Civic Intelligence

Kewanee Hospital

EIN 36-2167767 • 501(c)3

Profile

To improve the health and care of those we serve focusing on quality of care regardless of ability to pay.

1051 W South St PO Box 74761443

www.osfsaintluke.org

Siviq Scores

Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.

Liabilities / Assets

Score unavailable

No value available

Liabilities-to-assets requires both liabilities and assets on the latest valid filing.

Source year 2014

Liabilities / Revenue

6th percentile

0.00x

Tied with the lowest-debt nonprofits in its peer group.

501(c)3 • $10M-$25M nonprofits • Source year 2014

Net Margin

41st percentile

1.4%

Higher net margin than 41% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Source year 2014

Top Officer Pay

89th percentile

$446,936

Higher top officer pay than 89% of similar nonprofits.

Top officer pay equals 2.9% of source-year revenue.

501(c)3 • $10M-$25M nonprofits • Source year 2014

Asset Growth

1st percentile

-100%

Faster asset growth than 1% of similar nonprofits.

501(c)3 • $10M-$25M nonprofits • Annualized from 2013 to 2014

Revenue Growth

Score unavailable

No value available

No earlier valid filing was available within the previous three public years.

Source year 2014

Assets

Down

$0

Down $63,172,289 (-100%) from 2013

Liabilities

Down

$0

Down $32,135,070 (-100%) from 2013

Net Assets

Down

$0

Down $31,037,219 (-100%) from 2013

Revenue

$15,573,499

No earlier filing loaded for comparison.

Expenses

Down

$15,350,152

Down $14,474,715 (-49%) from 2013

Net Income

$223,347

No earlier filing loaded for comparison.

Trend Graphs

Balance Sheet Trend

Grouped bars show assets, liabilities, and net assets across loaded filings.

$80M$60M$40M$20M$0Assets 2010: $61,234,580Liabilities 2010: $34,353,976Net Assets 2010: $26,880,6042010Assets 2011: $58,950,000Liabilities 2011: $32,626,606Net Assets 2011: $26,323,3942011Assets 2012: $63,224,383Liabilities 2012: $33,412,238Net Assets 2012: $29,812,1452012Assets 2013: $63,172,289Liabilities 2013: $32,135,070Net Assets 2013: $31,037,2192013Assets 2014: $0Liabilities 2014: $0Net Assets 2014: $02014

Highlighted filing

2014

Assets$0
Liabilities$0
Net Assets$0

Operations Trend

Revenue, expenses, and net income by year, with the latest filing highlighted.

$40M$30M$20M$10M$0Expenses 2010: $31,441,5532010Expenses 2011: $28,020,1742011Expenses 2012: $27,817,7402012Expenses 2013: $29,824,8672013Revenue 2014: $15,573,499Expenses 2014: $15,350,152Net Income 2014: $223,3472014

Highlighted filing

2014

Revenue$15,573,499
Expenses$15,350,152
Net Income$223,347

Filings

Latest Filing Detail
Jump To
Filing Snapshot
Filing Period
Oct 1, 2013 to Mar 31, 2014
Signed
Feb 13, 2015
Return Version
2013v4.0
Gross Receipts
$15,634,186
Mission and Program Overview

Mission

To improve the health and care of those we serve focusing on quality of care regardless of ability to pay.

Operates a 25 bed critical access hospital plus related health care services.

Balance Sheet Detail
LineBeginningEndChange
Assets
Land, Buildings, and Equipment, Net$26,163,332$0▼ $26,163,332
Savings and Temporary Cash Investments$14,251,461$0▼ $14,251,461
Investments in Publicly Traded Securities$12,129,533$0▼ $12,129,533
Accounts Receivable$4,449,879$0▼ $4,449,879
Cash and Non-Interest-Bearing Accounts$2,300,342$0▼ $2,300,342
Prepaid Expenses and Deferred Charges$554,777$0▼ $554,777
Inventories for Sale or Use$356,286$0▼ $356,286
Pledges and Grants Receivable$9,937$0▼ $9,937
Other Notes and Loans Receivable, Net-$0-
Receivable From Disqualified Prsn-$0-
Receivables From Officers Etc-$0-
Investments Other Securities-$0-
Investments Program Related-$0-
Intangible Assets-$0-
Total Assets$63,172,289$0▼ $63,172,289
Other Assets Total$2,956,742$0▼ $2,956,742
Liabilities
Tax Exempt Bond Liabilities$27,305,000--
Accounts Payable and Accrued Expenses$2,781,825--
Other Liabilities$1,726,082$0▼ $1,726,082
Deferred Revenue$322,163--
Total Liabilities$32,135,070$0▼ $32,135,070
Net Assets / Fund Balance
Unrestricted Net Assets$30,306,051$0▼ $30,306,051
Permanently Rstr Net Assets$677,106$0▼ $677,106
Temporarily Rstr Net Assets$54,062$0▼ $54,062
Total Net Assets Fund Balance$31,037,219$0▼ $31,037,219
Total Liabilities and Net Assets / Fund Balance$63,172,289$0▼ $63,172,289

Endowment Activity

PeriodBeginningContrib.Gain/LossOther UsesEnd
2013$9,771,264$6,182▲ $493,327$10,270,773-
2012$9,372,410$3,596▲ $1,084,245$688,987$9,771,264
2011$8,148,017-▲ $1,280,567$56,174$9,372,410
2010$9,131,640-▼ $552,439$431,184$8,148,017
2009$7,210,168$892,005▲ $1,241,101$211,634$9,131,640
Compensation and Service Providers

Employees

NameTitleFull / Part TimeBaseOtherTotal
Daniel Congreve MdTrusteeFT$411,637$35,299$446,936
Lynn a FultonCEOFT$191,677$34,765$226,442
Aimee Shane CrnaCrnaFT$168,628$19,654$188,282
Neil TexCrnaFT$151,752$6,751$158,503
Jennifer JunisCNOFT$136,779$11,695$148,474
Debra Ewing DoPhysicianFT$140,469$6,078$146,547
Preston BeckerFormer CFO/treasurerFT$112,410$23,014$135,424
Priyanka PatelPharmacy DirectorFT$113,616$6,712$120,328
Tamara HarkerNurse PractitionerFT$106,587$5,377$111,964

Board Members and Trustees

NameTitle
Gary PheifferChairperson
Mark RewertsVice Chairperson
Frank TochaTrustee
Mike YaklichTrustee
Rita Hungate MdTrustee
Russell MedleyTrustee
Tom BurhornTrustee
Mary Kay NorthSecretary

Highest Paid Contractors

ContractorServicesLocationCompensation
EppsEd Physian Staffing-$1,635,598
Hospital Care ConsultantsHospitalist Staffing-$577,365
Osf Saint Francis INCMri Services-$560,889
Drinker Biddle & Reath LLPLegal-$474,245
Methodist Reference LaboratoryReference Lab-$221,977
Revenue and Support

Revenue Composition

Contributions and Grants
$33,182
Program Service Revenue
$14,786,927
Investment Income
$676,346
Other Revenue
$77,044
All Other Contributions
$21,182
Change in Net Assets
$223,347

Audited Revenue Reconciliation

Revenue per Audited Statements
$13,777,466
Revenue Not Reported on Financial Statements
$1,796,033
Revenue Not Reported on Form 990
$0
Other Revenue Adjustments
$1,796,033
Total Revenue per Audited Statements
$13,777,466
Total Revenue per Form 990
$15,573,499
Expenses and Functional Allocation

Major Expense Lines

Line ItemAmount
Other Expenses$8,941,092
Salaries, Compensation, and Employee Benefits$6,192,810
Grants and Similar Amounts Paid$216,250
Professional Fundraising Fees$0
Total Fundraising Expense$0

Functional Expense Allocation

Line ItemProgramManagementFundraisingTotal
Other Salaries and Wages$3,120,233$1,095,610-$4,215,843
Fees for Services Other$997,316$699,361-$1,696,677
Depreciation Depletion$464,595$828,492-$1,293,087
Current Officers, Directors, Trustees, and Key Employees$626,211$161,245-$787,456
All Other Expenses$189,549$568,622-$758,171
Other Expenses$717,426$1,386-$718,812
Interest$703,069--$703,069
Other Employee Benefits$431,773$144,851-$576,624
Payroll Taxes$329,002$110,373-$439,375
Grants to Domestic Orgs$216,250--$216,250
Occupancy$27,423$162,461-$189,884
Office Expenses$123,185$65,473-$188,658
Pension Plan Contributions$129,925$43,587-$173,512
Fees for Services Legal-$142,206-$142,206
Insurance$45,434$78,367-$123,801
Fees for Services Accounting-$84,922-$84,922
Advertising-$51,665-$51,665
Travel$29,611$9,251-$38,862
Conferences and Meetings$3,200$11,001-$14,201
Total Functional Expenses$11,091,279$4,258,873$0$15,350,152

Audited Expense Reconciliation

Line ItemAmount
Total Expenses per Form 990$15,350,152
Total Expenses per Audited Statements$13,360,301
Expenses per Audited Statements$13,299,614
Expenses Not Reported on Financial Statements$2,050,538
Other Expense Adjustments$2,050,538
Expenses Not Reported on Form 990$60,687
International Activity

Grant and Assistance Recipients

RecipientLocationCategoryPurposeAmount
80-6264344-501(c)(3)TO SUPPORT THE DELIVERY AND AVAILABILITY OF HIGH-QUALITY HEALTHCARE SERVICES WITHIN KEWANEE HOSPITAL'S SERVICE AREA PER THE AFFILIATION AGREEMENT.$200,000
23-7421930-501(c)(3)To Address the Disparate and Negative Effects of the Illinois Medicaid Program.$16,250
Fundraising, Events, and Gaming
Fundraising activities
No
Gaming activities
No
Professional fundraiser used
No

Fundraising and Gaming Totals

Line ItemAmount
Professional Fundraising Fees$0
Political and Lobbying Activity
Political campaign activity
No
Lobbying activity
Yes
Subject to proxy tax
No
Insider Transactions and Loans

Loans and Receivables

Line ItemBeginningEndChange
Receivables from Disqualified Persons-$0-
Receivables from Officers, Directors, Trustees, and Key Employees-$0-
Governance and Compliance

Governance Checklist

Compiled or reviewed by an accountant
No
Annual disclosure for covered persons
Yes
Audit committee
Yes
Business relationship with family members
No
Business relationship with organization members
No
Material changes to governing documents
No
Compensation from other sources disclosed
No
CEO compensation reviewed
Yes
Other officer compensation reviewed
Yes
Conflict-of-interest policy
Yes
Audited financial statements prepared
No
Key decisions subject to board approval
No
Management duties delegated
No

Governance Explanations

Form 990, Part VI, Section A, Line 8B

The organization does not have any committees with authority to act on behalf of the governing body.

Form 990, Part VI, Section B, Line 11

The form 990 for the six-month period ended march 31, 2014 will be reviewed and approved by the cfo and ceo and then it will be sent to osf (whom this organization merged with effective on april 1, 2014) for their final review and approval. At this time, the former bod is no longer fiducially responsible for the form 990.

Form 990, Part VI, Section B, Line 12C

Any interested person who has a personal or private interest in a measure, contract, resolution, or other transaction presented to the board or a committee thereof for deliberation, authorization, approval, or ratification, or any interested person who reasonably believes such an interest exists in another person, shall make a prompt, full, and frank disclosure in writing of the personal or private interest to the board or committee prior to its acting on such contract or transaction. The interested person shall disclose the existence of his or her personal or private interest and all material facts, known to him or her about the personal or private interest and potential conflict of interest.

Form 990, Part VI, Section B, Line 15

The executive committee of the hospital board of trustees acts as the compensation committee for kewanee hospital. Annually the executive committee of the board meets to review and approve compensation for the executive team which includes the chief executive officer, chief financial officer and chief nursing officer. Resource data for this review comes from salary surveys from a number of sources including sullivan cotter, central illinois society for healthcare human resource administration (cishra), iha executive and management salary survey, and a 990 review through guidestar.org of local and regional organizations. The surveys are analyzed by reviewing applicable cuts of the survey including critical access hospitals, hospitals with like revenue, and similarly staffed organizations. Surveys are also reviewed at regional and national levels. Compensation is proposed to the committee taking into consideration the median range of all salary sources, education/degree, training, certification, and experience. The committee reviews the salary proposal for reasonableness based on the data sources. The chief executive officer makes recommendations for the salaries of the other executives (cfo and cno).

Form 990, Part VI, Section C, Line 19

The organization's governing documents, conflict of interest policy, and financial statements are not made available to the public.

Filing and Contact Details

Filer

EIN
36-2167767
Phone
3098527500

Signing Officer

Name
John M Bowser
Title
CFO
Phone
3098527522
Signed
2015-02-13
Discuss with paid preparer
Yes

Organization Details

Principal Officer
John M Bowser
Formed
1902
Legal Domicile
Il
Voting Board Members
11
Independent Board Members
8
Employees
252
Volunteers
75

Preparer

Preparer
Terri Rexrode CPA Mst
Phone
9206620016
Supplemental Narrative

Additional Explanations

Form 990, Part III, Line 2

UROLOGY

Form 990, Part IX, Line 11G

Purchased medical staff services: program service expenses 997,316. Management and general expenses 699,361. Fundraising expenses 0. Total expenses 1,696,677.

FORM 990, PART XI, LINE 9:

Transfer of assets due to statutory merger -31,958,030.

Form 990, Part XII, Line 2C, Audited Financial Statements

The process has changed from the prior year. Effective april 1, 2014, the hospital was merged into osf healthcare system (osf), an illinois not-for-profit corporation. Due to the statutory merger with osf, the community board of directors no longer had a fiduciary responsibility, and was no longer a part of the final audit process.

Form 990, Part XI, Line 9, Other Changes in Net Assets

Effective april 1, 2014, the hospital was merged into osf healthcare system (osf), an illinois not-for-profit corporation. After the merger, the hospital and osf became a single not-for-profit corporation with osf being the surviving entity and the hospital becoming an operating division of osf known as osf saint luke medical center. The hospital as a separate corporation ceased to exist as of april 1, 2014, with its last day of operations being march 31, 2014. After the merger, the defined contribution plan for hospital employees was frozen and contributions to the plan can no longer be made. As a result of the merger, all assets and liabilities of the hospital as of march 31, 2014, were transferred and assumed by osf. The illinois finance authority revenue bonds, series 2006 assumed by osf and refinanced in august 2014. During march 2014, the hospital transferred $200,000 to kewanee area healthcare trust, a newly created charitable trust as required by the merger of the hospital and osf. Kewanee area healthcare trust is a not-for-profit private foundation established to support the delivery and availability of high-quality health care services to the residents within osf saint luke medical center's service area.

Financial Statement Notes

PART V, LINE 4:

Endowments included on form 990 include assets set aside by the board of trustees for future capital improvements, over which the board retains control and may at its discretion subsequently use for other purposes. Endowments also include donor-restricted funds which will be used for property and equipment additions, reimbursement of operating expenses, and to support health care services. The entire amount was transferred in the merger with osf healthcare system.

PART X, LINE 2:

In order to account for uncertain tax positions, the hospital determines whether it is more likely than not a tax position will be sustained upon examination by the taxing authorities, based on the technical merits of the position, assuming the taxing authorities have full knowledge of all information. If the tax position does not meet the more-likely-than-not recognition threshold, the benefit of that position is not recognized in the financial statements. The hospital has not recorded any assets or liabilities related to uncertain tax positions or unrecognized tax benefits as of the six-month period ended march 31, 2014 and the year ended september 30, 2013. The hospital's income tax returns for tax years 2011 and beyond are no longer subject to examination by tax authorities.

PART XI, LINE 4B - OTHER ADJUSTMENTS:

Cogs on inventory sales -17,625. Nonoperating revenue included in financial statement expense 6,182. Bad debt expense included in financial statement revenue 1,850,538. Rent expense included in form 990 revenue -43,062.

PART XII, LINE 2D - OTHER ADJUSTMENTS:

Cogs on inventory sales 17,625. Rent expense included in form 990 revenue 43,062.

PART XII, LINE 4B - OTHER ADJUSTMENTS:

Bad debt expense included in financial statement revenue 1,850,538. Grant expense not included in financial statement expesne 200,000.

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IRS990/Desc0KEWANEE HOSPITAL IS A 501(C)(3) NOT-FOR-PROFIT CORPORATION LICENSED ASA 25-BED CRITICAL ACCESS HOSPITAL (CAH) LOCATED IN A RURAL COMMUNITY INILLINOIS. KEWANEE HOSPITAL STRIVES TO PROVIDE QUALITY HEALTH CARE TOALL PATIENTS REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP,AGE, OR ABILITY TO PAY. MANY OF THE COMMUNITY MEMBERS WOULD HAVE NOACCESS TO HEALTH CARE WITHOUT KEWANEE HOSPITAL. THE PATIENTS AND THEIRFAMILIES ABILITY TO TRAVEL 50+ MILES TO A LARGER TERTIARY CENTER ISCOMPROMISED BY A LACK OF MOBILITY, A LACK OF INCOME, AND A LACK OFTRANSPORTATION. MANY OF THE SERVICES PROVIDED BY KEWANEE HOSPITAL ARE REIMBURSED AT OR BELOW THE COST TO PROVIDE CARE. KEWANEE HOSPITAL OFFERS A WIDE VARIETY OF SERVICES INCLUDING INPATIENT ACUTE AND CRITICAL CARE, SKILLED LEVEL CARE THROUGH SWING BEDS, DIAGNOSTIC CAPABILITIES INCLUDING RADIOLOGY,LABORATORY AND CARDIOPULMONARY, INPATIENT AND OUTPATIENT REHABILITATION AND TREATMENT, INPATIENT AND OUTPATIENT SURGICAL SERVICES, AND PRIMARY CARE SERVICES THROUGH THE FAMILY HEALTH CLINIC (FHC). DURING THE SIX-MONTH REPORTING PERIOD ENDING MARCH 31, 2014, KEWANEE HOSPITAL PROVIDED 606 DAYS OF INPATIENT CARE AND 212 DAYS OF SWING BED CARE IN THE SIX-MONTH REPORTING PERIOD ENDING MARCH 31, 2014. KEWANEE HOSPITAL PROVIDED A WIDE SCOPE OF OUTPATIENT SERVICES WHICH PROVIDED CARE TO 17,249 OUTPATIENTS. THE EMERGENCY DEPARTMENT (ED) IS A SAFETY NET TO THE RURAL COMMUNITY OF KEWANEE AND THE SURROUNDING AREA. THE ED IS STAFFED 24/7 BY DEDICATED EMERGENCY DEPARTMENT PHYSICIANS; DURING THE SIX-MONTH REPORTING PERIOD ENDING MARCH 31, 2014 THE ED HAD 5,099 VISITS. THE HOSPITAL OFFERS A VARIETY OF SURGICAL SERVICES INCLUDING GENERAL, ORTHOPEDIC, OPHTHALMOLOGIC, ENDOSCOPY AND GASTROENTEROLOGY. IN THE SIX-MONTH PERIOD ENDING MARCH 31, 2014 THE HOSPITAL PROVIDED A TOTAL OF 361 SURGICAL PROCEDURES.
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