STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

THE CARLE FOUNDATION HOSPITAL: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
THE CARLE FOUNDATION HOSPITAL (EIN 37-1119538)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-11-15
IRS object ID
201213209349304791
Schema version
2011v1.3
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)
Timestamp2012-11-15T12:28:24-06:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN371119538EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Carle Foundation HospitalBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% DENNIS HESCH EXEC VP & CFOInCareOfName
Name ControlCARLNameControl
Phone2173833311Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1611 WEST PARKAddressLine1
CityURBANACity
StateILState
ZIP Code61801ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDENNIS P HESCHName
TitleEXEC VP/CFOTitle
Date Signed2012-11-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDennis Hesch Exec VP CFONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1611 W Park StAddressLine1
CityUrbanaCity
StateILState
ZIP Code61801ZIPCode
FieldValueIRS element (for citing)
Gross Receipts460665972GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.carle.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionCARLE FOUNDATION HOSPITAL'S MISSION IS TO SERVE PEOPLE THROUGH HIGH QUALITY CARE, MEDICAL RESEARCH AND EDUCATION. HEALTH CARE SERVICES ARE PROVIDED TO INDIVIDUALS IN THE COMMUNITY REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees2397TotalNbrEmployees
Total Nbr Volunteers865TotalNbrVolunteers
Total Gross UBI2930169TotalGrossUBI
Net Unrelated Business Txbl Income-352672NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3809583ContributionsGrantsPriorYear
Contributions Grants Current Year7314083ContributionsGrantsCurrentYear
Program Service Revenue Prior Year224646088ProgramServiceRevenuePriorYear
Program Service Revenue CY415262724ProgramServiceRevenueCY
Investment Income Prior Year21935InvestmentIncomePriorYear
Investment Income Current Year6498279InvestmentIncomeCurrentYear
Other Revenue Prior Year4467256OtherRevenuePriorYear
Other Revenue Current Year5505704OtherRevenueCurrentYear
Total Revenue Prior Year232944862TotalRevenuePriorYear
Total Revenue Current Year434580790TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year1000520GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY3822286GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year62526289SalariesEtcPriorYear
Salaries Etc Current Year124148856SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year113848410OtherExpensePriorYear
Other Expenses Current Year198600549OtherExpensesCurrentYear
Total Expenses Prior Year177375219TotalExpensesPriorYear
Total Expenses Current Year326571691TotalExpensesCurrentYear
Revenues Less Expenses Prior Year55569643RevenuesLessExpensesPriorYear
Revenues Less Expenses CY108009099RevenuesLessExpensesCY
Total Assets BOY188401461TotalAssetsBOY
Total Assets EOY238294492TotalAssetsEOY
Total Liabilities BOY79895767TotalLiabilitiesBOY
Total Liabilities EOY71315039TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY108505694NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY166979453NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionSection 1. GENERAL PURPOSES. The corporation is organized and shall be exclusively operated as a not-for-profit corporation for charitable, benevolent, scientific and educational purposes within the meaning of Section 501c(3) of the Internal Revenue code of 1986, as amended, or the corresponding provisions of any future United States Internal Revenue Law (the "Code"). The main mission statement is: We serve people through high quality care, medical research and education. And, in furtherance of such charitable purposes, the corporation shall engage in the activities described in Section 2 of this statement. Section 2. SPECIFIC PURPOSES. The corporation's purposes shall include, but not be limited to, the following: (a)to provide and to assist in providing facilities for the rendering of comprehensive health care services on an inpatient or other basis through the operation of one or more hospitals, by providing services to providers of health care services and through all other approprMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense284779340Expense
Grants2470638Grants
Revenue417165389Revenue
DescriptionServing people through high quality medical care Carle Foundation Hospital is an Illinois not-for-profit Corporation established for the purpose of operating the Carle Foundation's 325-licensed bed hospital and related facilities and, conducting patient care related activities of the Foundation. The hospital, a level one trauma center, offers a full range of inpatient and outpatient diagnostic and therapeutic services for medical, surgical, obstetrical and gynecological patients. The hospital provides various ancillary support services to both inpatients and outpatients such as autopsy, blood bank, emergency services, respiratory therapy, operating room, occupational therapy, pastoral counseling, social services, pharmacy and physical therapy. Carle Foundation Hospital's mission is to serve people through high quality care, medical research and education. We make sure those who need care, get care, whether or not they can pay. Through our Community Care Discount Program for hospital services and our partnerships with area health agencies, access to dental, vision and general healthcare has been improved for those who are struggling financially. As the second tenet in our mission, research gives us tomorrow's answers, today. In collaboration with the University of Illinois scientists and the Carle Physician Group physicians, we are turning the latest medical knowledge into practical applications for the bedside. We are now conducting more than 126 active studies relating to cancer, gastro-intestinal disease, cardiovascular disease and more. Educational programs for both our professionals and the community ensure everyone is better prepared. For the community, we offer a myriad of opportunities like babysitting certification and new dad courses, along with free CPR and first aid classes. For our professionals, we have continuing education courses, three levels of management training classes and courses for physician leaders. Carle Foundation Hospital's continued success is rooted in our ability to adapt to a changing healthcare environment, plan diligently for our future and maintain a commitment to our patients and community. Not-for-Profit hospitals have a long standing practice of providing support, donations and services to their communities. This stems not from economic opportunity, but rather from a responsibility to address and improve the health of all the people they serve. At Carle Foundation Hospital, we also believe that we have an obligation to generously give back to our community in exchange for our tax exemption. All of these factors lead to Carle Foundation Hospital being a champion of access to healthcare and a pillar of community support. For the twelve months ended December 31, 2011 (CY11), the Carle Foundation's total community benefit was $55,193,287. Community benefit programs are based on assessed needs and designed to improve the health of those who live and work in our area, with a focus on serving those less fortunate. Areas of Community Benefit include: hospital services that operate at a loss, cash and in-kind donations, translational research, community education, community-building activities and workforce development. Another role of the Community Benefit is to step in where government falls short. As State and Federal budgets get tighter, funding for important health-related services rarely cover costs and, at a minimum, is usually slow in coming. That is most clearly evidenced by the hospital's unpaid costs of Medicare and Medicaid in the amount of $3,741,423 included in the Community Benefit total above. Carle Foundation Hospital strives to eliminate barriers that keep area residents from receiving the care they need. Carle Foundation Hospital's Community Care Discount Program is one of the most generous charity care discount programs in the country. We want to make sure that the people who qualify know about their options. Our advertising throughout the region is targeted to reach people who qualify so they are aware financial assistance is available. As a not-for-profit hospital, it is our obligation to reach out to those who cannot afford healthcare. Summary: Total Community Benefit = $55,193,287 less Medicaid "revenue" of $2,719,742, less Medicare shortfall of $3,741,423, less Community Building Activities of $235,917 = $48,496,171.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense15753168Expense
Grants0Grants
Revenue0Revenue
DescriptionThe Carle Community Care Discount Program (Charity Care) As a tax-exempt organization, Carle provides care to patients regardless of their ability to pay for that care or source of payment. We also recognize that some patients need help to pay their bills. Carle Foundation Hospital's Community Care Discount Program (charity care) provides discounts or free care to those who need it. The most recent revision of September 1, 2011, is focused primarily on providing greater clarity around covered services, based on our experiences and feedback following the inclusion of outpatient services.) An additional policy reflects our compliance with the Illinois Hospital Uninsured Patient Discount Act, established in 2009, it was last revised in January 2012. Our Community Care Discount Program is continually evaluated and managed as needed to meet the needs of our community. Evaluation involves input from administrative leaders, Patient Accounts staff, local consumer advocacy groups, and patients. For the twelve months ended December 31, 2011 (CFY11), charity care totaled $15,753,168 and served 6,295 people.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense9285568Expense
Grants1366648Grants
Revenue0Revenue
DescriptionResearch and Education initiatives Carle Foundation Hospital is actively involved in Research and Education Initiatives. The overall purpose of the Research Program is helping to discover new diagnostic and treatment technologies and methods that will improve the delivery and/or quality of healthcare. The Research Program is done in conjunction with area physicians and scientists, The University of Illinois and entrepreneurial companies. Carle Foundation Hospital's efforts in research and education have steadily grown in recent years with strategic emphasis now placed on Translational Research with The University of Illinois. In November 2010, University of Illinois researchers began to move into the Carle Biomedical Research Center, enjoying state-of-the-art laboratory facilities on our Urbana Medical Campus. As of December 2011, the Carle Research Institute had 126 active, with another 21 pending research studies underway. Of the total of 147 studies, the breakdown of studies into various areas was 23 translational, 30 investigator-initiated, 29 nursing, 17 clinical trials, and 37 residency program and student research studies. Carle physicians and University of Illinois scientists frequently collaborate on research projects within the Carle Research Institute. Besides patient and community education, significant resources are expended on the education and training of medical students, physician residents, nurses, allied health professionals and the general healthcare workforce. Through a variety of activities including significant donations, scholarship programs, and physician, nurse, and allied health education, more than $9.2 million was invested in programs that address community-wide workforce issues, strengthening the training and availability of professionals to care for our healthcare needs now and in the near and distant future. -Graduate Medical Education programs. Maintaining a geriatric fellowship and three medical residency programs, and serving as a clinical site for a fourth. There are 31 residents practicing on Carle's campus at any point in time. -Continuing Medical Education programs for regional providers who are not members of the Carle Foundation Hospital medical staff. This includes Carle Foundation Day, which is an event for providers held at the Forum. There are multiple presentations, speakers and displays which count toward required continuing medical education credit for physicians in the region who attend. -Support of the University of Illinois College of Medicine at Urbana-Champaign, with monies earmarked for the MD/PhD program.Description
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Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense309818076TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
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 AssetstrueReportOtherAssets
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 OrganizationstrueGrantsToOrganizations
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 EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096254NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees2397NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
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 Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOfalseCompensationProcessCEO
Compensation Process OtherfalseCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDENNIS HESCH EXEC VP CFONamePerson
Telephone Number2173268231TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1611 WEST PARK STAddressLine1
CityUrbanaCity
StateILState
ZIP Code61801ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Phillip Blankenburg
Chairman of Board0.5XX000
Donna Greene
Vice Chairman of Board0.5XX000
Cora E Musial Phd MD
Secretary of Board35.0XX020493835754
Mathew Gibb MD
Trustee11.0X088829032727
J Michael Martin
Trustee0.5X000
Marty Smith
Immediate Past Chair1.0X000
Paul Tender MD
Trustee10.0X049382229294
David Ikenberry Phd
Trustee (through 9/15/11)0.2X000
E Phillips Knox
Trustee (through 9/15/11)0.6X000
James C Leonard MD
ex-officio, President/CEO11.0XX01040335246421
R Bruce Wellman MD
ex-offico, Trustee19.0XX0805580226995
John Snyder
EXEC VP, COO15.0X0640038160811
Dennis Hesch
Exec VP & CFO16.0X0510086139104
Philip Kubow
SVP Human Resources13.5040818595490X
Pamela Bigler
Chief Nursing Officer25.0028853866917X
Lynne Barnes
VP Hospital Operations20.0026027157268X
Mark Berlin
VP-Surgical Spec20.0023434074664X
Dawn Walden
VP-Revenue Cycle Ops19.0023002350809X
Stephanie Beever
VP Strat Devl & Diag Svces20.0024655770001X
Diane Wasson term 2911
Home Svcs & CMS Exec Dir40.020715202978X
Gregory Puszkiewicz term 7111
Rx Express Director40.0204070022232X
Vijay Bavda
Pharmacist-Inpt40.0175984027318X
Cynthia Gordon
Pharmacist-Inpt40.0174174024054X
Linda Fred
Inpt Pharm Director24.0165054032778X
Robert Tonkinson
SVP & CFO-former0.003099330X
FieldValueIRS element (for citing)
Total Reportable Comp From Org926434TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs6560936TotalReportableCompFrmRltdOrgs
Total Other Compensation1395615TotalOtherCompensation
Number Individuals GT100 K54NumberIndividualsGT100K
Formers ListedtrueFormersListed
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
PNC BANK NATIONAL ASSOCIATION
PO BOX 931034CLEVELANDOH44193EQUIPMENT LEASING2111797
REGIONAL HEALTH RESOURCE CENTER
1408 WEST UNIVERSITY AVENUEURBANAIL61801BLOOD SERVICES1405067
AMERICAN MOBILE NURSES HEALTHCARE I
2735 COLLECTION CENTER DRIVECHICAGOIL60693STAFFING791868
QUEST DIAGNOSTICS
PO BOX 12989CHICAGOIL60693TESTING SERVICES722804
ASD SPECIALTY HEALTHCARE INC
ASD HEALTHCARE PO BOX 848104DALLASTX75284PHARMACEUTICALS600489
FieldValueIRS element (for citing)
Number Of Contractors GT100 K33NumberOfContractorsGT100K
Related Organizations3346075RelatedOrganizations
Government Grants3519679GovernmentGrants
All Other Contributions448329AllOtherContributions
Total Contributions7314083TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net Patient Care621110413153806413153806
Net Patient Care - ASC62111021089182108918
FieldValueIRS element (for citing)
Total Program Service Revenue415262724TotalProgramServiceRevenue

Investment Income InvestmentIncome

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Total Revenue Column323608TotalRevenueColumn
Exclusion$323,608ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

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Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

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Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

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Personal5455983Personal

Less Rental Expenses LessRentalExpenses

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Personal4034052Personal

Rental Income Or Loss RentalIncomeOrLoss

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Personal1421931Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

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Total Revenue Column1421931TotalRevenueColumn
Unrelated Business Revenue1421931UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other9183591Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other3008920Other

Gain Or Loss GainOrLoss

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Other6174671Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column6174671TotalRevenueColumn
Unrelated Business Revenue107169UnrelatedBusinessRevenue
Exclusion$6,067,502ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

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Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory20443279GrossSalesOfInventory
Cost Of Goods Sold19042210CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1401069TotalRevenueColumn
Unrelated Business Revenue1401069UnrelatedBusinessRevenue

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Internal Management Fees900099800015800015
INCOME TAX REFUNDS900099312720312720
HOSPICE HOMECARE SERVICES ROOM AND BOARD900099350711350711

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1219258TotalRevenueColumn
Related Or Exempt Function Income439219RelatedOrExemptFunctionIncome
Exclusion$780,039ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue2682704TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column434580790TotalRevenueColumn
Related Or Exempt Function Income417165389RelatedOrExemptFunctionIncome
Unrelated Business Revenue2930169UnrelatedBusinessRevenue
Exclusion$7,171,149ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total3822286Total
Program Services3822286ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total98632198Total
Program Services94795563ProgramServices
Management And General3836635ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4868322Total
Program Services4706220ProgramServices
Management And General162102ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total13512534Total
Program Services12783784ProgramServices
Management And General728750ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7135802Total
Program Services6864817ProgramServices
Management And General270985ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total205001Total
Program Services197943ProgramServices
Management And General7058ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total360087Total
Program Services341516ProgramServices
Management And General18571ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total308598Total
Program Services308598ProgramServices

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total18091383Total
Program Services17083247ProgramServices
Management And General1008136ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total85158Total
Program Services85158ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total9684794Total
Program Services7423847ProgramServices
Management And General2260947ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4291643Total
Program Services3960609ProgramServices
Management And General331034ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total20441303Total
Program Services18469335ProgramServices
Management And General1971968ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total689282Total
Program Services659520ProgramServices
Management And General29762ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total461297Total
Program Services453101ProgramServices
Management And General8196ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total131839Total
Program Services57178ProgramServices
Management And General74661ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5876648Total
Program Services5175162ProgramServices
Management And General701486ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total21255Total
Program Services17342ProgramServices
Management And General3913ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Internal Management Fees64305997602757444030253
Taxes101716409649634522006
Patient Care Supplies6295485562295748659107
All other expenses519769391724128045

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total326571691Total
Program Services309818076ProgramServices
Management And General16753615ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY112000BOY
EOY124000EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY76045181BOY
EOY86175599EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY8130434BOY
EOY6391661EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4549292BOY
EOY1739894EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis70818713LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec28336432LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY42270824BOY
EOY42482281EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY57293730BOY
EOY101381057EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY188401461BOY
EOY238294492EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY23119172BOY
EOY20492866EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY56776595BOY
EOY50822173EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY79895767BOY
EOY71315039EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY108505694BOY
EOY166979453EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY108505694BOY
EOY166979453EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY188401461BOY
EOY238294492EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses108009099ReconcilationRevenueExpenses
Reconcilation Other Changes-49535340ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$271,741DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$36,857OtherActivitiesAmount
Total Lobbying Expenditures IIB308598TotalLobbyingExpendituresIIB

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierDescription of other Lobbying activitesIdentifier
ExplanationSchedule C, Part II-B, Line (G) The Hospital has contract professionals to provide consulting services for the hospital. As a portion of the contractors' duties, the contractors interact with governmental officials on behalf of the Hospital. Schedule C, Part II-B, line (i) $28,969 - portion of Illinois Hospital Association (IHA) dues attributed to lobbying. $7,888 - portion of American Hospital Association (AHA) dues attributed to lobbying.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts
Current Year Minus3 YearsCurrentYearMinus3Years

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis485000OtherCostOrOtherBasis
Book Value485000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis7716311OtherCostOrOtherBasis
Depreciation2275595Depreciation
Book Value5440716BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1973548OtherCostOrOtherBasis
Depreciation1432398Depreciation
Book Value541150BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis56888063OtherCostOrOtherBasis
Depreciation23556168Depreciation
Book Value33331895BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3755791OtherCostOrOtherBasis
Depreciation1072271Depreciation
Book Value2683520BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings42482281TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
Inter-Company receivable97270338
Other receivables4110719
FieldValueIRS element (for citing)
Total Book Value Other Assets101381057TotalBookValueOtherAssets
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Estimated Third Party Settlements$22,043,503
Compensation and paid leave accrual$25,458,911
EST LIAB FOR SELF INSURED LOSSES$3,317,188
Other long term liabilities$2,571
FieldValueIRS element (for citing)
Total Of Amounts50822173TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return ReferenceSch D, Part X, line 2ReturnReference
ExplanationThe Foundation adopted the guidance for accounting for uncertainty in income taxes on July 1, 2007. This guidance clarifies the accounting for uncertainty in income taxes recognized in an organization's financial statement. The guidance prescribes a more-likely-than-not recognition threshold and measurement attribute for financial statement recognition of a tax position taken or expected to be taken. Amounts requiring recognition under tax accounting guidance is reflected as a liability for uncertain tax benefits along with any associated interest and penalties that would be payable to the taxing authorities upon examination. There are no uncertain tax benefits identified or recorded as a liability as of December 31, 2011.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense15753168TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense15753168NetCommunityBenefitExpense
Percent Of Total Expense0.04890PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense44441634TotalCommunityBenefitExpense
Direct Offsetting Revenue47161376DirectOffsettingRevenue
Net Community Benefit Expense-2719742NetCommunityBenefitExpense
Percent Of Total Expense0.00840PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense6051719TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense6051719NetCommunityBenefitExpense
Percent Of Total Expense0.01880PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense66246521TotalCommunityBenefitExpense
Direct Offsetting Revenue47161376DirectOffsettingRevenue
Net Community Benefit Expense19085145NetCommunityBenefitExpense
Percent Of Total Expense0.05930PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense535174TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense535174NetCommunityBenefitExpense
Percent Of Total Expense0.00170PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense7383115TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense7383115NetCommunityBenefitExpense
Percent Of Total Expense0.02290PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense7571993TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense7571993NetCommunityBenefitExpense
Percent Of Total Expense0.02350PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense9285568TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense9285568NetCommunityBenefitExpense
Percent Of Total Expense0.02880PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense4635176TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense4635176NetCommunityBenefitExpense
Percent Of Total Expense0.01440PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense29411026TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense29411026NetCommunityBenefitExpense
Percent Of Total Expense0.09130PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense95657547TotalCommunityBenefitExpense
Direct Offsetting Revenue47161376DirectOffsettingRevenue
Net Community Benefit Expense48496171NetCommunityBenefitExpense
Percent Of Total Expense0.15060PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense12568TotalCommunityBuildingExpense
Net Community Building Expense12568NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense53620TotalCommunityBuildingExpense
Net Community Building Expense53620NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense44076TotalCommunityBuildingExpense
Net Community Building Expense44076NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense3942TotalCommunityBuildingExpense
Net Community Building Expense3942NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense0TotalCommunityBuildingExpense
Net Community Building Expense0NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense1299TotalCommunityBuildingExpense
Net Community Building Expense1299NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense5446TotalCommunityBuildingExpense
Net Community Building Expense5446NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense108336TotalCommunityBuildingExpense
Net Community Building Expense108336NetCommunityBuildingExpense
Percent Of Total Expense0.00030PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense6664TotalCommunityBuildingExpense
Net Community Building Expense6664NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense235951TotalCommunityBuildingExpense
Net Community Building Expense235951NetCommunityBuildingExpense
Percent Of Total Expense0.00060PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$6,051,719BadDebtExpenseAmount
Amount Attributable To3025860AmountAttributableTo
Amount Reimbursed By Medicare88826779AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare91596930CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-2770151MedicareSurplusOrShortfall

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 Line1THE CARLE FOUNDATION HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1611 W PARK STREETAddressLine1
CityURBANACity
StateILState
ZIP Code61801ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Teaching HospitalXTeachingHospital
Research FacilityXResearchFacility
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1THE CARLE FOUNDATION HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent200.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent400.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Other PublicityXOtherPublicity
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
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 Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
CARLE THERAPY SERVICE
810 W ANTHONY DRURBANAIL61801THERAPY SERVICES
CARLE RX EXPRESS
602 W UNIVERSITYURBANAIL61801PHARMACEUTICAL SERVICES
Carle SurgiCenter - Danville
2300 North Vermilion StDanvilleIL61832GENERAL MEDICAL & SURGICAL
Carle SurgiCenter - Champaign
1702 South Mattis AveChampaignIL61821GENERAL MEDICAL & SURGICAL

Form990 Schedule H Part VI Form990ScheduleHPartVI (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
1. REQUIRED DESCRIPTIONSPART I, LINE 7BDuring the 12 months ending 12/31/2011 there were circumstances which contributed to IPA costs being fully reimbursed. A market based revenue rate increase was effective January 1, 2011. Meaningful use grant revenue for electronic health records was netted against costs. The organization has implemented a cost containment program. Due to the revenue rate increase, meaningful use grant revenue and cost containment program the cost to charge ratio decreased. The IPA pending accounts receivable which were historically identified as IPA were reclassified to the current payor resulting in a decrease in the IPA reserve and an increase in calculated reimbursement. Explanation of Costing Methodology (Part I, line 7 and Part III, line 4) To compute and convert charity care, unreimbursed Medicaid, means-tested programs and bad debt charges to cost; a consistent GAAP (Generally Accepted Accounting Principles) based cost-to-charge ratio was used across all payers. Although the methodology was similar to Worksheet #2, for simplicity purposes certain immaterial values were omitted. Other benefits costs were reported at the actual expense incurred. Patients' receivable payments were recorded at time of receipt and related discounts were also recorded at actual amounts at the time of payment receipt. A separate GAAP based provision for estimated bad debts and discounts was recognized for accounts in process and pending adjudication and payment. The estimated portion was based on historical trends and adjusted to actual in future periods when the account's adjudication and payment occur. Accounts determined to be eligible for charity care were processed immediately for charity care discount with no collection effort. For accounts with insufficient information and documentation to determine charity care eligibility, the hospital consulted with a variety of alternative sources to help determine an individual's financial means (or lack of means) to pay. Based on related trends, the hospital further developed a general estimate of charity care which continued to reside within bad debts. Explanation of Medicare Cost Report Costing Methodology (Part III,line 8) The numerator (total expense) and denominator (total gross charges) of the simple ratio of patient care cost to charges is adjusted by eliminating non-patient care that generates other revenue, bad debt expense, Medicaid and other provider taxes and the total cost of community benefit activities and programs. Also, any gross patient charges for programs not relying on the ratio are eliminated from both the numerator and denominator of the ratio. These adjustments are designed to eliminate "double counting" of community benefit expenses. The resultant ratio aligns with Schedule H requirements. While the Medicare shortfall is not included in the form 990 community benefit reportable number, the cost of unreimbursed Medicare charges for CY11 was $3,741,423 (calculated using the stated method). As an Illinois-based hospital, we are required to report community benefits provided to the Office of the Attorney General by the Community Benefit Act of 2003. For that report, Illinois law defines governmental-sponsored indigent health care as the unreimbursed cost of Medicare, Medicaid and other Federal, State or local indigent care programs. To reduce public confusion caused by variations in our reports, for consistency, we have included the Medicare shortfall in all of our community benefit related reports. However, we do believe this is a community benefit because, as a hospital, we are stepping up to carry the burden of the government, assuring care to seniors, where 14.2% are 60 years of age or older in Champaign County alone. According to Family Service of Champaign County, in 2010, those 85 and older - the fastest growing demographic in the county - have experienced increasing costs over the past decade while living on fixed incomes determined 20 years ago. In CY 2011, 22.91% of Carle Foundation Hospital's patients were Medicare recipients. In CY 2011, inpatient Medicare cases that had a secondary plan code of Medicaid comprised 20% of total Medicare inpatient cases. Outpatient Medicare cases that had a secondary plan code of Medicaid comprised 15.50% of total Medicare outpatient cases. (Patients with Medicare Advantage as the primary payer are not included in these figures.) Debt collection practices (Part III-line 9b, Part V-B-19d) It is the responsibility of our patients to request and complete a Community Care Discount Program (CCDP) application. They are informed about Community Care on multiple occasions throughout the collection process. If a patient does not request or complete and return the application, then the balance is deemed his or her responsibility to pay. We presume eligibility for traditional Medicaid for homeless patients (based on current area shelters or Social Worker verification). Patients may apply for the CCDP at any time, including before care is received. Out of pocket medical expenses are limited to 40% of the patient's annual gross income if the patient is uninsured or underinsured and earns at or below 400% of the Federal Poverty Level. Once all applicable discounts have been applied, we make every attempt to work with the patient to set up payment arrangements on the remaining balance due. The current minimum is 5% or $25.00 a month. If they cannot meet these guidelines, our in-house collectors work with them to set up a temporary/short term payment arrangement until they can make the minimum payment. If they are unable to make payment on the remaining balance after the CCDP discounts, then the balance may be listed with the collection agency. When the account is still in-house, the minimum notifications are one collection letter, one phone call and monthly itemized statements. If a patient does not respond to us, then the account is final noticed (additional letter) and sent to the agency. Carle will not file collection suit liens on a primary residence, nor do we allow the collection attorneys to use "body attachments." The agencies are aware of our Community Care Discount Program and have been advised to refer the patients back to Carle if they deem the patient is unable to pay. We then make one more attempt to work with the patient to see if help is available. If Carle then determines that the patient might qualify, we send the patient a CCDP application and put a hold on the account listed with the agency for as long as we have determined necessary; the average is 60 days. If the patient is then approved for charity care, the balance is adjusted and then the account is closed. If they are approved for less than 100%, the adjustments are reported to the agency and the balance is left with the agency for collection. Text of the Community Benefit and Charity Care footnote in the Carle Foundation Hospital's Financial Statements (Part III, line 4) Carle Foundation Hospital is committed to providing quality health care to all, regardless of their ability to pay. Under the Foundation's charity care policy, patients meeting certain criteria receive care without charge or with a significant reduction in charges. Because the Foundation does not pursue collection of amounts identified as charity care, they are not reported in net patient service revenues. Charges forgone, based on established rates, totaled $96.5 million for the twelve months ended December 31, 2011. The forgone charges represent 5.6% of the gross patient service revenue. Management believes that the difference between the costs to provide care and the amounts actually received from the Medicaid program, including the net amounts received from the Hospital Assessment Program, should be considered charity care. Using the overall ratio of cost to charges, the costs exceed the reimbursement for the Foundation by $23.6 million for the twelve months ended December 31, 2011. This amount comprises 1.1% of gross patient service revenue. In addition to providing direct charity health services, Carle Foundation Hospital periodically conducts a comprehensive community needs assessment including active partnering with various community service organizations. The assessment helps identify areas of under-served and under-insured populations and further helps promote a common and joint approach to responding to identified community needs. The Hospital is a key financial supporter to the Frances Nelson Health Center, a federally qualified community health center, and also financially supports other health and educational service access for eligible at-risk populations. The Hospital plays a vital role in Champaign County's emergency preparedness and home land security initiatives. These are in addition to numerous other community health and wellness programs identified by the community needs assessment.
2. NEEDS ASSESSMENTCarle Foundation Hospital used existing data, informal discussions, and comprehensive qualitative community health needs assessment (CHNA) to determine if existing programs are on track; what needs to be added, deleted or enhanced; and where our focus needed to be placed in the future. This year the CHNA not only included secondary research (noted below), but also four focus groups conducted by an independent research firm, to query community leaders, human service agency administrators, and Carle Foundation Hospital leadership. These focus groups were conducted in Champaign, Vermilion, and Coles counties. Data was also drawn from these sources and used to affirm and re-shape our Community Benefit Plan for 2011 through 2013 as needed: * Robert Wood Johnson County Health Rankings, Feb. 2010 * County QuickFacts from the U.S. Census Bureau for Champaign, Coles & Vemilion counties * Hunger in America Study with participation by the Eastern Illinois Foodbank, Feb. 2010 * Current and future workforce shortage statistics * The Affordable Care Act: Opportunities for the Aging Network; A presentation by ECI Area n Aging, 2010 * Current statewide health reports * Poverty trends in Vermilion County, IL, August 2008 * Coles County Health Department IPLAN 2010-2015 * Homeland Security initiatives * Input from CU Public Health and Human service agencies (on-going) * A Senior Needs Assessment Focus Group, commissioned by Carle Foundation Hospital, September 2007. * Oral Health in Champaign-Urbana, IL, a review prepared by the CU Public Health District * Unanticipated opportunities or challenges in the local markets with respect to community health and wellness offerings. * Champaign County regularly conducts disaster preparedness committee meetings to plan for and practice community wide disaster preparedness. Taking these sources into account, the Community Benefit Plan is written to be aligned with the long-term strategic plan of the Hospital. Current community benefit priorities include: *Access to healthcare, which encompasses The Carle Community Discount Program (charity care) *Childhood obesity *Children-at-risk *Communications to foster outreach and collaboration *Maintenance of existing Carle community benefit programs. In every way, these activities and programs meet established community benefit criteria-but moreso, in every way contribute to a significantly healthier community. In 2011, our Community Benefit Plan, reflected the first year of a three-year plan and primarily addressed needs identified in the Champaign-Urbana area within the scope of the determined Plan priorities. It also included community building activities, as well as research and education initiatives-all of which were reviewed and confirmed through the annual budgeting process.
3.PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCECarle is acutely aware of the need for access to care, making that a mainstay of our community benefit program, with a strong charity care program that is based in a philosophy of doing the right thing for their community and patients and balanced by a careful stewardship of the community's resources. By focusing on determining the financial status of patients up-front, we have been able to pinpoint those needing financial assistance early in the process, minimizing bad debt and optimizing our ability to help them. Staff is also diligent in following up with patients during hospitalization and after discharge if there's any reason to believe the patient could benefit from charity care. Carle Foundation Hospital has made a concerted, continuous effort to be sure that people have access to information that will help them with their medical bills. These include: *Advertising to promote awareness of the Community Care Discount Program. This past year, we used radio, bus panels and outdoor billboards to advertise this service. We continued a presence in appropriate special event program booklets as well as utilizing messages on our onsite digital displays, static displays throughout the hospital, clinics and web sites. *Billing envelopes that carry this message prominently on the outside of the envelope: Need help with your medical bill? Call 888-479-0008. *All billing statements have messaging on the back of the statements regarding the availability of the CCPD. *Community Care application forms and brochures available at all inpatient and outpatient registration points, as well as in the Hospital's main lobby. These forms have also been translated into Spanish. *A simplified application form. *Packets including application forms, instructions and a checklist that are distributed to area free clinics and FQHCs. *Information and application forms are easily found and accessed at www.carle.org. *Staff at Frances Nelson Health Center, the local FQHC and free clinics have a supply of application forms and have been trained to assist their patients in completing them. *Informational meetings are held with local legislators to help assist constituents with healthcare needs, including financial assistance. *All collection letters indicate the availability of the Community Care program. *Hospital admission packets contain information regarding Community Care. *We meet with our own staff to keep them informed about the program and what benefits are available to patients. *Community Care representatives are available at various community events. 4. COMMUNITY INFORMATION Targeted populations include the uninsured and underinsured, and children at risk-from conception through childhood. Carle's service area is generally defined as east central Illinois, including all or parts of more than 25 counties in east central Illinois and western Indiana. For the 2011 plan, research and remedies are directed towards community health issues identified in Champaign, Coles and Vermilion counties, with the primary focus being on Champaign County. These areas represent our headquarters and two other counties where Carle has a thriving presence. Our reach extends from these three counties-also identified in this report as Champaign-Urbana (Champaign County), Mattoon-Charleston (Coles County) and Danville (Vermilion County) areas into 14 adjoining, rural Illinois counties. These areas comprise nearly 50% of the Carle service area's population of about 1.2 million residents. And the three core counties represent about 25% of the total service area population. Pockets of extreme poverty exist throughout this region. The programs within our community benefit plan generally have impact upon all of these targeted communities, with certain programs directed at specific communities and populations. Generally, targeted populations include the uninsured and underinsured, and children-at-risk-from conception through childhood. In 2011, a greater proportion of our resources were spent in Champaign County, where the largest population in our service area resides and where our community benefit program has long been established. Carle Foundation Hospital serves as the region's only Level I Trauma Center and maintains a 42-bed Level III Neonatal Intensive Care Unit, comprised of 25 NICU and 17 step-down beds. As provider of the region's Level III perinatal services, Carle provides care to patients who live throughout the area extending from Kankakee to the southern-most tip of Illinois, and spanning from as far west as Decatur into western Indiana. For the purposes of our Community Care Discount Program, coverage encompasses this entire region-40 counties in Illinois and Indiana. Qualifying trauma patients, regardless of their place of residency, are covered for their trauma care, hospitalization, and follow-up care.
5.PROMOTION OF COMMUNITY HEALTHCarle Foundation Hospital has an open medical staff and is governed by a community board. Surplus funds are reinvested into the organization for technology replacement and advancement, building renovation or construction, clinical service expansion and quality improvement. Surplus funds are also invested into our communities to meet identified health needs which contribute to the overall well-being of the residents of the communities we serve. Because the needs are great and varied and it would be unreasonable to address each and every identified need, we set priorities and use our resources to focus primarily on identified needs within the community benefit priorities set. Many of these needs are addressed through partnerships and collaborative efforts. Our progress is shown below and presented with the respective community benefit priority: Community Benefit Priority: -Additional Access to Care Programming Financial and leadership support of community programs has been central to providing access to primary, dental, preventive, and mental health services. Carle has identified and sought ways to initiate and expand healthcare services for the underinsured and uninsured by working collaboratively with community organizations and leaders. A. Free Clinic Support Champaign County Christian Health Center - $59,000 As the lead funder of the Champaign County Christian Health Center, Carle helps the free health clinic fulfill its mission to provide quality, holistic care at no cost to as many people as possible during hours limited only by the availability of volunteer healthcare providers and the energy of three part-time paid administrative staff. They provide primary care, dental and mental health services, with 1,044 patient visits and 498 new patients served in CY 11. A significant number of the volunteer medical staff is Carle physicians, nurses and techs who have personally chosen to serve their community through the Champaign County Christian Health Center. Carle has continued to cover the facility's rent-$40,000 per year-as well as provide substantial support for operations. Since this clinic's inception in 2003, Carle has provided nearly $324,000 to help maintain this small clinic that provides huge benefits to people who are underinsured or uninsured. Avicenna Carle also supports the activities of Avicenna, a local Muslim-based clinic that provides free care to all. Avicenna currently uses the Christian Health Center space on weekends. Carle also works with them so they can access specialty care as well as lab results for their patients. B. Frances Nelson Health Center - $95,608 We also continued to financially support and provide leadership to Frances Nelson Health Center, a Federally Qualified Health Center. *In 2005, in concert with a community effort, Carle Foundation Hospital purchased a former furniture store in Champaign, renovated it for $1.2 million, provided free rent for three years and continued to support the operations of the facility: The Hospital continues to pay utilities and operating costs associated with the facility's maintenance, cleaning and security, which totaled $58,331 in CY11. As always, some of the more expensive medications were provided. This year, the facility required improvements due to wear and tear, bringing the total to $80,274. Carle also pays the property taxes. *Carle's All About Baby staff regularly provides prenatal, breastfeeding and newborn care education at the clinic. They also offered a teen pregnancy program. Cost of these programs totaled $14,333. *Carle Family Medicine residents provide obstetrical care. C. Community Dental Initiative for Adults and Children Frances Nelson Dental Center - $102,175 Carle Foundation Hospital made a significant contribution towards renovation of space within the Frances Nelson Health Center facility for a newly-opened community dental center that's making access to adult and senior dental services a reality, having opened in October 2011. Meanwhile, we continue to provide leadership and support to this community dental initiative headed by United Way of Champaign County. Carle leadership played an important role on the Community Dental Initiative Coalition, with their time valued at $1,858. And Carle covered some of the costs associated the public open house-$317-as well. SmileHealthy for Mobile Dental Care - $26,808 Prior to the opening of the Dental Center within Frances Nelson Health Center, an interim, mobile service was housed on the Urbana Carle Medical Campus, serving uninsured adults, as well as children. Cost to provide the space was $26,808. D. Providing Access to Care through Subsidized Services Over the years, multiple Carle initiatives have provided additional access to care. Because these services continue to meet an enormous need, these programs have been maintained, even though several of them operate at a loss: AirLife; HomeMeds, a medication management program for seniors; free health screenings; Low Vision Center; Neonatal Intensive Care Unit; Patient Advisory Nurse, ECHO (Expanding Children's Hearing Opportunities-Pediatric Hearing Services); free and discounted prenatal and family education; free sports injury evaluations and discounted Sports Medicine coverage at local and area school sporting events; Carle's Community Parish Nurse Program; and the Carle Breastfeeding Clinic. *The Community Parish Nurse Program-designed to train nurses from local and regional churches to educate congregants and to advocate for their healthcare interests. Tuition costs are minimal. In 2011, 18 RNs completed our training program. This program is one of the largest in the nation, with 454 total nurses trained to provide service to 223 congregations in 31 counties and three states. Altogether, they logged over 7,000 hours of volunteer services to their congregations. *The Carle Breastfeeding Clinic -the certified lactation specialists with Carle's Breastfeeding Clinic have been helping thousands of women successfully breastfeed and manage challenges along the way since 1997. This service is free and available to any nursing mother, regardless of where they receive care. Located at Carle Foundation Hospital, and now at clinics in Champaign and Urbana, the Breastfeeding Clinic operates a 24/7 pager service where breastfeeding mothers can call in with questions or concerns around-the-clock. During Carle's fiscal year 2011 there were 7,060 visits to the hospital-based, urban clinic, including 2,644 walk-ins. Staff also responded to 2,463 call requests for assistance. At the two Carle regional outpatient facilities, they had 475 visits during their first month opening. Community Benefit Priority: -Children-at-Risk Child Safety Programs and other Activities (some also involving adults) which focus on reducing unintentional injury and accidental deaths. *Playing It Safe-in its 15th year of bringing together public safety and other safety-minded organizations and agencies to teach children and their families how to prevent unintentional injuries, this free safety fair-co-sponsored with Safe Kids Champaign County-involved more than 50 interactive displays, stage presentations and points of interest. Attendance was remarkably high with more than 1,800 children and parents present. *Center for Rural Health and Farm Safety-the Center for Rural Health and Farm Safety at Carle accomplished a record-setting year during its 20th anniversary year, 2011. Carle formed the Center after recognizing the need to provide education on agricultural safety and health to both children and adults in the farming community. All programs remain free to those in Carle's service area. -Of the nearly 5,000 people trained in 2011, more than 3,500 were children. Last year, the Center reached more than 2,000 youth in surrounding rural communities through 31 school programs-the highest number ever achieved annually in Carle history. In addition, 995 children were reached at Progressive Ag Safety Days, coordinated by Carle and hosted in Vermilion, Piatt and Ford Counties. -The Center also certified more than 600 adults (14 years and older) in CPR and first aid last year. -Five emergency responder training courses included Agricultural Emergency Response classes as well as tractor rollover and grain entrapment sessions and involved 89 participants. *An innovative program-Emergency Action Tubes-was launched in 2010 to protect farmsteads and aid emergency responders. The Center placed sealed plastic cylinders with detailed farm info and maps on an additional 31 farms in 2011, bringing the number of protected farmsteads to 39. *Interpersonal Violence Program-provides community education with a focus on reducing domestic violence as well as training for Sexual Assault Nurse Examiners (SANE) and others who treat rape and abuse victims. Carle has nine SANE nurses in the Emergency Department, assisting approximately 115 adult/adolescent and pediatric sexual assault patients this year. *Carle
PROMOTION OF COMMUNITY HEALTH (CONTD)Community Benefit Priority: -Childhood Obesity The newest addition to our community benefit plan is an effort to join the fight against childhood obesity, first by joining with schools which have shown an interest in helping their students and families to live a healthier lifestyle through better nutrition and physical activity. During CY 11, Carle donated $2,500 to each school to boost their existing programs. Late in 2011, we began an initiative, at the request of the schools, to provide a customized, monthly health and wellness-related article featuring Carle expertise. These articles were provided to each school monthly for distribution in their PTA newsletters. In Champaign County, we partnered with Booker T. Washington STEM Academy (BTW), a Champaign School. In collaboration with the Champaign-Urbana Public Health Department, we teamed with a parent-teacher committee to create a plan which complemented what the school's leadership had already put into place. The multi-faceted program was kicked off in the spring of 2011 with baseline testing-BMI assessments and a food quiz. We also connected BTW's leadership with the principal of Northeast Elementary Magnet School in Danville, our partnership school in Vermilion County. Northeast has been recognized for its health and wellness program with a gold award from the Healthy Generations, a national organization headed by former President Bill Clinton. In Vermilion County, we continued our partnership with Northeast Elementary Magnet School. Our progress is reported later on in this report where we focus on community benefit provided to Vermilion and Coles counties. Community Benefit Priority: -Communications to Foster Outreach and Collaboration Carle has been active in facilitating community engagement and collaboration to connect, update, and expand existing databases and technology currently available to assist agencies, social workers, clergy, healthcare providers, and family members with referrals for their clients, patients and loved ones. *www.HelpSource.org-taking a leadership role in its development more than 11 years ago, we have continued to support HelpSource.org and provide guidance to the maintenance and promotion of this on-line directory of human services resources in east central Illinois. *Created the Community Communications Coalition (C-3) to convene area leaders in human service agencies to discuss how existing resources could be enhanced to include more information, reach more people and to incorporate social media technology. *Continued following updates on the status of 2-1-1- in Illinois and our region, and began considering the impact on activities of the Communications Coalition as well as HelpSource. Community Benefit Priority: -Carle Community Benefit Programs Maintained There are a host of other programs identified in earlier years that have been clearly answering the needs of our community which Carle continues to stand behind, support, and monitor to meet our obligation as a not-for-profit charitable organization. Besides maintaining the Carle Community Care Discount Program and serving Medicaid and Medicare patients, even though government reimbursement is typically below our costs, we continue to focus on the additional major categories of existing, identified health needs that Carle has consistently addressed over the years: Subsidized health services, initiated and maintained to improve the health of the community *AirLife *Carle Breastfeeding Clinic *Carle Community Parish Nurse Program *Carle Low Vision Center *ECHO (Expanding Children's Hearing Opportunities-Pediatric Hearing Services) *Carle Auditory Oral School *Home health services *Neonatal Intensive Care Unit *Patient Advisory Nurse *Pulmonary Rehabilitation Funding programs and shortages This represents a significant portion of our financial, in-kind, and leadership support of health and human service organizations with similar/compatible missions. *The new Stephens Family YMCA in Champaign County was the recipient of an 11-acre land transfer valued at $1,704,401 for construction of this modern, replacement facility which includes Larkin's Place, a recreational area dedicated to the health, wellness and fitness needs of children with all levels of abilities. Included in the donation value was approximately $200,000 in costs related to engineering, permit and water retention at the site. *Seventy-six additional community organizations received support. Some of those are: - Alzheimer's Association - American Diabetes Association - Arthritis Foundation - Camp Kesem (for children who have a parent with cancer) - Champaign County CASA - Champaign County YMCA - Coles County Council on Aging - Coles County Crisis Response Team - Community Elements - Cunningham Children's Home - Danville Rescue Mission - Developmental Services Center - Eastern Illinois Food Bank - Faith in Action - Faith United Methodist Church Christmas Meal Program - Make a Wish Foundation - Muscular Dystrophy Association - United Way-$158,105 *$138,177: Carle's corporate campaign contribution was $115,000 plus an additional $8,558 in fundraising. Campaign expenses and staff time are also included. *$4,558: Carle's corporate contribution to Stuff the Bus, a one-day event where supplies are gathered for distribution to clients through various human service agencies. *$15,370: Miscellaneous contributions throughout the year for various purposes. Health professions education/workforce development Through a variety of activities including significant donations, scholarship programs, and physician, nurse, and allied health education, more than $7.3 million was invested in programs that address community-wide workforce issues, strengthening the training and availability of professionals to care for our communities' healthcare needs now and in the near and distant future. In CY 11, the most significant contributions went towards these programs: *Graduate Medical Education programs. Maintaining a geriatric fellowship and five medical residency programs, including a general surgery residency program, and serving as a clinical site for a sixth. There were 31 residents practicing on Carle's campus in CY 11. *Continuing Medical Education programs for regional providers who are not members of the Carle Foundation Hospital medical staff, including Carle Foundation Day. *Support of the University of Illinois College of Medicine at Urbana-Champaign, with monies earmarked for the MD/PhD program. Research Carle Foundation Hospital is actively involved in research and education initiatives. The overall purpose of the research program is helping to discover new diagnostic and treatment modalities that will improve the delivery and/or quality of health care. The research program is predominantly in conjunction with Carle physicians and University of Illinois scientists, and entrepreneurial companies. Emphasis has been on continuing to create an infrastructure for a robust research program, including: *Setting up a research component of the electronic medical record system that allows for the identification of patients involved in research and assures that billing for the research is accurate and in alignment with all regulatory requirements. *Implementing a central clinical trials management system for optimal tracking of studies and subjects, and As of December 2011, the Carle Research Institute had 126 active research studies, with another 21 research studies pending. Of the total of 147 studies, the breakdown of studies into various areas was 23 translational, 30 investigator-initiated, 29 nursing, 17 clinical trials, and 37 residency program and student research studies. Reaching out to Vermilion and Coles Counties While the focus of the first year (2011) of our three-year plan is primarily on community benefits geared towards Champaign County (donations excluded), here are some of the ways we extended community benefit activities to the residents of Vermilion and Coles County: Access to Care: In Vermilion County: *We began collaborative talks with Provena United Samaritan Hospital in Danville to reduce the number of low birth weight babies born at Provena USMC to 2008 levels In Coles County: *We continued to provide Board leadership to the Coles County Community Health Center and also made a $5,000 annual pledge with a three-year commitment, beginning in 2012. *We are taking steps to strengthen mental health services for adults and children in Coles County. Last year we began to explore having additional mental health providers at our clinic, in the same building as the referring physicians-for a more private venue-and with crisis-sensitive access for the patient. We gave consideration to hiring a masters-prepared social worker at Carle Foundation Physician Services -Mattoon to be on site and immediately intervene with patients with mental health issues, but we put that position on hold. We also maintain a presence on the LifeLinks board. C
SCHEDULE H, PART V- B, LINE 19
STATE FILING OF COMMUNITY BENEFIT REPORT990 SCHEDULE H, PART VIIL,

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (10 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
YMCA
2501 Fields South DrChampaignIL61822370673564501c31704401Building site
University of Illinois
506 S Mathews AveUrbanaIL61801376000511501c31309908Scholarships & Sponsorships
United Way of Champaign County
404 W Church StChampaignIL61820370662519501c3211640Campaign
Parkland College Foundation
2400 West Bradley AveChampaignIL61821370892090501c3163000Scholarships & Sponsorships
Champaign County Christian Health
PO Box 1400ChampaignIL61824562421584501c379220OPERATIONS AND FACILITIES
Land of Lincoln Legal Assistance Fndn
302 SOUTH FIRST STChampaignIL61820370958448501c330000Volunteer Stipend
Vermilion County Advantage
28 W Norht StDanvilleIL61832370238000501c317110Membership, program support
Smile Healthy
PO Box 154ChampaignIL61824141880824501c310000CENTER ASSISTANCE
Don Moyer Boys & Girls Club
201 East Park StChampaignIL61820370906638501c39450Boys and girls program support
Mahomet Area Youth Club
601 E Franklin StMahometIL61853810615577501c38000Program support
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants11TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationThe majority of the requests for funding are to The Carle Foundation or its affiliates located in the communities we serve. Any charitable organization wishing to request funds is asked to submit their request in writing. Emailed requests are acceptable. The request must include a description of the purpose of the contribution and other relevant information such as requestors name, amount of the request, etc. The requests are reviewed, evaluated, and administered by the public relations director, seeking additional information from the requestor, as needed, and input from any appropriate Carle administrator or director. A set of established guidelines drive these decisions, and most are made to improve healthcare/access to healthcare or are in line with our role as a corporate citizen. Assessed need is a common criteria. In the case of most donations of $5,000 or more, such as to colleges and universities or community clinics, written agreements are in place and we have regular, casual contact with those organizations, oftentimes through a Carle contact person to assure that the donations are being used as agreed upon. Records are maintained either in administration or public relations.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
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 (19 entries)

Base 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
Cora E Musial Phd MD
01859650001897303133604418024069200
Mathew Gibb MD
078551100010277902875603971092101700
Paul Tender MD
043618000057642019051010243052311600
James C Leonard MD
0811190016537506377002297620166590128675600
R Bruce Wellman MD
0664501011637502470402169310100640103257500
John Snyder
05176440761970461970142807018004080084900
Dennis Hesch
04202640621250276970120254018850064919000
Philip Kubow
03194030373330514490792140162760503675017401
Pamela Bigler
024478102275002100706278304134035545500
Lynne Barnes
02326350201250751105522802040031753900
Stephanie Beever
022635801756102638052693017308031655800
Mark Berlin
0196419018812019109055161019503030900400
Dawn Walden
02233340006689033905016904028083200
Diane Wasson term 2911
2180308825017652401020019580210130000
Gregory Puszkiewicz term 7111
84003095000110567093740128580226302000
Vijay Bavda
174991032406690134180139000203302000
Cynthia Gordon
173779029401010139790100750198228000
Robert Tonkinson
06220000303713000003099330122321
Linda Fred
151181011173027000131090196690197832000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
ExplanationFORM 990, SCHEDULE J, PART 1, QUESTION 3 THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF THE CARLE FOUNDATION HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED, AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE. FORM 990, SCHEDULE J, PART 1, QUESTION 4A THE FOLLOWING THREE EMPLOYEES RECEIVED THE NOTED AMOUNT OF SEVERANCE PAY DURING CALENDAR YEAR 2011; ROBERT TONKINSON- $209,809, DIANE WASSON- $156,816 AND GREGORY PUSZKIEWICZ- $79,630.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (22 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, SUPPLEMENTAL INFORMATIONFORM 990, PART VI, QUESTION 2 TRUSTEES E. PHILLIPS KNOX AND DAVID IKENBERRY HAD A BUSINESS RELATIONSHIP FORM 990, PART VI, QUESTION 6 CARLE FOUNDATION HOSPITAL HAS ONE MEMBER WHICH IS THE PARENT COMPANY, THE CARLE FOUNDATION. FORM 990, PART VI, QUESTION 7A CARLE FOUNDATION HOSPITAL'S SOLE MEMBER, THE CARLE FOUNDATION, ACTING THROUGH ITS BOARD OF TRUSTEES, HAS THE EXCLUSIVE POWER TO ELECT AND REMOVE MEMBERS OF THE BOARD OF TRUSTEES FOR THE CORPORATION IN ADDITION TO FILLING VACANCIES. FORM 990, PART VI, QUESTION 7B CARLE FOUNDATION HOSPITAL'S BOARD OF TRUSTEES MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, THE CARLE FOUNDATION, THROUGH IT'S BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF THE BY-LAWS; AMENDMENTS TO THE ARTICLES OF THE CORPORATION; AUTHORIZING ANY NON-BUDGETED EXPENDITURE IN EXCESS OF $100,000 (THE EXCESS OF ANY PROPOSED EXPENDITURE OVER THE PREVIOUSLY APPROVED BUDGETED AMOUNT SHALL BE DEEMED A NON-BUDGETED EXPENDITURE); TO ADOPT ANY NEW OR ANY CHANGES TO EXISTING LONG TERM OR MASTER INSTITUTIONAL PLANS OF THE CORPORATION; TO ORGANIZE OR ACQUIRE, OR TO AUTHORIZE OR APPROVE THE ORGANIZATION'S ACQUISITION OF ANY SUBSIDIARY OR AFFILIATE OF THE CORPORATION; AND THE AUTHORIZATION TO ENTER INTO ANY CONTRACT OR ENGAGE IN ANY TRANSACTION OR ACTIVITY WHICH REQUIRES APPLICATION TO THE ILLINOIS HEALTH FACILITIES PLANNING BOARD FOR A PERMIT OR CERTIFICATE OF NEED. FORM 990, PART VI, QUESTION 11 THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY BY POSTING TO THE ORGANIZATION'S DIRECTOR COMMUNICATION PORTAL. ALSO BEFORE FILING, THE GOVERNING MEMBERS RECEIVED NOTIFICATION THAT THE FORM 990 WAS POSTED AND AVAILABLE FOR THEIR REVIEW. AS NECESSARY, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS. FORM 990, PART VI, QUESTION 12C THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE HUMAN RESOURCES DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM VOTING ON MATTERS RELATED TO THEIR CONFLICTS. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH CONFLICTS OF INTEREST. FORM 990, PART VI, QUESTION 15A & 15B Carle Foundation Hospital does not compensate its officers and key employees. These individuals are compensated by The Carle Foundation. THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT COMPANY OF CARLE FOUNDATION HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: *THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES, WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT, HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS, ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED, AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. *THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. *THE COMMITTEE APPROVES ALL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. *THE COMPENSATION COMMITTEE USES A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS REVIEW INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND REPORTS DIRECTLY TO THE COMPENSATION COMMITTEE. FORM 990, PART VI, QUESTION 19 THE CARLE FOUNDATION, THE PARENT COMPANY OF CARLE FOUNDATION HOSPITAL, PUBLISHES THROUGH WWW.DACBOND.COM ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, ANNUAL AUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THIS WEBSITE. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE. IN ADDITION, THE FORM 990S OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND. A COMMUNITY BENEFIT REPORT IS ALSO PUBLISHED AND DISTRIBUTED ANNUALLY TO THE COMMUNITY. QUARTERLY FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. PART VII, SECTION A, COLUMN B THE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40 HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK. FORM 990, PART XI, LINE 5 THE CARLE FOUNDATION HOSPITAL SETTLED VARIOUS INTERCOMPANY RECEIVABLE/PAYABLE BALANCES THROUGH EQUAL OFFSETTING EQUITY TRANSFERS. THE INTERCOMPANY RECEIVABLE/PAYABLE BALANCE RESULTED FROM THE NORMAL COURSE OF OPERATIONS AND WERE PRIMARILY ATTRIBUTABLE TO CENTRALIZED CASH MANAGEMENT AND DISBURSEMENT ACTIVITIES. THESE INTERCOMPANY RECEIVABLE/PAYABLE SETTLEMENTS HELPED PROVIDE SUPPLEMENTAL FUNDING FOR CERTAIN RELATED ORGANIZATIONS TO FURTHER THEIR EXEMPT PURPOSES. Equity transfers (to)/from affiliates (49,567,000) Rounding (403) Net income - CRIMCO 32,063 Net other changes in net assets or fund balances (47,535,340) FORM 990, PART XII, #2A,B,C AND PART IV, LINE 12,12A THE FINANCIAL STATEMENTS FOR CARLE FOUNDATION HOSPITAL WERE REVIEWED ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION DOES HAVE AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. FORM 5471 FILING REQUIREMENTS CARLE FOUNDATION HOSPITAL (CFH) EIN 37-1119538 FORM 5471 FILING REQUIREMENTS HAVE BEEN SATISFIED. CFH CONSTRUCTIVELY OWNED A CONTROLLED FOREIGN CORPORATION IN 2011 THROUGH ITS PARENT THE CARLE FOUNDATION EIN 37-0673465. PURSUANT TO IRS SECTION 6038, THE 2011 CONTROLLED FOREIGN CORPORATION FILING REQUIREMENT OF CFH WAS FULFILLED ON THE 2011 FORM 5471 FILED ON ITS BEHALF BY THE CARLE FOUNDATION. RETURN WITH WHICH THE REQUIRED INFORMATION WAS FILED: THE CARLE FOUNDATION 2011 FORM 990-T EIN 37-0673465 611 WEST PARK URBANA, IL 61801 THE 2011 FORM 5471 WAS FILED WITH THE CARLE FOUNDATION 2011 FORM 990-T. IRS SERVICE CENTER WHERE THE RETURN WAS FILED - OGDEN, UTAH.
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Phillip Blankenburg TITLE:Chairman of Board HOURS:4FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Donna Greene TITLE:Vice Chairman of Board HOURS:2FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Cora E. Musial, Phd MD TITLE:Secretary of Board HOURS:5FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Mathew Gibb, MD TITLE:Trustee HOURS:29FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:J. Michael Martin TITLE:Trustee HOURS:5FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Marty Smith TITLE:Immediate Past Chair HOURS:6FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Paul Tender, MD TITLE:Trustee HOURS:30FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:David Ikenberry, Phd TITLE:Trustee (through 9/15/11) HOURS:3FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:E. Phillips Knox TITLE:Trustee (through 9/15/11) HOURS:1FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:James C. Leonard, MD TITLE:ex-officio, President/CEO HOURS:29FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:R. Bruce Wellman, MD TITLE:ex-offico, Trustee HOURS:21FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:John Snyder TITLE:EXEC VP, COO HOURS:25FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Dennis Hesch TITLE:Exec VP & CFO HOURS:24FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Philip Kubow TITLE:SVP Human Resources HOURS:22FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Pamela Bigler TITLE:Chief Nursing Officer HOURS:15FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Lynne Barnes TITLE:VP Hospital Operations HOURS:20FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Mark Berlin TITLE:VP-Surgical Spec HOURS:20FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Dawn Walden TITLE:VP-Revenue Cycle Ops HOURS:21FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Stephanie Beever TITLE:VP Strat Devl & Diag Svces HOURS:20FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Linda Fred TITLE:Inpt Pharm Director HOURS:16FORM 990 PART VII
HOURS DEVOTED FOR RELATED ORGANIZATIONNAME:Robert Tonkinson TITLE:SVP & CFO-former HOURS:FORM 990 PART VII

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
The Carle Foundation
611 W Park StUrbanaIL61801370673465Parent/InvestIL501(c)(3)11b Type IInafalse
Carle Development Foundation
611 W Park StUrbanaIL61801371159978FundraisingIL501(c)(3)7TCFtrue
Carle Health Care Incorporated
611 W Park StUrbanaIL61801371140016Var svcsIL501(c)(3)9TCFtrue
Carle Retirement Centers Inc
611 W Park StUrbanaIL61801371160033RTRMT LIVINGIL501(c)(3)9TCFtrue
Carle Community Health Corp
611 W Park StUrbanaIL61801364458371FDN MISSIONIL501(c)(3)11a, Type ITCDFtrue

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodePrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINLegal Domicile StateLegalDomicileStateShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Health Systems Insurance LIMITED
GOVERNORS SQ 2ND FL BLDG 3Grand CaymanCJKY1-1102InsuranceCJnaC-CORP
Carle Holding Company Inc
HOLDING COMPANYtcfC-CORP611 W Park StUrbanaIL61801371188284IL
Carle Risk Management Co
Risk managementtcfc-corp611 W Park StUrbanaIL61801371217973IL31628545711.00000
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 OrgtrueGiftGrantOrCapContrFrOtherOrg
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 OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Carle Community Health Care
c2618160COST
Carle Development
c449575COST
Carle Health Care Incorporated
k861687COST
Carle Health Care Incorporated
l8794559COST
Carle Health Care Incorporated
p67554COST

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierSchedule R, Supplemental InformationIdentifier
ExplanationSCHEDULE R, PART II CARLE HEALTH CARE INCORPORATED PRIMARY ACTIVITY: EMERGENCY TRANSPORT, DAY CARE, PHYSICIAN SERVICES.Explanation