2014-02-26T15:21:37-06:00 2013-06-30 KERBER ECK & BRAECKEL LLP 1116 W MAIN ST CARBONDALE IL 629012335 990 2012-07-01 370661218 MARSHALL BROWNING HOSPITAL ASSOCIATION MARS 6185422146 900 N WASHINGTON ST PO BOX 192 DU QUOIN IL 62832 EDWIN GAST 6185422146 2014-02-24 true DAVID SCHNAKE 6185291040 2014-02-26 2012 2015-11-30 17:44:51Z EDWIN GAST 900 N WASHINGTON ST PO BOX 192 DU QUOIN IL 62832 19453266 false X WWW.MARSHALLBROWNINGHOSPITAL.COM X 1919 IL THE MISSION OF MARSHALL BROWNING HOSPITAL IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE PEOPLE AND COMMUNITY WE SERVE WITHIN THE SCOPE OF OUR ABILITIES. 11 11 156 70 0 258446 258331 16756764 17927184 260854 359625 842522 901500 18118586 19446640 4000 0 9281121 9161701 0 0 8420510 9196889 17701631 18362590 416955 1084050 21784457 22963186 14397561 13673376 7386896 9289810 X THE MISSION OF MARSHALL BROWNING HOSPITAL IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE PEOPLE AND COMMUNITY WE SERVE WITHIN THE SCOPE OF OUR ABILITIES. false false 18362590 4000 19446640 AS A NON-FOR-PROFIT COMMUNITY HOSPITAL, MARSHALL BROWNING HOSPITAL IS A CHARITABLE ORGANIZATION THAT EXISTS TO ADVANCE THE HEALTH OF THE RESIDENTS OF DUQUOIN AND THE SURROUNDING COMMUNITIES. MARSHALL BROWNING HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF MARSHALL BROWNING HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL SERVICES AND HEALTHCARE EDUCATION. THEREFORE, IN KEEPING WITH THIS CORPORATION'S COMMITMENT TO SERVE ALL MEMBERS OF THE COMMUNITY, FREE CARE AND/OR SUBSIDIZED CARE, ARE PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST, AND HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUAL'S INABILITY TO PAY COEXISTS. THE COMMUNITY BENEFITS CAN BE MEASURED IN MANY WAYS INCLUDING: DIRECT PATIENT CARE, SCREENINGS, EDUCATION, FUNDRAISING AND COMMUNITY SERVICE EFFORTS OF OUR COLLEAGUES. MARSHALL BROWNING HOSPITAL RECORDED 3,463 PATIENT DAYS. 2,962 OF THOSE DAYS WERE MEDICARE PATIENT DAYS, WHILE 152 CONSISTED OF MEDICAID DAYS. DURING FY 2013 THE HOSPITAL ADMITTED 712 PATIENTS AND DISCHARGED 713. THE AVERAGE LENGTH OF STAY FOR A PATIENT IS 5 DAYS. THE HOSPITAL PROVIDED 96,539 OUTPATIENT OCCASIONS OF SERVICE WHICH INCLUDED 5,992 EMERGENCY ROOM VISITS. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, PROVIDING SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. FINANCIAL ASSISTANCE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL POLICY AND IN FY 2013 THIS AMOUNTED TO 342,000 AT COST. MARSHALL BROWNING HOSPITAL OFFERS VARIOUS PROGRAMS AND SERVICES THAT SUPPORT THE HEALTH OF OUR COMMUNITY. HERE ARE A FEW EXAMPLES: AS PART OF OUR MISSION, THE HOSPITAL ANNUALLY PROVIDES ATHLETIC TRAINING SERVICES TO DUQUOIN HIGH SCHOOL ATHLETES. SERVICES ARE PROVIDED AT PRACTICES AS WELL AS AT SCHOOL SPORTING EVENTS AT NO COST TO THE SCHOOL. THE HOSPITAL ALSO PROVIDES RANDOM DRUG TESTING SERVICES AT COST-ONLY TO THE LOCAL HIGH SCHOOL. HOSPITIAL MANAGERS ARE FREQUENTLY GUEST SPEAKERS AT SCHOOLS ON VARIOUS HEALTH TOPICS AND HEALTHCARE CAREERS. HIGH SCHOOL STUDENTS PARTCIPATE IN JOB SHADOWING AND COOPERATIVE EDUCATION PROGRAMS AT THE HOSPITAL. MARSHALL BROWNING HOSPITAL ANNUALLY PROVIDES TWO SPORTS PHYSICAL CLININCS TO AREA JUNIOR HIGH AND HIGH SCHOOL STUDENTS AT A COST OF 10. THE FEE IS THEN RETURNED TO THE SCHOOLS. THE HOSPITAL ALSO SERVES AS A CLINICAL SITE FOR JOHN A. LOGAN COLLEGE NURSING STUDENTS. MARSHALL BROWNING HOSPITAL PROVIDES A VARIETY OF COMMUNITY SERVICES TO CITIZENS AND EMPLOYEES FOR WHICH WE RECEIVE NO REIMBURSEMENT SUCH AS HEALTH FAIRS, FIRST AID STATIONS, AND CLASSES FOR AUTOMATIC ELECTRONIC DEFIBULATOR'S (AED) AND BASIC LIFE SUPPORT (BLS). ADDITIONALLY, COLLEAGUES FROM MBH REACH HUNDREDS OF PEOPLE WITH PRESENTATIONS ON A WIDE VARIETY OF TOPICS INCLUDING HEART HEALTH, NUTRITION, ASTHMA, DIABETES, ALZHEIMER'S DISEASE, SLEEP APNEA, HEALTHLY GRIEVING, ARTHRITUS, BREAST CANCER, EXCERCISE AND DIET, SMOKING CESSATION, PNEUMONIA VACCINE, CIRCUIT BREAKER, AND IL CARE RX TO NAME A FEW. THE HOSPITAL ANNUALLY PROVIDES A FOUR-YEAR 1,000 SCHOLARSHIP TO A LOCAL HIGH SCHOOL SENIOR ENTERING THE HEALTHCARE FIELD. WE ALSO SPONSER A 5K RUN/WALK, GOLF TOURNAMENT, SPEAKERS FOR CAMPING CONVENTIONS AND SCREENINGS FOR LOCAL MANUFACTURING COMPANIES. THE HOSPITAL HOSTS FIVE AMERICAN RED CROSS BLOOD DRIVES EACH YEAR. MBH EMPLOYEES CONTINUE TO GROW THEIR TRADITION OF SUPPORTING THE COMMUNITY THROUGH PARTICIPATION IN A VARIETY OF FUNDRAISING WALKS FOR AMERICAN HEART ASSOCAITION AND AMERICAN CANCER SOCIETY. THEY ALSO FREQUENTLY RAISE FUNDS FOR THE LOCAL FOOD PANTRY AND HUMANE SHELTER. 18362590 true true false false false false false false false false true false false true true true false true false false false false false false true false true true false false true false false false false false true false false false false false false false true true false false false true 25 0 156 true false false false false false true true false false false false X 11 11 false false false false false false false true true false false true true true true true true true true false IL X MARSHALL BROWNING HOSPITAL 6185422146 900 N WASHINGTON ST PO BOX 192 DU QUOIN IL 62832 RICHARD ZIMMERMANDC 1.00 X 0 0 0 CHARLES GENISIO JR 1.00 X 0 0 0 MARK MACLIN 1.00 X 0 0 0 DAN EAVES 1.00 X 0 0 0 SUSAN ENGELHARDT 1.00 X 0 0 0 CRAIG FURRY MD 1.00 X 0 0 0 RICHARD K HAINES 1.00 X 0 0 0 DON HOFFMAN 1.00 X 0 0 0 BRAD GALLI RPH 1.00 X 0 0 0 DAVID SEARBY 1.00 X 0 0 0 KATHY WEST 1.00 X 0 0 0 EDWIN GAST 40.00 X 118031 0 7094 LAURIE KELLERMAN 40.00 X 86233 0 7055 BRICE HARSY 40.00 X 63651 0 5937 TERRENCE HALL 40.00 X 275582 0 9495 GLADSTONE TUCKER 36.00 X 210545 0 1877 JERRY PRIAR 40.00 X 181207 0 4370 BETH BIGHAM 32.00 X 157032 0 2442 ALAN MORRIS 40.00 X 120582 0 8279 1212863 46549 6 false true false ACUTE CARE INC 1609 N ANKENY BLVD STE 200 ANKENY IA 50023 HOSPITALIST SRV 1248354 ST LOUIS UNIVERSITY 1402 S GRAND BLVD ST LOUIS MO 63104 PHYSICIAN SERVI 163200 NUMED INC PO BOX 1098 DENTON TX 76202 NUCLEAR MEDICIN 156978 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 272162140 LAB SERVICES 109349 SHARED MEDICAL SERVICES INC PO BOX 330 COTTTAGE GROVE WI 53527 103605 5 222830 35501 258331 INPATIENT & OUTPATIENT SVC 17927184 17927184 17927184 357625 357625 2000 2000 2000 2000 21183 6626 14557 EHR REIMBURSEMENT 328681 328681 INDEPENDENT LIVING RENT 323697 323697 DR HALL-SHARED EXP 97230 97230 137335 137335 886943 19446640 18816127 357625 4000 4000 288001 288001 6857142 6857142 108935 108935 1420882 1420882 486741 486741 43565 43565 772233 772233 81069 81069 277688 277688 280121 280121 55177 55177 599746 599746 1034914 1034914 246960 246960 BAD DEBT 1638256 1638256 PHYSICIANS' FEES 1457857 1457857 MISC 732859 732859 MEDICAL SUPPLIES 649828 649828 1326616 1326616 18362590 18362590 0 0 317113 553067 4315835 3582725 393810 429703 509377 181253 20583853 11408083 9683940 9175770 5867785 7637934 45000 45000 651597 1357734 21784457 22963186 1627170 1495003 58775 9560581 9252889 3209810 2866709 14397561 13673376 X 7386896 9289810 7386896 9289810 21784457 22963186 1084050 818864 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 48400 3114 51514 8237205 3555515 4681690 1212116 643629 568487 11083018 7208939 3874079 9175770 THIRD PARTY REIMBURSEMENT PROGRAM 1016648 UNAMORTIZED BOND COSTS 291086 INSURANCE RECOVERY 50000 1357734 INTEREST RATE SWAP CONTRACTS 1132392 THIRD PARTY REIMBURSEMENT PROGRAMS 822485 ACCUMULATED BENEFIT OBLIGATION 635346 L-T OBLIGATION-CAPITAL LEASES 167489 ESTIMATED MED MALPRACTICE CLAIMS 50000 CURRENT OBLIG-CAPITAL LEASES 30997 CURRENT ACCUM BENEFIT OBLIGATION 28000 2866709 X LIABILITY UNDER FIN 48 FOOTNOTE SCHEDULE D, PAGE 3, PART X THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY AT JUNE 30, 2013 OR 2012. GOLF TOURNAMENT 21183 21183 6626 21183 21183 6626 6626 14557 true true true X true X true true true false true true 342292 342292 0.01860 2669787 2684739 -14952 3012079 2684739 327340 0.01860 255538 255538 0.01390 255538 255538 0.01390 3267617 2684739 582878 0.03260 true 783578 156716 8647556 8866309 -218753 X true true 1 1 MARSHALL BROWNING HOSPITAL

900 N WASHINGTON ST DUQUOIN IL 62832

X X X X OUTPATIENT PHYSICIAN CLINIC MARSHALL BROWNING HOSPITAL 1 true X X X X X X X X X X 13 true false true X X X X X X X false false true true 150.0 true 300.0 false true true X X X X true X X true X X X X X X true X false false 1 MARSHALL BROWNING HOSPITAL

MEDICAL CLINIC 900 N WASHINGTON STREET DUQUOIN IL 62832

RURAL HEALTH CLINIC COSTING METHODOLOGY EXPLANATION PART I LINE 7 THE MARSHALL BROWNING HOSPITAL ASSOCIATION THE ASSOCIATION USED A COST TO CHARGE RATIO AS CALCULATED FROM WORKSHEET 2 RATIO OF PATIENT CARE COSTTOCHARGES INCLUDED IN THE SCHEDULE H INSTRUCTIONS TO DETERMINE THE AMOUNTS ON LINES 7A AND 7B OF PART I OF SCHEDULE H BAD DEBT EXPENSE EXPLANATION PART III LINE 4 THE ASSOCIATION CALCULATED BAD DEBT EXPENSE AT COST USING THE COST TO CHARGE RATIO AS CALCULATED USING WORSHEET 2 OF THE SCHEDULE H INSTRUCTIONS PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT ONLY AFTER ALL COLLECTION PROCEDURES HAVE BEEN EXHAUSTED AS OUTLINED IN SCHEDULE H PART III LINE 9B PATIENT ACCOUNTS ARE WRITTEN OFF TO BAD DEBT AFTER ALL DISCOUNTS AND PAYMENTS HAVE BEEN APPLIED BASED ON THE ASSOCIATIONS EXPEREINCE WITH ALL ITS PATIENTS THEY ESTIMATE THAT IT IS LIKELY THAT UP TO 20 OF THE PATIENTS ACCOUNTS WRITTEN OFF TO BAD DEBTS MAY QUALIFY FOR FINANCIAL OR OTHER ASSISTANCE BUT CHOOSE NOT TO APPLY THEREFORE 20 OF THE BAD DEBT EXPENSE WAS INCLUDED ON PART III LINE 3 AT COST THE FOLLOWING DESCRIPTION OF BAD DEBT EXPENSE UNCOMPENSATED CAREIS INCLUDED IN THE COMMUNITY BENEFIT NOTE TO THE ASSOCIATIONS AUDITED FINANCIAL STATEMENTS THE HOSPITAL ALSO PROVIDES A SIGNIFICANT AMOUNT OF UNCOMPENSATED CARE FOR PATIENTS WHICH IS NOT INCLUDED ABOVE BUT IS REPORTED ON THE STATEMENT OF OPERATIONS AS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS MANY OF THOSE PATIENTS ARE UNINSURED OR UNDERINSURED BUT DID NOT APPLY FOR OR QUALIFY FOR CHARITY CARE DURING THE YEAR ENDED JUNE 30 2013 THE HOSPITAL REPORTED BAD DEBT EXPENSE AT COST OF 784000 MEDICARE EXPLANATION PART III LINE 8 FISCAL YEAR 2013 MEDICARE COST REPORT WAS USED TO DETERMINE THE UNPAID COST OF MEDICARE UNPAID COST OF MEDICARE REPRESENTS THE COST OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM IN EXCESS OF PAYMENTS FOR THOSE SERVICES IRS REVENUE RULING 69545 WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT 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 COLLECTION PRACTICES EXPLANATION PART III LINE 9B THE MARSHALL BROWNING HOSPITAL ASSOCIATION APPLIES ITS COLLECTION PRACTICES EQUALLY TO ALL PATIENTS BOTH FINANCIAL ASSISTANCE ELIGIBLE AND NONFINANCIAL ASSISTANCE ELIGIBLE PATIENTS THE PROCEDURES FOR COLLECTION ON PATIENT ACCOUNTS ARE AS FOLLOWS IT IS THE RESPONSIBILITY OF THE CREDIT AND COLLECTION MANAGER WITHIN THE PATIENT ACCOUNTS OFFICE TO SECURE PAYMENT ARRANGEMENTS FOR ALL ACCOUNTS ON WHICH INSURANCE BENEFITS ARE NOT AVAILABLE OR IF BENEFITS HAVE BEEN APPLIED AND A BALANCE IS DUE FROM THE PATIENT 1CREDIT AND COLLECTION MANAGER ACREDIT AND COLLECTION MANAGER REVIEWS ALL ADMISSION FOLDERS FOR INSURANCE INFORMATION OR ABILITY TO PAY MONDAY SATURDAY BCREDIT AND COLLECTION MANAGER CHECKS WITH RN ON THE PATIENT UNIT REGARDING THE PATIENTS CONDITION OR FAMILY WHEREABOUTS IF PATIENT IS A MINOR OR UNABLE PHYSICALLY OR MENTALLY TO MAKE A FINANCIAL DECISION CAFTER AN INTERVIEW WITH PATIENT OR FAMILY CREDIT AND COLLECTION MANAGER DETERMINES APPROPRIATE PAYMENT ARRANGEMENT WITH THE BEST INTERESTS OF THE PATIENT AND THE HOSPITAL IN MIND DCREDIT AND COLLECTION MANAGER DETERMINES IF PATIENTS NEEDS WOULD BE BETTER SERVED BY DEPARTMENT OF PUBLIC AID ASSISTANCE EIF IT IS DETERMINED THAT THE PATIENTS NEEDS WOULD BE BETTER SERVED THROUGH DPA THEN THE PATIENT CARE COORDINATORS OFFICE IS NOTIFIED FOR COMPLETION OF DPA APPLICATION NEEDS ASSESSMENT PART VI MARSHALL BROWNING HOSPITAL HAS A COMMUNITY BENEFITS TEAM WHICH IS COMPRISED OF HOSPITAL EMPLOYEES FROM VARIOUS DEPARTMENTS AS WELL AS COMMUNITY MEMBERS INCLUDING THE ADMINISTRATOR OF THE PERRY COUNTY HEALTH DEPARTMENT MARSHALL BROWNING HOSPITAL IS ALSO AN ACTIVE PARTICIPANT IN THE PERRY COUNTY HEALTHY COMMUNITY COALITION AND HOSTS COALITION MEETINGS ON A MONTHLY BASIS THE COMMUNITY HEALTH NEEDS ASSESSMENT CHNA WAS CONDUCTED TO IDENTIFY THE MOST IMPORTANT HEALTH ISSUES IN PERRY COUNTY PARTICULARLY FOR VULNERABLE AND UNDERREPRESENTED POPULATIONS TO ENSURE THAT PROGRAMS AND SERVICES CLOSELY MATCH THE PRIORITIES AND NEEDS OF THE COMMUNITY AND TO STRATEGICALLY ADDRESS THOSE NEEDS TO IMPROVE THE HEALTH OF THE COMMUNITY WE SERVE MARSHALL BROWNING HOSPITAL CONDUCTED A CHNA FOR 2012 THE ASSESSMENT WAS DONE USING MANY SOURCES INCLUDING A BROAD REPRESENTATION OF THE COMMUNITY THROUGH THE PERRY COUNTY HEALTHY COMMUNITY COALITION AND AN INTERNAL TEAM CONSISTING OF THE PERRY COUNTY HEALTH DEPARTMENT ADMINISTRATOR PASTOR OF LIBERTY CHURCH SCHOOL NURSE DIRECTOR OF FIVE STAR INDUSTRIES MARSHALL BROWNING HOSPITAL BOARD MEMBER HOSPITAL ER DIRECTOR HOSPITAL CFO HOSPITAL CHIEF NURSE EXECUTIVE HOSPITAL DIRECTOR OF SENIOR INDEPENDENT LIVING FACILITY HOSPITAL CEO AND HOSPITAL DIRECTOR OF MARKETING MARSHALL BROWNING HOSPITAL WAS ASSISTED BY THE COMMUNITY BENEFITS DEPARTMENT OF SOUTHERN ILLINOIS HEALTHCARE AS A SOURCE OF INFORMATION SINCE BOTH FACILITIES SERVE THE RESIDENTS OF PERRY COUNTY PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE PART VI PATIENT EDUCATION REGARDING ELIGIBILITY FOR ASSISTANCE PROVIDED IN THE FOLLOWING MEDIUMS HOSPITAL BROCHURE HOSPITAL WEBSITE POSTED IN ADMITTING PATIENTS ARE CONTACTED BY A PATIENT ACCOUNTS REPRESENTATIVE DURING AND AFTER THEIR HOSPITAL STAY REGARDING ELIGIBILITY FOR ASSISTANCE COMMUNITY INFORMATION PART VI PERRY COUNTY IS A RURAL AREA WITH AN ESTIMATED POPULATION OF 22350 THE AVERAGE HOUSEHOLD INCOME ACCORDING TO US CENSUS BUREAU IN 2010 WAS 40696 THERE WERE 2264 OF CHILDREN IN THE COUNTY LIVING IN POVERTY IN 2011 WHICH IS CONSIDERABLY HIGHER THAN 1768 OVERALL IN ILLINOIS PINKNEYVILLE COMMUNITY HOSPITAL LOCATED 12 MILES AWAY ALSO SERVES THE HEALTHCARE NEEDS OF PERRY COUNTY RESIDENTS MARSHALL BROWNING HOSPITAL PRIMARILY SERVES RESIDENTS OF PERRY COUNTY HOWEVER A SMALL PORTION OF SURROUNDING COMMUNITIES IS SERVED AND INCLUDES THE FOLLOWING ZIP CODES 62832DUQUOIN 62888 TAMAROA 62274 PINCKNEYVILLE 62932 ELKVILLE 62927DOWELL 62884 SESSER AND 62865 MULKEYTOWN PERRY COUNTY HAD A POPULATION OF 22350 IN THE YEAR 2010 WHICH IS A DECREASE OF 32 FROM 2000 AGE DISTRIBUTION OF POPULATION IN PERRY COUNTY IN YEAR 2010 US CENSUS BUREAU INCLUDED AGE 04 1152 AGE 517 3376 AGE 1824 2476 25 342966 3544 3124 4554 3212 AGE 5564 2661 AND OVER 65 3521 HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSE PART VI MARSHALL BROWNING HOSPITAL PROVIDES ACTIVITIES AND SERVICES FOR WHICH NO PATIENT BILL EXISTS THESE SERVICES ARE NOT EXPECTED TO BE FINANCIALLY SELFSUPPORTING ALTHOUGH SOME MAY BE SUPPORTED BY OUTSIDE GRANTS OR FUNDING SOME EXAMPLES INCLUDE FREE OR LOWCOST CLINICS SUCH AS THE SPORTS PHYSICAL CLINIC WHEREBY THE FEES ARE ONLY 10 AND DONATED BACK TO THE STUDENTS SCHOOL ALL PHYSICIANS AND STAFF DONATE THEIR TIME TO THE CLINICS THE HOSPITAL PROVIDES THE SALARY OF OUR ATHLETIC TRAINER TO ATTEND ALL PRACTICES AND BALLGAMES FOR ATHLETIC TRAINING SERVICES TO DU QUOIN HIGH SCHOOL ATHLETES AND PROVIDES A FREE SPORTS INJURY CLINIC EACH SATURDAY MORNING THROUGHOUT THE FALL SEASON THE HOSPITAL ESTABLISHED A COUMADIN CLINIC WHICH IS AN ANTICOAGULATION CLINIC HELD EACH WEDNESDAY THE CLINIC PROVIDES ONOONONE CARE TO ASSIST PATIENTS WITH THE CONTROL OF THEIR ANTICOAGULATION THERAPY SPECIFICALLY COUMADIN GENERIC WARFARIN PATIENTS ARE GIVEN EDUCATION AND DIETARY INSTRUCTION AND KNOW THEIR RESULTS AND DOSAGE FOR THE WEEK FOLLOWING EACH APPOINTMENT THIS IS A COLLABORATIVE PRACTICE WITH NO BILLING CODES FOR THE CONSULTATION OF THE PHARMACIST OR LAB DIRECTOR WHO PROVIDE THE INSTRUCTION FOR THE PATIENTS THIS SERVICE IS DONATED BACK TO THE COMMUNITY THE CLINIC IS HIGHLY SUCCESSFUL AND RESULTS IN THE AVOIDANCE OF ER VISITS AND ADMISSIONS TO THE HOSPITAL MARSHALL BROWNING HOSPITAL OFFERS A MONTHLY SECOND ACT LUNCHEON PROGRAM FOR INDIVIDUALS AGE 50 AND OLDER WITH A PHYSICIAN OR OTHER HEALTHCARE PROVIDER PRESENTING A HEALTHCARE PROGRAM THE HOSPITAL PROVIDES A TWODAY HEALTH FAIR FOR GENERAL CABLE MANUFACTURING PLANT EMPLOYEES EACH YEAR AND OFFERS FREE HEALTH SCREENINGS AT THE COMMUNITYS ANNUAL HOME AND GARDEN SHOW COMMUNITY MEMBERS ARE GIVEN FREE COLON CANCER SCREENING KITS AND PROVIDE THE TESTING AT NO CHARGE DURING COLON CANCER AWARENESS MONTH THE HOSPITAL HOSTS MANY FREE EDUCATIONAL PROGRAMS TO THE COMMUNITY THROUGHOUT THE YEAR ON TOPICS SUCH AS DIABETES BETTER BREATHERS SLEEP APNEA SMOKING CESSATION HEART DISEASE HIGH BLOOD PRESSURE ALZHEIMERS DISEASE GRIEF EXERCISE AND DIET COPD CPAPBIPAP CLINICS FIRST AIDCPRAED CLASSES CHANGES IN LAWS FOR SENIORS AND PROVIDES SPEAKERS FOR VARIOUS COMMUNITY ORGANIZATIONS THE HOSPITAL PROVIDES FREE SPACE EVERY OTHER MONTH FOR WEIGHT LOSS PROGRAMS PRESENTED BY A BARIATRIC SURGEON AT HERRIN HOSPITAL THE HOSPITAL EMPLOYS AN INDIVIDUAL WHO IS A CERTIFIED SHIP COUNSELOR FOR FREE COUNSELING TO SENIORS MARSHALL BROWNING PROVIDES CLINICAL ROTATIONS AND INTERNSHIPS FOR MEDICAL STUDENTS AND A VARIETY OF COLLEGE STUDENTS ENTERING THE HEALTHCARE FIELD MARSHALL BROWNING HOSPITAL OFFERS A FOURYEAR 1000 SCHOLARSHIP TO A HIGH SCHOOL SENIOR EACH YEAR ENTERING THE HEALTHCARE FIELD THE HOSPITAL HOSTS SIX COMMUNITY BLOOD DRIVES PER YEAR THE COMMUNITY IS OFFERED A REDUCED RATE MAMMOGRAM EACH YEAR IN OCTOBER DURING BREAST CANCER AWARENESS MONTH THE HOSPITAL CONDUCTS A 5K RUNWALK EACH YEAR TO PROMOTE EXERCISE AND FITNESS THE HOSPITAL PROVIDES DRUG TESTING FOR HIGH SCHOOL ATHLETES AT COST THE HOSPITAL PROVIDES A FIRST AID STATION AT THE LOCAL CONSERVATION FAIR FOR AREA SCHOOL CHILDREN THE HOSPITAL DONATES EACH YEAR TO THE AMERICAN HEART ASSOCIATION AMERICAN CANCER SOCIETY DU QUOIN YOUTH CLUB DU QUOIN FOOD PANTRY AND VARIOUS OTHER NEEDS IN THE COMMUNITY THE HOSPITAL OFFERS A SENIOR INDEPENDENT LIVING FACILITY ON ITS CAMPUS THAT IS OFFERED AS A BREAKEVEN SERVICE AND HAS NEVER BEEN OPERATED AS A FORPROFIT ENTITY MARSHALL BROWNING HOSPITAL PROVIDES OVERHEAD AND SPACE FOR COMMUNITY MEETINGS THE HOSPITAL PROVIDES EDUCATIONAL PROGRAMS FREE OF CHARGE TO CAMPERS UTILIZING THE DU QUOIN STATE FAIRGROUNDS FOR CAMPING CONVENTIONS AFFILIATED HEALTH CARE INFORMATION PART VI MARSHALL BROWNING HOSPITAL IS AFFILIATED WITH SOUTHERN ILLINOIS HEALTHCARE TO ENHANCE SERVICES FOR THE RESIDENTS OF PERRY COUNTY IT IS NOT A MERGER OR ACQUISITION BUT IS A PARTNERSHIP TO PROVIDE EDUCATIONAL ADMINISTRATIVE AND CLINICAL OPPORTUNITIES FOR HEALTHCARE STAFF DEVELOP LINKAGES AMONG HEALTHCARE PROVIDERS PROVIDE BETTER COORDINATION OF CARE AND SERVICES AND EXPAND THE POOL OF SPECIALISTS SINCE THE AFFILIATION MARSHALL BROWNING HOSPITAL HAS EXPANDED THE NUMBER OF SPECIALISTS OFFERING CLINICS AT THE HOSPITAL BEGAN OFFERING SECOND ACT COMMUNITY EDUCATION PROGRAMS COLLABORATED ON THE CHNA ESTABLISHED DIGITAL MAMMOGRAPHY SERVICES INITIATED A LEAN DAILY MANAGEMENT PROGRAM OFFER UROLOGIC SURGICAL PROCEDURES ESTABLISHED A MORE EFFICIENT EMAIL SYSTEM AND COLLABORATION ON IMPLEMENTING ELECTRONIC HEALTH RECORD MARSHALL BROWNING HOSPITAL LINE NUMBER 1 PART V LINE 3 PART V LINE 3 SEVERAL MBH STAFF ACTIVELY PARTICIPATE IN THE PERRY COUNTY HEALTH AND WELLNESS COALITION RECENTLY RENAMED AS PERRY COUNTY HEALTHY COMMUNITY COALITION A GRASSROOTS ORGANIZATION WHOSE MEMBERS FOSTER COLLABORATION AND LEVERAGE THEIR COLLECTIVE RESOURCES TO IMPROVE THE OVERALL HEALTH AND WELLBEING OF PERRY COUNTY RESIDENTS INPUT FROM MEMBERS INCLUDES HEALTH AND WELLNESS IN ALL ITS VARIOUS ASPECTS INCLUDING PHYSICAL SPIRITUAL OCCUPATIONAL SOCIAL INTELLECTUAL EMOTIONAL ENVIRONMENTAL FINANCIAL MENTAL AND MEDICAL IT SHARES RESOURCES WITH A NETWORK OF OTHER AREA COALITIONS SUCH AS CONNECT SI ON LOCAL AND REGIONAL PROGRAMS AND THROUGH THE DELTA REGIONAL AUTHORITY MEMBERSHIP INCLUDES REPRESENTATIVES FROM MARSHALL BROWNING HOSPITAL PINCKNEYVILLE COMMUNITY HOSPITAL FIRE DEPARTMENT POLICE DEPARTMENT CHILD ADVOCACY CENTER DISTRICT 300 SCHOOL DISTRICT PERRY COUNTY COUNSELING CENTER STATE OF ILLINOIS DIETITIAN DOC ZS FITNESS AND CHIROPRACTIC MOTIVATION FITNESS AMERICAN CANCER SOCIETY AMERICAN HEART ASSOCIATION AMERICAN RED CROSS PERRY COUNTY HEALTH DEPARTMENT FIVE STAR INDUSTRIES PERRYJACKSON REGIONAL OFFICE OF EDUCATION AND SOUTHERN ILLINOIS HEALTHCARE MARSHALL BROWNING HOSPITAL LINE NUMBER 1 PART V LINE 5C PART V LINE 5C COPIES ARE ALSO LOCATED IN EACH OF THE HOSPITALS WAITING ROOMS AND ARE AVAILABLE UPON REQUEST MARSHALL BROWNING HOSPITAL LINE NUMBER 1 PART V LINE 7 PART V LINE 7 THE HOSPITAL IS CONTINUALLY WORKING TO MEET THE NEEDS IDENTIFIED THROUGH COMMUNITY EDUCATION PROGRAMS HEALTH SCREENINGS AND OTHER EVENTS THE HOSPITAL IS NOT ABLE TO MEET EVERY NEED SUCH AS MENTAL ILLNESS AND SUBSTANCE ABUSE DISORDERS BECAUSE THEY DO NOT HAVE THOSE SERVICES AVAILABLE MARSHALL BROWNING HOSPITAL LINE NUMBER 1 PART V LINE 20D PART V LINE 20D THE HOSPITAL OFFERS A 10 DISCOUNT IF PAID IF FULL WITHIN 7 DAYS OF THE FIRST BILLING STATEMENT X X false false false false false true false false false TERRENCE HALL 275582 5125 4370 285077 GLADSTONE TUCKER 210545 1877 212422 JERRY PRIAR 181207 4370 185577 BETH BIGHAM 157032 2442 159474 COMPENSATION CONTINGENT UPON NET EARNINGS OF ORGANIZATION SCHEDULE J, PAGE 1, PART I, LINE 6A THE HOSPITAL ACCRUED BONUS IN THE AMOUNT OF 155,860 GENISIO REFRIGERATION 122335 DIRECTOR HVAC BOILER SERVICES false EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS FORM 990, PAGE 1, PART I, LINE 6 VOLUNTEERS ARE PART OF THE HOSPITAL AUXILIARY WHO RUN FUNDRAISERS ON BEHALF OF THE HOSPITAL AND OPERATE THE GIFT SHOP. FIRST ACCOMPLISHMENT DESCRIPTION FORM 990, PAGE 2, PART III, LINE 4A HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR INDIVIDUAL'S INABILITY TO PAY COEXISTS. THE COMMUNITY BENEFITS CAN BE MEASURED IN MANY WAYS INCLUDING: DIRECT PATIENT CARE, SCREENINGS, EDUCATION, FUNDRAISING AND COMMUNITY SERVICE EFFORTS OF OUR COLLEAGUES. MARSHALL BROWNING HOSPITAL RECORDED 3,463 PATIENT DAYS. 2,962 OF THOSE DAYS WERE MEDICARE PATIENT DAYS, WHILE 152 CONSISTED OF MEDICAID DAYS. DURING FY 2013 THE HOSPITAL ADMITTED 712 PATIENTS AND DISCHARGED 713. THE AVERAGE LENGTH OF STAY FOR A PATIENT IS 5 DAYS. THE HOSPITAL PROVIDED 96,539 OUTPATIENT OCCASIONS OF SERVICE WHICH INCLUDED 5,992 EMERGENCY ROOM VISITS. THE HOSPITAL PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS, PROVIDING SERVICES TO BOTH MEDICARE AND MEDICAID PATIENTS. FINANCIAL ASSISTANCE IS ALSO PROVIDED THROUGH THE HOSPITAL'S INTERNAL POLICY AND IN FY 2013 THIS AMOUNTED TO 342,000 AT COST. MARSHALL BROWNING HOSPITAL OFFERS VARIOUS PROGRAMS AND SERVICES THAT SUPPORT THE HEALTH OF OUR COMMUNITY. HERE ARE A FEW EXAMPLES: AS PART OF OUR MISSION, THE HOSPITAL ANNUALLY PROVIDES ATHLETIC TRAINING SERVICES TO DUQUOIN HIGH SCHOOL ATHLETES. SERVICES ARE PROVIDED AT PRACTICES AS WELL AS AT SCHOOL SPORTING EVENTS AT NO COST TO THE SCHOOL. THE HOSPITAL ALSO PROVIDES RANDOM DRUG TESTING SERVICES AT COST-ONLY TO THE LOCAL HIGH SCHOOL. HOSPITIAL MANAGERS ARE FREQUENTLY GUEST SPEAKERS AT SCHOOLS ON VARIOUS HEALTH TOPICS AND HEALTHCARE CAREERS. HIGH SCHOOL STUDENTS PARTCIPATE IN JOB SHADOWING AND COOPERATIVE EDUCATION PROGRAMS AT THE HOSPITAL. MARSHALL BROWNING HOSPITAL ANNUALLY PROVIDES TWO SPORTS PHYSICAL CLININCS TO AREA JUNIOR HIGH AND HIGH SCHOOL STUDENTS AT A COST OF 10. THE FEE IS THEN RETURNED TO THE SCHOOLS. THE HOSPITAL ALSO SERVES AS A CLINICAL SITE FOR JOHN A. LOGAN COLLEGE NURSING STUDENTS. MARSHALL BROWNING HOSPITAL PROVIDES A VARIETY OF COMMUNITY SERVICES TO CITIZENS AND EMPLOYEES FOR WHICH WE RECEIVE NO REIMBURSEMENT SUCH AS HEALTH FAIRS, FIRST AID STATIONS, AND CLASSES FOR AUTOMATIC ELECTRONIC DEFIBULATOR'S (AED) AND BASIC LIFE SUPPORT (BLS). ADDITIONALLY, COLLEAGUES FROM MBH REACH HUNDREDS OF PEOPLE WITH PRESENTATIONS ON A WIDE VARIETY OF TOPICS INCLUDING HEART HEALTH, NUTRITION, ASTHMA, DIABETES, ALZHEIMER'S DISEASE, SLEEP APNEA, HEALTHLY GRIEVING, ARTHRITUS, BREAST CANCER, EXCERCISE AND DIET, SMOKING CESSATION, PNEUMONIA VACCINE, CIRCUIT BREAKER, AND IL CARE RX TO NAME A FEW. THE HOSPITAL ANNUALLY PROVIDES A FOUR-YEAR 1,000 SCHOLARSHIP TO A LOCAL HIGH SCHOOL SENIOR ENTERING THE HEALTHCARE FIELD. WE ALSO SPONSER A 5K RUN/WALK, GOLF TOURNAMENT, SPEAKERS FOR CAMPING CONVENTIONS AND SCREENINGS FOR LOCAL MANUFACTURING COMPANIES. THE HOSPITAL HOSTS FIVE AMERICAN RED CROSS BLOOD DRIVES EACH YEAR. MBH EMPLOYEES CONTINUE TO GROW THEIR TRADITION OF SUPPORTING THE COMMUNITY THROUGH PARTICIPATION IN A VARIETY OF FUNDRAISING WALKS FOR AMERICAN HEART ASSOCAITION AND AMERICAN CANCER SOCIETY. THEY ALSO FREQUENTLY RAISE FUNDS FOR THE LOCAL FOOD PANTRY AND HUMANE SHELTER. ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 FORM 990, PAGE 6, PART VI, LINE 11B ALL BOARD MEMBERS ARE PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW AND COMMENT BEFORE IT IS FILED. ENFORCEMENT OF CONFLICTS POLICY FORM 990, PAGE 6, PART VI, LINE 12C ALL OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST STATEMENT EACH YEAR. OFFICERS, DIRECTORS, TRUSTEES AND KEY EMPLOYEES ARE EDUCATED EACH YEAR ON THE DEFINITION OF A CONFLICT OF INTEREST AND HOW TO AVOID THEM. COMPENSATION PROCESS FOR TOP OFFICIAL FORM 990, PAGE 6, PART VI, LINE 15A THE CEO'S SALARY IS DETERMINED BY THE BOARD OF DIRECTOR'S IN WHICH THEY REVIEW MARKET WAGE DATA FOR COMPARABILITY. COMPENSATION PROCESS FOR OFFICERS FORM 990, PAGE 6, PART VI, LINE 15B ALL OTHER OFFICERS AND EMPLOYEES ARE APPROVED BY THE CEO THROUGH THE HOSPITAL'S NORMAL WAGE AND SALARY POLICY. ALL EMPLOYEES WAGES ARE COMPARED TO MARKET RATES IN THE HEALTHCARE INDUSTRY. GOVERNING DOCUMENTS DISCLOSURE EXPLANATION FORM 990, PAGE 6, PART VI, LINE 19 COPIES OF THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, FINANCIAL STATEMENTS, AND THE FEDERAL FORM 990 TAX RETURN ARE AVAILABLE UPON REQUEST FROM THE ADMINISTRATIVE OFFICE. RECONCILIATION OF CHANGES - OTHER FORM 990, PART XI, LINE 9 NET UNREALIZED LOSS 0 OTHER CHANGES IN NET ASSETS EXPLANATION FORM 990, PART XI, LINE 9 UNREALIZED GAIN ON OTHER THAN TRADING SECURITIES 220,380 GAIN ON HEDGING ACTIVITY 507,484 FY 12 ADJUSTMENT FOR MEDICARE COST REPORT 91,000 NET UNREALIZED LOSS 0 DUQUOIN CLINIC INC 4 WEST MAIN ST PO BOX 192 DUQUOIN IL 62832 HEALTHCARE IL N/A C CORP 38514 313169 1.00000 true false false false false false false false false false false false false false false false false false false false