IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME (EIN 37-0673512)
- Tax period
- 2010-10-01 to 2011-09-30
- Filed
- 2012-08-10
- IRS object ID
- 201232239349301018
- Schema version
- 2010v3.7
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule I
- Schedule J
- Schedule K
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-08-10T11:16:48-05:00 | Timestamp |
| Tax Period End Date | 2011-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KERBER ECK & BRAECKEL LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1116 W MAIN ST | AddressLine1 |
| City | CARBONDALE | City |
| State | IL | State |
| ZIP Code | 629012335 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370673512 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL | BusinessNameLine1 |
| Business Name Line2 | & RESIDENT HOME | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | IROQ | NameControl |
| Phone | 8154325841 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E FAIRMAN AVENUE | AddressLine1 |
| City | WATSEKA | City |
| State | IL | State |
| ZIP Code | 609701644 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MICHAEL J STENGER | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 8154325841 | Phone |
| Date Signed | 2012-08-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID SCHNAKE | Name |
| Phone | 6185291040 | Phone |
| Date Prepared | 2012-08-10 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MICHAEL J STENGER | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200E FAIRMAN AVENUE | AddressLine1 |
| City | WATSEKA | City |
| State | IL | State |
| ZIP Code | 609701644 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 37836784 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.IROQUOISMEMORIAL.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1914 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVCES FOR THE REGION IN A CONVENIENT CARING ENVIROMENT. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 552 | TotalNbrEmployees |
| Total Nbr Volunteers | 196 | TotalNbrVolunteers |
| Total Gross UBI | 22237 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -26850 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 557926 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 902626 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 35357120 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 36360294 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 162473 | InvestmentIncomePriorYear |
| Investment Income Current Year | 291257 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 295957 | OtherRevenuePriorYear |
| Other Revenue Current Year | 246370 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 36373476 | TotalRevenuePriorYear |
| Total Revenue Current Year | 37800547 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 21549 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 18700 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 18515977 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 19292838 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 68046 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 19840433 | OtherExpensePriorYear |
| Other Expenses Current Year | 18397953 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 38377959 | TotalExpensesPriorYear |
| Total Expenses Current Year | 37709491 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -2004483 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 91056 | RevenuesLessExpensesCY |
| Total Assets BOY | 30906102 | TotalAssetsBOY |
| Total Assets EOY | 29252468 | TotalAssetsEOY |
| Total Liabilities BOY | 11171811 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 9533604 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 19734291 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 19718864 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME IS COMMITTED TO PROVIDING QUALITY HEALTHCARE SERVCES FOR THE REGION IN A CONVENIENT CARING ENVIROMENT. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 30484919 | Expense |
| Grants | 18700 | Grants |
| Revenue | 36366202 | Revenue |
| Description | IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME PROVIDES HIGH QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THE HOSPITAL, IT IS RECOGNIZED THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PURCHASE ESSENTIAL MEDICAL HEALTH CARE SERVICES AND HEALTH CARE EDUCATION. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF OUR COMMUNITY, SOME CARE IS PROVIDED TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST. DESCRIPTION OF PROGRAM SERVICE ACCOMPLISHMENTS CONTINUTED ON SCHEDULE 0 OTHER HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY EXIST. THESE ACTIVITIES INCLUDE PREVENTION AND WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, AND THE MEDICALLY UNDER SERVED INCLUDING A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. THE HOSPITAL IS LOCATED IN WATSEKA, ILLINOIS AND SERVES THE SURROUNDING COMMUNITIES IN IROQUOIS COUNTY AND WEST-CENTRAL INDIANA. THERE ARE OUTPATIENT CLINICS MAINTAINED IN GILMAN, MILFORD, AND WATSEKA, ILLINOIS AS WELL AS KENTLAND, INDIANA. THE HOSPITAL PROVIDES BEDS FOR ACUTE CARE, INTENSIVE CARE, NURSERY AND LONG-TERM CARE. THE HOSPITAL ALSO PROVIDES AMBULANCE SERVICES TO MOST OF IROQUOIS COUNTY WITH STATIONS IN GILMAN AND WATSEKA. HOME HEALTH AND HOSPICE PROVIDE SERVICES TO WATSEKA AND SURROUNDING COMMUNITIES IN THE HOSPITAL'S SERVICE AREA. THE IROQUOIS REGIONAL HEALTH CENTER HOUSES PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES ALONG WITH SPORTS MEDICINE. THE HOSPITAL IS CERTIFIED TO PROVIDE CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL RECORDS THESE AMOUNTS AS UNCOMPENSATED CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. THE COST IN EXCESS OF CHARGES FOR PROVIDING CARE TO ILLINOIS MEDICAID AND OTHER PUBLIC AID PROGRAMS WAS 2,578,000 DURING FISCAL YEAR 2011. THIS COST WAS MITIGATED BY ILLINOIS HOSPITAL MEDICAID ASSESSMENT PROGRAM PAYMENTS, NET OF TAXES ASSESSED, IN THE AMOUNT OF 971,000. WITH THE BOARD'S PARTICIPATION AND APPROVAL, THE HOSPITAL VOLUNTARILY PROVIDES CARE TO PATIENTS AT LESS THAN ITS ESTABLISHED CHARGES FOR PATIENTS WHO ARE IN NEED AND MEET THE HOSPITAL'S CHARITY CARE CRITERIA. CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S CHARITY CARE POLICY WERE APPROXIMATELY 1,561,000 FOR FISCAL 2011, WHILE THE COST OF PROVIDING THOSE SERVICES WAS APPROXIMATELY 746,000. IN ADDITION, THE HOSPITAL IS NOT ABLE TO COLLECT FOR ALL OF THE CARE THAT WAS CHARGED TO PATIENTS. DURING FISCAL 2011 THE HOSPITAL HAD TO WRITE-OFF 2,232,000 IN UNCOLLECTIBLE ACCOUNTS. THE COST OF PROVIDING THAT BENEFIT TO OUR PATIENTS TOTALED 1,100,000. IROQUOIS MEMORIAL HOSPITAL PROVIDES NON-TRADITIONAL HOSPITAL BASED SERVICES SUCH AS AMBULANCE COVERAGE TO WATSEKA AND THE SURROUNDING IROQUOIS COUNTY COMMUNITIES. THE COST IN EXCESS OF CHARGES, FOR PROVIDING THESE NEEDED SERVICES FOR FISCAL 2011 EXCEEDED 419,000. A PORTION OF THIS COST WAS OFFSET BY SUBSIDY PAYMENTS OF 60,000 RECEIVED FROM AREA MUNICIPALITIES AND TOWNSHIPS. IN ADDITION TO THE COSTS OF UNCOMPENSATED CARE AND OTHER NON-TRADITIONAL SERVICES, IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME COMMITTED SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND OTHER CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. SOME OF THOSE PROGRAMS THAT FURTHER THE HOSPITAL'S MISSION INCLUDE: 5K WALK/RUN BLOOD DRIVES BREAST CANCER AWARENESS EVENT BREAST-FEEDING CLASSES FOR EXPECTANT MOTHERS CAMP 911 SAFETY PROGRAMS FOR AREA SCHOOL CHILDREN COMMUNITY HEALTH WALK EMT-B COURSE FIRST AID FOR LOCAL COUNTY FAIRS FREE AND REDUCED FEE HEALTH SCREENINGS FREE BLOOD PRESSURE SCREENINGS FREE CPR TRAINING FOR THE PUBLIC GO RED HEALTHY HEART EVENT HEALTH-RELATED ARTICLES IN LOCAL PUBLICATIONS LAMAZE CLASSES LIFELINE MEALS ON WHEELS SMOKING CESSATION CLASSES SPEAKER'S BUREAU TODDLER OLYMPICS TOURS FOR AREA SCHOOL CHILDREN | Description |
| Total Program Service Expense | 30484919 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | true | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | true | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 70 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 552 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | true | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | true | LocalChapters |
| Policies Reference Chapters | true | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8154327929 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 EAST FAIRMAN AVENUE | AddressLine1 |
| City | WATSEKA | City |
| State | IL | State |
| ZIP Code | 60970 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| PHILIP ZUMWALT MD | ||||||||
| DIRECTOR | 4.00 | X | 37734 | 0 | 0 | |||
| DENNIS WITTENBORN | ||||||||
| DIRECTOR AND | 30.00 | X | 0 | 0 | 0 | |||
| STEVEN KNAPP | ||||||||
| DIRECTOR & V | 4.00 | X | 0 | 0 | 0 | |||
| CINDY SUMNER | ||||||||
| DIRECTOR & T | 4.00 | X | 0 | 0 | 0 | |||
| MAGGIE MARTIN | ||||||||
| DIRECTOR & S | 4.00 | X | 0 | 0 | 0 | |||
| ROGER BALL | ||||||||
| DIRECTOR | 4.00 | X | 0 | 0 | 0 | |||
| MEL WARD | ||||||||
| DIRECTOR | 4.00 | X | 0 | 0 | 0 | |||
| DAN TINCHER | ||||||||
| DIRECTOR | 4.00 | X | 0 | 0 | 0 | |||
| ROGER DITTRICH | ||||||||
| DIRECTOR | 4.00 | X | 0 | 0 | 0 | |||
| WESLEY OSWALD | ||||||||
| INTERIM CEO | 40.00 | 0 | 166539 | 41377 | X | |||
| THOMAS MCGEE | ||||||||
| INTERIM CFO | 40.00 | 0 | 90462 | 23339 | X | |||
| GREG JOHNSON | ||||||||
| INTERIM CEO | 40.00 | 0 | 29286 | 6089 | X | |||
| MICHAEL BARGER | ||||||||
| INTERIM CFO | 40.00 | 0 | 21949 | 5663 | X | |||
| JOSEPH SWAB | ||||||||
| INTERIUM CFO | 40.00 | 0 | 0 | 0 | X | |||
| DAVID ROLLINS | ||||||||
| INTERIM CFO | 40.00 | 0 | 0 | 0 | X | |||
| STEVEN H PACKARD | ||||||||
| PHYSICIAN | 40.00 | 489935 | 0 | 10256 | X | |||
| GONZALO T FLORIDO | ||||||||
| PHYSICIAN | 40.00 | 249768 | 0 | 8864 | X | |||
| CRISTANO M REYES | ||||||||
| PHYSICIAN | 40.00 | 195541 | 0 | 2004 | X | |||
| WILLIAM G NUSSBAUM | ||||||||
| PHARMACIST | 40.00 | 148146 | 0 | 8214 | X | |||
| WILFRED S CHANG | ||||||||
| PHARMACIST | 40.00 | 102700 | 0 | 10416 | X | |||
| STEPHEN O LEURCK | ||||||||
| CEO | 235133 | 0 | 2074 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1458957 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 308236 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 118296 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | true | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| QHR | |||||
| 105 CONTINENTAL PL | BRENTWOOD | TN | 370271018 | MANAGEMENT SERV | 830566 |
| IROQUOIS EMERGENCY MEDICIN SPECIALIS | |||||
| 150 QUAIL RIDGE DRIVE | WESTMONT | IL | 605596148 | PHYSICIAN SERVI | 487000 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 753972633 | PHYSICIAN SERV | 403107 |
| CPSI | |||||
| 6600 WALL STREET | MOBILE | AL | 366850309 | COMPUTER SERV | 341022 |
| J & J DEVELOPMENT CO INC | |||||
| PO BOX 461 | WATSEKA | IL | 60970 | GENERAL CONTRAC | 316096 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 16 | NumberOfContractorsGT100K |
| Fundraising Events | 22665 | FundraisingEvents |
| Government Grants | 46594 | GovernmentGrants |
| All Other Contributions | 833367 | AllOtherContributions |
| Total Contributions | 902626 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| NET PATIENT SERVICE REVENUE | 36075133 | 36075133 |
| OTHER PROGRAM SERVICES | 200415 | 200415 |
| CLINIC AND PHYSICIAN RENTAL | 84746 | 84746 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 36360294 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 289257 | TotalRevenueColumn |
| Exclusion | $289,257 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 24000 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 19763 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 4237 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4237 | TotalRevenueColumn |
| Unrelated Business Revenue | 4237 | UnrelatedBusinessRevenue |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2000 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 2000 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2000 | TotalRevenueColumn |
| Exclusion | $2,000 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 8870 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 22665 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 9071 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -201 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 13311 | GrossSalesOfInventory |
| Cost Of Goods Sold | 7403 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5908 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5908 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|
| CAFETERIA | 139480 | $139,480 |
| OUTSIDE SERVICES | 44329 | $44,329 |
| MISCELLANEOUS | 18300 | $18,300 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 34317 | TotalRevenueColumn |
| Unrelated Business Revenue | 18000 | UnrelatedBusinessRevenue |
| Exclusion | $16,317 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 236426 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37800547 | TotalRevenueColumn |
| Related Or Exempt Function Income | 36366202 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 22237 | UnrelatedBusinessRevenue |
| Exclusion | $509,683 | ExclusionAmount |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18700 | Total |
| Program Services | 18700 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 422438 | Total |
| Management And General | 422438 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16021203 | Total |
| Program Services | 12993196 | ProgramServices |
| Management And General | 2995965 | ManagementAndGeneral |
| Fundraising | 32042 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1620122 | Total |
| Program Services | 1313919 | ProgramServices |
| Management And General | 302963 | ManagementAndGeneral |
| Fundraising | 3240 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1229075 | Total |
| Program Services | 996780 | ProgramServices |
| Management And General | 229837 | ManagementAndGeneral |
| Fundraising | 2458 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 371665 | Total |
| Management And General | 371665 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 255142 | Total |
| Program Services | 206920 | ProgramServices |
| Management And General | 47712 | ManagementAndGeneral |
| Fundraising | 510 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61587 | Total |
| Program Services | 49947 | ProgramServices |
| Management And General | 11517 | ManagementAndGeneral |
| Fundraising | 123 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3224174 | Total |
| Program Services | 2614805 | ProgramServices |
| Management And General | 602921 | ManagementAndGeneral |
| Fundraising | 6448 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174632 | Total |
| Program Services | 141627 | ProgramServices |
| Management And General | 32656 | ManagementAndGeneral |
| Fundraising | 349 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6329620 | Total |
| Program Services | 5133322 | ProgramServices |
| Management And General | 1183639 | ManagementAndGeneral |
| Fundraising | 12659 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250118 | Total |
| Program Services | 202846 | ProgramServices |
| Management And General | 46772 | ManagementAndGeneral |
| Fundraising | 500 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1450113 | Total |
| Program Services | 1176042 | ProgramServices |
| Management And General | 271171 | ManagementAndGeneral |
| Fundraising | 2900 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 162375 | Total |
| Program Services | 131686 | ProgramServices |
| Management And General | 30364 | ManagementAndGeneral |
| Fundraising | 325 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 79689 | Total |
| Program Services | 64628 | ProgramServices |
| Management And General | 14902 | ManagementAndGeneral |
| Fundraising | 159 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1833552 | Total |
| Program Services | 1487011 | ProgramServices |
| Management And General | 342874 | ManagementAndGeneral |
| Fundraising | 3667 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 482406 | Total |
| Program Services | 391231 | ProgramServices |
| Management And General | 90210 | ManagementAndGeneral |
| Fundraising | 965 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBTS | 2198690 | 2198690 | ||
| AGENCY SERVICES | 849273 | 688760 | 158814 | 1699 |
| IDPA PROVIDER TAX | 674355 | 674355 | ||
| RECRUITING | 562 | 454 | 106 | 2 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37709491 | Total |
| Program Services | 30484919 | ProgramServices |
| Management And General | 7156526 | ManagementAndGeneral |
| Fundraising | 68046 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16494 | BOY |
| EOY | 23690 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4205566 | BOY |
| EOY | 2624502 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4227573 | BOY |
| EOY | 4712869 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 37934 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 595642 | BOY |
| EOY | 1077655 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 740334 | BOY |
| EOY | 732576 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 37259394 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 23737386 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14341065 | BOY |
| EOY | 13522008 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6779428 | BOY |
| EOY | 6521234 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30906102 | BOY |
| EOY | 29252468 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4413120 | BOY |
| EOY | 3280831 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5160000 | BOY |
| EOY | 4865000 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1043914 | BOY |
| EOY | 688000 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 554777 | BOY |
| EOY | 699773 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11171811 | BOY |
| EOY | 9533604 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14032635 | BOY |
| EOY | 14123691 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5701656 | BOY |
| EOY | 5595173 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19734291 | BOY |
| EOY | 19718864 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 30906102 | BOY |
| EOY | 29252468 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 91056 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -106483 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form4720 Filed4955 Tax | false | Form4720Filed4955Tax |
| Correction Made | false | CorrectionMade |
| Form1120 Pol Filed | false | Form1120PolFiled |
| Form4720 Filed | false | Form4720Filed |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | true | GrantsOtherOrganizations |
| Grants Other Organizations | $14,519 | GrantsOtherOrganizationsAmount |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | false | OtherActivities |
| Total Lobbying Expenditures IIB | 14519 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
| Form4720 Filed4912 Tax | false | Form4720Filed4912Tax |
| Substantially All Dues Nondeduct | false | SubstantiallyAllDuesNondeduct |
| Only In House Lobbying | false | OnlyInHouseLobbying |
| Agree To Carryover Prior Year | false | AgreeToCarryoverPriorYear |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 7984311 | BeginningOfYearBalance |
| Contributions | 908879 | Contributions |
| Investment Earnings Or Losses | 148839 | InvestmentEarningsOrLosses |
| Other Expenditures | 1809412 | OtherExpenditures |
| Administrative Expenses | 45 | AdministrativeExpenses |
| End Of Year Balance | 7232572 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 9467641 | BeginningOfYearBalance |
| Contributions | 876492 | Contributions |
| Investment Earnings Or Losses | 99741 | InvestmentEarningsOrLosses |
| Other Expenditures | 2459512 | OtherExpenditures |
| Administrative Expenses | 51 | AdministrativeExpenses |
| End Of Year Balance | 7984311 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 9472567 | BeginningOfYearBalance |
| Contributions | 790769 | Contributions |
| Investment Earnings Or Losses | 248121 | InvestmentEarningsOrLosses |
| Other Expenditures | 1043816 | OtherExpenditures |
| End Of Year Balance | 9467641 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.22650 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.76660 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.00690 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | true | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 249035 | OtherCostOrOtherBasis |
| Book Value | 249035 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 23296839 | OtherCostOrOtherBasis |
| Depreciation | 12598785 | Depreciation |
| Book Value | 10698054 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 477850 | OtherCostOrOtherBasis |
| Depreciation | 402781 | Depreciation |
| Book Value | 75069 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 13235670 | OtherCostOrOtherBasis |
| Depreciation | 10735820 | Depreciation |
| Book Value | 2499850 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 13522008 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| BENEFICIAL INTEREST IN TRUST | 5545173 |
| OTHER ASSET | 871987 |
| BOND ISSUE COST | 104074 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 6521234 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO THIRD PARTY | Description |
| Amount | $699,773 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 699773 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| INTENDED USES FOR ENDOWMENT FUNDS | SCHEDULE D, PAGE 2, PART V, LINE 4 | THE ENDOWMENT FUNDS ARE USED TO SUPPORT THE ONGOING OPERATIONAL AND CAPITAL NEEDS OF THE ORGANIZATION IN MEETING THE COMMUNITY NEEDS AND SERVICES. |
| LIABILITY UNDER FIN 48 FOOTNOTE | SCHEDULE D, PAGE 3, PART X | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITION UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | GOLF OUTING | NameOfEvent1 |
| Gross Receipts Event1 | 31535 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 22665 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 8870 | GrossRevenueEvent1 |
| Non Cash Prizes Event1 | 833 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 4464 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 3574 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 200 | EntertainmentEvent1 |
| Gross Receipts Total | 31535 | GrossReceiptsTotal |
| Charitable Contributions Total | 22665 | CharitableContributionsTotal |
| Gross Revenue Total Events | 8870 | GrossRevenueTotalEvents |
| Non Cash Prizes Total Events | 833 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 4464 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 3574 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 200 | EntertainmentTotalEvents |
| Direct Expense Summary Events | 9071 | DirectExpenseSummaryEvents |
| Net Income Summary | -201 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
| Pcent300 | X | Pcent300 |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | false | AnnualCommunityBenefitReport |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 759810 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 759810 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02140 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 5707594 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4300728 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1406866 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03960 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6467404 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4300728 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2166676 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06100 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 50947 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 14358 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 36589 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00100 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 28099 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 20900 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7199 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00020 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7644837 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5170095 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2474742 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06560 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 825 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 825 | NetCommunityBenefitExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 7724708 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 5205353 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2519355 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06680 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 14192112 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9506081 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4686031 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12780 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 911 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 911 | NetCommunityBuildingExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 28325 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 28325 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Building Expense | 29236 | TotalCommunityBuildingExpense |
| Net Community Building Expense | 29236 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00080 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $879,738 | BadDebtExpenseAmount |
| Amount Reimbursed By Medicare | 12803359 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 12623151 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 180208 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E FAIRMAN AVE | AddressLine1 |
| City | WATSEKA | City |
| State | IL | State |
| ZIP Code | 60970 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | false | CHNAConducted |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 100.0 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 300.0 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Report To Credit Agency | X | PermitReportToCreditAgency |
| Collection Activities | true | CollectionActivities |
| Report To Credit Agency | X | ReportToCreditAgency |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 7 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (7 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| IROQUOIS REGIONAL HEALTH CENTER | ||||
| 200 LAIRD LANE | WATSEKA | IL | 60970 | REHAB SERVICES, HOME HEALTH, HOSPICE |
| IROQUOIS HOME CARE INC | ||||
| 200 LAIRD LANE | WATSEKA | IL | 60970 | DURABLE MEDICAL EQUIPMENT |
| KENTLAND CLINIC | ||||
| 303 N SEVENTH ST | KENTLAND | IN | 47951 | PHYSICIAN OFFICE |
| GILMAN CLINIC | ||||
| 508 E CRESCENT ST | GILMAN | IL | 60938 | PHYSICIAN OFFICE |
| MILFORD CLINIC | ||||
| 207 N AXTEL AVE | MILFORD | IL | 60953 | PHYSICIAN OFFICE |
| IROQUOIS ORTHOPEDICS & HAND SURGERY | ||||
| 200 E FAIRMAN AVE | WATSEKA | IL | 60970 | PHYSICIAN OFFICE |
| MULTI-SPECIALTY CLINIC | ||||
| 200 LAIRD LANE | WATSEKA | IL | 60970 | PHYSICIAN OFFICE |
Form990 Schedule H Part VI Form990ScheduleHPartVI (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SUBSIDIZED HEALTH SERVICES EXPLANATION | PART I LINE 7G | THE ORGANIZATION INCLUDED COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC EMS AMBULANCE OB AND RESIDENT HOME IN ITS SUBSIDIZED HEALTH SERVICES |
| EXCLUSIONS FROM PERCENT OF TOTAL EXPENSE | PART I LINE 7 COLUMN F | THE ORGANIZATION HAD BAD DEBT EXPENSE IN THE AMOUNT OF 2232272 HOWEVER IT HAS BEEN SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGES APPLICABLE TO COMMUNITY BENEFITS |
| COSTING METHODOLOGY EXPLANATION | PART I LINE 7 | A COST TO CHARGE RATIO AS CALCULATED FROM WORKSHEET 2 RATIO OF PATIENT CARE COSTTOCHARGES INCLUDED IN THE SCHEDULE H INSTRUCTIONS WAS USED TO DETERMINE THE AMOUNTS ON LINE 7B OF PART I OF SCHEDULE H ACTUAL COSTS WERE USED TO DETERMINE THE BENEFIT EXPENSES ON LINES 7A 7E 7F 7G AND 7I OF SCHEDULE H PART I |
| COMMUNITY BUILDING ACTIVITIES | PART II | IN ORDER TO PROMOTE THE WELLBEING OF THE COMMUNITIES IT SERVES THE ORGANIZATION ALLOWS VARIOUS COMMUNITY ORGANIZATIONS TO USE ITS FACILITIES A NO COST |
| BAD DEBT EXPENSE EXPLANATION | PART III LINE 4 | FOOTNOTE FROM AUDITED FINANCIAL STATEMENTS THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT NET REALIZABLE AMOUNTS FROM THIRDPARTY PAYORS PATIENTS AND OTHERS THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS AS A SERVICE TO THE PATIENT THE HOSPITAL BILLS THIRDPARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENTS LIABILITY IS DETERMINED PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED ACCOUNTS ARE CONSIDERED DELINQUENT AND SUBSEQUENTLY WRITTEN OFF AS BAD DEBTS BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCE OF THE ACCOUNT THE HOSPITAL USES AN OVERALL HOSPITAL COST TO CHARGE RATIO TO CALCULATE THE UNPAID COST OF BAD DEBT EXPENSE IN ADDITION TO THE ABOVE COST OF UNCOMPENSATED CARE THE HOSPITAL ALSO COMMITS SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS MANY OF THESE ACTIVITIES ARE SPONSORED WITH THE KNOWLEDGE THAT THEY WILL NOT BE SELFSUPPORTING OR FINANCIALLY VIABLE DESCRIPTION OF COSTING METHODOLOGY USED THE COSTING METHODOLOGY USED IN DETERMINING THE AMOUNTS REPORTED ON LINE 2 WAS RATIO OF PATIENT CARE COSTS TO CHARGES AS COMPUTED IN WORKSHEET 2 OF THE FORM 990 SCHEDULE H INSTRUCTIONS |
| MEDICARE EXPLANATION | PART III LINE 8 | MEDICARE COST WAS DETERMINED USING AN OVERALL COST TO CHARGE RATIO |
| COLLECTION PRACTICES EXPLANATION | PART III LINE 9B | QUALIFICATIONS ARE BASED ON POVERTY GUIDELINES PUBLISHED NO COLLECTION EFFORTS FOR QUALIFYING PATIENTS PATIENTS WHO DO NOT QUALIFY RECEIVE AT LEAST 3 STATEMENTS AND GENERALLY ARE TURNED TO COLLECTIONS IF NO PAYMENTS ARE RECEIVED |
| NEEDS ASSESSMENT | PART VI | IN PREVIOUS YEARS THE ORGANIZATION HIRED A CONSULTANT TO ASSESS THE HEALTH CARE NEED OF THE COMMUNITIES IT SERVES |
| PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE | PART VI | INFORMATION REGARDING THE ORGANIZATIONS FINANCIAL ASSISTANCE POLICY IS DISTRIBUTED AT TIME OF THE PATIENT ADMISSION THE ORGANIZATION ALSO HAS SIGNAGE IN THE ADMISSIONS AREA |
| COMMUNITY INFORMATION | PART VI | THE COMMUNITY IS RURAL WITH OVERALL LOW INCOME LEVELS AND HIGH LEVELS OF UNINSURED PATIENTS MANY PATIENTS WOULD HAVE PROBLEMS WITH ACCESS TO CARE WITHOUT THE ORGANIZATION SUBSIDIZED PHYSICIAN CLINICS AND OTHER SERVICES |
| AFFILIATED HEALTH CARE INFORMATION | PART VI | THE ORGANIZATION JOINTLY COMPENSATES OR PROVIDES LOCATIONS TO PROVIDE CARE FOR A LARGE NUMBER OF PHYSICIAN SPECIALISTS WHICH PROMOTES MUCH ACCESS TO CARE FOR THE COMMUNITY IT SERVES |
| ADDITIONAL INFORMATION | PART VI | THE ORGANIZATION PROVIDES AN OPEN MEDICAL STAFF TO PROMOTE ACCESS TO CARE FOR THE COMMUNITY THE BOARD SUPPORTS PROVIDING LARGE AMOUNTS OF UNCOMPENSATED OR SUBSIDIZED CARE TO THE COMMUNITY |
| IROQUOIS MEMORIAL HOSPITAL LINE NUMBER 1 PART V LINE 19D | PART V LINE 19D | UNINSURED DISCOUNT OF 30 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)
| Type Of GrantTypeOfGrant | Number Of RecipientsNumberOfRecipients | Amount Of Cash GrantAmountOfCashGrant |
|---|---|---|
| SCHOLARSHIPS | 21 | 14600 |
| EMPLOYEE ASSISTANCE | 15 | 4100 |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES | Identifier |
| Return Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | ReturnReference |
| Explanation | THE FINANCE DEPARTMENT MONITORS THE USE OF GRANT FUNDS BY SEPARATING THEM FROM NORMAL OPERATING EXPENSES IN THE GENERAL LEDGER AND BY ENSURING COMPLIANCE WITH TERMS AND CONDITIONS OF THE GRANTS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Written Employment Contract | X | WrittenEmploymentContract |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg |
|---|---|---|---|---|---|---|---|---|---|
| WESLEY OSWALD | |||||||||
| 166539 | 41377 | 207916 | |||||||
| THOMAS MCGEE | |||||||||
| 90462 | 23339 | 113801 | |||||||
| GREG JOHNSON | |||||||||
| 28346 | 6089 | 35375 | 940 | ||||||
| MICHAEL BARGER | |||||||||
| 21949 | 5663 | 27612 | |||||||
| JOSEPH SWAB | |||||||||
| DAVID ROLLINS | |||||||||
| STEVEN H PACKARD | |||||||||
| 489737 | 198 | 660 | 9596 | 500191 | |||||
| GONZALO T FLORIDO | |||||||||
| 209132 | 25450 | 2000 | 6864 | 258632 | 15186 | ||||
| CRISTANO M REYES | |||||||||
| 184571 | 198 | 2004 | 197545 | 10772 | |||||
| WILLIAM G NUSSBAUM | |||||||||
| 148146 | 816 | 7398 | 156360 | ||||||
| STEPHEN O LEURCK | |||||||||
| 22735 | 212398 | 2074 | 237207 | ||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| SEVERANCE, NONQUALIFIED, AND EQUITY-BASED PAYMENTS | SCHEDULE J, PAGE 1, PART I, LINE 4 | STEPHEN O. LEURCK 212,398 0 0 |
| OTHER ADDITIONAL INFORMATION | SCHEDULE J, PART III | COMPENSATION FOR INTERIM CEOS AND INTERIM CFOS IS PAID BY AN UNRELATED MANAGEMENT COMPANY, QUORUM HEALTH RESOURCES. FEES ARE PAID TO QHR BY IROQUOIS MEMORIAL HOSPITAL FOR THEIR SERVICES |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTY OF IROQUOIS ILLINOIS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 376001070 | IssuerEIN |
| CUSIP Number | 463547AV1 | CUSIPNumber |
| Date Issued | 2003-07-29 | DateIssued |
| Issue Price | 7000000 | IssuePrice |
| Description Of Purpose | 2003 SERIES REVENUES FOR EXPANSION | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Pool Financing | false | PoolFinancing |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 7084189 | TotalProceeds |
| Amount In Reserve Fund | 556538 | AmountInReserveFund |
| Issuance Costs From Proceeds | 140000 | IssuanceCostsFromProceeds |
| Capital Expenditures | 6257511 | CapitalExpenditures |
| Year Of Subst Completion | 2005 | YearOfSubstCompletion |
| Current Refunding | false | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part III Form990ScheduleKPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Owning Bond Financed Property | false | OwningBondFinancedProperty |
| Any Lease Arrangements | false | AnyLeaseArrangements |
| Mngment Cntrct Bond Financd Prprty | false | MngmentCntrctBondFinancdPrprty |
| Any Research Agreements | false | AnyResearchAgreements |
| Bond Counsel Routinely Engaged | false | BondCounselRoutinelyEngaged |
| Post Issuance Compliance Procdrs | true | PostIssuanceComplianceProcdrs |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | true | VariableRateIssue |
| Hedge Identified In Books And Recds | false | HedgeIdentifiedInBooksAndRecds |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
Schedule L IRS990ScheduleL
Loan Table LoanTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | GONZALO T FLORIDO | NamePerson |
| Purpose Of Loan | CONTINUING MEDICAL EDUCATION LOAN | PurposeOfLoan |
| Loan From Organization | X | LoanFromOrganization |
| Original Principal | $48,109 | OriginalPrincipalAmount |
| Balance Due | 37934 | BalanceDue |
| Default | false | Default |
| Approved By Board | true | ApprovedByBoard |
| Written Agreement | true | WrittenAgreement |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 37934 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FIRST ACHIEVEMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4A | OTHER HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY WILL BE CONSIDERED WHERE THE NEED AND/OR AN INDIVIDUAL'S INABILITY TO PAY EXIST. THESE ACTIVITIES INCLUDE PREVENTION AND WELLNESS PROGRAMS, COMMUNITY EDUCATION PROGRAMS, AND SPECIAL PROGRAMS FOR THE ELDERLY, HANDICAPPED, AND THE MEDICALLY UNDER SERVED INCLUDING A VARIETY OF BROAD COMMUNITY SUPPORT ACTIVITIES. THE HOSPITAL IS LOCATED IN WATSEKA, ILLINOIS AND SERVES THE SURROUNDING COMMUNITIES IN IROQUOIS COUNTY AND WEST-CENTRAL INDIANA. THERE ARE OUTPATIENT CLINICS MAINTAINED IN GILMAN, MILFORD, AND WATSEKA, ILLINOIS AS WELL AS KENTLAND, INDIANA. THE HOSPITAL PROVIDES BEDS FOR ACUTE CARE, INTENSIVE CARE, NURSERY AND LONG-TERM CARE. THE HOSPITAL ALSO PROVIDES AMBULANCE SERVICES TO MOST OF IROQUOIS COUNTY WITH STATIONS IN GILMAN AND WATSEKA. HOME HEALTH AND HOSPICE PROVIDE SERVICES TO WATSEKA AND SURROUNDING COMMUNITIES IN THE HOSPITAL'S SERVICE AREA. THE IROQUOIS REGIONAL HEALTH CENTER HOUSES PHYSICAL, OCCUPATIONAL AND SPEECH THERAPIES ALONG WITH SPORTS MEDICINE. THE HOSPITAL IS CERTIFIED TO PROVIDE CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. RECOGNIZING ITS MISSION TO THE COMMUNITY, SERVICES ARE PROVIDED TO BOTH MEDICARE AND MEDICAID PATIENTS. TO THE EXTENT REIMBURSEMENT IS BELOW COST, THE HOSPITAL RECORDS THESE AMOUNTS AS UNCOMPENSATED CARE IN MEETING ITS MISSION TO THE ENTIRE COMMUNITY. THE COST IN EXCESS OF CHARGES FOR PROVIDING CARE TO ILLINOIS MEDICAID AND OTHER PUBLIC AID PROGRAMS WAS 2,578,000 DURING FISCAL YEAR 2011. THIS COST WAS MITIGATED BY ILLINOIS HOSPITAL MEDICAID ASSESSMENT PROGRAM PAYMENTS, NET OF TAXES ASSESSED, IN THE AMOUNT OF 971,000. WITH THE BOARD'S PARTICIPATION AND APPROVAL, THE HOSPITAL VOLUNTARILY PROVIDES CARE TO PATIENTS AT LESS THAN ITS ESTABLISHED CHARGES FOR PATIENTS WHO ARE IN NEED AND MEET THE HOSPITAL'S CHARITY CARE CRITERIA. CHARGES EXCLUDED FROM REVENUE UNDER THE HOSPITAL'S CHARITY CARE POLICY WERE APPROXIMATELY 1,561,000 FOR FISCAL 2011, WHILE THE COST OF PROVIDING THOSE SERVICES WAS APPROXIMATELY 746,000. IN ADDITION, THE HOSPITAL IS NOT ABLE TO COLLECT FOR ALL OF THE CARE THAT WAS CHARGED TO PATIENTS. DURING FISCAL 2011 THE HOSPITAL HAD TO WRITE-OFF 2,232,000 IN UNCOLLECTIBLE ACCOUNTS. THE COST OF PROVIDING THAT BENEFIT TO OUR PATIENTS TOTALED 1,100,000. IROQUOIS MEMORIAL HOSPITAL PROVIDES NON-TRADITIONAL HOSPITAL BASED SERVICES SUCH AS AMBULANCE COVERAGE TO WATSEKA AND THE SURROUNDING IROQUOIS COUNTY COMMUNITIES. THE COST IN EXCESS OF CHARGES, FOR PROVIDING THESE NEEDED SERVICES FOR FISCAL 2011 EXCEEDED 419,000. A PORTION OF THIS COST WAS OFFSET BY SUBSIDY PAYMENTS OF 60,000 RECEIVED FROM AREA MUNICIPALITIES AND TOWNSHIPS. IN ADDITION TO THE COSTS OF UNCOMPENSATED CARE AND OTHER NON-TRADITIONAL SERVICES, IROQUOIS MEMORIAL HOSPITAL & RESIDENT HOME COMMITTED SIGNIFICANT TIME AND RESOURCES TO ENDEAVORS AND OTHER CRITICAL SERVICES WHICH MEET OTHERWISE UNFILLED COMMUNITY NEEDS. SOME OF THOSE PROGRAMS THAT FURTHER THE HOSPITAL'S MISSION INCLUDE: 5K WALK/RUN BLOOD DRIVES BREAST CANCER AWARENESS EVENT BREAST-FEEDING CLASSES FOR EXPECTANT MOTHERS CAMP 911 SAFETY PROGRAMS FOR AREA SCHOOL CHILDREN COMMUNITY HEALTH WALK EMT-B COURSE FIRST AID FOR LOCAL COUNTY FAIRS FREE AND REDUCED FEE HEALTH SCREENINGS FREE BLOOD PRESSURE SCREENINGS FREE CPR TRAINING FOR THE PUBLIC GO RED HEALTHY HEART EVENT HEALTH-RELATED ARTICLES IN LOCAL PUBLICATIONS LAMAZE CLASSES LIFELINE MEALS ON WHEELS SMOKING CESSATION CLASSES SPEAKER'S BUREAU TODDLER OLYMPICS TOURS FOR AREA SCHOOL CHILDREN |
| MANAGEMENT DELEGATED | FORM 990, PAGE 6, PART VI, LINE 3 | THE ORGANIZATION CONTRACTED QUORUM HEALTH RESOURCES (QHR) FOR THE ORGANIZATION'S MANAGEMENT SERVICES EFFECTIVE FEBRUARY 1, 2010. QHR PROVIDES IROQUOIS MEMORIAL HOSPITAL WITH LEADERSHIP VIA THE CEO AND CFO ALONG WITH OTHER CONSULTING SERVICES ON FINANCIAL AND STAFFING NEEDS. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | MAYOR, COUNTY BOARD CHAIRPERSON AND DISTRICT JUDGE EACH APPOINT 3 MEMBERS OF THE ORGANIZATION'S BOARD OF TRUSTEES TO 3-YEAR TERMS. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE STAFF MEMBERS THAT PROVIDE INFORMATION TO THE OUTSIDE RETURN PREPARER CONDUCT A THOROUGH REVIEW OF A DRAFT OF THE RETURN. PRIOR TO FILING, THE 990 IS DISTRIBUTED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATIONS CONFLICT OF INTEREST POLICY COVERS DIRECTORS, OFFICERS, MANAGERS, MEDICAL STAFF MEMBERS, PHYSICIANS, EXECUTIVE STAFF MEMBERS, DEPARTMENT DIRECTORS, AND COORDINATORS. CONFLICT OF INTEREST STATEMENTS ARE REQUIRED TO BE COMPLETED ANNUALLY BY DIRECTORS, OFFICERS, AND HIGHLY-COMPENSATED EMPLOYEES AND ARE REVIEWED BY ADMINISTRATION. INDIVIDUALS WITH CONFLICTS OF INTEREST ARE REQUIRED TO DISCLOSE THEM AND TO REFRAIN FROM PARTICIPATION IN ANY DECISION THAT COULD BENEFIT THEM PERSONALLY. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF TRUSTEES AND QHR, THE HOSPITAL'S MANAGEMENT COMPANY, CONDUCTED THE COMPENSATION REVIEW IN 2011 . |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE BOARD OF TRUSTEES AND QHR, THE HOSPITAL'S MANAGEMENT COMPANY, CONDUCTED THE COMPENSATION REVIEW IN 2011. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | FINANCIAL DOCUMENTS ARE AVAILABLE UPON REQUEST. CONFLICT OF INTEREST POLICY AND GOVERNING DOCUMENTS ARE NOT PUBLIC INFORMATION AT THIS TIME. HOWEVER, IF REQUESTED, THE BOARD WOULD BE NOTIFIED TO DETERMINE RESPONSE. |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 5 | CHANGE IN BENEFICIAL INTEREST IN PERPETUAL TRUST OF (106,483) |
Schedule R IRS990ScheduleR
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IROQUOIS HOME CARE INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 LAIRD LANE | AddressLine1 |
| City | WATSEKA | City |
| State | IL | State |
| ZIP Code | 60970 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activity | SALES/RENT | PrimaryActivity |
| Legal Domicile State | IL | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C CORP | TypeOfEntity |
| Share Of Total Income | 100499 | ShareOfTotalIncome |
| Share Of EOY Assets | 1071173 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | true | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| IROQUOIS HOME CARE INC | ||
| A | 24000 | RENTAVG COMMERCIAL MV |
| IROQUOIS HOME CARE INC | ||
| L | 149973 | RETAIL PRICE |
| IROQUOIS HOME CARE INC | ||
| P | 83016 | ACTUAL COST |