2024-05-10T16:24:30-05:00 2023-08-31 371206530 SCHEFFEL BOYLE 19 N US HIGHWAY 67 CARROLLTON IL 62016 990 2022-09-01 370673461 THOMAS H BOYD MEMORIAL HOSPITAL THOM 2179426946 800 SCHOOL STREET CARROLLTON IL 62016 KATHRYN GARNER CFO 2179426946 2024-05-10 1 KATHRYN GARNER 999009999 0 DANNY PHIPPS CPA P00160585 2179423821 2024-05-10 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z BOYD HEALTHCARE SERVICES KATHRYN GARNER 800 SCHOOL STREET CARROLLTON IL 62016 16158224 0 X WWW.BOYDHCS.ORG X 1941 IL PROVIDE QUALITY HEALTH CARE AND PROMOTES WELLNESS FOR THE RESIDENTS IN OUR REGION THROUGH HEALTH SERVICES, INFORMATION RESOURCES, AND EDUCATION. 6 6 168 10 0 0 1389305 1285986 14205957 14766664 21586 19713 135487 85861 15752335 16158224 0 0 0 0 9398467 9893597 0 0 0 5574217 5671567 14972684 15565164 779651 593060 8394510 8176844 3556414 2739114 4838096 5437730 PROVIDES QUALITY HEALTH CARE AND PROMOTES WELLNESS FOR THE RESIDENTS IN OUR REGION THROUGH THE PROVISION OF HEALTH SERVICES, INFORMATION RESOURCES, AND EDUCATION. 0 0 11435561 14852525 PROVIDED INPATIENT SERVICES (101 PATIENTS, 297 PATIENT DAYS), SWINGBED STAYS (37 PATIENTS, 426 PATIENT DAYS), OBSERVATION (138 PATIENTS, 3,153 HOURS), CUSTODIAL CARE (10 PATIENTS, 46 PATIENT DAYS), RURAL HEALTH CLINICS (4 REGIONAL LOCATIONS) (13,522 VISITS) AND AMBULANCE SERVICES TO THE RESIDENTS OF GREENE COUNTY. 11435561 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 168 1 0 0 0 0 0 0 0 0 0 0 X 6 6 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 IL X KATHRYN GARNER CFO 2179426946 800 SCHOOL STREET CARROLLTON IL 62016 KIRBY BALLARD PRESIDENT 2.00 X 0 0 0 JENNY CLOUGH TRUSTEE 2.00 X 0 0 0 MARY FRANCIS TUNISON SECRETARY 2.00 X 0 0 0 MARY PLUMMER TRUSTEE 2.00 X 0 0 0 DIANE WOLFLEY TRUSTEE 2.00 X 0 0 0 R SCOTT BEAVERS TREASURER 2.00 X 0 0 0 DEBORAH J CAMPBELL CEO 40.00 X 63049 0 8499 KATHRYN GARNER CFO 40.00 X 100604 0 20595 DONNA DEWITT INTERM CEO 40.00 X 94387 0 35738 MOHAMMED W SIDDIQUI MD PHYSICIAN 40.00 X 303715 0 33011 GULAM SIDDIQUI MD PHYSICIAN 40.00 X 252897 0 12833 RENAN MAPUE MD PHYSICIAN 40.00 X 331683 0 33011 SARAH ALTERMOTT ER NURSE 40.00 X 170087 0 38084 MICHAEL MCNEAR MD PHYSICIAN 40.00 X 252610 0 18939 1569032 0 200710 6 0 1 0 WELLUCATE INC 2831 SAINT ROSE PARKWAY 200-323 HENDERSON NV 89052 PHYSICIAN 486360 SCHULZ SURGICAL SERVICES LLC 251 DOGWOOD MEADOW CT ST PETERS MO 63376 ER PHYSICIAN 388745 2 1044185 241801 1285986 PATIENT SERVICES 621300 14413328 14413328 340B PROGRAM 456110 284759 284759 PT SERVICES GREENE CO. 621610 68577 68577 14766664 19713 19713 2800 0 2800 2800 2800 CAFETERIA 722210 33589 33589 WELLNESS CENTER 624100 33369 33369 MISCELLANEOUS 900099 17198 17198 -1095 -1095 83061 16158224 14852525 0 19713 322872 322872 7538998 6410668 1128330 1481497 1209536 271961 550230 448581 101649 21038 21038 52013 52013 1269996 1244423 25573 1128281 693828 434453 279550 63286 216264 46154 14687 31467 759258 387542 371716 551080 515215 35865 EQUIPMENT RENTAL 811539 307118 504421 PROVISION FOR BAD DEBTS 361904 361904 COLLECTION AGENCY EXPEN 22348 22348 368406 140677 227729 15565164 11435561 4129603 0 1662330 1611262 179350 178249 39964 1762684 1366597 41424 34111 240577 91509 8316957 3517377 4457238 4799580 10943 13090 82446 8394510 8176844 2557343 2203263 504550 6160 494521 529691 3556414 2739114 X 4718674 5322793 119422 114937 4838096 5437730 8394510 8176844 593060 6575 -1 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 70514 70514 3042509 526732 2515777 5203934 2990645 2213289 4799580 X 16164799 6575 6575 16158224 0 16158224 15565164 0 15565164 0 15565164 PART X, LINE 2: ACCOUNTING STANDARDS CODIFICATION TOPIC 740 PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. TOPIC 740 DEVELOPED A TWO-STEP PROCESS TO EVALUATE A TAX POSITION AND ALSO PROVIDES GUIDANCE ON DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. THE HOSPITAL HAS NOT RECORDED A RESERVE FOR ANY TAX POSITIONS FOR WHICH THE ULTIMATE DEDUCTIBILITY IS HIGHLY CERTAIN BUT FOR WHICH THERE IS UNCERTAINTY ABOUT THE TIMING OF SUCH DEDUCTIBILITY. THE HOSPITAL FILES TAX RETURNS IN ALL APPROPRIATE JURISDICTIONS. THE OPEN TAX YEARS ARE THOSE YEARS ENDED AUGUST 31, 2020 THROUGH AUGUST 31, 2023. AS OF AUGUST 31, 2023 AND 2022, THE HOSPITAL HAS NO RECORDED LIABILITY FOR UNRECOGNIZED TAX BENEFITS. THE HOSPITAL RECOGNIZES INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS AS INTEREST EXPENSE AND PENALTIES AS INCURRED. NO SUCH EXPENSE WAS RECOGNIZED FOR THE YEARS ENDED AUGUST 31, 2023 AND 2022. 1 1 X 1 X 1 X 1 1 1 0 1 1 65864 65864 0.00420 5537917 814966 4722951 0.30340 5603781 814966 4788815 0.30760 5603781 814966 4788815 0.30760 1 361904 126666 4137229 4976728 -839499 X 1 1 1 1 THOMAS H BOYD MEMORIAL HOSPITAL 800 SCHOOL STREET CARROLLTON IL 62016 X X X X THOMAS H BOYD MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 22 1 0 0 1 X SEE URL REPORTED IN SECTION C X X 1 22 1 SEE URL REPORTED IN SECTION C 0 1 X 200.000000000000 300.000000000000 X X X X X 1 1 X X X 1 X BOYDHCS.ORG X BOYDHCS.ORG X BOYDHCS.ORG X X X X X 1 X 0 X X X 1 X 0 0 THOMAS H. BOYD MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THE CHNA INCLUDED INPUT FROM FOCUS GROUPS CONSISTING OF COMMUNITY HEALTHCARE PROFESSIONALS, LOCAL OFFICIALS, BUSINESS OWNERS, SCHOOL LEADERSHIP, AND OTHER COMMUNITY MEMBERS AT LARGE. THOMAS H. BOYD MEMORIAL HOSPITAL PART V, SECTION B, LINE 7D: THE CHNA IMPLEMENTATION STRATEGY IS AVAILABLE ON OUR WEBSITE AT: HTTP://WWW.BOYDHCS.ORG/FILE/100/CHNA_22.PDF THOMAS H. BOYD MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: EDUCATIONAL LUNCH AND LEARNS OVER SPECIFIC TOPICS IDENTIFIED IN THE CHNA ARE ONGOING. WE ARE CURRENTLY IN THE PLANNING PHASE OF BUILDING A NEW CLINIC IN WHITE HALL , IL, WHICH WOULD ADDRESS MENTAL HEALTH ACCESS AND EXPAND HEALTH CARE ACCESSIBILITY AND EMS COVERAGE IN NORTHERN COUNTY. 4 1 - THOMAS H BOYD RURAL HEALTH CLINIC 800 SCHOOL STREET CARROLLTON IL 62016 OUTPATIENT RURAL HEALTH CLINIC 2 - BOYD-FILLAGER RURAL HEALTH CLINIC 712 COLLEGE STREET GREENFIELD IL 62044 OUTPATIENT RURAL HEALTH CLINIC 3 - GREENE COUNTY RURAL HEALTH CLINIC 727 9TH STREET CARROLLTON IL 62016 OUTPATIENT RURAL HEALTH CLINIC 4 - RURAL HEALTH CENTER OF ROODHOUSE 132 LORTON STREET ROODHOUSE IL 62082 OUTPATIENT RURAL HEALTH CLINIC PART III, LINE 2: THE HOSPITAL REPORTS PATIENT ACCOUNTS RECEIVABLE FOR SERVICES RENDERED AT THE NET REALIZABLE AMOUNTS FOR THIRD PARTY PAYERS, PATIENTS AND OTHERS. THE HOSPITAL PROVIDES AN ALLOWANCE FOR DOUBTFUL ACCOUNTS BASED UPON A REVIEW OF OUTSTANDING RECEIVABLES, HISTORICAL COLLECTION INFORMATION AND EXISTING ECONOMIC CONDITIONS. AS A SERVICE TO THE PATIENT, THE HOSPITAL BILLS THIRD PARTY PAYERS DIRECTLY AND BILLS THE PATIENT WHEN THE PATIENT LIABILITY IS DETERMINED. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. BALANCES REMAINING PAST DUE MORE THAN 120 DAYS ARE CONSIDERED DELINQUENT. ACCOUNTS CONSIDERED DELINQUENT ARE SUBSEQUENTLY WRITTEN OFF AS BAD DEBT BASED ON INDIVIDUAL CREDIT EVALUATION AND SPECIFIC CIRCUMSTANCES OF THE ACCOUNT. THE HOSPITAL PROVIDES CHARITY CARE TO PATIENTS WHO ARE UNABLE TO PAY FOR SERVICES. THE AMOUNT OF CHARITY CARE IS INCLUDED IN NET PATIENT REVENUE AND IS SEPERATLY CLASSIFIED FROM THE PROVISION FOR UNCOLLECTABLE ACCOUNTS.WE CURRENTLY ESTIMATE THAT APPROXIMATELY 35% OF OUR BAD DEBTS THAT WERE NOT COLLECTABLE AND HAVE BEEN WRITTEN OFF TO BAD DEBT EXPENSE, WOULD HAVE BEEN ELIGIBLE FOR CHARITY CARE BUT DID NOT FOLLOW THE GUIDELINE TO BE APPROVED. (NO APPLICATION, INADEQUATE/MISSING INFORMATION) THE HOSPITAL ALSO HAS PROVISIONS WRITTEN IN THE COLLECTION POLICY THAT ALLOWS CHARITY ELIGIBLE PATIENTS TO APPLY FOR ASSISTANCE UP TO 240 DAYS AFTER THE DATE OF SERVICE. PART VI, LINE 2: THE HOSPITAL ALSO WORKS WITH THE ILLINOIS DEPARTMENT OF HEALTH THROUGH ITS "I-PLAN" PROGRAM TO ASSESS THE HEALTH NEEDS OF THE COMMUNITY AND PROVIDE ASSISTANCE TO HELP ALLEVIATE ISSUES THAT ARE IDENTIFIED. PART VI, LINE 3: OUR FINANCIAL ASSISTANCE POLICY IS POSTED AT THE MAIN ENTRANCE, AS WELL AS, THE O/P, AMBULANCE, RHC'S AND EMERGENCY ROOM ENTRANCES. UPON ADMISSION ALL PATIENTS WHO DO NOT HAVE INSURANCE ARE GIVEN A BROCHURE THAT OUTLINES OUR FINANCIAL ASSISTANCE POLICIES. IN ADDITION, OUR FINANCIAL COUNSELOR PROVIDES THIS INFORMATION TO ALL INDIVIDUALS WHO ARE HAVING DIFFICULTY PAYING THIER BILL. PART VI, LINE 4: BOYD HOSPITAL IS THE ONLY HOSPITAL IN GREENE COUNTY ILLINOIS, WHICH IS A FARMING COMMUNITY OF APPROXIMATELY 13,000 PEOPLE. CARROLLTON WHERE THE HOSPITAL IS LOCATED IS A TOWN OF 2,500 WITH THREE SMALLER COMMUNITIES OF WHITE HALL, ROODHOUSE, AND GREENFIELD BEING OUR SERVICE AREA. THE MEDIAN FAMILY INCOME WAS $58,900. X 1 0 0 0 0 0 0 0 0 RENAN MAPUE MD PHYSICIAN 331683 0 0 0 0 0 0 0 0 0 331683 0 0 0 MOHAMMED W SIDDIQUI MD PHYSICIAN 303715 0 0 0 0 0 0 0 0 0 303715 0 0 0 GULAM SIDDIQUI MD PHYSICIAN 252897 0 0 0 0 0 0 0 0 0 252897 0 0 0 MICHAEL MCNEAR MD PHYSICIAN 252610 0 0 0 0 0 0 0 0 0 252610 0 0 0 SARAH ALTERMOTT ER NURSE 170087 0 0 0 0 0 0 0 0 0 170087 0 0 0 PART I, LINE 4A DEBORAH J CAMPBELL $12,152.42 FORM 990, PART VI, SECTION B, LINE 11B UPON COMPLETION OF FORM 990, THE BOARD AND ADMINISTRATIVE STAFF ARE INFORMED, BY THE CHIEF FINANCIAL OFFICER, THAT THE FORM 990 IS AVAILABLE FOR PUBLIC INSPECTION AND IS MADE AVAILABLE IN THE OFFICE OF THE CHIEF FINANCIAL OFFICER'S OFFICE, MONDAY THROUGH FRIDAY DURING NORMAL BUSINESS HOURS (9:00-4:00). FORM 990, PART VI, SECTION B, LINE 12C AS NEEDED, AT LEAST ANNUALLY, INTERESTED PARTIES AND BOARD MEMBERS ARE REQUIRED TO COMPLETE THE HOSPITAL'S "CONFLICT OR DUALITIES OF INTEREST STATEMENT" (INDIVIDUALS ARE EACH GIVEN A COPY OF THE CONFLICT OF INTEREST POLICY). THIS STATEMENT DISCLOSES ANY CONFLICTS OR RELATED PARTY INTERESTS INDIVIDUALS MAY HAVE REGARDING HOSPITAL PROJECTS/WORK, SERVICES ON BOARDS AND ANY FAMILY MEMBERS THAT MAY BE EMPLOYEES OF THE ORGANIZATION THAT MAY CREATE A POTENTIAL CONFLICT REGARDING THE HOSPITAL'S "CONFLICT OF INTEREST POLICY". ALL COMPLETED STATEMENTS ARE REVIEWED TO ENSURE THAT ALL INDIVIDUALS HAVE NO CONFLICT OR PERSONAL INTERESTS NOTED THAT MAY JEPORDIZE THE HOSPITAL'S STATUS AS A TAX EXEMPT/NOT FOR PROFIT ENTITY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO REVIEWS WAGE DATA, THE ANNUAL CISSHRA WAGE SURVEY TO DETERMINE AND CHANGES IN EMPLOYEE COMPENSATION IN CONJUNCTION WITH THE ANNUAL BUDGET PREPARED BY THE CFO PRESENTED TO THE BOARD. THE BOARD OF DIRECTORS WOULD APPROVE ANY INCREASE IN SALARY OF CEO OR OTHER KEY MANAGEMENT. FORM 990, PART VI, SECTION C, LINE 19 CERTAIN NON-PATIENT DOCUMENTS IE: CONFLICT OF INTEREST POLICY, FINANCIAL STATEMENTS, ECT. WILL BE MADE AVAILABLE TO THE PUBLIC DURING NORMAL WORKING HOURS M-F 9:00-4:00. ALL REQUESTS MUST BE MADE IN WRITING WITH A 72 HOUR ADVANCE NOTICE. THOMAS H BOYD MEMORIAL FOUNDATION 800 SCHOOL STREET CARROLLTON IL 62016 208989948 RAISE FUNDS FOR MEDICAL EXPENSES AND SCHOLARSHIPS IL 501(C)(3) LINE 10 THOMAS H BOYD MEMORIAL FOUNDATION BOARD 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0