TY 2019 Form 990 Schedule O

efile Public Visual Render ObjectId: 202002409349300800 - Submission: 2020-08-27 TIN: 55-0809159

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
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Attach to Form 990 or 990-EZ.
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Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2019

Open to Public
Inspection

Name of the organization

THE ILLINOIS CRITICAL ACCESS HOSPITAL
NETWORK

Employer identification number

55-0809159

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 6	THE MEMBERS OF THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK ARE CRITICAL ACCESS HOSPITALS AND NECESSARY PROVIDER HOSPITALS RESIDING IN THE STATE OF ILLINOIS WHO HAVE PAID AN INITIAL MEMBERSHIP FEE OF FIVE THOUSAND DOLLARS ($5,000). EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS. AS OF 2019 THE MEMBERSHIP DUES FOR THE YEAR ARE $8,300.
FORM 990, PART VI, SECTION A, LINE 7A	EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7B	THE BYLAWS MAY BE AMENDED AT ANY MEETING OF THE MEMBERSHIP PROVIDED A NOTICE SETTING FORTH THE AMENDMENT OR A SUMMARY OF THE CHANGES TO BE AFFECTED THEREBY IS GIVEN TO EACH MEMBER ENTITLED TO VOTE THEREON IN THE MANNER AND WITHIN THE TIME PROVIDED IN THE BYLAWS FOR THE NOTICE OF THE MEETING. NO AMENDMENT INCONSISTENT WITH THE ARTICLES OF INCORPORATION SHALL BE EFFECTIVE PRIOR TO AMENDMENT OF THE ARTICLES OF INCORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS PROVIDED TO BOTH THE FINANCE COMMITTEE AND BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW. THE GOAL IS TO PROVIDE THE REPORT TO BOTH PRIOR TO THE FILING, SO IF DISCREPANCIES ARE DISCOVERED, THERE IS TIME FOR CORRECTIONS IF DEEMED NECESSARY AFTER REVIEW, A MEETING WILL BE SCHEDULED FOR DISCUSSION AND FURTHER REVIEW OF THE 990.
FORM 990, PART VI, LINE 1	THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, PRESIDENT-ELECT, SECRETARY/TREASURER, AND IMMEDIATE PAST PRESIDENT IF THE IMMEDIATE PAST PRESIDENT REMAINS ON THE BOARD OF DIRECTORS WHEN THE IMMEDIATE PAST PRESIDENT SERVES ON THE EXECUTIVE COMMITTEE, THE PRESIDENT SHALL NOT VOTE EXCEPT TO END A TIE VOTE THE PRESIDENT OF THE BOARD OF DIRECTORS SHALL SERVE AS THE CHAIR OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD OF DIRECTORS PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH ANY RULE AND REGULATION ESTABLISHED BY THE BOARD OF DIRECTORS OR EXPRESSED WISHES OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK REQUIRES THEIR BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST ACTIVITY QUESTIONNAIRE ANNUALLY. ANY QUESTION OF WHETHER A CONFLICT EXISTS SHALL BE DECIDED UPON BY A MAJORITY VOTE OF THE DIRECTORS OR COMMITTEE MEMBERS, EXCLUDING THE DIRECTOR OR COMMITTEE MEMBER WITH A POSSIBLE CONFLICT IN THE CASE AN ACTUAL CONFLICT EXISTS, THE DIRECTOR OR MEMBER WITH THE CONFLICT MUST ABSTAIN FROM VOTING ON SUCH MATTER.
FORM 990, PART VI, SECTION B, LINE 15A	THE FINANCE COMMITTEE OF THE ORGANIZATION RECOMMENDS TO THE BOARD THE APPROVAL OF THE FISCAL YEAR BUDGET WHICH INCLUDES SALARY INCREASES. INCREASES ARE THEN MADE BY THE EXECUTIVE DIRECTOR PRIOR TO THE START OF THE NEXT FISCAL YEAR. THE EXECUTIVE DIRECTOR'S CONTRACT ALLOWS FOR A YEARLY INCREASE PER BUDGET. THE EXECUTIVE DIRECTOR'S CONTRACT IS NEGOTIATED EVERY THREE YEARS AND SALARY IS SET AT THAT TIME. THIS COMPENSATION IS SET BASED ON A COMPARISON REVIEW OF OTHER NETWORK DIRECTOR'S SALARIES AND COMPENSATION. OTHER ICAHN POSITIONS ARE BASED ON SIMILAR POSITIONS IN OTHER ORGANIZATIONS INCLUDED IN THE BUDGET PRESENTATION ARE BUDGET ASSUMPTIONS WHICH IDENTIFIES THE SALARY INCREASES.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART IX, LINE 11G	MANAGED CARE: PROGRAM SERVICE EXPENSES 433,116. MANAGEMENT AND GENERAL EXPENSES 100,983. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 534,099. OTHER FEES: PROGRAM SERVICE EXPENSES 103,939. MANAGEMENT AND GENERAL EXPENSES 24,234. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 128,173. EDUCATION: PROGRAM SERVICE EXPENSES 3,186. MANAGEMENT AND GENERAL EXPENSES 743. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,929.

Return Reference

Explanation

FORM 990, PART VI, SECTION A, LINE 6

THE MEMBERS OF THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK ARE CRITICAL ACCESS HOSPITALS AND NECESSARY PROVIDER HOSPITALS RESIDING IN THE STATE OF ILLINOIS WHO HAVE PAID AN INITIAL MEMBERSHIP FEE OF FIVE THOUSAND DOLLARS ($5,000). EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS. AS OF 2019 THE MEMBERSHIP DUES FOR THE YEAR ARE $8,300.

FORM 990, PART VI, SECTION A, LINE 7A

EACH HOSPITAL MEMBER HAS ONE VOTE AND IS REPRESENTED BY ITS CHIEF EXECUTIVE OFFICER. MEMBERS HAVE THE RIGHT TO VOTE FOR THE BOARD OF DIRECTORS.

FORM 990, PART VI, SECTION A, LINE 7B

THE BYLAWS MAY BE AMENDED AT ANY MEETING OF THE MEMBERSHIP PROVIDED A NOTICE SETTING FORTH THE AMENDMENT OR A SUMMARY OF THE CHANGES TO BE AFFECTED THEREBY IS GIVEN TO EACH MEMBER ENTITLED TO VOTE THEREON IN THE MANNER AND WITHIN THE TIME PROVIDED IN THE BYLAWS FOR THE NOTICE OF THE MEETING. NO AMENDMENT INCONSISTENT WITH THE ARTICLES OF INCORPORATION SHALL BE EFFECTIVE PRIOR TO AMENDMENT OF THE ARTICLES OF INCORPORATION.

FORM 990, PART VI, SECTION B, LINE 11B

THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM. THE FORM 990 IS PROVIDED TO BOTH THE FINANCE COMMITTEE AND BOARD OF DIRECTORS VIA E-MAIL FOR REVIEW. THE GOAL IS TO PROVIDE THE REPORT TO BOTH PRIOR TO THE FILING, SO IF DISCREPANCIES ARE DISCOVERED, THERE IS TIME FOR CORRECTIONS IF DEEMED NECESSARY AFTER REVIEW, A MEETING WILL BE SCHEDULED FOR DISCUSSION AND FURTHER REVIEW OF THE 990.

FORM 990, PART VI, LINE 1

THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT, PRESIDENT-ELECT, SECRETARY/TREASURER, AND IMMEDIATE PAST PRESIDENT IF THE IMMEDIATE PAST PRESIDENT REMAINS ON THE BOARD OF DIRECTORS WHEN THE IMMEDIATE PAST PRESIDENT SERVES ON THE EXECUTIVE COMMITTEE, THE PRESIDENT SHALL NOT VOTE EXCEPT TO END A TIE VOTE THE PRESIDENT OF THE BOARD OF DIRECTORS SHALL SERVE AS THE CHAIR OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN MEETINGS OF THE BOARD OF DIRECTORS PROVIDED THAT ANY ACTION TAKEN SHALL NOT CONFLICT WITH ANY RULE AND REGULATION ESTABLISHED BY THE BOARD OF DIRECTORS OR EXPRESSED WISHES OF THE BOARD OF DIRECTORS.

FORM 990, PART VI, SECTION B, LINE 12C

THE ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK REQUIRES THEIR BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO COMPLETE A CONFLICT OF INTEREST ACTIVITY QUESTIONNAIRE ANNUALLY. ANY QUESTION OF WHETHER A CONFLICT EXISTS SHALL BE DECIDED UPON BY A MAJORITY VOTE OF THE DIRECTORS OR COMMITTEE MEMBERS, EXCLUDING THE DIRECTOR OR COMMITTEE MEMBER WITH A POSSIBLE CONFLICT IN THE CASE AN ACTUAL CONFLICT EXISTS, THE DIRECTOR OR MEMBER WITH THE CONFLICT MUST ABSTAIN FROM VOTING ON SUCH MATTER.

FORM 990, PART VI, SECTION B, LINE 15A

THE FINANCE COMMITTEE OF THE ORGANIZATION RECOMMENDS TO THE BOARD THE APPROVAL OF THE FISCAL YEAR BUDGET WHICH INCLUDES SALARY INCREASES. INCREASES ARE THEN MADE BY THE EXECUTIVE DIRECTOR PRIOR TO THE START OF THE NEXT FISCAL YEAR. THE EXECUTIVE DIRECTOR'S CONTRACT ALLOWS FOR A YEARLY INCREASE PER BUDGET. THE EXECUTIVE DIRECTOR'S CONTRACT IS NEGOTIATED EVERY THREE YEARS AND SALARY IS SET AT THAT TIME. THIS COMPENSATION IS SET BASED ON A COMPARISON REVIEW OF OTHER NETWORK DIRECTOR'S SALARIES AND COMPENSATION. OTHER ICAHN POSITIONS ARE BASED ON SIMILAR POSITIONS IN OTHER ORGANIZATIONS INCLUDED IN THE BUDGET PRESENTATION ARE BUDGET ASSUMPTIONS WHICH IDENTIFIES THE SALARY INCREASES.

FORM 990, PART VI, SECTION C, LINE 19

GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.

FORM 990, PART IX, LINE 11G

MANAGED CARE: PROGRAM SERVICE EXPENSES 433,116. MANAGEMENT AND GENERAL EXPENSES 100,983. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 534,099. OTHER FEES: PROGRAM SERVICE EXPENSES 103,939. MANAGEMENT AND GENERAL EXPENSES 24,234. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 128,173. EDUCATION: PROGRAM SERVICE EXPENSES 3,186. MANAGEMENT AND GENERAL EXPENSES 743. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,929.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2019

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