TY 2023 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) Gary Houchin Secretary / Treasurer	1.5 ................. 1.5	X	X		0	0
(2) Jennifer Cummins-Zuber Chair	2.0 ................. 2.0	X	X		0	0
(3) Matthew Kolb JD MHA Ex Officio // President, Carle Health Regions // EVP, COO // TRUSTEE THRU 3/08/2023	1.0 ................. 39.0	X	X		1,567,332	363,305
(4) Patricia Kessler-Bookhout DDS Vice Chair	1.5 ................. 1.5	X	X		0	0
(5) Tanner Miller MD Trustee Beg 02/01/2023 // Physician	1.0 ................. 39.0	X		X	518,048	34,451
(6) Bernard Brauer Trustee	1.0 ................. 1.0	X			0	0
(7) Brian Atwood MD Trustee Beg 02/01/2023	3.0 ................. 3.0	X			0	0
(8) Cole Duke Trustee Thru 01/31/2023	1.0 ................. 0.0	X			0	0
(9) Larry Dunn Trustee	1.0 ................. 1.0	X			0	0
(10) Raymond Fisher MD Trustee // Physician	1.0 ................. 39.0	X			647,807	15,808
(11) Sally Salmons MD Trustee Thru 01/31/2023 // CHRH MEDICAL DIRECTOR	1.0 ................. 39.0	X			572,407	72,879
(12) Sherry Geier Trustee	1.5 ................. 1.5	X			0	0
(13) Steve Thomson Trustee	4.0 ................. 4.0	X			0	0
(14) Dennis Hesch Officer - EVP, Chief Finance & Strategy Officer	2.0 ................. 38.0		X		1,395,995	366,889
(15) James C Leonard MD Officer - President & CEO	0.5 ................. 39.5		X		5,690,001	36,885
(16) Napoleon Knight MD MBA Officer - EVP, Chief Medial Officer	1.0 ................. 39.0		X		940,875	115,459
(17) Regina Thomas DNP MBA Ex Officio, Non-Voting // Officer - President, Carle Health - South Region	20.0 ................. 20.0		X		379,780	52,557

(A) Name and business address	(B) Description of services	(C) Compensation
Abbot Laboratories 100 Abbot Park Rd Abbot,IL60064	Medical Laboratory Services	307,908
Sentry Data Systems Inc 800 Fairway Dr Ste 400 Deerfield Beach,FL33441	Pharmacy Software Maintenance	233,216
Pioneer Pathology Sc 4887 N Whitewater Rd Olney,IL62450	Pathology Services	215,000
Arup Laboratories 500 Chipeta Way Salt Lake City,UT84108	Medical Laboratory Services	122,417
Hartz Lawn & Janitorial 14267 Hartz Lane Lawrenceville,IL62439	Housekeeping Services	111,950
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 6

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

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

Cat. No. 11285F

Schedule A (Form 990) 2023

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf ....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) ..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support. Add lines 7 through 10

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2022. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2023. If the organization did not check a box on line 13, 16a, or 16b, and line 14 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

10%-facts-and-circumstances test—2022. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line 15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported organization ............ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge
6	Total. Add lines 1 through 5
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here................................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3 % support tests—2022. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ..... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2023

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2023

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by 0.035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2023

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization RICHLAND MEMORIAL HOSPITAL

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization RICHLAND MEMORIAL HOSPITAL		Employer identification number 37-1363001

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization RICHLAND MEMORIAL HOSPITAL			Employer identification number 37-1363001
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2023)

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE C
(Form 990)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... right arrow

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ right arrow

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... right arrow

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990.

Cat. No. 50084S

Schedule C (Form 990) 2022

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check right arrow

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check right arrow

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ........................
c	Total lobbying expenditures (add lines 1a and 1b) ............................................................
d	Other exempt purpose expenditures ...............................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ..................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ...................................................................................................................	Yes No

4-Year Averaging Period Under Section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990) 2022

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes|No

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

15,084

Total. Add lines 1c through 1i ....................................................................................................

15,084

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures. See Instructions .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	$15,084 - PORTION OF DUES PAID TO AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS, ILLINOIS COUNCIL OF HEALTH-SYSTEM PHARMACISTS, AMERICAN ASSOCIATION OF NURSE ANESTHETISTS, AMERICAN ACADEMY OF ORHOPAEDIC SURGEONS, ILLINOIS ACADEMY OF PHYSICIANS ASSISTANTS, AND ILLINOIS HEALTH AND HOSPITAL ASSOCIATION.

Schedule C (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after July 25, 2006, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year right arrow

Number of states where property subject to conservation easement is located right arrow

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
right arrow

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....	1,017,266		1,017,266
b	Buildings ....	33,664,105	22,874,444	10,789,661
c	Leasehold improvements
d	Equipment ....	30,270,870	24,449,909	5,820,961
e	Other .....	1,298,712	667,920	630,792
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				18,258,680

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
DUE TO BLUE CROSS	442,028
ASSET RETIREMENT OBLIGATION	3,536,030







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	3,978,058
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2022

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ...........	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote	THE GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR FINANCIAL STATEMENTS RECOGNITION OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. THERE WERE NO UNCERTAIN TAX BENEFITS IDENTIFIED OR RECORDED AS A LIABILITY AS OF DECEMBER 31, 2023 AND 2022.

Schedule D (Form 990) 2022

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .			722,825		722,825	0.98 %
b	Medicaid (from Worksheet 3, column a) . . . . .			14,560,716	11,845,504	2,715,212	3.67 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .					0	0 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	0	0	15,283,541	11,845,504	3,438,037	4.64 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).			18,091		18,091	0.02 %
f	Health professions education (from Worksheet 5) . . .			235,628		235,628	0.32 %
g	Subsidized health services (from Worksheet 6) . . . .			9,840,295		9,840,295	13.29 %
h	Research (from Worksheet 7) .					0	0 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .					0	0 %
j	Total. Other Benefits . .	0	0	10,094,014	0	10,094,014	13.64 %
k	Total. Add lines 7d and 7j .	0	0	25,377,555	11,845,504	13,532,051	18.28 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing					0	0 %
2	Economic development			14,240		14,240	0.02 %
3	Community support					0	0 %
4	Environmental improvements					0	0 %
5	Leadership development and training for community members					0	0 %
6	Coalition building					0	0 %
7	Community health improvement advocacy					0	0 %
8	Workforce development					0	0 %
9	Other					0	0 %
10	Total	0	0	14,240	0	14,240	0.02 %

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................

Yes

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

937,797

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

468,899

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

25,637,724

Enter Medicare allowable costs of care relating to payments on line 5.....

29,821,121

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-4,183,397

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions)How many hospital facilities did the organization operate during the tax year?1Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)
1	Carle Richland Memorial Hospital 800 East Locust Street Olney,IL62450 https://carle.org/locations/carle-richland-memorial-hospital 0004200	X	X	X	X

Schedule H (Form 990) 2023

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Carle Richland Memorial Hospital
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 21

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): https://carle.org/about-us/community-health-needs-assessments

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): https://carle.org/about-us/community-health-needs-assessments

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Carle Richland Memorial Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.0%
and FPG family income limit for eligibility for discounted care of 400.0%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Was widely publicized within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

SEE SCHEDULE H PART VI

The FAP application form was widely available on a website (list url):

SEE SCHEDULE H PART VI

A plain language summary of the FAP was widely available on a website (list url):
SEE SCHEDULE H PART VI

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

Notified members of the community who are most likely to require financial assistance about availability of the FAP

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	Carle Richland Memorial Hospital
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon nonpayment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

	Carle Richland Memorial Hospital
Name of hospital facility or letter of facility reporting group

Yes

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2023

Page 8

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Schedule H, Part V, Section B, Line 3E	THE SIGNIFICANT HEALTH NEEDS ARE A PRIORITIZED DESCRIPTION OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY AND IDENTIFIED THROUGH THE CHNA.
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - Carle Richland Memorial Hospital. Provisions in the Affordable Care Act (ACA) require charitable hospitals to conduct a Community Health Needs Assessment (CHNA). The CHNA is a systematic process involving the community to identify and analyze community health needs as well as community assets and resources in order to plan and act upon priority community health needs. This assessment process results in a CHNA report which assists the hospital in planning, implementing, and evaluating hospital strategies and community benefit activities. The Community Health Needs Assessment was developed and conducted, in partnership with representatives from the community, by a consultant provided through the Illinois Critical Access Hospital Network (ICAHN). ICAHN is a not-for-profit 501(c)(3) corporation established in 2003 for the purposes of sharing resources, education, promoting operational efficiencies, and improving healthcare services for member critical access and rural hospitals and their communities. ICAHN, with 57 member hospitals, is an independent network governed by a nine-member board of directors, with standing and project development committees facilitating the overall activities of the network. ICAHN continually strives to strengthen the capacity and viability of its members and rural health providers. 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 Olney and the surrounding area. Three focus groups met through facilitated virtual conferencing on May 20, 2021, to discuss the state of overall health and wellness in the Carle Richland Memorial Hospital service area. They were also tasked with identifying 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, faith-based organizations, local elected officials, public health, and others. Several members of the 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 through a virtual conference on June 28, 2021. The focus group consisted of representatives from Richland County Ministerial Alliance, The Master's Hands, Richland County Housing Authority, Stopping Woman Abuse Now, Department of Human Services, Richland County Community Unit 1 Schools, Richland County Addiction Prevention Coalition, Community Unit School District 20, Olney Central College, Carle Richland Memorial Hospital, Richland County TB and Public Health Office, Arrow Ambulance, SIHF, Jasper County Health Department and Wayne County Health Department.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Carle Richland Memorial Hospital. Health Needs Selected 1. Mental health services for children, adolescents, and adults, including: - Youth and adult inpatient care for treatment through recovery - Improved access to counseling for youth, including services at schools - Inpatient behavioral health and substance use crisis care - Addiction medicine services, including Medication Assisted Treatment Actions the hospital intends to take to address the health need: - Carle Richland Memorial Hospital will explore increasing access to Medication Assisted Treatment/recovery resources - Carle Richland Memorial Hospital will explore increasing relationships with inpatient behavioral health and substance use disorder providers - Carle Richland Memorial Hospital will provide reasonable and appropriate support to development of the crisis program at Lawrence County Health Department - Carle Richland Memorial Hospital will explore developing tele-counseling - Carle Richland Memorial Hospital will explore new avenues to increase access to counseling - Carle Richland Memorial Hospital will continue and expand the Mental Health First Aid program Anticipated impacts of these actions: Carle Richland Memorial Hospital anticipates that the steps set out above will create increased access to counseling for youth and adults, medication assisted treatment, and inpatient and crisis care for behavioral health and substance use disorder. Programs and resources the hospital plans to commit to address health need: - Administrative team Planned collaboration between hospital and other facilities or organizations: - SIU School of Medicine - Public Health - Inpatient providers - Law enforcement - Carle Behavioral Health services Evaluation of Prior Impact: Mental and behavioral health continue to be an identified health needs for Carle Richland and Richland County, similar to counties across Illinois and the United States. In 2023, the number of mental health providers in Richland County is roughly 190:1, according to most recently available data, and increase from 210:1 in recent years. This is better than both the Illinois and national average. In most recent available suicide data, there were 15 suicides per 100,000 people in Richland County, which is higher than both the statewide and national average. In response, Carle Richland Memorial Hospital took the following actions in 2023: - CRMH began the Little Spot of Emotion program with all 2nd graders in Richland County. This program helps the children to recognize the feelings they are having and talk about them. This started during the 2023-24 school year. - CRMH team members were recognized for their work with Mental Health First Aid at the annual conference held by Illinois Critical Access Hospital Network (ICAHN), with a team member being recognized as winner of the Community Project Award for her behavioral health work with both adult organizations and in the local high schools. - CRMH added an additional PMHNP to the medical staff, making that 2 full-time psychiatric practitioners that are available to see patients. - CRMH maintained a behavioral health room in our ED so we can safely keep patients who need to be transferred to a behavioral facility or are on suicide precautions, supported by the Richland County Board in recognition of need, and the work Carle Richland Memorial Hospital does in caring for patients. 2. Flexible transportation for local appointments and assistance when needed for persons that have little or no transportation at home Actions the hospital intends to take to address the health need: - Carle Richland Memorial Hospital will explore expanding care coordination services to include transportation Anticipated impacts of these actions: Carle Richland Memorial Hospital anticipates the expanding care coordination services to include transportation will improve coordination of transportation with appointments and address patient needs related to transportation. Programs and resources the hospital plans to commit to address health need: - Administration Planned collaboration between hospital and other facilities or organizations: - RIDES Mass Transit District - Embarras River Basin Area Agency (ERBA) Evaluation of Prior Impact: Like many rural communities, physical landmass is large and reliable transportation to access community services and care is not always easy to attain. As with often common in rural communities, there is a large aging population. In Richland County, adults aged 65+ with an independent living difficulty (including access to transportation), is roughly 15%, higher than the statewide and national average. In response to this identified health need, Carle Richland Memorial Hospital took the following actions: - Carle Richland Memorial Hospital continues to work to increase services for those needing transportation assistance. Inpatient Care Coordination staff have access to hospital discharge service transportation for patients as needed - which helps take patients being discharged from the hospital home if they are needing help getting into their home or are going home with medical equipment. When patients do not need any special circumstances upon discharge, the care coordinators continue to schedule rides for them through Rides Mass Transit. ED also utilizes both services as needed for discharges from the ED. - Carle Richland Memorial Hospital continues to work with the Mass Transit District to advocate for assistance and routes for patients in our rural communities - a commitment to ongoing dialogue. 3. Improved opportunities to achieve wellness through: - Access to healthy foods and nutrition education - Access to low cost or free opportunities for recreation and fitness Actions the hospital intends to take to address the health need: - Carle Richland Memorial Hospital will explore development of a community garden program - Carle Richland Memorial Hospital will continue the demonstration garden for nutrition education - Carle Richland Memorial Hospital will provide funding for lighting to enhance use of the community walking path in Olney - Carle Richland Memorial Hospital will explore expanding services of Carle Health's Mobile Market - Carle Richland Memorial Hospital will partner with Carle Health to provide the community with access to video with health and wellness content - Carle Richland Memorial Hospital will continue to support local youth sports Anticipated impacts of these actions: Carle Richland Memorial Hospital anticipates that the addition of the programs and services to be undertaken will improve opportunities to achieve wellness through access to healthy foods and nutrition education, and access to low cost or free opportunities for recreation and fitness. Programs and resources the hospital plans to commit to address health need: - Administrative team - Organizational and community development Planned collaboration between hospital and other facilities or organizations: - Volunteers - Carle Health - City of Olney - University of Illinois Extension - Carle Richland Auxiliary Evaluation of Prior Impact: Like many communities in the United States, obesity and obesity related illnesses continue to be a concern in Richland County. Obesity is associated with poorer mental health outcomes, reduced quality of life, and the leading cause of death in the U.S. and worldwide, through contributing to heart disease, stroke, diabetes and some types of cancer. According to 2023 County Health Rankings, adult obesity in Richland County is 37%, higher than the statewide and national average, and higher than recent years. Additionally, Access to Exercise Opportunities is significantly lower than the statewide and national averages, at only 67% of people living near a park or recreation facility. In response to this identified health need, Carle Richland Memorial Hospital took the following actions: - In 2023, CRMH Respiratory Therapy brought back the Better Breather's Club. This group has not met since before COVID. They now meet monthly again for those with COPD and other breathing issues. - In 2023, CRMH added new specialties, including full-time Pain Management and full-time Podiatry services. We had been without podiatry services for close to a year and Pain Management is a completely new service for Richland. Both providers have been well-received and are continuing to get more referrals and new patients. - CRMH started a walking group that encouraged residents to get out and walk on Saturday mornings. A representative would meet residents and walk with them for up to an hour at various outdoor locations in town. The group disbanded once the weather got too cold to walk outdoors, but did meet for 3-4 months.
Schedule H, Part V, Section B, Line 11 Facility , 2	Facility , 2 - Carle Richland Memorial Hospital (Continued). - CRMH also added a Urology and Cardiology APP to our medical staff. While we already had established Urology and Cardiology practices, the volume for both areas was in need of additional providers. 4. Dental care for underinsured and uninsured Actions the hospital intends to take to address the health need: Carle Richland Memorial Hospital continues to recognize the importance of access to dentalcare and the impact of dental care on wellness but observes that dental care is not a function for which the hospital is well-suited. Carle Richland Memorial Hospital recognizes that the Federally Qualified Health Center (FQHC) may be better positioned to address this issue, and the hospital will promote partnerships between dentists, the FQHC, and any other potential partners as reasonably possible. Anticipated impacts of these actions: Any impacts from any developments on this issue are dependent on external partners and solutions they may offer. Programs and resources the hospital plans to commit to address health need: - Administration Planned collaboration between hospital and other facilities or organizations: - Federally Qualified Health Center - Dentists - Others that may be interested in the effort - Public Health Evaluation of Prior Impact: According to most recently available data, Richland County does have a higher proportion of dentists to the population at 3,950:1 than the statewide and national averages, and the average number of adults visiting a dentist is higher than the statewide and national averages. Carle Richland Memorial Hospital continues to recognize the importance of access to dentalcare and the impact of dental care on wellness but observes that dental care is not a function for which the hospital is well-suited. Carle Richland Memorial Hospital recognizes that the Federally Qualified Health Center (FQHC) may be better positioned to address this issue, and the hospital will promote partnerships between dentists, the FQHC, and any other potential partners as reasonably possible, and works to continue to advocate and support these community partners as we are able.

Schedule H (Form 990) 2023

Page 9

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?5
Name and address		Type of Facility (describe)
1	CARLE OLNEY PRIMARY CARE 363 N WEST ST OLNEY,IL62450	RURAL HEALTH CLINIC
2	CARLE (OLNEY) SURGICAL SERVICES 605 E MAIN ST OLNEY,IL62450	SURGICAL SERVICES
3	CARLE WEST SALEM 100 S MAIN ST WEST SALEM,IL62476	RURAL HEALTH CLINIC
4	CARLE BRIDGEPORT 101 INDUSTRY RD BRIDGEPORT,IL624172242	OUTPATIENT CLINIC
5	RMH PROFESSIONAL SERVICES 605 E Main Street Olney,IL62450	GENERAL SURGERY AND PODIATRY SERVICES
6
7
8
9
10

Schedule H (Form 990) 2023

Page 10

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Schedule H, Part I, Line 3 FINANCIAL ASSISTANCE ELIGIBILITY CRITERIA	PATIENTS MAY REQUEST AND COMPLETE A FINANCIAL ASSISTANCE APPLICATION AT ANY TIME, INCLUDING BEFORE CARE IS RECEIVED. PATIENTS ARE INFORMED ABOUT FINANCIAL ASSISTANCE ON MULTIPLE OCCASIONS THROUGHOUT THE COLLECTION PROCESS. IN ADDITION TO PATIENTS COMPLETING APPLICATIONS FOR OUR FINANCIAL ASSISTANCE PROGRAM, WE HAVE ROBUST PRESUMPTIVE ELIGIBILITY PROCESSES IN PLACE. WE HAVE PARTNERED WITH EXPERIAN INFORMATION SOLUTIONS, INC. TO HELP US IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BASED ON KEY FINANCIAL INDICATORS. THESE PATIENTS MAY BE APPROVED WITHOUT EVER COMPLETING AN APPLICATION OR EXPRESSING A NEED FOR FINANCIAL ASSISTANCE. IN ADDITION, WE PRESUME ELIGIBILITY FOR PATIENTS WHO ARE VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTALLY INCAPACITATED, ELIGIBLE FOR SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP) OR WOMEN, INFANTS, AND CHILDREN NUTRITION PROGRAM (WIC), TOWNSHIP ASSISTANCE, LOW INCOME ENERGY ASSISTANCE PROGRAM (LIHEAP), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM OR COVERED BY ILLINOIS MEDICAID.
Schedule H, Part II Describe How Community Building Activities Promote the Health of the Community	VOLUNTEER SERVICES: Employee: Carle Richland administrators and leaders provided more than 75 hours on behalf of Carle for participation in community boards, committees and community functions in 2023. Most of these hours were spent by senior leadership. Non-employee: In 2023, non-employee volunteers put in more than 6,032 hours at the hospital, receiving no payment but contributing to Carle's mission. At a minimum wage of $13/hour, this equated to more than $78,000 of potential wages that Carle saved by having such a strong volunteer program.
Schedule H, Part V, Section B, Line 16a FAP AVAILABLE WEBSITE	HTTPS://CARLE.ORG/PATIENTS-VISITORS/FINANCIAL-ASSISTANCE
Schedule H, Part V, Section B, Line 16b FAP APPLICATION FORM WEBSITE	HTTPS://DEV-CMS.CARLE.ORG/GETMEDIA/ADCADB9A-2903-478C-A4A7-06BCF9DB10BC/358-0123-CFAPAPPLICATION.PDF
Schedule H, Part V, Section B, Line 16c PLAIN LANGUAGE FAP SUMMARY WEBSITE	HTTPS://CARLE.ORG/GETMEDIA/F7608F63-CB1C-4EB5-8F0B-02F00EAFEC74/X0873-0223-CFAP-PLAIN-LANGUAGE-SUMMARY.PDF
Schedule H, Part I, Line 7 OTHER COMMUNITY BENEFITS	CASH AND IN-KIND: A LARGE PORTION OF CARLE'S COMMUNITY-BUILDING ACTIVITIES FOCUSED ON ECONOMIC DEVELOPMENT, INCLUDING CASH, IN-KIND DONATIONS AND BUDGETED EXPENDITURES FOR THE CITY, BUSINESS ASSOCIATIONS AND OTHER PROGRAMS IN RICHLAND COUNTY. IN ADDITION TO THE MORE THAN $8,000 IN CASH DONATIONS, LEADERSHIP PROVIDED IN-KIND SUPPORT OF OVER $20,000 BY SERVING ON NUMEROUS COMMUNITY BOARDS AND COMMITTEES.
Schedule H, Part I, Line 7g Subsidized Health Services	SUBSIDIZED HEALTH SERVICES ARE NET COSTS FOR BILLED SERVICES THAT ARE SUBSIDIZED BY THE HOSPITAL. THESE INCLUDE SERVICES OFFERED DESPITE A FINANCIAL LOSS BECAUSE THEY ARE NEEDED IN THE COMMUNITY AND EITHER OTHER PROVIDERS ARE UNWILLING TO PROVIDE THESE SERVICES OR THE SERVICES WOULD OTHERWISE NOT BE AVAILABLE IN A SUFFICIENT AMOUNT. WE INCLUDED AS UNREIMBURSED COSTS OF SUBSIDIZED HEALTH SERVICES: $84,235 FOR HOSPITAL OUTPATIENT SERVICES, $3,461,723 FOR EMERGENCY AND TRAUMA SERVICES, AND $6,114,247 FOR SUBSIDIZED CONTINUING CARE.
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	SEE NARRATIVE FOR SCHEDULE H, PART III, LINE 2
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	TO COMPUTE AND CONVERT FINANCIAL ASSISTANCE, UNREIMBURSED MEDICAID, MEANS-TESTED PROGRAMS, AND BAD DEBT CHARGES TO COST; A CONSISTENT GAAP (GENERALLY ACCEPTED ACCOUNTING PRINCIPLES) BASED COST-TO-CHARGE RATIO WAS USED ACROSS ALL PAYERS. ALTHOUGH THE METHODOLOGY WAS SIMILAR TO WORKSHEET #2, FOR SIMPLICITY PURPOSES CERTAIN IMMATERIAL VALUES WERE OMITTED. OTHER COMMUNITY BENEFITS COSTS WERE REPORTED AT THE ACTUAL EXPENSE INCURRED. PATIENT RECEIVABLE PAYMENTS AND RELATED DISCOUNTS WERE RECORDED AT ACTUAL AMOUNTS AT THE TIME OF PAYMENT RECEIPT. A SEPARATE GAAP BASED PROVISION FOR ESTIMATED BAD DEBTS AND DISCOUNTS WAS RECOGNIZED FOR ACCOUNTS IN PROCESS AND PENDING ADJUDICATION AND PAYMENT. THE ESTIMATED PORTION WAS BASED ON HISTORICAL TRENDS AND ADJUSTED TO ACTUAL WHEN ADJUDICATION AND PAYMENT OCCUR. ACCOUNTS DETERMINED ELIGIBLE FOR FINANCIAL ASSISTANCE WERE PROCESSED IMMEDIATELY FOR FINANCIAL ASSISTANCE DISCOUNT WITH NO COLLECTION EFFORT. FOR ACCOUNTS WITH INSUFFICIENT INFORMATION AND DOCUMENTATION TO DETERMINE FINANCIAL ASSISTANCE ELIGIBILITY, THE HOSPITAL CONSULTED WITH A VARIETY OF ALTERNATIVE SOURCES TO HELP DETERMINE AN INDIVIDUAL'S FINANCIAL MEANS (OR LACK OF MEANS) TO PAY. BASED ON RELATED TRENDS, THE HOSPITAL FURTHER DEVELOPED A GENERAL ESTIMATE OF FINANCIAL ASSISTANCE WHICH CONTINUED TO RESIDE WITHIN BAD DEBTS. THIS NARRATIVE ALSO PERTAINS TO SCHEDULE H, PART I, LINE 7 - EXPLANATION OF COSTING METHODOLOGY USED FOR CALCULATING LINE 7 TABLE.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	CARLE RICHLAND MEMORIAL HOSPITAL USES 50% AS A GENERAL ESTIMATE OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	AS A RESULT OF ADOPTING ASU 2014-09, THE HEALTH SYSTEM CONTINUED TO MAINTAIN AN ALLOWANCE FOR BAD DEBTS RELATED TO PERFORMANCE OBLIGATIONS SATISFIED PRIOR TO JANUARY 1, 2018. THESE ACCOUNTS HAVE ALL BEEN FULLY RESOLVED, THEREFORE THE ALLOWANCE FOR BAD DEBTS HAS DECLINED TO $0. PLEASE SEE SCHEDULE H, PART III, LINE 2 METHODOLOGY USED TO ESTIMATE BAD DEBT FOR 990 REPORTING PURPOSES.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	THE NUMERATOR (TOTAL EXPENSE) AND DENOMINATOR (TOTAL GROSS CHARGES) OF THE SIMPLE RATIO OF PATIENT CARE COST TO CHARGES IS ADJUSTED BY ELIMINATING NON-PATIENT CARE THAT GENERATES OTHER REVENUE, BAD DEBT EXPENSE, MEDICAID, AND OTHER PROVIDER TAXES AND THE TOTAL COST OF COMMUNITY BENEFIT ACTIVITIES AND PROGRAMS. ALSO, ANY GROSS PATIENT CHARGES FOR PROGRAMS NOT RELYING ON THE RATIO ARE ELIMINATED FROM BOTH THE NUMERATOR AND DENOMINATOR OF THE RATIO. THESE ADJUSTMENTS ARE INTENDED TO ELIMINATE ANY POTENTIAL FOR DOUBLE COUNTING OF COMMUNITY BENEFIT EXPENSES. THE RESULTANT RATIO ALIGNS WITH SCHEDULE H REQUIREMENTS. ILLINOIS LAW DEFINES GOVERNMENTAL-SPONSORED INDIGENT HEALTH CARE AS THE UNREIMBURSED COST OF MEDICARE, MEDICAID, AND OTHER FEDERAL, STATE, OR LOCAL INDIGENT CARE PROGRAMS. WHEN THERE IS A SHORTFALL, WE DO BELIEVE THIS IS A COMMUNITY BENEFIT BECAUSE, AS A HOSPITAL, WE ARE STEPPING UP TO CARRY THE BURDEN OF THE GOVERNMENT, ASSURING CARE TO SENIORS, AND THOSE LESS FORTUNATE DEMOGRAPHICS THAT HAVE EXPERIENCED INCREASING COSTS OVER THE PAST DECADE WHILE LIVING ON FIXED INCOMES.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	THE CARLE FINANCIAL ASSISTANCE PROGRAM (CFAP) PROVIDES DISCOUNTED OR FREE CARE TO THOSE WHO NEED IT WITHIN THE CARLE HEALTH SYSTEM, INCLUDING THIS HOSPITAL. NOT ONLY DOES THIS RESULT IN A MORE TIMELY APPLICATION PROCESS, BUT MOST IMPORTANTLY, IT MEANS PATIENTS RECEIVE THE SAME DISCOUNT AT THE HOSPITAL AND CLINICS IF THEY MIGHT NEED AN ADDITIONAL LEVEL OF SPECIALTY OR HOSPITAL CARE. WITH THIS PROGRAM, THE HOSPITAL HAS A ROBUST PRESUMPTIVE ELIGIBILITY PROCESS. WE PRESUME ELIGIBILITY FOR VERIFIED HOMELESS, DECEASED WITH NO ESTATE, MENTAL INCAPACITATION, RECIPIENTS OF WIC (WOMEN, INFANTS AND CHILDREN NUTRITION PROGRAM), SNAP (SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM), LIHEAP (LOW INCOME HOME ENERGY ASSISTANCE PROGRAM), ILLINOIS FREE LUNCH AND BREAKFAST PROGRAM, RECEIPT OF GRANT ASSISTANCE FOR MEDICAL SERVICE, FEDERALLY QUALIFIED HEALTH CLINIC (FQHC) DISCOUNT REFERRALS, MEDICAID TITLE XIX, XXI, AND IN-NETWORK MEDICAID MANAGED CARE PLANS. IN ADDITION, WE UTILIZE A VENDOR, EXPERIAN INFORMATION SOLUTIONS, INC., TO PROACTIVELY IDENTIFY PATIENTS WHO MAY BE PRESUMPTIVELY-QUALIFIED FOR ASSISTANCE - NOT ONLY FOR PUBLIC PROGRAMS LIKE MEDICAID, BUT ALSO BASED ON A NUMBER OF KEY FINANCIAL INDICATORS, INCLUDING CREDIT HISTORY, DEMOGRAPHICS AND GROSS INCOME. IDENTIFIED PATIENTS MAY BE PRESUMED ELIGIBLE AND AUTOMATICALLY ENROLLED IN THE PROGRAM, OR THEY MAY BE CONTACTED AND ENCOURAGED TO APPLY FOR ASSISTANCE. PATIENTS WHO ARE NOT DEEMED PRESUMPTIVELY ELIGIBLE WOULD NEED TO REQUEST AND COMPLETE AN APPLICATION. IF THE PATIENT DOES NOT REQUEST OR COMPLETE AND RETURN THE APPLICATION, THEN THE BALANCE IS DEEMED THEIR RESPONSIBILITY TO PAY. FOR PATIENTS THAT DO NOT QUALIFY FOR CARLE FINANCIAL ASSISTANCE AND WHO MAY BE UNINSURED OR UNDERINSURED, THE HOSPITAL HAS OTHER DISCOUNT OPTIONS AVAILABLE, SUCH AS PROMPT PAY, ILLINOIS UNINSURED DISCOUNT, AND CAPPED DISCOUNT - WHERE A PATIENT'S OUT-OF-POCKET MEDICAL EXPENSES ARE LIMITED TO 40% OF THEIR ANNUAL GROSS INCOME IF THEY EARN AT OR BELOW 400% OF THE FEDERAL POVERTY LEVEL. ONCE ALL APPLICABLE DISCOUNTS HAVE BEEN APPLIED, WE MAKE EVERY ATTEMPT TO WORK WITH THE PATIENT AND SET UP PAYMENT ARRANGEMENTS ON THE REMAINING BALANCE DUE. THE CURRENT MINIMUM IS 5% OF THE TOTAL BALANCE DUE OR $25.00 A MONTH. IF THEY CANNOT MEET THESE GUIDELINES, OUR IN-HOUSE BILLING STAFF MEMBERS WORK WITH THEM TO SET UP A TEMPORARY/SHORT TERM PAYMENT ARRANGEMENT UNTIL THEY CAN MAKE THE MINIMUM PAYMENT. IF THEY ARE UNABLE TO MAKE PAYMENT ON THE BALANCE DUE, THEN THE BALANCE MAY BE LISTED WITH AN OUTSIDE COLLECTION AGENCY. WHEN THE ACCOUNT IS STILL IN-HOUSE, THE MINIMUM NOTIFICATION IS MONTHLY ITEMIZED STATEMENTS. IF A PATIENT DOES NOT RESPOND, THE ACCOUNT IS GIVEN A FINAL NOTICE, EITHER BY LETTER OR PHONE, AND SENT TO AN OUTSIDE COLLECTION AGENCY. THE HOSPITAL WILL NOT FILE COLLECTION SUIT LIENS ON A PRIMARY RESIDENCE, NOR DO WE AUTHORIZE AN AGENCY TO USE SO-CALLED "BODY ATTACHMENTS". THE AGENCIES ARE AWARE OF OUR CFAP AND HAVE BEEN ADVISED TO REFER THE PATIENTS BACK TO CARLE IF THEY DEEM THE PATIENT IS UNABLE TO PAY. BILLING STAFF WILL THEN MAKE ONE MORE ATTEMPT TO WORK WITH THE PATIENT TO SEE IF HELP IS AVAILABLE. IF STAFF DETERMINES THAT THE PATIENT MIGHT QUALIFY, WE SEND THE PATIENT A CFAP APPLICATION AND INSTRUCT THE AGENCY TO PUT A HOLD ON THE ACCOUNT; THE AVERAGE HOLD IS 60 DAYS. IF THE PATIENT IS THEN APPROVED FOR DISCOUNTS AT 100% FOR FINANCIAL ASSISTANCE, THE BALANCE IS ADJUSTED AND THE ACCOUNT IS CLOSED WITH THE AGENCY. IF THE PATIENT IS APPROVED FOR LESS THAN 100%, THE ADJUSTMENTS ARE REPORTED TO THE AGENCY AND THE AGENCY WILL BEGIN COLLECTION EFFORTS ON ANY REMAINING BALANCE.
Schedule H, Part V, Section B, Line 16a FAP website	- Carle Richland Memorial Hospital: Line 16a URL: SEE SCHEDULE H PART VI;
Schedule H, Part V, Section B, Line 16b FAP Application website	- Carle Richland Memorial Hospital: Line 16b URL: SEE SCHEDULE H PART VI;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- Carle Richland Memorial Hospital: Line 16c URL: SEE SCHEDULE H PART VI;
Schedule H, Part VI, Line 2 Needs assessment	Carle primarily addresses healthcare needs in our community by being a part of the aforementioned CHNA. However, Carle is acutely aware of the need for Access to Care, making it a mainstay of our community benefit efforts. We have a strong financial assistance program based on a philosophy of doing the right thing for the community and patients, balanced by a careful stewardship of the community's resources. While Access to Care was not selected as a priority for the 2021 CHNA, it will continue to be a priority for Carle. As a tax-exempt organization, Carle Richland Memorial Hospital provides care to patients regardless of the ability to pay. Carle's generous financial assistance program has resulted in our ability to reach many people over the years. To ensure we addressing the needs of the community, the finance and quality committees of the Carle Board of Trustees review and evaluate Charity Care figures annually. We do not limit the amount of financial assistance we provide, at this time. Other ways to help improve Access to Care: In addition to charity care, Carle supports a wide range of programs and services to increase community capacity, health care work force expansion, and social services that provide complementary healthcare-related services. Carle Richland Memorial Hospital has, and will continue to, pursue these initiatives to improve access to care: 1. Offer a charity care program 2. Communicate the availability of the charity care program 3. Recruit more providers into the Carle system, thereby expanding access/capacity 4. Support local community clinics to ensure added local capacity for health care 5. Donate to existing community health 6. Participate in population health initiatives that actively manage the health of members 7. Promote prescription affordability as a 340B provider 8. Continue access to care through subsidized services, including the LTC Skilled Nursing, the Extended Care Wing, the Emergency Department, Cardiac Rehab, and more.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	Our practice is to look at each patient's financial status in relation to our Carle Financial Assistance Program and the criteria of the Uninsured Patient Discount Act, and to provide the patient with the deepest discount available. By expanding the presumptive eligibility screening processes and determining the financial status of patients up-front, we have been able to pinpoint those needing assistance early in the process, minimizing bad debt and optimizing our ability to help. Staff is also diligent in following up with patients during hospitalization and after discharge if there's any reason to believe the patient could benefit from financial assistance, and we auto-qualify certain patient populations for Carle Financial Assistance Program, such as the homeless, WIC, SNAP (Supplemental Nutrition Assistance Program), Medicaid, Low Income Home Energy Assistance Program (LIHEAP), and Township Assistance recipients. Communicating that Financial Assistance is Available Carle Richland Memorial Hospital has made a concerted, continuous effort to be sure that people have access to information that will help them with their medical bills. These include: - Advertising Carle Financial Assistance Program; continued presence in appropriate community publications; and on-site via displays throughout the hospital and clinics - Simplified application form, including a version in Spanish, that contains information regarding the Carle Financial Assistance Program - Publication of a Plain Language Summary and all other financial assistance-related information on carle.org/patients-visitors/financial-assistance - Information about the Carle Financial Assistance Program on all statements, collection letters and Hospital admission packets - Carle Financial Assistance Program information and applications at all registration points, Hospital main lobby and carle.org - Meetings with local legislators to help them assist constituents with healthcare needs, including financial assistance
Schedule H, Part VI, Line 4 Community information	Carle Richland Memorial Hospital has defined its primary service area and populations as the general population within the geographic area in and surrounding Richland County defined in detail below. The hospital's patient population includes all who receive care without regard to insurance coverage or eligibility for assistance. Carle Richland Memorial Hospital's service area is comprised of approximately 3,298.30 square miles, with a population of approximately 108,055 people and a population density of 33 people per square mile. The service area consists of the following rural Illinois counties: Richland, Lawrence, Edwards, Jasper, Clay, Crawford, Wabash, and Wayne. The average household size of the area, at 2.3, is lower than both Illinois (3) and the U.S. (2.5). Median age is over 43.5 years, which is higher than Illinois and the U.S. The largest education segment is reported as some college, followed by high school graduates. College graduates in the area exceed the number of residents that did not complete high school. The unemployment rate is typical of surrounding counties and other rural counties in Illinois and is better than national and statewide numbers. Also, as is the case in much of rural Illinois, income by households in the service area is lower than statewide In the report area, 41.23%, or 11,937 families report a total annual income of $75,000 or greater. Total income includes all reported income from wages and salaries as well as income from selfemployment, interest or dividends, public assistance, retirement, and other sources. As defined by the US Census Bureau, a family household is any housing unit in which the householder is living with one or more individuals related to him or her by birth, marriage, or adoption. A non family household is any household occupied by the householder alone, or by the householder and one or more unrelated individuals. Within the report area 13.74% or 14,051 individuals are living in households with income below the Federal Poverty Level (FPL). This indicator is relevant because poverty creates barriers to access including health services, health food, and other necessities that contribute to poor health status. In addition to Carle Richland Memorial Hospital, Richland County is served by Lawrence County Memorial Hospital, Wabash General Hospital, Crawford Memorial Hospital, Clay County Hospital, and Fairfield Memorial Hospital. There are also other clinics within our service areas from hospitals and health systems outside our service area.
Schedule H, Part VI, Line 5 Promotion of community health	CARLE RICHLAND MEMORIAL HOSPITAL has an open medical staff and is governed by a community board that serves on a volunteer basis. Surplus funds are reinvested into the organization for technology replacement and advancement, clinical service expansion and quality improvement. Funds are also invested into our communities to meet identified health needs which contribute to the overall well-being of the residents of the communities we serve.
Schedule H, Part VI, Line 6 Affiliated health care system	CARLE RICHLAND MEMORIAL HOSPITAL is a 25 bed, not-for-profit healthcare facility located in Olney, IL and became part of the Carle Health System on April 1, 2017. As part of the Carle Health System, it currently serves eight Southeastern Illinois counties, with a total population of more than 107,000 individuals. The integration of Carle and CRMH allows for expanded access to healthcare in the region. Though CRMH falls under the umbrella of The Carle Foundation, it maintains a separate board of trustees and senior leadership. While CRMH's CHNA and community benefit reporting is separate from the Carle Foundation Hospital, it follows the same guidelines and principles as Carle. CRMH staff is involved in the CHNA and implementation plan, and serve on human services agency boards and committees to provide support to help address identified community health needs

Schedule H (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

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Note: To capture the full content of this document, please select landscape mode (11" x 8.5") when printing.

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
RICHLAND MEMORIAL HOSPITAL

Employer identification number
37-1363001

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section (if applicable)	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of noncash assistance	(h) Purpose of grant or assistance
(1) Richland County High School 1200 East Laurel Street Olney,IL62450	37-6004449	Government	7,826				Sponsorship
(2) Richland County Development Corporation 315 West Main Street Olney,IL62450	37-1201502	501(c)(3)	13,500				Program Services

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2023

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of noncash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of noncash assistance

(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.

Return Reference

Explanation

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.

ANY CHARITABLE ORGANIZATION WISHING TO REQUEST FUNDS IS ASKED TO SUBMIT THEIR REQUEST IN WRITING. EMAILED REQUESTS ARE ACCEPTABLE. THE REQUEST MUST INCLUDE A DESCRIPTION OF THE PURPOSE OF THE CONTRIBUTION AND OTHER RELEVANT INFORMATION SUCH AS REQUESTORS NAME, AMOUNT OF THE REQUEST, ETC. THE REQUESTS ARE REVIEWED, EVALUATED, AND ADMINISTERED BY THE MARKETING AND COMMUNICATIONS (PUBLIC RELATIONS) DEPARTMENT, SEEKING ADDITIONAL INFORMATION FROM THE REQUESTOR, AS NEEDED, AND INPUT FROM ANY APPROPRIATE CARLE ADMINISTRATOR OR DIRECTOR. A SET OF ESTABLISHED GUIDELINES DRIVE THESE DECISIONS WHILE MOST ARE MADE TO IMPROVE HEALTHCARE/ACCESS TO HEALTHCARE OR ARE IN LINE WITH OUR ROLE AS A CORPORATE CITIZEN. ASSESSED NEED IS A COMMON CRITERIA. IN THE CASE OF MOST DONATIONS OF $5,000 OR MORE, SUCH AS TO COLLEGES AND UNIVERSITIES OR COMMUNITY CLINICS, WRITTEN AGREEMENTS ARE IN PLACE AND WE HAVE REGULAR CONTACT WITH THOSE ORGANIZATIONS, OFTENTIMES THROUGH A CARLE CONTACT PERSON TO ASSURE THAT THE DONATIONS ARE BEING USED AS AGREED UPON. THE RECORDS ARE EITHER MAINTAINED IN ADMINISTRATION OR PUBLIC RELATIONS.

Schedule I (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
medium right arrow graphic

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
medium right arrow graphic

Attach to Form 990.
medium right arrow graphic

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

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

Cat. No. 50053T

Schedule J (Form 990) 2023

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1Matthew Kolb JD MHA Ex Officio // President, Carle Health Regions // EVP, COO // TRUSTEE THRU 3/08/2023	(i) (ii)	0 ------------- 1,092,613	0 ------------- 219,047	0 ------------- 255,672	0 ------------- 335,494	0 ------------- 27,811	0 ------------- 1,930,637	0 ------------- 226,485
2Tanner Miller MD Trustee Beg 02/01/2023 // Physician	(i) (ii)	0 ------------- 424,496	0 ------------- 91,289	0 ------------- 2,263	0 ------------- 6,600	0 ------------- 27,851	0 ------------- 552,499	0 ------------- 0
3Raymond Fisher MD Trustee // Physician	(i) (ii)	0 ------------- 623,380	0 ------------- 0	0 ------------- 24,427	0 ------------- 6,600	0 ------------- 9,208	0 ------------- 663,615	0 ------------- 0
4Sally Salmons MD Trustee Thru 01/31/2023 // CHRH MEDICAL DIRECTOR	(i) (ii)	0 ------------- 446,923	0 ------------- 46,250	0 ------------- 79,234	0 ------------- 50,708	0 ------------- 22,171	0 ------------- 645,286	0 ------------- 0
5Dennis Hesch Officer - EVP, Chief Finance & Strategy Officer	(i) (ii)	0 ------------- 1,104,200	0 ------------- 262,608	0 ------------- 29,187	0 ------------- 346,286	0 ------------- 20,603	0 ------------- 1,762,884	0 ------------- 0
6Napoleon Knight MD MBA Officer - EVP, Chief Medial Officer	(i) (ii)	0 ------------- 775,491	0 ------------- 136,231	0 ------------- 29,153	0 ------------- 103,114	0 ------------- 12,345	0 ------------- 1,056,334	0 ------------- 0
7James C Leonard MD Officer - President & CEO	(i) (ii)	0 ------------- 1,690,975	0 ------------- 443,047	0 ------------- 3,555,979	0 ------------- 16,500	0 ------------- 20,385	0 ------------- 5,726,886	0 ------------- 3,526,792
8Regina Thomas DNP MBA Ex Officio, Non-Voting // Officer - President, Carle Health - South Region	(i) (ii)	0 ------------- 293,950	0 ------------- 30,968	0 ------------- 54,862	0 ------------- 36,601	0 ------------- 15,956	0 ------------- 432,337	0 ------------- 0
9Kenneth Aronson MD Former - Key Employee	(i) (ii)	0 ------------- 548,487	0 ------------- 100,157	0 ------------- 26,237	0 ------------- 16,500	0 ------------- 19,905	0 ------------- 711,286	0 ------------- 0
10Nicholas Crompton VP, Construction & Facility Services	(i) (ii)	0 ------------- 291,871	0 ------------- 30,843	0 ------------- 41,658	0 ------------- 37,180	0 ------------- 30,879	0 ------------- 432,431	0 ------------- 0
11Lauren Schmid MBA EVP, Chief Human Resources Officer	(i) (ii)	0 ------------- 674,332	0 ------------- 113,339	0 ------------- 158,040	0 ------------- 182,309	0 ------------- 27,331	0 ------------- 1,155,351	0 ------------- 128,983
12John Allen CRNA - CRMH Anesthesiology	(i) (ii)	334,029 ------------- 0	10,951 ------------- 0	9,442 ------------- 0	6,267 ------------- 0	28,487 ------------- 0	389,176 ------------- 0	0 ------------- 0
13Benjamin Curtis CRNA - CRMH Anesthesiology	(i) (ii)	324,071 ------------- 0	10,951 ------------- 0	12,430 ------------- 0	6,231 ------------- 0	28,750 ------------- 0	382,433 ------------- 0	0 ------------- 0
14Thomas Falcone CRNA - CRMH Anesthesiology	(i) (ii)	314,937 ------------- 0	10,951 ------------- 0	1,510 ------------- 0	6,195 ------------- 0	30,879 ------------- 0	364,472 ------------- 0	0 ------------- 0
15John Wall CRNA Lead - CRMH Anesthesiology	(i) (ii)	345,882 ------------- 0	11,389 ------------- 0	1,569 ------------- 0	6,458 ------------- 0	30,616 ------------- 0	395,914 ------------- 0	0 ------------- 0
16Mary Waller MD Physician - Urology	(i) (ii)	455,237 ------------- 0	1,721 ------------- 0	2,031 ------------- 0	6,600 ------------- 0	0 ------------- 0	465,589 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation	THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: - THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. - THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. - THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. - THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	THE 2023 PARTICIPANTS IN THE 457(F) PLAN OFFERED BY THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, THAT ARE LISTED IN THE 990 PART VII INCLUDE MATTHEW KOLB, JD, MHA, SALLY SALMONS, MD, DENNIS HESCH, JAMES C. LEONARD, MD, REGINA THOMAS, DNP, MBA, LAUREN SCHMID, MBA, AND NICHOLAS CROMPTON. IN 2023, PAYMENTS FROM THE 457(F) PLAN WERE MADE TO MATTHEW KOLB, JD, MHA ($226,485), JAMES C. LEONARD, MD ($3,526,792), AND LAUREN SCHMID, MBA ($128,983).
Schedule J, Part I, Line 7 Non-fixed payments	PART OF THE CEO'S COMPENSATION INCLUDES AN INCENTIVE COMPONENT WHICH IS DESIGNED TO ENCOURAGE AND PROMOTE THE ACHIEVEMENT OF CERTAIN QUALITY, OPERATIONAL, AND EFFICIENCY IMPROVEMENTS. ALTHOUGH THIS INCENTIVE COMPONENT IS BASED ON THE ORGANIZATION MEETING CERTAIN MINIMUM FINANCIAL THRESHOLDS, ALL PAYMENTS MUST BE APPROVED BY THE BOARD OF TRUSTEES PRIOR TO ANY INCENTIVE PAYOUT.

Schedule J (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

Schedule L
(Form 990)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered "Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c, or Form 990-EZ, Part V, line 38a or 40b.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... $

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ $

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e) Original principal amount	(f) Balance due	(g) In default?		(h) Approved by board or committee?		(i) Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e) Original principal amount	(f) Balance due	Yes	No	Yes	No	Yes	No




Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990) 2023

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Whitley Houchin	FAMILY MEMBER OF TRUSTEE	104,524	EMPLOYMENT		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation
Schedule L, Part V FAMILY RELATIONSHIPS	Whitley Houchin IS AN EMPLOYEE OF Richland Memorial Hospital Inc. AND HAS A FAMILY RELATIONSHIP WITH Gary Houchin (SECRETARY AND TREASURER OF BOARD).

Schedule L (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE O
(Form 990)

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Return Reference	Explanation
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	James C. Leonard, MD (Officer), Matthew Kolb, JD, MHA (Officer), Napoleon Knight, MD, MBA (Officer), and Sally Salmons, MD (Trustee) - Business relationship, James C. Leonard, MD (Officer) and Napoleon Knight, MD, MBA (Officer) - Business relationship, James C. Leonard, MD (Officer), Dennis Hesch (Officer), and Lauren Schmid, MBA (Key Employee) - Business relationship, Dennis Hesch (Officer), Matthew Kolb, JD, MHA (Officer), and Nicholas Crompton (Key Employee) - Business relationship
Form 990, Part VI, Line 4 Significant changes to organizational documents	DURING 2023, THE CARLE FOUNDATION D/B/A THE CARLE HEALTH SYSTEM AND PARENT ORGANIZATION OF THE CARLE FOUNDATION HOSPITAL, FORMED THREE SUBSIDIARY REGIONAL GOVERNING ENTITIES KNOWN AS CARLE HEALTH - EAST REGION, CARLE HEALTH - CENTRAL REGION, AND CARLE HEALTH - SOUTH REGION. EACH REGIONAL ENTITY BECAME THE SOLE MEMBER OF THE HOSPITALS WITHIN THE ORGANIZATION BASED ON THE GEOGRAPHICAL REGIONS. THE GOVERNING DOCUMENTS OF RICHLAND MEMORIAL HOSPITAL INC ARE TO BE AMENDED TO LIST THE SOLE MEMBER AS CARLE HEALTH - SOUTH REGION.
Form 990, Part VI, Line 6 Classes of members or stockholders	Richland Memorial Hospital, Inc. DBA Carle Richland Memorial Hospital has one member which is Carle Health - South Region.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	Richland Memorial Hospital Inc.'s sole member, Carle Health - South Region, acting through its board of trustees, has the exclusive power to elect and remove members of the board of trustees for the corporation in addition to filling vacancies.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	RICHLAND MEMORIAL HOSPITAL, INC. MUST HAVE THE APPROVAL OF ITS SOLE MEMBER, CARLE HEALTH - SOUTH REGION, THROUGH ITS BOARD OF TRUSTEES, WHEN VOTING ON MATTERS INCLUDING THE AMENDING OF GOVERNING DOCUMENTS; RECOMMENDING THE CEO TO THE BOARD; APPROVING ANY ANNUAL OR LONG-TERM CAPITAL OR OPERATIONAL BUDGETS; APPROVING PAYMENT TO THE MEMBERS OF THE RICHLAND BOARD OF TRUSTEES FOR THEIR EXPENSES OR COMPENSATION FOR SERVICES; APPROVING ANY NEW, LONG-TERM OR MASTER INSTITUTIONAL PLANS OR CHANGES TO SUCH PLANS; APPROVING THE ADDITION OF ANY NEW MEMBER AND ANY DISSOLUTION, MERGER, CONSOLIDATION, OR SALE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL ASSETS OR ANY DISPOSITION OF REAL PROPERTY OR RELOCATION OF THE HOSPITAL AND/OR CLINIC; APPROVING ANY ORGANIZATION OR ACQUISITION OF A SUBSIDIARY OR AFFILIATE; APPROVING ANY INITIATIVE REQUIRING CERTIFICATE OF NEED (CON) APPROVAL; APPROVING ANY PLEDGE OF ALL OR ANY PART OF THE CORPORATION'S ASSETS AS SECURITY FOR A DEBT, LIABILITY OR OTHER OBLIGATION; APPROVING ANY LOAN TO OR FOR THE CORPORATION OR ANY OTHER INDEBTEDNESS; AND APPROVING NON-BUDGETED EXPENDITURES OR SALE EXCEEDING THE CHIEF EXECUTIVE OFFICER'S (CEO) AUTHORIZED SPENDING AUTHORITY.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE FORM 990 WAS PREPARED BY STAFF AND AN EXTERNAL TAX ADVISOR AND REVIEWED BY MANAGEMENT. PRIOR TO FILING THIS FORM 990, A FULL AND COMPLETE COPY WAS PROVIDED TO THE GOVERNING BODY. AT THEIR DISCRETION, THE GOVERNING MEMBERS HAVE THE OPPORTUNITY TO CONTACT MANAGEMENT OR DISCUSS AND ADDRESS CONCERNS AT SUBSEQUENT BOARD MEETINGS.
Form 990, Part VI, Line 12c Conflict of interest policy	THE ORGANIZATION'S ESTABLISHED CONFLICT OF INTEREST POLICIES REQUIRE ANNUAL DISCLOSURE OF ACTUAL AND POTENTIAL CONFLICTS OF INTEREST FOR OFFICERS, DIRECTORS, TRUSTEES, MEMBERS OF BOARD COMMITTEES, ADMINISTRATIVE AND MANAGERIAL EMPLOYEES AS WELL AS ALL EMPLOYEES OF THE PURCHASING DEPARTMENT. IF CIRCUMSTANCES CHANGE DURING THE COURSE OF A YEAR, INTERIM DISCLOSURE IS ALSO REQUIRED OF THE SAME INDIVIDUALS. THE DISCLOSURES OF EMPLOYEES ARE REVIEWED INITIALLY BY THE COMPLIANCE DEPARTMENT AND ANY IDENTIFIED CONFLICTS ARE REFERRED TO, AND ADDRESSED BY, THE ORGANIZATION'S INTERNAL LEGAL COUNSEL AND/OR CORPORATE INTEGRITY OFFICER. THE DISCLOSURES OF TRUSTEES AND MEMBERS OF BOARD COMMITTEES ARE REVIEWED BY THE CHAIR OF THE BOARD. THE ENTIRE BOARD, ABSENT THE SUBJECT TRUSTEE OR COMMITTEE MEMBER DETERMINES WHETHER A CONFLICT EXISTS. TRUSTEES AND/OR BOARD COMMITTEE MEMBERS WITH IDENTIFIED CONFLICTS ARE REQUIRED TO RECUSE THEMSELVES FROM DELIBERATING AND VOTING ON MATTERS THAT MAY PRESENT A CONFLICT. THE ORGANIZATION ALSO MAINTAINS PURCHASING POLICIES REQUIRING COUNTER SIGNATURES TO FURTHER MINIMIZE THE RISK ASSOCIATED WITH ACTUAL AND/OR POTENTIAL CONFLICTS OF INTEREST.
Form 990, Part VI, Line 19 Required documents available to the public	THE CARLE FOUNDATION PUBLISHES THROUGH WWW.DACBOND.COM AND HTTPS://EMMA.MSRB.ORG/ ITS QUARTERLY UNAUDITED FINANCIAL STATEMENTS, ANNUAL AUDITED FINANCIAL STATEMENTS, A MANAGEMENT'S DISCUSSION & ANALYSIS TO ACCOMPANY THE FINANCIAL STATEMENTS, AND AN ANNUAL REPORT OF CERTAIN OPERATING AND FINANCIAL INFORMATION. ADDITIONALLY, OFFICIAL STATEMENTS FOR OUTSTANDING MUNICIPAL BOND ISSUES FOR WHICH THE CARLE FOUNDATION IS OBLIGATED ARE AVAILABLE AT THIS WEBSITE. THESE DOCUMENTS INCLUDE EXTENSIVE INFORMATION ABOUT THE ORGANIZATION'S HEALTH CARE DELIVERY SYSTEM MODEL, RECENT HIGHLIGHTS/ACCOMPLISHMENTS, GOVERNANCE AND ADMINISTRATION, STRATEGIC PLAN, FACILITIES, CLINICAL PROGRAMS, MEDICAL STAFF, SERVICE AREA, COMPETITIVE ENVIRONMENT, DEMOGRAPHIC DATA, UTILIZATION STATISTICS, SUMMARY FINANCIAL INFORMATION, ACADEMIC AFFILIATIONS AND EDUCATIONAL PROGRAMS, MEDICAL RESEARCH, ACCREDITATIONS, AND ITS EMPLOYEES. THIS INFORMATION IS AVAILABLE AT NO CHARGE TO THOSE WHO REGISTER AT THE WWW.DACBOND.COM WEBSITE. IN ADDITION, THE FORM 990S OF THE ORGANIZATION'S FILING ENTITIES ARE AVAILABLE THROUGH DACBOND. QUARTERLY FINANCIAL STATEMENTS ARE ALSO AVAILABLE UPON REQUEST DELIVERED TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE ALSO AVAILABLE UPON REQUEST TO THE ORGANIZATION'S ADMINISTRATIVE OFFICES.
Form 990, Part VII, Section A COLUMN B	THE AVERAGE ESTIMATED HOURS PER WEEK LISTED FOR THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS ARE BASED ON A STANDARD 40 HOUR WEEK. MEMBERS MAY FREQUENTLY DEVOTE MORE THAN 40 HOURS OF SERVICE TO THE ENTIRE ORGANIZATION DURING AN AVERAGE WEEK.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Other - Total Revenue: 86416, Related or Exempt Function Revenue: 75835, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: 10581;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	INTERCOMPANY RECEIVABLE/PAYABLE SETTLEMENTS - 8802013;
Form 990, Part XII, Line 2c Change of Oversight Process or Selection Process	FORM 990 PART XII, QUESTION 2A, B, C AND PART IV, QUESTION 12 THE FINANCIAL STATEMENTS FOR RICHLAND MEMORIAL HOSPITAL WERE REVIEWED ON A CONSOLIDATED BASIS UNDER THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE CARLE FOUNDATION HAS AN AUDIT COMMITTEE CONSISTING OF MEMBERS OF THE GOVERNING BOARD AND THE CHIEF FINANCIAL OFFICER WHO TOGETHER ASSUME RESPONSIBILITY FOR OVERSIGHT OF THE REVIEW AND AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT OR AUDITOR.
Form 990, Part VI, Line 15 15A & 15B - Procces to establish compensation of top management official	RICHLAND MEMORIAL HOSPITAL DOES NOT COMPENSATE ITS OFFICERS. EMPLOYEE COMPENSATION FOR THESE INDIVIDUALS IS COMPENSATED BY THE PARENT ORGANIZATION, THE CARLE FOUNDATION. THE BOARD OF TRUSTEES OF THE CARLE FOUNDATION, THE PARENT ORGANIZATION OF RICHLAND MEMORIAL HOSPITAL, THROUGH ITS COMPENSATION COMMITTEE COMPRISED OF INDEPENDENT MEMBERS FREE OF CONFLICT, ANNUALLY REVIEWS EXECUTIVE COMPENSATION LEVELS AND ESTABLISHES APPROPRIATE SALARY RANGES AND OTHER FEATURES OF THE COMPENSATION PLAN IN ACCORDANCE WITH THE ORGANIZATION'S APPROVED COMPENSATION PHILOSOPHY AND STRATEGY: - THE COMMITTEE IS COMPRISED OF MEMBERS OF THE BOARD OF TRUSTEES; WHO ARE INDEPENDENT OF THE CARLE FOUNDATION MANAGEMENT; HAVE NO PERSONAL INTEREST IN THE COMPENSATION ARRANGEMENTS; ARE NOT RELATED TO, OR UNDER THE CONTROL OF ANY INDIVIDUAL WHOSE COMPENSATION ARRANGEMENT IS BEING REVIEWED; AND HAVE NO MATERIAL BUSINESS RELATIONSHIP WITH THE CARLE FOUNDATION. - THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS DETERMINED BY THE COMPENSATION COMMITTEE IN RELATION TO APPROPRIATE COMPARABILITY DATA. COMPENSATION FOR OTHER MEMBERS OF THE EXECUTIVE STAFF IS DEVELOPED BY THE CEO, EVALUATED AGAINST MARKET DATA, AND REVIEWED AND APPROVED BY THE COMMITTEE. - THE COMMITTEE APPROVES ALL ANNUAL COMPENSATION DECISIONS IN ADVANCE OF THEIR IMPLEMENTATION AND DOCUMENTS ITS DETERMINATIONS AND DISCUSSIONS. - THE COMPENSATION COMMITTEE RELIES UPON A NUMBER OF EXTERNAL RESOURCES AND COMPARISONS, AND ITS ANALYSIS INCLUDES TOTAL COMPENSATION (CASH COMPENSATION PLUS BENEFITS PROVIDED BY THE CARLE FOUNDATION) IN RELATION TO ORGANIZATIONAL PERFORMANCE AND PREVAILING INDUSTRY PRACTICES FOR LIKE RESPONSIBILITIES AT COMPARABLY-SIZED ORGANIZATIONS. THE COMMITTEE HAS ENGAGED THE SERVICES OF A COMPENSATION CONSULTING FIRM SPECIALIZING IN THE NOT-FOR-PROFIT SECTOR WHICH HAS WORKED WITH THE CARLE FOUNDATION AND MAKES ITS REPORTS DIRECTLY AVAILABLE TO THE COMPENSATION COMMITTEE.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

RICHLAND MEMORIAL HOSPITAL

Employer identification number

37-1363001

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)CARLE BROMENN MEDICAL CENTER 611 W PARK STREET URBANA,IL61801 85-0682363	Hospital Services	IL	501(c)(3)	3	CHCR	Yes
(2)CARLE COMMUNITY HEALTH CORPORATION 611 W PARK STREET URBANA,IL61801 36-4458371	FNDN Mission	IL	501(c)(3)	Type I	TCDF	Yes
(3)CARLE EUREKA HOSPITAL 611 W PARK STREET URBANA,IL61801 85-0688306	Hospital Services	IL	501(c)(3)	3	CHCR	Yes
(4)CARLE HEALTH - CENTRAL REGION 611 W PARK STREET URBANA,IL61801 99-0548510	Governance/Oversight	IL	501(c)(3)	Type III-FI	TCF	Yes
(5)CARLE HEALTH - EAST REGION 611 W PARK STREET URBANA,IL61801 99-0582680	Governance/Oversight	IL	501(c)(3)	Type III-FI	TCF	Yes
(6)CARLE HEALTH - SOUTH REGION 611 W PARK STREET URBANA,IL61801 99-0614340	Governance/Oversight	IL	501(c)(3)	Type III-FI	TCF	Yes
(7)CARLE HEALTH - WEST REGION 611 W PARK STREET URBANA,IL61801 37-1111135	Governance/Oversight	IL	501(c)(3)	Type III-FI	TCF	Yes
(8)CARLE HEALTH CARE INCORPORATED 611 W PARK STREET URBANA,IL61801 37-1140016	Various Medical Services	IL	501(c)(3)	10	TCF	Yes
(9)CARLE RETIREMENT CENTERS INC 611 W PARK STREET URBANA,IL61801 37-1160033	Retirement Living	IL	501(c)(3)	10	TCF	Yes
(10)CARLE WEST PHYSICIAN GROUP INC 611 W PARK STREET URBANA,IL61801 85-0703768	Physician Services	IL	501(c)(3)	10	CHCI	Yes
(11)CRIS HEALTHY AGING 611 W PARK STREET URBANA,IL61801 37-0948852	Senior Citizen Services	IL	501(c)(3)	7	CHCI	Yes
(12)HOOPESTON COMMUNITY MEMORIAL HOSPITAL 611 W PARK STREET URBANA,IL61801 36-3637465	Hospital Services	IL	501(c)(3)	3	CHER	Yes
(13)HULT CENTER FOR HEALTHY LIVING INC 611 W PARK STREET URBANA,IL61801 36-3510390	Wellness Services	IL	501(c)(3)	7	PH	Yes
(14)HUMAN SERVICE CENTER 611 W PARK STREET URBANA,IL61801 37-1004882	Behavioral Health Services	IL	501(c)(3)	7	TP	Yes
(15)METHODIST MEDICAL CENTER FOUNDATION 611 W PARK STREET URBANA,IL61801 51-0186460	Fundraising	IL	501(c)(3)	7	CHWR	Yes
(16)METHODIST SERVICES INC 611 W PARK STREET URBANA,IL61801 37-1111134	Property Holding Co.	IL	501(c)(3)	10	CHWR	Yes
(17)PARK COURT LIMITED 611 W PARK STREET URBANA,IL61801 37-1178386	Property Holding Co.	IL	501(c)(3)	Type II	CHWR	Yes
(18)PEKIN MEMORIAL HOSPITAL 611 W PARK STREET URBANA,IL61801 37-0692351	Hospital Services	IL	501(c)(3)	3	CHWR	Yes
(19)PEKIN MEMORIAL HOSPITAL FOUNDATION 611 W PARK STREET URBANA,IL61801 37-1200267	Fundraising	IL	501(c)(3)	7	CHWR	Yes
(20)PRAIRIE VIEW VILLAS NO 1 1900 SPRING ROAD STE 300 OAK BROOK,IL605231480 26-1755679	Housing Services	IL	501(c)(3)	7	TMHC	Yes
(21)PROCTOR HEALTH SYSTEMS 611 W PARK STREET URBANA,IL61801 36-4147437	Physician Services	IL	501(c)(3)	3	CHWR	Yes
(22)PROCTOR HOSPITAL 611 W PARK STREET URBANA,IL61801 37-0681540	Hospital Services	IL	501(c)(3)	3	CHWR	Yes
(23)TAZWOOD MENTAL HEALTH CENTER INC 611 W PARK STREET URBANA,IL61801 37-1278969	Behavioral Health Services	IL	501(c)(3)	7	TP	Yes
(24)THE CARLE DEVELOPMENT FOUNDATION 611 W PARK STREET URBANA,IL61801 37-1159978	Fundraising	IL	501(c)(3)	7	TCF	Yes
(25)THE CARLE FOUNDATION 611 W PARK STREET URBANA,IL61801 37-0673465	Parent/Inv Mgmt	IL	501(c)(3)	Type III-FI	NA		No
(26)THE CARLE FOUNDATION HOSPITAL 611 W PARK STREET URBANA,IL61801 37-1119538	Hospital Services	IL	501(c)(3)	3	CHER	Yes
(27)THE METHODIST MEDICAL CENTER OF ILLINOIS 611 W PARK STREET URBANA,IL61801 37-0661223	Hospital Services	IL	501(c)(3)	3	CHWR	Yes
(28)THE METHODIST MEDICAL CENTER OF ILLINOIS SELF INSURANCE TRUST AGREEMENT 611 W PARK STREET URBANA,IL61801 37-6181831	Self Insurance	IL	501(c)(3)	Type I	MMCI	Yes
(29)TRILLIUM PLACE 611 W PARK STREET URBANA,IL61801 83-4051901	Behavioral Health Services	IL	501(c)(3)	10	CHWR	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) CHAMPAIGN SURGICENTER LLC 611 W PARK STREET URBANA,IL61801 20-1915925	Surgical Center	IL	NA	N/A
(2) FIELDS SOUTH LLC 611 W PARK STREET URBANA,IL61801 82-3187698	Property & Facility Management	IL	NA	N/A
(3) MOUPH LLC 611 W PARK STREET URBANA,IL61801 92-1791534	Outpatient Orthopedic Services	IL	NA	N/A
(4) REHABILITATION THERAPY SERVICES LLC 416 ST MARKS CT 110 PEORIA,IA61603 81-0584193	Rehabilitation Therapy	IL	NA	N/A
(5) THE CENTER FOR ORTHOPEDIC MEDICINE LLC RECOVERY CARE CENTER 2502B E EMPIRE ST BLOOMINGTON,IL61704 27-0934895	Outpatient Orthopedic Services	IL	NA	N/A
(6) THE CENTER FOR ORTHOPEDIC MEDICINE LLC SURGERY CENTER 2502B E EMPIRE ST BLOOMINGTON,IL61704 37-1356453	Outpatient Orthopedic Services	IL	NA	N/A

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) BELCREST SERVICES LTD 611 W PARK STREET URBANA,IL61801 37-1196307	Medical Services	IL	NA	C Corporation				Yes
(2) CARLE HEALTH JUNCTION MEDICAL LLC 611 W PARK STREET URBANA,IL61801 81-4609769	Care Coordination	IL	NA	C Corporation				Yes
(3) CARLE HEALTH PHYSICIAN PARTNERS INC 611 W PARK STREET URBANA,IL61801 85-0718392	Physician Services	IL	NA	C Corporation				Yes
(4) CARLE HOLDING COMPANY INC 611 W PARK STREET URBANA,IL61801 37-1188284	Holding Co.	IL	NA	C Corporation				Yes
(5) CARLE RESEARCH PRODUCTS INC 611 W PARK STREET URBANA,IL61801 99-9999999	Medical Research - INACTIVE	IL	NA	C Corporation				Yes
(6) CARLE RISK MANAGEMENT COMPANY 611 W PARK STREET URBANA,IL61801 37-1217973	Risk Management	IL	NA	C Corporation				Yes
(7) CARLE VENTURES INC 611 W PARK STREET URBANA,IL61801 37-1313150	Health Care Partnerships	IL	NA	C Corporation				Yes
(8) CHA HOLDING INC 3310 SOUTH FIELDS DR CHAMPAIGN,IL61822 47-1854275	Holding Co.	IL	NA	C Corporation				Yes
(9) FIRSTCAROLINACARE INSURANCE COMPANY 42 MEMORIAL DR PINEHURST,NC28374 33-1160597	Insurance	IL	NA	C Corporation				Yes
(10) HEALTH ALLIANCE CONNECT INC 3310 SOUTH FIELDS DR CHAMPAIGN,IL61822 46-4796891	Health Care Coordination	IL	NA	C Corporation				Yes
(11) HEALTH ALLIANCE MEDICAL PLANS INC 3310 SOUTH FIELDS DR CHAMPAIGN,IL61822 37-1260731	Health Coverage	IL	NA	C Corporation				Yes
(12) HEALTH ALLIANCE MIDWEST INC 3310 SOUTH FIELDS DR CHAMPAIGN,IL61822 37-1354502	Health Coverage	IL	NA	C Corporation				Yes
(13) HEALTH ALLIANCE NORTHWEST HEALTH PLAN 820 N CHELAN AVE WENATCHEE,WA98801 46-1966323	Health Coverage	WA	NA	C Corporation				Yes
(14) HEALTH ALLIANCE NORTHWEST HOLDING 820 N CHELAN AVE WENATCHEE,WA98801 46-1717578	Holding Co.	WA	NA	C Corporation				Yes
(15) HEALTH PLUS INC 611 W PARK STREET URBANA,IL61801 37-1295532	Contracting	IL	NA	C Corporation				Yes
(16) HEALTH SYSTEMS INSURANCE LIMITED Governors Square 2nd Floor Bldg 3 23 Lime Tree Bay Ave Grand CaymanKY11102 CJ 98-0638449	Insurance	CJ	NA	C Corporation				Yes
(17) METHODIST HEALTH VENTURES INC 611 W PARK STREET URBANA,IL61801 37-1140939	Holding Co.	IL	NA	C Corporation				Yes
(18) OPTIMUM HEALTH SOLUTIONS INC 611 W PARK STREET URBANA,IL61801 20-5430137	Care Coordination - INACTIVE	IL	NA	C Corporation				Yes
(19) PEKIN PROHEALTH INC 611 W PARK STREET URBANA,IL61801 37-1117052	Clinical Operations	IL	NA	C Corporation				Yes
(20) PROVIDER RESOURCE MANAGEMENT INC 611 W PARK STREET URBANA,IL61801 37-1223550	Physician Services	IL	NA	C Corporation				Yes

Schedule R (Form 990) 2023

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

Yes

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

Yes

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

o Sharing of paid employees with related organization(s) ............................

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) Carle Health Care Incorporated	A	9,600	Book
(2) Health Alliance Medical Plans Inc	A	538	Book
(3) Carle Development Foundation	C	111,768	Book
(4) Health Alliance Connect Inc	L	536,117	Book
(5) Health Alliance Medical Plans Inc	L	2,265,205	Book
(6) Methodist Medical Center of Illinois	L	98,850	Book
(7) Health Systems Insurance Limited	M	291,201	Book
(8) Hoopeston Community Memorial Hospital	S	87,087	Book

Schedule R (Form 990) 2023

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2023

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2023

Additional Data

Software ID:	23017437
Software Version:	2023v5.1

1	Briefly describe the organization’s mission or most significant activities: TO PROVIDE EXCELLENT HEALTHCARE, PROMOTE WELLNESS, AND EDUCATE PATIENTS, STAFF, AND THE COMMUNITY.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	10
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	7
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	514
6	Total number of volunteers (estimate if necessary) .............	6	53
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	578,931
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	2,755,502	160,537
9	Program service revenue (Part VIII, line 2g) .........	59,309,027	62,991,249
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	40,627	24,892
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	724,228	870,075
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	62,829,384	64,046,753
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	74,527	50,396
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	40,721,287	41,811,150
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	31,003,925	32,162,008
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	71,799,739	74,023,554
19	Revenue less expenses. Subtract line 18 from line 12.......	-8,970,355	-9,976,801
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	26,663,290	24,883,089
21	Total liabilities (Part X, line 26).............	13,457,935	12,852,522
22	Net assets or fund balances. Subtract line 21 from line 20.....	13,205,355	12,030,567

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 66,039,785 including grants of $ 50,396 ) (Revenue $ 63,067,084 )
	Richland Memorial Hospital, Inc., DBA Carle Richland Memorial Hospital (CRMH) is a tax-exempt Illinois not-for-profit corporation established for the purpose of operating a hospital and conducting patient care related activities. Richland is a 25 bed hospital (45 bed during tax year 2023) providing a range of ancillary and support services. For 2023, the hospital admitted 1,652 patients, is fully accredited by the Healthcare Facilities Accreditation Program (HFAP), has an Emergent Stroke Ready Designation and a Level II Nursery Designation by the Illinois Department of Public Health and is a clinical hub site for Southern Illinois University Physician Assistant Program. In 2023, CRMH recorded 11,655 patient days. In addition to the hospital, the organization has three rural health clinics: -Carle Bridgeport is located at 100 Industry Road, Bridgeport, IL, and offers audiology and hearing, behavioral health, cardiovascular medicine, family medicine, midwifery, orthopedics, and otolaryngology (ENT: ear, nose, and throat) services Monday through Friday, 8 a.m. to 5 p.m. -Carle Olney is located at 363 N. West Street, Olney, IL, 1.3 miles from the hospital, which offers behavioral health, convenient care, and family medicine services 8 a.m. - 8 p.m. seven days per week. -Carle West Salem is located at 100 S. Main Street, West Salem, IL, and offers family medicine services Monday through Friday, 8 a.m. to 5 p.m. In addition to the rural health clinics, Richland provides services under the following: -CRMH Professional Services located at 605 E. Main Street, Olney, IL one-half mile from the hospital and offers general surgery and podiatry services. -The Apothecary Shoppe, located at 108 S. Main Street, West Salem, IL, offers retail pharmacy services Monday through Friday from 9 a.m. to 3 p.m., and Saturdays from 9 a.m. to noon. CRMH provides quality medical healthcare regardless of race, creed, gender, national origin, disability, age or ability to pay. Although reimbursement for services rendered is critical to the operation and stability of the hospital, it is recognized that not all individuals possess the ability to purchase essential medical services. The mission of CRMH is to serve our community with respect in providing healthcare services and healthcare education. Therefore, in keeping with the commitment to serve all members of the community, we offer: -Free care to qualified individuals under the CRMH financial assistance program -Care provided to persons covered by governmental programs at below cost; and -Health activities and programs to support and educate the community. These activities include wellness programs, community education programs, professional education programs, and a variety of broad community support activities. CRMH provides care to persons covered by governmental programs at below cost. The hospital also provides care to persons covered by commercial insurance at below cost. Recognizing its mission to the community, services are provided to both Medicare and Medicaid patients. To the extent reimbursement is below cost, the hospital recognizes these amounts as cost incurred in meeting its mission to the entire community. Financial assistance was also provided through CRMH's financial assistance policy offered in 2023.

4b	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4c	(Code: ) (Expenses $ including grants of $ ) (Revenue $ )












4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses66,039,785

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)				(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) Lauren Schmid MBA EVP, Chief Human Resources Officer	1.0 .......................39.0	X			0	945,711	209,640
(19) Nicholas Crompton VP, Construction & Facility Services	1.0 .......................39.0	X			0	364,372	68,059
(20) Benjamin Curtis CRNA - CRMH Anesthesiology	40.0 .......................0.0		X		347,452	0	34,981
(21) John Allen CRNA - CRMH Anesthesiology	40.0 .......................0.0		X		354,422	0	34,754
(22) John Wall CRNA Lead - CRMH Anesthesiology	40.0 .......................0.0		X		358,840	0	37,074
(23) Mary Waller MD Physician - Urology	40.0 .......................0.0		X		458,989	0	6,600
(24) Thomas Falcone CRNA - CRMH Anesthesiology	40.0 .......................0.0		X		327,398	0	37,074
(25) Kenneth Aronson MD Former - Key Employee	0.0 .......................40.0			X	0	674,881	36,405

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	1,847,101	13,697,209	1,522,820

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	111,768
e	Government grants (contributions)		1e	48,769

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		160,537

		Business Code
2a	NET PATIENT SERVICE REVENUE	622110	62,980,170	62,980,170
b	RENT FROM RELATED ORGS	523000	10,138	10,138
c	ALL OTHER PROGRAM SERVICES REVENUE	900099	941	941
d
e
f	All other program service revenue.		0	0	0	0
g	Total. Add lines 2a–2f .....		62,991,249

3 Investment income (including dividends, interest, and othersimilar amounts) ......			24,892			24,892
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c	0	0
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a
b	Less: cost or other basis and sales expenses	7b
c	Gain or (loss)	7c	0	0
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a	1,670,908
b	Less: cost of goods sold ..		10b	1,133,560
c	Net income or (loss) from sales of inventory..			537,348		537,348

Business Code
11a	CAFETERIA SERVICES		722331	204,728			204,728
b	CATERING REVENUE		722320	27,550		27,550
c	LAUNDRY SERVICES		812331	14,033		14,033
d	All other revenue ....			86,416	75,835	0	10,581
e	Total. Add lines 11a–11d ......			332,727
12	Total revenue. See instructions.....			64,046,753	63,067,084	578,931	240,201

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	50,396	50,396
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........	104,524	104,524
7	Other salaries and wages........	35,245,467	31,131,292	4,114,175
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	520,914	471,370	49,544
9	Other employee benefits .......	3,666,730	3,057,801	608,929
10	Payroll taxes ...........	2,273,515	2,078,271	195,244
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........
d	Lobbying ...........	15,084		15,084
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	3,292,948	2,848,539	444,409	0
12	Advertising and promotion ....	2,249	2,249
13	Office expenses .......	1,136,009	692,912	443,097
14	Information technology ......	293,084	256,204	36,880
15	Royalties ..
16	Occupancy ...........	950,550	660,355	290,195
17	Travel ............	37,361	22,860	14,501
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	40,390	33,150	7,240
20	Interest ...........	187,669	161,656	26,013
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	2,045,693	1,501,821	543,872
23	Insurance ...	361,323	272,144	89,179
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Internal Management Fees	12,858,453	12,307,580	550,873
b	Patient Care Supplies	7,237,480	7,237,480
c	Provider Assessment Tax	2,999,979	2,999,979
d	Physician recruitment	132,792		132,792
e	All other expenses	570,944	149,202	421,742	0
25	Total functional expenses. Add lines 1 through 24e	74,023,554	66,039,785	7,983,769	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........			1,377,471	2	2,232,803
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			4,231,585	4	3,183,933
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........			232,045	7	64,183
8	Inventories for sale or use ............			1,724,548	8	835,852
9	Prepaid expenses and deferred charges ......			212,171	9	223,229
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	66,250,953
b	Less: accumulated depreciation	10b	47,992,273	18,636,196	10c	18,258,680
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			249,274	15	84,409
16	Total assets. Add lines 1 through 15 (must equal line 33)...			26,663,290	16	24,883,089

17	Accounts payable and accrued expenses .....	4,204,867	17	4,610,864
18	Grants payable ...		18
19	Deferred revenue .........	998	19	0
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	4,634,730	23	4,263,600
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	4,617,340	25	3,978,058
26	Total liabilities. Add lines 17 through 25..	13,457,935	26	12,852,522

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	13,205,355	27	12,030,567
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	13,205,355	32	12,030,567
33	Total liabilities and net assets/fund balances ........	26,663,290	33	24,883,089