2024-08-01T14:29:20-05:00 2023-12-31 351178661 BLUE & CO LLC 2650 EASTPOINT PKWY SUITE 300 LOUISVILLE KY 40223 990 2023-01-01 370860281 HOSPITAL & MEDICAL FOUNDATION OF PARIS INC HOSP 2174654141 721 EAST COURT STREET PARIS IL 61944 OLIVER M SMITH PRESIDENT/CEO 2174654141 2024-08-01 1 1 EMILIE M KNIERIEM CPA P01330194 5029923500 2024-08-01 2023 2024-08-08 14:25:15Z HORIZON HEALTH OLIVER M SMITH 721 EAST COURT STREET PARIS IL 61944 128015390 0 X WWW.MYHORIZONHEALTH.ORG X 1958 IL TO PROVIDE EXCELLENT PATIENT CARE AND PROMOTE WELLNESS THROUGHOUT OUR COMMUNITIES. 11 10 969 31 0 0 2230063 1513217 103707184 124232814 43061 61783 1887679 2198576 107867987 128006390 13900 25919 0 0 63739503 74336489 0 0 0 42910583 52699227 106663986 127061635 1204001 944755 81984497 91262818 30337739 38140069 51646758 53122749 TO PROVIDE EXCELLENT PATIENT CARE AND PROMOTE WELLNESS THROUGHOUT OUR COMMUNITIES. 0 0 107431813 25919 126196043 OPERATION OF A HOSPITAL AND MEDICAL CLINIC - 3,390 INPATIENT DAYS PLUS EMERGENCY, ANCILLARY, AND OUTPATIENT SERVICES FOR RESIDENTS IN PARIS, EDGAR COUNTY, EAST IL, AND CENTRAL IL. 107431813 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 1 88 0 1 969 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X MARTIN D ADAMS CPA 2174654141 721 EAST COURT STREET PARIS IL 61944 NOLAN LONGEST CHAIRMAN 1.00 X X 0 0 0 MARY LIZ WRIGHT VICE CHAIRWOMAN 1.00 X X 0 0 0 J RENEE CRAIG TREASURER 1.00 X X 0 0 0 BRIAN BLAIR SECRETARY 1.00 X X 0 0 0 DAVID FRISSE BOARD MEMBER 1.00 1.00 X 0 0 0 TOM HEBERMEHL BOARD MEMBER (TERM END 01/23) 1.00 X 0 0 0 SCOTT HOGAN BOARD MEMBER 1.00 X 0 0 0 JAIME HOULIHAN BOARD MEMBER 1.00 X 0 0 0 DARRIN JOHNSON BOARD MEMBER 1.00 X 0 0 0 AMANDA NEAL BOARD MEMBER (TERM END 07/23) 1.00 X 0 0 0 DOUG SMITTKAMP BOARD MEMBER (TERM END 06/23) 1.00 X 0 0 0 REID SUTTON BOARD MEMBER 1.00 X 0 0 0 RAHAT SHEIKH MD BOARD MEMBER/CHIEF MEDICAL STAFF 40.00 X X 530597 0 46112 BRUCE YOUNG BOARD MEMBER 1.00 X 0 0 0 DR PHILIP HOLLOWAY BOARD MEMBER (04/23-07/23) 1.00 X 0 0 0 LOGAN KNOWLES BOARD MEMBER (04/23-07/23) 1.00 X 0 0 0 OLIVER M SMITH CEO 40.00 X 453810 0 37710 MARTIN D ADAMS CFO 40.00 1.00 X 311487 0 39613 RACHEL KELLEY CHIEF NURSING OFFICER 40.00 X 198138 0 27667 ADAM SCHNEIDER CRNA 40.00 X 923740 0 59283 DR JOHN VENTURA PHYSICIAN 40.00 X 795603 0 20205 DR JEFFEREY BOLLENBACHER PHYSICIAN 40.00 X 813428 0 46102 DR JAMES HARRY GRIGGS PHYSICIAN 40.00 X 655404 0 45212 DR HARISH KEMPEGOWDA PHYSICIAN 40.00 X 852587 0 58834 5534794 0 380738 101 0 1 0 SYCAMORE PAIN & WELLNESS 1378 S STATE ROAD 46 TERRE HAUTE IN 47803 PAIN MANAGEMENT PROVIDER SERVICES 3186051 COCHRAN DESIGN GROUP LTD 1231 E WOOD STREET PARIS IL 61944 GENERAL CONTRACTOR 2862106 THE REVENUE CYCLIST LLC PO BOX 129 STE GENEVIEVE MO 63670 REVENUE CYCLE/BILLING CONSULTING 1332159 SYCAMORE ENGINEERING 1010 CHESTNUT ST PO BOX 1056 TERRE HAUTE IN 47808 ENGINEERING , CONSTRUCTION AND MAINTENAN 1282780 LABORATORY CORP OF AMERICA PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 811864 27 1488827 24390 20788 1513217 NET PATIENT SERVICE REVENUE 621999 121755387 121755387 340B PHARMACY REVENUE 621399 2477427 2477427 124232814 63771 63771 111300 0 111300 111300 111300 7012 9000 -1988 -1988 -1988 CAFETERIA REVENUE 722310 194469 194469 PROFESSIONAL FEE REVENUE 900099 124047 124047 OTHER PHARMACY REVENUE 621399 62931 62931 1705829 1705829 2087276 128006390 126196043 0 297130 X 25919 25919 1645134 1308571 336563 55022570 43765987 11256583 1721750 1372995 348755 13110876 10455155 2655721 2836159 2261671 574488 495712 302579 193133 143426 87546 55880 51250 51250 17157933 15049801 2108132 662638 615478 47160 4791889 4365602 426287 1258378 1049289 209089 427717 397276 30441 1211449 1041846 169603 5543599 4767495 776104 1292752 1111767 180985 MEDICAL SUPPLIES AND DR 15139147 15139147 PROVIDER TAX 2071119 2071119 REPAIRS AND MAINTENANCE 1810090 1646143 163947 TAXES AND LICENSES 194208 180386 13822 447920 416041 31879 127061635 107431813 19629822 0 15350 130797 910577 1488574 16277857 17538907 780700 1592944 58843 21507 3028371 3285093 1032492 1154422 111713918 51303938 58675259 60409980 1205048 5640594 81984497 91262818 7905962 9279333 106038 106038 21135434 25177694 1190305 3577004 30337739 38140069 X 51646758 53122749 51646758 53122749 81984497 91262818 X 944755 531236 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 23083 23083 0 PART II-B, LINE 1: HORIZON HEALTH PAID MEMBERSHIP DUES TO IHA AND AHA IN 2023. 37% AND 32% OF THE TOTAL IHA AND AHA DUES WERE ALLOCABLE TOWARDS LOBBYING EXPENDITURES, RESPECTIVELY. 1626832 1626832 73200538 26545985 46654553 154786 138603 16183 29111250 22113826 6997424 7620512 2505524 5114988 60409980 ROU ASSETS - FINANCING LEASE 2797745 ROU ASSET - OPERATING LEASE 661065 ESTIMATED THIRD PARTY SETTLEMENTS 2156784 MINORITY INTEREST INVESTMENT 25000 5640594 OPERATING LEASE LIABILITY 661065 FINANCE LEASE LIABILITY 2915939 3577004 X PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. 1 1 1 X 1 X 1 1 0 1 1 2754250 2754250 0.02170 20804804 13171847 7632957 0.06010 23559054 13171847 10387207 0.08180 4 1264 274415 274415 0.00220 1 164 136058 136058 0.00110 0 0 23 42610 42610 0.00030 5 1451 453083 453083 0.00360 5 1451 24012137 13171847 10840290 0.08540 14652 14652 0.00010 269 269 0.00000 7734 7734 0.00010 22655 22655 0.00020 0 5243422 1573027 20608594 38130405 -17521811 X 1 1 1 1 PARIS COMMUNITY HOSPITAL 721 E COURT ST PARIS IL 61944 WWW.MYHORIZONHEALTH.ORG 0001784 X X X X X FAMILY MEDICAL CENTER PARIS COMMUNITY HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X WWW.MYHORIZONHEALTH.ORG X 1 22 1 WWW.MYHORIZONHEALTH.ORG 0 1 X 150.000000000000 250.000000000000 X X 1 1 X X X 1 X WWW.MYHORIZONHEALTH.ORG/FINANCIALASSISTANCE X WWW.MYHORIZONHEALTH.ORG/FINANCIALASSISTANCE X WWW.MYHORIZONHEALTH.ORG/FINANCIALASSISTANCE X X X X X 1 X 0 X 1 X 0 0 PARIS COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: THIS COMMUNITY HEALTH NEEDS ASSESSMENT WILL SERVE AS A GUIDE FOR PLANNING AND IMPLEMENTATION OF HEALTHCARE INITIATIVES THAT WILL ALLOW THE HOSPITAL AND ITS PARTNERS TO BEST SERVE THE EMERGING HEALTH NEEDS OF PARIS AND THE SURROUNDING AREA. THE CHNA PROCESS WAS COORDINATED BY THE EXECUTIVE ASSISTANT. TWO FOCUS GROUPS MET TO DISCUSS THE STATE OF OVERALL HEALTH AND WELLNESS IN THE HORIZON HEALTH SERVICE AREA AND TO IDENTIFY HEALTH CONCERNS AND NEEDS IN THE DELIVERY OF HEALTHCARE AND HEALTH SERVICES IN ORDER TO IMPROVE WELLNESS AND REDUCE CHRONIC ILLNESS FOR ALL RESIDENTS. THE FOCUS GROUPS INCLUDED REPRESENTATION OF HEALTHCARE PROVIDERS, COMMUNITY LEADERS, COMMUNITY SERVICES PROVIDERS, SCHOOLS, A COMMUNITY COLLEGE, FAITH-BASED ORGANIZATIONS, LAW ENFORCEMENT, LOCAL ELECTED OFFICIALS, PUBLIC HEALTH, AND OTHERS. SOME MEMBERS OF THESE GROUPS PROVIDED SERVICES TO UNDERSERVED AND UNSERVED PERSONS AS ALL OR PART OF THEIR ROLES. THE FINDINGS OF THE FOCUS GROUPS WERE PRESENTED, ALONG WITH SECONDARY DATA ANALYZED BY THE CONSULTANT, TO A THIRD GROUP FOR IDENTIFICATION AND PRIORITIZATION OF THE SIGNIFICANT HEALTH NEEDS FACING THE COMMUNITY. THE GROUP CONSISTED OF REPRESENTATIVES OF PUBLIC HEALTH, COMMUNITY LEADERS, HEALTHCARE PROVIDERS, SCHOOLS, AND COMMUNITY SERVICES PROVIDERS. MANY PROVIDE SERVICES TO POTENTIALLY UNDERSERVED AND UNSERVED POPULATIONS. PARIS COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: AT THE CONCLUSION OF 2 FOCUS GROUPS' REVIEW AND DISCUSSION, THEY ADVANCED THE FOLLOWING NEEDS:1. MENTAL HEALTH:- CONTINUE TO IDENTIFY STRATEGIC PARTNERS IN ORDER TO CREATE SUSTAINABILITY FOR PROGRAMS AND SERVICES- DEVELOP CRISIS COVERAGE- CONTINUE TO IMPROVE ACCESS TO CARE AT ALL LEVELS2. TRANSPORTATION:- EXPLORE WAYS TO ADDRESS GAPS IN NON-EMERGENT/NON-AMBULANCE MEDICAL TRANSPORTATION (LONGER HOURS, FLEXIBLE TRANSPORTATION FOR LOW-INCOME RESIDENTS IN OUTLYING AREAS, BETTER COORDINATION AND COOPERATION AMONG SYSTEMS IN DIFFERENT COUNTIES).- EXPLORE WAYS TO ADDRESS GAPS IN MEDICAL TRANSPORTATION (OUT-OF-AREA TRANSPORTATION FOR MEDICAL APPOINTMENTS AND CARE) 3. DEVELOP/EXPAND COMMUNITY EDUCATION ABOUT INSURANCE, INCLUDING:- MEDICARE AND MEDICAID (AVAILABILITY, CHOICES, AND COVERAGE)4. DEVELOP/EXPAND COMMUNITY EDUCATION ABOUT PARENTING AND FAMILY WELLNESS5. IMPROVE COOPERATION AND COORDINATION AMONG PROVIDERS, AGENCIES, COMMUNITY GROUPS, AND INTEREST PERSONS IN ORDER TO PROMOTE COMMUNITY WELLNESSTHE RESULTS OF THE ASSESSMENT PROCESS WERE THEN PRESENTED TO SENIOR STAFF AT HORIZON HEALTH THROUGH A FACILITATED DISCUSSION FOR DEVELOPMENT OF A PLAN TO ADDRESS THE IDENTIFIED AND PRIORITIZED NEEDS. THE GROUP ADDRESSED THE NEEDS WITH THE FOLLOWING STRATEGIES:- HORIZON HEALTH WILL RECRUIT TWO ADVANCED PRACTICE PSYCHIATRIC NURSES.- HORIZON HEALTH WILL EXPAND THE TYPES AND NUMBERS OF MENTAL HEALTH THERAPISTS.- HORIZON HEALTH WILL DEVELOP COMMUNITY PARTNERSHIPS TO SUPPORT GROWTH AND SUSTAINABILITY FOR PROGRAMS AND SERVICES.- HORIZON HEALTH WILL WORK WITH COMMUNITY PARTNERS TO ASSESS NON-MEDICAL AND MEDICAL TRANSPORTATION GAPS AND DEVELOP A COOPERATIVE PLAN TO ADDRESS GAPS WHERE POSSIBLE.- HORIZON HEALTH WILL SHARE CURRENT INFORMATION ABOUT AVAILABLE TRANSPORTATION OPTIONS AND HOW TO ACTIVATE THEM WITH ALL STAFF.- HORIZON HEALTH WILL EXPLORE DEVELOPING RESOURCES, IN-HOUSE AND IN COLLABORATION WITH PARTNERS, TO PURSUE GRANTS AND OTHER FUNDING OPPORTUNITIES FOR THESE AND OTHER EFFORTS.- HORIZON HEALTH WILL OFFER A LIVE (AND WEB VIEWABLE) EDUCATION PROGRAM ON MEDICARE. 17 1 - PARIS CLINIC 727 E COURT ST PARIS IL 61944 RURAL HEALTH CLINIC 2 - CHRISMAN CLINIC 112 W MADISON AVE CHRISMAN IL 61924 RURAL HEALTH CLINIC 3 - SENIOR CARE 745 EAST COURT STREET PARIS IL 61944 CLINIC 4 - OAKLAND CLINIC 5 S WALNUT ST OAKLAND IL 61943 RURAL HEALTH CLINIC 5 - WALK-IN CLINIC EZ CARE (PARIS) 1 PHIPPS LANE PARIS IL 61944 RURAL HEALTH CLINIC 6 - NAL HEALTH CLINIC 1 PHIPPS LANE PARIS IL 61944 CLINIC 7 - WALK-IN CLINIC EZ CARE (MARSHALL) 1602 N IL HWY 1 MARSHALL IL 62441 RURAL HEALTH CLINIC 8 - ACKLIN-SHACKELFORD CLINIC 723 E COURT ST PARIS IL 61944 CLINIC 9 - MARSHALL SPECIALTY CLINIC 1006 S 6TH STREET MARSHALL IL 62441 CLINIC 10 - TERRE HAUTE SPECIALTY CLINIC 3736 SOUTH 4TH STREET TERRE HAUTE IN 47802 CLINIC 11 - SYCAMORE PAIN & WELLNESS CLINIC 1378 SOUTH STATE ROAD 46 TERRE HAUTE IN 47803 CLINIC 12 - EDUCATION CENTER 15197 US HIGHWAY 150 PARIS IL 61944 EDUCATION 13 - HOME CARE 798 E COURT STREET PARIS IL 61944 CLINIC 14 - DIALYSIS CENTER 725 EAST COURT STREET PARIS IL 61944 CLINIC 15 - PAIN MANAGEMENT CLINIC 15317 US HIGHWAY 150 PARIS IL 61944 CLINIC 16 - OCCUPATIONAL HEALTH 15323 US HIGHWAY 150 PARIS IL 61944 CLINIC 17 - HORIZON HEALTH MEDICAL EQUIPMENT 721 EAST COURT STREET PARIS IL 61944 MEDICAL EQUIPMENT PART I, LINE 3C: ELIGIBILITY CRITERIA: THE FOLLOWING CLASSES OF INDIVIDUALS AND CATEGORIES OF CARE ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY:1. FINANCIALLY IN NEED: TO QUALIFY AS FINANCIALLY IN NEED, THE PATIENT MUST BE UNINSURED OR UNDERINSURED AND HAVE A HOUSEHOLD INCOME OF EQUAL TO OR LESS THAN 250% OF FEDERAL POVERTY LEVEL. THE FOLLOWING DEFINITIONS APPLY TO SUCH ELIGIBILITY CRITERIA: "UNINSURED": A PATIENT WHO (I) HAS NO HEALTH INSURANCE OR COVERAGE UNDER GOVERNMENTAL HEALTH CARE PROGRAMS, AND (II) IS NOT ELIGIBLE FOR ANY OTHER THIRD-PARTY PAYMENT SUCH AS WORKER'S COMPENSATION OR CLAIMS AGAINST OTHERS INVOLVING ACCIDENTS. "UNDERINSURED": A PATIENT WHO (I) HAS LIMITED HEALTH INSURANCE COVERAGE THAT DOES NOT PROVIDE COVERAGE FOR HOSPITAL SERVICES OR OTHER MEDICALLY NECESSARY SERVICES PROVIDED BY HORIZON HEALTH OR (II) HAS EXCEEDED THE MAXIMUM LIABILITY UNDER HIS/HER INSURANCE COVERAGE. "HOUSEHOLD INCOME": THE TOTAL INCOME OF ALL MEMBERS LIVING IN THE PATIENT'S HOUSEHOLD OVER THE TWELVE (12) MONTHS PRIOR TO APPLICATION FOR ASSISTANCE UNDER THIS POLICY.2. FAILURE TO APPLY FOR MEDICAID: PATIENTS WHO MAY BE ELIGIBLE FOR MEDICAID AND FAIL TO APPLY FOR MEDICAID AT HORIZON HEALTH'S REQUEST ARE NOT CONSIDERED ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY.3. CATEGORIES OF CARE ELIGIBLE FOR FINANCIAL ASSISTANCE: PROVIDED THAT THE PATIENT QUALIFIES AS FINANCIALLY IN NEED, THE FOLLOWING CLASSES OF CARE ARE ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY:- EMERGENCY MEDICAL CARE- MEDICALLY NECESSARY CAREREGARDLESS OF A PATIENT'S STATUS AS FINANCIALLY IN NEED, COSMETIC PROCEDURES, SPECIAL CASH PAY SERVICES, AND OCCUPATIONAL HEALTH SERVICES ARE NOT ELIGIBLE FOR FINANCIAL ASSISTANCE UNDER THIS POLICY. VETERANS: FINANCIAL ASSISTANCE IS ONLY AVAILABLE FOR SERVICES APPROVED BY THE VA TO BE PROVIDED BY HORIZON HEALTH. PART II, COMMUNITY BUILDING ACTIVITIES: THE ORGANIZATION CONDUCTS HEALTH FAIRS IN THE COMMUNITY THROUGHOUT THE YEAR AND PROVIDES VARIOUS HEALTH SCREENINGS FOR INDUSTRY WORKERS AND THE PUBLIC IN GENERAL. A MONTHLY NEWSLETTER IS DEVOTED TO INFORMING THE PUBLIC ABOUT TIMELY HEALTH ISSUES AND THE AVAILABILITY OF THE LOCAL HEALTH SERVICES. THE VOLUNTEER GOVERNING BODY IS COMPRISED MOSTLY OF PEOPLE WHO RESIDE IN THE PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR CONTRACTORS OF THE ORGANIZATION NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEDGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR SOME OF ALL OF ITS DEPARTMENTS. ALL SURPLUS FUNDS ARE USED TO IMPROVE FACILITIES AND TO REPLACE OR UPGRADE EQUIPMENT TO PROVIDE THE HIGHEST QUALITY OF PATIENT CARE POSSIBLE. CONTINUOUS MEDICAL EDUCATION IS PROVIDED TO PHYSICIANS AND STAFF. PART III, LINE 2: THE ORGANIZATION USED AN OVERALL COST TO CHARGE RATIO TO DETERMINE THE AMOUNTS ON PART III, SECTION A. PART III, LINE 3: IT IS ESTIMATED THAT 30% OF BAD DEBTS WOULD BE ELIGIBLE FOR FINANCIAL ASSISTANCE IF THE PATIENTS APPLIED AND PROVIDED FAMILY INCOME INFORMATION. THIS PORTION OF BAD DEBT SHOULD BE INCLUDED IN COMMUNITY BENEFIT AS THE PATIENTS ARE UNINSURED AND PRESUMED TO BE NEEDY AND UNABLE TO PAY FOR THE SERVICES. PART III, LINE 4: PART III, LINE 4: GENERALLY, PATIENTS WHO ARE COVERED BY THIRD-PARTY PAYORS ARE RESPONSIBLE FOR RELATED DEDUCTIBLES AND COINSURANCE, WHICH VARY IN AMOUNT. THE HOSPITAL ALSO PROVIDES SERVICES TO UNINSURED PATIENTS AND OFFERS THOSE UNINSURED PATIENTS A DISCOUNT, EITHER BY POLICY OR LAW, FORM STANDARD CHARGES. THE HOSPITAL ESTIMATES THE TRANSACTION PRICE FOR PATIENTS WITH DEDUCTIBLES AND COINSURANCE AND FROM THOSE WHO ARE INSURED BASED ON HISTORICAL EXPERIENCE AND CURRENT MARKET CONDITIONS. THE INITIAL ESTIMATE OF THE TRANSACTION PRICE IS DETERMINED BY REDUCING THE STANDARD CHARGE BY ANY CONTRACTUAL ADJUSTMENTS, DISCOUNTS, AND IMPLICIT PRICE CONCESSIONS BASED ON HISTORICAL COLLECTION EXPERIENCE. SUBSEQUENT CHANGES TO THE ESTIMATE OF THE TRANSACTION PRICE ARE GENERALLY RECORDED AS ADJUSTMENTS TO PATIENT SERVICE REVENUE IN THE PERIOD OF THE CHANGE. SUBSEQUENT CHANGES THAT ARE DETERMINED TO BE THE RESULT OF AN ADVERSE CHANGE IN THE PATIENT'S ABILITY TO PAY ARE RECORDED AS BAD DEBT EXPENSE.AT DECEMBER 31, 2023 AND 2022, IMPLICIT PRICE CONCESSIONS (PROVISION FOR BAD DEBT) INCLUDE $5,243,422 AND $5,122,612, RESPECTIVELY. PART III, LINE 8: THE SAME COST TO CHARGE RATIO CALCULATED TO DETERMINE COMMUNITY BENEFIT EXPENSE IN PART I WAS APPLIED TO MEDICARE CHARGES TO DETERMINE ESTIMATED COST. UNPAID COST OF MEDICARE REPRESENTS THE COST OF PROVIDING SERVICES TO PRIMARILY ELDERLY BENEFICIARIES OF THE MEDICARE PROGRAM, IN EXCESS OF PAYMENTS FOR THOSE SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS, STATES THAT IF A HOSPIATL SERVES PATIENTS WITH GOVERNMENT BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT. PART III, LINE 9B: PATIENTS WHO ARE KNOWN TO QUALIFY FOR FINANCIAL ASSISTANCE ARE IDENTIFIED AT REGISTRATION WITH A UNIQUE FINANCIAL CLASS CODE. IF THEY QUALIFY FOR 100% ASSISTANCE, THEIR ACCOUNT IS ADJUSTED TO ZERO AND NO BILL IS SENT. IF THEY QUALIFY FOR PARTIAL ASSISTANCE, THEIR ACCOUNT IS ADJUSTED ACCORDINGLY BEFORE A BILL IS SENT FOR THE BALANCE DUE. PART VI, LINE 2: ON A BI-ANNUAL BASIS THE ADMINISTRATIVE STAFF MEET IN A RETREAT WITH THE BOARD OF DIRECTORS AND MEDICAL STAFF TO ASSESS AND PLAN FOR THE NEEDS OF THE COMMUNITY. A PHONE SURVEY OF 375 RESIDENTS OF THE HOSPITAL'S SERVICE AREA IS PERFORMED TO GET COMMUNITY INPUT. PART VI, LINE 3: NOTICES OF THE AVAILABILITY OF FINANCIAL ASSITANCE ARE POSTED IN THE ADMISSIONS AREA OF THE HOSPITAL AND MEDICAL CENTER AND IN THE EMERGENCY ROOM. UNINSURED PATIENTS NOT ALREADY IN THE PROGRAM ARE GIVEN A BROCHURE THAT EXPLAINS THE PROGRAM ALONG WITH AN APPLICATION WHEN THEY ARE ADMITTED OR REGISTERED. A BROCHURE IS INCLUDED IN THE INFORMATION PACKET GIVEN TO ALL INPATIENTS. INFORMATION IS ALSO POSTED ON THE HOSPITAL'S WEBISTE. THE FINANCIAL ASSISTANCE COORDINATOR FOLLOWS UP WITH PATIENTS TO ANSWER QUESTIONS AND PROVIDE ASSISTANCE IN APPLYING. ALL BILLS SENT TO THE HOSPITAL PATIENTS INCLUDE A MESSAGE ABOUT THE AVAILABILITY OF FINANCIAL ASSISTANCE AND WHO TO CONTACT TO APPLY. PATIENTS ARE SCREENED FOR STATE PROGRAMS AND ASSISTED WITH APPLICATIONS. PART VI, LINE 4: HORIZON HEALTH HAS DEFINED ITS PRIMARY SERVICE AREA AND POPULATION BY ZIP CODES THAT INCLUDE EDGAR COUNTY AND PARTS OF CLARK, COLES, AND DOUGLAS COUNTIES. A TOTAL OF 25,405 PEOPLE LIVE IN THE 771.50 SQUARE MILE REPORT AREA DEFINED FOR THIS ASSESSMENT ACCORDING TO THE U.S. CENSUS BUREAU AMERICAN COMMUNITY SURVEY 2016-2020 5-YEAR ESTIMATES. THE POPULATION DENSITY FOR THIS AREA, ESTIMATED AT 33 PERSONS PER SQUARE MILE, IS LESS THAN THE NATIONAL AVERAGE POPULATION DENSITY OF 92 PERSONS PER SQUARE MILE. THE AVERAGE HOUSEHOLD SIZE OF THE AREA, AT 2.4, IS LOWER THAN BOTH ILLINOIS (3.00) AND THE U.S. (2.50). MEDIAN AGE IS 44.1 YEARS, WHICH IS HIGHER THAN BOTH ILLINOIS (38.6) AND THE U.S. (38.0). THE LARGEST EDUCATION SEGMENT IS HIGH SCHOOL GRADUATE, FOLLOWED BY SOME COLLEGE. THE UNEMPLOYMENT RATE OF 3.4% IS LOWER THAN BOTH ILLINOIS (4.6%) AND THE U.S. (3.6%) ALSO, MEDIAN FAMILY HOUSEHOLD INCOME IN THE SERVICE AREA ($63,962) IS LOWER THAN THE ILLINOIS' MEDIAN FAMILY HOUSEHOLD INCOME ($65,886) AND HIGHER THAN THE U.S. ($61,937). PART VI, LINE 5: COMMUNITY BENEFITS ARE PROGRAMS AND SERVICES DESIGNED TO IMPROVE HEALTH IN COMMUNITIES AND INCREASE ACCESS TO HEALTHCARE. HORIZON HEALTH PERFORMS COMMUNITY BENEFIT ACTIVITIES IN A NUMBER OF WAYS, INCLUDING OFFERING FREE HEALTH-RELATED EVENTS AND PROGRAMS THROUGHOUT ITS SERVICE AREA. HORIZON HEALTH PROVIDED 6,180 STAFF HOURS OF FREE OR DISCOUNTED PROGRAMS/SERVICES IN 2023. MAJOR CATEGORIES INCLUDED PROVIDING FREE CPR/AED/FIRST AID CLASSES; COMMUNITY HEALTH EDUCATION; EDUCATION/JOB SHADOWING FOR HIGH SCHOOL STUDENTS, MEDICAL STUDENTS, AND OTHER HEALTHCARE PROFESSIONALS; AND FINANCIAL ENROLLMENT ASSISTANCE.HORIZON HEALTH'S COMMUNITY INVOLVEMENT INCLUDED:- NUMEROUS HEALTH & CAREER FAIRS- SCHOOL TOURS- SPEAKING ENGAGEMENTS: 25 DINE WITH A DOC EVENTS, EDGAR CLARK CAREER EXPLORATION LEADERSHIP ACADEMY (ECCEL), OSHER LIFELONG LEARNING INSTITUTE (OLLI) - WELLNESS (WEAR RED EVENT, ANNUAL FOOT CARE CLINIC, BLOOD TYPING & GLUCOSE TESTING AT THE LOCAL HIGH SCHOOL)- FLU SHOT CLINICS- MONTHLY RADIO PODCASTS (MIDWEST COMMUNICATIONS 100.7 FM)- EDUCATION SEGMENTS (WEIU-TV) PART VI, LINE 6: N/A PART VI, LINE 7, REPORTS FILED WITH STATES IL X X 0 1 0 0 0 0 0 0 0 ADAM SCHNEIDER CRNA 448391 0 473031 0 2318 0 19800 0 39483 0 983023 0 0 0 DR HARISH KEMPEGOWDA PHYSICIAN 850269 0 0 0 2318 0 19800 0 39034 0 911421 0 0 0 DR JEFFEREY BOLLENBACHER PHYSICIAN 810110 0 0 0 3318 0 19800 0 26302 0 859530 0 0 0 DR JOHN VENTURA PHYSICIAN 718640 0 74400 0 2563 0 19800 0 405 0 815808 0 0 0 DR JAMES HARRY GRIGGS PHYSICIAN 652086 0 0 0 3318 0 19800 0 25412 0 700616 0 0 0 RAHAT SHEIKH MD BOARD MEMBER/CHIEF MEDICAL STAFF 411600 0 104548 0 14449 0 19800 0 26312 0 576709 0 0 0 OLIVER M SMITH CEO 348846 0 35000 0 69964 0 19800 0 17910 0 491520 0 0 0 MARTIN D ADAMS CFO 284050 0 0 0 27437 0 18806 0 20807 0 351100 0 0 0 RACHEL KELLEY CHIEF NURSING OFFICER 190097 0 0 0 8041 0 12097 0 15570 0 225805 0 0 0 PART I, LINE 4B CERTAIN INDIVIDUALS LISTED ON 990, PART VII PARTICIPATED IN A SPLIT DOLLAR LIFE INSURANCE PLAN. PLEASE REFER TO SCHEDULE L FOR PARTICIPANTS, PREMIUMS AND OUTSTANDING LOAN AMOUNTS. RAHAT SHEIKH MD BOD/OFFICER TO FUND SPLIT DOLLAR LIFE INSURANCE PREMIUMS FOR SUPPLEMENTAL LIFE INSURANC X 371538 392746 0 1 1 DR SODVADIYA EMPLOYEE TO FUND SPLIT DOLLAR LIFE INSURANCE PREMIUMS FOR SUPPLEMENTAL LIFE INSURANC X 681784 715522 0 1 1 DR HARISH KEMPEGOWDA EMPLOYEE TO FUND SPLIT DOLLAR LIFE INSURANCE PREMIUMS FOR SUPPLEMENTAL LIFE INSURANC X 313846 324453 0 1 1 ADAM SCHNEIDER EMPLOYEE TO FUND SPLIT DOLLAR LIFE INSURANCE PREMIUMS FOR SUPPLEMENTAL LIFE INSURANC X 152885 160223 0 1 1 1592944 X VEHICLE 1 20788 FMV 0 0 0 FORM 990, PART VI, SECTION A, LINE 1A THE CORPORATION SHALL HAVE AN EXECUTIVE COMMITTEE, WHICH SHALL CONSIST OF NOT FEWER THAN THREE (3) NOR MORE THAN FIVE (5) PERSONS, AS SHALL FROM TIME TO TIME BE PRESCRIBED IN A RESOLUTION OF THE BOARD OF DIRECTORS, EACH OF WHOM SHALL BE AN ELECTED DIRECTOR. THE CHAIR SHALL BE A MEMBER OF THE EXECUTIVE COMMITTEE, SHALL SERVE AS THE CHAIRMAN OF SUCH COMMITTEE, AND , SUBJECT TO THE APPROVAL OF THE BOARD OF DIRECTORS AT EACH ANNUAL MEETING, SHALL APPOINT THE OTHER MEMBERS OF SUCH COMMITTEE, EACH FOR A ONE (1) YEAR TERM. THE EXECUTIVE DIRECTOR, IF ANY, SHALL SERVE AS EX OFFICIO, NON-VOTING MEMBER OF THE EXECUTIVE COMMITTEE. WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE ALL POWERS OF THE BOARD OF DIRECTORS THAT MAY BE LEGALLY DELEGATED TO THE EXECUTIVE COMMITTEE. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS PREPARED BY AN INDEPENDENT AUDIT FIRM. THE HOSPITAL POSTS FORM 990 TO THE HOSPITAL'S INTRANET AND EACH MEMBER OF THE BOARD OF DIRECTORS, CEO, AND CFO ARE ASKED TO REVIEW BEFORE THE FORM 990 IS FILED. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE GIVEN TO THE BOARD MEMBERS YEARLY AND ARE ACCUMULATED BY THE PRESIDENT/CEO'S SECRETARY WHO MONITORS THAT ALL ARE RETURNED. WHEN THERE IS A DIRECT CONFLICT OR PERCEIVED CONFLICT, THOSE MEMBERS INVOLVED ABSTAIN FROM VOTING ON THAT PARTICULAR MATTER AND ABSTENTIONS ARE NOTED IN THE MINUTES. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION PROCESS FOR TOP OFFICIAL: CEO/CFO REVIEW PROCESS - EACH BOARD MEMBER IS ASKED TO COMPLETE A SURVEY THAT SCORES THE CEO/CFO IN SEVERAL AREAS OF JOB PERFORMANCE AND COMMUNITY INVOLVEMENT. THE EXECUTIVE COMMITTEE OF THE BOARD REVIEWS THE SURVEY RESULTS AND REVIEWS SALARY SURVEY DATA FOR THE SAME POSITIONS IN COMPARABLE ORGANIZATIONS. COMPENSATION PROCESS FOR OFFICERS: PHYSICIAN EMPLOYEE REVIEW PROCESS - PHYSICIANS ARE REVIEWED BY THE CEO. NON-PHYSICIAN REVIEW PROCESS - NON-PHYSICIAN EMPLOYEES ARE EVALUATED BY THE CEO AND MARKET BENCHMARK DATA IS OBTAINED FOR REVIEW IN MAKING A DECISION ON SALARY CHANGES. COL ADJUSTMENTS ARE APPROVED BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST FROM ADMINISTRATION. FORM 990, PART IX, LINE 11G CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 3,262,585. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,262,585. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 4,119,864. MANAGEMENT AND GENERAL EXPENSES 1,039,760. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,159,624. PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 2,845,150. MANAGEMENT AND GENERAL EXPENSES 283,362. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,128,512. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 4,822,202. MANAGEMENT AND GENERAL EXPENSES 785,010. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,607,212. FORM 990, PART XI, LINE 9: ESTIMATED THIRD PARTY SETTLEMENTS ACCRUED FROM 2022 531,236. PARIS COMMUNITY HOSPITAL FOUNDATION INC 721 EAST COURT ST PARIS IL 619442460 473034746 FOUNDATION - SUPPORTING ORGANIZATION IL 501(C)(3) LINE 12A, I HORIZON HEALTH 1 0 0 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 HORIZON HEALTH FOUNDATION OF EAST CENTRAL ILLINOIS INC C 1462946 FMV HORIZON HEALTH FOUNDATION OF EAST CENTRAL ILLINOIS INC O 168819 CASH