANY FUTURE UNITED STATES INTERNAL REVENUE LAW (THE "CODE"). AND, IN FURTHERANCE OF SUCH CHARITABLE PURPOSES, THE CORPORATION SHALL ENGAGE IN THE ACTIVITIES DESCRIBED IN SECTION 2 OF THIS STATEMENT. SECTION 2. SPECIFIC PURPOSES. THE CORPORATION'S PURPOSES SHALL INCLUDE, BUT NOT BE LIMITED TO, THE FOLLOWING: (A) TO PROVIDE AND TO ASSIST IN PROVIDING FACILITIES FOR THE RENDERING OF HEALTH CARE SERVICES ON AN INPATIENT OR OTHER BASIS THROUGH THE OPERATION OF A CRITICAL ACCESS HOSPITAL AND RURAL HEALTH CLINICS, AND OTHER CLINICAL SERVICES THROUGH ALL OTHER APPROPRIATE MEANS; AND (B) TO TRAIN AND TO PROVIDE CONTINUING EDUCATION FOR PERSONS ENGAGED IN PROVIDING HEALTH	MissionDesc
Significant New Program Srvc	Yes (true)	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$34,129,729	ExpenseAmt
Grant	$28,586	GrantAmt
Revenue	$35,352,883	RevenueAmt
Desc	HOOPESTON COMMUNITY MEMORIAL HOSPITAL (HCMH), A 24 BED CRITICAL ACCESS HOSPITAL LOCATED IN HOOPESTON, IL SERVES HOOPESTON, VERMILION COUNTY AND THE SURROUNDING AREA. HCMH EMPLOYS MORE THAN 255 STAFF MEMBERS, 40 PHYSICIANS AND 32 ADVANCED PRACTICE PROVIDERS. HCMH IS COMMITTED TO PROVIDING QUALITY, DEPENDABLE HEALTH SERVICES. HCMH OFFERS SPECIALTY SERVICES WITH CARDIOLOGY, ORTHOPEDICS, GYNECOLOGY, MENTAL HEALTH, UROLOGY AND DIAGNOSTIC SERVICES INCLUDING NUCLEAR MEDICINE, DIGITAL MAMMOGRAPHY, RADIOLOGY AND LABORATORY. EMERGENCY MEDICINE AND SURGICAL SERVICES ARE PROVIDED IN STATE OF THE ART FACILITIES WHICH OPENED IN 2012. HCMH PROVIDES ACCESS TO PRIMARY CARE WITH CLINICS IN HOOPESTON, ROSSVILLE, MILFORD, CISSNA PARK, DANVILLE, WATSEKA, TUSCOLA AND MATTOON, IL. HCMH HAS BEEN DEDICATED TO CARING FOR THOSE IN THE AREA FOR OVER 50 YEARS.	Desc
Total Program Service Expenses	$34,129,729	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	false	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	Yes (true)	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	Yes (true)	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	25	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	362	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	2	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	false	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	IL	StatesWhereCopyOfReturnIsFldCd
Other Website	Yes (X)	OtherWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DENNIS HESCH EXEC VP CFO	PersonNm
Phone	2173833311	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	611 WEST PARK ST	AddressLine1Txt
City	URBANA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61801	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Russ Leigh
Chairman of Board	1.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
Lynn Galloway
Secretary/Treasurer of Board	2.0	0.0	Yes (X)	Yes (X)	$0	$0	$0
Ed Layden Jr
Trustee	1.0	0.0	Yes (X)		$0	$0	$0
Karla Coon
Trustee	2.0	0.0	Yes (X)		$0	$0	$0
Henry Hornbeck
Trustee	0.25	0.0	Yes (X)		$0	$0	$0
Joseph Barkmeier MD
Trustee	0.5	39.5	Yes (X)		$0	$455,993	$141,838
Letha Kramer
Trustee	2.96	37.04	Yes (X)		$0	$166,274	$21,147
Harry Brockus
Ex-Officio Board, CEO	40.0	0.0		Yes (X)	$215,062	$0	$68,635
Dennis Hesch
Exec VP & CFO	1.0	39.0		Yes (X)	$0	$878,025	$204,201
Laurence Fallon
Exec VP-Legal Affairs & HR	1.0	39.0			$0	$647,842	$159,301	Yes (X)
Jay Colbert DO DPM
Ex-Officio Brd,CMO & Physician	40.0	0.0			$231,739	$0	$14,176	Yes (X)
Daniel Chase MD
Physician	40.0	0.0			$487,695	$0	$41,073		Yes (X)
William McCarthy MD
Physician	40.0	0.0			$278,077	$0	$21,460		Yes (X)
Albert Tanlim MD
Physician	40.0	0.0			$245,194	$0	$37,447		Yes (X)
Cortney Joneikis MD MS
Physician	40.0	0.0			$310,417	$0	$15,163		Yes (X)
Susan Berg MD
Physician	40.0	0.0			$290,121	$0	$5,494		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,058,305	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,148,134	TotReportableCompRltdOrgAmt
Total Other Compensation	$729,935	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	22	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
HOOPESTON EMERGENCY MEDICINE SPECIA
6523 26TH PLACE	BERWYN	IL	60402	PHYSICIAN STAFFING	$1,238,096
DMS IMAGING INC
26273 NETWORK PL	CHICAGO	IL	606731262	IMAGING SERVICES	$192,667
MED ONE CAPITAL FUNDING ILLINOIS LP
PO BOX 271128	SALT LAKE CITY	UT	84127	MEDICAL EQUIP LEASIN	$138,881
GOLDFISH LOCUMS LLC
5741 LEGACY DRIVE STE 200	PLANO	TX	75024	PHYSICIAN STAFFING	$110,036

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	4	CntrctRcvdGreaterThan100KCnt
Federated Campaigns	$0	FederatedCampaignsAmt
Membership Dues	$0	MembershipDuesAmt
Fundraising	$0	FundraisingAmt
Related Organizations	$0	RelatedOrganizationsAmt
Government Grants	$28,016	GovernmentGrantsAmt
All Other Contributions	$0	AllOtherContributionsAmt
Noncash Contributions	$0	NoncashContributionsAmt
Total Contributions	$28,016	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	NET PATIENT SERVICES	Desc
Business	622110	BusinessCd
Total Revenue Column	$35,348,183	TotalRevenueColumnAmt
Related Or Exempt Func Income	$35,348,183	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$35,348,183	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$15,898	TotalRevenueColumnAmt
Exclusion	$15,898	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$19,416	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$19,617	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$201	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$201	TotalRevenueColumnAmt
Exclusion	-$201	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$7,425	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$13,270	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	-$5,845	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$5,845	TotalRevenueColumnAmt
Exclusion	-$5,845	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt	ExclusionExclusionAmt
CATERING	722320	$24,863	$24,863
COFFEE SHOP	722212	$14,960		$14,960
PERPETUAL TRUST INTEREST	900099	$178,710		$178,710

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$23,677	TotalRevenueColumnAmt
Related Or Exempt Func Income	$4,700	RelatedOrExemptFuncIncomeAmt
Exclusion	$18,977	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$242,210	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$35,628,261	TotalRevenueColumnAmt
Related Or Exempt Func Income	$35,352,883	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$24,863	UnrelatedBusinessRevenueAmt
Exclusion	$222,499	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$28,586	TotalAmt
Program Services	$28,586	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$550,599	TotalAmt
Program Services	$245,915	ProgramServicesAmt
Management And General	$304,684	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$302,687	TotalAmt
Program Services	$302,687	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$12,370,946	TotalAmt
Program Services	$11,512,759	ProgramServicesAmt
Management And General	$858,187	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$651,185	TotalAmt
Program Services	$600,387	ProgramServicesAmt
Management And General	$50,798	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,013,624	TotalAmt
Program Services	$1,903,034	ProgramServicesAmt
Management And General	$110,590	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$890,859	TotalAmt
Program Services	$802,711	ProgramServicesAmt
Management And General	$88,148	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$172	TotalAmt
Management And General	$172	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$11,582	TotalAmt
Management And General	$11,582	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$1,848,591	TotalAmt
Program Services	$1,517,914	ProgramServicesAmt
Management And General	$330,677	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$1,083	TotalAmt
Management And General	$1,083	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,799,088	TotalAmt
Program Services	$1,423,758	ProgramServicesAmt
Management And General	$375,330	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$611,696	TotalAmt
Program Services	$323,420	ProgramServicesAmt
Management And General	$288,276	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,332,048	TotalAmt
Program Services	$886,353	ProgramServicesAmt
Management And General	$445,695	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$99,153	TotalAmt
Program Services	$83,793	ProgramServicesAmt
Management And General	$15,360	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$53,427	TotalAmt
Program Services	$42,058	ProgramServicesAmt
Management And General	$11,369	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$382,861	TotalAmt
Program Services	$382,834	ProgramServicesAmt
Management And General	$27	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,762,762	TotalAmt
Program Services	$1,012,998	ProgramServicesAmt
Management And General	$749,764	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$502,996	TotalAmt
Program Services	$492,135	ProgramServicesAmt
Management And General	$10,861	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
INTERNAL PURCHASED SERVICES	$5,506,273	$5,397,552	$108,721
INTERNAL MANAGEMENT FEES	$4,388,886	$3,436,238	$952,648
PATIENT CARE SUPPLIES	$3,153,615	$3,153,615
OTHER TAXES	$382,376	$375,127	$7,249

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$506,940	TotalAmt
Program Services	$205,855	ProgramServicesAmt
Management And General	$301,085	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$39,152,035	TotalAmt
Program Services	$34,129,729	ProgramServicesAmt
Management And General	$5,022,306	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$2,682,596	BOYAmt
EOY	$4,118,020	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$6,994,575	BOYAmt
EOY	$7,164,549	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$158,421	BOYAmt
EOY	$340,227	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$19,961,033	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$3,919,201	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$16,252,110	BOYAmt
EOY	$16,041,832	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,444,690	BOYAmt
EOY	$4,444,690	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$4,214,921	BOYAmt
EOY	$4,199,267	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$34,747,313	BOYAmt
EOY	$36,308,585	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$1,384,904	BOYAmt
EOY	$1,519,914	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$11,362,003	BOYAmt
EOY	$7,094,839	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$18,524,720	BOYAmt
EOY	$27,668,343	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$31,271,627	BOYAmt
EOY	$36,283,096	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	-$97,543	BOYAmt
EOY	-$3,618,818	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$57,646	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,573,229	BOYAmt
EOY	$3,586,661	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,475,686	BOYAmt
EOY	$25,489	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$34,747,313	BOYAmt
EOY	$36,308,585	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	-$3,523,774	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$0	NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts	$0	DonatedServicesAndUseFcltsAmt
Investment Expense	$0	InvestmentExpenseAmt
Prior Period Adjustments	$59,674	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$13,903	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$11,582	OtherActivitiesAmt
Total Lobbying Expenditures	$11,582	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART II-B, LINE 1I	FormAndLineReferenceDesc
Explanation	OTHER ACTIVITIES $8,063 - PORTION OF ILLINOIS HOSPITAL ASSOCIATION (IHA) DUES ATTRIBUTABLE TO LOBBYING $3,202 - PORTION OF AMERICAN HOSPITAL ASSOCIATION (AHA) DUES ATTRIBUTABLE TO LOBBYING $317 - PORTION OF MISCELLANEOUS HEALTH CARE ORGANIZATION DUES ATTRIBUTABLE TO LOBBYING	ExplanationTxt

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$84,231	OtherCostOrOtherBasisAmt
Book Value	$84,231	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$10,319,085	OtherCostOrOtherBasisAmt
Depreciation	$1,388,268	DepreciationAmt
Book Value	$8,930,817	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$25,947	OtherCostOrOtherBasisAmt
Depreciation	$6,305	DepreciationAmt
Book Value	$19,642	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,832,036	OtherCostOrOtherBasisAmt
Depreciation	$2,355,738	DepreciationAmt
Book Value	$5,476,298	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,699,734	OtherCostOrOtherBasisAmt
Depreciation	$168,890	DepreciationAmt
Book Value	$1,530,844	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$16,041,832	TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDesc	Book ValueBookValueAmt
HRHC FCS ESCROW	$554,960
DEVL LIMITED ASSETS	$57,646
LONG TERM INVESTMENTS	$3,586,661

Field	Value	IRS element (for citing)
Total Book Value Other Assets	$4,199,267	TotalBookValueOtherAssetsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDesc	AmtAmt
ACCTS REC-MEDICARE	$307,798
DUE TO BLUE CROSS	$695,247
HRHC/FNDN NOTES PAYABLE	$3,718,322
ASSET RETIREMENT OBLIGATION	$144,350
INTERCOMPANY PAYABLES	$22,802,626

Field	Value	IRS element (for citing)
Total Liability	$27,668,343	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE D, PART X, LINE 2	FormAndLineReferenceDesc
Explanation	FIN 48 (ASC740) FOOTNOTE THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THERESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2014 AND 2013.	ExplanationTxt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	125.	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	false	AnnualCommunityBnftReportInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,074,018	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$2,074,018	NetCommunityBenefitExpnsAmt
Total Expense	0.05300	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,787,686	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,845,630	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$942,056	NetCommunityBenefitExpnsAmt
Total Expense	0.02410	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$10,861,704	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,845,630	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,016,074	NetCommunityBenefitExpnsAmt
Total Expense	0.07710	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$171,178	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$171,178	NetCommunityBenefitExpnsAmt
Total Expense	0.00440	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$30,079	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$30,079	NetCommunityBenefitExpnsAmt
Total Expense	0.00080	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$25,336	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$25,336	NetCommunityBenefitExpnsAmt
Total Expense	0.00060	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$226,593	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$226,593	NetCommunityBenefitExpnsAmt
Total Expense	0.00580	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$11,088,297	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$7,845,630	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,242,667	NetCommunityBenefitExpnsAmt
Total Expense	0.08290	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$2,675	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$2,675	NetCommunityBenefitExpnsAmt
Total Expense	0.00010	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$19,056	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$19,056	NetCommunityBenefitExpnsAmt
Total Expense	0.00040	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$149	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$149	NetCommunityBenefitExpnsAmt

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$21,880	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$21,880	NetCommunityBenefitExpnsAmt
Total Expense	0.00050	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$664,858	BadDebtExpenseAmt
Bad Debt Expense Attributable	$332,429	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$10,093,642	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$11,060,134	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$966,492	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	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	HOOPESTON COMMUNITY MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	701 E ORANGE ST	AddressLine1Txt
City	HOOPESTON	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	609421801	ZIPCd

Field	Value	IRS element (for citing)
Website Address	WWW.CARLE.ORG/HOOPESTON	WebsiteAddressTxt
State License	0004200	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	HOOPESTON COMMUNITY MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	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
Other	Yes (X)	OtherInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	false	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	false	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	CARLE.ORG/CHNA	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	CARLE.ORG/CHNA	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	125.	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	300.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Residency Criteria	Yes (X)	ResidencyCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	X	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	X	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	X	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Actions On Nonpayment	false	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	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
Other Actions Taken	Yes (X)	OtherActionsTakenInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Other Method Used	Yes (X)	OtherMethodUsedInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V SUPPLEMENTAL INFORMATION	COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 3J) A COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS COMPLETED IN 2013 TO COVER PROGRAMS FOR 2014-2016. SURVEYS AND ASSESSMENTS WERE DISCUSSED AT THE ANNUAL STRATEGIC PLANNING SESSION WITH THE COMMUNITY BOARD OF DIRECTORS. SUBSEQUENTLY, THE 2014-16 CHNA AND implementation PLAN WAS APPROVED BY THE BOARD IN DECEMBER 2013. COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 5) CONDUCTED INTERVIEWS WITH COMMUNITY STAKEHOLDERS, EVALUATED OUTSIDE RESEARCH, PRIORITIZED NEEDS BASED ON THAT INFORMATION. PHONE AND IN-PERSON INTERVIEWS WERE CONDUCTED IN SEPTEMBER 2013. KEY INFORMANTS PARTICIPATED IN INTERVIEWS RANGING FROM 30-90 MINUTES IN LENGTH: KAREN LANGDON, PA-C, AND MISTI RUNGE, INFECTION CONTROL MANAGER & QUALITY NURSE SPECIALIST, HCMH; MARCIE SHERIDAN, EXECUTIVE DIRECTOR OF HOOPESTON MULTI-AGENCY; JOSIE SIDDENS, RN, SCHOOL NURSE AT BISMARCK-HENNING SCHOOL DISTRICT AND ALSO REGISTERED NURSE AT PRESENCE UNITED SAMARITANS MEDICAL CENTER EMERGENCY DEPARTMENT; JENNY TRIMMELL, BSN, DIRECTOR OF COMMUNITY HEALTH SERVICES AT THE VERMILION COUNTY HEALTH DEPARTMENT; DIANA CORENZA, ASSOCIATE DIRECTOR OF THE VETERAN'S AFFAIRS (VA) ILLIANA HEALTH CARE SYSTEM; ALICE MARIE JACOBS, PHD, PRESIDENT OF DANVILLE AREA COMMUNITY COLLEGE; AND THOM POLLOCK, EXECUTIVE DIRECTOR OF CROSSPOINT HUMAN SERVICES.
COMMUNITY HEALTH NEEDS ASSESSMENT (PART V, SECT B, LINE 11)	CARLE HOOPESTON REGIONAL HEALTH CENTER CONTINUES ITS WORK TO IMPROVE THE OVERALL HEALTH OF THE COMMUNITY WHICH INCLUDES EMPHASIS ON ACCESS TO HEALTH SERVICES, HEART DISEASE AND STROKE AND THE OTHER SPECIALTIES AND SERVICES THE HOSPITAL OR CARLE HEALTH SYSTEM PROVIDES. THE CARLE FOUNDATION IS DILIGENTLY WORKING TO IMPROVING ACCESS AND SERVICES THROUGHOUT THE EAST CENTRAL ILLINOIS REGION, NOT JUST FOR THIS GEOGRAPHIC AREA. MANY OF THE OTHER CONCERNS ARE ALSO ADDRESSED THROUGH SERVICES PROVIDED, BUT THESE AREAS ARE NOT THE PRIMARY EMPHASIS OF THE COMMUNITY BENEFIT IMPLEMENTATION PLAN WHICH TARGETS MORE SPECIFIC LOW INCOME POPULATIONS IN VERMILION COUNTY. HOW HCMH IS ADDRESSING SIGNIFICANT HEALTH NEEDS 1. CHILDREN'S HEALTH HCMH STAFF MAINTAINED A PRESENCE IN THE LOCAL SCHOOL SYSTEM, PROVIDING HEAD LICE CHECKS, HANDWASHING EDUCATION, AND VISION AND HEARING TESTING FOR SCHOOLS IN THE REGION. THE HOSPITAL ALSO PROVIDED FULL-TIME ATHLETIC TRAINERS TO SCHOOLS IN HOOPESTON, CISSNA PARK AND MILFORD. SERVICE IS PROVIDED TO ALL STUDENT ATHLETES, REGARDLESS OF WHERE THEY RECEIVE CARE, AND IS FREE OF CHARGE TO THE SCHOOL DISTRICTS. IN 2014, THREE PEDIATRIC PROVIDERS WERE IN THE ORGANIZATION'S PRIMARY CARE FACILITY IN DANVILLE, ALSO IN VERMILION COUNTY, AND THEY BEGAN A ROTATION TO HOOPESTON. THIS ROTATION HELPED MEET THE NEED FOR PEDIATRIC CARE AND NOW A NEW FULL-TIME PEDIATRICIAN POSITION HAS BEEN PERMANENTLY LOCATED IN HOOPESTON. IN ADDITION, HCMH ADDED A DEDICATED PEDIATRICIAN TO THE WATSEKA LOCATION, BOTH OF WHICH HELP COVER THE GAPS IN PEDIATRIC CARE IN NORTHERN VERMILION AND SOUTHERN IROQUOIS COUNTIES. 2. TEEN AND ADOLESCENT HEALTH HCMH IMPLEMENTED A SCHOOL-BASED EDUCATION PROGRAM FOR SEXUALLY TRANSMITTED DISEASE (STD) EDUCATION IN 2014. HCMH PROVIDERS PRESENTED TO ALL STUDENTS IN PHYSICAL EDUCATION CLASSES AT HOOPESTON AREA HIGH SCHOOL. THE PLAN IS TO PRESENT THIS MATERIAL TO STUDENTS EVERY OTHER YEAR, AND THE NEXT SESSION WILL BE CONDUCTED IN THE FALL OF 2016. ADDITIONALLY, HCMH OFFERED THIS STD EDUCATION MATERIAL TO ALL OTHER SCHOOL DISTRICTS IN VERMILION AND IROQUOIS COUNTIES. ALTHOUGH THERE HAS BEEN INTEREST FROM SEVERAL SCHOOLS, NO PROGRAMS HAVE BEEN SCHEDULED; HOWEVER, SCHOOL OFFICIALS CONTINUE TO MEET WITH AND DISCUSS THIS OPTION WITH HOSPITAL MANAGEMENT. HCMH ALSO ADDED OB/GYN SERVICES VIA A VISITING SPECIALIST FROM DANVILLE IN 2013. THIS PROVIDER CONTINUES TO OFFER GENERAL OB/GYN CARE IN HOOPESTON TWICE A MONTH. LAB AND RADIOLOGY PROVIDE NECESSARY RELATED OB/GYN SCREENINGS AT HOOPESTON. TO FURTHER EXPAND ACCESS TO CARE, HCHM HIRED AN ADDITIONAL OB/GYN, DR. LORAINE NOLLA, IN 2014. 3. ORAL HEALTH HOOPESTON COMMUNITY MEMORIAL HOSPITAL CONTINUES TO FUND THE DELTA DENTAL OF ILLINOIS' LAND OF SMILES PROGRAM IN VERMILION COUNTY. THIS PROGRAM TEACHES CHILDREN IN THE COMMUNITY HOW TO TAKE CARE OF THEIR TEETH BY DEMONSTRATING PROPER BRUSHING AND FLOSSING TECHNIQUES, REVIEWING GOOD AND BAD FOODS FOR TEETH AND WHY IT IS IMPORTANT TO VISIT THE DENTIST REGULARLY. THIS PROGRAM HAS REACHED HUNDREDS OF CHILDREN IN ROSSVILLE AND BISMARCK-HENNING, TWO RURAL COMMUNITIES LOCATED WITHIN VERMILION COUNTY WHERE IT HAS BEEN IDENTIFIED THAT YOUTH LACK EDUCATION ABOUT THE IMPORTANCE OF DENTAL CARE. PRE- AND POST-TESTING ILLUSTRATES THAT CHILDREN IMPROVE THEIR KNOWLEDGE OF THE IMPORTANCE OF DENTAL CARE BOTH AT HOME AND AT THE DENTIST AFTER PARTICIPATING IN THE SESSION. 4. CANCER CANCER-RELATED DEATHS IN VERMILION COUNTY ILLUSTRATED THE NEED FOR FURTHER PROGRAMS AND INITIATIVES IN VERMILION COUNTY, CENTERING PRIMARILY AROUND EARLY DETECTION AND SCREENINGS. CARLE HOOPESTON OFFERS DIGITAL MAMMOGRAPHY PROVIDING CLEARER IMAGES FOR WOMEN RECEIVING SCREENINGS. PATIENTS CAN NOW ALSO GET BIOPSIES PERFORMED AT HOOPESTON FACILITIES - TWO PROVIDERS WERE TRAINED TO DO BASIC SKIN BIOPSIES IN THEIR HOOPESTON PHYSICIAN OFFICE, AS WELL AS A GENERAL SURGEON, WHO HAS BEGUN PERFORMING MANY GENERAL SURGERY BIOPSIES. HCMH HAS ALSO WORKED WITH MILLS BREAST CANCER INSTITUTE (MBCI) IN URBANA, IL TO DO AT LEAST ONE SCREENING EVENT IN HOOPESTON EACH YEAR. IN 2014, BREAST CANCER RISK ASSESSMENTS WERE PERFORMED ON APPROXIMATELY 150 LOCAL RESIDENTS THROUGH A HEALTH FAIR. AFTER TRAINING WITH PATIENTS WHO HAVE PORTS, NURSING STAFF AT HCMH HAS ALSO BECOME MORE EDUCATED IN TREATING PATIENTS WITH CANCER, THUS LOWERING INFECTION CHANCES AND HELPING WITH CONTINUITY OF CARE. 5. DIABETES IN 2014, HCMH FOCUSED ON CONTINUING TO EDUCATE STAFF, PATIENTS, AND THE COMMUNITY ABOUT DIABETES. AS SUCH, A DIETICIAN PROVIDED FREE DIABETIC NUTRITION CLASSES, AND PLANNED A DIABETIC EDUCATION AND SUPPORT GROUP. HCMH HAS ALSO ACQUIRED PEDIATRIC DIABETIC COOKBOOKS THROUGH THE INITIATIVE OF MEDICAL/SURGICAL NURSES WHO PROVIDE THEM TO FAMILIES OF PEDIATRIC PATIENTS WITH DIABETES. CASH AND IN-KIND DONATIONS HOOPESTON COMMUNITY MEMORIAL HOSPITAL CONTRIBUTED NEARLY $20,000 TO CHARITABLE ORGANIZATIONS IN THE COMMUNITY VIA CASH AND IN-KIND DONATIONS, INCLUDING PROGRAMS AIMED TO HELP YOUTH, HEALTH IMPROVEMENT, HEALTH EDUCATION AND HEALTH PROFESSIONS EDUCATION. BECAUSE THE NEEDS ARE GREAT AND IT WOULD BE UNREASONABLE TO ADDRESS EACH AND EVERY IDENTIFIED NEED, WE SET PRIORITIES AND USE OUR RESOURCES TO FOCUS PRIMARILY ON IDENTIFIED NEEDS WITHIN THE COMMUNITY BENEFIT PRIORITIES SET. MANY OF THESE NEEDS ARE ADDRESSED THROUGH PARTNERSHIPS AND COLLABORATIVE EFFORTS. ONE SIGNIFICANT CONTRIBUTION WAS TO THE HOOPESTON MULTI AGENCY ($2,500) TO ENHANCE THE MULTITUDE OF SERVICES THEY OFFER. THE MULTI AGENCY IS A COMMUNITY PARTNER THAT HELPS PROVIDE DISABLED AND ELDERLY PATIENTS RIDES THROUGHOUT HOOPESTON AND DANVILLE TO HELP MAINTAIN THEIR HEALTH AND LIFESTYLE. THE ORGANIZATION ALSO ADDRESSES TWO OTHER CRITICAL AREAS OF NEED IN VERMILION COUNTY BY PROVIDING A FREE AFTER-SCHOOL PROGRAM FOR TEENS. THIS PROGRAM PROVIDES THE PARTICIPANT WITH A MEAL AND TUTORING, HELPING KEEP YOUTH FED, HEALTHY AND IN SCHOOL. THE FINAL SERVICE PROVIDED BY THE MULTI AGENCY IS HEALTH NAVIGATION. THEY ASSIST CLIENTS IN COORDINATING CARE APPOINTMENTS, AND FINDING RESOURCES TO ASSIST THEM WITH ALL THEIR DIFFICULTIES. HCMH ALSO SUPPORTS ALL LIONS CLUB CHAPTERS IN VERMILION COUNTY. THE LIONS CLUB IS KNOWN FOR THEIR HUMANITARIAN EFFORTS ON BEHALF OF THE DEAF AND BLIND, AND SPECIFICALLY PROVIDES EYE GLASSES FOR UNDERPRIVILEGED CHILDREN IN THEIR RESPECTIVE SERVICE AREAS. THERE ARE ALSO SEVERAL STATEWIDE AND NATIONWIDE ORGANIZATIONS THAT HAVE REGIONAL CHAPTERS THAT RECEIVE SUPPORT FROM HCMH. THOSE INCLUDE: ROTARY OF HOOPESTON, SPECIAL OLYMPICS OF ILLINOIS, AND FELLOWSHIP OF CHRISTIAN ATHLETES. EACH OF THESE ORGANIZATIONS HAS A MISSION STATEMENT OUTLINING THEIR COMMITMENT TO IMPROVING THE HEALTH OF OTHERS, STAYING ACTIVE AND THE WELLBEING OF OUR YOUTH. WHILE THERE WERE A NUMBER OF ADDITIONAL NEEDS IDENTIFIED BY THE DATA AND INPUT FROM COMMUNITY LEADERS, AS A CRITICAL ACCESS HOSPITAL, CARLE HOOPESTON REGIONAL HEALTH CENTER DOES NOT HAVE THE RESOURCES TO ADDRESS ALL OF THEM. THE ISSUES THAT WILL NOT BE ADDRESSED IN THE IMPLEMENTATION PLAN ARE LOWER PRIORITY BECAUSE THE NEED WAS NOT AS SIGNIFICANT; THEY ARE NOT CENTRAL TO THE HOSPITAL'S MISSION; AND CHRHC HAS DETERMINED IT DOES NOT HAVE THE ABILITY TO MAKE A MEASURABLE IMPACT IN THOSE AREAS. CHRHC WILL NOT FOCUS THE COMMUNITY BENEFIT IMPLEMENTATION PLAN ON ADDRESSING COMMUNITY HEALTH CHALLENGES RELATED TO DISABILITIES; EXERCISE, NUTRITION AND WEIGHT; IMMUNIZATION AND INFECTIOUS DISEASES; MATERNAL, FETAL AND INFANT HEALTH; MENTAL HEALTH; OLDER ADULTS AND AGING; RESPIRATORY DISEASES OR SUBSTANCE ABUSE.
FINANCIAL ASSISTANCE POLICY (PART V, SECT B, LINE 20E)	HOOPESTON COMMUNITY MEMORIAL HOSPITAL HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE CERTAIN THAT PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THIS INCLUDES: - A SIMPLIFIED APPLICATION FORM THAT CLEARLY EXPLAINS PATIENT RIGHTS AND Hoopeston community memorial hospital'S EXPECTATIONS - INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM ON ALL BILLING STATEMENTS, COLLECTION LETTERS AND HOSPITAL ADMISSION PACKETS - INFORMATION AND APPLICATION FORMS ARE READILY AVAILABLE AND ACCESSED AT WWW.CARLE.ORG/HOOPESTON - FINANCIAL ASSISTANCE APPLICATION FORMS AND BROCHURES ARE AVAILABLE AT ALL INPATIENT AND OUTPATIENT REGISTRATION POINTS, AS WELL AS IN THE HOSPITAL'S MAIN LOBBY - MEETING WITH OUR STAFF TO KEEP THEM INFORMED ABOUT THE PROGRAM AND THE BENEFITS THAT ARE AVAILABLE TO PATIENTS - FINANCIAL ASSISTANCE REPRESENTATIVES ARE AVAILABLE AT VARIOUS COMMUNITY FORUMS - SCREENING PATIENTS THROUGH OUR VENDOR FOR KEY FINANCIAL INDICATORS TO PRESUME ELIGIBILITY OR CONTACT REGARDING OUR ASSISTANCE PROGRAMS
FINANCIAL ASSISTANCE POLICY (PART V, SECT B, LINE 22D)	Carle establishes a standardized fee schedule using a national database of fee information which blends the relative value of a service with statistical profiling of actual charge data specific to this region. This is the same methodology used by the Centers for Medicare and Medicaid Services (CMS) to set Medicare fees. This allows us to establish a fair fee that represents the cost of delivering the services. Charges for patients who apply and are identified as qualified for financial assistance are discounted based upon THE discount level FOR WHICH THEY QUALIFY. Discounts for Hoopeston Regional Health Center financial assistance program are either 50% or 100% based upon the applicants Federal Poverty Level.

Field	Value	IRS element (for citing)
Facility	8	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
CARLE DANVILLE ON FAIRCHILD
311 W FAIRCHILD	DANVILLE	IL	61832	RURAL HEALTH CLINIC
CHARLOTTE ANN RUSSELL MEDICAL CENTER
801 E ORANGE ST	HOOPESTON	IL	60342	RURAL HEALTH CLINIC
ROBERTS CLINIC
845 S 4th St	WATSEKA	IL	60970	RURAL HEALTH CLINIC
CARLE MATTOON ON HURST
2512 HURST DRIVE	MATTOON	IL	61938	MEDICAL CLINIC
ROSSVILLE MEDICAL CENTER
619 N CHICAGO ST	ROSSVILLE	IL	60963	RURAL HEALTH CLINIC
MILFORD CLINIC
322 CHICAGO ST	MILFORD	IL	60953	RURAL HEALTH CLINIC
CISSNA PARK MEDICAL CLINIC
141 W GARFIELD AVE	CISSNA PARK	IL	60924	RURAL HEALTH CLINIC
CARLE AT TUSCOLA
301 E SOUTHLINE ROAD	TUSCOLA	IL	61953	RURAL HEALTH CLINIC

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H SUPPLEMENTAL INFORMATION	SCHEDULE H, PART VI 1 - REQUIRED DESCRIPTIONS FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA (PART I, LINE 3C) PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE ON MULTIPLE OCCASIONS. IT IS THE RESPONSIBILITY OF THE PATIENT TO REQUEST AND COMPLETE A FINANCIAL ASSISTANCE APPLICATION. IF A PATIENT DOES NOT REQUEST OR COMPLETE AND RETURN THE APPLICATION, THEN THE BALANCE IS DEEMED THEIR RESPONSIBILITY TO PAY. WE PRESUME ELIGIBILITY FOR VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION AND PATIENTS COVERED BY MEDICAID TITLE XIX. A VENDOR, EXPERIAN INFORMATION SOLUTIONS, INC. IS UTILIZED TO DETERMINE THOSE PATIENTS WHO MAY BE PRESUMPTIVELY QUALIFIED FOR ASSISTANCE BASED ON KEY FINANCIAL INDICATORS. IDENTIFIED PATIENTS MAY BE PRESUMED ELIGIBLE OR RECEIVE ADDITIONAL CONTACT REGARDING APPLICATION FOR ASSISTANCE. PATIENTS MAY APPLY FOR FINANCIAL ASSISTANCE AT ANY TIME, INCLUDING BEFORE CARE IS RECEIVED. THE MAXIMUM AMOUNT HOOPESTON COMMUNITY MEMORIAL HOSPITAL SHALL COLLECT FOR FACILITY SERVICES FROM A PATIENT IN A TWELVE MONTH PERIOD IS 25% OF THE ANNUAL PRE-TAX EARNINGS AND CASH BENEFITS FROM ALL SOURCES OF THE PATIENT; IF THE PATIENT IS UNINSURED AND EARNS AT OR BELOW 300% OF THE FEDERAL POVERTY LEVEL. EXPLANATION OF COSTING METHODOLOGY (PART I, LINE 7 AND PART III, LINE 2) TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS AND BAD DEBT CHARGES TO COST; A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER BENEFITS COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCUR. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUAL'S FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. COMMUNITY BUILDING ACTIVITIES (PART II) ECONOMIC DEVELOPMENT MUCH OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S COMMUNITY BUILDING ACTIVITIES ARE THROUGH IN-KIND SUPPORT VIA COMMITTEES, BOARDS AND SPECIAL PROJECTS. THREE MEMBERS OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL LEADERSHIP AND STAFF WERE A PART OF THE HOOPESTON COMMUNITY ALLIANCE IN 2014, A COMMITTEE DEDICATED TO THE IMPROVEMENT OF HOOPESTON. 74 HOURS OF MEETINGS AND PREPARATION WERE SPENT ON THE COMMITTEE AND VARIOUS SUB-COMMITTEES FOR THE ALLIANCE, AMOUNTING TO $4,400 IN COMMUNITY BENEFIT. IN ADDITION, CEO HARRY BROCKUS JOINED THE VERMILION ADVANTAGE BOARD IN 2014, AMOUNTING TO $1,092 OF IN-KIND SUPPORT. AGAIN THIS YEAR, THE HOOPESTON ECONOMIC DEVELOPMENT COMMITTEE HELD WEEKLY MEETINGS TO DISCUSS A NUMBER OF ISSUES THAT IMPACT THE COMMUNITY'S HEALTH AND SAFETY, WHICH AMOUNTED TO 12 HOURS SPENT BY HOOPESTON COMMUNITY MEMORIAL HOSPITAL LEADERSHIP AND STAFF, OR $690 OF IN-KIND SUPPORT. COMMUNITY SUPPORT A SIGNIFICANT PORTION OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S COMMUNITY-BUILDING ACTIVITIES ($13,175) FOCUSED ON COMMUNITY SUPPORT, INCLUDING CASH, IN-KIND DONATIONS AND BUDGETED EXPENDITURES FOR THE CITY, BUSINESS ASSOCIATIONS AND OTHER PROGRAMS IN HOOPESTON. ALTHOUGH THESE ITEMS WERE NOT COUNTED AS COMMUNITY BENEFIT, THIS SUPPORT IS AN IMPORTANT PART OF CONTRIBUTING TO THE ECONOMIC VIABILITY OF THE COMMUNITY. EMERGENCY MANAGEMENT THE ADDITIONAL FUNDS CAPTURED AS COMMUNITY BUILDING ($1,483) WERE FOR DISASTER READINESS - THOSE HOURS AND STAFF TIME SPENT ABOVE AND BEYOND NORMAL REQUIREMENTS FOR A HOSPITAL. AT HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S EMERGENCY PREPAREDNESS WAS A PRIORITY, WITH ONE STAFF MEMBER SERVING AS THE DISASTER PREPAREDNESS COORDINATOR. THIS INDIVIDUAL SAT ON THE HOOPESTON EMERGENCY MANAGEMENT AGENCY AS A REPRESENTATIVE OF CARLE HOOPESTON, ATTENDED DISASTER MEETINGS, AND PARTICIPATED IN DRILLS. SHE ALSO CONTINUED TO PARTICIPATE IN REGULAR DISCUSSIONS WITH THE REGION, INCLUDING THE CARLE EMERGENCY MANAGEMENT COMMITTEE, WORKING TOGETHER AND STANDING READY IF THE NEED OCCURS. BAD DEBT, MEDICARE, & COLLECTION PRACTICES (PART III, LINE 3) HOOPESTON COMMUNITY MEMORIAL HOSPITAL USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY. BAD DEBT FOOTNOTE (PART III, LINE 4) THE FOOTNOTE PERTAINING TO BAD DEBT EXPENSE CAN BE FOUND ON PAGE 28 OF THE ATTACHED CONSOLIDATED FINANCIAL STATEMENTS. EXPLANATION OF MEDICARE COST REPORT COSTING METHODOLOGY (PART III, LINE 8) THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE DESIGNED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. ILLINOIS LAW DEFINES GOVERNMENTAL-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID AND OTHER FEDERAL, STATE OR LOCAL INDIGENT CARE PROGRAMS. WHEN THERE IS A SHORTFALL, WE DO BELIEVE THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE STEPPING UP TO CARRY THE BURDEN OF THE GOVERNMENT, ASSURING CARE TO SENIORS, A DEMOGRAPHIC THAT HAS EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES. COLLECTION PRACTICES (PART III, LINE 9B) ONCE ALL APPLICABLE DISCOUNTS HAVE BEEN APPLIED TO QUALIFIED PATIENTS, WE MAKE EVERY ATTEMPT TO WORK WITH THE PATIENT TO SET UP PAYMENT ARRANGEMENTS ON THE REMAINING IN-HOUSE BALANCE DUE. OUR IN-HOUSE COLLECTORS WILL WORK WITH THE PATIENT TO SET UP A TEMPORARY/SHORT TERM PAYMENT ARRANGEMENT. IF A MUTUALLY ACCEPTABLE ARRANGEMENT CANNOT BE REACHED OR IF THEY ARE UNABLE TO MAKE PAYMENT ON THE REMAINING BALANCE AFTER THE FINANCIAL ASSISTANCE DISCOUNTS, THE BALANCE MAY BE LISTED WITH AN OUTSIDE COLLECTION AGENCY. THE MINIMUM NOTIFICATIONS ARE MONTHLY ITEMIZED STATEMENTS ON IN-HOUSE BALANCES. IF A PATIENT DOES NOT RESPOND TO US, THE ACCOUNT IS SENT A FINAL NOTICE LETTER AND REFERRED TO AN OUTSIDE COLLECTION AGENCY. HOOPESTON COMMUNITY MEMORIAL HOSPITAL WILL NOT FILE COLLECTION SUIT LIENS ON A PRIMARY RESIDENCE, NOR DO WE AUTHORIZE THE COLLECTION ATTORNEYS TO USE SO-CALLED BODY ATTACHMENTS. THE AGENCIES ARE AWARE OF OUR FINANCIAL ASSISTANCE PROGRAM AND HAVE BEEN ADVISED TO REFER THE PATIENTS BACK TO OUR IN-HOUSE COLLECTORS AND/OR PATIENT ACCOUNTS DEPARTMENT AT HOOPESTON COMMUNITY MEMORIAL HOSPITAL IF THEY DEEM THE PATIENT UNABLE TO PAY AND THE PATIENT HAS NOT ALREADY APPLIED OR BEEN APPOVED FOR CHARITY. WE THEN MAKE ONE MORE ATTEMPT TO WORK WITH THE PATIENT TO SEE IF HELP IS AVAILABLE. IF HOOPESTON COMMUNITY MEMORIAL HOSPITAL THEN DETERMINES THAT THE PATIENT MIGHT QUALIFY, WE SEND THE PATIENT A FINANCIAL ASSISTANCE APPLICATION AND PUT A HOLD ON THE ACCOUNT LISTED WITH THE AGENCY FOR AS LONG AS WE HAVE DETERMINED NECESSARY; THE AVERAGE IS 60 DAYS. IF THE PATIENT IS THEN APPROVED FOR DISCOUNTS AT 100% FOR FINANCIAL ASSISTANCE, THE BALANCE IS ADJUSTED AND THE ACCOUNT IS CLOSED. IF THEY ARE APPROVED FOR LESS THAN 100%, THE ADJUSTMENTS ARE REPORTED TO THE AGENCY TO COLLECT ANY REMAINING BALANCE.
2 - NEEDS ASSESSMENT	HOOPESTON COMMUNITY MEMORIAL HOSPITAL USED EXISTING DATA, INFORMAL DISCUSSIONS, AND A COMPREHENSIVE QUALITATIVE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) TO DETERMINE IF EXISTING PROGRAMS ARE ON TRACK; WHAT NEEDS TO BE ADDED, DELETED OR ENHANCED; AND WHERE OUR FOCUS NEEDED TO BE PLACED IN THE FUTURE. THE CHNA INCLUDED DISCUSSIONS WITH COMMUNITY LEADERS, INCLUDING HUMAN SERVICE AGENCY ADMINISTRATORS, PUBLIC HEALTH REPRESENTATIVES AND HOOPESTON COMMUNITY MEMORIAL HOSPITAL LEADERSHIP.
3 - PATIENT EDUCATION FOR ELIGIBILITY FOR ASSISTANCE	HOOPESTON COMMUNITY MEMORIAL HOSPITAL IS ACUTELY AWARE OF THE NEED FOR ACCESS TO CARE AND AS A RESULT, OFFERS A STRONG FINANCIAL ASSISTANCE PROGRAM THAT IS BASED IN A PHILOSOPHY OF DOING THE RIGHT THING FOR THE COMMUNITY AND PATIENTS AND BALANCED BY A CAREFUL STEWARDSHIP OF THE COMMUNITY'S RESOURCES. BY DETERMINING THE FINANCIAL STATUS OF PATIENTS UP-FRONT, WE HAVE BEEN ABLE TO PINPOINT THOSE NEEDING FINANCIAL ASSISTANCE EARLY IN THE PROCESS, MINIMIZING BAD DEBT AND OPTIMIZING OUR ABILITY TO HELP. STAFF IS ALSO DILIGENT IN FOLLOWING UP WITH PATIENTS DURING HOSPITALIZATION AND AFTER DISCHARGE IF THERE'S ANY REASON TO BELIEVE THE PATIENT COULD BENEFIT FROM FINANCIAL ASSISTANCE. HOOPESTON COMMUNITY MEMORIAL HOSPITAL HAS MADE A CONCERTED, CONTINUOUS EFFORT TO BE SURE THAT PEOPLE HAVE ACCESS TO INFORMATION THAT WILL HELP THEM WITH THEIR MEDICAL BILLS. THIS INCLUDES: - A SIMPLIFIED APPLICATION FORM THAT CLEARLY EXPLAINS PATIENT RIGHTS AND HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S EXPECTATIONS - INFORMATION ABOUT THE FINANCIAL ASSISTANCE PROGRAM ON ALL BILLING STATEMENTS, COLLECTION LETTERS AND HOSPITAL ADMISSION PACKETS - INFORMATION AND APPLICATION FORMS ARE READILY AVAILABLE AND ACCESSED AT WWW.CARLE.ORG/HOOPESTON - FINANCIAL ASSISTANCE APPLICATION FORMS AND BROCHURES ARE AVAILABLE AT ALL INPATIENT AND OUTPATIENT REGISTRATION POINTS, AS WELL AS IN THE HOSPITAL'S MAIN LOBBY - CONTINUOUSLY EDUCATING OUR STAFF TO KEEP THEM INFORMED ABOUT THE PROGRAM AND WHAT BENEFITS ARE AVAILABLE TO PATIENTS - FINANCIAL ASSISTANCE REPRESENTATIVES ARE AVAILABLE AT VARIOUS COMMUNITY FORUMS - SCREENING PATIENTS THROUGH OUR VENDOR FOR KEY FINANCIAL INDICATORS TO PRESUME ELIGIBILITY OR CONTACT REGARDING OUR ASSISTANCE PROGRAMS
4 - COMMUNITY INFORMATION	THE SERVICE AREA OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL IS DEFINED AS THE GEOGRAPHICAL BOUNDARY OF VERMILION COUNTY, ILLINOIS. WHILE SOME RESIDENTS OF SURROUNDING COUNTIES UTILIZE HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S SERVICES, OUR MOST RECENT CHNA TARGETED VERMILION COUNTY RESIDENTS, WHO MAKE UP 84% OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL PATIENTS. POCKETS OF EXTREME POVERTY EXIST THROUGHOUT THIS REGION, WITH RATES HIGHEST AROUND THE CITY OF DANVILLE. THE PROGRAMS WITHIN OUR COMMUNITY Health PLAN GENERALLY HAVE IMPACT UPON ALL THE TARGETED COMMUNITIES, WITH CERTAIN PROGRAMS DIRECTED AT SPECIFIC POPULATIONS.
5 - PROMOTION OF COMMUNITY HEALTH	HOOPESTON COMMUNITY MEMORIAL HOSPITAL HAS AN OPEN MEDICAL STAFF AND IS GOVERNED BY AN 11-MEMBER COMMUNITY BOARD THAT SERVES ON A VOLUNTEER BASIS, WITH 7 VOTING MEMBERS AND 4 NON-VOTING STAFF MEMBERS. SURPLUS FUNDS ARE REINVESTED INTO THE ORGANIZATION FOR TECHNOLOGY REPLACEMENT AND ADVANCEMENT, CLINICAL SERVICE EXPANSION AND QUALITY IMPROVEMENT. FUNDS ARE ALSO INVESTED INTO OUR COMMUNITIES TO MEET IDENTIFIED HEALTH NEEDS WHICH CONTRIBUTE TO THE OVERALL WELL-BEING OF THE RESIDENTS OF THE COMMUNITIES WE SERVE.
6 - AFFILIATED HEALTH CARE SYSTEM	HOOPESTON COMMUNITY MEMORIAL HOSPITAL IS A CRITICAL ACCESS HOSPITAL COMMITTED TO IMPROVING QUALITY OF LIFE IN NORTHERN VERMILION COUNTY AND THE SURROUNDING AREA. HOOPESTON COMMUNITY MEMORIAL HOSPITAL INTEGRATED WITH THE CARLE FOUNDATION IN 2012 TO PROVIDE MORE ACCESS TO PRIMARY AND SPECIALTY CARE. THOUGH HCMH FALLS UNDER THE UMBRELLA OF THE CARLE FOUNDATION, IT MAINTAINS A SEPARATE BOARD OF DIRECTORS AND SENIOR LEADERSHIP, AND CONDUCTED ITS OWN COMMUNITY HEALTH NEEDS ASSESSMENT AND IMPLEMENTATION PLAN IN 2013. WHILE HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S CHNA AND COMMUNITY BENEFIT REPORTING IS SEPARATE FROM CARLE FOUNDATION HOSPITAL, IT FOLLOWS THE SAME GUIDELINES AND PRINCIPLES AS CARLE. HOOPESTON COMMUNITY MEMORIAL HOSPITAL STAFF ARE INVOLVED IN THE CHNA AND IMPLEMENTATION PLAN, AND SERVE ON HUMAN SERVICES AGENCY BOARDS AND COMMITTEES TO PROVIDE SUPPORT TO HELP ADDRESS IDENTIFIED COMMUNITY NEEDS IN NORTHERN VERMILION COUNTY, INCLUDING CHILDREN'S HEALTH, TEEN AND ADOLESCENT HEALTH, ORAL HEALTH, CANCER AND DIABETES.
7 - STATE FILING OF COMMUNITY BENEFIT REPORT	AS A CRITICAL ACCESS HOSPITAL, HOOPESTON COMMUNITY MEMORIAL HOSPITAL IS NOT RESPONSIBLE FOR FILING A STATE COMMUNITY BENEFIT REPORT.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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
Joseph Barkmeier MD
Trustee	$0	$383,446	$0	$64,029	$0	$8,518	$0	$131,763	$0	$10,075	$0	$597,831	$0
Letha Kramer
Trustee	$0	$151,833	$0	$13,596	$0	$845	$0	$12,811	$0	$8,336	$0	$187,421	$0	$0
Harry Brockus
Ex-Officio Board, CEO	$187,744	$0	$26,049	$0	$1,269	$0	$48,427	$0	$20,208	$0	$283,697	$0	$0	$0
Dennis Hesch
Exec VP & CFO	$0	$574,941	$0	$123,194	$0	$179,890	$0	$182,686	$0	$21,515	$0	$1,082,226	$0	$152,969
Laurence Fallon
Exec VP-Legal Affairs & HR	$0	$473,396	$0	$81,195	$0	$93,251	$0	$138,667	$0	$20,634	$0	$807,143	$0	$88,905
Jay Colbert DO DPM
Ex-Officio Brd,CMO & Physician	$216,206	$0	$0	$0	$15,533	$0	$0	$0	$14,176	$0	$245,915	$0	$0	$0
Daniel Chase MD
Physician	$435,776	$0	$0	$0	$51,919	$0	$21,060	$0	$20,013	$0	$528,768	$0	$0	$0
William McCarthy MD
Physician	$229,435	$0	$0	$0	$48,642	$0	$19,524	$0	$1,936	$0	$299,537	$0	$0	$0
Albert Tanlim MD
Physician	$221,400	$0	$0	$0	$23,794	$0	$17,586	$0	$19,861	$0	$282,641	$0	$0	$0
Cortney Joneikis MD MS
Physician	$283,419	$0	$25,000	$0	$1,998	$0	$0	$0	$15,163	$0	$325,580	$0	$0	$0
Susan Berg MD
Physician	$257,047	$0	$25,000	$0	$8,074	$0	$0	$0	$5,494	$0	$295,615	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SUPPLEMENTAL COMPENSATION INFORMATION	FormAndLineReferenceDesc
Explanation	SCHEDULE J, PART I, QUESTION 3 THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF HCMH, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE. SCHEDULE J, PART I, QUESTION 4B PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF HCMH, THAT ARE LISTED IN THE 990 PART VII INCLUDE JOSEPH BARKMEIER, MD, HARRY BROCKUS, DENNIS HESCH, AND LAURENCE FALLON. IN 2014, PAYMENTS FROM THE 457(F) PLAN WERE MADE TO DENNIS HESCH ($152,969), AND LAURENCE FALLON ($88,905). SCHEDULE J, PART I, QUESTION 7 PART OF THE CEO'S COMPENSATION INCLUDES AN INCENTIVE COMPONENT WHICH IS DESIGNED TO ENCOURAGE AND PROMOTE THE ACHIEVEMENT OF CERTAIN QUALITY, OPERATIONAL, AND EFFICIENCY IMPROVEMENTS. ALTHOUGH THIS INCENTIVE COMPONENT IS BASED ON THE ORGANIZATION MEETING CERTAIN MINIMUM FINANCIAL THRESHOLDS, ALL PAYMENTS MUST BE APPROVED BY THE BOARD OF DIRECTORS PRIOR TO ANY INCENTIVE PAYOUT.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
ELIZABETH SILVER
FAMILY MEMB OF BOARD CHR	$60,735	EMPLOYMENT	false
SHAUN GILLINS
FAMILY MEMB OF BOARD CHR	$48,638	EMPLOYMENT	false
KIMBERLY S HOUMES
FAMILY MEMB OF TRUSTEE	$90,500	EMPLOYMENT	false
JONI HORNBECK
FAMILY MEMB OF TRUSTEE	$83,408	EMPLOYMENT	false
ABIGAIL COLBERT
FAMILY MEMB OF KEY EMP	$19,406	EMPLOYMENT	false

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, SUPPLEMENTAL INFORMATION	FORM 990, PART III, LINE 2 HOOPESTON COMMUNITY MEMORIAL HOSPITAL BEGAN OPERATING CLINICS IN TUSCOLA AND MATTOON DURING THE TAX YEAR PROVIDING PRIMARY CARE ACCESS TO RESIDENTS OF THOSE COMMUNITIES. REFER TO PART III, LINE 4A FOR A MORE DETAILED DESCRIPTION OF THESE SERVICES. FORM 990, PART VI, QUESTION 2 TRUSTEE, JOSEPH BARKMEIER, MD AND OFFICER, DENNIS HESCH HAD A BUSINESS RELATIONSHIP. FORM 990, PART VI, QUESTION 6 HOOPESTON COMMUNITY MEMORIAL HOSPITAL HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION.
FORM 990, PART VI, QUESTION 7A	HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES.
FORM 990, PART VI, QUESTION 7B	HOOPESTON COMMUNITY MEMORIAL HOSPITAL'S BOARD OF TRUSTEES MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF THE BY-LAWS; AMENDMENTS TO THE ARTICLES OF INCORPORATION; AUTHORIZING ANY NON-BUDGETED EXPENDITURE IN EXCESS OF $50,000 (THE EXCESS OF ANY PROPOSED EXPENDITURE OVER THE PREVIOUSLY APPROVED BUDGETED AMOUNT SHALL BE DEEMED A NON-BUDGETED EXPENDITURE); TO ADOPT ANY NEW OR ANY CHANGES TO EXISTING LONG TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; TO ORGANIZE OR ACQUIRE, OR TO AUTHORIZE OR APPROVE THE ORGANIZATION'S ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; THE AUTHORIZATION TO ENTER INTO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION OR ACTIVITY WHICH REQUIRES APPLICATION TO THE ILLINOIS HEALTH FACILITIES PLANNING BOARD FOR A PERMIT OR CERTIFICATE OF NEED AND FOR RECOMMENDING THE CEO OF THE CORPORATION TO THE HOOPESTON BOARD OF TRUSTEES.
FORM 990, PART VI, QUESTION 11B	THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY. AT THEIR DISCRETION, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS.
FORM 990, PART VI, QUESTION 12C	THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE HUMAN RESOURCES DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON MATTERS RELATED TO THEIR CONFLICTS. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH CONFLICTS OF INTEREST.
FORM 990, PART VI, QUESTIONS 15A & 15B	THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO OF THE CARLE FOUNDATION, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE.
FORM 990, PART VI, QUESTIONS 18 & 19	THE CARLE FOUNDATION, THE SOLE MEMBER OF HOOPESTON COMMUNITY MEMORIAL HOSPITAL, PUBLISHES THROUGH WWW.DACBOND.COM ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, ANNUAL AUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THIS WEBSITE. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE. IN ADDITION, THE FORM 990S OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND. QUARTERLY FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES.
FORM 990, PART VII, SECTION A, COLUMN B	THE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40 HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK.
FORM 990, PART XI, 8	$59,674 REVERSAL OF PRIOR YEAR REAL ESTATE TAX ACCRUAL.
FORM 990, PART XI, LINE 9	PERMANANTLY RESTRICTED ASSETS INCREASED AS A RESULT OF A CHANGE IN VALUE OF THE BENEFICIAL INTEREST IN A PERPETUAL TRUST OF $13,432. TEMPORARILY RESTRICTED ASSETS INCREASED BY $471 RESULTING FROM CHANGES IN THE POLAND TRUST ACCOUNT WHICH IS A TEMPORARILY RESTRICTED FUND USED TO PROVIDE TUITION ASSITANCE FOR NURSING STUDENTS.
FORM 990, PART XII, LINES 2A, B, C AND PART IV, LINES 12A & 12B	THE FINANCIAL STATEMENTS FOR HOOPESTON COMMUNITY MEMORIAL HOSPITAL WERE REVIEWED ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION DOES HAVE AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
THE CARLE FOUNDATION HOSPITAL
611 W PARK ST	URBANA	IL	618012595	371119538	HOSPITAL SERV	IL	501(c)(3)	3	TCF	Yes (true)
THE CARLE FOUNDATION
611 W PARK ST	URBANA	IL	618012595	370673465	PARENT/INVMGT	IL	501(c)(3)	11b TYPE II	NA	false
CARLE HEALTH CARE INCORPORATED
611 W PARK ST	URBANA	IL	618012595	371140016	VAR MED SVCS	IL	501(c)(3)	9	TCF	Yes (true)
CARLE RETIREMENT CENTERS INC
611 W PARK ST	URBANA	IL	618012595	371160033	RTRMT LIVING	IL	501(C)(3)	9	TCF	Yes (true)
THE CARLE DEVELOPMENT FOUNDATION
611 W PARK ST	URBANA	IL	618012595	371159978	FUNDRAISING	IL	501(c)(3)	7	TCF	Yes (true)
CARLE COMMUNITY HEALTH CORPORATION
611 W PARK ST	URBANA	IL	618012595	364458371	FNDN MISSION	IL	501(c)(3)	11a TYPE I	TCDF	Yes (true)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	CHAMPAIGN SURGICENTER LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	611 W PARK ST	AddressLine1Txt
City	URBANA	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	618012595	ZIPCd

Field	Value	IRS element (for citing)
EIN	201915925	EIN
Primary Activities	SURGICAL CENT	PrimaryActivitiesTxt
Legal Domicile State	IL	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Predominant Income Type	N/A	PredominantIncomeTypeTxt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)

Address Line1ForeignAddress/AddressLine1Txt	CityForeignAddress/CityNm	CountryForeignAddress/CountryCd	Foreign PostalForeignAddress/ForeignPostalCd	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile Foreign CountryLegalDomicileForeignCountryCd	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Entity TypeEntityTypeTxt	Controlled OrganizationControlledOrganizationInd	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Legal Domicile StateLegalDomicileStateCd
HEALTH SYSTEMS INSURANCE LIMITED
GOVERNORS SQ 2ND FL BLDG 3	GRAND CAYMAN	CJ	KY1-1102	INSURANCE	CJ	NA	C Corp	Yes (true)
CARLE HOLDING COMPANY INC
				HOLDING COMPA		NA	C Corp	Yes (true)	611 W PARK ST	URBANA	IL	618012595	371188284	IL
CARLE RISK MANAGEMENT COMPANY
				RISK MANAGEMENT		NA	C Corp	Yes (true)	611 W PARK ST	URBANA	IL	618012595	371217973	IL
EVALIDATA INC
				PHYS CREDENTI		NA	C Corp	Yes (true)	611 W PARK ST	URBANA	IL	618012595	462022658	IL
HEALTH ALLIANCE CONNECT INC
				HEALTH CARE C		NA	C Corp	Yes (true)	301 S VINE ST	URBANA	IL	61801	464796891	IL
HEALTH ALLIANCE MEDICAL PLANS INC
				HEALTH COVERAGE		NA	C CORP	Yes (true)	301 S VINE ST	URBANA	IL	61801	371260731	IL
CHA HOLDING INC
				HOLDING COMPANY		NA	C CORP	Yes (true)	301 S VINE ST	URBANA	IL	61801	471854275	IL
HEALTH ALLIANCE NORTHWEST HOLDING INC
				HOLDING COMPANY		NA	C CORP	Yes (true)	820 N CHELAN AVE	WENATCHEE	WA	98801	461717578	WA
HEALTH ALLIANCE NORTHWEST HEALTHPLAN INC
				HEALTH COVERAGE		NA	C CORP	Yes (true)	820 N CHELAN AVE	WENATCHEE	WA	98801	461966323	WA
HEALTH ALLIANCE MIDWEST INC
				HEALTH COVERAGE		NA	C CORP	Yes (true)	301 S VINE ST	URBANA	IL	61801	371354502	IL

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	Yes (true)	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	Yes (true)	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	Yes (true)	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (5 entries)

Transaction TypeTransactionTypeTxt	InvolvedInvolvedAmt	Method Of Amount DeterminationMethodOfAmountDeterminationTxt
HEALTH ALLIANCE MEDICAL PLANS INC
L	$7,844,544	Book Value
CARLE HEALTH CARE INCORPORATED
M	$5,274,037	Book Value
CARLE HEALTH CARE INCORPORATED
H	$594,419	Book Value
HEALTH SYSTEMS INSURANCE LIMITED
M	$81,307	Book value
THE CARLE FOUNDATION HOSPITAL
M	$164,350	BOOK VALUE