2023-08-09T07:51:09-05:00 2022-12-31 410746749 CLIFTONLARSONALLEN LLP 600 WASHINGTON AVENUE SUITE 1800 ST LOUIS MO 63101 990 2022-01-01 371293506 PANA COMMUNITY HOSPITAL FOUNDATION PANA 2175626340 101 EAST NINTH STREET PANA IL 62557 KATRINA CASNER CEO 2175626340 2023-08-02 1 KATRINA CASNER 999009999 0 AMBER ROGNAN-HAMILTON P01251012 3149254300 2023-08-02 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z KATRINA CASNER 101 EAST NINTH STREET PANA IL 62557 227160 0 X WWW.PANAHOSPITAL.COM/GIVE/ABOUT-THE-FOUNDATION X 1992 IL TO PROVIDE SUPPORT FOR OUR COMMUNITY'S HEALTH CARE. 13 10 6 28 0 0 167429 97443 0 0 204968 108870 -6048 8442 366349 214755 4346 14661 0 0 0 0 0 0 979 36332 44048 40678 58709 325671 156046 6671113 5891607 0 0 6671113 5891607 TO SUPPORT OUR COMMUNITY'S HEALTH CARE BY PROVIDING FOR THE CONTINUED ADVANCEMENT OF PANA COMMUNITY HOSPITAL'S HEALTH CARE DELIVERY SERVICES. 0 0 14661 14661 0 TO PROVIDE FUNDING FOR THE MEDICAL AND HEALTHCARE NEEDS OF PANA COMMUNITY HOSPITAL AND THE PEOPLE IT SERVES AND TO ESTABLISH AND MAINTAIN A PERMANENT ENDOWMENT FUND IN SUPPORT OF THE HOSPITAL.WE ARE COMMITTED TO IMPROVING THE RESOURCES AVAILABLE TO THE CITIZENS OF PANA AND SURROUNDING COMMUNITIES BY CULTIVATING RELATIONSHIPS WITHIN THE COMMUNITY THAT WILL INSPIRE A GREATER NETWORK OF SUPPORTERS; BY CREATING FUNDRAISING PROGRAMS THAT ARE COMPLEMENTARY TO THE VALUES OF THE FOUNDATION, THE HOSPITAL AND THE COMMUNITY AND BY WORKING SIDE BY SIDE WITH PANA COMMUNITY HOSPITAL TO FULFILL THEIR MISSION OF BEING A LEADING PARTNER IN ASSURING COMMUNITY-BASED, QUALITY HEALTH CARE. 14661 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 6 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 13 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X JAMES MOON CFO 2175622131 101 EAST NINTH STREET PANA IL 62557 BRIAN SIMS CHAIRMAN 1.50 0.00 X X 0 0 0 GAYLE MCROBERTS VICE CHAIRMAN 1.50 0.00 X X 0 0 0 MARY KIRKBRIDE SECRETARY/TREASURER 1.50 0.00 X X 0 0 0 CHUCK BANNING DIRECTOR (TERM ENDED) 1.50 0.00 X 0 0 0 DON BILYEU DIRECTOR 1.50 0.00 X 0 0 0 ED CHAUSSE DIRECTOR 1.50 0.00 X 0 0 0 DWAIN MCAFEE DIRECTOR 1.50 0.00 X 0 0 0 DR MARLON MUNESES DIRECTOR, HOSPITAL EMPLOYEE 1.50 40.00 X 0 290432 42235 SELENA REED DIRECTOR, HOSPITAL EMPLOYEE 1.50 40.00 X 0 46332 24091 LUANN FUNK DIRECTOR, HOSPITAL EMPLOYEE 1.50 20.00 X 0 15735 0 CHERYL SWENNY DIRECTOR 1.50 0.00 X 0 0 0 GARY BOWKER DIRECTOR 1.50 0.00 X 0 0 0 BRENDA PARKER DIRECTOR 1.50 0.00 X 0 0 0 TOM ROLAND DIRECTOR 1.50 0.00 X 0 0 0 KATRINA CASNER PRESIDENT & CEO 1.50 40.00 X 0 224729 17031 JAMES MOON CFO 1.50 40.00 X 0 142125 18847 DEREK ADE EXECUTIVE DIRECTOR 40.00 0.00 X 0 53303 20672 0 772656 122876 0 0 1 0 0 23539 73904 97443 108870 108870 18070 23539 10598 7472 7472 2248 500 1748 1748 509 1307 -798 -798 MEMBERSHIP DUES 900099 20 20 20 214755 0 0 117312 9661 9661 5000 5000 7354 7354 19565 19565 9394 9394 3812 3812 2035 2035 OTHER TAXES 747 747 WELLNESS/REHAB CAMP 722 722 DONOR RECOGNITION 257 257 MISCELLANEOUS 155 155 7 7 58709 14661 43069 979 39146 0 1642368 1785018 43007 13355 1591 1762 81796 50980 34628 30816 4126806 3152958 783567 907698 6671113 5891607 0 0 X 5111905 4075279 1559208 1816328 6671113 5891607 6671113 5891607 X 156046 -935956 404 X X 0 1 X 1 0 X X 1 PANA COMMUNITY HOSPITAL ASSOCIATION 376062326 3 1 9661 49047 1 9661 49047 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 81796 50980 30816 30816 INVESTMENT IN PEOPLES BANC SHARES 895400 F CASH SURRENDER VALUE OF LIFE INSURANCE POLICIES 12298 F 907698 X PART X, LINE 2: AT DECEMBER 31, 2022 AND 2021, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED. PRESENTLY, THERE ARE NO ONGOING INCOME TAX AUDITS OR UNRESOLVED DISPUTES WITH THE TAX AUTHORITIES THAT THE ORGANIZATION CURRENTLY FILES OR HAS FILED WITH. GOLF OUTING 30887 16007 14880 4022 4420 656 BREAST CANCER AWARENESS EVENT 6995 6995 264 966 37882 23002 14880 4022 4420 264 1622 10328 4552 1 PANA COMMUNITY HOSPITAL ASSOCIATION 101 EAST NINTH STREET PANA IL 62557 376062326 501(C)(3) 9661 0 SUPPORT FOR MEDICAL CARE 1 PART I, LINE 2: PER THE MISSION STATEMENT OF PANA COMMUNITY HOSPITAL FOUNDATION, THE ONLY ORGANIZATION TO WHICH THE FOUNDATION CAN GIVE GRANTS TO IS PANA COMMUNITY HOSPITAL ASSOCIATION. 0 0 0 0 0 0 0 0 0 DR MARLON MUNESES DIRECTOR, HOSPITAL EMPLOYEE 0 290432 0 0 0 0 0 10410 0 31825 0 332667 0 0 KATRINA CASNER PRESIDENT & CEO 0 202734 0 21995 0 0 0 10049 0 6982 0 241760 0 0 JAMES MOON CFO 0 132113 0 10012 0 0 0 5981 0 12866 0 160972 0 0 PART I, LINE 3 DR. MARLAN MUNESES, MD IS COMPENSATED BY A RELATED ORGANIZATION, PANA COMMUNITY HOSPITAL ASSOCIATION. OUR EMPLOYED PHYSICIANS ARE COMPENSATED USING A BASE SALARY PLUS PRODUCTIVITY COMPENSATION. THE PRODUCTIVITY COMPENSATION IS CALCULATED BASED UPON MINIMUM LEVELS OF RECEIPTS GENERATED BY EACH PHYSICIAN. PANA COMMUNITY HOSPITAL ASSOCIATION USES A COMPENSATION COMMITTEE, WRITTEN EMPLOYMENT CONTRACTS, COMPENSATION SURVEYS OR STUDIES, FORM 990 OF OTHER ORGANIZATIONS AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION FOR THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS PANA COMMUNITY HOSPITAL ASSOCIATION. FORM 990, PART VI, SECTION A, LINE 7A THE SOLE MEMBER OF THE CORPORATION IS PANA COMMUNITY HOSPITAL ASSOCIATION. THE MEMBER HAS THE POWER TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B DECISIONS OF GOVERNING BODY. SOME DECISIONS LIKE APPROVING NEW BOARD MEMBERS ARE APPROVED BY THE HOSPITAL'S BOARD OF DIRECTORS NOTWITHSTANDING ANY CONTRARY-PROVISION IN THESE BY-LAWS. THE CORPORATION SHALL NOT, WITHOUT THE PRIOR APPROVAL OF THE SOLE MEMBER A) ALTER, AMEND, OR REPEAL THE INCORPORATION OR BY-LAWS OF THE CORPORATION OR ADOPT ANY BY-LAWS FOR ANY SUBSIDIARY, B) APPROVE THE ANNUAL OPERATING BUDGET OF THE CORPORATION OR APPROVE ANY FORMAL LONG-RANGE PLAN OF THE CORPORATION, C) APPROVE ANY TRANSACTION FOR WHICH THE CORPORATION WOULD BE REQUIRED TO OBTAIN CERTIFICATE OF NEED APPROVAL UNDER ILLINOIS LAW, D) BORROW FUNDS UNSECURED, OR INCUR DEBT, WHETHER SECURED OR UNSECURED, E) APPROVE OR ADOPT ANY PLAN OF MERGER OR CONSOLIDATION, OR ANY SALE, LEASE, EXCHANGE, MORTGAGE, PLEDGE, OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL (10% OR MORE) OF THE PROPERTY AND ASSETS OF THE CORPORATION, F) SELECT AUDITORS FOR THE CORPORATION, G) CREATE OR ACQUIRE ANY SUBSIDIARY CORPORATION, OR CREATE ANY OTHER WHICH THE CORPORATION IS A MEMBER, H) DISSOLVE THE CORPORATION OR ADOPT ANY PLAN OF DISSOLUTION. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION CONTRACTS WITH A PUBLIC ACCOUNTING FIRM FOR THE PREPARATION OF THE FORM 990. THE RETURN IS PREPARED BASED ON INFORMATION PROVIDED BY FINANCIAL MANAGEMENT AND OTHERS WITHIN THE FOUNDATION. THE FORM 990 IS REVIEWED BY THE CFO PRIOR TO FILING WITH THE IRS. CFO PRESENTS A COPY OF FORM 990 TO THE GOVERNING BOARD FOR REVIEW. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY COVERS THE BOARD OF DIRECTORS, ADMINISTRATION, EMPLOYEES AND VOLUNTEERS. CONFLICT OF INTEREST POLICY IS SENT OUT TO THE BOARD, ADMINISTRATION, EMPLOYEES AND VOLUNTEERS ON AN ANNUAL BASIS REQUIRING ANY DISCLOSURES TO BE MADE. WHEN A BOARD MEMBER HAS A CONFLICT THEY ARE ALLOWED TO PROVIDE THEIR POSITION ON THE MATTER AND WILL BE ALLOWED TO ANSWER QUESTIONS, BUT THEY ARE NOT ALLOWED TO VOTE OR USE PERSONAL INFLUENCE ON THE MATTER. ADMINISTRATION, EMPLOYEES AND VOLUNTEERS ARE REQUIRED TO REPORT CONFLICTS AT THE EARLIEST OPPORTUNITY BEFORE CONSUMMATING THE TRANSACTION. FORM 990, PART VI, SECTION C, LINE 19 THE FOUNDATION WOULD CONSIDER EACH REQUEST FOR ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, OR FINANCIAL STATEMENTS AND IF DEEMED APPROPRIATE MAKE SAID DOCUMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS INCREASE IN CSV OF LIFE INSURANCE 404. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. PANA COMMUNITY HOSPITAL ASSOCIATION 101 EAST 9TH STREET PANA IL 62557 376062326 ACUTE CARE IL 501(C)(3) LINE 3 N/A 0 QUAD COUNTY HOME MEDICAL SUPPLIES & EQUIPMENT 1 HUBER STREET PANA IL 62557 371198049 DME RETAILER IL N/A C 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0