2011-10-17T10:29:43-05:00 2010-12-31 990 2010-01-01 362181997 FREEPORT MEMORIAL HOSPITAL FREE 8155996209 1045 W STEPHENSON ST FREEPORT IL 61032 MICHAEL C CLARK 8155996361 2011-10-13 2010 2016-03-07 17:11:31Z MICHAEL R PERRY MD PRES 1045 W STEPHENSON ST FREEPORT IL 61032 123541114 0 X WWW.FHN.ORG X 1964 IL OUR MISSION IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES, WORKING TOGETHER WITH THOSE WE SERVE. 14 7 1420 657 11113 -4647 143112 131783 123946097 123253247 242103 148141 0 0 124331312 123533171 0 0 0 0 38615447 38848317 0 0 0 66664776 65104964 105280223 103953281 19051089 19579890 71261535 75004004 24112402 27132024 47149133 47871980 X SEE SCHEDULE O 0 0 30295074 70520766 FREEPORT MEMORIAL HOSPITAL PROVIDES INPATIENT AND OUTPATIENT HOSPITAL SERVICES TO PATIENTS IN FIVE NORTHWESTERN ILLINOIS COUNTIES. THE HOSPITAL ENSURES CONTINIUED ACCESS TO CARE BY SERVING PATIENTS IN MEDICALLY UNDERSERVED AREAS. THE HOSPITAL QUALIFIES AS A MEDICARE DISPROPORTIONATE SHARE HOSPITAL BECAUSE IT SERVES A DISPROPORTIONATELY HIGH NUMBER OF LOW-INCOME PATIENTS. 64479375 52721368 OTHER UNCOMPENSATED CARE: THE HOSPITAL IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELLY 67% OF ITS' PATIENT BASE QUALIFYING FOR AT LEAST ONE OF THESE PROGRAMS. AT PRESENT THE REIMBURSEMENT RATES OF THESE PROGRAMS DO NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THE ESTIMATED UNFUNDED COST OF SERVICE FOR MEDICARE PATIENTS WAS APPROXIMATELY $7,238,341 AND MEDICAID PATIENTS WAS APPROXIMATELY $4,519,666 FOR THE YEAR ENDING 12/31/2010. 2860751 CHARITY CARE: THE HOSPITAL PROVIDED CHARITY CARE BENEFITS FOR PATIENTS WHOSE INCOME WAS UP TO 300% OF THE FEDERALLY DETERMINED PROVERTY LEVEL. CHARGES FOREGONE FOR CHARITY CARE AMOUNTED TO APPROXIMATELY $9,064,812 IN 2010. ESTIMATED COSTS OF PROVIDING THESE SERVICES AMOUNTED TO APPROXIMATELY $2,860,751 IN 2010. 941333 OTHER COMMUNITY BENEFITS: THE HOSPITAL OPERATES AND SUPPORTS A NUMBER OF COMMUNITY BENEFIT PROGRAMS THAT INCLUDE BUT ARE NOT LIMITED TO COMMUNITY HEALTH EDUCATION, HEALTH CARE SUPPORT SERVICES AND HEALTH PROFESSIONAL EDUCATION. 941333 98576533 1 1 0 1 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 1 78 0 1 1420 1 1 1 0 0 0 0 0 0 0 0 0 X 14 7 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X WILLIAM SPANGLER 8155996376 1045 W STEPEHNSON ST FREEPORT IL 61032 GARY HOSPELHORN 0.50 X 0 0 0 LAWRENCE H LUY MD 0.50 X 0 267865 64486 GARY QUINN 0.50 X 0 0 0 RAVI VYAS MD 0.50 X 0 1045474 58177 VINOD K WADHWA MD 0.50 X 0 318913 74432 LARRY MAIN 0.50 X 0 0 0 ELLEN POPPEN 0.50 X 0 0 0 CAROL SCHUSTER 0.50 X 0 0 0 MARTIN CLEARY MD 0.50 X 0 417517 68052 DARIN DOAK 0.50 X 0 0 0 SHERRY FLACK 0.50 X 0 0 0 GARY FONTANA 0.50 X 0 0 0 DOUG FREIDAG 0.50 X 0 0 0 BRUCE HELM 0.50 X 0 0 0 DICK DROGOSZ 0.50 X 0 0 0 BHADRESH PATEL MD 0.50 X 0 512740 84682 REBECCA PEDERSON MD 0.50 X 0 291126 58413 TIMOTHY JESSEN MD 0.50 X 0 233972 73695 MICHAEL PERRY MD 24.00 X 277635 177504 64741 MICHAEL C CLARK 24.00 X 133503 85354 58677 SHARON SUMMERS 24.00 X 135025 86327 65334 LEONARD CARTER 24.00 X 97344 62236 27541 ROBERT GELLER MD 40.00 X 0 281021 71544 NANCY V CUTLER 40.00 X 169052 0 35555 WILLIAM SPANGLER 41.00 X 115231 0 36022 MICHAEL G WEAVER 40.00 X 128068 0 49453 THOMAS WAGNER 43.00 X 115198 0 36736 ROBIN SCALISE 40.00 X 120435 0 10683 BETH KALNINS MD 40.00 X 270948 0 36533 DENNIS HAMILTON 0.10 X 0 141258 33604 WENDY LAWLER 48.00 X 106961 0 10791 WILLIAM PALMQUIST 44.00 X 113265 0 44379 MICHAEL MERRY MD 0.50 X 0 449152 41556 1782665 4370459 1105086 18 1 1 0 MEA-FREEPORT LLC 1 TRNSAM PLAZA DR SUITE 360 OAK BROOK IL 60181 EMERGENCY DEPT 4046949 CAMELOT RADIOLOGY DBA N ILLINOIS RADIOL 3849 PERRYVILLE RD ROCKFORD IL 61114 RADIOLOGY PHYSICIANS 2054350 ALLIANCE IMAGING PO BOX 6600 NEWPORT BEACH CA 92658 IMAGING SERVICES 828288 HLS WHEELING LLC 2689 RELIABLE PARKWAY CHICAGO IL 60686 LAUNDRY SERVICE 424011 MEDICAL STAFFING NETWORK PO BOX 20300 DALLAS TX 75320 STAFFING AGENCY 385513 14 34392 97391 131783 PATIENT SERV. REVENUE 621400 117647601 117636488 11113 PROVIDER TAX REVENUE 621400 4854073 4854073 CAFETERIA REVENUE 621400 480670 480670 GIFT SHOP 621400 156208 156208 OTHER REVENUE 621500 88960 88960 25735 25735 123253247 156084 156084 1830 6113 -1830 -6113 -7943 -7943 123533171 123242134 11113 148141 980053 980053 29598211 28282959 1315252 502968 328700 174268 5619586 5619586 2147499 2035334 112165 10000 10000 50000 50000 11154963 10777028 377935 4760393 4543785 216608 74102 68349 5753 165136 50430 114706 44704 44704 4680240 4680240 1979592 1979592 CONTRACTED SERVICES 11171095 9268374 1902721 CORPORATE ALLOCATION 9918512 9918512 MEDICAL SPECIALIST 7727440 7702623 24817 BAD DEBTS 7716472 7716472 DRUGS 3199622 3172142 27480 2452693 2387703 64990 103953281 98576533 5376748 0 17491868 19870845 20585936 21464217 970672 1987725 1446712 1493498 1911618 2349091 73532975 48832388 26471448 24700587 1451004 1600990 932277 1537051 71261535 75004004 13595119 14371986 3133561 1065044 365692 9452239 9260785 24112402 27132024 X 45985114 46715232 1164019 1156748 47149133 47871980 71261535 75004004 X 19579890 -18857043 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 26362 26362 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: PORTION OF 2010 ILLINOIS HOSPITAL ASSOCIATION DUES USED FOR LOBBYING:$20,337 PORTION OF 2010 AMERICAN HOSPITAL ASSOCIATION DUES USED FOR LOBBYING:$6,025. 945058 945058 44662915 30238274 14424641 25478439 16959211 8519228 2446563 1634903 811660 24700587 PENSION LIABILITY 7041529 ACCRUED MALPRACTICE LIABILITY 613754 ASSET RETIREMENT OBLIGATION 1605502 9260785 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THERE IS NO FIN 48 LIABILITY AND AS SUCH THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS DOES NOT INCLUDE A FIN 48 FOOTNOTE. 1 1 1 X 1 X 1 1 1 0 1 0 2860751 2860751 0.02970 16498513 11978847 4519666 0.04700 19359264 11978847 7380417 0.07670 515926 23372 492554 0.00510 249040 249040 0.00260 149318 149318 0.00160 914284 23372 890912 0.00930 20273548 12002219 8271329 0.08600 91912 91912 0.00090 91912 91912 0.00090 1 2435002 0 40742521 47980862 -7238341 X 1 1 1 1 FREEPORT MEMORIAL HOSPITAL

1045 WEST STEPHENSON STREET FREEPORT IL 61032

X X X FREEPORT MEMORIAL HOSPITAL 1 PART I, LINE 7: SCHEDULE H PART I LINE 7 COLUMN(F): OUR TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN(A) WAS $103,953,281. THE BAD DEBT EXPENSE INCLUDED IN THIS AMOUNT WAS $7,716,472. THIS LEFT US WITH A TOTAL EXPENSE OF $96,236,809 FOR PURPOSES OF CALCULATING LINE 7, COLUMN(F). PART I, L7 COL(F): SCHEDULE H PART I LINE 7: OUR TOTAL EXPENSES FROM FORM 990, PART IX, LINE 25, COLUMN(A) $103,953,281. THE BAD DEBT EXPENSES INCLUDED IN THIS AMOUNT WAS $7,716,472. THIS LEFT US WITH A TOTAL EXPENSES OF $96,236,809 FOR THE PURPOSES OF CALCULATING LINE 7, COLUMN(F). PART III, LINE 4: LINE #2: THE RATIO OF PATIENT CARE COST TO CHARGES AS DETERMINED ON WORKSHEET 2 IS APPLIED TO THE BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS TO CALCULATE THE ESTIMATED COST OF BAD DEBT ATTRIBUTABLE TO PATIENT ACCOUNTS THAT IS REPORTED ON LINE 2.LINE # 3: NO BAD DEBT IS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE CHARITY CARE POLICY. PART III, LINE 8: COSTING METHODOLOGY: MEDICARE ALLOWABLE COSTS WERE CALCULATED USING THE MEDICARE COST-TO-CHARGE RATIO FROM OUR FILED 12/31/10 MEDICARE COST REPORT.COMMUNITY BENEFIT: WE BELIEVE THAT ALL OF THE 7,238 MILLION SHORTFALL SHOULD BE CONSIDERED AS COMMUNITY BENEFIT. THE IRS COMMUNITY BENEFIT STANDARD INCLUDES THE PROVISION OF CARE OF THE ELDERLY AND MEDICARE PATIENTS. MEDICARE SHORTFALLS MUST BE ABSORDED BY THE HOSPITAL IN ORDER TO CONTINUE TREATING THE ELDERLY IN OUR COMMUNITY. THIS YEAR, MEDICARE ACCOUNTED FOR 51% OF HOSPITAL REVENUES. THE HOSPITAL PROVIDES CARE REGARDLESS OF THIS SHORTFALL AND THEREBY RELIEVES THE GOVERNMENT OF THE BURDEN OF PAYING THE FULL COST OF MEDICARE BENEFICIARIES.0 PART III, LINE 9B: INDIVIDUALS APPROVED FOR ASSISTED CARE ARE GIVEN A CARD WHICH IS TYPICALLY VALID FOR 6 MONTHS. THEY PRESENT THE CARD WHEN THEY RECEIVE SERVICES. INDIVIDUALS APPROVED FOR ASSISTED CARE WILL BE ASKED TO MAKE A MODEST CO-PAY AT THE TIME OF SERVICE, BASED ON THE FOLLOWING SCHEDULE:HOSPITAL INPATIENT SERVICES: $50HOSPITAL EMERGENCY DEPARTMENT: $35HOSPITAL OUTPATIENT SERVICES: $25OUR COLLECTION POLICIES ARE THE SAME FOR ALL OF OUR PATIENTS. PATIENTS ARE SCREENED FOR ELIGIBILITY FOR FINANCIAL ASSISTANCE BEFORE COLLECTION PROCEDURES BEGIN. IF AT ANY POINT IN THE COLLECTION PROCESS, DOCUMENTATION IS RECEIVED THAT INDICATES THE PATIENT IS POTENTIALLY ELIGIBLE FOR FINANCIAL ASSISTANCE BUT HAS NOT APPLIED FOR IT, AN APPLICATION FOR ASSISTED CARE IS SENT TO THE PATIENT. AFTER A PATIENT MEETS THE QUALIFICATIONS FOR FINANCIAL ASSISTANCE, THE ACCOUNT BALANCE IS EITHER PARTIALLY OR ENTIRELY WRITTEN OFF. ANY REMAINING BALANCE WOULD BE COLLECTED UNDER THE EXISTING DEBT COLLECTION POLICY. COVERAGE FOR THE ASSISTED CARE PROGRAM IS FOR 6 MONTHS AFTER WHICH TIME PATIENTS CAN REAPPLY IF THEY CONTINUE TO MEET THE GUIDELINES ESTABLISHED. SCHEDULE H PART I LINE 6A: ANNUAL COMMUNITY BENEFIT REPORT - OUR ANNUAL COMMUNITY BENEFIT REPORT IS PREPARED FOR THE FHN NETWORK AS A WHOLE AND IS INCLUDED AS A NON-AUDITED SCHEDULE ON THE AUDITED FINANCIAL STATEMENTS. REPORTS FILED WITH STATES PART VI, LINE 7 IL X 1 1 X X X X X 0 1 0 0 0 0 0 0 0 LAWRENCE H LUY MD 0 244673 0 2400 0 20792 0 31069 0 33417 0 332351 0 12528 RAVI VYAS MD 0 897110 0 4500 0 143864 0 25000 0 33177 0 1103651 0 69153 VINOD K WADHWA MD 0 286812 0 3750 0 28351 0 37838 0 36594 0 393345 0 0 MARTIN CLEARY MD 0 386561 0 3050 0 27906 0 40274 0 27778 0 485569 0 22434 BHADRESH PATEL MD 0 457816 0 3800 0 51124 0 43505 0 41177 0 597422 0 40841 REBECCA PEDERSON MD 0 277554 0 4800 0 8772 0 27750 0 30663 0 349539 0 4000 TIMOTHY JESSEN MD 0 208034 0 15100 0 10838 0 45848 0 27847 0 307667 0 9401 MICHAEL PERRY MD 248128 158639 0 0 29507 18865 25315 16185 14177 9064 317127 202753 7931 5071 MICHAEL C CLARK 132740 84866 0 0 763 488 21250 13586 14543 9298 169296 108238 0 0 SHARON SUMMERS 131758 84239 0 0 3267 2088 25315 16185 14539 9295 174879 111807 0 0 LEONARD CARTER 96319 61581 0 0 1025 655 113 72 16687 10669 114144 72977 0 0 ROBERT GELLER MD 0 260455 0 0 0 20566 0 30500 0 41044 0 352565 0 5157 NANCY V CUTLER 168334 0 0 0 718 0 9089 0 26466 0 204607 0 0 0 WILLIAM SPANGLER 114650 0 0 0 581 0 15753 0 20269 0 151253 0 0 0 MICHAEL G WEAVER 127318 0 0 0 750 0 24101 0 25352 0 177521 0 0 0 THOMAS WAGNER 112774 0 1542 0 882 0 13501 0 23235 0 151934 0 0 0 ROBIN SCALISE 119943 0 0 0 492 0 8588 0 2095 0 131118 0 0 0 BETH KALNINS MD 256588 0 3300 0 11060 0 7393 0 29140 0 307481 0 9069 0 DENNIS HAMILTON 0 109501 0 0 0 31757 0 23400 0 10204 0 174862 0 9681 WENDY LAWLER 106159 0 0 0 802 0 10142 0 649 0 117752 0 0 0 WILLIAM PALMQUIST 111911 0 261 0 1093 0 23773 0 20606 0 157644 0 0 0 MICHAEL MERRY MD 0 417907 0 1850 0 29395 0 14004 0 27552 0 490708 0 22490 PART I, LINE 1A FREEPORT MEMORIAL HOSPITAL REIMBURSED A DIRECTOR/TRUSTEE FOR BUSINESS TRAVEL EXPENSES INCLUDING TRAVEL EXPENSES FOR A SPOUSE. PART I, LINE 4B (MICHAEL PERRY M.D. 457F DIST.-$13,002),(RAVISHANKAR VYAS M.D. 457F DIST.- $69,153),(LAWRENCE H. LUY M.D. 457F DIST.-$12,527 457F DEF.-$6,069),(MARTIN CLEARY M.D. 457F DIST.-$22,434 457F DEF.-$12,874),(BHADRESH PATEL M.D.457F DIST.-$40,481 457F DEF.-$18,505),(REBECCA PEDERSON M.D. 457F DIST.-$4,000),(MICHEAL J. MERRY M.D. 457F DIST.-$22,489 457F DEF.-$14,004),(TIMOTHY JESSEN M.D. 457F DIST.-9,401 457F DEF.-$5,168)BETH KALNINS M.D.457F DIST.-$9,069) GARY QUINN DIRECTOR/TRUSTEE 64717 GARY QUINN HAS A FAMILY MEMBER THAT RECEIVED MORE THAN $10,000 FROM FMH. 0 DARIN DOAK DIRECTOR/TRUSTEE 192751 DARIN DOAK HAS A FAMILY MEMBER THAT RECEIVED MORE THAT $10,000 FROM FMH. 0 DOUG FREIDAG DIRECTOR/TRUSTEE 19437 DOUG FREIDAG HAS A FAMILY MEMBER THAT RECEIVED MORE THAN $10,000 FROM FMH. 0 BRUCE HELM DIRECTOR/TRUSTEE 112413 BRUCE HELM IS A SHAREHOLDER IN CORPORATION THAT PROVIDES SERVICES TO FMH. 0 VINOD WADHWA MD DIRECTOR/TRUSTEE 75038 VINOD WADHWA M.D. HAS A FAMILY MEMBER THAT RECEIVED MORE THAN $10,000 FROM FMH. 0 ORGANIZATION MISSION STATEMENT FORM 990 PART III FREEPORT MEMORIAL HOSPITAL COORDINATES AND INTEGRATES MEDICAL CARE SERVICES AND PROVIDES INDIVIDUALS IMPARTIAL ACCESS TO MEDICAL CARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, OR SOURCE OF PAYMENT. THE HOSPITAL PROVIDES MEDICALLY NECESSARY CARE TO PATIENTS REGARDLESS OF ABILITY TO PAY. THE HOSPITAL QUALIFIES AS A MEDICARE DISPROPORTIONATE SHARE HOSPITAL BECAUSE IT SERVES A DISPROPORTIONATELY HIGH NUMBER OF LOW INCOME PATIENTS. INSURED AND UNDERINSURED PATIENTS, WHO MEET CERTAIN FEDERAL POVERTY GUIDELINES AND/OR OTHER UNIQUE CIRCUMSTANCES, ARE PROVIDED FREE OR DISCOUNTED CARE AFTER A NOMINAL CO-PAYMENT. BECAUSE THE HOSPITAL DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO BE CHARITY CARE, THEY ARE NOT REPORTED AS REVENUE. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE AMOUNT OF CHARITY CARE IT PROVIDES. DURING 2010, THE CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER THE HOSPITALS CHARITY CARE POLICY WAS $9,064,812 AT A COST OF $2,860,751. FREEPORT MEMORIAL HOSPITAL IS A LICENSED MEDICARE AND MEDICAID PROVIDER WITH APPROXIMATELY 67% OF ITS PATIENT BASE QUALIFYING FOR AT LEAST ONE OF THESE PROGRAMS. AT PRESENT, THE REIMBURSEMENT RATES FOR BOTH PROGRAMS DO NOT FULLY COVER THE COST OF CARE TO THESE PATIENTS. THE ESTIMATED UNFUNDED COSTS OF SERVICES FOR MEDICAID PATIENTS WERE APPROXIMATELY $4,519,666 FOR THE YEAR ENDING 12/31/2010. MEDICARE PAYMENTS WERE APPROXIMATELY $7,238,341 LESS THAN THE HOSPITAL'S COST TO PROVIDE CARE DURING THE SAME PERIOD. IN ADDITION, THE COST OF CARE PROVIDED TO PEOPLE WHO DID NOT PAY WAS $2,435,002 IN 2010. FREEPORT MEMORIAL HOSPITAL AND ITS RELATED ORGANIZATIONS SUPPORT AND PARTICIPATE IN MANY COMMUNITY SERVICES AND OUTREACH PROGRAMS, INCLUDING SUPPORT FOR COMMUNITY HEALTH EDUCATION PROGRAMS, COMMUNITY-BASED CLINICAL SERVICES, HEALTH PROFESSIONAL EDUCATION, RESEARCH, SPONSORSHIP OF COMMUNITY EVENTS, AND COMMUNITY-BUILDING ACTIVITIES. THE HOSPITAL CONTRIBUTED $941,333 TOWARDS THESE PROGRAMS IN 2010. PROGRAM SERVICE EXPENSES: $98,576,533 FORM 990, PART VI, SECTION B, LINE 11 THE ORGANIZATION'S BOARD OF DIRECTORS REVIEWS THE FORM 990 BEFORE THE TAX RETURN IS FILED. QUESTIONS AND EXPLANATIONS ARE ANSWERED BY THE FINANCE DEPARTMENT TO THE BOARD'S SATSIFACTION. THE BOARD REVIEWS ALL TRANSACTIONS THAT AFFECT THE FILING OF THE ORGANIZATION'S FORM 990 AND EQUIVALENT STATE RETURNS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A DEDICATED CORPORATE COMPLIANCE OFFICER. ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO COMPLETE ANNUALLY A CONFLICT OF INTEREST QUESTIONNAIRE. THESE DOCUMENTS ARE REVIEWED BY THE CCO TO DETERMINE IF ANY INDIVIDUAL HAS A CONFLICT OF INTEREST THAT NEEDS TO BE ADDRESSED. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS AN EXECUTIVE COMPENSATION COMMITTEE THAT REVIEWS THE CEO, TOP MANAGEMENT AND EXECUTIVE DIRECTORS COMPENSATION. THE COMMITTEE RELIES ON INTERNAL AND EXTERNAL INFORMATION TO DETERMINE THE APPROPRIATE COMPENSATION AND EMPLOYS AN INDEPENDENT THIRD PARTY TO CONDUCT THE ANNUAL EXECUTIVE COMPENSATION ANALYSIS. THIS ANALYSIS IS USED TO DETERMINE IF THE BOARD'S WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY HAS BEEN MET. THE EXECUTIVE COMPENSATION COMMITTEE ALSO RECEIVES A REASONABLENESS LETTER FROM THE THIRD PARTY. FORM 990, PART VI, SECTION C, LINE 19 THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 137,629. CHANGE IN MINIMUM PENSION LIABILITY -714,419. TRANSFERS TO AFFILIATE -18,272,982. NET ASSETS RELEASED FROM RESTRICTION -127,973. CONTRIBUTIONS TEMPORARY RESTRICTED 120,702. TOTAL TO FORM 990, PART XI, LINE 5: -18,857,043. FINANCIAL STATEMENT AND REPORTING THE ORGANIZATION IS PART OF A CONSOLIDATED AUDIT REPORT. THE ORGANIZATION HAS AN INDEPENDENT AUDIT SELECTION COMMITTEE THAT REVIEWS AND ASSUMES RESPONSIBILITY OF THE SELECTION OF THE INDEPENDENT ACCOUNTING FIRM. THE COMMITTEE IS COMPRISED OF INDEPENDENT INDIVIDUALS WITH THE APPROPRIATE BUSINESS BACKGROUNDS. NO CHANGES HAVE BEEN MADE TO THE OVERSIGHT/SELECTION PROCESS OF THE INDEPENDENT ACCOUNTING FIRM. FREEPORT REGIONAL HEALTH CARE FOUNDATION 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363994636 HEALTH CARE IL 501(C)(3) LINE 11 N/A 0 FREEPORT REGIONAL HEALTHCARE SERVICES 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363967303 HEALTH CARE IL 501(C)(3) LINE 3 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 FREEPORT REGIONAL MANAGEMENT SERVICES 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363994636 HEALTH CARE IL 501(C)(3) LINE 3 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 JANE ADDAMS INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 362879689 HEALTH CARE IL 501(C)(3) LINE 11 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 JANE ADDAMS HEALTHCARE SERVICES INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363677357 HEALTH CARE IL 501(C)(3) LINE 7 FREEPORT REGIONAL HEALTH CARE FOUNDATION 0 MEMORIAL ENTERPRISES INC 1045 WEST STEPHENSON STREET FREEPORT IL 61032 363353871 HEALTH CARE IL FREEPORT REGIONAL HEALTH CARE FOUNDATION C 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0