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BLESSING HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
BLESSING HOSPITAL (EIN 37-0661183)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-13
IRS object ID
201422259349301577
Schema version
2012v2.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-13T09:45:07-07:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Gray Hunter Stenn LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1500 Maine StreetAddressLine1
CityQuincyCity
StateILState
ZIP Code62301ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN370661183EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1BLESSING HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlBLESNameControl
Phone2172231200Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11005 BROADWAYAddressLine1
CityQUINCYCity
StateILState
ZIP Code62301ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMAUREEN KAHNName
TitlePresidentTitle
Date Signed2014-08-13DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSTEPHEN C KOESTER CPAName
PTINP00342386PTIN
Phone2172220304Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts410068489GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.blessinghealthsystem.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1875YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionBlessing Hospital's mission is to provide high quality, accessible health care showing compassion and respect to those we serve.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees2711TotalNbrEmployees
Total Nbr Volunteers801TotalNbrVolunteers
Total Gross UBI1299297TotalGrossUBI
Net Unrelated Business Txbl Income-487556NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year5379936ContributionsGrantsPriorYear
Contributions Grants Current Year7812497ContributionsGrantsCurrentYear
Program Service Revenue Prior Year294475665ProgramServiceRevenuePriorYear
Program Service Revenue CY305258022ProgramServiceRevenueCY
Investment Income Prior Year3199876InvestmentIncomePriorYear
Investment Income Current Year4261487InvestmentIncomeCurrentYear
Other Revenue Prior Year9738053OtherRevenuePriorYear
Other Revenue Current Year8923758OtherRevenueCurrentYear
Total Revenue Prior Year312793530TotalRevenuePriorYear
Total Revenue Current Year326255764TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1467722GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2040637GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year139042142SalariesEtcPriorYear
Salaries Etc Current Year145307757SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year138158415OtherExpensePriorYear
Other Expenses Current Year137329435OtherExpensesCurrentYear
Total Expenses Prior Year278668279TotalExpensesPriorYear
Total Expenses Current Year284677829TotalExpensesCurrentYear
Revenues Less Expenses Prior Year34125251RevenuesLessExpensesPriorYear
Revenues Less Expenses CY41577935RevenuesLessExpensesCY
Total Assets BOY363145586TotalAssetsBOY
Total Assets EOY382927402TotalAssetsEOY
Total Liabilities BOY214615775TotalLiabilitiesBOY
Total Liabilities EOY181540921TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY148529811NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY201386481NetAssetsOrFundBalancesEOY
Mission DescriptionBlessing Hospital's mission is to provide high quality, accessible health care showing compassion and respect to those we serve.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense225040705Expense
Grants2040637Grants
Revenue326890828Revenue
DescriptionSINCE IT WAS FOUNDED IN 1875, Blessing Hospital HAS PROVIDED quality health care services to ALL patients regardless of race, sex, national origin, age or ability to pay. In serving all members of its community, Blessing Hospital CONTINUES THIS TRADITION BY PROVIDING free/subsidized care, care to persons covered by governmental programs at less than full charges, and community health/education/wellness programs. For fiscal year 2013, the cost of charity care provided was $8,097,468. Medicare and Medicaid shortfalls were $38,645,122 and $2,076,264, respectively. Blessing Hospital serviced 13,322 inpatients and 65,925 emergency department patients. Outpatient services included 327,402 laboratory exams and 80,477 radiology procedures.Blessing Hospital provided ADDITIONAL benefits of $10,137,436 to the community DURING FISCAL YEAR 2013 as follows:Health Professionals Education SIU Residency Program $2,835,946 Blessing-Rieman College of Nursing $1,707,602 NURSING EDUCATIONAL PreceptorS $ 711,549 SCHOOL OF RADIOLOGIC TECHNOLOGY $ 250,447 SCHOOL OF MEDICAL LABORATORY TECHNICIANS $ 96,962 SUB Total Health Professionals education $5,602,506Community Health Improvement Services COMMUNITY OUTREACH CLINIC $ 831,258 SIU PATIENT CENTERED MEDICAL HOME $ 213,750 ADAMS COUNTY HEALTH DEPARTMENT DENTAL PROGRAM $ 70,000 Health Screenings/Tests $ 39,063 Educational Programs $ 63,703 Patient Transportation $ 52,729 CHARITY PHARMACY PRESCRIPTIONS $ 16,862 Medical Supplies/Services for Patients $ 48,826 MEDICAL INTERPRETING SERVICES $ 4,985 SUB Total community health improvement serviceS $1,408,681Subsidized Health Services Home Healthcare SERVICES $1,229,800 CARE COORDINATION $1,053,136 HOSPICE $ 182,277 BLESSING FAST CARE $ 300,854 SUB TOTAL SUBSIDIZED HEALTH SERVICES $2,766,067In-Kind Contributions/Donations Donations/Sponsorships $ 143,393 MEETING SPACE $ 77,064 Adams County Ambulance Service $ 70,775 COMMUNITY OUTREACH CLINIC $ 68,950 SUB Total in-kind contributions/donations $ 360,182Description
Total Program Service Expense225040705TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiestrueReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096182NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2711NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTIMOTHY MOORENamePerson
Telephone Number2172238400TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1BROADWAY AT 11TH PO BOX 7005AddressLine1
CityQUINCYCity
StateILState
ZIP Code62305ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (23 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
HARRY RUTH MD
Trustee1.000.00X000
B BRADFORD BILLINGS
Trustee1.0039.00X0821440477102
CHRISTOPHER J NIEMANN
Trustee1.000.00X000
MAUREEN A KAHN
PRESIDENT/CEO40.000.00X472834069496X
DENNIS GO MD
Trustee1.000.00X3837800
THOMAS H MILLER MD
Chairman1.000.00X000X
TIMOTHY KOONTZ
Trustee1.000.00X000X
MICHAEL J FOSTER
Trustee1.000.00X000
MICHAEL D KLINGNER
Trustee1.000.00X000
ABBY REICH MD
Trustee1.0039.00X017529016954
DAVID BOSTER
VICE CHAIRMAN1.000.00X000
MICHAEL HULSEN
Trustee1.000.00X000
JEAN A DISSELER MD
Trustee1.000.00X220000
PHIL CONOVER
Trustee1.000.00X000
TIMOTHY A MOORE
SECRETARY/CAO40.000.00226074083877X
PATRICK M GERVELER
Treasurer1.0039.00038907259743X
GEORGE E LIESMANN
CMO40.000.0017433905955X
JILL MASON
CNO40.000.002375880144494X
STUART L PYATT DO
PHYSICIAN40.000.00676483067101X
RICHARD A SAALBORN DO
PHYSICIAN40.000.00644074075816X
THOMAS A CLIATT DO
PHYSICIAN40.000.00566443060247X
JAMES B KASE MD
PHYSICIAN40.000.00582497023622X
ANTONY S WOLLASTON MD
PHYSICIAN40.000.00565176023085X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4186086TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1385802TotalReportableCompFrmRltdOrgs
Total Other Compensation1107492TotalOtherCompensation
Number Individuals GT100 K67NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WEST CENTRAL PATHOLOGY SPECIALISTS SC
4000 CATAMARAN CTQUINCYIL62301PATHOLOGY SERVICES2328703
QUINCY ANESTHESIA ASSOCIATES PC
BROADWAY AT 11THQUINCYIL62301ANESTHESIA SERVICES8322431
DELOITTE CONSULTING LLP
PO BOX 7247-6447PHILADELPHIAPA191706447CONSULTING SERVICES2996343
CHRISTNER INC
PO BOX 790379ST LOUISMO63179ENGINEERING SERVICES1875923
ALLSCRIPTS HEALTHCARE
PO BOX 8538-0133PHILADELPHIAPA191710133INFORMATION TECHNLGY2195174
FieldValueIRS element (for citing)
Number Of Contractors GT100 K50NumberOfContractorsGT100K
Related Organizations5151114RelatedOrganizations
Government Grants1236696GovernmentGrants
All Other Contributions1424687AllOtherContributions
Total Contributions7812497TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
PHYSICAL THERAPY621400371581371581
PATIENT REVENUE621110776194891776194891
LESS: CONTRACT ALLOW621110-443396401-443396401
LESS: CHARITY CARE621110-31262535-31262535
COLLEGE OF NURSING6116003350486$3,350,486
FieldValueIRS element (for citing)
Total Program Service Revenue305258022TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1774399TotalRevenueColumn
Exclusion$1,774,399ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1019450Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1019450Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1019450TotalRevenueColumn
Exclusion$1,019,450ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities85664749Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities83177661Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2487088Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2487088TotalRevenueColumn
Related Or Exempt Function Income2487088RelatedOrExemptFunctionIncome

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory1934361GrossSalesOfInventory
Cost Of Goods Sold635064CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1299297TotalRevenueColumn
Unrelated Business Revenue1299297UnrelatedBusinessRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
SALE OF FOOD7222101412433$1,412,433
OTHER9000992825783$2,825,783
CHILD CARE CENTER6244101482188$1,482,188

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column884607TotalRevenueColumn
Exclusion$884,607ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue6605011TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column326255764TotalRevenueColumn
Related Or Exempt Function Income304394624RelatedOrExemptFunctionIncome
Unrelated Business Revenue1299297UnrelatedBusinessRevenue
Exclusion$12,749,346ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total1705372Total
Program Services1705372ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total335265Total
Program Services335265ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1644870Total
Program Services1336864ProgramServices
Management And General308006ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total103616094Total
Program Services84213704ProgramServices
Management And General19402390ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total9842726Total
Program Services7999649ProgramServices
Management And General1843077ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total23471340Total
Program Services19076269ProgramServices
Management And General4395071ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total6732727Total
Program Services5472006ProgramServices
Management And General1260721ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total6984249Total
Management And General6984249ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total210361Total
Management And General210361ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total113025Total
Program Services10626ProgramServices
Management And General102399ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total461387Total
Management And General461387ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total23172193Total
Program Services20841690ProgramServices
Management And General2330503ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total541155Total
Program Services541155ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3773813Total
Program Services1792448ProgramServices
Management And General1981365ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total685270Total
Program Services377146ProgramServices
Management And General308124ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total189495Total
Program Services90836ProgramServices
Management And General98659ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2498966Total
Program Services2031028ProgramServices
Management And General467938ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total14359466Total
Program Services8261001ProgramServices
Management And General6098465ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1540577Total
Program Services866364ProgramServices
Management And General674213ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
EQUIP RENTAL AND MAINTENAN460704430953271511717
SOFTWARE703828535849893453296
BAD DEBT EXPENSE2273573322735733
SUPPLIES38210297366750871535210

All Other Expenses AllOtherExpenses

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Total10208119Total
Program Services3998146ProgramServices
Management And General6209973ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total284677829Total
Program Services225040705ProgramServices
Management And General59637124ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY67929743BOY
EOY66885231EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

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EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
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Accounts Receivable AccountsReceivable

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BOY58109979BOY
EOY55871523EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

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EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY6374352BOY
EOY5947157EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3411772BOY
EOY4539970EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis335652685LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec204300732LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY108468772BOY
EOY131351953EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY76523855BOY
EOY68802910EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY23584606BOY
EOY28424253EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY18742507BOY
EOY21104405EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY363145586BOY
EOY382927402EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY33553609BOY
EOY30386556EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY69411735BOY
EOY65885584EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

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BOY11122232BOY
EOY10427999EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY100528199BOY
EOY74840782EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY214615775BOY
EOY181540921EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

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BOY143819887BOY
EOY197833258EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY3012651BOY
EOY1855950EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1697273BOY
EOY1697273EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY148529811BOY
EOY201386481EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY363145586BOY
EOY382927402EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses41577935ReconcilationRevenueExpenses
Reconciliation Unrealized Invest2235047ReconciliationUnrealizedInvest
Reconcilation Other Changes9043688ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement BothXFinancialStatementBoth
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1844729BeginningOfYearBalance
Investment Earnings Or Losses-36194InvestmentEarningsOrLosses
End Of Year Balance1808535EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance560920BeginningOfYearBalance
Contributions60036Contributions
Investment Earnings Or Losses1223773InvestmentEarningsOrLosses
End Of Year Balance1844729EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance568392BeginningOfYearBalance
Investment Earnings Or Losses-5502InvestmentEarningsOrLosses
Other Expenditures1970OtherExpenditures
End Of Year Balance560920EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance555077BeginningOfYearBalance
Investment Earnings Or Losses14824InvestmentEarningsOrLosses
Other Expenditures1509OtherExpenditures
End Of Year Balance568392EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Contributions80883Contributions
Grants Or Scholarships15464GrantsOrScholarships
Administrative Expenses555077AdministrativeExpenses
End Of Year Balance555077EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.93850PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.06150TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis12869734OtherCostOrOtherBasis
Book Value12869734BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis141448769OtherCostOrOtherBasis
Depreciation90118719Depreciation
Book Value51330050BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis6558947OtherCostOrOtherBasis
Depreciation4640555Depreciation
Book Value1918392BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis174775235OtherCostOrOtherBasis
Depreciation109541458Depreciation
Book Value65233777BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings131351953TotalOfBookValueLandBuildings
Total Of Book Value Securities28424253TotalOfBookValueSecurities

Other Assets OtherAssets (5 entries)

DescriptionDescriptionBook ValueBookValue
OTHER RECEIVABLES4821704
INTEREST RECEIVABLE155106
INTEREST IN NET ASSETS OF FOUNDATION4602273
INSURANCE RECOVERY RECEIVABLE2192951
GOODWILL9332371
FieldValueIRS element (for citing)
Total Book Value Other Assets21104405TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (16 entries)

DescriptionDescriptionAmountAmount
PREMIUM ON LONG TERM DEBT$556,905
OTHER LONG TERM LIABILITY$6,863,928
MOB III BUILD OUT$1,967,081
MOB CARDIO REHAB LEASE$118,427
MOB BLOOD DRAW LEASE$112,950
MAMMOGRAPHY FURNITURE LEASE$26,552
HILL-ROM LEASE$129,447
ESTIMATED 3RD-PARTY PAYOR SETTLEMENTS$9,695,878
DEFERRED COMPENSATION$4,865,933
DA VINCI ROBOT LEASE$538,528
CATH LAB 1$192,075
ADVANCES AND DEFERRED REVENUE$2,213,793
ACCRUED SALARIES & WAGES$16,903,776
ACCRUED PENSION COSTS$29,461,602
ACCRUED PAYROLL TAXES$536,378
ACCRUED INTEREST$657,529
FieldValueIRS element (for citing)
Total Of Amounts74840782TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt294422204TotRevenueEtcAuditedFinclStmt
Other Revenues-20361208OtherRevenues
Revenue Not Rptd F990-20361208RevenueNotRptdF990
Revenue Subtotal314783412RevenueSubtotal
Other Revenues Not Included11472352OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt11472352RevenueNotRptdOnFinStmt
Total Revenue Per Form990326255764TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt263811781TotExpensesEtcAuditedFinclStmt
Other Expenses Included2331072OtherExpensesIncluded
Expenses Not Rptd F9902331072ExpensesNotRptdF990
Expenses Subtotal261480709ExpensesSubtotal
Investment Expenses Not Included2461387InvestmentExpensesNotIncluded2
Other Expenses Not Included22735733OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt23197120ExpensesNotRptdOnFinStmt
Total Expenses Per Form990284677829TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 4bPart XII, Line 4b: Other revenue amounts included on 990 but not included in F/SBAD DEBT REDUCTION OF REVENUE ON F/S $22735733
Part XII, Line 2dPart XII, Line 2d: Other expenses and losses per audited F/SLIABILITY CLAIMS RPTD ON SEPARATE 990 $1696008 COGS INCLUDED IN EXPENSES ON F/S $635064
Part XI, Line 4bPart XI, Line 4b: Other revenue amounts included on 990 but not included in F/SCOGS INCLUDED IN EXPENSES ON F/S $635064 TEMPORARILY RESTRICTED CONTRIBUTIONS $6575801 PERMANENTLY RESRTICTED CONTRIBUTIONS $0 INVESTMENT INCOME $1774399 REALIZED GAINS ON SECURITIES AND ASSETS $2487088
Part V, Line 4Part V, Line 4: Intended uses of the endowment fund.ENDOWMENT FUNDS ARE TO BE USED FOR THE GENERAL SUPPORT AND OPERATIONS OF BLESSING HOSPITAL.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage250.000000000FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense8097468TotalCommunityBenefitExpense
Net Community Benefit Expense8097468NetCommunityBenefitExpense
Percent Of Total Expense0.03090PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense39074467TotalCommunityBenefitExpense
Direct Offsetting Revenue36998203DirectOffsettingRevenue
Net Community Benefit Expense2076264NetCommunityBenefitExpense
Percent Of Total Expense0.00790PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense47171935TotalCommunityBenefitExpense
Direct Offsetting Revenue36998203DirectOffsettingRevenue
Net Community Benefit Expense10173732NetCommunityBenefitExpense
Percent Of Total Expense0.03880PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1408681TotalCommunityBenefitExpense
Direct Offsetting Revenue5991DirectOffsettingRevenue
Net Community Benefit Expense1402690NetCommunityBenefitExpense
Percent Of Total Expense0.00540PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense5602506TotalCommunityBenefitExpense
Net Community Benefit Expense5602506NetCommunityBenefitExpense
Percent Of Total Expense0.02140PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense15519660TotalCommunityBenefitExpense
Direct Offsetting Revenue12753593DirectOffsettingRevenue
Net Community Benefit Expense2766067NetCommunityBenefitExpense
Percent Of Total Expense0.01050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense360182TotalCommunityBenefitExpense
Net Community Benefit Expense360182NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense22891029TotalCommunityBenefitExpense
Direct Offsetting Revenue12759584DirectOffsettingRevenue
Net Community Benefit Expense10131445NetCommunityBenefitExpense
Percent Of Total Expense0.03870PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense70062964TotalCommunityBenefitExpense
Direct Offsetting Revenue49757787DirectOffsettingRevenue
Net Community Benefit Expense20305177NetCommunityBenefitExpense
Percent Of Total Expense0.07750PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense80928TotalCommunityBuildingExpense
Net Community Building Expense80928NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense80928TotalCommunityBuildingExpense
Net Community Building Expense80928NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$22,735,733BadDebtExpenseAmount
Amount Attributable To1061759AmountAttributableTo
Amount Reimbursed By Medicare89707277AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare98564946CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-8857669MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CarefalseProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivityOrganization Profit Or OwnershipOrganizationProfitOrOwnership
LINCOLN LAND HEALTH EXCHNGE
INFORMATION EXCHANGE0.27000
ADVANCE LLC
PHYSICAL THERAPY SERVICES0.17000
FieldValueIRS element (for citing)
Number Of Hospital Facilities2NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)

Facility NumberFacilityNumberAddress Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalTeaching HospitalTeachingHospitalResearch FacilityResearchFacilityFacility Reporting GroupFacilityReportingGroupEr24 HoursEr24Hours
BLESSING HOSPITAL AT 14TH ST
2BROADWAY AT 14TH STQUINCYIL62301XXXXA
BLESSING HOSPITAL AT 11TH ST
1BROADWAY AT 11TH STQUINCYIL62301XXXXAX

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ABusinessNameLine1
FieldValueIRS element (for citing)
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Identifying ProcessXIdentifyingProcess
OtherXOther
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccountfalseTakeIntoAccount
Other FacilitiesfalseOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
File Form4720 Report Excise TaxfalseFileForm4720ReportExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent250.0000FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.0000FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities9NumberOfOtherFacilities

Other Facilities OtherFacilities (9 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
DENMAN COUNTRY DRUGS
102 PRAIRIE MILLS ROADGOLDENIL62339PHARMACY WITHIN RURAL HEALTH CLINIC
EAST ADAMS COUNTY RURAL HEALTH CLINIC
102 PRAIRIE MILLS ROADGOLDENIL62339RURAL HEALTH CLINIC
BLESSING HOSPICE - PIKE COUNTY
967 WEST WASHINGTONPITTSFIELDIL62363FULL HOSPICE PROGRAM IN ILLINOIS
BLESSING HOSPICE - HANCOCK COUNTY
71 SOUTH ADAMSCARTHAGEIL62321FULL HOSPICE PROGRAM IN ILLINOIS
BLESSING HOSPICE - GREENE COUNTY
330 5TH STREETCARROLTONIL62016FULL HOSPICE PROGRAM IN ILLINOIS
BLESSING HOSPICE & PALLIATIVE CARE
BROADWAY AT 14TH STREETQUINCYIL62301FULL HOSPICE PROGRAM IN ILLINOIS
BLESSING HOME CARE - PALMYRA
6996 COUNTY ROAD 326PALMYRAMO63461HOME HEALTH AGENCY IN MISSOURI
BLESSING HOME CARE
BROADWAY AT 14TH STREETQUINCYIL62301HOME HEALTH AGENCY IN ILLINOIS
BLESSING AMBULATORY SURGERY CENTER
1118 HAMPSHIRE STREETQUINCYIL62301AMBULATORY SURGICAL TREATMENT CENTER

Form990 Schedule H Part VI Form990ScheduleHPartVI (21 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part VI - Additional InformationBLESSING HOSPITAL'S COMMUNITY BENEFIT REPORT IS PRESENTED TO THE COMMUNITY AS A SUPPLEMENT IN THE QUINCY HERALD-WHIG ONCE A YEAR. IT IS ALSO PLACED IN LITERATURE RACKS AROUND THE HOSPITAL CAMPUS. ILLINOIS IS THE ONLY STATE IN WHICH THE COMMUNITY BENEFIT REPORT IS PUBLISHED.
Part V - Explanation of Number of Facility TypeBLESSING HOSPITAL OPERATES NO FACILITIES OTHER THAN THE LOCATIONS LISTED IN PART V.
Part VI - States Where Community Benefit Report FiledIL
Part VI - Affilated Health Care System Roles and PromotionBlessing Corporate Services, Inc. is the parent organization of a group of related organizations and provides overall direction to all entities within the structure. During the year ended September 30, 2005, Blessing Corporate Services, Inc. began operating a division comprised of practicing physicians. The Group is related through Board control. The following is a brief description of each member of the Group.Organization - Blessing Hospital (Hospital), located in Quincy, Illinois, is a not-for-profit acute care hospital. The Hospital provides inpatient, outpatient and emergency care services for residents of Western Illinois and Northeastern Missouri. The Hospital was incorporated in Illinois in 1875.Organization - The Blessing Foundation, Inc. serves Blessing Corporate Services and its affiliated entities by providing financial support for services and programs promoting the improvement and availability of healthcare services within the general community.Organization - Denman Services, Inc. (a taxable corporation) engages primarily in the business of selling and renting medical equipment and operating a commercial laundry. Denman Services, Inc. is a wholly owned subsidiary of Blessing Corporate Services, Inc.Organization - BlessingCare Corporation dba Illini Community Hospital and Subsidiary, located in Pittsfield, Illinois, is a not-for-profit acute care hospital. The Hospital provides inpatient, outpatient and emergency care services for residents of Western Illinois. The Hospital was incorporated on January 20, 2000. For financial reporting purposes, the Hospital's financial information is consolidated with West Central Illinois Therapy & Sports Medicine, LLC. The Hospital has a 51% partnership interest in West Central Illinois Therapy & Sports Medicine, LLC, and the outside investor's 49% interest in the partnership is included as a minority interest. THIS PARTNERSHIP WAS DISSOLVED IN FY2013.Organization - Illini Health Services, LLC conducts a pharmacy business in Pittsfield, Illinois. The Pharmacy is owned ninety-five percent (95%) by Denman Services, Inc. and five percent (5%) by BlessingCare Corporation dba Illini Community Hospital.
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeBlessing Hospital offers a wide range of specialty services important to promoting the health and well-being of Adams County and the surrounding area. Included in these are the Cancer Center, the Heart and Vascular Center, the Breast Center, psychiatric services, and Hospice and Home Care programs. Surplus funds generated from these operations, as well as the operations of all other Blessing Hospital Services, are used to fund capital expenditures and the expansion of health care service lines to the community we serve. Blessing Hospital operates an emergency room available to all regardless of the ability to pay. The financial assistance policy of Blessing Hospital enables patients to have access to area resources to assist them with payment of medical expenses. Blessing Hospital operates the Blessing-Rieman College of Nursing, which offers a Bachelor of Science in Nursing degree and a Master of Science in Nursing degree, along with other programs. The college has a 100 year history in the community and is currently accredited by the Higher Learning Commission.Blessing Hospital is the largest employer in the area with 2,277 employees. Of significant importance are the volunteers who serve the Hospital. In Fiscal Year 2013, Blessing Hospital had 801 active volunteers who served for a total of 74,301 hours. In addition to the volunteers actively working in the hospital, Blessing's Board of Trustees is comprised of volunteers that include business leaders, physicians, and other community leaders.
Part VI - Community Building ActivitiesIN PARTNERSHIP WITH THE ALLIANCE FOR BUILDING COMMUNITY, BLESSING HOSPITAL PROVIDES FUNDS TO PAY FOR THE POSITION OF THE DIRECTOR OF COMMUNITY IMPACT, A KEY INDIVIDUAL IN THE COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT.
Part VI - Community InformationFor 137 years, Blessing Hospital has served the health care needs of the people of west central Illinois, northeast Missouri and southeast Iowa. Approximately 227,000 people live within a 50 mile radius of Blessing Hospital. The Hospital's primary market area covers six counties-four in west central Illinois (Adams, Brown, Hancock and Pike) and two in northeast Missouri (Marion and Lewis). The region's economy is heavily agricultural, with a mix of approximately 100 manufacturers in addition to commercial/retail business making up the rest of the local economy. Blessing Hospital is the largest employer in its region. Quincy, ILLINOIS - the city in which the main Blessing Hospital campus is located - is the hub of non-farm employment and retail trade in the market area. THE PERCENTAGE OF TOTAL POPULATION IN POVERTY IN BLESSING'S PRIMARY MARKET AREA COUNTIES ARE: PIKE, IL - 16.1%; ADAMS, IL - 12.4%; BROWN, IL - 16.3%; AND HANCOCK, IL - 13.1%. IN MISSOURI, LEWIS - 16.1% AND MARION - 17.5%.ACROSS THE SIX COUNTIES IN BLESSING'S PRIMARY MARKET AREA, THE AVERAGE ADULT OBESITY IS FIVE PERCENT HIGHER THAN THE NATIONAL AVERAGE. THE PERCENTAGE OF CHILDREN LIVING IN POVERTY RANGED FROM 16% TO 25% ACROSS THE PRIMARY MARKET AREA AND THE AVERAGE PERCENTAGE OF PEOPLE 65 YEARS AND OLDER IS NEARLY FIVE PERCENT HIGHER THAN THE ILLINOIS AVERAGE AND ONE AND A HALF TIMES HIGHER THAN THE MISSOURI AVERAGE.
Part VI - Patient Education of Eligibility for AssistanceAll Blessing Hospital self-pay inpatients are contacted by a Financial Account Specialist (FAS) within 24 hours of admission. The patient is screened for government programs or eligibility for participation in our Community Outreach Clinic or Access Health Adams County. Outpatients are contacted once the patient's condition has been stabilized and are screened in the same manner as inpatients. If a FAS is not available to meet with a patient at an appropriate time, the patient is given contact information and asked to call if assistance is needed.
Part VI - Needs AssessmentBlessing Hospital HAS workED in partnership with the community public health department, the local United Way agency and other area agencies in conducting a needs assessment. THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN MAY 2012.
Part V, Line 14g - Other Means Hospital Facility Publicized the PolicyTHE BILLING INVOICE INCLUDES A STATEMENT INDICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE AND WHO TO CONTACT IN THE ORGANIZATION.Number of Hospital Faciltiy - 1
Part V, Line 7 - Explanation of Needs Not Addressed and Reasons WhyTHE FOLLOWING NEEDS IDENTIFIED IN THE MOST RECENTLY CONDUCTED CHNA WERE NOT ADDRESSED BY BLESSING HOSPITAL BECAUSE THEY ARE BEING ADDRESSED BY OTHER PARTNER ORGANIZATIONS:1) SUBSTANCE ABUSE2) NUTRITION & WEIGHT STATUS AND PHYSICAL ACTIVITY3) MATERNAL, INFANT & CHILD HEALTH4) ENVIRONMENTAL HEALTHNumber of Hospital Faciltiy - 1
Part V, Line 1j - Description of Other Needs AssessmentOTHER INFORMATION DESCRIBED IN BLESSING HOSPITAL'S CHNA REPORT IS AS FOLLOWS:1) THE MAPP (MOBILIZING FOR ACTION THROUGH PLANNING & PARTNERSHIPS) TO GUIDE COMMUNITY PLANNING EFFORTS.2) THE RELATIONSHIP OF THE ALLIANCE FOR BUILDING COMMUNITY TO OTHER EFFORTS TO CREATE THE ADAMS COUNTY PLAN.3) THE ALIGNMENT OF BLESSING HOSPITAL WITH THE ALLIANCE FOR BUILDING COMMUNITY TO PROVIDE REPRESENTATION AND RESOURCES TO CONTINUE THE EFFORTS OF IDENTIFYING SPECIFIC OBJECTIVES TOWARD WHICH OUR COMMUNITY WILL WORK IN THE COMING YEARS.4) PLANS FOR LEADERSHIP & SOLUTIONS OF CURRENT AND FUTURE COMMUNITY HEALTH NEEDS.Number of Hospital Faciltiy - 1
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsCollection practices are not pursued if a completed financial assistance application has been returned and approved.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe hospital uses a cost-to-charge ratio to calculate cost amounts. This ratio is computed using Blessing Hospital's as-filed Medicare cost report. These costs and charges are adjusted to account for items not reimbursed through the cost report such as provider-based physician services. IRS Revenue Ruling 69-545, which established the community benefit standard for nonprofit hospital's states that if a hospital serves patients with government health benefits, including Medicare, then this is an indication that the hospital operates to promote the health of the community. This implies that treating medicare patients is a community benefit.
Part III, Line 4 - Bad Debt ExpenseSEE NOTE (3) ON PAGES 11 AND 12 OF THE HOSPITAL'S ATTACHED FINANCIAL STATEMENTS.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community BenefitA number of patients are truly unable to pay for their medical expenditures but do not complete the process required to apply for financial assistance. THE HOSPITAL USES FINANCIAL AND OTHER INFORMATION OF SUCH PATIENTS OTHERWISE AVAILABLE TO THE HOSPITAL TO IDENTIFY THOSE patients THAT would qualify for charity care if they completed the paperwork. THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES THE PERCENTAGE OF THE BAD DEBT EXPENSE THAT IS EVENTUALLY REVERSED DUE TO PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE. THE HOSPITAL APPLIES THAT PERCENTAGE TO THE BAD DEBT EXPENSE TO ESTIMATE THE AMOUNT OF THE HOSPITAL'S BAD DEBT EXPENSE THAT WILL BE FOUND TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. The bad debt expense associated with SUCH PATIENTS' ACCOUNTS ARE treated as community benefit.
Part III, Line 2 - Methodology Used To Estimate Bad Debt ExpenseBad debt expense is calculated on the net patient account balance after the balance has been reduced for any payments received or discounts/adjustments that are known. Patients qualifying for financial assistance are recognized as charity care accounts when sufficient information is received to determine their eligibility. Prior to this point, an allowance for doubtful accounts is calculated on uninsured accounts. This allowance is reversed if the account is determined to qualify for financial assistance.
Part I, Line 7g - Costs Associated With Physicans ClinicsBLESSING HOSPITAL DOES NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
Part I, Line 7, Column F - Explanation of Bad Debt ExpenseBAD DEBT EXPENSE OF $22,735,733 IS SUBTRACTED FROM TOTAL EXPENSES OF $284,677,829 REPORTED ON LINE 25, COLUMN A OF FORM 990, PART IX,FOR A NET TOTAL EXPENSE OF $261,942,096.
Part I, Line 7 - Explanation of Costing MethodologyWHEN POSSIBLE, CALCULATIONS OF DIRECT AND INDIRECT COSTS ASSOCIATED WITH THE SERVICES PROVIDED ARE REPORTED. IF NOT AVAILABLE, A COST-TO-CHARGE RATIO IS USED TO CALCULATE THE COST AMOUNTS. THIS RATIO IS COMPUTED USING BLESSING HOSPITAL'S AS-FILED MEDICARE COST REPORT. THESE COSTS AND CHARGES ARE ADJUSTED TO ACCOUNT FOR ITEMS NOT REIMBURSED THROUGH THE COST REPORT SUCH AS PROVIDER-BASED PHYSICIAN SERVICES.
Part I, Line 6a - Related Organization Community Benefit ReportBLESSING HOSPITAL'S COMMUNITY BENEFIT REPORT IS PREPARED BY BLESSING HOSPITAL, NOT A RELATED ORGANIZATION.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1SIU SCHOOL OF MEDICINEBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 19607 327 W CALHOUN STREETAddressLine1
CitySPRINGFIELDCity
StateILState
ZIP Code62794ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient376005961EINOfRecipient
Amount Of Cash Grant1705372AmountOfCashGrant
Amount Of Non Cash Assistance0AmountOfNonCashAssistance
Method Of ValuationBOOKMethodOfValuation
Purpose Of GrantMEDICAL EDUCATION & RESEARCH AT SIUPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantGRANTS TO STUDENTS AT BLESSING-RIEMAN COLLEGE OF NURSINGTypeOfGrant
Number Of Recipients128NumberOfRecipients
Amount Of Cash Grant335265AmountOfCashGrant
Method Of ValuationBOOKMethodOfValuation

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierAdditional Supplemental InformationIdentifier
ExplanationPART I, LINE 2SIU SCHOOL OF MEDICINESIU PROVIDES THE HOSPITAL BOARD OF TRUSTEES WITH AN ANNUAL UPDATE REGARDING THEIR USE OF THE GRANT FUNDS PROVIDED TO THEIR PROGRAM.Blessing-Rieman College of NursingBlessing-Rieman College of Nursing requires a financial aid application upon admittance, has academic performance and financial need criteria, and has a selection committee that awards grants. The College monitors and reviews the recipients individually on a semester basis for satisfactory academic progress and good standing.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
TIMOTHY A MOORE
SECRETARY/CAO15127341103336986900614871309951
THOMAS A CLIATT DO
PHYSICIAN326957212642268444156518682626690
STUART L PYATT DO
PHYSICIAN337753318104206264748519616743584
RICHARD A SAALBORN DO
PHYSICIAN510960106094270206174014076719890
PATRICK M GERVELER
Treasurer26816481817390914461415129448815
MAUREEN A KAHN
PRESIDENT/CEO340887107398245495471614780542330
JILL MASON
CNO1868604293477941369017593382082
JAMES B KASE MD
PHYSICIAN5439192700011578494018682606119
GEORGE E LIESMANN
CMO1611461000031935955180294
B BRADFORD BILLINGS
Trustee43532834593340179462674144281298542193647
ANTONY S WOLLASTON MD
PHYSICIAN33956220564919965440318682588261
ABBY REICH MD
Trustee1700325258182515129192244

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancingCUSIP NumberCUSIPNumber
CITY OF QUINCY ADAMS CNTY
C3760003782012-08-0130000000SCHEDULE Ofalsefalsefalse
CITY OF QUINCY ADAMS CNTY
B3760003782012-08-0132785000SCHEDULE Ofalsefalsefalse
CITY OF QUINCY ADAMS CNTY
A3760003782007-05-0348850181SCHEDULE Ofalsefalsefalse748476BN7

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresAmount UnspentAmountUnspentCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionAmount RetiredAmountRetired
C284500016458226769143504falsefalsefalsetrue
B32785000164582truefalsetruetrue326204182012
A48853595570296truetruetruetrue48853595200913175000

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsEngage Bond Counsel ResearchEngageBondCounselResearchBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrsPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersTotal Private Business UseTotalPrivateBusinessUse
Cfalsefalsefalsefalsefalsetruefalsetrue
Bfalsefalsefalsefalsefalsetruefalsetrue
Afalsefalsefalsefalsefalsetruefalsetrue0.029000.02900

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
Cfalsetruefalsefalsefalsefalsefalsetrue
Bfalsefalsetruefalsefalsefalsefalsetrue
Afalsefalsetruefalsefalsefalsefalsetrue

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Ctrue
Btrue
Atrue

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSupplemental InformationIdentifier
Return ReferencePart VIReturnReference
ExplanationPART II, LINE 3, BOND C - PROCEEDS ARE BEING DRAWN AS CONSTRUCTION PROGRESSES AND THUS TOTAL PROCEEDS DIFFER FROM THE ISSUE PRICE.Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

FieldValueIRS element (for citing)
Name PersonKLINGNER AND ASSOCIATESNamePerson
FieldValueIRS element (for citing)
RelationshipSEE PART VRelationship
Amount Of Transaction137305AmountOfTransaction
Description Of TransactionENGINEERING SERVICESDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
ExplanationBOARD TRUSTEE, MICHAEL KLINGNER, IS PRESIDENT OF ENTITY WITH WHICH BUSINESS TRANSACTIONS WERE CONDUCTED.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
SCHEDULE K, PART II, LINE 12 - OTHER UNSPENT PROCEEDSOTHER UNSPENT PROCEEDS ARE IN THE ADVANCE FUND.
SCHEDULE K, PART I, (f) DESC. OF PURPOSEA - USED TO (i) CURRENTLY REFUND ALL OF THE OUTSTANDING CITY OF QUINCY, ADAMS COUNTY, ILLINOIS REVENUE BONDS, SERIES 1993 (BLESSING HOSPITAL)(THE "SERIES 1993 BONDS"), (ii) ADVANCE REFUND ALL OF THE OUTSTANDING ILLINOIS HEALTH FACILITIES AUTHORITY REVENUE BONDS, SERIES 1999A (BLESSING HOSPITAL)(THE "SERIES 1999A BONDS") AND (iii) PAY CERTAIN EXPENSES INCURRED IN CONNECTION WITH THE ISSUANCE OF THE SERIES 2007 BONDS AND THE REFUNDING OF THE SERIES 1993 BONDS AND THE SERIES 1999A BONDS.B - USED TO (i) REFUND THE OUTSTANDING VARIABLE RATE DEMAND REVENUE REFUNDING BONDS, SERIES 2008 (BLESSING HOSPITAL)(THE "SERIES 2008 BONDS")AND(ii) REFUND THE OUTSTANDING ADJUSTABLE RATE DEMAND REVENUE BONDS, SERIES 2004 (BLESSING HOSPITAL PROJECT)(THE "SERIES 2004 BONDS").C - TO REIMBURSE FOR THE COSTS OF THE PROJECT AND TO PAY CERTAIN COSTS OF ISSUANCE OF THE SERIES 2012B BONDS. THE PROJECT CONSISTS OF THE ACQUISITION, CONSTRUCTION, AND EQUIPPING OF AN APPROXIMATELY 172,755 SQUARE FOOT PATIENT CARE ADDITION LOCATED ON THE MAIN CAMPUS AT BROADWAY AND 11TH STREETS IN QUINCY, ILLINOIS.
Other Changes In Net Assets Or Fund Balances - Other DecreasesTRANSFERS TO SITF = -$11650000Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other DecreasesTRANSFERS TO AFFILIATES = -$13042828Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other IncreasesDECREASE IN MINIMUM PENSION LIABILITY = $33736516Form 990, Part XI, Line 9
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThese forms are located in the corporate administrative offices and are available upon request for public inspection.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesTIMOTHY A. MOORE - CAO AND secretary of blessing hospital - No compensation IS RECEIVED FOR POSITION as Secretary OF BLESSING HOSPITAL. ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL.JILL K. MASON - cno OF BLESSING HOSPITAL - ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL.GEORGE E. LIESMAN - CMO OF BLESSING HOSPITAL - ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementMAUREEN A. KAHN - president and ceo of blessing hospital - ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL.Form 990, Part VI, Line 15a
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsA COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO BE READ, SIGNED, AND RETURNED TO THE ORGANIZATION. THE SIGNED POLICIES ARE RETAINED IN THE CORPORATE ADMINISTRATIVE FILES. IN ADDITION, EACH OFFICER, DIRECTOR, OR TRUSTEE IS REQUIRED TO DECLARE NO CONFLICT OF INTEREST IN REGARDS TO AGENDA ITEMS BEING PRESENTED AT THE START OF EACH MONTHLY BOARD MEETING.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review ProcessFOLLOWING MANAGEMENT AND LEGAL REVIEW, THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT PRIOR TO FILING.Form 990, Part VI, Line 11b
Form 990, Part VI, Line 7b: Describe Decisions of Governing Body Approval by Members or ShareholdersBLESSING CORPORATE SERVICES SHALL POSSESS THE RIGHTS AND RESPONSIBILITIES TO (b)appoint the corporation's president and nominate all candidates to serveas directors of Quincy Health Care Management, Inc., (c) approveexpressly all amendments to the corporation's articles of incorporationand bylaws before they may become effective, (d) approve long-term debt,long-range plans and capital and operating budgets, (e) approve thepurchase and sale of real and personal property and contracts enteredinto by the corporation, not expressly made part of an approved budget,the reasonable value of which exceeds an amount set forth in the bylawsof the member, (f) approval of material investment decisions,including without limitation establishment and modification ofinvestment policies, engagement and removal of investment managers andadvisors, and changes in investment allocations not permitted by anexisting investment policy, (g) approval of the parameters for terms of employment of physicians, including physician compensation plans, and any material variances from such parameters for individual physicians, (h) approval of the selection of auditors and legal counsel, (i) approval of charity care and community benefits-related policies, (j) approval of the formation of subsidiary entities and/or joint ventures, (k) approval of the filing of a petition in bankruptcy, making and assignment for the benefit of creditors, or applying for protection under any insolvency laws, (l) approval of the participation in any merger, combination, consolidation, liquidation, dissolution or other corporate or business entity restructuring, and (m) the power to compel the corporation to enforce and/or perform any contractual obligation.Form 990, Part VI, Line 7b
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyBLESSING CORPORATE SERVICES SHALL POSSESS THE RIGHTS AND RESPONSIBILITIES TO (A) Appoint and/or remove all the trustees of the corporation.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderBLESSING CORPORATE SERVICES, INC. IS THE SOLE VOTING MEMBER OF BLESSING HOSPITAL.Form 990, Part VI, Line 6
Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company1) BLESSING CORPORATE SERVICES PROVIDES GENERAL MANAGEMENT SERVICES.2) NATIONAL HEALING PROVIDES MANAGEMENT SERVICES FOR THE WOUND CARE DEPARTMENT WHICH INCLUDES HYPERBARIC SERVICES.3) QUINCY MEDICAL GROUP PROVIDES MANAGEMENT OF THE SURGERY CENTER OF QUINCY.4) ARAMARK PROVIDES MANAGEMENT OF FOOD SERVICES AND STERILE PROCESSING.5) BRIDGE HOME CARE PARTNERS PROVIDES MANAGEMENT OF BLESSING'S HOME CARE SERVICES.Form 990, Part VI, Line 3

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
BLESSING AFFILIATES INC
BROADWAY AT 11TH PO BOX 7005QUINCYIL623057005371128708CURRENTLY INACTIVEIL501(C)(3)9BCS INCfalse
BLESSING VOLUNTEERS IN PARTNERSHIP
BROADWAY AT 11TH PO BOX 7005QUINCYIL623057005237160187PROVIDE SUPPORT FOR BLESSING HOSPITALIL501(C)(3)11BNAfalse
BLESSINGCARE CORPORATION - MISSOURI
1005 BROADWAYQUINCYIL62301431371818CURRENTLY INACTIVEMO501(C)(3)3BCS INCfalse
BLESSING HOSPITAL SELF-INSURANCE PLAN
BROADWAY AT 11TH PO BOX 7005QUINCYIL623057005371045366PROVIDE SUPPORT FOR MEDICAL LIABILITY CLAIMSIL501(C)(3)11ABCS INCfalse
BLESSINGCARE CORP DBA ILLINI COMM HOSP
640 WEST WASHINGTONPITTSFIELDIL62363371396010PROVIDE HEALTHCAREIL501(C)(3)3BCS INCfalse
THE BLESSING FOUNDATION
BROADWAY AT 11TH POBOX 7005QUINCYIL623057005371128705FUNDRAISING & GRANT-MAKINGIL501(C)(3)11BBCS INCfalse
BLESSING CORPORATE SERVICES
BROADWAY AT 11TH PO BOX 7005QUINCYIL623057005371128706PROVIDE DIRECTION AND CONTROL TO ENTITIESIL501(C)(3)9BCS INCfalse

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1ILLINI HEALTH SERVICES LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 40AddressLine1
CityQUINCYCity
StateILState
ZIP Code623060040ZIPCode
FieldValueIRS element (for citing)
EIN470901851EIN
Primary ActivityPHARMACYPrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1DENMANBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1DENMAN SERVICES INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1BROADWAY AT 14TH STREETAddressLine1
CityQUINCYCity
StateILState
ZIP Code62306ZIPCode
FieldValueIRS element (for citing)
EIN371132117EIN
Primary ActivityMED. EQUIP.PrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1BCS INCBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CORPTypeOfEntity
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgtrueGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg