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MARSHALL BROWNING HOSPITAL ASSOCIATION: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
MARSHALL BROWNING HOSPITAL ASSOCIATION (EIN 37-0661218)
Tax period
2011-07-01 to 2012-06-30
Filed
2012-12-21
IRS object ID
201203569349300105
Schema version
2011v1.2
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)
Timestamp2012-12-21T09:39:32-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1KERBER ECK & BRAECKEL LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11116 W MAIN STAddressLine1
CityCARBONDALECity
StateILState
ZIP Code629012335ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN370661218EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MARSHALL BROWNING HOSPITALBusinessNameLine1
Business Name Line2ASSOCIATIONBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMARSNameControl
Phone6185422146Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1900 N WASHINGTON ST PO BOX 192AddressLine1
CityDU QUOINCity
StateILState
ZIP Code62832ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameEDWIN GASTName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone6185422146Phone
Date Signed2012-12-21DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDAVID SCHNAKEName
Phone6185291040Phone
Date Prepared2012-12-21DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonEDWIN GASTNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1900 N WASHINGTON ST PO BOX 192AddressLine1
CityDU QUOINCity
StateILState
ZIP Code62832ZIPCode
FieldValueIRS element (for citing)
Gross Receipts18118586GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MARSHALLBROWNINGHOSPITAL.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1919YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF MARSHALL BROWNING HOSPITAL IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE PEOPLE AND COMMUNITY WE SERVE WITHIN THE SCOPE OF OUR ABILITIES.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees228TotalNbrEmployees
Total Nbr Volunteers70TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year89089ContributionsGrantsPriorYear
Contributions Grants Current Year258446ContributionsGrantsCurrentYear
Program Service Revenue Prior Year16335081ProgramServiceRevenuePriorYear
Program Service Revenue CY16756764ProgramServiceRevenueCY
Investment Income Prior Year697320InvestmentIncomePriorYear
Investment Income Current Year260854InvestmentIncomeCurrentYear
Other Revenue Prior Year585106OtherRevenuePriorYear
Other Revenue Current Year842522OtherRevenueCurrentYear
Total Revenue Prior Year17706596TotalRevenuePriorYear
Total Revenue Current Year18118586TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8731986SalariesEtcPriorYear
Salaries Etc Current Year9281121SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year8782248OtherExpensePriorYear
Other Expenses Current Year8420510OtherExpensesCurrentYear
Total Expenses Prior Year17514234TotalExpensesPriorYear
Total Expenses Current Year17701631TotalExpensesCurrentYear
Revenues Less Expenses Prior Year192362RevenuesLessExpensesPriorYear
Revenues Less Expenses CY416955RevenuesLessExpensesCY
Total Assets BOY21427995TotalAssetsBOY
Total Assets EOY21784457TotalAssetsEOY
Total Liabilities BOY13510572TotalLiabilitiesBOY
Total Liabilities EOY14397561TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7917423NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7386896NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF MARSHALL BROWNING HOSPITAL IS TO PROVIDE QUALITY HEALTHCARE SERVICES TO THE PEOPLE AND COMMUNITY WE SERVE WITHIN THE SCOPE OF OUR ABILITIES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense17701631Expense
Revenue18118586Revenue
DescriptionAS 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 2,836 PATIENT DAYS. 2,321 OF THOSE DAYS WERE MEDICARE PATIENT DAYS, WHILE 145 CONSISTED OF MEDICAID DAYS. DURING FY 2012 THE HOSPITAL ADMITTED 614 PATIENTS AND DISCHARGED 614. THE AVERAGE LENGTH OF STAY FOR A PATIENT IS 5 DAYS. THE HOSPITAL PROVIDED 98,492 OUTPATIENT OCCASIONS OF SERVICE WHICH INCLUDED 5,993 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 2012 THIS AMOUNTED TO 306,000 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. HOSPTIAL 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.Description
Total Program Service Expense17701631TotalProgramServiceExpense
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 EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
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 OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
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 RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109626NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees228NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementfalseRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
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 Line1MARSHALL BROWNING HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6185422146TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1900 N WASHINGTON STAddressLine1
Address Line2PO BOX 192AddressLine2
CityDU QUOINCity
StateILState
ZIP Code62832ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
HAROLD RICE
PRESIDENT1.00X000
CHARLES GENISIO JR
DIRECTOR1.00X000
MARK MACLIN
SECRETARY1.00X000
DAN EAVES
VICE PRESIDE1.00X000
SUSAN ENGELHARDT
DIRECTOR1.00X000
CRAIG FURRY MD
DIRECTOR1.00X000
RICHARD K HAINES
TREASURER1.00X000
DON HOFFMAN
DIRECTOR1.00X000
BRAD GALLI RPH
DIRECTOR1.00X000
DAVID SEARBY
DIRECTOR1.00X000
KATHY WEST
DIRECTOR1.00X000
WILLIAM HUFF
CEO40.0014471305207X
LAURIE KELLERMAN
CNO40.008427805833X
BRICE HARSY
CFO40.006185905497X
EDWIN GAST
CEO40.00000X
TERRENCE HALL
PHYSICIAN40.0027757907021X
GLADSTONE TUCKER
PHYSICIAN40.0018157905249X
JERRY PRIAR
ANESTHETIST/40.0018155407249X
BETH BIGHAM
PHYSICIAN40.0015999400X
ALAN MORRIS
PHARMACIST40.0012138506128X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1212941TotalReportableCompFromOrg
Total Other Compensation42184TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
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
ACUTE CARE INC
1609 N ANKENY BLVD STE 200ANKENYIA50023HOSPITALIST SRV1231341
ST LOUIS UNIVERSITY
1402 S GRAND BLVDST LOUISMO63104PHYSICIAN SERVI158400
NUMED INC
PO BOX 1098DENTONTX76202NUCLEAR MEDICIN132576
HEALTHCARE MANAGEMENT SYS INC
3102 WEST END AVE STE 400NASHVILLETN37203SYSTEM MANAGEME114960
LABORATORY CORPORATION OF AMERICA
PO BOX 12140BURLINGTONNC272162140LAB SERVICES108954
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Government Grants210881GovernmentGrants
All Other Contributions47565AllOtherContributions
Total Contributions258446TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionINPATIENT & OUTPATIENT SVCDescription
Total Revenue Column16756764TotalRevenueColumn
Related Or Exempt Function Income16756764RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue16756764TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column256754TotalRevenueColumn
Exclusion$256,754ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4100Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4100Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column4100TotalRevenueColumn
Related Or Exempt Function Income4100RelatedOrExemptFunctionIncome

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
INDEPENDENT LIVING RENT302776$302,776
EHR REIMBURSEMENT294000$294,000
DR HALL-SHARED EXP95010$95,010

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column150736TotalRevenueColumn
Exclusion$150,736ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue842522TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18118586TotalRevenueColumn
Related Or Exempt Function Income16760864RelatedOrExemptFunctionIncome
Exclusion$1,099,276ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total307387Total
Program Services307387ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6535989Total
Program Services6535989ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total93100Total
Program Services93100ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1867294Total
Program Services1867294ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total477351Total
Program Services477351ProgramServices

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total35840Total
Program Services35840ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total743892Total
Program Services743892ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total57684Total
Program Services57684ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total267732Total
Program Services267732ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total308597Total
Program Services308597ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total43086Total
Program Services43086ProgramServices

Interest Interest

FieldValueIRS element (for citing)
Total622182Total
Program Services622182ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1071747Total
Program Services1071747ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total246737Total
Program Services246737ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
PHYSICIANS' FEES14405131440513
BAD DEBT13499431349943
DRUGS602903602903
MEDICAL SUPPLIES576014576014

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1053640Total
Program Services1053640ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total17701631Total
Program Services17701631ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY769123BOY
EOY317113EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY3035452BOY
EOY4315835EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY335713BOY
EOY393810EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY198482BOY
EOY509377EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis20365466LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec10681526LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY10314316BOY
EOY9683940EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY6414470BOY
EOY5867785EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY45000BOY
EOY45000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY315439BOY
EOY651597EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY21427995BOY
EOY21784457EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1446951BOY
EOY1627170EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY9851217BOY
EOY9560581EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2212404BOY
EOY3209810EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY13510572BOY
EOY14397561EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY7917423BOY
EOY7386896EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7917423BOY
EOY7386896EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21427995BOY
EOY21784457EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses416955ReconcilationRevenueExpenses
Reconcilation Other Changes-947482ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

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

FieldValueIRS element (for citing)
Disclosed Orgs Legal ControlfalseDisclosedOrgsLegalControl
Disclosed For Charitable PurposesfalseDisclosedForCharitablePurposes
Written Policy MonitoringfalseWrittenPolicyMonitoring
Sect170h Requirements SatisfiedfalseSect170hRequirementsSatisfied
Solicited Assets For SalefalseSolicitedAssetsForSale
Agent Trustee EtcfalseAgentTrusteeEtc
Included On FSfalseIncludedOnFS
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis48400InvestmentCostOrOtherBasis
Other Cost Or Other Basis3114OtherCostOrOtherBasis
Book Value51514BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8270627OtherCostOrOtherBasis
Depreciation3268885Depreciation
Book Value5001742BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1258140OtherCostOrOtherBasis
Depreciation605722Depreciation
Book Value652418BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis10713815OtherCostOrOtherBasis
Depreciation6806919Depreciation
Book Value3906896BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis71370OtherCostOrOtherBasis
Book Value71370BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9683940TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
INTEREST RATE SWAP CONTRACTS$1,639,875
ACCUMULATED BENEFIT OBLIGATION$635,346
THIRD PARTY REIMBURSEMENT PROGRAMS$533,785
L-T OBLIGATION-CAPITAL LEASES$165,714
CURRENT OBLIG-CAPITAL LEASES$157,090
ESTIMATED MED MALPRACTICE CLAIMS$50,000
CURRENT ACCUM BENEFIT OBLIGATION$28,000
FieldValueIRS element (for citing)
Total Of Amounts3209810TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierLIABILITY UNDER FIN 48 FOOTNOTEIdentifier
Return ReferenceSCHEDULE D, PAGE 3, PART XReturnReference
ExplanationTHERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY AT JUNE 30, 2012 OR 2011.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReportfalseAnnualCommunityBenefitReport

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense306407TotalCommunityBenefitExpense
Net Community Benefit Expense306407NetCommunityBenefitExpense
Percent Of Total Expense0.01730PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense2720706TotalCommunityBenefitExpense
Direct Offsetting Revenue2181799DirectOffsettingRevenue
Net Community Benefit Expense538907NetCommunityBenefitExpense
Percent Of Total Expense0.03040PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense3027113TotalCommunityBenefitExpense
Direct Offsetting Revenue2181799DirectOffsettingRevenue
Net Community Benefit Expense845314NetCommunityBenefitExpense
Percent Of Total Expense0.04780PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense219952TotalCommunityBenefitExpense
Net Community Benefit Expense219952NetCommunityBenefitExpense
Percent Of Total Expense0.01240PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense219952TotalCommunityBenefitExpense
Net Community Benefit Expense219952NetCommunityBenefitExpense
Percent Of Total Expense0.01240PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3247065TotalCommunityBenefitExpense
Direct Offsetting Revenue2181799DirectOffsettingRevenue
Net Community Benefit Expense1065266NetCommunityBenefitExpense
Percent Of Total Expense0.06020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$694,276BadDebtExpenseAmount
Amount Attributable To138855AmountAttributableTo
Amount Reimbursed By Medicare7929302AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare8013931CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-84629MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
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 Line1MARSHALL BROWNING HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1900 N WASHINGTON STAddressLine1
CityDUQUOINCity
StateILState
ZIP Code62832ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours
OtherOUTPATIENT PHYSICIAN CLINICOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1MARSHALL BROWNING HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent150.0FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent10.0FPGDiscountPercent
Explains BasisfalseExplainsBasis
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Permit Report To Credit AgencyXPermitReportToCreditAgency
Permit LawsuitXPermitLawsuit
Collection ActivitiestrueCollectionActivities
Report To Credit AgencyXReportToCreditAgency
LawsuitXLawsuit
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledfalseAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities1NumberOfOtherFacilities

Other Facilities OtherFacilities

Name Name

FieldValueIRS element (for citing)
Business Name Line1MARSHALL BROWNING HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1MEDICAL CLINICAddressLine1
Address Line2900 N WASHINGTON STREETAddressLine2
CityDUQUOINCity
StateILState
ZIP Code62832ZIPCode
FieldValueIRS element (for citing)
Facility TypeRURAL HEALTH CLINICFacilityType

Form990 Schedule H Part VI Form990ScheduleHPartVI (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COSTING METHODOLOGY EXPLANATIONPART I LINE 7THE 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 EXPLANATIONPART III LINE 4THE 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 2012 THE HOSPITAL REPORTED BAD DEBT EXPENSE AT COST OF 694000
MEDICARE EXPLANATIONPART III LINE 8FISCAL YEAR 2012 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 EXPLANATIONPART III LINE 9BTHE 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 ASSESSMENTPART VIMARSHALL BROWNING HOSPITAL HAS A COMMUNITY BENEFITS TEAM WHICH IS COMPRISED OF HOSPITAL EMPLOYEES FROM VARIOUS DEPARTMENTS OF THE HOSPITAL THE MISSION OF THE TEAM IS TO PROVIDE ONGOING ASSESSMENTS OF THE HEALTHCARE NEEDS OF PERRY COUNTY AND THE SURROUNDING COMMUNITIES AND STRIVE TO MEET THE NEEDS IDENTIFIED THE TEAM MEETS PERIODICALLY TO PLAN AND DISCUSS EDUCATIONAL SEMINARS AND EVENTS TO HELP MEET THE HEALTH AND SOCIAL NEEDS OF THE COMMUNITY THE HOSPITAL ALSO UNDERWENT A STRATEGIC PLAN AND MARKET ANALYSIS IN 2010 WHICH PROVIDED VALUABLE INFORMATION LINKING THE HOSPITAL STRATEGIC PLAN WITH SPECIAL ATTENTION GIVEN TO THOSE MOST IN NEED IN THE COMMUNITY THE DIRECTOR OF MARKETING DIRECTOR OF INFECTION CONTROLEMPLOYEE HEALTH AND DIRECTOR OF REHAB SERVE ON THE PERRY COUNTY COMMUNITY WELLNESS AND HEALTH COALITION THE ASSISTANT DIRECTOR OF NURSING DIRECTOR OF EDUCATION AND CFO SERVE ON THE BOARD OF DIRECTORS FOR THE PERRY COUNTY DEPARTMENT OF PUBLIC HEALTH THE DIRECTOR OF INFECTION CONTROL SERVES ON THE PERRY COUNTY INTERAGENCY COUNCIL PARTICIPATION IN EACH OF THESE GROUPS ASSISTS THE HOSPITAL IN CONTINUALLY ASSESSING THE NEEDS OF THE COMMUNITY
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEPART VIPATIENT 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 INFORMATIONPART VIPERRY COUNTY IS A RURAL AREA WITH AN ESTIMATED POPULATION OF 22562 THE AVERAGE HOUSEHOLD INCOME IN 2008 INFLATION ADJUSTED DOLLARS WAS 40751 THE PERCENTAGE OF INDIVIDUALS BELOW POVERTY LEVEL WAS 112 PINCKNEYVILLE COMMUNITY HOSPITAL LOCATED 12 MILES AWAY ALSO SERVES THE HEALTHCARE NEEDS OF PERRY COUNTY RESIDENTS MARSHALL BROWNING HOSPITAL PRIMARILY SERVES RESIDENTS IN RURAL AREAS OF SEVEN ZIP CODES PRIMARILY BUT NOT EXCLUSIVELY WITHIN PERRY COUNTY WHICH COMPRISED APPROXIMATELY 88 OF THE HOSPITALS 692 INPATIENT DISCHARGES IN CALENDAR YEAR 2009 THOSE ZIP CODES ARE 62832DUQUOIN 62888 TAMAROA 62274 PINCKNEYVILLE 62932 ELKVILLE 62927DOWELL 62884 SESSER AND 62865 MULKEYTOWN THIS PRIMARY SERVICE AREA HAD A POPULATION OF 26764 IN THE YEAR 2006 AND IS PROJECTED TO HAVE A POPULATION OF 27247 IN 2011 AGE DISTRIBUTION OF POPULATION IN THE PRIMARY SERVICE AREA IN YEAR 2006 INCLUDED UNDER 15 17 1524 13 254426 4564 28 6574 7 AND OVER 75 9 AGE DISTRIBUTION OF POPULATION PROJECTED FOR 2015 IS UNDER 15 15 1524 13 2544 274564 27 6574 10 AND OVER 75 8 DESPITE THE EXPECTED FLAT TOTAL POPULATION GROWTH THROUGH 2015 THE PERCENTAGE OF THE POPULATION IN THE HIGHEST HEALTH CARE DEMAND AGE GROUPS IS INCREASING THE PROPORTION OF PEOPLE IN THE OVER 65 AGE GROUP IS EXPECTED TO INCREASE FROM 16 IN 2006 TO 18 IN 2015 IN THE PRIMARY SERVICE AREAS SOURCES COMPDATA AND USCENSUS BUREAU
HEALTH OF COMMUNITY IN RELATION TO EXEMPT PURPOSEPART VIMARSHALL 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 DONATED BACK TO THE STUDENTS SCHOOL ALL PHYSICIANS AND STAFF DONATE THEIR TIME 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 THE HOSPITAL EMPLOYEES ALSO COLLECT MONEY OR FOOD ON AN ANNUAL BASIS FOR THE LOCAL FOOD PANTRY THE HOSPITAL ALSO OFFERED A HEALTH FAIR FOR THE COMMUNITY IN APRIL 2009 WHICH PROVIDED FREE SCREENINGS SLEEP APNEA SKIN CANCER PULMONARY FUNCTION BLOOD PRESSURE CHILD ID LIPID PROFILE BLOOD GLUCOSE AND HEALTH INFORMATION THE HOSPITAL PROVIDES A TWODAY HEALTH FAIR FOR GENERAL CABLE MANUFACTURING COMPANY EMPLOYEES MBH EMPLOYEES ALSO PARTICIPATED IN COLLECTING MONEY FOR THE ALZHEIMERS ASSOCIATION AMERICAN CANCER SOCIETY AND AMERICAN HEART ASSOCIATION MARSHALL BROWNING HOSPITAL PARTICIPATES WITH THE PERRY COUNTY HEALTH DEPARTMENT IN PROVIDING PSA TESTING FOR THEIR MENS HEALTH FAIR THE HOSPITAL OFFERS MANY FREE CLASSES WHEN AVAILABLE THROUGHOUT THE YEAR INCLUDING TOPICS SUCH AS DIABETES BETTER BREATHERS BASIC LIFE SUPPORT HEALTHY GRIEVING SLEEP APNEA SMOKING CESSATION EXERCISE AND DIET BUILDING A BETTER MEMORY COPD HEART HEALTH SKIN CANCER NUTRITION ALZHEIMERS DISEASE ILLINOIS CARES RX AND CIRCUIT BREAKER PROGRAM PNEUMONIA VACCINE CPAPBIPAP CLINICS MEDICARE DRUG COVERAGE CLASSES ETC THE HOSPITAL OFFERS DISCOUNTED MAMMOGRAMS DURING THE MONTH OF OCTOBER IN HONOR OF BREAST CANCER AWARENESS MONTH THE REHAB DEPARTMENT EACH YEAR SPONSORS A 5K RUNWALK TO PROMOTE THE IMPORTANCE OF FITNESS THE HOSPITAL SUPPLIES A REGISTERED NURSE FOR THREE DAYS FOR THE DEPARTMENT OF SOIL AND WATER CONSERVATIONS CONSERVATION FAIR FOR AREA SCHOOL CHILDREN THE REGISTERED NURSE MAINTAINS A FIRST AID STATION THROUGHOUT THE FAIR THE HOSPITAL PROVIDES FREE AED TRAINING FOR THE POLICE DEPARTMENT PERRY COUNTY COUNSELING CENTER AND OTHER AGENCIES WHEN REQUESTED THE HOSPITAL PROVIDES RANDOM DRUG SCREENS FOR HIGH SCHOOL STUDENTS AT COST MARSHALL BROWNING REHAB STAFF PROVIDES EXERCISE CLASSES FOR THE RESIDENTS OF OUR INDEPENDENT LIVING FACILITY THE HOSPITAL PROVIDED SLEEP SCREENS FOR THE PERRY COUNTY FLU CLINIC AND PROVIDED BLOOD PRESSURE CHECKS AT THE FARMERS MARKET AND OTHER COMMUNITY EVENTS THE HOSPITAL PROVIDES A FREE SPORTS INJURY CHECK EACH SATURDAY MORNING DURING FOOTBALL SEASON THE HOSPITAL HOSTS SIX BLOOD DRIVES AT THEIR FACILITY EACH YEAR PUBLIC SERVICE ANNOUNCEMENTS ARE PROVIDED THROUGH WDQN RADIO STATION TO EDUCATE THE COMMUNITY ABOUT BREAST CANCER MARSHALL BROWNING HOSPITAL PROVIDES OVERHEAD AND SPACE FOR COMMUNITY ORGANIZATION MEETINGS MARSHALL BROWNING HOSPITAL PROVIDES EDUCATIONAL PROGRAMS TO CAMPERS DURING CAMPING CONVENTIONS AT THE DU QUOIN STATE FAIR DIABETES HEART HEALTH
MARSHALL BROWNING HOSPITAL LINE NUMBER 1 PART V LINE 19DPART V LINE 19DTHE HOSPITAL OFFERS A 10 DISCOUNT IF PAID IF FULL WITHIN 7 DAYS OF THE FIRST BILLING STATEMENT

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
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

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
TERRENCE HALL
27757932033818284600
GLADSTONE TUCKER
18157934921757186828
JERRY PRIAR
18155434913758188803
BETH BIGHAM
159994159994

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITSFORM 990, PAGE 1, PART I, LINE 6VOLUNTEERS ARE PART OF THE HOSPITAL AUXILIARY WHO RUN FUNDRAISERS ON BEHALF OF THE HOSPITAL AND OPERATE THE GIFT SHOP.
FIRST ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4AHEALTH 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 2,836 PATIENT DAYS. 2,321 OF THOSE DAYS WERE MEDICARE PATIENT DAYS, WHILE 145 CONSISTED OF MEDICAID DAYS. DURING FY 2012 THE HOSPITAL ADMITTED 614 PATIENTS AND DISCHARGED 614. THE AVERAGE LENGTH OF STAY FOR A PATIENT IS 5 DAYS. THE HOSPITAL PROVIDED 98,492 OUTPATIENT OCCASIONS OF SERVICE WHICH INCLUDED 5,993 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 2012 THIS AMOUNTED TO 306,000 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. HOSPTIAL 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 990FORM 990, PAGE 6, PART VI, LINE 11BALL BOARD MEMBERS ARE PROVIDED A COPY OF THE FORM 990 FOR THEIR REVIEW AND COMMENT BEFORE IT IS FILED.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE CEO'S SALARY IS DETERMINED BY THE BOARD OF DIRECTOR'S IN WHICH THEY REVIEW MARKET WAGE DATA FOR COMPARABILITY.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BALL 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 EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19COPIES 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.
OTHER CHANGES IN NET ASSETS EXPLANATIONFORM 990, PART XI, LINE 5CHANGE IN NET UNREALIZED GAINS ADN LOSSESS ON OTHER THAN TRADING SECURITIES 306,035 NET GAIN (LOSS) ON HEDGING ACTIVITY DUE TO CHANGE IN FAIR VALUE OF SWAP CONTRACT 641,447

Schedule R IRS990ScheduleR

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1DUQUOIN CLINIC INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line14 WEST MAIN STAddressLine1
Address Line2PO BOX 192AddressLine2
CityDUQUOINCity
StateILState
ZIP Code62832ZIPCode
FieldValueIRS element (for citing)
Primary ActivityHEALTHCAREPrimaryActivity
Legal Domicile StateILLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityC CORPTypeOfEntity
Share Of Total Income34474ShareOfTotalIncome
Share Of EOY Assets290288ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg