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ST MARGARETS HEALTH SPRING VALLEY: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ST MARGARETS HEALTH SPRING VALLEY (EIN 36-2167884)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-11
IRS object ID
201132239349302148
Schema version
2009v1.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-11T16:34:44-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1EIDE BAILLY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13999 PENNSYLVANIA AVE SUITE 100AddressLine1
CityDUBUQUECity
StateIAState
ZIP Code52002ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362167884EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Margaret's HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTMANameControl
Phone8156642700Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 East First StreetAddressLine1
CitySpring ValleyCity
StateILState
ZIP Code61362ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameTimothy MuntzName
TitlePresident/CEOTitle
Phone8156642700Phone
Date Signed2011-08-11DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameCarmen KrantzName
Phone5635561790Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

Doing Business As DoingBusinessAs

FieldValueIRS element (for citing)
Business Name Line1St Margaret's HealthBusinessNameLine1
FieldValueIRS element (for citing)
Name Of Principal Officer PersonTimothy MuntzNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1600 East First StreetAddressLine1
CitySpring ValleyCity
StateILState
ZIP Code61362ZIPCode
FieldValueIRS element (for citing)
Gross Receipts67141819GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web Sitewww.aboutsmh.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1903YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionProvide health care services to improve the health of the people in the communityActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members5NbrIndependentVotingMembers
Total Nbr Employees755TotalNbrEmployees
Total Nbr Volunteers200TotalNbrVolunteers
Total Gross UBI-14119TotalGrossUBI
Net Unrelated Business Txbl Income-13791NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year172673ContributionsGrantsPriorYear
Contributions Grants Current Year462783ContributionsGrantsCurrentYear
Program Service Revenue Prior Year65914406ProgramServiceRevenuePriorYear
Program Service Revenue CY65824872ProgramServiceRevenueCY
Investment Income Prior Year613004InvestmentIncomePriorYear
Investment Income Current Year507894InvestmentIncomeCurrentYear
Other Revenue Prior Year274590OtherRevenuePriorYear
Other Revenue Current Year209954OtherRevenueCurrentYear
Total Revenue Prior Year66974673TotalRevenuePriorYear
Total Revenue Current Year67005503TotalRevenueCurrentYear
Grants And Similar Amnts CY42450GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year33958625SalariesEtcPriorYear
Salaries Etc Current Year32550815SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year32050908OtherExpensePriorYear
Other Expenses Current Year32281557OtherExpensesCurrentYear
Total Expenses Prior Year66009533TotalExpensesPriorYear
Total Expenses Current Year64874822TotalExpensesCurrentYear
Revenues Less Expenses Prior Year965140RevenuesLessExpensesPriorYear
Revenues Less Expenses CY2130681RevenuesLessExpensesCY
Total Assets BOY52841989TotalAssetsBOY
Total Assets EOY58828529TotalAssetsEOY
Total Liabilities BOY14333436TotalLiabilitiesBOY
Total Liabilities EOY17482761TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY38508553NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY41345768NetAssetsOrFundBalancesEOY
Mission DescriptionSt. Margaret's Health, in union with the Sisters of Mary of the Presentation, is committed to the values of Catholic health care in caring for the needs of our patients and their families, the community and one another. Through our belief in God and our respect for life, we provide holistic quality health care with dignity and compassion.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change1SignificantChange
Expense57918982Expense
Grants42450Grants
Revenue66048945Revenue
DescriptionSt. Margaret's Health has a tradition of serving the poor and others in the area surrounding Spring Valley for over 100 years. This report summarizes how, following in the footsteps of Jesus Christ, St. Margaret's Hospital is reaching out to the poor and those most in need. The presence of St. Margaret's Hospital means much more than dollars and cents. The value of services to those in need has been more than a financial sheet can describe, because sometimes the smaller programs do the most good and because the organization cannot possibly count up all the services. St. Margaret's Hospital has been a leader in the community, helping others to see the need to respond to the needs of the poor.St. Margaret's Hospital is committed to improving the health of the people in the communities. Some of the services provided to the community at a reduced price or free of charge include the following:1. Participated in various health fairs throughout the area, providing information on health issues.2. Helped in the early detection of illness, a number of health screenings were provided at no cost or at prices less than cost for services, such as blood pressure, blood sugar, and cholesterol.3. Provided various education programs for items such as diabetes, joint replacements, arthritis, babysitting, healthy eating and physical fitness. As an extension of these programs, we also provided numerous support groups for patients suffering from chronic illness, all offered free to the public.4. Provided flu shots to the community at prices less than our costs.St. Margaret's Hospital also helped support other groups in joint efforts to serve the community.1. Donated money to Bureau County Health & Wellness, a free clinic located in Princeton.2. Provided free food to the area homeless shelter.COMMUNITY BUILDING ACTIVITIESSt. Margaret's Hospital worked with other organizations to help serve the community. Some examples include the following:1. Worked with EMS services in the area to help coordinate services2. Worked with Bureau and Putnam County Health Departments to help with Emergency Preparedness.Volunteerism is very much alive at St. Margaret's Health. We had more than 40 teenagers and 160 adults who contributed almost 14,000 hours of volunteer service in the past year. Employees also contributed time in hospital-related projects, such as the holiday dinner for those alone or in need and the American Red Cross blood drives at St. Margaret's.The Hospital maintains records to identify and monitor the level of charity care it provides. These records include the amount of charges foregone for services and supplies furnished under its charity care policy. The amount of charges foregone for the year ended September 30, 2010 were $1,289,358. The estimated costs of the charges foregone, by using methodology of the Catholic Health Association of the United States, for the year ended September 30, 2010 were $567,000.In addition, the Hospital provides services to other medically indigent patients under certain government reimbursed public aid programs. Such programs pay providers amounts which are less than established charges for the services provided to the recipients, and for some services the payments are less than the cost of rendering the services provided. The Hospital also commits significant time and resources to endeavors and critical services which meet otherwise unfulfilled community needs. Many of these activities are sponsored with the knowledge that they will not be self-supporting or financially viable.Description
Total Program Service Expense57918982TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109678NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees755NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members5NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees0MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Kim SantmanBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8156641328TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1600 East First StreetAddressLine1
CitySpring ValleyCity
StateILState
ZIP Code61362ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Dr Frank Zeller
Chairperson0.50XX000
Richard Twanow MD
Vice Chairperson40.00XX344869018120
Aaron Alton
Director-President SMPHS5.00X046261844786
Jim Brady
Director0.50X000
Dick Koontz
Director0.50X000
Dan Fitzgerald
Director0.50X000
Sharon Kunkel
Director0.50X000
Sr Dorothy Bertsch
Director0.50X000
Sr Anne Germaine Picard
Director0.50X000
Steve Lukancic MD
Director until 6/30/100.50X000
Robert Morrow MD
Director commenced 7/1/100.50X263346020080
Timothy Muntz
President/CEO40.00XX034066439541
Kim Santman
VP of Finance40.00X018226435355
Jason Dotson
VP of Clinical Operations40.00016387225351X
Dr Paul Perona
Physician40.001305276036580X
Dr Dale Chilson
Physician40.00965524020080X
Dr Thaw Tun
Physician40.00468398020080X
Dr Shawn Bailey
Physician40.00407098037816X
Dr Ram Pankaj
Physician40.00644067011822X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4398578TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1149418TotalReportableCompFrmRltdOrgs
Total Other Compensation309611TotalOtherCompensation
Number Individuals GT100 K27NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Matthei & Colin Associates
332 S Michigan Suite 614ChicagoIL60604Architect1495507
SMP Health Corporation
1202 Page Drive SWFargoND58106Administrative services1340265
Aramark Facilities Services
1101 Market StreetPhiladelphiaPA19107Facilities management1052880
St Francis Inc
8001 North University St Suite OPeoriaIL61615Administrative services841000
Empire Emergency Physicians
2020 N Lincoln Park West 37HChicagoIL60614Contract physicians561500
FieldValueIRS element (for citing)
Number Of Contractors GT100 K21NumberOfContractorsGT100K
Related Organizations183719RelatedOrganizations
Government Grants150580GovernmentGrants
All Other Contributions128484AllOtherContributions
Total Contributions462783TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Patient service revenu6221106501367865013678
Employee retail pharma446110447481447481
Other supporting reven900099363713363713
FieldValueIRS element (for citing)
Total Program Service Revenue65824872TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column500089TotalRevenueColumn
Exclusion$500,089ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real346270Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real136316Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real209954Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column209954TotalRevenueColumn
Related Or Exempt Function Income224073RelatedOrExemptFunctionIncome
Unrelated Business Revenue-14119UnrelatedBusinessRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other7805Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other7805Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column7805TotalRevenueColumn
Exclusion$7,805ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column67005503TotalRevenueColumn
Related Or Exempt Function Income66048945RelatedOrExemptFunctionIncome
Unrelated Business Revenue-14119UnrelatedBusinessRevenue
Exclusion$507,894ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total42450Total
Program Services42450ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total548472Total
Program Services548472ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total477959Total
Program Services477959ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total26388957Total
Program Services24269486ProgramServices
Management And General2119471ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total623250Total
Program Services559666ProgramServices
Management And General63584ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2783498Total
Program Services2577013ProgramServices
Management And General206485ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1728679Total
Program Services1595152ProgramServices
Management And General133527ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total106995Total
Management And General106995ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total45735Total
Management And General45735ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11222523Total
Program Services8491347ProgramServices
Management And General2731176ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total583969Total
Management And General583969ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total11839555Total
Program Services11240940ProgramServices
Management And General598615ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1011057Total
Program Services976166ProgramServices
Management And General34891ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total77134Total
Program Services40336ProgramServices
Management And General36798ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total86938Total
Program Services80275ProgramServices
Management And General6663ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total385162Total
Program Services385162ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total2981782Total
Program Services2981782ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total990713Total
Program Services705713ProgramServices
Management And General285000ManagementAndGeneral

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad debt expense29470632947063
Miscellaneous expense29312931

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total64874822Total
Program Services57918982ProgramServices
Management And General6955840ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1246750BOY
EOY872121EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY168895BOY
EOY168895EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8594120BOY
EOY9144852EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY630017BOY
EOY594616EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1299769BOY
EOY2596404EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY581936BOY
EOY419437EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis71385462LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec45091816LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY23075748BOY
EOY26293646EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY16401442BOY
EOY18084180EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY435000BOY
EOY435000EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY408312BOY
EOY219378EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY52841989BOY
EOY58828529EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4349361BOY
EOY3653338EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY7622291BOY
EOY10322885EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2361784BOY
EOY3506538EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY14333436BOY
EOY17482761EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY38002138BOY
EOY41053583EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY469415BOY
EOY255185EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY37000BOY
EOY37000EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY38508553BOY
EOY41345768EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY52841989BOY
EOY58828529EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis385690InvestmentCostOrOtherBasis
Other Cost Or Other Basis2654274OtherCostOrOtherBasis
Book Value3039964BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1257276InvestmentCostOrOtherBasis
Other Cost Or Other Basis39232171OtherCostOrOtherBasis
Depreciation25269019Depreciation
Book Value15220428BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis15303InvestmentCostOrOtherBasis
Other Cost Or Other Basis21991985OtherCostOrOtherBasis
Depreciation18443938Depreciation
Book Value3563350BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis74400InvestmentCostOrOtherBasis
Other Cost Or Other Basis5774363OtherCostOrOtherBasis
Depreciation1378859Depreciation
Book Value4469904BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings26293646TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescriptionAmountAmount
Deferred compensation obligation$400,252
Estimated health claims$151,000
Estimated third-party payor settlements$2,010,000
Construction accounts payable$945,286
FieldValueIRS element (for citing)
Total Of Amounts3506538TotalOfAmounts
Total Revenue67005503TotalRevenue
Total Expenses64874822TotalExpenses
Excess Or Deficit For Year2130681ExcessOrDeficitForYear
Net Unrealized GL On Investments917846NetUnrealizedGLOnInvestments
Other-$211,312OtherAmount
Total Adjustments706534TotalAdjustments
Excess Or Deficit Per FS2837215ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt67682431TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments917846NetUnrealizedGainsInvestments
Other Revenues19388OtherRevenues
Revenue Not Rptd F990937234RevenueNotRptdF990
Revenue Subtotal66745197RevenueSubtotal
Other Revenues Not Included260306OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt260306RevenueNotRptdOnFinStmt
Total Revenue Per Form99067005503TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt64874822TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal64874822ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99064874822TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part X:Description of Uncertain Tax Positions Under FIN 48:The Hospital has adopted the provisions of FASB Accounting Standards Codification Topic 740-10 (previously Financial Interpretation No. 48, Accounting for Uncertainty in Income Taxes) on October 1, 2009. The implementation of this standard had no impact on the financial statements. As of both the date of adoption, and as of September 30, 2010, the unrecognized tax benefit accrual was zero. The Hospital will recognize future accrued interest and penalties related to unrecognized tax benefits in income tax expense if incurred. The Hospital is no longer subject to Federal and state tax examinations by tax authorities for years before 2006.
Part XI, Line 8 - Other Adjustments:Change in equity of investment in St. Margaret's Health Organization: 3794. Equity transfer to Sisters of Mary of the Presentation Health Corporation: -55669. Change in interest in net assets of St. Margaret's Hospital Foundation: -159437.
Part XII, Line 2d - Other Adjustments:Net assets released from restrictions: 15594. Change in equity in gains of investees: 3794.
Part XII, Line 4b - Other Adjustments:Contributions restricted by donors included in revenue per Form 990: 25. Capital contributions and grants included in revenue per Form 990: 260281.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent150XPcent150
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent250XPcent250
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Persons Served847PersonsServed
Total Community Benefit Expense567000TotalCommunityBenefitExpense
Net Community Benefit Expense567000NetCommunityBenefitExpense
Percent Of Total Expense0.00920PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Persons Served6571PersonsServed
Total Community Benefit Expense10647664TotalCommunityBenefitExpense
Direct Offsetting Revenue3258735DirectOffsettingRevenue
Net Community Benefit Expense7388929NetCommunityBenefitExpense
Percent Of Total Expense0.11930PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Persons Served7418PersonsServed
Total Community Benefit Expense11214664TotalCommunityBenefitExpense
Direct Offsetting Revenue3258735DirectOffsettingRevenue
Net Community Benefit Expense7955929NetCommunityBenefitExpense
Percent Of Total Expense0.12850PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Number Of Activities Or Programs151NumberOfActivitiesOrPrograms
Persons Served7859PersonsServed
Total Community Benefit Expense37345TotalCommunityBenefitExpense
Direct Offsetting Revenue4120DirectOffsettingRevenue
Net Community Benefit Expense33225NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Number Of Activities Or Programs1NumberOfActivitiesOrPrograms
Total Community Benefit Expense8000TotalCommunityBenefitExpense
Net Community Benefit Expense8000NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1899769TotalCommunityBenefitExpense
Direct Offsetting Revenue757915DirectOffsettingRevenue
Net Community Benefit Expense1141854NetCommunityBenefitExpense
Percent Of Total Expense0.01840PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Persons Served1327PersonsServed
Total Community Benefit Expense62540TotalCommunityBenefitExpense
Net Community Benefit Expense62540NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs152NumberOfActivitiesOrPrograms
Persons Served9186PersonsServed
Total Community Benefit Expense2007654TotalCommunityBenefitExpense
Direct Offsetting Revenue762035DirectOffsettingRevenue
Net Community Benefit Expense1245619NetCommunityBenefitExpense
Percent Of Total Expense0.02000PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Number Of Activities Or Programs152NumberOfActivitiesOrPrograms
Persons Served16604PersonsServed
Total Community Benefit Expense13222318TotalCommunityBenefitExpense
Direct Offsetting Revenue4020770DirectOffsettingRevenue
Net Community Benefit Expense9201548NetCommunityBenefitExpense
Percent Of Total Expense0.14850PercentOfTotalExpense

Physical Improvements And Housing PhysicalImprovementsAndHousing

FieldValueIRS element (for citing)
Total Community Building Expense5648TotalCommunityBuildingExpense
Net Community Building Expense5648NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense9967TotalCommunityBuildingExpense
Net Community Building Expense9967NetCommunityBuildingExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense8429TotalCommunityBuildingExpense
Net Community Building Expense8429NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Environmental Improvements EnvironmentalImprovements

FieldValueIRS element (for citing)
Total Community Building Expense1516TotalCommunityBuildingExpense
Net Community Building Expense1516NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Leadership Development LeadershipDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense3253TotalCommunityBuildingExpense
Net Community Building Expense3253NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense2184TotalCommunityBuildingExpense
Net Community Building Expense2184NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense1941TotalCommunityBuildingExpense
Net Community Building Expense1941NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense32938TotalCommunityBuildingExpense
Net Community Building Expense32938NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$998,588BadDebtExpenseAmount
Amount Attributable To8914AmountAttributableTo
Amount Reimbursed By Medicare17072948AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare20231378CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-3158430MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
OtherXOther
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1St Margaret's HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1600 East First StreetAddressLine1
CitySpring ValleyCity
StateILState
ZIP Code61362ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedPart I, Line 7: Charity care expense was converted to cost on line 7a based on an overall cost to charge ratio addressing all patient segments. Unreimbursed Medicaid on line 7b was calculated using the costing methods to prepare the cost reports. Community health improvement services, line 7e, health professions education, line 7f, and cash and in-kind donations, line 7i were reported from expenses in the general ledger. The cost for subsidized health services reported on line 7g was determined using the Medicare Cost Report. Total community benefit expense as a percentage of total expenses is 20%.CostingMethodUsed
Subsidized Health Services ExplnPart I, Line 7g:SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnPart I, Line 7f: The amount of bad debt expense removed from total expenses to determine the percentage was $2,947,063.PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: The organization's bad debt expense was converted to cost using the cost-to-charge ratio derived from Worksheet 2.St. Margaret's Hospital determines bad debt expense by estimating what may not be collectible from patient balances after taking into account appropriate discounts and payments (uninsured discount, eligible charity care discounts/adjustments, and payments received and expected to be received). Payments on accounts that were written off as bad debt reduces bad debt expense.The estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's charity care policy is calculated based on an estimate of charges foregone to gross patient charges. Footnote to financial statements:The carrying amount of patient receivables is reduced by a valuation allowance that reflects management's estimate of amounts that will not be collected from patients and third-party payors. Management reviews patient receivables by payor class and applies percentages to determine estimated amounts that will not be collected from third parties under contractual agreements and amounts that will not be collected from patients due to bad debts. Management considers historical write off and recovery information in determining the estimated bad debt provision. Management also reviews accounts to determine if classification as charity care is appropriate.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: St. Margaret's Hospital provides services to patients under the Medicare program knowing they will not recover all the costs associated with providing these services. Providing these services is essential to these patients and the community and increases their access to healthcare services. Therefore, the entire Medicare shortfall is considered a community benefit. The organization reported only those allowable costs and Medicare reimbursements reported in the Medicare Cost Report for the year.Total revenue received from Medicare is the gross reimbursement plus settlement. Both total revenue received from Medicare and the Medicare allowable costs are reported from the Medicare Cost Report.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: In keeping with the mission, vision and values of St. Margaret's Hospital, our organization is committed to giving a patient every opportunity to pay their medical debt in full or to make arrangements based on organizational policy. Patients are required to complete an application for financial assistance however, patients eligible for Illinois Medicaid that receive services not covered by the program, may be granted 100% financial assistance for those non-covered services. Patients that are homeless are granted 100% financial assistance. Efforts are made to have a completed application. If information cannot be obtained, verification from the Police Department, or other official must be obtained verifying the patient is homeless. Homeless patients and Illinois Medicaid patients will not be subject to any collection efforts. When a patient is in the process of applying for financial assistance there will be no collection efforts. After a determination of financial assistance, any personal portion due follows the same collection procedures as other accounts. Collection procedures includes past due notices and phone calls and then the account is referred to a collection agency.DebtCollectionPolicy
Number Of Facility Type ExplnPart V: The organization also has the following types of facilities other than those required to be licensed as a healthcare facilities in the state of Illinois.1 Ear Nose & Throat Center1 Women's Health Center10 Outpatient Physician Clinics2 Orthopedic Clinics1 Occupational Health Center1 Durable Medical EquipmentNumberOfFacilityTypeExpln
General ExplanationPart I, Line 6b: The community benefit report is available upon request to the public.GeneralExplanation
Patient Education AssistancePart VI, Line 3: St. Margaret's Hospital posts its charity care policy in the admissions/registration areas, waiting rooms, emergency rooms, and other areas the organization finds beneficial to patients. The policy and contact information on financial assistance is provided and discussed during the admission and discharge process. Upon notification from Registration regarding self pay admissions, the Patient Account clerk or staff member from another department tries to contact the patient to discuss availability of financial assistance. Also, information on other programs, such as government benefits, Medicaid or state programs, are discussed with patients. Assistance is also provided for individuals applying for government benefits. Patients are encouraged to explore their options and use our resources to obtain assistance with their bills. Each patient bill includes an explanation on how to inquire about financial assistance or an uninsured discount.PatientEducationAssistance
Community InformationPart VI, Line 4: St. Margaret's Hospital is a 83-bed acute care hospital located in Spring Valley, IL. Spring Valley, IL is a city situated on the Illinois river in the southeastern corner of Bureau County, IL. Bureau County is located in the Northcentral region of Illinois. The population is approximately 5,400 people. Spring Valley is part of the "Illinois Valley Micropolitan" (La Salle, Peru, and Spring Valley) which total approximately 25,000 people. Wal-Mart is the largest employer and has a labor force from over 100 different zip codes that easily commute to Spring Valley. In 2009 the median household income was $44,177, the unemployment rate was 11.2%, and 9.1% of people were living in poverty. Over 6,500 of our patients were low-income Medicaid participants. Medicare and public aid make up 52% of our net revenues. The nearest city with a population greater than 50,000 is Peoria, IL located 47 miles SW of Spring Valley.CommunityInformation
Community Building ActivitiesPart VI, Line 5: Individuals from St. Margaret's Hospital attended community building events at the Illinois Valley Area Chamber and monthly meetings for community betterment activities at the North Central Regional Betterment Coalition (NCRBC). Meetings were attended for economic development at the LaSalle Business Association and meetings to address labor needs of the North Central Illinois region at NCIworks. St. Margaret's provides community support through attending IEMA meetings and working on partnerships for state wide emergency response efforts. The organization met with multiple community partners to plan emergency response exercises involving the entire community and plan training and education of volunteer responders. Together with the local EMS system and volunteers, the Hospital was able to provide education, training, and problem resolution for emergency care issues. Also, the Hospital acted as the healthcare liaison in the county Emergency Operations Center for a response to a chemical plant fire.Environmental improvements include meetings with multiple community partners to develop response plans, provide community education, and develop working relationships with local businesses that use, store, or ship chemicals hazardous to the community.Individuals from St. Margaret's Hospital were on the local advisory council that plans local training, response and fundraising for the Red Cross through the Bureau County American Red Cross Advisory Council.The Hospital was involved in Community Partners Against Substance Abuse (CPASA) representing healthcare issues related with substance abuse. The group works on prevention strategies, community awareness and education, and community partnerships.Through the Regional 3 Transportation Advisory Committee the Hospital provided input to planning of regional transportation services and access to healthcare issues. St. Margaret's Hospital worked toward a coordinated transportation system in Bureau and Putnam counties that provides low cost rides to the elderly, low income, and special needs populations. Also, assistance was provided in linking low income and underinsured women with resources so they are able to obtain preventive healthcare.CommunityBuildingActivities
Other InformationPart VI, Line 6: St. Margaret's Hospital's board is comprised of 11 members: Timothy Muntz, CEO, two sisters from the Sisters of Mary of the Presentation, two hospital physicians, the President of the Sisters of Mary of the Presentation Health System, a related, controlling organization, and five community members. To meet the needs of our community, the hospital extends privileges to medical staff that are qualifed and licensed. Our organization is committed to be involved and helping the community. Our employees serve on several committees working to improve the health and lives of the community. The emergency room is open 24 hours a day and everyone is treated regardless of their ability to pay. The hospital operates a separate foundation which conducts fundraising activities and solicits funds that are utilized to further the exempt purpose of the hospital. The foundation makes regular contributions to the hospital for items that directly improve patient care. Surplus funds are reinvested in patient care and facility upgrades.OtherInformation
Affiliated Health Care SystemPart VI, Line 7: We are an affiliate of the Sisters of Mary of the Presentation Health System. St. Margaret's Hospital operates in accordance with the mission, vision, and values of the Sisters of Mary of the Presentation Health System. Our annual budgeting process includes an assessment of how our budget demonstrates a commitment to the values of the system and the system works to ensure we are always mindful of our duty to care for the poor and those in need. St. Margaret's Hospital has a Strategic Plan developed from themes set forth by the health system for all affiliates. The strategic plan is an active document which St. Margaret's Hospital works on continuously and reports back to the health system on our progress toward established goals which again, align with the mission, vision, and values of the organization.AffiliatedHealthCareSystem

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Bureau County Health and Wellness Clinic
500 Elm PlacePrincetonIL61356300129789501(c)(3)17000Donation for operating costs
Arthritis Foundation
1301 Peoria StreetPeruIL61354264639290501(c)(3)5000Corporate sponsorship for fundraising events
March of Dimes
111 West Jackson Blvd Ste 2200ChicagoIL60604131846366501(c)(3)10000Corporate sponsorship for fundraising events
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierProcedure for Monitoring Grants in the U.S.:Identifier
Return ReferencePart I, Line 2:ReturnReference
ExplanationSchedule I, Part I, Line 2: St. Margaret's Hospital provides donations and sponsorships to local organizations. Organization's make requests and the board makes a determination of funding. Each organization provides documentation of what the funding was used for.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Richard Twanow MD
26649207731001067048000144110364080000
Aaron Alton
0383390043869035359026796021212051062600
Robert Morrow MD
1914740716520220048000162980284444000
Timothy Muntz
0290885027731022048024592018171038342700
Kim Santman
016890001207501289018267019276021980700
Jason Dotson
015597007140076209874017727019147300
Dr Paul Perona
7942620510654036002130001576601342342000
Dr Dale Chilson
30628106588830360048000163710986695000
Dr Thaw Tun
34559201224460360048000163710489569000
Dr Shawn Bailey
281195012535105520213000178470446245000
Dr Ram Pankaj
641019000304804800081910657058000

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Part I, Line 1aSt. Margaret's Hospital provides travel for board member companions in the years board members are required to attend a retreat. The retreat is intended for education on ethics, finance and healthcare.
Part I, Line 7Incentive calculations for physicians are based upon net collected receipts of professional services performed by the physician, based upon the physician's contract and paid quarterly based upon the physician's net collected professional receipts. The bonus amounts for Aaron Alton, Timothy Muntz, Kim Santman, and Jason Dotson are determined by Sisters of Mary of the Presentation Health Corporation, a related organization.
Part IIIPart I, Question 3: St. Margaret's Hospital does not pay compensation to Timothy Muntz, President/CEO. This individual is compensated by Sisters of Mary of the Presentation Health System, a related organization, for his services at the Hospital. Sisters of Mary of the Presentation uses some of the methods on line 3 to determine his compensation.Supplemental Information

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
JB Contracting Corp
Board member Jim Brady is also the owner164542Compensation for construction services through JB Contracting Corp.0
Christine Slingsby
Sister to Robert Morrow, MD, board member101614Compensation and benefits as an employee0
Cindy Muntz
Wife to Timothy Muntz, President/CEO40030Compensation and benefits as an employee0
Sue May
Sister-in-law to Dan Fitzgerald, board member36509Compensation and benefits as an employee0
Dr Michael Morrow
Brother to Robert Morrow, MD, board member299807Compensation and benefits as an employee0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part III, line 3Changes in Program ServicesA separate skilled nursing facility unit closed in April 2010. Skilled nursing services are still provided through St. Margaret's Hospital swing bed program.
Form 990, Part VI, Section A, line 3Sisters of Mary of the Presentation Health Corporation (SMP Health Corporation), a related organization, facilitates the management and operations of St. Margaret's Hospital. The officers of the organization are directly compensated by SMP Health Corporation.
Form 990, Part VI, Section A, line 6The sole member of the organization is the Sisters of Mary of the Presentation Health Corporation.
Form 990, Part VI, Section A, line 7aThe member is entitled to vote in the election of Directors and to cast one vote for each Director to be elected. The member is also entitled to one vote on every other matter to be voted on by the member. Votes cast on behalf of the member are cast by the Chief Executive Officer of Sisters of Mary of the Presentation Health Corporation.
Form 990, Part VI, Section A, line 7bThe authority to act on the following matters are exclusively vested in the member of the organization: 1. any change in the philosophy, objectives and purposes of the organization; 2. amendment of the articles of incorporation and bylaws; 3. the election or removal of the Directors; 4. merger or consolidation with any other organization; 5. dissolution of the organization or the sale, lease or exchange of all or substantially all of its property or assets; 6. the sale, lease, transfer or encumbrance of any land, buildings or other assets owned by the organization or in which the organization has or will have equitable or legal title; 7. approval of the annual operating and capital budgets; 8. appointment of the Chief Executive Officer.
Form 990, Part VI, Section A, line 8bThe organization does not have committees with authority to act on behalf of the governing body.
Form 990, Part VI, Section B, line 11Each Director is provided a copy of the Form 990 before it is filed. The President and Vice President of Finance review the Form 990.
Form 990, Part VI, Section B, line 12cEach Director must submit in writing to the Chairperson of the Board and the CEO a list of all business or other organizations of which the individual is an officer, director, trustee, member, owner (either as a sole proprietor or partner), shareholder with a 5% or greater interest in all outstanding voting shares, employee or agent, with which the organization has, or might reasonably in the future enter into, a relationship or a transaction in which the Director would have conflicting interests. Each written statement is resubmitted with any necessary changes each year. The Chairperson of the Board reviews the statements of the Directors and the Vice Chairperson of the Board reviews the statement filed by the Chairperson. When a conflict arises the affected Director makes known the potential conflict, whether disclosed by written statement or not, and after answering any questions, will withdraw from the meeting for as long as the matter continues under discussion. Should the matter be brought to a vote, the affected Director will not vote on it. In the event the Director does not withdraw voluntarily, the Chairperson of the Board as authority to require the Director to remove himself from the room during both the discussion and vote on the matter. In the event the conflict of interest affects the Chairperson, the Vice Chairperson has authority to require the Chairperson remove himself in the same matter. If the matter is the item of business for which a special meeting of the Board was called, the affected Director will not be counted to establish a quorum, and he/she will not participate in the deliberations or vote on it.
Form 990, Part VI, Section B, Line 15: The organization's President/CEO, other officers, and key employees are compensated by Sisters of Mary of the Presentation Health Corporation, a related organization. The compensation process is determined by Sisters of Mary of the Presentation Health Corporation.
Form 990, Part VI, Section C, line 19The organization's governing documents, conflict of interest policy, and financial statements are not available to the public. Financial information is available through the public disclosure copy of the 990.
Form 990, Part VII, Section A:The following individuals devoted time providing services to the following related organizations. Sisters of Mary of the Presentation Health System Aaron Alton 50 hours per week St. Margaret's Hospital Foundation Timothy Muntz .16 hours per week Sisters of Mary of the Presentation Prairieland Home Care Aaron Alton 4 hours per week Sisters of Mary of the Presentation Long Term Care Aaron Alton 12 hours per week
Form 990, Part XI, Line 2c:The governing board of Sisters of Mary of the Presentation assumes responsibility for oversight of the audit for St. Margaret's Hospital.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNA
Sisters of Mary of the Presentation Health Corporation
1202 Page Drive SWFargoND58103450359620Facilitates management and operations of ten related facilitiesND501(c)(3)11aN/A
St Margaret's Hospital Foundation
600 East First StreetSpring ValleyIL61362364042262Provide support to deliver high quality health care for St. Margaret's HospIL501(c)(3)11aN/A
Sisters of Mary of the Presentation Prairieland Home Care
1102 Page Drive SWFargoND581060007450391192Home health and supportive servicesND501(c)(3)9N/A
Presentation Medical Center
213 2nd Avenue NERollaND583670759450227391Acute care hospitalND501(c)(3)3N/A
St Aloisius Medical Center
325 East Brewster StreetHarveyND58341450226729Provision of health care servicesND501(c)(3)3N/A
St Andrew's Hospital
316 Ohmer StreetBottineauND58318450226426Acute care critical access hospitalND501(c)(3)3N/A
St Andrew's Hospital Foundation
316 Ohmer StreetBottineauND58318450413201Provide support to St. Andrew's HospitalND501(c)(3)11aN/A
Sisters of Mary of the Presentation Long Term Care
1202 Page Dr SWFargoND581060007752999939Provide extended care and medically related servicesND501(c)(3)9N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SMP EnterprisesBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 10007AddressLine1
CityFargoCity
StateNDState
ZIP Code581060007ZIPCode
FieldValueIRS element (for citing)
EIN363486506EIN
Primary ActivityHome health care servicesPrimaryActivity
Legal Domicile StateNDLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityCTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg