SOUTHERN ILLINOIS MEDICAL SERVICES NFP: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHERN ILLINOIS MEDICAL SERVICES NFP (EIN 20-5521741)
- Tax period
- 2010-04-01 to 2011-03-31
- Filed
- 2011-11-11
- IRS object ID
- 201103159349302485
- Schema version
- 2010v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2011-11-11T13:00:33-06:00 | Timestamp |
| Tax Period End Date | 2011-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9600 Brownsboro Road | AddressLine1 |
| Address Line2 | Suite 400 | AddressLine2 |
| City | Louisville | City |
| State | KY | State |
| ZIP Code | 402411122 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2010-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205521741 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN ILLINOIS MEDICAL SERVICES NFP | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SOUT | NameControl |
| Phone | 6184575200 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1239 EAST MAIN STREET | AddressLine1 |
| City | CARBONDALE | City |
| State | IL | State |
| ZIP Code | 62901 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MIKE KASSER | Name |
| Title | CFO | Title |
| Date Signed | 2011-11-11 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5023263996 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REX BUDDE | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1239 EAST MAIN STREET | AddressLine1 |
| City | CARBONDALE | City |
| State | IL | State |
| ZIP Code | 62901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 30806669 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SIH.NET | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | SOUTHERN ILLINOIS MEDICAL SERVICES IS DEDICATED TO IMPROVING THE HEALTH AND WELL-BEING OF ALL OF THE PEOPLE IN THE COMMUNITIES IT SERVES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 5 | NbrIndependentVotingMembers |
| Total Nbr Employees | 315 | TotalNbrEmployees |
| Total Nbr Volunteers | 6 | TotalNbrVolunteers |
| Total Gross UBI | 19876 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | -3588 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 26529563 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 30743772 | ProgramServiceRevenueCY |
| Investment Income Prior Year | -54586 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2584 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 53264 | OtherRevenuePriorYear |
| Other Revenue Current Year | 43147 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 26528241 | TotalRevenuePriorYear |
| Total Revenue Current Year | 30789503 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 19314021 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 12392755 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 11186123 | OtherExpensePriorYear |
| Other Expenses Current Year | 21999765 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 30500144 | TotalExpensesPriorYear |
| Total Expenses Current Year | 34392520 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -3971903 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -3603017 | RevenuesLessExpensesCY |
| Total Assets BOY | 11090995 | TotalAssetsBOY |
| Total Assets EOY | 11417438 | TotalAssetsEOY |
| Total Liabilities BOY | 6351491 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 6364856 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4739504 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 5052582 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SOUTHERN ILLINOIS MEDICAL SERVICES NFP (SIMS) EMPLOYS PHYSICIANS AND OPERATES PHYSICIAN PRACTICES TO PROVIDE CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED, OR AFFLICTED ON A NOT-FOR-PROFIT BASIS. (CONTINUED IN SCHEDULE O) | MissionDescription |
| Significant Change | false | SignificantChange |
| Expense | 12580283 | Expense |
| Grants | 0 | Grants |
| Revenue | 12682170 | Revenue |
| Description | SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) OPERATES HOSPITAL PHYSICIAN PRACTICES TO PROVIDE CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED ON A NOT-FOR PROFIT BASIS AT THE THREE HOSPITALS OPERATED BY OUR SOLE MEMBER SOUTHERN ILLINOIS HOSPITAL SERVICES (SIHS). THESE HOSPITAL PHYSICIANS PROVIDE TWO DISTINCT SERVICES. ONE GROUP STAFFS THE EMERGENCY ROOMS AT EACH OF THE THREE HOSPITALS AND THE SECOND GROUP PROVIDES CARE DURING A HOSPITAL STAY AT THESE SAME HOSPITALS TO THOSE PATIENTS THAT DO NOT HAVE A PRIMARY CARE PHYSICIAN. BOTH GROUPS OF PHYSICIANS ARE VITAL TO PROVIDING HEALTHCARE TO THE POPULATION OF OUR SERVICE AREAS, AS MANY OF THE RESIDENTS DO NOT HAVE A PRIMARY CARE PHYSICIAN. THE HOSPITAL PHYSICIANS PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. DURING THE YEAR ENDED MARCH 31, 2011, THE HOSPITAL PHYSICIANS OF SIMS RECORDED 83,883 ENCOUNTERS IN TREATING THIS POPULATION. OF THESE ENCOUNTERS 61,853 OCCURRED IN THE EMERGENCY ROOMS AND 22,030 WERE ENCOUNTERS WITH HOSPITAL INPATIENTS. (CONTINUED IN SCHEDULE O) | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 11712764 | Expense |
| Grants | 0 | Grants |
| Revenue | 10319488 | Revenue |
| Description | SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) OPERATES THE CENTER FOR MEDICAL ARTS IN CARBONDALE, IL. THE CENTER ENCOMPASSES NEARLY 60,000 SQUARE FEET OF SPACE, MAKING IT ONE OF THE AREA'S LARGEST HEALTHCARE FACILITIES. A PROMPT CARE CLINIC IS AVAILABLE WITHIN THE CENTER TO MEET THE IMMEDIATE MEDICAL NEEDS OF PATIENTS ALONG WITH AN IMAGING CENTER AND LABORATORY SERVICES. BOTH PRIMARY CARE AND SPECIALIZED MEDICAL CARE ARE PROVIDED INCLUDING FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, GENERAL SURGERY AND UROLOGY, AMONG OTHERS. THE CENTER FOR MEDICAL ARTS PROVIDES CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED ON A NOT-FOR PROFIT BASIS. THE CENTER'S PHYSICIAN PRACTICES PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. DURING THIS REPORTING PERIOD, THE CENTER FOR MEDICAL ARTS RECORDED 97,758 ENCOUNTERS IN TREATING THIS POPULATION. (CONTINUED IN SCHEDULE O) | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 8176535 | Expense |
| Grants | 0 | Grants |
| Revenue | 7292958 | Revenue |
| Description | SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) OPERATES COMMUNITY PHYSICIAN PRACTICES TO PROVIDE CARE AND TREATMENT OF THE MEDICALLY SICK, INJURED OR AFFLICTED ON A NOT-FOR PROFIT BASIS. THESE PRACTICES ARE LOCATED IN VARIOUS COMMUNITIES IN OUR CENTRAL SERVICE AREA. BOTH PRIMARY CARE AND SPECIALIZED MEDICAL CARE ARE PROVIDED INCLUDING FAMILY MEDICINE, GENERAL SURGERY, BREAST SURGERY, PULMONOLOGIST, BARIATRIC, ONCOLOGY, AND NEUROLOGY. THESE PRACTICES PROVIDE THE ONLY ACCESS TO SEVERAL OF THESE SPECIALTIES WITHIN OUR SERVICE AREA. THESE COMMUNITY PHYSICIAN PRACTICES PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. DURING THE YEAR ENDED MARCH 31, 2011, THE COMMUNITY PHYSICIAN PRACTICES OF SIMS RECORDED 45,638 ENCOUNTERS IN TREATING THIS POPULATION. (CONTINUED IN SCHEDULE O) | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 0 | Expense |
| Grants | 0 | Grants |
| Revenue | 472427 | Revenue |
| Description | SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) ALSO PROVIDES OTHER ADMINISTRATIVE SERVICES AND LEASES SPACE TO ITS RELATED ORGANIZATIONS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 472427 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 32469582 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | 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 | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| 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 | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 76 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 315 | 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 | false | QuidProQuoContributions |
| 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 | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 5 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| 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 | Mike Kasser | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6184575200 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1239 East Main Stret | AddressLine1 |
| City | Carbondale | City |
| State | IL | State |
| ZIP Code | 62901 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | Individual Trustee Or DirectorIndividualTrusteeOrDirector |
|---|---|---|---|---|---|---|---|
| JAMES MILLER MD | |||||||
| VP/CMO | 10 | X | 0 | 432110 | 42140 | ||
| DAVE HOLLAND | |||||||
| VP/INFO SYSTEMS | 8 | X | 0 | 211423 | 94123 | ||
| PHILIP SCHAEFER | |||||||
| VP/PHYSICIAN SERVICES | 30 | X | 0 | 260629 | 128583 | ||
| WILLIAM SHERWOOD | |||||||
| VP/GENERAL COUNSEL | 6 | X | 0 | 253081 | 157395 | ||
| JAMES PAVLOVICH | |||||||
| PHYSICIAN | 40 | 466401 | 0 | 46480 | X | ||
| JEFFREY JONES | |||||||
| PHYSICIAN | 40 | 649383 | 0 | 51948 | X | ||
| ANAD SALEM MD | |||||||
| TRUSTEE | 1 | 33623 | 0 | 0 | X | ||
| STEVE SABENS | |||||||
| TRUSTEE | 1 | 0 | 0 | 0 | X | ||
| JEFFREY PARKS MD | |||||||
| TRUSTEE | 1 | 0 | 0 | 0 | X | ||
| PHIL NORDSTROM | |||||||
| SECRETARY | 1 | X | 0 | 0 | 0 | X | |
| KATHLEEN FRALISH | |||||||
| TRUSTEE | 1 | 0 | 0 | 0 | X | ||
| HAROLD BARDO | |||||||
| TRUSTEE | 1 | 0 | 0 | 0 | X | ||
| MIKE KASSER | |||||||
| VP/CFO | 8 | X | 0 | 278862 | 112060 | ||
| REX BUDDE | |||||||
| PRESIDENT | 4 | X | 0 | 409888 | 208901 | X | |
| JON W TAVEAU | |||||||
| PHYSICIAN | 40 | 644234 | 0 | 35986 | X | ||
| AISHA WHITE | |||||||
| PHYSICIAN | 40 | 468163 | 0 | 23963 | X | ||
| TANATIP KORTE | |||||||
| PHYSICIAN | 40 | 465369 | 0 | 39719 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2727173 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1845993 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 941298 | TotalOtherCompensation |
| Number Individuals GT100 K | 55 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| RIVER2 EMERGENCY PHYSICIANS | |||||
| PO BOX 793 | TRAVERSE CITY | MI | 496850793 | MEDICAL AND HEALTHCARE PAYMENTS | 1354043 |
| MEDICAL MARKETING MANAGEMENT LTD | |||||
| 21415 CIVIC CTR DR 211 | SOUTHFIELD | MI | 48076 | MEDICAL AND HEALTHCARE PAYMENTS | 951174 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 7972633 | DALLAS | TX | 753972633 | MEDICAL AND HEALTHCARE PAYMENTS | 651107 |
| LOCUM MEDICAL GRP | |||||
| 13792 COLLECTIONS CTR | CHICAGO | IL | 60693 | MEDICAL AND HEALTHCARE PAYMENTS | 372771 |
| MURPHYSBORO INTERNAL MED CINIC | |||||
| 1415 BRADFORD PEAR LANE | CARBONDALE | IL | 62902 | MEDICAL AND HEALTHCARE PAYMENTS | 363780 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 24 | NumberOfContractorsGT100K |
| Total Contributions | 0 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| NET PATIENT REVENUE | 30464538 | 30464538 |
| LEASEHOLD REVENUE FROM RELATED ORGANIZATIONS | 279234 | 279234 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 30743772 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2584 | TotalRevenueColumn |
| Exclusion | $2,584 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 22645 | GrossSalesOfInventory |
| Cost Of Goods Sold | 17166 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5479 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4376 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1103 | UnrelatedBusinessRevenue |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|---|
| TRANSCRIPTION FEES | 561000 | 7511 | 7511 | |
| RECEPTION SERVICE FEES | 561000 | 11262 | 11262 | |
| MISCELLANEOUS REVENUE | 18895 | 18895 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 37668 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 30789503 | TotalRevenueColumn |
| Related Or Exempt Function Income | 30767043 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 19876 | UnrelatedBusinessRevenue |
| Exclusion | $2,584 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33623 | Total |
| Program Services | 33623 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8917378 | Total |
| Program Services | 8313621 | ProgramServices |
| Management And General | 603757 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 486161 | Total |
| Program Services | 472786 | ProgramServices |
| Management And General | 13375 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1863137 | Total |
| Program Services | 1753294 | ProgramServices |
| Management And General | 109843 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1092456 | Total |
| Program Services | 1048757 | ProgramServices |
| Management And General | 43699 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168925 | Total |
| Management And General | 168925 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 228406 | Total |
| Management And General | 228406 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8791346 | Total |
| Program Services | 8553696 | ProgramServices |
| Management And General | 237650 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 105450 | Total |
| Management And General | 105450 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1935141 | Total |
| Program Services | 1899366 | ProgramServices |
| Management And General | 35775 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22340 | Total |
| Program Services | 20722 | ProgramServices |
| Management And General | 1618 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 947099 | Total |
| Program Services | 903031 | ProgramServices |
| Management And General | 44068 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61925 | Total |
| Program Services | 53284 | ProgramServices |
| Management And General | 8641 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 129116 | Total |
| Program Services | 117730 | ProgramServices |
| Management And General | 11386 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 704446 | Total |
| Program Services | 694865 | ProgramServices |
| Management And General | 9581 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1994046 | Total |
| Program Services | 1851130 | ProgramServices |
| Management And General | 142916 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| BAD DEBT | 6192163 | 6192163 | |
| LOSS ON DISPOSAL OF FIXED ASSETS | 4653 | 4653 | |
| EQUIPMENT RENTAL | 358616 | 355616 | 3000 |
| OTHER EXPENSE | 356093 | 201245 | 154848 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34392520 | Total |
| Program Services | 32469582 | ProgramServices |
| Management And General | 1922938 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3043 | BOY |
| EOY | -408842 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 96427 | BOY |
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4675511 | BOY |
| EOY | 4724847 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6664 | BOY |
| EOY | 16654 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18475 | BOY |
| EOY | 12004 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 620218 | BOY |
| EOY | 776060 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7947380 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1991705 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5490780 | BOY |
| EOY | 5955675 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 179877 | BOY |
| EOY | 341040 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11090995 | BOY |
| EOY | 11417438 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3103402 | BOY |
| EOY | 2965026 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3248089 | BOY |
| EOY | 3399830 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6351491 | BOY |
| EOY | 6364856 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4739504 | BOY |
| EOY | 5052582 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4739504 | BOY |
| EOY | 5052582 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11090995 | BOY |
| EOY | 11417438 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -3603017 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 3916095 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Exmpt Function Expenditures | 0 | TotalExmptFunctionExpenditures |
| Total Lobbying Expenditures IIB | 0 | TotalLobbyingExpendituresIIB |
| Non Ded Lobby Political Total | 0 | NonDedLobbyPoliticalTotal |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 420225 | OtherCostOrOtherBasis |
| Book Value | 420225 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3179913 | OtherCostOrOtherBasis |
| Depreciation | 573302 | Depreciation |
| Book Value | 2606611 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 439894 | OtherCostOrOtherBasis |
| Depreciation | 142969 | Depreciation |
| Book Value | 296925 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3775157 | OtherCostOrOtherBasis |
| Depreciation | 1275434 | Depreciation |
| Book Value | 2499723 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 132191 | OtherCostOrOtherBasis |
| Book Value | 132191 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5955675 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 0 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| MEDICAL PROFESSIONAL LIABILITY INSURANCE | $1,343,928 |
| EXECUTIVE BENEFITS LIABILITY | $36,296 |
| DUE TO AFFILIATE - SIHS | $1,992,348 |
| DUE TO AFFILIATE - SIHE | $27,258 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 3399830 | TotalOfAmounts |
| Total Revenue | 30789503 | TotalRevenue |
| Total Expenses | 34392520 | TotalExpenses |
| Excess Or Deficit For Year | -3603017 | ExcessOrDeficitForYear |
| Other | $0 | OtherAmount |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -3603017 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 31648869 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 872981 | OtherRevenues |
| Revenue Not Rptd F990 | 872981 | RevenueNotRptdF990 |
| Revenue Subtotal | 30775888 | RevenueSubtotal |
| Other Revenues Not Included | 13615 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 13615 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 30789503 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 35251886 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 872981 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 872981 | ExpensesNotRptdF990 |
| Expenses Subtotal | 34378905 | ExpensesSubtotal |
| Other Expenses Not Included | 13615 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 13615 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 34392520 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| FIN 48 (ASC 740) footnote | Schedule D, Part X, Line 2 | THE CORPORATION ADOPTED THE PROVISIONS OF ASC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, ON APRIL 1, 2007. WHEN TAX RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD BE ULTIMATELY SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE MATTERS SUCH AS THE TAX EXEMPT ENTITY TAKING A TAX POSITION THAT AN ORGANIZATION IS TAX EXEMPT WITHOUT OBSERVING CORRESPONDING PROOF OF TAX EXEMPTION FROM FEDERAL AND STATE TAXING AUTHORITIES AND THERE IS MATERIAL NET INCOME GENERATED BY THE ENTITY OR EGREGIOUS COMPENSATION PAID TO INSIDERS THAT COULD RESULT IN REVOCATION OF EXEMPT STATUS (OUTSIDE THE SCOPE OF INTERMEDIATE SANCTIONS EXCISE TAX PENALTIES). THE TAX POSITION IS TO CONSIDER THAT THESE COMPENSATORY ARRANGEMENTS DO NOT JEOPARDIZE TAX EXEMPTION. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS TAKEN ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE-LIKELY-THAN-NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY UPON THE ADOPTION OF ASC 740 OR AT MARCH 31, 2011 AND 2010. THE COMPANY DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE COMPANY WOULD RECOGNIZE INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN MISCELLANEOUS EXPENSES. TAX RETURNS FILED BY THE CORPORATION ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. TAX RETURNS FILED BY THE CORPORATION ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEARS ENDED MARCH 31, 2007 AND PRIOR. |
| Other revenues in audited financial statements not in form 990 | Schedule D, Part XII, Line 2d | DEPARTMENTAL ALLOCATIONS - 855815; COST OF GOODS SOLD - 17166; |
| Other revenues in form 990 not in audited financial statements | Schedule D, Part XII, Line 4b | REVENUE REPORTED AS REIMBURSEMENT OF EXPENSE - 8962; LOSS ON DISPOSAL OF FIXED ASSETS - 4653; |
| Other expenses in audited financial statements not in form 990 | Schedule D, Part XIII, Line 2d | DEPARTMENTAL ALLOCATIONS - 855815; COST OF GOODS SOLD - 17166; |
| Other expenses in form 990 not in audited financial statements | Schedule D, Part XIII, Line 4b | REVENUE REPORTED AS REIMBURSEMENT OF EXPENSE - 8962; LOSS ON DISPOSAL OF FIXED ASSETS - 4653; |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | 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)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES MILLER MD | |||||||||||||
| 0 | 284433 | 0 | 680 | 0 | 146997 | 0 | 7099 | 0 | 35041 | 0 | 474250 | 0 | 37359 |
| DAVE HOLLAND | |||||||||||||
| 0 | 200794 | 0 | 816 | 0 | 9813 | 0 | 75674 | 0 | 18449 | 0 | 305546 | 0 | 0 |
| PHILIP SCHAEFER | |||||||||||||
| 0 | 246329 | 0 | 816 | 0 | 13484 | 0 | 93967 | 0 | 34616 | 0 | 389212 | 0 | 5017 |
| WILLIAM SHERWOOD | |||||||||||||
| 0 | 232790 | 0 | 816 | 0 | 19475 | 0 | 120422 | 0 | 36973 | 0 | 410476 | 0 | 7147 |
| JAMES PAVLOVICH | |||||||||||||
| 331951 | 0 | 132241 | 0 | 2209 | 0 | 26758 | 0 | 19722 | 0 | 512881 | 0 | 0 | 0 |
| JEFFREY JONES | |||||||||||||
| 643101 | 0 | 748 | 0 | 5534 | 0 | 27550 | 0 | 24398 | 0 | 701331 | 0 | 0 | 0 |
| MIKE KASSER | |||||||||||||
| 0 | 248467 | 0 | 816 | 0 | 29579 | 0 | 82134 | 0 | 29926 | 0 | 390922 | 0 | 9004 |
| REX BUDDE | |||||||||||||
| 0 | 396020 | 0 | 1173 | 0 | 12695 | 0 | 158125 | 0 | 50776 | 0 | 618789 | 0 | 0 |
| JON W TAVEAU | |||||||||||||
| 641745 | 0 | 530 | 0 | 1959 | 0 | 11800 | 0 | 24186 | 0 | 680220 | 0 | 0 | 0 |
| AISHA WHITE | |||||||||||||
| 466646 | 0 | 475 | 0 | 1042 | 0 | 11929 | 0 | 12034 | 0 | 492126 | 0 | 0 | 0 |
| TANATIP KORTE | |||||||||||||
| 314240 | 0 | 149658 | 0 | 1471 | 0 | 17471 | 0 | 22248 | 0 | 505088 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Supplemental nonqualified retirement plan | Schedule J, Part I, Line 4b | COMPENSATION FOR THE ORGANIZATION'S OFFICERS IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. SIHS MADE THE FOLLOWING SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN PAYMENTS/CONTRIBUTIONS: REX BUDDE - NO PAYMENT RECEIVED; $152,000 DEFERRED COMPENSATION MIKE KASSER - $9,004 PAYMENT RECEIVED; $72,334 DEFERRED COMPENSATION WILLIAM SHERWOOD - $7,147 PAYMENT RECEIVED; $110,689 DEFERRED COMPENSATION PHIL SCHAEFER - $5,016 PAYMENT RECEIVED; $84,167 DEFERRED COMPENSATION DAVE HOLLAND - NO PAYMENT RECEIVED; $68,646 DEFERRED COMPENSATION JAMES MILLER - $127,175 PAYMENT RECEIVED; NO DEFERRED COMPENSATION JEFFREY JONES - NO PAYMENT RECEIVED; $19,500 DEFERRED COMPENSATION JON W. TAVEAU - NO PAYMENT RECEIVED; $8,125 DEFERRED COMPENSATION AISHA WHITE - NO PAYMENT RECEIVED; $4,750 DEFERRED COMPENSATION JAMES PAVLOVICH - NO PAYMENT RECEIVED; $16,958 DEFERRED COMPENSATION TANATIP KORTE - NO PAYMENT RECEIVED; $8,921 DEFERRED COMPENSATION |
| METHODS USED TO ESTABLISH COMPENSATION OF CEO/EXECUTIVE DIRECTOR | SCHEDULE J, PART I, LINE 3 | COMPENSATION FOR THE ORGANIZATION'S PRESIDENT IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. SIHS USES THE FOLLOWING METHODS TO DETERMINE THE PRESIDENT'S COMPENSATION: -COMPENSATION COMMITTEE -INDEPENDENT COMPENSATION CONSULTANT -COMPENSATION SURVEY OR STUDY -APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE |
Schedule L IRS990ScheduleL
Loan Table LoanTable (2 entries)
| Loan From OrganizationLoanFromOrganization | Original PrincipalOriginalPrincipalAmount | Balance DueBalanceDue | DefaultDefault | Approved By BoardApprovedByBoard | Written AgreementWrittenAgreement |
|---|---|---|---|---|---|
| JEFFERY JONES EMPLOYED PHYSICIAN | |||||
| X | $60,000 | 8327 | false | true | true |
| JON TAVEAU EMPLOYED PHYSICIAN | |||||
| X | $40,000 | 8327 | false | true | true |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | 16654 | TotalBalanceDue |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (16 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of other program services | Form 990, Part III, Line 4d | SOUTHERN ILLINOIS MEDICAL SERVICES, NFP (SIMS) ALSO PROVIDES OTHER ADMINISTRATIVE SERVICES AND LEASES SPACE TO ITS RELATED ORGANIZATIONS. |
| ORGANIZATION'S MISSION | FORM 990, PART III, LINE 1 | (CONTINUED FROM PART III) THESE PHYSICIANS AND PRACTICES PROVIDE QUALITY HEALTH SERVICES TO PEOPLE THROUGHOUT SOUTHERN ILLINOIS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. SIMS CONDUCTS ITS BEHAVIORS BY SHOWING THE ORGANIZATION'S VALUES OF RESPECT, INTEGRITY, COMPASSION, COLLABORATION, STEWARDSHIP, ACCOUNTABILITY AND QUALITY. THE PRIMARY SERVICE AREA OF SIMS IS A VERY RURAL SEVEN-COUNTY REGION WITH A COMBINED POPULATION OF APPROXIMATELY 240,000. THESE COUNTIES ARE CHARACTERIZED BY: - THE RESIDENTS OF EACH OF THESE COUNTIES HAVE MEDIAN HOUSEHOLD INCOMES THAT ARE SUBSTANTIALLY LESS THAN THE STATEWIDE AVERAGE OF $46,590. - MORE OF THE RESIDENTS IN THESE COUNTIES LIVE IN POVERTY THAN THE STATE AVERAGE OF 10.7%. - THE PERCENTAGES OF CHILDREN LIVING IN POVERTY IN THESE COUNTIES ARE SOME OF THE HIGHEST IN THE STATE. SIMS PROVIDES SERVICES THROUGH THE FOLLOWING: CENTER FOR MEDICAL ARTS: THE CENTER FOR MEDICAL ARTS HAS A LONG-STANDING TRADITION OF CARING FOR SOUTHERN ILLINOIS RESIDENTS, WITH A HISTORY DATING BACK TO THE 1930S. ORIGINALLY OPERATED AS THE CARBONDALE CLINIC, THE CENTER FOR MEDICAL ARTS WAS PURCHASED IN 2006. TODAY IT IS A GROWING HEALTH FACILITY THAT INCLUDES A PROMPT CARE CLINIC, AMBULATORY SURGERY CENTER AND A RETAIL PHARMACY. BASIC LAB AND RADIOLOGY SERVICES ARE ALSO PROVIDED ON-SITE. PRACTITIONERS INCLUDE FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, AND SPECIALISTS SUCH AS GASTROENTEROLOGY, GENERAL SURGERY AND UROLOGY. COMMUNITY PHYSICIANS: ANOTHER GROUP OF PHYSICIANS ARE OUR COMMUNITY PHYSICIANS. THESE PHYSICIANS ARE LOCATED AT VARIOUS LOCATIONS WITHIN OUR CENTRAL SERVICE AREA. THESE PRACTITIONERS PROVIDE A VARIETY OF SPECIALTIES, INCLUDING GENERAL SURGERY, BREAST SURGERY, PULMONOLOGIST AND NEUROLOGY. THESE PRACTICES PROVIDE THE ONLY ACCESS TO SEVERAL OF THESE SPECIALTIES WITHIN OUR SERVICE AREA. HOSPITAL PHYSICIANS: ANOTHER GROUP OF PHYSICIANS ARE LOCATED AND WORK WITHIN THE HOSPITALS OPERATED BY OUR SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES. THESE PHYSICIANS STAFF THE EMERGENCY ROOMS AND PROVIDE HOSPITALIST CARE AT THESE HOSPITALS. THESE PHYSICIANS ARE VITAL TO PROVIDING HEALTHCARE TO THE POPULATION OF OUR SERVICE AREA AS MANY OF THE RESIDENTS DO NOT HAVE A PRIMARY CARE PHYSICIAN. SERVICES PROVIDED: DURING THE YEAR ENDED MARCH 31, 2011, SIMS' PHYSICIANS RECORDED 227,279 ENCOUNTERS IN TREATING THE POPULATION AREA. THE CENTER FOR MEDICAL ARTS ACCOUNTED FOR 97,758 OF THESE ENCOUNTERS, COMMUNITY PHYSICIANS ACCOUNTED FOR 45,638 ENCOUNTERS AND HOSPITAL PHYSICIANS PROVIDED THE REMAINING 83,883 ENCOUNTERS. APPROXIMATELY 57.35% OF THESE ENCOUNTERS PROVIDED CARE THAT WAS CLASSIFIED AS EITHER UNCOMPENSATED CHARITY CARE OR UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. AN ADDITIONAL 8.98% OF THE TOTAL CARE PROVIDED IN THESE ENCOUNTERS WAS WRITTEN OFF AS BAD DEBT. COMMUNITY BENEFITS: THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES, HAS EXTENDED ITS SERVICES BEYOND HOSPITAL WALLS AND INTO THE NEIGHBORHOODS WHERE PEOPLE LIVE AND WORK. THESE PROGRAMS EXTEND TO THE PATIENTS OF SIMS. THE FOLLOWING COMMUNITIES AND POPULATIONS ARE TARGETED THROUGH THESE PROGRAMS: - UNINSURED, UNDERINSURED AND UNDER-SERVED; - POPULATIONS THAT ARE VULNERABLE DUE TO A RANGE OF SOCIO-ECONOMIC BARRIERS SUCH AS POVERTY, EDUCATION LEVELS, EMPLOYMENT STATUS, AND/OR RACIAL DISPARITIES IN HEALTH CARE; - POPULATIONS THAT ARE HARD TO REACH DUE TO LANGUAGE AND CULTURAL CHALLENGES; - POPULATIONS WITH IDENTIFIED NEEDS THAT CAN BE EFFICIENTLY REACHED THROUGH THE LEVERAGING OF COMMUNITY LINKAGES (I.E. FAITH-BASED, SCHOOLS, NEIGHBORHOODS, COMMUNITIES, ETC.); - THE WORKING POOR; AND - POPULATIONS AT RISK OF EXPERIENCING ADVERSE HEALTH CONDITIONS OR OUTCOMES. |
| HOSPITAL PHYSICIAN PRACTICES | FORM 990, PART III, LINE 4A | (CONTINUED FROM PART III) THROUGH DAILY OPERATIONS, THE HOSPITAL PHYSICIAN PRACTICES OF SIMS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE AND UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. THE PATIENT POPULATION OF THE HOSPITAL PHYSICIAN PRACTICES OF SIMS IS COMPRISED OF 34% MEDICARE, 31% MEDICAID, 10% SELF-PAY/CHARITY AND 25% COMMERCIAL/MANAGED CARE. UNCOMPENSATED HEALTH CARE: THE HOSPITAL PHYSICIANS OF SIMS PROVIDED $1,087,724 OF UNCOMPENSATED HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICARE HEALTH CARE PROGRAM. INDIGENT HEALTH CARE: THE HOSPITAL PHYSICIANS OF SIMS HAVE PROVIDED $2,990,746 OF INDIGENT HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICAID HEALTH CARE PROGRAM AND $226,857 OF INDIGENT CHARITY HEALTH CARE. BAD DEBTS: THE HOSPITAL PHYSICIAN PRACTICES OF SIMS WROTE OFF $1,932,864 FROM PRIVATE PAY ACCOUNTS THAT WERE UNCOLLECTIBLE, BUT DID NOT MEET THE CRITERIA TO BE CONSIDERED CHARITY CARE. SIMS HAS DETERMINED THAT 20.7% OR $400,103 OF THE AMOUNTS WRITTEN OFF AS BAD DEBT WOULD HAVE QUALIFIED AS CHARITY CARE IF THE PATIENTS WOULD HAVE SUBMITTED THE REQUIRED DOCUMENTATION. |
| CENTER FOR MEDICAL ARTS | FORM 990, PART III, LINE 4B | (CONTINUED FROM PART III) THROUGH DAILY OPERATIONS, THE PHYSICIAN PRACTICES OF THE CENTER FOR MEDICAL ARTS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE AND UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. THE PATIENT POPULATION OF THE CENTER FOR MEDICAL ARTS IS COMPRISED OF 18% MEDICARE, 31% MEDICAID, 4% SELF-PAY/CHARITY AND 47% COMMERCIAL/MANAGED CARE. UNCOMPENSATED HEALTH CARE: THE CENTER FOR MEDICAL ARTS OF SIMS HAS PROVIDED $1,275,285 OF UNCOMPENSATED HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICARE HEALTH CARE PROGRAM. INDIGENT HEALTH CARE: THE CENTER FOR MEDICAL ARTS OF SIMS HAS PROVIDED $926,447 OF INDIGENT HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICAID HEALTH CARE PROGRAM AND $261,456 OF INDIGENT CHARITY HEALTH CARE. BAD DEBTS: THE CENTER FOR MEDICAL ARTS OF SIMS WROTE OFF $677,088 OF PRIVATE PAY ACCOUNTS THAT WERE UNCOLLECTIBLE, BUT DID NOT MEET THE CRITERIA TO BE CONSIDERED CHARITY CARE. THE CENTER FOR MEDICAL ARTS HAS DETERMINED THAT 20.7% OR $140,157 OF THE AMOUNTS WRITTEN OFF AS BAD DEBT WOULD HAVE QUALIFIED AS CHARITY CARE IF THE PATIENTS WOULD HAVE SUBMITTED THE REQUIRED DOCUMENTATION. COMMUNITY BENEFIT: EACH MONTH, THE CENTER FOR MEDICAL ARTS PROVIDES CLINIC SPACE TO THE DIVISION OF SPECIALIZED CARE FOR CHILDREN AT NO CHARGE. THREE EXAM ROOMS PLUS A DEDICATED WAITING ROOM AREA FOR THIS CLINIC ARE PROVIDED. THIS CLINIC IS SPONSORED BY THE UNIVERSITY OF ILLINOIS TO PROVIDE SPECIALTY CARE TO CHILDREN UNABLE TO AFFORD CARE. SOME OF THE CHILDREN, EVEN THOUGH COVERED BY INSURANCE, ARE SEEN FOR CASE MANAGEMENT OF SPECIALTY SERVICES. A SPECIALIST, USUALLY AN ORTHOPEDIST, EXAMINES CHILDREN WHO MAY OTHERWISE HAVE HAD TO MAKE A TRIP TO AN URBAN AREA FOR SPECIALTY CARE. THE CHILDREN THAT ARE SEEN RANGE IN AGE FROM INFANT TO 19 YEARS. THESE CHILDREN ARE RESIDENTS OF THE SERVICE REGION THAT THE CENTER FOR MEDICAL ARTS IS WITHIN. THE VALUE OF THIS SPACE IS ESTIMATED TO BE $2,200 ANNUALLY. |
| COMMUNITY PHYSICIAN PRACTICES | FORM 990, PART III, LINE 4C | (CONTINUED FROM PART III) THROUGH DAILY OPERATIONS, THE COMMUNITY PHYSICIAN PRACTICES OF SIMS PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CHARITY CARE AND UNCOMPENSATED GOVERNMENT-SPONSORED HEALTH CARE. THE PATIENT POPULATION OF THE COMMUNITY PHYSICIAN PRACTICES OF SIMS IS COMPRISED OF 40% MEDICARE, 14% MEDICAID, 3% SELF-PAY/CHARITY AND 43% COMMERCIAL/MANAGED CARE. UNCOMPENSATED HEALTH CARE: THE COMMUNITY PHYSICIAN PRACTICES OF SIMS HAVE PROVIDED $1,516,442 OF UNCOMPENSATED HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICARE HEALTH CARE PROGRAM. INDIGENT HEALTH CARE: THE COMMUNITY PHYSICIAN PRACTICES OF SIMS HAVE PROVIDED $703,061 OF INDIGENT HEALTH CARE THROUGH PARTICIPATION IN THE GOVERNMENT-SPONSORED MEDICAID HEALTH CARE PROGRAM AND $143,182 OF INDIGENT CHARITY HEALTH CARE. BAD DEBTS: THE COMMUNITY PHYSICIAN PRACTICES OF SIMS WROTE OFF $285,061 FROM PRIVATE PAY ACCOUNTS THAT WERE UNCOLLECTIBLE, BUT DID NOT MEET THE CRITERIA TO BE CONSIDERED CHARITY CARE. SIMS HAS DETERMINED THAT 20.7% OR $59,008 OF THE AMOUNTS WRITTEN OFF AS BAD DEBT WOULD HAVE QUALIFIED AS CHARITY CARE IF THE PATIENTS WOULD HAVE SUBMITTED THE REQUIRED DOCUMENTATION. |
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | THE ORGANIZATION'S SOLE MEMBER IS SOUTHERN ILLINOIS HOSPITAL SERVICES, A RELATED TAX-EXEMPT ORGANIZATION. THE MEMBER HAS THE RIGHT TO ELECT MEMBERS TO THE BOARD OF TRUSTEES AND APPROVE SOME DECISIONS OF THE BOARD. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES, INC., HAS THE EXCLUSIVE RIGHT TO ELECT TRUSTEES TO THE ORGANIZATION'S BOARD OF TRUSTEES. |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | THE ORGANIZATION'S SOLE MEMBER, SOUTHERN ILLINOIS HOSPITAL SERVICES (CORPORATE MEMBER), HAS RESERVED POWERS FOUND IN THE ORGANIZATIONS BYLAWS. EXCEPT FOR TRANSFERS IDENTIFIED IN THE BUDGET OF THE ORGANIZATION APPROVED BY THE CORPORATE MEMBER, THE ORGANIZATION MAY NOT TRANSFER ASSETS TO ENTITIES OTHER THAN THE CORPORATE MEMBER OR ENTITIES THAT THE CORPORATE MEMBER CONTROLS (THE "CORPORATE MEMBER AFFILIATES"), WITHOUT THE APPROVAL OF THE CORPORATE MEMBER. THE CORPORATE MEMBER HAS THE RIGHT TO REQUIRE THE ORGANIZATION TO TRANSFER ASSETS TO THE EXTENT NECESSARY TO ACCOMPLISH THE CORPORATE MEMBER'S GOALS AND OBJECTIVES. THE CORPORATE MEMBER ALSO HAS THE RIGHT TO REQUIRE THE ORGANIZATION TO PROVIDE FOR THE PAYMENT OF ALL INDEBTEDNESS OF THE CORPORATE MEMBER OR A CORPORATE MEMBER AFFILIATE. THE ORGANIZATION CANNOT BE REQUIRED TO VIOLATE ITS CHARITABLE PURPOSES, THE TERMS OF ANY RESTRICTED GIFTS, OR THE COVENANTS OF ITS DEBT INSTRUMENTS IN COMPLYING WITH ANY ASSET TRANSFERS DIRECTED BY THE CORPORATE MEMBER. IN ADDITION, THE FOLLOWING MATTERS MUST BE SUBMITTED TO AND RECEIVE THE APPROVAL OF THE CORPORATE MEMBER: 1. CAPITAL EXPENDITURES IN EXCESS OF $500,000; 2. THE BUYING, SELLING, LEASING, MORTGAGING OR DISPOSING OF REAL PROPERTY BELONGING TO THE CORPORATION OR ANY OF ITS SUBSIDIARIES; 3. THE ESTABLISHMENT OR DISCONTINUANCE OF ANY MAJOR SERVICES; INCLUDING SERVICES REQUIRING CERTIFICATES OF NEED; 4. LONG-RANGE STRATEGIC PLANS; 5. MASTER FACILITIES AND SITE PLANS; 6. THE CREATION OR DISSOLUTION OF ANY CORPORATION, THE SOLE MEMBER OR MAJORITY STOCKHOLDER OF WHICH IS THE CORPORATION; 7. JOINT VENTURE OR AFFILIATION AGREEMENTS; 8. THE INCURRENCE OF INDEBTEDNESS IN EXCESS OF $500,000; 9. SUCH OTHER MATTERS AS MAY BE REQUIRED BY LAW OR BY THE ORGANIZATION'S ARTICLES OF INCORPORATION, OR BY ITS BYLAWS TO BE SUBMITTED TO THE CORPORATE MEMBER; 10. DELEGATION OF THE FUNCTIONS, POWERS, DUTIES AND RESPONSIBILITIES OF ANY OFFICER OF THE CORPORATION, AND; 11. ANY OTHER MATTER WHICH MAY BE SPECIFIED FROM TIME TO TIME BY THE CORPORATE MEMBER. IN ADDITION, THE CORPORATE MEMBER RETAINS THE RIGHT TO APPROVE ALL CHANGES TO THE ORGANIZATION'S BYLAWS. |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | A DRAFT OF THE FORM 990 AND SUPPLEMENTAL SCHEDULES WAS DISTRIBUTED TO THE CEO, CFO AND CERTAIN VICE-PRESIDENTS OF THE CORPORATION FOR THEIR REVIEW AND COMMENTS. THIS DRAFT COPY WAS PRESENTED TO THE FINANCE COMMITTEE BY THE CFO AND THE ORGANIZATION'S TAX ADVISORS FOR REVIEW AND COMMENTS ON NOVEMBER 2, 2011. AFTER THIS REVIEW AND COMMENT PERIOD, ALL SUGGESTIONS AND COMMENTS WERE CONSIDERED AND THE FORM 990 WAS UPDATED AS APPROPRIATE. THE FINALIZED FORM 990 AND SUPPLEMENTAL SCHEDULES WAS THEN PRESENTED TO THE BOARD OF TRUSTEES AND A COPY OF THE RETURN WAS MADE AVAILABLE TO EVERY MEMBER OF THE GOVERNING BODY BEFORE IT WAS FILED WITH THE IRS. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | ANNUALLY, THE GENERAL COUNSEL SENDS OUT A CONFLICT OF INTEREST QUESTIONNAIRE TO EACH TRUSTEE, DIRECTOR, OFFICER, AND MANAGER TO COMPLETE AND RETURN. THE GENERAL COUNSEL THEN REVIEWS THESE QUESTIONNAIRES TO DETERMINE WHAT CONFLICTS, REAL OR PERCEIVED, EXIST. DURING EVERY BOARD MEETING, THE GENERAL COUNSEL REMINDS THE TRUSTEES THAT THE BOARD HAS A CONFLICT OF INTEREST POLICY, THAT THE GENERAL COUNSEL HAS REVIEWED THE AGENDA FOR ANY CONFLICTS, BUT THAT THE TRUSTEES ARE OBLIGATED TO GIVE NOTICE IF A CONFLICT HAS BEEN OVER-LOOKED OR IF A DISCUSSION OR ACTION COMES BEFORE THE BOARD WHICH MAY INVOLVE OR CREATE A CONFLICT OF INTEREST FOR SOMEONE. IF A TRUSTEE HAS A CONFLICT OF INTEREST, THE TRUSTEE OR THE GENERAL COUNSEL DISCLOSES THE CONFLICT. THE TRUSTEE WITH THE CONFLICT IS ALLOWED TO REMAIN IN THE MEETING TO ANSWER ANY QUESTION THE TRUSTEE MAY NEED TO ANSWER AND THEN THE CONFLICTED TRUSTEE IS EXCUSED FROM THE MEETING. THE REMAINING TRUSTEES THEN DISCUSS THE MATTER FURTHER AND ACTION IS TAKEN ON THE MATTER. FINALLY, THE CONFLICTED TRUSTEE IS THEN INVITED BACK INTO THE MEETING. |
| Process used to establish compensation of top management official | Form 990, Part VI, Section B, Line 15a | COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER OFFICERS IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF THE PRESIDENT/CEO FOR THE FULL BOARD. ONLY THE FULL BOARD HAS THE AUTHORITY TO APPROVE THE COMPENSATION OF THE PRESIDENT/CEO. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2010. |
| Process used to establish compensation of other officers/key employees | Form 990, Part VI, Section B, Line 15b | COMPENSATION FOR THE ORGANIZATION'S PRESIDENT AND OTHER OFFICERS IS PAID BY SOUTHERN ILLINOIS HOSPITAL SERVICES, INC. (SIHS), A RELATED TAX-EXEMPT ORGANIZATION. THE BOARD OF TRUSTEES SETS THE EXECUTIVE COMPENSATION POLICY AND IS RESPONSIBLE FOR APPROVAL OF THE COMPENSATION. THE GOVERNANCE COMMITTEE IS DESIGNATED BY THE BOARD TO ACT AS THE COMPENSATION COMMITTEE FOR MATTERS CONCERNING EXECUTIVE COMPENSATION. EACH MEMBER OF THE COMMITTEE, WHILE CONSIDERING EXECUTIVE COMPENSATION ISSUES, MUST BE AN INDEPENDENT DIRECTOR, FREE FROM ANY CONFLICT OF INTEREST. THE COMMITTEE SEEKS OUT AND CONTRACTS THE SERVICES OF AN OUTSIDE, INDEPENDENT EXECUTIVE COMPENSATION CONSULTANT TO ADVISE THE COMMITTEE IN MATTERS OF MARKET VALUES OF COMPARABLE EXECUTIVE POSITIONS. THE COMMITTEE ANNUALLY REVIEWS ALL COMPARABILITY DATA AND PREPARES A RECOMMENDATION AS TO THE COMPENSATION PACKAGE OF ALL OFFICERS FOR THE FULL BOARD. ONLY THE COMMITTEE WILL HAVE THE AUTHORITY TO APPROVE THE COMPENSATION OF THE SENIOR MANAGEMENT TEAM AND WILL REPORT ITS ACTIONS TO THE BOARD. THE DECISIONS AND DELIBERATIONS ARE DOCUMENTED IN THE GOVERNANCE COMMITTEE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN JUNE 2010. |
| Public Disclosure | Form 990, Part VI, Section C, Line 19 | THE ORGANIZATION MAKES ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST. GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| OFFICERS, DIRECTORS, TRUSTEES, KEY EMPLOYEES, AND HIGHEST COMPENSATED EMPLOYEES | FORM 990, PART VII, SECTION A, LINE 1A | THE FOLLOWING OFFICERS AND TRUSTEES DEVOTE TIME TO SOUTHERN ILLINOIS HOSPITAL ENTERPRISES, INC., A RELATED TAX-EXEMPT ORGANIZATION, AS FOLLOWS (APPROXIMATE): ANAD SALEM - 1 HOUR PER WEEK HAROLD BARDO - 1 HOUR PER WEEK JEFFREY PARKS - 1 HOUR PER WEEK KATHLEEN FRALISH - 1 HOUR PER WEEK MIKE KASSER - 1 HOUR PER WEEK PHIL NORDSTROM - 1 HOUR PER WEEK REX BUDDE - 1 HOUR PER WEEK STEVE SABENS - 1 HOUR PER WEEK WILLIAM SHERWOOD - 1 HOUR PER WEEK THE FOLLOWING OFFICERS AND TRUSTEES DEVOTE TIME TO SOUTHERN ILLINOIS HOSPITAL SERVICES, A RELATED TAX-EXEMPT ORGANIZATION, AS FOLLOWS (APPROXIMATE): ANAD SALEM - 2 HOURS PER WEEK DAVE HOLLAND - 32 HOURS PER WEEK HAROLD BARDO - 2 HOURS PER WEEK JAMES MILLER - 30 HOURS PER WEEK JEFFREY PARKS - 2 HOURS PER WEEK KATHLEEN FRALISH - 2 HOURS PER WEEK MIKE KASSER - 31 HOURS PER WEEK PHIL NORDSTROM - 2 HOURS PER WEEK PHIL SCHAEFER - 10 HOURS PER WEEK REX BUDDE - 35 HOURS PER WEEK STEVE SABENS - 2 HOURS PER WEEK WILLIAM SHERWOOD - 33 HOURS PER WEEK WILLIAM THORNE - 36 HOURS PER WEEK THE FOLLOWING OFFICERS AND TRUSTEES DEVOTE TIME TO SIH FOUNDATION, NFP, A RELATED TAX-EXEMPT ORGANIZATION, AS FOLLOWS (APPROXIMATE): MIKE KASSER - 1 HOUR PER WEEK REX BUDDE - 1 HOUR PER WEEK WILLIAM SHERWOOD - 1 HOUR PER WEEK |
| Other changes in net assets or fund balances | Form 990, Part XI, Line 5 | EQUITY TRANSFER FROM SIHS - 3916095; |
| REQUIREMENTS UNDER SINGLE AUDIT ACT AND OMB CIRCULAR A-133 | FORM 990, PART XII, LINE 3 | AS REQUIRED BY THE U.S. OFFICE OF MANAGEMENT AND BUDGET CIRCULAR A-133, AUDITS OF STATES, LOCAL GOVERNMENTS, AND NON-PROFIT ORGANIZATIONS, IN 2011 SOUTHERN ILLINOIS HEALTHCARE SERVICES AND AFFILIATES RECEIVED AN AUDIT FOR THE 2010 CONSOLIDATED FINANCIAL STATEMENTS IN ACCORDANCE WITH THE SINGLE AUDIT ACT. SOUTHERN ILLINOIS MEDICAL SERVICES, NFP IS AN AFFILIATE OF SOUTHERN ILLINOIS HEALTHCARE SERVICES. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|
| SOUTHERN ILLINOIS HOSPITAL SERVICES | |||||||||
| PO BOX 3988 | CARBONDALE | IL | 62902 | 370618939 | HEALTHCARE | IL | 501(C)(3) | 3 | SOUTHERN ILLINOIS HOSPITAL ENTERPRISES |
| SOUTHERN ILLINOIS HEALTHCARE ENTERPRISES INC | |||||||||
| PO BOX 3988 | CARBONDALE | IL | 62902 | 371136788 | LEASING OF MEDICAL SPACE | IL | 501(C)(3) | 11 - Type II | NA |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType |
|---|---|---|---|---|---|---|---|---|
| RIC AND SIHS REHABILITATION SERVICES LLC | ||||||||
| PO BOX 3988 | CARBONDALE | IL | 629023988 | 364566925 | MEDICAL SERVICES | IL | NA | N/A |
| PHYSICIANS' SURGERY CENTER LLC | ||||||||
| 2601 WEST MAIN STREET | CARBONDALE | IL | 62901 | 260425547 | MEDICAL SERVICES | IL | NA | N/A |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SIH CAYMAN SPC GROUP LTD | BusinessNameLine1 |
Address Foreign AddressForeign
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1051 | AddressLine1 |
| City | GRAND CAYMAN | City |
| Province Or State | CJ | ProvinceOrState |
| Country | CJ | Country |
| Postal Code | KY1-1102 | PostalCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 980611605 | EIN |
| Primary Activity | FINANCING | PrimaryActivity |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountry |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHERN ILLINOIS HOSPITAL SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C CORPORATION | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | 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 | true | 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 | true | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | 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 | true | OtherTransferFromOtherOrg |