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HSHS HOLY FAMILY HOSPITAL INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
HSHS HOLY FAMILY HOSPITAL INC (EIN 37-0792770)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-21
IRS object ID
201332339349300428
Schema version
2012v2.1
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)
Timestamp2013-08-21T15:31:03-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1600 WASHINGTON AVENUE SUITE 1800AddressLine1
CityST LOUISCity
StateMOState
ZIP Code63101ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN370792770EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GREENVILLE REGIONAL HOSPITAL INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGREENameControl
Phone6186641230Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1200 HEALTH CARE DRIVEAddressLine1
CityGREENVILLECity
StateILState
ZIP Code622461156ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRIAN NALLName
TitlePRESIDENT & CEOTitle
Phone6186641230Phone
Date Signed2013-08-20DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJEFF PARKERName
PTINP00970069PTIN
Phone3149254300Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBRIAN NALLNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1200 HEALTH CARE DRIVEAddressLine1
CityGREENVILLECity
StateILState
ZIP Code622461156ZIPCode
FieldValueIRS element (for citing)
Gross Receipts40950708GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.GREENVILLEREGIONALHOSPITAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1956YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionPROVIDE COMPASSIONATE CARE AND EXCELLENT SERVICE IN A MODERN AND EFFICIENT HEALTHCARE ORGANIZATION STAFFED BY HIGHLY TRAINED PROFESSIONALS.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees573TotalNbrEmployees
Total Nbr Volunteers750TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year276732ContributionsGrantsPriorYear
Contributions Grants Current Year2827313ContributionsGrantsCurrentYear
Program Service Revenue Prior Year36621899ProgramServiceRevenuePriorYear
Program Service Revenue CY37003093ProgramServiceRevenueCY
Investment Income Prior Year48090InvestmentIncomePriorYear
Investment Income Current Year49680InvestmentIncomeCurrentYear
Other Revenue Prior Year1013575OtherRevenuePriorYear
Other Revenue Current Year1064838OtherRevenueCurrentYear
Total Revenue Prior Year37960296TotalRevenuePriorYear
Total Revenue Current Year40944924TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year310000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY300000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year20489590SalariesEtcPriorYear
Salaries Etc Current Year22355171SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year24000TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY24000TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year30822TotalFundrsngExpCurrentYear
Other Expense Prior Year17788423OtherExpensePriorYear
Other Expenses Current Year17934141OtherExpensesCurrentYear
Total Expenses Prior Year38612013TotalExpensesPriorYear
Total Expenses Current Year40613312TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-651717RevenuesLessExpensesPriorYear
Revenues Less Expenses CY331612RevenuesLessExpensesCY
Total Assets BOY32824669TotalAssetsBOY
Total Assets EOY33001751TotalAssetsEOY
Total Liabilities BOY18436775TotalLiabilitiesBOY
Total Liabilities EOY17674183TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14387894NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY15327568NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPROVIDE COMPASSIONATE CARE AND EXCELLENT SERVICE IN A MODERN AND EFFICIENT HEALTHCARE ORGANIZATION STAFFED BY HIGHLY TRAINED PROFESSIONALS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense33233161Expense
Grants300000Grants
Revenue37003093Revenue
DescriptionGREENVILLE REGIONAL HOSPITAL IS A FULL-SERVICE, ACUTE CARE FACILITY OFFERING 42 LICENSED BEDS, A GERIATRIC BEHAVIORAL HEALTH UNIT, A 24-HOUR EMERGENCY DEPARTMENT, FAMILY BIRTH CENTER, SURGERY DEPARTMENT, REHABILITATION DEPARTMENT, SLEEP DISORDERS CENTER, OUTPATIENT PSYCHIATRIC/MENTAL HEALTH SERVICES, AND OUTPATIENT SPECIALTY CLINICS. DIAGNOSTIC SERVICES INCLUDE A LABORATORY, CARDIOPULMONARY DEPARTMENT, AND IMAGING SERVICES DEPARTMENT. THE HOSPITAL IS CERTIFIED BY THE HEALTHCARE FACILITIES ACCREDITATION PROGRAM (HFAP). IN ADDITION TO PROVIDING INPATIENT ACUTE CARE, GREENVILLE REGIONAL HOSPITAL OFFERS "SWING BEDS". MEDICARE PATIENTS QUALIFYING FOR TRANSITIONAL CARE CAN RECEIVE TREATMENT AT GREENVILLE REGIONAL THROUGH THE "SWING BED" PROGRAM. THE GERIATRIC BEHAVIORAL HEALTH UNIT IS A 10-BED INPATIENT UNIT INTENDED FOR SENIORS NEEDING MEDICATION ADJUSTMENT AND THERAPY PROGRAMS DESIGNED FOR BEHAVIORAL ISSUES. THE GERIATRIC BEHAVIORAL HEALTH UNIT SERVES SENIOR PATIENTS FROM A 150-MILE RADIUS. A PSYCHIATRIST DIRECTS THE CARE PROVIDED. WHITE OAKS SENIOR WELLNESS IS AN OUTPATIENT, GERIATRIC DAY-CARE PROGRAM INTENDED FOR PATIENTS DISCHARGED FROM A BEHAVIORAL HEALTH UNIT, OR THOSE EXPERIENCING BEHAVIORAL ISSUES. MEDICARE PATIENTS QUALIFYING FOR OUTPATIENT BEHAVIORAL HEALTH TREATMENTS CAN RECEIVE CARE THROUGH THE WHITE OAKS PROGRAM. THE HOSPITAL OWNS THREE CLINIC STRUCTURES ON THE HOSPITAL CAMPUS, AS WELL AS THREE CLINICS LOCATED IN NEARBY, RURAL COMMUNITIES. ALL SIX FACILITIES ARE CERTIFIED RURAL HEALTH CLINICS. THE CLINICS ARE UTILIZED BY PRIMARY CARE AND SPECIALTY PHYSICIANS, AS WELL AS MID-LEVEL PRACTITIONERS. BOND COUNTY EMERGENCY MEDICAL SERVICES IS BASED AT AND OPERATED BY THE HOSPITAL. THE SERVICE PROVIDES ADVANCED CARDIAC LIFE SUPPORT (ACLS) AND THE ORGANIZATION HAS ALSO ACHIEVED "RESOURCE HOSPITAL" STATUS. SOME YEARS AGO, THE HOSPITAL WAS ASKED BY THE BOND COUNTY BOARD TO ASSUME OPERATION OF THE AMBULANCE SERVICE AND PROVIDE EMERGENCY MEDICAL TREATMENT AT THE SCENE AFTER IT BECAME APPARENT THAT A PRIVATE COMPANY COULD NO LONGER REMAIN OPERATIONAL. THE HOSPITAL EMERGENCY DEPARTMENT IS STAFFED 24-HOURS PER DAY BY A PHYSICIAN. FOUR MAJOR TRAUMA SUITES, THREE EXAMINATION ROOMS, A TRIAGE ROOM, AND AN IV THERAPY ROOM ARE LOCATED WITHIN THE DEPARTMENT. WHEN NEEDED, HELICOPTER AMBULANCE SERVICE IS AVAILABLE. IN 2012, 205 INFANTS WERE DELIVERED AT THE GREENVILLE REGIONAL FAMILY BIRTH CENTER. PHYSICAL, SPEECH, AND OCCUPATIONAL THERAPY ARE OFFERED ON BOTH AN INPATIENT AND OUTPATIENT BASIS. THE HOSPITAL HAS THE STATE-OF-THE-ART BIONESS FOOT DROP SYSTEM AVAILABLE. THE HOSPITAL IS THE ONLY FACILITY IN THE IMMEDIATE AREA OFFERING THIS TECHNOLOGY. THE HOSPITAL OUTPATIENT SPECIALTY CLINIC OFFERS 16 MEDICAL SPECIALTIES AND CONTAINS 13 EXAMINATION ROOMS. FOUR CLINICS CAN BE IN OPERATION SIMULTANEOUSLY. THE HOSPITAL MAY HOST AS MANY AS 100 CLINICS IN JUST 27 WORKING DAYS. FOR THE CONVENIENCE OF PATIENTS, SATURDAY CARDIOLOGY APPOINTMENTS ARE AVAILABLE. MEDICAL SPECIALTIES AVAILABLE AT THE HOSPITAL'S OUTPATIENT CLINIC ARE: CARDIOLOGY, OBSTETRICS/GYNECOLOGY, NEPHROLOGY, SPORTS MEDICINE, MEMORY, ORTHOPEDICS, ONCOLOGY, PULMONARY MEDICINE, EARS/NOSE/THROAT, HAND SURGERY, GASTROENTEROLOGY, NERVE CONDUCTION, UROLOGY, GENERAL AND VASCULAR SURGERY, ALLERGIES, AND SLEEP DISORDERS. THE HOSPITAL'S LABORATORY CAN PERFORM A WIDE ARRAY OF BLOOD, TISSUE, AND FLUID TESTING. THE IMAGING SERVICES DEPARTMENT OFFERS IN-HOUSE X-RAY, CAT SCAN, MRI, ULTRASOUND, NUCLEAR SCAN, BONE DENSITY, AND DIGITAL MAMMOGRAPHY TECHNOLOGY. MOBILE PET SCANS ARE ALSO AVAILABLE. THE HOSPITAL HAS THE CAPABILITY OF TRANSMITTING IMAGES TO ON-CALL RADIOLOGISTS FOR SCANS PERFORMED AFTER NORMAL BUSINESS HOURS.Description

Activity2 Activity2

FieldValueIRS element (for citing)
DescriptionFAIR OAKS IS A 108-BED, MEDICARE AND MEDICAID CERTIFIED, SHORT-TERM REHABILITATION AND LONG-TERM CARE FACILITY ADJOINING THE HOSPITAL. ADULT DAY CARE AND RESPITE CARE ARE ALSO PROVIDED AT FAIR OAKS. EMERALD POINTE IS AN INDEPENDENT, SENIOR LIVING DEVELOPMENT LOCATED ON THE HOSPITAL CAMPUS. THE DEVELOPMENT CONSISTS OF A 15-UNIT APARTMENT BUILDING, FIVE DUPLEX STRUCTURES, AND A SINGLE UNIT PROVIDING 11 RESIDENCES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
DescriptionTHE ORGANIZATION OWNS THREE CLINIC STRUCTURES ON THE HOSPITAL CAMPUS, AS WELL AS THREE CLINICS LOCATED IN NEARBY, RURAL COMMUNITIES. ALL SIX FACILITIES ARE CERTIFIED RURAL HEALTH CLINICS. THE CLINICS ARE UTILIZED BY PRIMARY CARE AND SPECIALTY PHYSICIANS, AS WELL AS MID-LEVEL PRACTITIONERS.Description
FieldValueIRS element (for citing)
Total Program Service Expense33233161TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109623NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees573NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Form8899 Filed0Form8899Filed
Form1098 C Filed0Form1098CFiled
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1BRIAN NALL PRESIDENT & CEOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6186641230TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 HEALTH CARE DRIVEAddressLine1
CityGREENVILLECity
StateILState
ZIP Code622461156ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
MORRIS BOND
CHAIRMAN OF THE BOARD / INTERIM CEO (BOTH IN 2012)40.002.00XX14833700
JEFF MOLLET
BOARD MEMBER/CHAIRMAN OF THE BOARD5.0010.00X000
DOUG STROUD
BOARD MEMBER1.002.00X000
SALLY BOLEN
BOARD MEMBER1.002.00X000
BART CALDIERARO
BOARD MEMBER1.002.00X000
BETTY IMBODEN
BOARD MEMBER1.002.00X000
DR SUSAN HUGHEY-RASLER
BOARD MEMBER/PHYSICIAN1.002.00X1162000
FRANK JOY JR
BOARD MEMBER1.002.00X000
JILL YOUNG
BOARD MEMBER1.002.00X000
ROSIE YORK
BOARD MEMBER1.002.00X000
ERNIE CHAPPEL
BOARD MEMBER1.002.00X000
DR RANDALL BERGEN
BOARD MEMBER1.002.00X000
JERRY GAFFNER
BOARD MEMBER1.002.00X000
MIKE SUESS
BOARD MEMBER1.002.00X000
BRIAN NALL
CEO40.002.00X36430012166
MICHAEL ZILM
INTERIM CEO40.002.00X10848000
SHERRY KOEHLER
CFO40.002.00X17800802430
TAMMY LETT
CNO40.002.00X7214002567
PAT PEVERLY
INTERIM CNO40.002.00X1157950540
DR JOHN DAWDY
PHYSICIAN40.0032918205072X
DR DAWN MCDAID
PHYSICIAN40.0032234104409X
DR BOYD MCCRACKEN
PHYSICIAN40.0031295604272X
DR RAYMOND RYAN
PHYSICIAN40.0030480102045X
DR CHRISTINA DOTHAGER
PHYSICIAN40.002701710560X
SARA MCPEAK
FORMER CNO0.000.0013148802782X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2341749TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation36843TotalOtherCompensation
Number Individuals GT100 K22NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MIDWEST EMERGENCY DEPARTMENT SVCS
320 EAST HIGHWAY 50OFALLONIL62269ER PHYSICIAN COVERAGE1383665
SELECT REHABILITATION
PO BOX 809056CHICAGOIL606809056THERAPY SERVICES818931
QUEST DIAGNOSTICS
PO BOX 14730ST LOUISMO631504730REFERENCE LABS289312
SPECIALCARE HOSPITAL MANAGEMENT
502 EARTH CITY PLAZA SUITE 311EARTH CITYMO63045MEDICAL STABILIZATION SVCS187642
HITS SCANNING SOLUTIONS
11833 NEW HALLS FERRY ROADST LOUISMO63033MEDICAL RECORDS SCANNING113832
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K
Related Organizations2782184RelatedOrganizations
Government Grants45129GovernmentGrants
Total Contributions2827313TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT REVENUES6211103501222735012227
EHR REIMBURSEMENTS62111015747361574736
PHARMACEUTICALS446110230524230524
LABORATORY621500185606185606
FieldValueIRS element (for citing)
Total Program Service Revenue37003093TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column55374TotalRevenueColumn
Exclusion$55,374ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real410952Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real410952Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column410952TotalRevenueColumn
Exclusion$410,952ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other90Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other5784Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-5694Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-5694TotalRevenueColumn
Exclusion-$5,694ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
GIFT SHOP453220312290$312,290
MISCELLANEOUS INCOME624100149056$149,056
CAFETERIA722210133272$133,272

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column59268TotalRevenueColumn
Exclusion$59,268ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue653886TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column40944924TotalRevenueColumn
Related Or Exempt Function Income37003093RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,114,518ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total300000Total
Program Services300000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total682198Total
Program Services68220ProgramServices
Management And General607156ManagementAndGeneral
Fundraising6822Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total17257656Total
Program Services13833502ProgramServices
Management And General3424154ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total181267Total
Program Services145301ProgramServices
Management And General35966ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3052177Total
Program Services2446583ProgramServices
Management And General605594ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1181873Total
Program Services947373ProgramServices
Management And General234500ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total66162Total
Management And General66162ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total72889Total
Management And General72889ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total15310Total
Program Services15310ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total24000Total
Fundraising24000Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total114993Total
Program Services92177ProgramServices
Management And General22816ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4418447Total
Program Services3541767ProgramServices
Management And General876680ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total263930Total
Program Services211563ProgramServices
Management And General52367ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1838145Total
Program Services1473432ProgramServices
Management And General364713ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total95885Total
Program Services76860ProgramServices
Management And General19025ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total493301Total
Program Services395423ProgramServices
Management And General97878ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1973833Total
Program Services1973833ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total638464Total
Program Services511784ProgramServices
Management And General126680ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACTED SERVICES31810822549912631170
PROVISION FOR BAD DEBT23412912341291
PHYSICIAN SERVICES19352161935216
EQUIPMENT & REPAIRS27438221994154441

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total210811Total
Program Services153673ProgramServices
Management And General57138ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total40613312Total
Program Services33233161ProgramServices
Management And General7349329ManagementAndGeneral
Fundraising30822Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY549376BOY
EOY1950702EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY6363703BOY
EOY6292248EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY55298BOY
EOY22457EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY446145BOY
EOY483501EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1075847BOY
EOY1182505EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis42106710LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec21935877LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY21415205BOY
EOY20170833EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY2771251BOY
EOY2516351EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY147844BOY
EOY383154EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY32824669BOY
EOY33001751EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4441732BOY
EOY4690189EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY643666BOY
EOY103523EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY9997358BOY
EOY9534542EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY148237BOY
EOY82997EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY3205782BOY
EOY3262932EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY18436775BOY
EOY17674183EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY14378524BOY
EOY15325221EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY9370BOY
EOY2347EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14387894BOY
EOY15327568EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY32824669BOY
EOY33001751EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses331612ReconcilationRevenueExpenses
Reconcilation Other Changes608062ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$15,310GrantsOtherOrganizationsAmount
Direct Contact Legislators1DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB15310TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis32058706OtherCostOrOtherBasis
Depreciation14606608Depreciation
Book Value17452098BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis9811205OtherCostOrOtherBasis
Depreciation7329269Depreciation
Book Value2481936BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis236799OtherCostOrOtherBasis
Book Value236799BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings20170833TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
LIFE RESIDENCY FEES$1,566,967
ASSET RETIREMENT OBLIGATION$316,918
DUE TO THIRD PARTY PAYORS$1,379,047
FieldValueIRS element (for citing)
Total Of Amounts3262932TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X, LINE 2:ReturnReference
ExplanationTHE CONSOLIDATED AFFILIATES ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3)OF THE INTERNAL REVENUE CODE, THUS THERE IS NO PROVISION FOR INCOME TAXES AT DECEMBER 31, 2012 AND 2011. THE HOSPITAL APPLIES THE INCOME TAX STANDARD FOR UNCERTAIN TAX POSITIONS. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ORGANIZATION'S FINANCIAL STATEMENTS IN ACCORDANCE WITH THE INCOME TAX STANDARD. THIS STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE CONSOLIDATED AFFILIATES INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE HOSPITAL IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS AND IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. THE TAX RETURNS FOR THE FISCAL YEARS 2009 TO 2012 ARE OPEN TO EXAMINATION BY FEDERAL, LOCAL, AND STATE AUTHORITIES.Explanation

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation

FieldValueIRS element (for citing)
Name Of IndividualPATRICIA BONDNameOfIndividual

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11303 SPRING DRIVEAddressLine1
CityGREENVILLECity
StateILState
ZIP Code62246ZIPCode
FieldValueIRS element (for citing)
ActivityGRANT WRITING & APPLICATIONActivity
Fundraiser Control Of Funds0FundraiserControlOfFunds
Gross Receipts0GrossReceipts
Amount Retained By Contractor24000AmountRetainedByContractor
Net To Organization-24000NetToOrganization
FieldValueIRS element (for citing)
Total Retained By Contractors24000TotalRetainedByContractors
Total Net To Organization-24000TotalNetToOrganization
Licensed StatesILLicensedStates

Form990 Schedule G Part IV Form990ScheduleGPartIV

FieldValueIRS element (for citing)
IdentifierPROFESSIONAL FUNDRAISINGIdentifier
Return ReferenceSCHEDULE G; PART I; LINE 2ReturnReference
ExplanationGREENVILLE REGIONAL HOSPITAL, INC. EMPLOYS A PROFESSIONAL FUNDRAISER AND REPORTS THE SALARIES OF THIS INDIVIDUAL ON THIS RETURN. THE REVENUE GENERATED FROM THE FUNDRAISERS EFFORTS ARE RECORDED UNDER UTLAUT MEMORIAL FOUNDATION, A SISTER CORPORATION OF THE HOSPITAL.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent300XPcent300
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense790530TotalCommunityBenefitExpense
Net Community Benefit Expense790530NetCommunityBenefitExpense
Percent Of Total Expense0.02070PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense5411276TotalCommunityBenefitExpense
Direct Offsetting Revenue2515596DirectOffsettingRevenue
Net Community Benefit Expense2895680NetCommunityBenefitExpense
Percent Of Total Expense0.07570PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense6201806TotalCommunityBenefitExpense
Direct Offsetting Revenue2515596DirectOffsettingRevenue
Net Community Benefit Expense3686210NetCommunityBenefitExpense
Percent Of Total Expense0.09640PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs8NumberOfActivitiesOrPrograms
Persons Served4314PersonsServed
Total Community Benefit Expense129819TotalCommunityBenefitExpense
Direct Offsetting Revenue177605DirectOffsettingRevenue
Net Community Benefit Expense-47786NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Persons Served14PersonsServed
Total Community Benefit Expense17436TotalCommunityBenefitExpense
Net Community Benefit Expense17436NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense11370172TotalCommunityBenefitExpense
Direct Offsetting Revenue8478373DirectOffsettingRevenue
Net Community Benefit Expense2891799NetCommunityBenefitExpense
Percent Of Total Expense0.07560PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served50PersonsServed
Total Community Benefit Expense68522TotalCommunityBenefitExpense
Net Community Benefit Expense68522NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served4378PersonsServed
Total Community Benefit Expense11585949TotalCommunityBenefitExpense
Direct Offsetting Revenue8655978DirectOffsettingRevenue
Net Community Benefit Expense2929971NetCommunityBenefitExpense
Percent Of Total Expense0.07790PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs9NumberOfActivitiesOrPrograms
Persons Served4378PersonsServed
Total Community Benefit Expense17787755TotalCommunityBenefitExpense
Direct Offsetting Revenue11171574DirectOffsettingRevenue
Net Community Benefit Expense6616181NetCommunityBenefitExpense
Percent Of Total Expense0.17430PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served100PersonsServed
Total Community Building Expense830TotalCommunityBuildingExpense
Net Community Building Expense830NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Number Of Activities Or Programs4NumberOfActivitiesOrPrograms
Persons Served100PersonsServed
Total Community Building Expense830TotalCommunityBuildingExpense
Net Community Building Expense830NetCommunityBuildingExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$1,022,859BadDebtExpenseAmount
Amount Attributable To102285AmountAttributableTo
Amount Reimbursed By Medicare8966466AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare9340061CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-373595MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1GREENVILLE REGIONAL HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1200 HEALTHCARE DRIVEAddressLine1
CityGREENVILLECity
StateILState
ZIP Code62246ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GREENVILLE REGIONAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent150.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent300.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges1GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities5NumberOfOtherFacilities

Other Facilities OtherFacilities (5 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
FAIR OAKS NURSING HOME
200 HEALTH CARE DRIVEGREENVILLEIL62246SKILLED NURSING FACILITY
GREENVILLE FAMILY WELLNESS CENTER
150 HEALTH CARE DRIVEGREENVILLEIL62246PHYSICIAN CLINIC
GREENVILLE MEDICAL ASSOCIATES
101 HEALTHCARE DRIVEGREENVILLEIL62246PHYSICIAN CLINIC
MCHCRACKEN-DAWDY-HALL FAMILY PRACTICE
201 HEALTHCARE DRIVEGREENVILLEIL62246PHYSICIAN CLINIC
EMERALD POINTE
105 HONEY LOCUST LANEGREENVILLEIL62246INDEPENDENT LIVING FACILITY

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

ExplanationExplanationIdentifierIdentifier
PART I, LINE 6A: THE UTLAUT MEMORIAL FOUNDATION'S ANNUAL REPORT CONTAINS THE COMMUNITY BENEFIT INFORMATION.
PART I, LINE 7: THE COST TO CHARGE RATIO SHOWN IN THE MEDICARE COST REPORT IS APPLIED TO THE GROSS AMOUNTS FOR CHARITY, MEDICAID, ETC. TO DETERMINE THE TRUE COST OF THESE PROGRAMS. FOR THE OTHER SUBSIDIZED PROGRAMS, SOME COSTS ARE ESTIMATED BASED ON CERTAIN ALLOCATIONS: SQUARE FOOTAGE, STATISTICS, STAFF TIME, SUPPLIES USED, AND OTHER VARIOUS FACTORS.
PART I, LINE 7G: THE SERVICE OF PHYSICIAN PRACTICE OPERATIONS INCLUDES COSTS ATTRIBUTABLE TO PHYSICIAN CLINICS. SOME OF THE COSTS INCLUDED IN THIS SUBSIDIZED SERVICE ARE SALARIES, BENEFITS, SUPPLIES, OUTSOURCED PHYSICIAN FEES, AND OTHER VARIOUS EXPENSES.
PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2341291.
PART II: GREENVILLE REGIONAL HOSPITAL HOSTS A VARIETY OF COMMUNITY EVENTS. A NUMBER OF HOSPITAL ROOMS ARE USED FOR HEALTH-RELATED COMMUNITY FUNCTIONS. SUPPORT GROUPS THAT MEET WITHIN THE HOSPITAL INCLUDE: DIABETES; DEMENTIA CAREGIVERS; PARKINSON'S DISEASE, AND WOMEN'S WELLNESS. GOOD HEALTH, HEALTH IMPROVEMENT, AND QUALITY OF LIFE ARE PROMOTED THROUGH THE EDUCATION, INFORMATION, AND SUPPORT THAT IS PROVIDED DURING THE SESSIONS LISTED. INDIVIDUALS AFFLICTED WITH DIABETES AND PARKINSON'S DISEASE HAVE THE OPPORTUNITY TO RECEIVE IMPORTANT INFORMATION RELATED TO THEIR ILLNESS. TREATMENT REGIMES, MEDICATIONS AVAILABLE, AND SUGGESTIONS FOR COPING WITH THE DISEASES ARE OFFERED. PATIENTS DIAGNOSED WITH THESE DISEASES CAN INTERACT WITH OTHERS WHO ARE AFFLICTED WITH THESE CONDITIONS. INDIVIDUALS PROVIDING ASSISTANCE TO THOSE WITH DEMENTIA-RELATED CONDITIONS OR ALZHEIMER'S DISEASE ATTEND THE DEMENTIA CAREGIVERS SUPPORT GROUP. FAMILY MEMBERS ARE WELCOME TO ATTEND THE SUPPORT GROUP SESSIONS AND BENEFIT FROM THE INFORMATION PRESENTED AND THE SOCIAL INTERACTION THAT TAKES PLACE. AN ANNUAL EVENT TITLED "IN THE PINK" (WHICH PROMOTES WOMEN'S WELLNESS) IS HELD AT A LOCAL CHURCH AND IS CATERED BY GREENVILLE REGIONAL HOSPITAL. ON OCTOBER 4TH, 2012, OVER 100 WOMEN ATTENDED THE EVENT IN WHICH SEVERAL HEALTH FAIR BOOTHS WERE AVAILABLE AND TWO SPEAKERS DISCUSSED TOPICS AFFECTING WOMEN'S HEALTH.
PART III, LINE 4: THE COST TO CHARGE RATIO FROM THE MOST RECENT MEDICARE COST REPORT IS APPLIED TO THE ORGANIZATION'S BAD DEBT EXPENSE FOR THE FISCAL YEAR. THE ORGANIZATION EMPLOYS A FINANCIAL COUNSELOR THAT WORKS WITH ALL SELF-PAY PATIENTS. BASED ON REVIEW OF TAX RETURNS, BANK STATEMENTS, AND OTHER FINANCIAL DOCUMENTS PROVIDED BY THE PATIENT, AN ESTIMATE EQUAL TO 10% OF BAD DEBT PATIENTS WOULD QUALIFY FOR CHARITY CARE BUT FAILED TO PROVIDE THE APPROPRIATE LEVEL OF DOCUMENTATION AND INFORMATION.
PART III, LINE 8: THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT IS UTILIZED IN DETERMINING THE ORANIZATION'S COMMUNITY BENEFIT.
PART V, SECTION B, LINE 20D: IF THE PATIENT DOES NOT QUALIFY FOR FINANCIAL ASSISTANCE AND HE/SHE REQUESTS A DISCOUNT, GREENVILLE REGIONAL HOSPITAL AWARDS A 40% REDUCTION. A "PROMPT PAY" MARKDOWN IS ALSO GRANTED (UP TO 20%) IF THE PATIENT PAYS WITHIN 10 DAYS OF SERVICE DATE.GREENVILLE REGIONAL HOSPITAL
PART V, SECTION B, LINE 22: ALL PATIENTS ARE CHARGED THE SAME AMOUNT (GROSS CHARGES) AND ANY APPLICABLE DISCOUNTS FOR CHARITY CARE, PROMPT PAY, UNINSURED, MANAGED CARE, ETC. ARE APPLIED AFTER THE FACT.GREENVILLE REGIONAL HOSPITAL
PART VI, LINE 2: GREENVILLE REGIONAL HOSPITAL ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES USING A VARIETY OF FORMAL AND INFORMAL METHODS. NRC PICKER SURVEYS WERE UTILIZED TO MONITOR THE QUALITY OF SERVICES PROVIDED AT THE HOSPITAL. FEEDBACK REGARDING HEALTH CARE NEEDS IS RECEIVED CONTINUALLY FROM FREQUENT INTERACTION AND ENCOUNTERS WITHIN THE COMMUNITY. SERVING A CLOSELY-KNIT AREA, GREENVILLE REGIONAL HOSPITAL'S MANAGEMENT TEAM IS INVOLVED IN MANY COMMUNITY CLUBS, ORGANIZATIONS, CHURCHES, TEAMS, AND COMMITTEES. THE BOARD OF DIRECTORS REPRESENTS A DIVERSE, CROSS SECTION OF THE COMMUNITY. BOARD MEMBERS RECEIVE AND SHARE COMMENTS RELATED TO HEALTH CARE NEEDS AND NEW SERVICES DESIRED. AN EVALUATION FORM IS SENT TO EACH HEALTH FAIR PARTICIPANT. THESE INDIVIDUALS ARE AFFORDED THE OPPORTUNITY TO PROVIDE FEEDBACK REGARDING THE EVENT AND THEIR NEED FOR LOW COST HEALTH SCREENINGS AND TESTING. ANY HEALTH TRENDS DETECTED THROUGH THE TESTING OFFERED AT THE HEALTH FAIR CAN BE ASSESSED AND USED TO SHAPE SERVICES PROVIDED BY THE HOSPITAL. MONTHLY MEDICAL STAFF MEETINGS OFFER PHYSICIANS THE OPPORTUNITY TO INTERACT WITH HOSPITAL MANAGEMENT AND DISCUSS SERVICES NEEDED BY THEIR PATIENTS. IN 2011, THE HOSPITAL UTILIZED A CONSULTANT TO CONDUCT A MARKET RESEARCH SURVEY. THE STUDY GENERATED CONSUMER INFORMATION REGARDING HEALTH ISSUES, UNMET MEDICAL NEEDS, PHYSICIAN SHORTAGES, AND DESIRED SERVICES. PLANNING IS UNDERWAY TO PERFORM A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT. THE PROJECT WILL BEGIN IN LATE 2012 AND WILL BE COMPLETED DURING 2013.
PART VI, LINE 3: THE HOSPITAL EMPLOYS A FINANCIAL COUNSELOR WHO WORKS WITH ALL SELF-PAY PATIENTS. THE COUNSELOR ASSESSES THE PATIENTS FINANCIAL POSITION AND WILL ASSIST THE PATIENT IN COMPLETING THE NECESSARY PAPERWORK TO APPLY FOR MEDICAID OR CHARITY CARE ASSISTANCE (IF APPLICABLE).
PART VI, LINE 4: GREENVILLE REGIONAL HOSPITAL SERVES THE RESIDENTS OF BOND COUNTY AND THE SURROUNDING FOUR COUNTIES (FAYETTE, CLINTON, MONTGOMERY, AND MADISON). THE HOSPITAL HAS A PRIMARY AND SECONDARY MARKET AREA CONSISTING OF APPROXIMATELY 30,000 TO 32,000 INDIVIDUALS. THE MARKET AREA INCLUDES AN ABOVE AVERAGE NUMBER OF SENIOR CITIZENS. WHILE THE NATIONAL AND STATE AVERAGE FOR THOSE OVER THE AGE OF 60 IS APPROXIMATELY 12 PERCENT, THOSE OVER THE AGE OF 60 IN THE HOSPITAL'S PRIMARY MARKET AREA IS 22 PERCENT. THE MARKET AREA IS RURAL IN ITS COMPOSITION. THE AGRICULTURAL ECONOMY IS SIGNIFICANT WITHIN THE AREA. SOME MANUFACTURING DOES EXIST IN THE LOCAL COMMUNITIES. MEDICARE, MEDICAID, AND UNCOMPENSATED CARE PATIENTS COMPRISE A MAJORITY OF THOSE SERVED BY THE HOSPITAL. THE INCOME LEVELS OF THE MARKET AREA ARE NOT HIGH. MANY OF THE RESIDENTS IN THE REGION RELY ON THE HOSPITAL TO PROVIDE ROUTINE DIAGNOSTIC SERVICES SUCH AS LAB AND IMAGING SERVICES. THE HOSPITAL IS THE PRIMARY SOURCE OF AMBULANCE, EMERGENCY, AND REHABILITATION SERVICES. GREENVILLE REGIONAL IS THE ONLY FACILITY IN THE COUNTY, AND ONE OF ONLY TWO HOSPITALS IN THE AREA, THAT PROVIDES OBSTETRICAL SERVICES. THE NEXT CLOSEST OB UNIT WOULD REQUIRE A MINIMUM DRIVE TIME OF 30-40 MINUTES. THE HOSPITAL PROVIDES INFANT DELIVERY SERVICES FOR PATIENTS SPANNING AN 80 MILE RADIUS. GREENVILLE REGIONAL HOSPITAL IS THE LARGEST EMPLOYER IN BOND COUNTY WITH APPROXIMATELY 475 FULL- AND PART-TIME STAFF MEMBERS. THE FACILITY'S ANNUAL PAYROLL IS OVER $16.4 MILLION WITHOUT BENEFITS AND $20.5 MILLION WITH BENEFITS. THE HOSPITAL'S ECONOMIC IMPACT EXCEEDS $74 MILLION.
PART VI, LINE 5: GREENVILLE REGIONAL HOSPITAL, AND ITS AFFILIATED DIVISIONS, EXISTS ONLY TO PROVIDE HEALTH CARE SERVICES FOR RESIDENTS OF THE AREA. IN 2012, THE HOSPITAL'S COMMUNITY BENEFIT TOTAL WAS DETERMINED TO BE APPROXIMATELY $7.6 MILLION. THE HOSPITAL IS INTENTIONALLY STRUCTURED AS A NOT-FOR-PROFIT ORGANIZATION IN THAT ITS ONLY PURPOSE IS TO SERVE OTHERS. NO SINGLE INDIVIDUAL OR GROUP OF INVESTORS PROFITS FROM THE ACTIVITIES OF THE HOSPITAL. AS IS EVIDENT BY THE FINANCIAL LOSSES REPORTED IN THIS DOCUMENT, THE HOSPITAL BOARD OF DIRECTORS IS COMMITTED TO SERVING THE HEALTH CARE NEEDS OF THE REGION. MEDICAL SERVICES CRITICAL TO THE HEALTH AND WELL-BEING OF THOSE SERVED BY THE HOSPITAL ARE PROVIDED EVEN THOUGH THE REVENUES GENERATED MAY NOT COVER THE OPERATIONAL COSTS. THE HOSPITAL'S "NOT-FOR-PROFIT" STATUS IS VITAL TO THE ORGANIZATION'S EXISTENCE. GREENVILLE REGIONAL ADHERES TO A "NON-DISCRIMINATION TREATMENT POLICY". REGARDLESS OF A PATIENT'S FINANCIAL OR HEALTH INSURANCE STATUS, CARE IS PROVIDED. NO PATIENT IS REFUSED TREATMENT BASED UPON THEIR ABILITY TO PAY. GREENVILLE REGIONAL HOSPITAL FUNDS ITS OWN "HEALTH CARE ASSISTANCE PROGRAM". IN 2012, $790,530 IN CHARITY ASSISTANCE (AT COST) WAS PROVIDED TO PATIENTS WHO QUALIFIED FOR BILLING REDUCTIONS UP TO 100 PERCENT. INCOME GUIDELINES AND FAMILY SIZE ARE USED TO DETERMINE ELIGIBILITY FOR THIS SELF-FUNDED PROGRAM. THE HOSPITAL-OWNED, OBSTETRICS/GYNECOLOGY (OB/GYN) PROVIDER PRACTICE LOST $504,000 IN 2012. THE PRACTICE CONSISTS OF TWO OB/GYN SPECIALISTS AND TWO MIDWIVES. OBSTETRICAL PATIENTS FROM A WIDE GEOGRAPHICAL RADIUS USE THE GREENVILLE REGIONAL OBSTETRICAL DEPARTMENT. GREENVILLE REGIONAL IS ONE OF ONLY TWO HOSPITALS IN THE IMMEDIATE AREA THAT PROVIDE INFANT DELIVERY SERVICES. AN ANNUAL LOSS ASSOCIATED WITH PROVIDING INFANT DELIVERIES HAS BECOME AN EXPECTED PRACTICE. THE HOSPITAL'S BOARD OF DIRECTORS HAS ACCEPTED THE LOSS AS A RESULT OF THE PAYER MIX AND THE LACK OF OBSTETRICAL SERVICES WITHIN THE AREA. SEVEN OF EVERY TEN BIRTHS AT THE HOSPITAL ARE OF MEDICAID STATUS. THE STATE OF ILLINOIS MEDICAID PROGRAM DOES NOT MEET THE COST OF PROVIDING CARE. THE MEDICAID PAYMENT CYCLE RANGES FROM SEVEN TO EIGHT MONTHS, CREATING A CASH FLOW CRISIS. THE "LOW AND SLOW" CHALLENGE HAS BEEN A PROBLEM IN ILLINOIS FOR OVER 30 YEARS. THE BOARD OF DIRECTORS BELIEVES THAT THE AVAILABILITY OF INFANT DELIVERY SERVICES IS VITALLY IMPORTANT FOR THE HEALTH AND WELL BEING OF THE MULTI-COUNTY AREA SERVED BY THE HOSPITAL. GREENVILLE REGIONAL PROVIDES OUTPATIENT PSYCHIATRIC AND MENTAL HEALTH SERVICES, INCLUDING COUNSELING. THESE SERVICES ARE HIGHLY UTILIZED AS A RESULT OF NEED AND LIMITED AVAILABILITY WITHIN THE REGION. THE HOSPITAL-OWNED FAMILY, OB/GYN, PSYCHIATRIC, SPORTS MEDICINE, ONCOLOGY, PULMONOLOGY, AND SURGERY PRACTICES EXPERIENCED A LOSS OF $2.4M IN 2012. DURING THE 2012 FISCAL YEAR, THE OPERATIONAL LOSS AT FAIR OAKS NURSING HOME WAS $788K. THE RESIDENT PAYER MIX IS A SIGNIFICANT CAUSE OF THE LOSS. APPROXIMATELY 50 TO 60 PERCENT OF THE RESIDENTS ARE COVERED BY THE MEDICAID PROGRAM. THE ILLINOIS MEDICAID LONG-TERM CARE REIMBURSEMENT RATE RANKS 49TH LOWEST IN THE NATION. FAIR OAKS IS ONE OF ONLY TWO NURSING HOMES LOCATED IN BOND COUNTY. BOND COUNTY EMERGENCY MEDICAL SERVICES IS OPERATED BY THE HOSPITAL AND REPRESENTS A UNIQUE PRIVATE-PUBLIC PARTNERSHIP. GREENVILLE REGIONAL HOSPITAL IS A "COMMUNITY RESOURCE" THAT IMPROVES THE HEALTH AND QUALITY OF LIFE FOR THOSE RESIDING IN THE AREA. IN ADDITION TO THE AVAILABILITY OF EMERGENCY, DIAGNOSTIC, TREATMENT, AND REHABILITATION SERVICES, GREENVILLE REGIONAL HOSPITAL OFFERS MONTHLY SUPPORT MEETINGS AT NO CHARGE TO THE PARTICIPANTS. SUPPORT GROUPS ARE OFFERED ON THE TOPICS OF DEMENTIA, DIABETES, PARKINSON'S DISEASE, AND CHILDBIRTH EDUCATION. A "WOMEN'S WELLNESS" PROGRAM IS ALSO HELD EACH YEAR. NO-COST LANGUAGE TRANSLATION IS PROVIDED FOR PATIENTS IN NEED OF THIS SERVICE. THE HOSPITAL OWNS MEDICAL CLINICS IN THREE, NEIGHBORING, SMALL COMMUNITIES. THESE MEDICAL OFFICES SAVE TIME AND COSTS FOR MANY WHO WOULD HAVE TO DRIVE GREATER DISTANCES TO RECEIVE PRIMARY CARE. ACCESS TO A PHYSICIAN IS MADE POSSIBLE BECAUSE OF THE CLINIC BUILDINGS OWNED BY THE HOSPITAL. THE FACILITIES ARE CERTIFIED RURAL HEALTH CLINICS. MID - LEVEL PRACTITIONERS AND PHYSICIANS STAFF THE OUTREACH FACILITIES. FOR THE PAST 30 YEARS, GREENVILLE REGIONAL HOSPITAL HAS SPONSORED A MULTI-FACETED HEALTH FAIR. THE EVENT IS ONE OF THE LARGEST HEALTH FAIRS IN THE ST. LOUIS METROPOLITAN AREA. THE EVENT FEATURES MANY FREE HEALTH TESTS IN ADDITION TO FOUR, LOW-COST COMPREHENSIVE BLOOD TESTS. IN 2012, APPROXIMATELY 3,700 BLOOD TESTS WERE PERFORMED IN CONJUNCTION WITH THE HEALTH FAIR. THE PARTICIPANTS RECEIVE THE DIRECT COMMUNITY BENEFIT OF THE FREE AND REDUCED PRICE TESTING OFFERED BY THE HOSPITAL. PARTICIPANTS COULD CHOOSE FROM A COMPREHENSIVE BLOOD TEST, PROSTATE SPECIFIC ANTIGEN BLOOD TEST (PSA), HEMOGLOBIN A1-C, VITAMIN D BLOOD TEST, OR A COMBINATION OF THE FOUR BLOOD TESTS. THE OPPORTUNITY COST INCURRED BY GREENVILLE REGIONAL HOSPITAL FOR OFFERING THESE DISCOUNTED SERVICES WAS $1,566,932. THE ORGANIZATION CONSIDERS THE OPPORTUNITY COST AS THE REDUCTION IN REVENUE THAT WOULD HAVE BEEN RECEIVED HAD THE HEALTH FAIR TESTING BEEN PROVIDED AT TYPICAL RETAIL PRICING. MORE THAN 250 VOLUNTEERS ASSIST WITH THE EVENT. IN ADDITION TO THE SERVICES PROVIDED ON THE DAY OF THE HEALTH FAIR, THE HOSPITAL ALSO PERFORMS THE LOW-COST BLOOD TESTS AT SEVERAL OFF-SITE LOCATIONS FOR THE EMPLOYEES OF AREA SCHOOLS, BUSINESSES, AND MANUFACTURERS. THROUGH THE YEARS, A NUMBER OF LIFE-THREATENING AND SERIOUS MEDICAL CONDITIONS HAVE BEEN DISCOVERED BY TESTING PERFORMED IN ASSOCIATION WITH THE EVENT. THE $851,656 VIOLA THOMPSON SCHOLARSHIP FUND, ADMINISTERED BY GREENVILLE REGIONAL HOSPITAL, PROVIDES TUITION ASSISTANCE FOR INDIVIDUALS PURSUING A HEALTH OR MEDICAL CAREER. IN 2012, SCHOLARSHIPS TOTALING $17,100 WERE AWARDED. NURSING STUDENTS, MEDICAL STUDENTS, PHYSICIAN RESIDENTS, AND GREENVILLE COLLEGE PSYCHOLOGY STUDENTS UTILIZE THE HOSPITAL AND SENIOR CARE FACILITIES FOR TRAINING AND LEARNING OPPORTUNITIES. THE HOSPITAL IS OFFERED AS A TRAINING SITE AT NO COST TO THE STUDENTS. THE HOSPITAL IS ALSO THE SITE OF REGULARLY SCHEDULED BLOOD COLLECTION DRIVES. THESE ORGANIZATIONS ARE NOT CHARGED FOR USE OF THE HOSPITAL. THE LEMUAL RHODES CANCER FUND BOARD OF DIRECTORS MEETS AT THE HOSPITAL AND AWARDS FUNDING TO PATIENTS UNDERGOING TREATMENT FOR CANCER. EXERCISE CLASSES, RETIRED TEACHERS, COMMUNITY CLUBS, AND ORGANIZATIONS MEET AT THE HOSPITAL. NO FUNDS ARE PAID FOR USE OF THE FACILITY. TWO SCOREBOARDS LOCATED AT THE LOCAL HIGH SCHOOL ARE CO-SPONSORED BY THE HOSPITAL. GREENVILLE REGIONAL HOSPITAL SUPPORTS VARIOUS COMMUNITY ORGANIZATIONS AND ACTIVITIES THAT PROMOTE HEALTHY LIFESTYLES AND WORK TO IMPROVE QUALITY OF LIFE ISSUES.
PART VI, LINE 6: THE ORGANIZATION IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1UTLAUT MEMORIAL FOUNDATION INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1200 HEALTH CARE DRIVEAddressLine1
CityGREENVILLECity
StateILState
ZIP Code62246ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient371140166EINOfRecipient
IRC Section501(C)(3)IRCSection
Amount Of Cash Grant300000AmountOfCashGrant
Purpose Of GrantHOSPITAL / AUXILIARY ACTIVITYPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
ExplanationSCHEDULE I, PART I, LINE 2 GRANTS ARE GIVEN FROM THE HOSPITAL / AUXILIARY TO THE FOUNDATION. OUR GENERAL LEDGER PROGRAM MONITORS THESE TRANSACTIONS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
SHERRY KOEHLER
CFO1548950002311300024300180438000
DR JOHN DAWDY
PHYSICIAN2813400004784200050720334254000
DR DAWN MCDAID
PHYSICIAN320591000175000044090326750000
DR BOYD MCCRACKEN
PHYSICIAN2822870003066900042720317228000
DR RAYMOND RYAN
PHYSICIAN303455000134600020450306846000
DR CHRISTINA DOTHAGER
PHYSICIAN2694400007310005600270731000
SARA MCPEAK
FORMER CNO000013148800027820134270000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1ATHE GROSS-UP PAYMENT IS FOR LONG-TERM DISABILITY.
PART I, LINE 4ASARA MCPEAK: $131,488 - SEVERANCE PAYMENT

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF GREENVILLEBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN376000403IssuerEIN
CUSIP NumberNONEAVAILCUSIPNumber
Date Issued2011-10-20DateIssued
Issue Price10000000IssuePrice
Description Of PurposeREFUND A PRIOR ISSUE (04/01/03) CONSTRUCTION/ REMODEL PROJECTS AND EQUIPMENTDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Amount Retired465458AmountRetired
Total Proceeds10000000TotalProceeds
Amount In Reserve Fund952249AmountInReserveFund
Refunding Escrow7119136RefundingEscrow
Issuance Costs From Proceeds115223IssuanceCostsFromProceeds
Capital Expenditures242781CapitalExpenditures
Other Spent Proceeds12000OtherSpentProceeds
Amount Unspent1558611AmountUnspent
Year Of Subst Completion2014YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test0BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop0ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs0NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiled
Rebate Not Due Yet1RebateNotDueYet
Exception To Rebate0ExceptionToRebate
No Rebate Due0NoRebateDue
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Written Proc To Monitor Reqs1WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Proc To Undertk Corrective Action1ProcToUndertkCorrectiveAction

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11REVIEWED BY KEY EMPLOYEES (CFO, CEO, CNO) AND DISTRIBUTED TO THE BOARD OF DIRECTORS VIA EMAIL BEFORE FINAL SUBMISSION. AMPLE TIME IS ALLOWED FOR BOARD MEMBERS TO REVIEW THE 990 AND SUGGEST ANY CHANGES PRIOR TO FINAL SUBMISSION.
FORM 990, PART VI, SECTION B, LINE 12CEACH YEAR, THE BOARD OF DIRECTORS AND ANY KEY EMPLOYEES, HIGHEST COMPENSATED EMPLOYEES, AND MEMBERS OF MANAGEMENT COMPLETE A RELATIONSHIP/CONFLICT OF INTEREST QUESTIONAIRE. ANY CONFLICTS THAT ARISE ARE DEALT WITH ACCORDINGLY BY THE ORGANIZATION'S OFFICERS.
FORM 990, PART VI, SECTION B, LINE 15THE EXECUTIVE COMMITTEE OF THE BOARD AND THE HOSPITAL'S HUMAN RESOURCES' COLLABORATE AND MAKE A FINAL DETERMINATION BY REVIEWING COMPARABLE SALARIES OF THE REGION.
FORM 990, PART VI, SECTION C, LINE 19GREENVILLE REGIONAL HOSPITAL MAKES ITS FORM 990 AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST, BUT ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 9:NET TRANSFERS BETWEEN AFFILIATE 608,062.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PAGE 12, PART XII, LINE 2CTHE ORGANIZATION HAS AN AUDIT COMMITTEE THAT OVERSEES THE AUDIT AND THE SELECTION OF THE INDEPENDENT AUDITOR.SELECTION OF AUDITORS AND OVERSIGHT OF AUDIT

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrg
GREENVILLE REGIONAL HEALTHCARE INC
200 HEALTHCARE DRIVEGREENVILLEIL62246371139987HEALTHCAREIL501(C)(3)LINE 11B, IIN/A0
UTLAUT MEMORIAL FOUNDATION INC
200 HEALTHCARE DRIVEGREENVILLEIL62246371140166FUNDRAISINGIL501(C)(3)LINE 11B, IIN/A0
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets1ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg