2024-05-02T14:23:30-05:00 2023-06-30 430352985 KERBER ECK & BRAECKEL LLP 3401 OFFICE PARK DRIVE MARION IL 62959 990 2022-07-01 370966854 SHAWNEE HEALTH SERVICE & DEVEL CORP SHAW 6189858221 109 CALIFORNIA STREET CARTERVILLE IL 629180577 PATSY JENSEN CEO 6189858221 2024-05-01 1 PATSY JENSEN 999009999 1 AMBER HALSTEAD P01343727 6185291040 2024-04-30 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z CHRISTINA CARNEY 109 CALIFORNIA STREET CARTERVILLE IL 62918 41776379 0 X WWW.SHSDC.ORG X 1972 IL TO WORK FOR THE PRESERVATION AND ENHANCEMENT OF HEALTH FOR CITIZENS OF SOUTHERN ILLINOIS. 12 12 476 3 0 0 11753067 11309535 27512657 30322604 14003 144240 0 0 39279727 41776379 0 0 0 0 29420948 32446603 0 0 0 9121328 11389941 38542276 43836544 737451 -2060165 31152423 29351919 7611293 7870954 23541130 21480965 TO PROVIDE PRIMARY MEDICAL AND DENTAL HEALTHCARE. 0 0 32407957 24839848 FEDERALLY QUALIFIED RURAL HEALTH CLINIC - PROVIDES QUALITY PRIMARY HEALTHCARE, DENTAL SERVICES AND PHARMACY REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY TO UNDERSERVED RURAL COMMUNITIES. 4745041 5482756 SHAWNEE ALLIANCE FOR SENIORS PROGRAMS - SHAWNEE ALLIANCE CARE COORDINATORS HELP OLDER ADULTS AND THEIR CAREGIVERS CONNECT TO SERVICES AVAILABLE IN THE COMMUNITY WHICH ENABLE THEM TO MAINTAIN THEIR INDEPENDENCE. CARE COORDINATORS MAKE HOME VISITS TO EVALUATE THE OLDER ADULTS' ABILITY TO FUNCTION INDEPENDENTLY. THE EVALUATION IS COMPREHENSIVE AND PROVIDES THE CARE COORDINATORS WITH INFORMATION NEEDED TO ADVISE THE OLDER ADULT AND THEIR CAREGIVER ON PROGRAMS AND SERVICES AVAILABLE TO MEET THEIR NEEDS. 37152998 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 71 0 476 0 0 0 0 0 0 0 0 0 0 0 X 12 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X X JEFF COOPER 6189858221 109 CALIFORNIA STREET CARTERVILLE IL 62918 KELLEY HESSIAN PRESIDENT 1.00 X 0 0 0 DALE RITZEL VICE PRESIDENT 1.00 X 0 0 0 PAULA REEVES SECRETARY/TREASURER 1.00 X 0 0 0 SUSAN MURRAY ASST. SEC/TREAS. 1.00 X 0 0 0 JOSE LLAMAS DIRECTOR 1.00 X 0 0 0 SHANE CARSRUD DIRECTOR 1.00 X 0 0 0 KEVIN LIPE DIRECTOR 1.00 X 0 0 0 CARL FLOWERS DIRECTOR 1.00 X 0 0 0 CAROLIN HARVEY DIRECTOR 1.00 X 0 0 0 JULIAN VALDES DIRECTOR 1.00 X 0 0 0 ARUN SUBRAMANIAN DIRECTOR 1.00 X 0 0 0 GEORGE MARIN DIRECTOR 1.00 X 0 0 0 PATSY JENSEN CEO 40.00 X 214062 0 40148 JEFFREY COOPER CFO 40.00 X 170708 0 25152 CLARE WILLIAMS PHYSICIAN 40.00 X 445654 0 48510 AARON NEWCOMB PHYSICIAN 40.00 X 348233 0 56262 MATIN NEKZAD PHYSICIAN 40.00 X 343987 0 55452 JEFFREY RIPPERDA PHYSICIAN 40.00 X 302877 0 56448 SHERRY JONES PHYSICIAN 40.00 X 385282 0 43761 2210803 0 325733 51 0 1 0 FRANCIS TSUNG 487 EGRET LAKE RD CARBONDALE IL 62903 OBSTERTICS CALL COVERAGE AT MEMORIAL HOS 263449 1 11309535 11309535 PATIENT SERVICE REVENUE 621110 18349834 18349834 PHARMACY REVENUE 621110 5569005 5569005 ASSESSMENT FEES 621110 3379842 3379842 OTHER 621110 2222561 2222561 CASE MANAGEMENT FEES 621110 748357 748357 53005 53005 30322604 144240 144240 41776379 30322604 0 144240 384771 384771 25400804 22712508 2688296 606879 496639 110240 4662184 3815292 846892 1391965 1139113 252852 4149 4149 92102 30427 61675 2614676 2351401 263275 3675685 3269485 406200 1546754 905208 641546 301392 231253 70139 177344 154341 23003 107273 107273 774437 774437 193075 57551 135524 MISCELLANEOUS 1661090 1661090 SMALL EQUIPMENT 241964 221417 20547 43836544 37152998 6683546 0 10649205 9219730 1058942 1065213 1270271 775097 3045886 3032455 336576 227710 463205 371640 22599496 8434606 14064811 14164890 263527 240222 0 254962 31152423 29351919 958286 886285 327503 277411 3345231 3106086 2980273 3601172 7611293 7870954 X 23541130 21480965 23541130 21480965 31152423 29351919 -2060165 0 X 0 1 X 1 1 1 X 6869791 7735553 10671460 11753067 11309535 48339406 6869791 7735553 10671460 11753067 11309535 48339406 48339406 52285 82892 39662 14003 144240 333082 48672488 0.99320 0.99570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 952232 952232 16690346 5337089 11353257 469575 222048 247527 4487343 2875469 1611874 14164890 ACCRUED PAYROLL 1559157 ACCRUED FRINGE BENEFITS 1787192 ACCRUED INTEREST 2331 OPERATING LEASE 95635 FINANCING LEASE 156857 3601172 41776379 0 41776379 0 41776379 43836544 0 43836544 0 43836544 PART XII, LINE 2B THE CORPORATION HAS BEEN GRANTED EXEMPT STATUS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, THEREFORE, NO PROVISION FOR FEDERAL INCOME TAX HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. AT JUNE 30, 2023, NO INTEREST OR PENALTIES WERE ATTRIBUTED TO THE CORPORATION. THE CORPORATION DOES NOT BELIEVE THERE ARE ANY UNCERTAIN TAX POSITIONS FOR WHICH A LIABILITY SHOULD BE RECORDED. X X 0 0 0 0 0 0 0 1 0 CLARE WILLIAMS PHYSICIAN 244130 0 100524 0 101000 0 21600 0 26910 0 494164 0 0 0 SHERRY JONES PHYSICIAN 371862 0 13420 0 0 0 25992 0 17769 0 429043 0 0 0 AARON NEWCOMB PHYSICIAN 183450 0 120126 0 44657 0 14391 0 41871 0 404495 0 0 0 MATIN NEKZAD PHYSICIAN 268881 0 7000 0 68106 0 24480 0 30972 0 399439 0 0 0 JEFFREY RIPPERDA PHYSICIAN 182433 0 83444 0 37000 0 18480 0 37968 0 359325 0 0 0 PATSY JENSEN CEO 212062 0 2000 0 0 0 26990 0 13158 0 254210 0 0 0 JEFFREY COOPER CFO 165708 0 5000 0 0 0 1200 0 23952 0 195860 0 0 0 PART I, LINE 7 PHYSICIANS RECEIVE INCENTIVE BONUSES BASED ON PRODUCTIVITY LEVELS FORM 990, PART VI, SECTION B, LINE 11B BOARD OF DIRECTORS WERE GIVEN A COPY OF THE 990 FOR THEIR REVIEW AND APPROVAL AT THE BOARD MEETING. FORM 990, PART VI, SECTION B, LINE 12C SHAWNEE REQUIRES THAT ALL DIRECTORS, OFFICERS, COMMITTEE MEMBERS AND CANDIDATES FOR BOARD SEATS DISCLOSE IN WRITING, AND UPDATE THE WRITTEN DISCLOSURE IF CONDITIONS CHANGE, BUSINESS AND FAMILY RELATIONSHIPS WHICH WOULD CREATE A CONFLICT OF INTEREST AND, WHERE APPLICABLE, PROVIDE A STATEMENT SUGGESTING HOW SUCH CONFLICT COULD BE AVOIDED OR MITIGATED. IN ORDER TO FACILITATE SUCH FULL DISCLOSURE, SHAWNEE REQUIRES DIRECTORS, OFFICERS, AND COMMITTEE MEMBERS TO COMPLETE A DISCLOSURE FORM. COMPLETION OF A DISCLOSURE FORM DOES NOT RELIEVE INDIVIDUALS OF THE OBLIGATION TO COMPLY WITH THESE STANDARDS OF CONDUCT WITH REGARD TO CONFLICTS THAT OCCUR AFTER THE FILING OF THE DISCLOSURE FORM. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS WILL REVIEW THE CEO'S PERFORMANCE, REVIEW SALARY SURVEYS AND DOCUMENT ALL STAGES OF THE REVIEW PROCESS. THESE ARE PERFORMED BY THE GOVERNANCE COMMITTEE AND THE FULL BOARD HAS INPUT ABILITY. THE CEO WILL REVIEW THE CFO'S PERFORMANCE AND COMPARABLE DATA. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. CHC ACCESS PARTNERSHIP LLC 500 S 9TH STREET SPRINGFIELD IL 62701 473229670 CONTRACT IL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0