TY 2022 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) DR SEAN D HENDRICKS...................................................................... CLINIC PHYSI	40.00 ................. 0.00				X	1,437,693	0	23,545
(2) DR HUMAM FARAH...................................................................... CLINIC PHYSI	40.00 ................. 0.00				X	1,407,533	0	43,152
(3) DR DARR W LEUTZ...................................................................... CLINIC PHYSI	40.00 ................. 0.00				X	1,309,964	0	47,735
(4) MAUREEN A KAHN RETIRED 7123...................................................................... PRES/CEO BCS	0.00 ................. 40.00	X	X			0	1,032,261	222,469
(5) DR HARSHA V POLAVARAPU...................................................................... TRUSTEE	40.00 ................. 0.00	X				1,161,837	0	48,735
(6) DR DAVID C LIEBER...................................................................... CLINIC PHYSI	40.00 ................. 0.00				X	1,148,061	0	48,735
(7) DR WILLIAM C SEVERINO...................................................................... CLINIC PHYSI	40.00 ................. 0.00				X	1,147,828	0	48,735
(8) DR JOHN D HAMMOCK...................................................................... TRUSTEE	40.00 ................. 0.00	X				828,018	0	44,284
(9) DR CHRISTOPHER R SOLARO...................................................................... CHIEF MEDICA	40.00 ................. 0.00			X		756,841	0	48,735
(10) PATRICK M GERVELER...................................................................... TREASURER	0.00 ................. 40.00		X			0	641,872	144,045
(11) BRIAN T CANFIELD...................................................................... PRES/CEO BCS	0.00 ................. 40.00	X				0	525,747	15,250
(12) TIMOTHY L TRANOR...................................................................... CHIEF NURSIN	40.00 ................. 0.00			X		281,248	0	46,513
(13) DR TIMOTHI J BETH...................................................................... TRUSTEE	40.00 ................. 0.00	X				248,958	0	37,023
(14) DR ABBY REICH...................................................................... TRUSTEE	40.00 ................. 0.00	X				172,744	0	29,302
(15) SAYEED ALI...................................................................... BOARD VICE-C	1.00 ................. 0.00	X	X			0	0	0
(16) NANCY BLUHM...................................................................... TRUSTEE	1.00 ................. 0.00	X				0	0	0
(17) DAVID BOSTER...................................................................... TRUSTEE	1.00 ................. 0.00	X				0	0	0

(A) Name and business address	(B) Description of services	(C) Compensation
MEDICAL SOLUTIONS LLC PO BOX 850737 MINNEAPOLIS,MN55485	CONTRACT LABOR	16,094,404
QUINCY ANESTHESIA ASSOCIATES PC PO BOX 7005 QUINCY,IL62301	ANESTHESIA SVCS	14,881,307
MAXIM HEALTHCARE STAFFING SERVICES 12558 COLLECTIONS CENTER DR CHICAGO,IL60693	CONTRACT LABOR	5,952,230
SM WILSON & CO 2185 HAMPTON AVE ST LOUIS,MO63139	CONSTRUCTION	4,350,606
WEST CENTRAL PATHOLOGY SPECIALISTS 4000 CATAMARAN CT QUINCY,IL62305	PATHOLOGY SVCS	3,412,763
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 68

- 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

2022

Open to Public
Inspection

Name of the organization

BLESSING HOSPITAL

Employer identification number

37-0661183

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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 2022 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2022. 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—2021. 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—2022. 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—2021. 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) 2022

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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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) 2018	(b) 2019	(c) 2020	(d) 2021	(e) 2022	(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 2022 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2021 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2022 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2021 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2022. 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—2021. 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) 2022

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) 2022

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) 2022

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) 2022

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 2022 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-2022	(iii) Distributable Amount for 2022
1 Distributable amount for 2022 from Section C, line 6
2 Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2022:
a From 2017.......
b From 2018.......
c From 2019.......
d From 2020.......
e From 2021.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2022 distributable amount
i Carryover from 2017 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2022 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2022 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2022, 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 2022. 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 2023. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2018.....
b Excess from 2019.....
c Excess from 2020.....
d Excess from 2021.....
e Excess from 2022.....

Schedule A (Form 990) (2022)

Schedule A (Form 990) 2022

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) 2022

Additional Data

Software ID:
Software Version:

- 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

2022

Name of the organization

BLESSING HOSPITAL

Employer identification number

37-0661183

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) (2022)

Schedule B (Form 990) (2022) Page 2

Name of organization BLESSING 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) (2022)

Schedule B (Form 990) (2022)

Page 3

Name of organization BLESSING HOSPITAL		Employer identification number 37-0661183

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) (2022)

Schedule B (Form 990) (2022)

Page 4


Name of organization BLESSING HOSPITAL			Employer identification number 37-0661183
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) (2022)

Additional Data

Software ID:
Software Version:

- 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

SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

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

OMB No. 1545-0047

2021

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

BLESSING HOSPITAL

Employer identification number

37-0661183

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 .................................................................... SchCMd Bullet

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 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

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 ..... SchCMd Bullet

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

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

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) 2021

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 SchCMd Bullet

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 SchCMd Bullet

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) 2018	(b) 2019	(c) 2020	(d) 2021	(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) 2021

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? ..........................................................

Yes

41,714

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

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

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

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

41,714

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	MEMBERSHIP DUES ARE PAID ON AN ANNUAL BASIS TO THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. 37% OF DUES ARE ALLOCABLE TO LOBBYING EXPENDITURES, WHICH INCLUDE CONGRESSIONAL VISITS AND CONTACTING REPRESENTATIVES.

Schedule C (Form 990) 2021

Additional Data

Software ID:
Software Version:

- 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.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

BLESSING HOSPITAL

Employer identification number

37-0661183

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 7/25/06, 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 SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

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
SchDMd Bullet

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

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 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

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 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2021

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 ....	1,859,684	1,859,659	1,826,971	1,859,737	1,928,985
b	Contributions ...
c	Net investment earnings, gains, and losses	135,779	25	32,688	-32,766	-69,278
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	29,021
f	Administrative expenses ....	6,837
g	End of year balance ......	1,959,605	1,859,684	1,859,659	1,826,971	1,859,737

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

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

95.210 %

Term endowment SchDMd Bullet

4.790 %

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)

Yes

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

Yes

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 .....	16,905,128		16,905,128
b	Buildings ....	339,138,450	120,161,634	218,976,816
c	Leasehold improvements	13,522,539	6,973,169	6,549,370
d	Equipment ....
e	Other .....	274,912,079	169,059,366	105,852,713
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				348,284,027

Schedule D (Form 990) 2021

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) MUTUAL FUNDS	41,363,406	F
(B) OTHER INVESTMENT ASSETS	16,013,236	F
(C) CORP. MORTGAGE/ASSET BACKED SE	2,907,067	F
(D) PREFERRED FIXED RATE SECURITIES	1,878,349	F
(E) MUNICIPAL BONDS	640,946	F
(F) FOREIGN BONDS	353,502	F
(G) CERTIFICATES OF DEPOSITS	208,648	F
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)	63,365,154

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
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	115,164,610
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) 2021

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	622,479,951
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	18,576,286
e	Add lines 2a through 2d .....................			2e	18,576,286
3	Subtract line 2e from line 1..................			3	603,903,665
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	21,163,312
c	Add lines 4a and 4b....................			4c	21,163,312
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	625,066,977

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	588,231,009
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	588,231,009
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	13,877,111
c	Add lines 4a and 4b.....................			4c	13,877,111
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	602,108,120

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, PAGE 2, PART V, LINE 4	ENDOWMENT FUNDS ARE TO BE USED FOR THE GENERAL SUPPORT AND OPERATIONS OF BLESSING HOSPITAL.
SCHEDULE D, PAGE 4, PART XI, LINE 2D	NET ASSETS RELEASED FROM RESTRICTIONS 6,537,106 UNREALIZED GAINS 12,039,180
SCHEDULE D, PAGE 4, PART XI, LINE 4B	TEMPORARILY RESTRICTED CONTRIBUTIONS 7,186,280 TEMPORARILY RESTRICTED INCOME 0 INVESTMENT MANAGEMENT FEES 601,511 BAD DEBT REDUCTION OF REVENUE ON F/S 13,275,600 UNREALIZED LOSS 0 PERMANENTLY RESTRICTED INCOME 99,921
SCHEDULE D, PAGE 4, PART XII, LINE 4B	INVESTMENT EXPENSES 601,511 BAD DEBT REDUCTION OF REVENUE ON F/S 13,275,600

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. 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

Name of the organization
BLESSING HOSPITAL

Employer identification number

37-0661183

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










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

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

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

Cat. No. 50083H

Schedule G (Form 990) 2022

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 HEART GALA (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	62,500	62,500
2	Less: Contributions . . . .
3	Gross income (line 1 minus line 2) . . . . . .	62,500	62,500

4	Cash prizes . . . . .
5	Noncash prizes . . . .
6	Rent/facility costs . . . .	2,750	2,750
7	Food and beverages . . .	31,948	31,948
8	Entertainment . . . .	6,000	6,000
9	Other direct expenses . . .	15,375	15,375
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		56,073
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		6,427

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .

2	Cash prizes . . . . .
3	Noncash prizes . . . .
4	Rent/facility costs . . . .
5	Other direct expenses . . .

Volunteer labor . . . .

	Yes %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

Enter the state(s) in which the organization conducts gaming activities:

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2022

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

Address

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2022

Additional Data

Software ID:
Software Version:

- 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.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

BLESSING HOSPITAL

Employer identification number

37-0661183

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 275.0000000000 %

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? . . . . . .

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		(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) . . .	5,375,920		5,375,920	0.890 %
b	Medicaid (from Worksheet 3, column a) . . . . .	108,151,956	108,151,956
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	113,527,876	108,151,956	5,375,920	0.890 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	1,005,094		1,005,094	0.170 %
f	Health professions education (from Worksheet 5) . . .	4,482,481		4,482,481	0.740 %
g	Subsidized health services (from Worksheet 6) . . . .	7,898,963	6,559,557	1,339,406	0.220 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	110,230		110,230	0.020 %
j	Total. Other Benefits . .	13,496,768	6,559,557	6,937,211	1.150 %
k	Total. Add lines 7d and 7j .	127,024,644	114,711,513	12,313,131	2.050 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2022

Schedule H (Form 990) 2022

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.

		(c) Total community building expense	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy	71,926	71,926	0.010 %
8	Workforce development
9	Other
10	Total	71,926	71,926	0.010 %

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. ......

12,984,077

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. ......

606,356

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).....

115,136,575

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

124,102,929

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

-8,966,354

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) 2022

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)							Facility reporting group
1	BLESSING HOSPITAL AT 11TH ST BROADWAY AT 11TH ST QUINCY,IL62301	X	X	X	X	X	A

Schedule H (Form 990) 2022

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)

	A
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. ............................

Yes

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): WWW.BLESSINGHEALTH.ORG

Other website (list url): WWW.UNITEDWAYADAMSCO.ORG

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 22

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

Yes

If "Yes" (list url): WWW.BLESSINGHEALTH.ORG

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) 2022

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	A
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 275.000000000000%
and FPG family income limit for eligibility for discounted care of 275.000000000000%

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):

WWW.BLESSINGHEALTH.ORG

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

WWW.BLESSINGHEALTH.ORG

A plain language summary of the FAP was widely available on a website (list url):
WWW.BLESSINGHEALTH.ORG

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) 2022

Page 6

Part VFacility Information (continued)

Billing and Collections

	A
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) 2022

Page 7

Part VFacility Information (continued)

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

	A
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) 2022

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
GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 3E	COMMUNITY PRIORITIES WERE IDENTIFIED BY THE COMMUNITY BUILDING COUNCIL ("CBC") MEMBERS UTILIZING THE DATA OBTAINED THROUGH THE NEEDS ASSESSMENT PROCESS. CBC MEMBERS ARE COMMUNITY LEADERS REPRESENTING WORKFORCE/BUSINESSES, FOUNDATIONS, HUMAN SERVICE PROVIDERS, FAITH, LAW ENFORCEMENT, MEDIA, EDUCATION, PUBLIC HEALTH, HEALTHCARE-INCLUDING BLESSING HOSPITAL (WHICH IS THE ONLY LOCAL HOSPITAL) AND OUTPATIENT PROVIDERS, COMMUNITY MEMBERS, AND GOVERNMENT. COMMUNITY PRIORITIES WERE CHOSEN BASED ON THE MAGNITUDE OF THE PROBLEM, THE SEVERITY OF THE PROBLEM, THE NEED AMONG VULNERABLE POPULATIONS, THE COMMUNITYS CAPACITY AND WILLINGNESS TO ACT ON THE ISSUE, THE ABILITY TO HAVE A MEASURABLE IMPACT ON THE ISSUE, EXISTING INTERVENTIONS FOCUSED ON THE ISSUE AND OPPORTUNITY TO INTERVENE AT THE PREVENTION LEVEL. THREE COMMUNITY PRIORITIES WERE IDENTIFIED AND INCLUDE: 1. HOUSING: GOOD HEALTH DEPENDS ON HAVING HOMES THAT ARE SAFE AND FREE FROM PHYSICAL HAZARDS. POOR QUALITY AND INADEQUATE HOUSING CONTRIBUTE TO HEALTH PROBLEMS SUCH AS INFECTIOUS AND CHRONIC DISEASES, INJURIES, AND POOR CHILD DEVELOPMENT. 2. POVERTY: POVERTY IS LINKED WITH NEGATIVE CONDITIONS SUCH AS SUBSTANDARD HOUSING, HOMELESSNESS, INADEQUATE NUTRITION, FOOD INSECURITY, AND UNDER-RESOURCED SCHOOLS. POOR CHILDREN AND TEENS ARE AT A GREATER RISK FOR NEGATIVE OUTCOMES SUCH AS POOR ACADEMIC ACHIEVEMENT, SCHOOL DROPOUT, ABUSE AND NEGLECT, BEHAVIORAL AND SOCIOEMOTIONAL PROBLEMS, PHYSICAL HEALTH PROBLEMS, AND DEVELOPMENTAL DELAYS. 3. BEHAVIORAL HEALTH: BEHAVIORAL HEALTH ISSUES SIGNIFICANTLY IMPACT PEOPLE, FAMILIES, COMMUNITIES, AND SOCIETIES. MANY FACTORS ARE LINKED TO BEHAVIORAL HEALTH, INCLUDING GENETICS, AGE, INCOME, EDUCATION, EMPLOYMENT, AND ENVIRONMENTAL CONDITIONS. SUBSTANCE ABUSE IS A CHRONIC BUT TREATABLE BRAIN DISORDER. PEOPLE ADDICTED CANNOT CONTROL THEIR NEED FOR ALCOHOL OR OTHER DRUGS, EVEN IN THE FACE OF NEGATIVE HEALTH, SOCIAL OR LEGAL CONSEQUENCES.
GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 5	ADAMS COUNTY HAS BEEN CONDUCTING A COMMUNITY ASSESSMENT FOR 20 YEARS. IN 2021-2022, THE UNITED WAY OF ADAMS COUNTY, BLESSING HEALTH SYSTEM, ADAMS COUNTY HEALTH DEPARTMENT, AND THEIR PARTNERS OPTED TO DIG DEEPER TO PAINT A MORE ROBUST PICTURE OF ADAMS COUNTY, AND PROVIDE A FOUNDATION FOR PROBLEM IDENTIFICATION AND SOLVING ON BEHALF OF THE COMMUNITY. THE SURVEY INSTRUMENT WAS OVERHAULED AND AN EFFORT WAS LAUNCHED TO GET A MORE DIVERSE REPRESENTATION OF THE COMMUNITY. WE WERE ABLE TO SECURE FEEDBACK FROM 861 RESPONDENTS VIA TWO SURVEY INSTRUMENTS. RESPONDENTS FROM THE SURVEYS WERE 93 PERCENT WHITE OR CAUCASIAN, 55 PERCENT FEMALE, AND THE RATIO OF QUINCY TO RURAL ADAMS COUNTY RESIDENTS WAS AROUND 80/20. THESE DEMOGRAPHICS GENERALLY MATCH THE DEMOGRAPHICS OF THE ADAMS COUNTY REGION. IN ADDITION TO THE SURVEY, THE FOLLOWING DATA WAS INCLUDED IN THE CHNA: O 535 2-QUESTION COMMUNITY THEMES SURVEY RESPONSES O 36 KEY INFORMANT INTERVIEWS O 290 KEY INFORMANT SURVEY RESPONSES O 64% RESPONSE RATE TO KEY INFORMANT SURVEY AND INTERVIEWS O KEY INFORMANTS WERE IDENTIFIED WITH THE HELP OF THE COMMUNITY BUILDING COUNCIL AND INCLUDE REPRESENTATIVES FROM COMMUNITY SECTORS SUCH AS GOVERNMENT, SOCIAL SERVICE, CHURCHES/FAITH, HEALTHCARE, BUSINESS, EDUCATION, AND NONPROFIT ORGANIZATIONS. FOLLOWING THE ASSESSMENT, A GROUP OF 40 COMMUNITY LEADERS AND FRONTLINE WORKERS IN THE AREAS OF EDUCATION, SOCIAL SERVICES, AND HEALTH (INCLUDING 4 LEADERS FROM BLESSING) CONVENED FOR AN ALL-DAY PLANNING SESSION. THE PURPOSE OF THE SESSION WAS TO DEVELOP FOCUS AREAS, SHARED GOALS, AND COMMUNITY-WIDE INITIATIVES THAT SUPPORT THE HEALTH AND WELL-BEING OF ALL ADAMS COUNTY RESIDENTS. IN ADDITION, FIVE FOCUS GROUPS AND NINE ONE-ON- ONE INTERVIEWS WERE CONDUCTED WITH 43 PARTICIPANTS. A STRUCTURED GUIDE WAS USED TO GATHER PARTICIPANT EXPERIENCES WITH AND PERSPECTIVES ON THE IDENTIFIED COMMUNITY PRIORITY AREAS. THE COMMUNITY BUILDING STRUCTURE, FACILITATED BY THE UNITED WAY OF ADAMS COUNTY IS ANOTHER SOURCE OF COMMUNITY FEEDBACK AND INPUT FOR THE CHNA. THE STRUCTURE INCLUDES TEAMS OF INDIVIDUALS WITH REPRESENTATION FROM BLESSING HEALTH SYSTEM, THE ADAMS COUNTY HEALTH DEPARTMENT, MENTAL HEALTH PROFESSIONALS, SOCIAL WORKERS, AND MANY OTHER COMMUNITY PROFESSIONALS. IN TOTAL, APPROXIMATELY 125 VOLUNTEERS PARTICIPATE IN ALL ASPECTS OF COMMUNITY BUILDING, ENGAGING IN MEANINGFUL AND RISK DISCUSSIONS TO LEARN ABOUT COMMUNITY ISSUES AND PROMISING PRACTICES. THEY HAVE A LEAD ROLE IN THE FORMATION, IMPLEMENTATION, AND UPDATING OF LONG-RANGE VISIONS AND GOALS TO MEET THE MOST CRITICAL NEEDS IN OUR COMMUNITY THROUGH STUDYING TRENDS THAT AFFECT OUR COMMUNITY AND RECOMMENDING WAYS IN WHICH WE CAN MAKE AN IMPACT ON THESE TRENDS THROUGH THE MOBILIZATION OF FINANCIAL, VOLUNTEER, AND COMMUNITY RESOURCES.
GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 6B	THE CHNA IS LED IN PARTNERSHIP WITH THE UNITED WAY OF ADAMS COUNTY, ADAMS COUNTY HEALTH DEPARTMENT, AND THE BLESSING HEALTH SYSTEM. IN ADDITION THE FOLLOWING ENTITIES ARE ON THE COMMUNITY BUILDING COUNCIL LEADERSHIP STEERING COMMITTEE: PHIBRO ANIMAL HEALTH (BUSINESS SECTOR), TRANSITIONS MENTAL HEALTH FACILITY, QUANADA WOMEN'S SHELTER, QUINCY UNIVERSITY, PUBLIC SCHOOLS, YMCA, UWCA, TRI-STATE VETERANS SUPPORT, SIU MEDICAL, TRACY FAMILY FOUNDATION, JOHN WOOD COMMUNITY COLLEGE, QUINCY YOUNG LIFE, COMMUNITY FOUNDATION, WORKFORCE OFFICE OF WESTERN ILLINOIS, QUINCY CHAMBER OF COMMERCE, THE MOORMAN FOUNDATION, J.W. GARDNER II FOUNDATION, QUINCY POLICE DEPARTMENT, GREAT RIVER ECONOMIC DEVELOPMENT FOUNDATION, CITY OF QUINCY, TRINITY UNITED CHURCH OF CHRIST, KHQA-TV, AND QUINCY HOUSING AUTHORITY.
GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 7D	SINCE THE RELEASE OF THE CHNA, REPRESENTATIVES FROM THE UNITED WAY OF ADAMS COUNTY AND THE CONSULTANT WHO ASSISTED IN THE CREATION OF THE REPORT, HAVE PRESENTED THE KEY FINDINGS OF THE REPORT TO NUMEROUS COMMUNITY GROUPS IN ADAMS COUNTY. IN ADDITION TO THE PRESENTATIONS, THREE ONLINE MEETINGS WERE HELD IN WHICH A VARIETY OF COMMUNITY LEADERS AND INTERESTED STAKEHOLDERS WERE INVITED TO ATTEND A PRESENTATION ON THE CHNA. TIME WAS ALLOCATED FOR PARTICIPANTS TO ASK QUESTIONS AND TO PROVIDE FEEDBACK. ALSO, A GROUP OF 40 COMMUNITY LEADERS AND FRONTLINE WORKERS CONVENED IN AN ALL-DAY PLANNING SESSION TO DISCUSS THE CHNA AND IDENTIFY COMMUNITY PRIORITIES. THE PRESENTATIONS PROVIDED AN OPPORTUNITY TO CREATE BROAD COMMUNITY AWARENESS OF THE ISSUES AND OPPORTUNITIES ADDRESSED IN THE CHNA. THE CHNA IS SHARED WITH THE COMMUNITY BUILDING COUNCIL MEMBERS AS WELL AS THE COMMUNITY SOLUTIONS TEAM MEMBERS TO GUIDE THEIR STRATEGIC PLANNING AROUND THE IDENTIFIED COMMUNITY PRIORITIES. THE UNITED WAY MEMBER ORGANIZATIONS ALSO RECEIVE A COPY OF THE CHNA AND ARE REQUIRED TO DISCUSS HOW THEIR PROGRAMMING MEETS THE NEEDS IDENTIFIED IN THE CHNA DURING THE ANNUAL FUNDING PROCESS. THE CHNA IS ALSO POSTED ON THE UNITED WAY AND BLESSING HEALTH SYSTEM WEBSITES FOR THE PUBLIC TO ACCESS.
GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 11	IN 2021, BLESSING CONTINUED ITS STRONG PARTNERSHIP WITH THE UNITED WAY OF ADAMS COUNTY AND THE ADAMS COUNTY HEALTH DEPARTMENT IN FUNDING AND CONDUCTING THE CHNA. THE ADAMS COUNTY COMMUNITY BUILDING COUNCIL (CBC) GUIDES THE COMMUNITY NEEDS ASSESSMENT AND PLANNING PROCESS THROUGH THE DEVELOPMENT OF PROGRAMS, PARTNERSHIPS, AND COLLABORATIONS WORKING TO ADDRESS THE NEEDS IDENTIFIED IN THE 2021 CHNA. CBC MEMBERS ARE COMMUNITY LEADERS REPRESENTING WORKFORCE/ BUSINESSES, FOUNDATIONS, HUMAN SERVICE PROVIDERS, FAITH, LAW ENFORCEMENT, MEDIA, EDUCATION, PUBLIC HEALTH, HEALTHCARE- INCLUDING BLESSING HOSPITAL (WHICH IS THE ONLY LOCAL HOSPITAL) AND OUTPATIENT PROVIDERS, COMMUNITY MEMBERS, AND GOVERNMENT. THE CBC IS CO-CHAIRED BY STAFF OF BLESSING HOSPITAL AND THE ADAMS COUNTY HEALTH DEPARTMENT. REPORTING TO THE CBC ARE THREE COMMUNITY SOLUTIONS TEAMS (CST) COMPRISED OF COMMUNITY EXPERTS IN THE AREAS OF THE STRATEGIC PRIORITIES. THE COMMUNITY SOLUTIONS TEAMS ARE CHARGED WITH ESTABLISHING GOALS AND WORK PLANS TO CREATE POSITIVE IMPACT ON THE GAPS IDENTIFIED IN THE CHNA. BLESSING HOSPITAL STAFF ARE ACTIVE IN EITHER LEADERSHIP OR MEMBERSHIP OF THE CST THAT ALIGN WITH BLESSING HOSPITAL'S IDENTIFIED FOCUS AREAS. THREE TOP HEALTH PRIORITIES WERE IDENTIFIED IN ORDER TO PROVIDE A COLLECTIVE FOCUS FOR VARIOUS ENTITIES TO SUPPORT EFFORTS RESULTING IN POSITIVE, LASTING CHANGE FOR ADAMS COUNTY: 1.HOUSING INSTABILITY/HOMELESSNESS 2.POVERTY/FINANCIAL INSTABILITY 3.BEHAVIORAL HEALTH BLESSING HOSPITAL IDENTIFIED BEHAVIORAL HEALTH AS ITS HEALTH PRIORITY AS IT MOST CLOSELY ALIGNS WITH THE ORGANIZATION'S GOALS. THIS PRIORITY AREA AND STRATEGIES WERE DETERMINED BY TAKING INTO ACCOUNT THE PROGRAMMING, RESOURCES, AND PRIORITIES OF THE HOSPITAL. BLESSING HOSPITAL'S BEHAVIORAL HEALTH STRATEGY INCLUDES: IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES, INCLUDING MENTAL HEALTH AND SUBSTANCE ABUSE DISORDER SERVICES. INCREASE AWARENESS AND NORMALIZE TREATMENT OF MENTAL HEALTH. DECREASE THE PERCENTAGE OF ADAMS COUNTY ADULTS WHO REPORT 14 OR MORE DAYS OF POOR MENTAL HEALTH PER MONTH. TARGET: 12% BY 2025; BASELINE: 14%; DATA SOURCE: 2021 COUNTY HEALTH RANKINGS, BRFSS DECREASE THE NUMBER OF MENTALLY UNHEALTHY DAYS REPORTED BY ADAMS COUNTY RESIDENTS IN THE PAST 30 DAYS. TARGET: 3.8% BY 2025; BASELINE: 4.5%; DATA SOURCE: 2021 COUNTY HEALTH RANKINGS, BRFSS DECREASE THE PERCENTAGE OF EMERGENCY DEPARTMENT VISITS FOR MENTAL AND BEHAVIORAL DISORDERS AT BLESSING HOSPITAL. TARGET 30% BY 2025; BASELINE 35% DATA SOURCE: BLESSING HEALTH SYSTEM DATA ANALYTICS, 2021 DECREASE THE PERCENTAGE OF THE ADAMS COUNTY POPULATION THAT IS AT RISK FOR BINGE DRINKING (5 OR MORE DRINKS ON ONE OCCASION FOR MEN, 4 OR MORE DRINKS ON ONE OCCASION FOR WOMEN). TARGET: 15% BY 2025; BASELINE: 19.2%; DATA SOURCE: ILLINOIS COUNTY BEHAVIORAL RISK FACTOR SURVEY, 2015-2019. DECREASE THE PERCENTAGE OF THE ADAMS COUNTY POPULATION THAT IS AT RISK FOR HEAVY DRINKING (2 OR MORE DRINKS PER DAY FOR MEN, 1 OR MORE DRINK PER DAY FOR WOMEN). TARGET: 6.4 % BY 2025; BASELINE 6.9%; DATA SOURCE: ILLINOIS COUNTY BEHAVIORAL RISK FACTOR SURVEY, 2015-2019. DECREASE THE PERCENTAGE OF ADAMS COUNTY 10TH GRADERS WHO CONSIDERED SUICIDE. TARGET 19%; BASELINE 21%; DATA SOURCE: 2020 ILLINOIS YOUTH SURVEY. DECREASE THE PERCENTAGE OF ADAMS COUNTY 10TH GRADERS WHO REPORT THAT THEY EXPERIENCE DEPRESSION. TARGET: 38% BY 2025; BASELINE 43%; DATA SOURCE: 2020 ILLINOIS YOUTH SURVEY. DECREASE THE NUMBER OF NON-FATAL OPIOID OVERDOSE PER 10,000 POPULATION IN ADAMS COUNTY. TARGET: 3% BY 2025; BASELINE 3.8%; DATA SOURCE: ILLINOIS DEPARTMENT OF PUBLIC HEALTH. DECREASE THE NUMBER OF DRUG OVERDOSE DEATHS IN ADAMS COUNTY. TARGET 1% REDUCTION IN NUMBER BY 2025; BASELINE: 41 PEOPLE; DATA SOURCE: ILLINOIS DEPARTMENT OF PUBLIC HEALTH. DECREASE THE PERCENTAGE OF ADAMS COUNTY 10TH GRADERS WHO USE TOBACCO OR VAPE. TARGET 5% BY 2025; BASELINE 7%; DATA SOURCE 2020 ILLINOIS YOUTH SURVEY. BLESSING HOSPITAL DEVELOPS AN INTERNAL STRATEGY THAT ALIGNS WITH THE IDENTIFIED COMMUNITY GOALS AND OBJECTIVES. BLESSING HOSPITAL'S BEHAVIORAL HEALTH STRATEGY AIMS TO INCREASE ACCESS, REDUCE BEHAVIORAL HEALTH ADMISSIONS TO THE EMERGENCY DEPARTMENT, AND INCREASE COMMUNITY PARTICIPATION. TACTICS UTILIZED TO ACHIEVE THIS GOAL INCLUDE: RECRUITMENT-ADD ADDITIONAL THERAPISTS, PSYCHOLOGISTS, PMHNP, AND PSYCHIATRISTS RETENTION-RETAIN EXISTING THERAPISTS, PSYCHOLOGISTS, PMHNP, AND PSYCHIATRISTS MARKETING/SOCIAL MEDIA TACTICS TO CONTINUE EFFORTS OF PROMOTING BEHAVIORAL HEALTH SERVICES CONTINUE TO GROW THE PARTIAL HOSPITALIZATION PROGRAM INCREASE TELEHEALTH USAGE FOR BEHAVIORAL HEALTH SERVICES, INCLUDING THE RURAL CLINICS UTILIZE THE BEHAVIORAL HEALTH INTEGRATION MODEL TO IMPROVE THE QUALITY OF BEHAVIORAL HEALTH SERVICES IN PRIMARY AND SPECIALTY CARE CLINICS CRISIS STABILIZATION MODEL FOR EMERGENCY ROOM-DEVELOP A MODEL FOR CRISIS STABILIZATION FOR PATIENTS WHO PRESENT WITH BEHAVIORAL HEALTH CONCERNS IN THE EMERGENCY DEPARTMENT EVIDENCE-BASED TRAINING-PROVIDE TRAINING TO ALL STAFF THROUGHOUT THE SERVICE LINE STRENGTHEN CLINICAL INTERVENTION STRATEGIES AND TREATMENT IN INPATIENT UNITS THE REMAINING PRIORITY AREAS ARE NOT BEING DIRECTLY ADDRESSED BY BLESSING HOSPITAL, ALTHOUGH BLESSING CONTINUES TO SUPPORT THE INITIATIVES AND HAS REPRESENTATION ON ALL OF THE COMMUNITY SOLUTION TEAMS. THE REASON THAT BLESSING HOSPITAL IS NOT WORKING ON THESE DIRECTLY IS THAT THEY DON'T FIT WITHIN THE STRATEGIC PRIORITIES OF THE HEALTH SYSTEM, AND THERE ARE OTHER ENTITIES WITHIN THE COMMUNITY BETTER EQUIPPED TO ADDRESS THESE IMPORTANT COMMUNITY PRIORITIES: POVERTY- THE POVERTY TEAM IS CO-CHAIRED BY THE WORKFORCE DEVELOPMENT COMMITTEE MEMBERS. THE GOAL IS TO LIFT FAMILIES OUT OF POVERTY THROUGH SUSTAINED FINANCIAL STABILITY. BLESSING HAS THREE REPRESENTATIVES ON THE COMMITTEE. OTHER MEMBERS REPRESENT QUANADA, UNIVERSITY OF ILLINOIS EXTENSION, BELLA EASE, COMMUNITY FOUNDATION, ADAMS COUNTY HEALTH DEPARTMENT, HORIZONS, UNITED WAY OF ADAMS COUNTY, THE CROSSING CHURCH, SIU, SAFE AND LIVABLE HOUSING COMMITTEE, WESTERN ILLINOIS WORKS, QUINCY PUBLIC SCHOOLS, FIRST BANKER'S TRUST, SALVATION ARMY, AND WEST CENTRAL CHILDCARE CONNECTION. HOUSING- A REPRESENTITIVE FROM THE YWCA AND THE GREAT RIVER ECONOMIC DEVELOPMENT OFFICE CO-CHAIR THE HOUSING TEAM. THERE ARE TWO SUBCOMMITTEES- SUPPLY AND ACCESS. THE COMMITTEE'S GOAL IS TO INCREASE THE NUMBER OF RESIDENTS IN AFFORDABLE, SAFE, AND LIVABLE HOUSING. THE KEY STRATEGIES ARE IDENTIFYING THE NUMBER OF AFFORDABLE HOUSING UNITS AVAILABLE TO RESIDENTS IN ADAMS COUNTY AND INCREASING AND REMOVING BARRIERS TO HOUSING FOR LOW-INCOME RESIDENTS. BLESSING HAS FOUR REPRESENTATIVES ON THE COMMITTEE. OTHER MEMBERS REPRESENT THE ADAMS COUNTY BOARD, CONNECT CHILD AND FAMILY SOLUTIONS, LOCAL REALTORS, FIRST BANKER'S TRUST, KROC CENTER, QUINCY HUMAN RIGHTS COMMISSION, TRANSITIONS, QUANADA WOMEN'S SHELTER, TWO RIVERS, BELLA EASE, HORIZONS, QUINCY HOUSING AUTHORITY, QUINCY SAFE AND LIVABLE HOUSING COMMITTEE, SALVATION ARMY, AND THE ADAMS COUNTY HEALTH DEPARTMENT.
GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 13B	PATIENTS ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE IF THEIR INCOME EXCEEDS 275% OF THE FEDERAL POVERTY GUIDELINES AND THEIR MEDICAL BILLS EXCEED 20% OF THEIR TOTAL REPORTED FAMILY INCOME. ELIGIBILITY IS BASED ON AN INDIVIDUAL'S FAMILY'S TOTAL INCOME AND FAMILY SIZE. PATIENTS EXPERIENCING CATASTROPHIC MEDICAL INDIGENCE ARE ELIGIBLE FOR A DISCOUNT OF 85%.
GROUP A, FACILITY 1, BLESSING HOSPITAL AT 11TH ST. - PART V, LINE 16J	THE UNITED WAY SHARES BLESSING HOSPITALS FINANCIAL ASSISTANCE POLICY TO THOSE IN NEED OF MEDICAL CARE OR FACING MEDICAL DEBT THROUGH THEIR HELPLINE AND THEIR UNMET NEEDS GROUP. THE HELPLINE IS A FREE INFORMATION AND REFERRAL SERVICE THAT ASSISTS RESIDENTS IN FINDING THE HELP THEY NEED. WHETHER THOSE CALLING NEED A PHONE NUMBER OR INFORMATION ABOUT AVAILABILITY OF A SERVICE OR THEY NEED ASSISTANCE IN FINDING HEALTHCARE, HOUSING, FOOD, UTILITY AND RENT ASSISTANCE, SENIOR SERVICES, SUBSTANCE ABUSE PROGRAMS, OR LEGAL SERVICES, THE UNITED WAY HELPLINE OFFERS THAT HELP. THE UNITED WAY ALSO SHARES THE INFORMATION THROUGH THE QUINCY AREA PARTNERSHIP FOR UNMET NEEDS. THIS GROUP IS A NETWORK OF SOCIAL SERVICE AGENCIES AND FAITH-BASED ORGANIZATIONS. MEMBER AGENCIES PRESENT CASES FOR CONSIDERATION AT UNMET NEEDS MEETINGS. CLIENTS IN NEED OF ASSISTANCE CONTACT A MEMBER AGENCY WITH THEIR SPECIFIC NEED. AS THE CASES ARE DISCUSSED, ENTITY REPRESENTATIVES TALK ABOUT PROGRAMS THEY HAVE THAT COULD ASSIST THE PATIENT. BLESSING IS REPRESENTED AT THESE MEETINGS. THE UNITED WAY ALSO HAS AN INTERAGENCY COUNCIL THAT MEETS MONTHLY. SEVERAL AGENCIES FROM THROUGHOUT THE COMMUNITY ATTEND THIS MEETING. THEY HAVE A PRESENTER AT MOST MEETINGS. BLESSING HAS PRESENTED IN THE PAST, FOCUSING ON CARE COORDINATION AND TOUCHING ON THE FINANCIAL ASSISTANCE PROGRAM. BLESSING HOSPITAL HAS ALSO ESTABLISHED A CARE COORDINATION DEPARTMENT THAT WORKS WITH PATIENTS IN THE AMBULATORY SETTING TO ASSIST THEM IN MEETING THEIR HEALTHCARE NEEDS. ONE OF THE TARGETED AREAS OF THE CARE COORDINATION PROGRAM IS TO HELP PATIENTS ESTABLISH A PRIMARY CARE HOME. THIS CAN INCLUDE PROVIDING EDUCATION TO PATIENTS ABOUT SERVICES AVAILABLE IN THE COMMUNITY AND IF APPLICABLE HOW TO ACCESS THE FINANCIAL ASSISTANCE PROGRAMS WITHIN THOSE AGENCIES.

Schedule H (Form 990) 2022

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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?9
Name and address		Type of Facility (describe)
1	DENMAN COUNTRY DRUGS 102 PRAIRIE MILLS ROAD GOLDEN,IL62339	PHARMACY
2	EAST ADAMS COUNTY RURAL HEALTH CLIN 102 PRAIRIE MILLS ROAD GOLDEN,IL62339	RURAL HEALTH CLINIC
3	BLESSING AMBULATORY SURGERY CENTER 1100 SPRING STREET QUINCY,IL62301	AMBULATORY SURGICAL TREATMENT CENTER
4	THE BROWN DRUG CO 1121 MAINE STREET QUINCY,IL62301	PHARMACY
5	BLESSING HOME CARE 5011 OAK STREET QUINCY,IL62301	HOME HEALTH AGENCY IN ILLINOIS
6	BLESSING HOSPICE & PALLIATIVE CARE 5011 OAK STREET QUINCY,IL62301	FULL HOSPICE PROGRAM IN ILLINOIS
7	BLESSING HOME CARE - PALMYRA 6996 COUNTY ROAD 326 PALMYRA,MO63461	HOME HEALTH AGENCY IN MISSOURI
8	BLESSING HOSPICE - PIKE COUNTY 967 WEST WASHINGTON PITTSFIELD,IL62363	FULL HOSPICE PROGRAM IN ILLINOIS
9	ILLINI HEALTH SERVICES LLC PO BOX 40 QUINCY,IL62306	PHARMACY
10

Schedule H (Form 990) 2022

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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 3C	PATIENTS ARE ELIGIBLE FOR CATASTROPHIC FINANCIAL ASSISTANCE IF THEIR INCOME EXCEEDS 275% OF THE FEDERAL POVERTY GUIDELINES AND THEIR MEDICAL BILLS EXCEED 20% OF THEIR TOTAL REPORTED FAMILY INCOME. ELIGIBILITY IS BASED ON AN INDIVIDUAL'S OR FAMILY'S TOTAL INCOME AND FAMILY SIZE. PATIENTS EXPERIENCING CATASTROPHIC MEDICAL INDIGENCE ARE ELIGIBLE FOR A DISCOUNT OF 85%.
SCHEDULE H, PART I, LINE 7G	BLESSING HOSPITAL DOES NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
SCHEDULE H, PART I, LINE 7, COLUMN (F)	BAD DEBT EXPENSE OF 12,984,077 IS SUBTRACTED FROM TOTAL EXPENSES OF 602,108,119 REPORTED ON LINE 25, COLUMN A OF FORM 990, PART IX, FOR A NET TOTAL EXPENSE OF 589,124,042.
SCHEDULE H, PART I, LINE 7	WHEN POSSIBLE, CALCULATIONS OF DIRECT AND INDIRECT COSTS ASSOCIATED WITH THE SERVICES PROVIDED ARE REPORTED. IF NOT AVAILABLE, A COST-TO-CHARGE RATIO IS USED TO CALCULATE THE COST AMOUNTS. THIS RATIO IS COMPUTED USING BLESSING HOSPITAL'S AS-FILED MEDICARE COST REPORT. THESE COSTS AND CHARGES ARE ADJUSTED TO ACCOUNT FOR ITEMS NOT REIMBURSED THROUGH THE COST REPORT SUCH AS PROVIDER-BASED PHYSICIAN SERVICES.
SCHEDULE H, PART II	IN PARTNERSHIP WITH THE ALLIANCE FOR BUILDING COMMUNITY, BLESSING HOSPITAL PROVIDES FUNDS TO PAY FOR THE POSITION OF THE DIRECTOR OF COMMUNITY IMPACT, A KEY INDIVIDUAL IN THE COMPLETION OF THE COMMUNITY HEALTH NEEDS ASSESSMENT.
SCHEDULE H, PART III, LINE 2	BAD DEBT EXPENSE IS CALCULATED ON THE NET PATIENT ACCOUNT BALANCE AFTER THE BALANCE HAS BEEN REDUCED FOR ANY PAYMENTS RECEIVED OR DISCOUNTS/ADJUSTMENTS THAT ARE KNOWN. PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE ARE RECOGNIZED AS CHARITY CARE ACCOUNTS WHEN SUFFICIENT INFORMATION IS RECEIVED TO DETERMINE THEIR ELIGIBILITY. PRIOR TO THIS POINT, AN ALLOWANCE FOR DOUBTFUL ACCOUNTS IS CALCULATED ON UNINSURED ACCOUNTS. THIS ALLOWANCE IS REVERSED IF THE ACCOUNT IS DETERMINED TO QUALIFY FOR FINANCIAL ASSISTANCE.
SCHEDULE H, PART III, LINE 3	A NUMBER OF PATIENTS ARE TRULY UNABLE TO PAY FOR THEIR MEDICAL EXPENDITURES BUT DO NOT COMPLETE THE PROCESS REQUIRED TO APPLY FOR FINANCIAL ASSISTANCE. THE HOSPITAL USES FINANCIAL AND OTHER INFORMATION OF SUCH PATIENTS OTHERWISE AVAILABLE TO THE HOSPITAL TO IDENTIFY THOSE PATIENTS THAT WOULD QUALIFY FOR CHARITY CARE IF THEY COMPLETED THE PAPERWORK. THE HOSPITAL ANALYZES ITS PAST HISTORY AND IDENTIFIES THE PERCENTAGE OF THE BAD DEBT EXPENSE THAT IS EVENTUALLY REVERSED DUE TO PATIENTS QUALIFYING FOR FINANCIAL ASSISTANCE. THE HOSPITAL APPLIES THAT PERCENTAGE TO THE BAD DEBT EXPENSE TO ESTIMATE THE AMOUNT OF THE HOSPITAL'S BAD DEBT EXPENSE THAT WILL BE FOUND TO BE ATTRIBUTABLE TO PATIENTS ELIGIBLE FOR FINANCIAL ASSISTANCE. THE BAD DEBT EXPENSE ASSOCIATED WITH SUCH PATIENTS' ACCOUNTS ARE TREATED AS COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 4	SEE NOTE (2) ON PAGES 13-16 OF THE HOSPITAL'S ATTACHED FINANCIAL STATEMENTS.
SCHEDULE H, PART III, LINE 8	THE HOSPITAL USES A COST-TO-CHARGE RATIO TO CALCULATE COST AMOUNTS. THIS RATIO IS COMPUTED USING BLESSING HOSPITAL'S AS-FILED MEDICARE COST REPORT. THESE COSTS AND CHARGES ARE ADJUSTED TO ACCOUNT FOR ITEMS NOT REIMBURSED THROUGH THE COST REPORT SUCH AS PROVIDER-BASED PHYSICIAN SERVICES. IRS REVENUE RULING 69-545, WHICH ESTABLISHED THE COMMUNITY BENEFIT STANDARD FOR NONPROFIT HOSPITALS STATES THAT IF A HOSPITAL SERVES PATIENTS WITH GOVERNMENT HEALTH BENEFITS, INCLUDING MEDICARE, THEN THIS IS AN INDICATION THAT THE HOSPITAL OPERATES TO PROMOTE THE HEALTH OF THE COMMUNITY. THIS IMPLIES THAT TREATING MEDICARE PATIENTS IS A COMMUNITY BENEFIT.
SCHEDULE H, PART III, LINE 9B	COLLECTION PRACTICES ARE NOT PURSUED IF A COMPLETED FINANCIAL ASSISTANCE APPLICATION HAS BEEN RETURNED AND APPROVED.
SCHEDULE H, PART VI, LINE 2	BLESSING HOSPITAL HAS WORKED IN PARTNERSHIP WITH THE COMMUNITY PUBLIC HEALTH DEPARTMENT, THE LOCAL UNITED WAY AGENCY AND OTHER AREA AGENCIES IN CONDUCTING A NEEDS ASSESSMENT. THIS COMMUNITY HEALTH NEEDS ASSESSMENT WAS COMPLETED IN 2021.
SCHEDULE H, PART VI, LINE 3	BLESSING HOSPITAL FINANCIAL ACCOUNT SPECIALISTS (FAS) ATTEMPT TO CONTACT SELF-PAY INPATIENTS WITHIN 24 HOURS OF ADMISSION. IF THIS ATTEMPT TO MEET WITH THE PATIENT IS UNSUCCESSFUL, FURTHER ATTEMPTS ARE MADE LATER DURING THEIR STAY OR VIA PHONE FOLLOWING DISCHARGE. THE PATIENT IS SCREENED FOR GOVERNMENT PROGRAMS AND ELIGIBILITY FOR THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM. OUTPATIENTS ARE CONTACTED ONCE THE PATIENT'S CONDITION HAS BEEN STABILIZED AND ARE SCREENED IN THE SAME MANNER AS INPATIENTS. FOR SCHEDULED TESTING, FAS CONTACT UNINSURED PATIENTS PRIOR TO THEIR SERVICE AND PROVIDE ESTIMATES OF CHARGES AND EDUCATION ON AVAILABLE PROGRAMS IF THE SERVICE IS SCHEDULED 3 OR MORE DAYS IN ADVANCE. THE METHOD FOR OUTREACH, WHETHER THAT BE PHONE OR MAIL, IS DEPENDENT ON THE ESTIMATED PATIENT RESPONSIBILITY FOR THE SCHEDULED SERVICE. IF THE FAS ARE NOT AVAILABLE TO MEET WITH THE PATIENT PRIOR TO SERVICE, CONTACT INFORMATION IS GIVEN TO THE PATIENT IF ASSISTANCE IS NEEDED.
SCHEDULE H, PART VI, LINE 4	FOR 151 YEARS, BLESSING HOSPITAL HAS SERVED THE HEALTH CARE NEEDS OF THE PEOPLE OF WEST CENTRAL ILLINOIS, NORTHEAST MISSOURI AND SOUTHEAST IOWA. APPROXIMATELY 233,000 PEOPLE LIVE WITHIN A 50 MILE RADIUS OF BLESSING HOSPITAL. THE HOSPITALS PRIMARY MARKET AREA COVERS SIX COUNTIES, FOUR IN WEST CENTRAL ILLINOIS (ADAMS, BROWN, HANCOCK AND PIKE) AND TWO IN NORTHEAST MISSOURI (MARION AND LEWIS). THE REGIONS ECONOMY IS HEAVILY AGRICULTURAL, WITH A MIX OF MANUFACTURING, COMMERCIAL/RETAIL BUSINESS, AND RESTAURANTS MAKING UP THE REST OF THE LOCAL ECONOMY. BLESSING HOSPITAL IS THE LARGEST EMPLOYER IN ITS REGION. QUINCY, ILLINOIS, THE CITY IN WHICH THE MAIN BLESSING HOSPITAL CAMPUS IS LOCATED, IS THE HUB OF NON-FARM EMPLOYMENT AND RETAIL TRADE IN THE MARKET AREA. THE MEDIAN HOUSEHOLD INCOME IN ILLINOIS IS 78,433. THE MEDIAN HOUSEHOLD INCOME IN THE FOUR ILLINOIS COUNTIES IN BLESSINGS PRIMARY MARKET AREA IS BELOW THE ILLINOIS AVERAGE, RANGING FROM 13,700 TO 22,900 LOWER. THE MISSOURI MEDIAN HOUSEHOLD INCOME IS 65,920. IN THE TWO MISSOURI COUNTIES IN BLESSINGS PRIMARY MARKET AREA THE MEDIAN HOUSEHOLD INCOME IS BELOW THE STATE AVERAGE BETWEEN 3,400 AND 16,100. THE PERCENTAGE OF RESIDENTS OVER THE AGE OF 65 IN ILLINOIS IS 17.2 PERCENT. THE ILLINOIS COUNTIES IN BLESSINGS PRIMARY MARKET AREA, WITH THE EXCEPTION OF BROWN COUNTY, EXCEED THAT RATE BY AN AVERAGE OF 5.3 PERCENTAGE POINTS. THE PERCENTAGE OF RESIDENTS OVER THE AGE OF 65 IN MISSOURI IS 18.0 PERCENT. THE MISSOURI COUNTIES IN BLESSINGS PRIMARY MARKET AREA EXCEED THE STATE AVERAGE BY APPROXIMATELY 1.1 PERCENTAGE POINTS. THE ILLINOIS POVERTY RATE IS 11.9 PERCENT. FOR THE FOUR COUNTIES IN BLESSINGS PRIMARY MARKET IN ILLINOIS, THE AVERAGE POVERTY RATE IS 14.1 PERCENT, WHICH IS 2.2 PERCENTAGE POINTS ABOVE THE STATE AVERAGE. THE MISSOURI POVERTY RATE IS 13.2 PERCENT. FOR THE TWO MISSOURI COUNTIES IN BLESSINGS PRIMARY MARKET, THE POVERTY RATE AVERAGES 13.0 PERCENT, WHICH IS SLIGHTLY BELOW THE STATE AVERAGE. THE OBESITY RATE AVERAGE ACROSS THE FOUR ILLINOIS COUNTIES IN BLESSINGS PRIMARY MARKET IS 37.0 PERCENT, 4.0 PERCENT ABOVE THE STATE AVERAGE OF 33.0 PERCENT. IN MISSOURI, THE OBESITY RATE AVERAGE IS 40.0 PERCENT IN THE TWO COUNTIES IN BLESSINGS PRIMARY MARKET, 6.0 PERCENT ABOVE THE STATE AVERAGE OF 34.0 PERCENT.
SCHEDULE H, PART VI, LINE 5	BLESSING HOSPITAL OFFERS A WIDE RANGE OF SPECIALTY SERVICES IMPORTANT TO PROMOTING THE HEALTH AND WELL-BEING OF ADAMS COUNTY AND THE SURROUNDING AREA. INCLUDED IN THESE ARE THE CANCER CENTER, THE HEART AND VASCULAR CENTER, THE BREAST CENTER, PSYCHIATRIC SERVICES, AND HOSPICE AND HOME CARE PROGRAMS. SURPLUS FUNDS GENERATED FROM HOSPITAL OPERATIONS ARE USED TO FUND CAPITAL EXPENDITURES AND THE EXPANSION OF HEALTH CARE SERVICE LINES TO THE COMMUNITY WE SERVE. BLESSING HOSPITAL OPERATES AN EMERGENCY ROOM AVAILABLE TO ALL REGARDLESS OF THE ABILITY TO PAY. THE FINANCIAL ASSISTANCE POLICY OF BLESSING HOSPITAL ENABLES PATIENTS TO HAVE ACCESS TO AREA RESOURCES TO ASSIST THEM WITH PAYMENT OF MEDICAL EXPENSES. BLESSING HOSPITAL IS AFFILIATED WITH THE BLESSING-RIEMAN COLLEGE OF NURSING, WHICH OFFERS A BACHELOR OF SCIENCE IN NURSING DEGREE AND A MASTER OF SCIENCE IN NURSING DEGREE, ALONG WITH OTHER PROGRAMS. THE COLLEGE HAS OVER A 100 YEAR HISTORY IN THE COMMUNITY AND IS CURRENTLY ACCREDITED BY THE HIGHER LEARNING COMMISSION. BLESSING HOSPITAL IS THE LARGEST EMPLOYER IN THE AREA WITH 4,427 EMPLOYEES. OF SIGNIFICANT IMPORTANCE ARE THE VOLUNTEERS WHO SERVE THE HOSPITAL. IN FISCAL YEAR 2023, BLESSING HOSPITAL HAD 367 ACTIVE VOLUNTEERS WHO SERVED FOR A TOTAL OF 31,816 HOURS. IN ADDITION TO THE VOLUNTEERS ACTIVELY WORKING IN THE HOSPITAL, BLESSING'S BOARD OF TRUSTEES IS COMPRISED OF VOLUNTEERS THAT INCLUDE BUSINESS LEADERS, PHYSICIANS, AND OTHER COMMUNITY LEADERS.
SCHEDULE H, PART VI, LINE 6	BLESSING CORPORATE SERVICES, INC. IS THE PARENT ORGANIZATION OF A GROUP OF RELATED ORGANIZATIONS AND PROVIDES OVERALL DIRECTION TO ALL ENTITIES WITHIN THE STRUCTURE. DURING THE YEAR ENDED SEPTEMBER 30, 2005, BLESSING CORPORATE SERVICES, INC. BEGAN OPERATING A DIVISION COMPRISED OF PRACTICING PHYSICIANS. THE GROUP IS RELATED BY BLESSING CORPORATE SERVICES, INC. CONTROL OVER THE RELATED ORGANIZATION'S BOARD. THE FOLLOWING IS A BRIEF DESCRIPTION OF EACH MEMBER OF THE GROUP. ORGANIZATION - BLESSING HOSPITAL IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN QUINCY, ILLINOIS. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WESTERN ILLINOIS, NORTHEASTERN MISSOURI, AND SOUTHEASTERN IOWA. THE HOSPITAL WAS INCORPORATED IN ILLINOIS IN 1873. ORGANIZATION - THE BLESSING FOUNDATION, INC. RAISES, MANAGES, AND DISTRIBUTES CHARITABLE DONATIONS ON BEHALF OF THE BLESSING HEALTH SYSTEM. ORGANIZATION - DENMAN SERVICES, INC. IS A TAXABLE CORPORATION THAT IS ENGAGED PRIMARILY IN THE BUSINESS OF SELLING AND RENTING MEDICAL EQUIPMENT AND OPERATING A COMMERCIAL LAUNDRY. THE ENTITY IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL IS A NOT-FOR-PROFIT ACUTE CARE HOSPITAL LOCATED IN PITTSFIELD, ILLINOIS. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT AND EMERGENCY CARE SERVICES FOR RESIDENTS OF WESTERN ILLINOIS. THE HOSPITAL WAS INCORPORATED IN ILLINOIS IN 2000. ORGANIZATION - ILLINI HEALTH SERVICES, LLC CONDUCTS A DURABLE MEDICAL EQUIPMENT BUSINESS IN PITTSFIELD, ILLINOIS. THE ENTITY IS OWNED NINETY- FIVE PERCENT (95%) BY DENMAN SERVICES, INC. AND FIVE PERCENT (5%) BY BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL. ORGANIZATION - CHS HOLDING COMPANY IS A TAXABLE CORPORATION THAT PROVIDES HEALTH INSURANCE PRODUCTS AND SERVICES. ORGANIZATION - BLESSING WALK-IN CLINIC, LLC DBA BLESSING CONVENIENT CARE OPERATES HEALTH CLINICS IN RETAIL FACILITIES. ORGANIZATION - CROSSRIVER QUALITY HEALTH PARTNERS IS A CLINICALLY INTEGRATED NETWORK OF REGIONAL PHYSICIANS DEDICATED TO ENHANCING HEALTH CARE QUALITY AND EFFICIENCY ACROSS ILLINOIS, MISSOURI, AND IOWA. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - BLESSING ASSURANCE COMPANY IS A WHOLLY OWNED FOREIGN SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. AND IS A PROVIDER OF SELF-INSURANCE TO THE AFFILIATED GROUP. ORGANIZATION - THE HANNIBAL CLINIC, INC. IS A TAXABLE CORPORATION THAT OPERATES A PHYSICIAN CLINIC PROVIDING MULTI-SPECIALTY OUTPATIENT SERVICES TO THE REGION. IT IS A WHOLLY OWNED SUBSIDIARY OF BLESSING CORPORATE SERVICES, INC. ORGANIZATION - THE BROWN DRUG COMPANY IS A TAXABLE CORPORATION THAT OPERATES A RETAIL PHARMACY. ORGANIZATION - KEOKUK HEALTH SYSTEMS, INC. IS A PARENT COMPANY TO KEOKUK AREA MEDICAL EQUIPMENT AND SUPPLY, INC., AND FORMALLY A PARENT COMPANY TO KEOKUK AREA HOSPITAL DBA BLESSING HEALTH KEOKUK (INTEREST TRANSFERRED IN 2023), TRI-STATE MEDICAL GROUP, INC. (A TAXABLE ENTITY DISSOLVED IN 2022), AND KEOKUK AREA HOSPITAL FOUNDATION (DISSOLVED IN 2022. ORGANIZATION - RIVERCROSS DIAGNOSTICS, LLC IS A LABORATORY THAT SERVICES BLESSING HEALTH SYSTEM AND OTHER AREA MEDICAL SERVICE PROVIDERS.
SCHEDULE H, PART VI, LINE 7	ILLINOIS
SCHEDULE H, PART VI	BLESSING HOSPITAL'S COMMUNITY BENEFIT REPORT IS PRESENTED TO THE COMMUNITY AS AN ADVERTISEMENT IN THE HERALD-WHIG, QUINCY, ILLINOIS' LOCAL NEWSPAPER, ONCE A YEAR. IN THIS AD, INFORMATION IS PROVIDED TO DIRECT PEOPLE TO THE HOSPITAL'S WEBSITE FOR A COMPREHENSIVE INVESTMENT REPORT.

Schedule H (Form 990) 2022

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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

2022

Open to Public
Inspection

Name of the organization
BLESSING HOSPITAL

Employer identification number
37-0661183

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	(f) Method of valuation (book, FMV, appraisal, other)	(h) Purpose of grant or assistance
(1) SIU SCHOOL OF MEDICINE PO BOX 19607 SPRINGFIELD,IL62794	37-6005961	501C3	1,838,857	BOOK	MED ED & RESEARCH
(2) ADAMS COUNTY HEALTH DEPARTMENT 330 VERMONT ST QUINCY,IL62301	37-6000379	GOV	100,000	BOOK	DENTAL PROGRAM
(3) UNITED WAY OF ADAMS COUNTY 936 BROADWAY SUITE F QUINCY,IL62301	37-0673476	501C3	123,193	BOOK	GENERAL SUPPORT
(4) HORIZONS SOCIAL SERVICES OF ADAMSCO 224 SOUTH 8TH ST QUINCY,IL62301	26-3734445	501C3	15,000	BOOK	GENERAL SUPPORT
(5) CULVER-STOCKTON COLLEGE ONE COLLEGE HILL CANTON,MO63435	43-0610813	501C3	10,000	BOOK	STUDENT SCHOLARSHIPS
(6) JACKSON LINCOLN SWIMMING COMPLEX PO BOX 176 QUINCY,IL62306	36-4168494	501C3	7,500	BOOK	GENERAL SUPPORT

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) 2022

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) BLESSING-RIEMAN STUDENTS	273	1,551,455	BOOK
(2) BLESSING HEALTH PATIENTS	1118	124,324	BOOK
(3) EMPLOYEE ASSISTANCE	82	69,658	BOOK
(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, PAGE 1, PART I, LINE 2

SIU SCHOOL OF MEDICINE SIU PROVIDES THE HOSPITAL BOARD OF TRUSTEES WITH AN ANNUAL UPDATE REGARDING THEIR USE OF THE GRANT FUNDS PROVIDED TO THEIR PROGRAM. ALL OTHER ORGANIZATIONS BLESSING HOSPITAL PROVIDED GRANTS PRIMARILY TO LOCALLY MANAGED 501C3 ORGANIZATIONS THAT SUPPORT OR SHARE THE MISSION OF THE BLESSING HEALTH SYSTEM. SENIOR LEADERSHIP APPROVES ALL GRANTS. WHEN AN ORGANIZATION IS GIVEN A DONATION, IT EITHER AGREES TO RESTRICT THE DONATION TO THE PURPOSE FOR WHICH IT WAS GIVEN, OR IT RECEIVES A LETTER DIRECTING THAT THE DONATION MAY BE USED ONLY FOR THE APPROVED PURPOSE. BLESSING HEALTH SYSTEM EMPLOYEES FREQUENTLY ATTEND MANY OF THE SPONSORED EVENTS OR THE HEALTH SYSTEM RECEIVES ACKNOWLEDGEMENT FROM THE ORGANIZATION ABOUT THE PROGRAM THAT WAS SUPPORTED BY THE GRANT. PART III, LINE 1 BLESSING-RIEMAN COLLEGE OF NURSING STUDENTS THE BLESSING-RIEMAN COLLEGE OF NURSING REQUIRES A FINANCIAL AID APPLICATION UPON ADMITTANCE, HAS ACADEMIC PERFORMANCE AND FINANCIAL NEED CRITERIA, AND HAS A SELECTION COMMITTEE THAT AWARDS GRANTS. THE COLLEGE MONITORS AND REVIEWS THE RECIPIENTS INDIVIDUALLY ON A SEMESTER BASIS FOR SATISFACTORY ACADEMIC PROGRESS AND GOOD STANDING. PART III, LINE 2 BLESSING HEALTH SYSTEM PATIENTS SOCIAL WORKERS AND CARE MANAGERS WITHIN THE BLESSING HEALTH SYSTEM SEND REQUESTS FOR ASSISTANCE TO PATIENTS WHO ARE IN MEDICAL NECESSITY AND FINANCIAL DISABILITY WHEN THERE ARE NO COMMUNITY RESOURCES AVAILABLE. THE BLESSING FOUNDATION ADMINISTERS THE BEST MATCHED RESTRICTED SPECIFIC PURPOSE FUND TO THE HEALTH ISSUE OF THE PATIENT. THE APPLICATIONS MUST BE APPROVED BY THE FOUNDATION OFFICE BEFORE THE FUNDS ARE DISBURSED. PART III, LINE 3 EMPLOYEE ASSISTANCE THE EMPLOYEE CRISIS FUND IS FOR FINANCIAL ASSISTANCE FOR EMPLOYEES WHO MEET A REQUIRED LENGTH OF SERVICE AND ARE IN GOOD EMPLOYMENT STANDING. THE FUND IS ADMINISTERED BY THE BLESSING FOUNDATION. EMPLOYEES MAKE REQUESTS FOR ASSISTANCE DIRECTLY TO THE OUTPATIENT CARE COORDINATION DEPARTMENT. THE SOCIAL WORKER OR CARE MANAGER DISCUSSES THE NEEDS WITH THE EMPLOYEE AND AVAILABLE COMMUNITY RESOURCES ARE UTILIZED. IF FURTHER ASSISTANCE IS NEEDED, A GRANT FORM IS SENT TO THE BLESSING FOUNDATION REQUESTING USE OF THE EMPLOYEE CRISIS FUND. THE BALANCE OF THE FUND IS IN A GENERAL LEDGER ACCOUNT ON THE BOOKS OF BLESSING HOSPITAL AND IS MONITORED BY HOSPITAL ACCOUNTANTS.

Schedule I (Form 990) 2022

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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
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

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

BLESSING HOSPITAL

Employer identification number

37-0661183

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 ............

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) 2022

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)
1DR SEAN D HENDRICKS CLINIC PHYSICIAN	(i) (ii)	1,246,878 -------------	50,000 -------------	140,815 -------------	11,346 -------------	16,266 -------------	1,461,238 -------------	-------------
2DR HUMAM FARAH CLINIC PHYSICIAN	(i) (ii)	716,837 -------------	684,178 -------------	6,518 -------------	14,117 -------------	32,262 -------------	1,450,685 -------------	-------------
3DR DARR W LEUTZ CLINIC PHYSICIAN	(i) (ii)	1,282,068 -------------	-------------	27,896 -------------	15,250 -------------	37,645 -------------	1,357,699 -------------	-------------
4MAUREEN A KAHN RETIRED 7123 PRES/CEO BCS AND BH	(i) (ii)	------------- 837,016	-------------	------------- 195,245	------------- 188,502	------------- 33,967	------------- 1,254,730	------------- 165,951
5DR HARSHA V POLAVARAPU TRUSTEE	(i) (ii)	657,431 -------------	476,815 -------------	27,591 -------------	15,250 -------------	35,317 -------------	1,210,572 -------------	-------------
6DR DAVID C LIEBER CLINIC PHYSICIAN	(i) (ii)	1,105,929 -------------	-------------	42,132 -------------	15,250 -------------	37,974 -------------	1,196,796 -------------	-------------
7DR WILLIAM C SEVERINO CLINIC PHYSICIAN	(i) (ii)	1,128,359 -------------	-------------	19,469 -------------	15,250 -------------	37,974 -------------	1,196,563 -------------	-------------
8DR JOHN D HAMMOCK TRUSTEE	(i) (ii)	764,029 -------------	38,820 -------------	25,169 -------------	15,250 -------------	32,376 -------------	872,302 -------------	-------------
9DR CHRISTOPHER R SOLARO CHIEF MEDICAL OFF.	(i) (ii)	605,305 -------------	126,322 -------------	25,214 -------------	15,250 -------------	36,350 -------------	805,576 -------------	-------------
10PATRICK M GERVELER TREASURER	(i) (ii)	------------- 526,907	-------------	------------- 114,965	------------- 115,294	------------- 28,751	------------- 785,917	------------- 89,876
11BRIAN T CANFIELD PRES/CEO BCS AND BH	(i) (ii)	------------- 501,024	-------------	------------- 24,723	------------- 15,250	------------- 2,139	------------- 540,997	-------------
12TIMOTHY L TRANOR CHIEF NURSING OFF.	(i) (ii)	258,295 -------------	-------------	22,953 -------------	13,028 -------------	39,100 -------------	327,761 -------------	-------------
13DR TIMOTHI J BETH TRUSTEE	(i) (ii)	232,956 -------------	11,668 -------------	4,334 -------------	11,551 -------------	26,690 -------------	285,981 -------------	-------------
14DR ABBY REICH TRUSTEE	(i) (ii)	170,958 -------------	-------------	1,786 -------------	8,260 -------------	22,019 -------------	202,046 -------------	-------------

Schedule J (Form 990) 2022

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, PAGE 1, PART I, LINE 3

COMPENSATION OF ORGANIZATION'S CEO - CEO MAUREEN KAHN AND BRIAN CANFIELD ARE EMPLOYEES OF BLESSING CORPORATE SERVICES, INC., THE PARENT COMPANY OF BLESSING HOSPITAL. COMPARABILITY DATA PROVIDED BY A THIRD PARTY IS USED TO ESTABLISH A MARKET RANGE OF COMPENSATION. THIS INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES BOARD OF TRUSTEE'S COMPENSATION COMMITTEE FOR APPROVAL. COMPENSATION OF ORGANIZATION'S BOARD MEMBERS - MAUREEN KAHN, BRIAN CANFIELD, DR. ABBY REICH, DR. HARSHA POLAVARAPU, PATRICK GERVELER, DR. JOHN HAMMOCK, AND DR. TIMOTHI BETH ARE EMPLOYEES OF BLESSING CORPORATE SERVICES, INC., THE PARENT COMPANY OF BLESSING HOSPITAL. COMPARABILITY DATA PROVIDED BY A THIRD PARTY IS USED TO ESTABLISH A MARKET RANGE OF COMPENSATION. THIS INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES BOARD OF TRUSTEE'S COMPENSATION COMMITTEE FOR APPROVAL.

SCHEDULE J, PAGE 1, PART I, LINE 4

MAUREEN A. KAHN (RETIRED 7/1/23) 0 173,252 0 PATRICK M. GERVELER 0 100,044 0

Schedule J (Form 990) 2022

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
BLESSING HOSPITAL

Employer identification number
37-0661183

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	ILLINOIS FINANCE AUTHORITY	86-1091967		11-15-2017	15,955,000	SEE PART VI A - TO REIMBURSE CERTAIN COSTS OF A CAPITAL EXPENDITURE PROJECT, CURRENTLY REFUND A PORT		X		X		X
B	ILLINOIS FINANCE AUTHORITY REVENUE REFUNDING BONDS SERIES 2019	86-1091967		06-27-2019	28,977,500	SEE PART VI B - SERIES 2019A - USED TO (I) LEGALLY DEFEASE THE OUTSTANDING VARIABLE RATE REVENUE REF		X		X		X
C	ILLINOIS FINANCE AUTHORITY REVENUE REFUNDING BONDS SERIES 2019	86-1091967		06-27-2019	28,977,500	SEE PART VI C - SERIES 2019B - USED TO (I) LEGALLY DEFEASE A PORTION OF THE SERIES 2012B BONDS, AND		X		X		X
D	ILLINOIS FINANCE AUTHORITY REVENUE BONDS SERIES 2019C	86-1091967		06-27-2019	45,230,000	SEE PART VI D - SERIES 2019C - USED FOR (I) 35M - THE CONSTRUCTION AND EQUIPPING OF AN EXPANSION OF		X		X		X
	ILLINOIS FINANCE AUTHORITY REVENUE NOTE SERIES 2023	86-1091967		04-06-2023	15,000,000	SEE PART VI E - USED TO (I) FINANCE AND REIMBURSE CERTAIN COSTS OF CAPITAL EXPENDITURE PROJECTS AND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	7,495,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	15,955,000		28,977,500		28,977,500		45,230,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	2,412
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	147,588		147,500		147,500		230,000
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	4,000,000						45,000,000
11 Other spent proceeds .............	11,805,000		28,830,000		28,830,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2017		2022		2022		2022
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	2.900 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............	2.900 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI A - TO REIMBURSE CERTAIN COSTS OF A CAPITAL EXPENDITURE PROJECT, CURRENTLY REFUND A PORTION OF THE CITY OF QUINCY, ADAMS COUNTY, ILLINOIS REVENUE REFUNDING BONDS, SERIES 2007 (BLESSING HOSPITAL), PAY A PORTION OF THE INTEREST ON THE SERIES 2017 BONDS AND PAY CERTAIN EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2017 BONDS.
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI B - SERIES 2019A - USED TO (I) LEGALLY DEFEASE THE OUTSTANDING VARIABLE RATE REVENUE REFUNDING BONDS, SERIES 2012A (BLESSING HOSPITAL)(THE "SERIES 2012A BONDS"), (II) LEGALLY DEFEASE A PORTION OF THE OUTSTANDING VARIABLE RATE REVENUE BONDS, SERIES 2012B (BLESSING HOSPITAL) (THE "SERIES 2012B BONDS"), AND (III) PAY CERTAIN EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2019A BONDS.
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI C - SERIES 2019B - USED TO (I) LEGALLY DEFEASE A PORTION OF THE SERIES 2012B BONDS, AND (II) PAY EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2019B BONDS.
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI D - SERIES 2019C - USED FOR (I) 35M - THE CONSTRUCTION AND EQUIPPING OF AN EXPANSION OF THE MOORMAN PAVILION, (II) 10M - THE CONSTRUCTION AND EQUIPPING OF AN EXPANSION TO THE AMBULATORY SURGERY CENTER, AND (III) 230K TO PAY EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2019C BONDS.
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI E - USED TO (I) FINANCE AND REIMBURSE CERTAIN COSTS OF CAPITAL EXPENDITURE PROJECTS AND (II) PAY CERTAIN EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2023 NOTE.

Schedule K (Form 990) 2021

Additional Data

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Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax-Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization
BLESSING HOSPITAL

Employer identification number
37-0661183

Part Ⅰ

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	ILLINOIS FINANCE AUTHORITY	86-1091967		11-15-2017	15,955,000	SEE PART VI A - TO REIMBURSE CERTAIN COSTS OF A CAPITAL EXPENDITURE PROJECT, CURRENTLY REFUND A PORT		X		X		X
B	ILLINOIS FINANCE AUTHORITY REVENUE REFUNDING BONDS SERIES 2019	86-1091967		06-27-2019	28,977,500	SEE PART VI B - SERIES 2019A - USED TO (I) LEGALLY DEFEASE THE OUTSTANDING VARIABLE RATE REVENUE REF		X		X		X
C	ILLINOIS FINANCE AUTHORITY REVENUE REFUNDING BONDS SERIES 2019	86-1091967		06-27-2019	28,977,500	SEE PART VI C - SERIES 2019B - USED TO (I) LEGALLY DEFEASE A PORTION OF THE SERIES 2012B BONDS, AND		X		X		X
D	ILLINOIS FINANCE AUTHORITY REVENUE BONDS SERIES 2019C	86-1091967		06-27-2019	45,230,000	SEE PART VI D - SERIES 2019C - USED FOR (I) 35M - THE CONSTRUCTION AND EQUIPPING OF AN EXPANSION OF		X		X		X
	ILLINOIS FINANCE AUTHORITY REVENUE NOTE SERIES 2023	86-1091967		04-06-2023	15,000,000	SEE PART VI E - USED TO (I) FINANCE AND REIMBURSE CERTAIN COSTS OF CAPITAL EXPENDITURE PROJECTS AND		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	7,495,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	15,955,000		28,977,500		28,977,500		45,230,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............	2,412
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............	147,588		147,500		147,500		230,000
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............	4,000,000						45,000,000
11 Other spent proceeds .............	11,805,000		28,830,000		28,830,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2017		2022		2022		2022
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........		X	X		X		X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X		X		X
16 Has the final allocation of proceeds been made? ..........	X		X		X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2021

Page 2

Part Ⅲ

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X		X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............	X		X		X		X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?	X		X		X		X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....	2.900 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............	2.900 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X		X

Part Ⅳ

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X		X		X
b Exception to rebate? ........	X		X		X		X
c No rebate due? .........		X		X		X		X
If "Yes" to line 2c, provide in Part Ⅵ the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X	X		X		X

Schedule K (Form 990) 2021

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X		X

Part Ⅴ

Procedures To Undertake Corrective Action

---------------------------------------------------------------------------------------------------------------	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X		X

Part Ⅵ

Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).

Return Reference	Explanation
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI A - TO REIMBURSE CERTAIN COSTS OF A CAPITAL EXPENDITURE PROJECT, CURRENTLY REFUND A PORTION OF THE CITY OF QUINCY, ADAMS COUNTY, ILLINOIS REVENUE REFUNDING BONDS, SERIES 2007 (BLESSING HOSPITAL), PAY A PORTION OF THE INTEREST ON THE SERIES 2017 BONDS AND PAY CERTAIN EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2017 BONDS.
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI B - SERIES 2019A - USED TO (I) LEGALLY DEFEASE THE OUTSTANDING VARIABLE RATE REVENUE REFUNDING BONDS, SERIES 2012A (BLESSING HOSPITAL)(THE "SERIES 2012A BONDS"), (II) LEGALLY DEFEASE A PORTION OF THE OUTSTANDING VARIABLE RATE REVENUE BONDS, SERIES 2012B (BLESSING HOSPITAL) (THE "SERIES 2012B BONDS"), AND (III) PAY CERTAIN EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2019A BONDS.
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI C - SERIES 2019B - USED TO (I) LEGALLY DEFEASE A PORTION OF THE SERIES 2012B BONDS, AND (II) PAY EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2019B BONDS.
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI D - SERIES 2019C - USED FOR (I) 35M - THE CONSTRUCTION AND EQUIPPING OF AN EXPANSION OF THE MOORMAN PAVILION, (II) 10M - THE CONSTRUCTION AND EQUIPPING OF AN EXPANSION TO THE AMBULATORY SURGERY CENTER, AND (III) 230K TO PAY EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2019C BONDS.
PURPOSE OF ISSUE DESCRIPTION	ILLINOIS FINANCE AUTHORITY SEE PART VI E - USED TO (I) FINANCE AND REIMBURSE CERTAIN COSTS OF CAPITAL EXPENDITURE PROJECTS AND (II) PAY CERTAIN EXPENSES RELATED TO THE ISSUANCE OF THE SERIES 2023 NOTE.

Schedule K (Form 990) 2021

Additional Data

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Software Version:

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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.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

BLESSING HOSPITAL

Employer identification number

37-0661183

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. ........................... Bullet Image

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

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) 2021

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) MISSA J GERVELER	FAMILY MEMBER	56,099	EMPLOYMENT		No
(2) ELLEN J TRAMAN	FAMILY MEMBER	52,874	EMPLOYMENT		No
(3) ROBERT G TRAMAN	FAMILY MEMBER	68,467	EMPLOYMENT		No
(4) SURYA V POLAVARAPU	FAMILY MEMBER	92,489	EMPLOYMENT		No
(5) EVAN CANFIELD	FAMILY MEMBER	150,579	EMPLOYMENT		No
(6) APRIL CANFIELD	FAMILY MEMBER	42,522	EMPLOYMENT		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2021

Additional Data

Software ID:
Software Version:

- 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.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

BLESSING HOSPITAL

Employer identification number

37-0661183

Return Reference	Explanation
FORM 990, PAGE 2, PART III, LINE 4A	SINCE IT WAS FOUNDED IN 1873, BLESSING HOSPITAL HAS PROVIDED QUALITY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF RACE, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. IN SERVING ALL MEMBERS OF ITS COMMUNITIES, BLESSING HOSPITAL CONTINUES THIS TRADITION BY PROVIDING FREE/SUBSIDIZED CARE, CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT LESS THAN FULL CHARGES, AND COMMUNITY HEALTH/EDUCATION/WELLNESS PROGRAMS. FOR FISCAL YEAR 2023, THE COST OF CHARITY CARE PROVIDED WAS 5,375,920 AND MEDICARE SHORTFALLS WERE 88,592,740. BLESSING HOSPITAL TREATED PATIENTS THROUGH THE FOLLOWING SERVICES DURING FISCAL YEAR 2023: 39,575 EMERGENCY CENTER VISITS; 457,960 OUTPATIENT VISITS; 14,536 SURGICAL OPERATIONS, INCLUDING 180 OPEN HEART SURGERIES, 14,858 INPATIENT ADMISSIONS, AND 1,164 BABIES. OUTPATIENT SERVICES INCLUDED 94,998 CARDIOPULMONARY/CARDIOLOGY PROCEDURES, 1,295,149 LABORATORY TESTS, 95,174 RADIOLOGY PROCEDURES, AND 136,849 PHYSICAL THERAPY/REHABILITATION VISITS. BLESSING HOSPITAL PROVIDED ADDITIONAL BENEFITS OF 6,937,211 TO THE COMMUNITY DURING FISCAL YEAR 2023 AS FOLLOWS: HEALTH PROFESSIONALS EDUCATION SIU RESIDENCY PROGRAM 2,457,659 BLESSING-RIEMAN COLLEGE OF NURSING 2,000,993 NURSING EDUCATIONAL PRECEPTORS 23,829 SUB TOTAL HEALTH PROFESSIONALS EDUCATION 4,482,481 COMMUNITY HEALTH IMPROVEMENT SERVICES PSYCHIATRIC SERVICES TO SIU CENTER FOR FAMILY MEDICINE - QUINCY, CHADDOCK, AND TRANSITIONS OF WESTERN ILLINOIS 200,978 ADAMS COUNTY HEALTH DEPARTMENT DENTAL PROGRAM 100,000 PATIENT TRANSPORTATION AND LODGING 365,348 CHARITY PHARMACY PRESCRIPTIONS 167,079 HEALTH SCREENINGS/TESTS 94,262 MEDICAL SUPPLIES/SERVICES FOR PATIENTS 42,883 BEHAVIORAL HEALTH EDUCATIONAL PROGRAMS 8,825 MEDICAL INTERPRETING SERVICES 25,719 SUB TOTAL COMMUNITY HEALTH IMPROVEMENT SERVICES 1,005,094 SIU CENTER FOR FAMILY MEDICINE - QUINCY, CHADDOCK, AND TRANSITIONS OF WESTERN ILLINOIS SUBSIDIZED HEALTH SERVICES CARE COORDINATION 1,189,621 HOME HEALTHCARE 149,785 SUB TOTAL SUBSIDIZED HEALTH SERVICES 1,339,406 IN-KIND CONTRIBUTIONS/DONATIONS DONATIONS/SPONSORSHIPS 110,230 SUB TOTAL IN-KIND CONTRIBUTIONS/DONATIONS 110,230 BLESSING HOSPITAL'S STRATEGIC OBJECTIVES FOR THE UPCOMING YEARS ARE AS FOLLOWS: 1) QUALITY OUTCOMES/METRICS AND ZERO HARM GOALS A) REDUCE PATIENT HARM EVENTS BY 15% PER YEAR 2) BEST PLACE TO WORK/EMPLOYEE ENGAGEMENT/RECRUITMENT/RETENTION B) INCREASE EMPLOYEE SATISFICATION TO 80TH PERCENTILE C) REDUCE CONTRACT LABOR BY 80% BY END OF FY 3) PHYSICIAN/PROVIDER SATISFICATION A) 90TH PERCENTILE 4) PATIENT SATISFACTION A) 90TH PERCENTILE 5) ACCESS TO CARE A) INCREASE MARKET SHARE IN MISSOURI BY 15% B) DECREASE OUTMIGRATION C) ENHANCE DIGITAL FRONT DOOR D) ALWAYS SAY YES 6) TURNAROUND PLAN EXECUTION 7) FISCAL HEALTH A) CONTROL EXPENSES B) INCREASE REVENUE C) GREATER THAN 200 DAYS CASH ON HAND D) GREATER THAN 3.5% OPERATING MARGIN 8) PREPARE FOR ELECTRONIC HEALTH RECORD CHANGE IN 2 YEARS
FORM 990, PART VI	BLESSING HOSPITAL CONTRACTS WITH BLESSING CORPORATE SERVICES TO EXECUTE THE DUTIES NORMALLY PERFORMED BY MANAGEMENT. THE MANAGEMENT COMPANY CARRIES OUT THE GOVERNING DECISIONS OF THE BOARD OF DIRECTORS, SIMILAR TO THE ROLE AND FUNCTIONS OF AN EMPLOYEE-OFFICER. BLESSING CORPORATE SERVICES PAID COMPENSATION TO VARIOUS EMPLOYEES COLLECTIVELY ACTING AS MANAGMENT. THE COMPENSATION PAID TO THOSE EMPLOYEES WHO SERVE ON BLESSING HOSPITAL'S BOARD OF DIRECTORS IS DISCLOSED ON PART VII.
FORM 990, PAGE 6, PART VI, LINE 3	1) BLESSING CORPORATE SERVICES PROVIDES GENERAL MANAGEMENT SERVICES. 2) ARAMARK PROVIDES MANAGEMENT OF FOOD SERVICES AND ENVIRONMENTAL SERVICES. 3) BRIDGE HOME CARE PARTNERS PROVIDES MANAGEMENT OF BLESSING'S HOME CARE SERVICES.
FORM 990, PAGE 6, PART VI, LINE 4	THE GOVERNING DOCUMENTS OF BLESSING HOSPITAL (BH) WERE AMENDED THROUGH BOARD APPROVAL ON MAY 31, 2023. THE KEY CHANGES INCLUDE: - UPDATE AND CONFORM THE PURPOSES AND DISSOLUTION CLAUSES IN THE ARTICLES AND BYLAWS. - ELEVATE THE MANAGEMENT OF BH TO BLESSING CORPORATE SERVICES AS THE SOLE MEMBER OF BH. - REDUCE THE SIZE OF THE BH BOARD AND ADD A REPRESENTATIVE OF THE BLESSING PROVIDER COUNCIL AS A VOTING TRUSTEE. - ELIMINATE THE OPERATIONS AND FINANCE COMMITTEE, PERFORMANCE IMPROVEMENT LEADERSHIP COUNCIL, AND NOMINATING AND GOVERNANCE COMMITTEE. - CREATE A QUALITY AND SAFETY COMMITTEE AND A COMMUNITY BENEFIT AND ADVOCACY COMMITTEE. - UPDATE THE INDEMNIFICATION PROVISIONS TO PERMIT, BUT NOT REQUIRE, BH TO INDEMNIFY EMPLOYEES AND AGENTS UNDER CERTAIN CIRCUMSTANCES.
FORM 990, PAGE 6, PART VI, LINE 6	BLESSING CORPORATE SERVICES, INC. IS THE SOLE VOTING MEMBER OF BLESSING HOSPITAL.
FORM 990, PAGE 6, PART VI, LINE 7A	BLESSING CORPORATE SERVICES, INC., THE SOLE VOTING MEMBER OF BLESSING HOSPITAL, SHALL POSSESS THE RIGHTS AND RESPONSIBILITIES TO APPOINT AND/OR REMOVE ALL THE TRUSTEES OF THE CORPORATION AND APPOINT THE CORPORATION'S PRESIDENT.
FORM 990, PAGE 6, PART VI, LINE 7B	BLESSING CORPORATE SERVICES SHALL POSSESS THE EXCLUSIVE RIGHTS AND RESPONSIBILITIES TO (A) APPOINT AND/OR REMOVE ALL THE TRUSTEES OF THE CORPORATION, (B) APPOINT THE CORPORATION'S PRESIDENT, (C) APPROVE EXPRESSLY ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE, (D) APPROVE AND OVERSEE CAPITAL AND OPERATING BUDGETS, LONG-TERM DEBT, LONG-RANGE PLANS, THE SALE OR PURCHASE OF REAL ESTATE, AND CONTRACTS ENTERED INTO BY THE CORPORATION, THE REASONABLE VALUE OF WHICH EXCEEDS AN AMOUNT SPECIFIED IN THE BYLAWS OF THE MEMBER, (E) APPROVE MATERIAL INVESTMENT DECISIONS, INCLUDING WITHOUT LIMITATION ESTABLISHMENT AND MODIFICATION OF INVESTMENT POLICIES, ENGAGEMENT AND REMOVAL OF INVESTMENT MANAGERS AND ADVISORS, AND CHANGES IN INVESTMENT ALLOCATIONS NOT PERMITTED BY AN EXISTING INVESTMENT POLICY, (F) APPROVE THE PARAMETERS FOR TERMS OF EMPLOYMENT OF PROVIDERS, INCLUDING PROVIDER COMPENSATION PLANS, AND ANY MATERIAL VARIANCES FROM SUCH PARAMETERS FOR INDIVIDUAL PROVIDERS, (G) APPROVE THE SELECTION OF AUDITORS AND LEGAL COUNSEL AND OVERSEE AUDITS, (H) APPROVE CHARITY CARE AND COMMUNITY BENEFITS-RELATED POLICIES, (I) APPROVE THE FORMATION OF SUBSIDIARY ENTITIES AND/OR JOINT VENTURES, (J) APPROVE THE FILING OF A PETITION IN BANKRUPTCY, MAKING AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS, OR APPLYING FOR PROTECTION UNDER ANY INSOLVENCY LAWS, (K) APPROVE THE PARTICIPATION IN ANY MERGER, COMBINATION, CONSOLIDATION, LIQUIDATION, DISSOLUTION OR OTHER CORPORATE OR BUSINESS ENTITY RESTRUCTURING, (L) ENACT AND IMPLEMENT SUCH POLICIES AND PROCEDURES AS THE MEMBER DEEMS NECESSARY OR ADVISABLE FOR THE MANAGEMENT OF THE CORPORATION, AND (M) COMPEL THE CORPORATION'S BOARD, OFFICERS AND AGENTS TO ENFORCE AND/OR PERFORM ANY CONTRACTUAL OR OTHER OBLIGATIONS AND/OR TAKE ANY ACTION THE MEMBER DETERMINES IS NECESSARY OR ADVISABLE FOR THE MANAGEMENT OF THE CORPORATION.
FORM 990, PAGE 6, PART VI, LINE 11B	FOLLOWING MANAGEMENT REVIEW, THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES FOR REVIEW AND COMMENT PRIOR TO FILING.
FORM 990, PAGE 6, PART VI, LINE 12C	A COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO BE READ, SIGNED, AND RETURNED TO THE ORGANIZATION. THE SIGNED POLICIES ARE RETAINED IN THE CORPORATE ADMINISTRATIVE FILES. IN ADDITION, EACH OFFICER, DIRECTOR, OR TRUSTEE IS REQUIRED TO DECLARE NO CONFLICT OF INTEREST IN REGARDS TO AGENDA ITEMS BEING PRESENTED AT THE START OF EACH MONTHLY BOARD MEETING.
FORM 990, PAGE 6, PART VI, LINE 15B	NO COMPENSATION IS RECEIVED FOR SERVING AS AN OFFICER OF BLESSING HOSPITAL. ON A BIANNUAL BASIS, COMPARABLE COMPENSATION DATA THROUGH A THIRD PARTY (SULLIVAN-COTTER) IS USED TO ESTABLISH MARKET RANGE. INFORMATION IS SUBMITTED TO THE BLESSING CORPORATE SERVICES COMPENSATION COMMITTEE FOR REVIEW AND TO BLESSING HOSPITAL BOARD OF TRUSTEES FOR APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 19	THESE FORMS ARE LOCATED IN THE CORPORATE ADMINISTRATIVE OFFICES AND ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION.
FORM 990, PART XI, LINE 9	INCREASE IN MINIMUM PENSION LIABILITY 5,555,547 TRANSFER OF CLINIC ASSETS AND LIABILITIES 17,179,328 TRANSFERS TO AFFILIATES -17,124,058 CUMULATIVE EFFECT OF ADOPTION OF ASC 842 -751,952 TOTAL 4,858,865

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

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

- 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.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

BLESSING HOSPITAL

Employer identification number

37-0661183

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)BLESSING CORPORATE SERVICES INC BROADWAY AT 11TH PO BOX 7005 QUINCY,IL623057005 37-1128706	MGMT SVCS	IL	501C3	10	N/A		No
(2)THE BLESSING FOUNDATION BROADWAY AT 11TH POBOX 7005 QUINCY,IL623057005 37-1128705	FUNDRAISE	IL	501C3	12B	BCS INC BCS INC		No
(3)BLESSINGCARE CORPORATION DBA ILLINI 640 WEST WASHINGTON PITTSFIELD,IL62363 37-1396010	HOSPITAL	IL	501C3	3	BCS INC BCS INC		No
(4)BLESSINGCARE CORPORATION - MISSOURI 1005 BROADWAY QUINCY,IL62301 43-1371818	INACTIVE	MO	501C3	3	BCS INC BCS INC		No
(5)BLESSING VOLUNTEERS IN PARTNERSHIP BROADWAY AT 11TH PO BOX 7005 QUINCY,IL623057005 23-7160187	HSP SUPPRT	IL	501C3	12B	N/A		No
(6)BLESSING AFFILIATES INC BROADWAY AT 11TH PO BOX 7005 QUINCY,IL623057005 37-1128708	INACTIVE	IL	501C3	10	BCS INC		No
(7)BLESSING WALK-IN CLINIC LLC 1005 BROADWAY QUINCY,IL62301 81-4181593	MED SVCS	IL	501C3	3	BCS INC BCS INC		No
(8)KEOKUK AREA HOSPITAL DBA BLESSING 1600 MORGAN STREET KEOKUK,IA52632 42-0710268	HOSPITAL	IA	501C3	3	KHS INC		No
(9)KEOKUK HEALTH SYSTEMS INC 1600 MORGAN STREET KEOKUK,IA52632 42-1237361	MGMT SVCS	IA	501C3	12B	BCS INC		No

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

Cat. No. 50135Y

Schedule R (Form 990) 2021

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	(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) ILLINI HEALTH SERVICES LLC PO BOX 40 QUINCY,IL623060040 47-0901851	PHARMACY	IL	DENMAN DENMAN				No			No
(2) CURRENT HEALTH NETWORK LLC 1005 BROADWAY QUINCY,IL62301 81-1681509	PRVDR NTWK	IL	CHS HLDGS				No			No

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) DENMAN SERVICES INC PO BOX 40 QUINCY,IL62306 37-1132117	MED EQUIP	IL	BCS INC BCS INC	C CORP					No
(2) CHS HOLDING COMPANY 1005 BROADWAY QUINCY,IL62301 32-0481381	GRP HLTH	IL	BCS INC BCS INC	C CORP					No
(3) HANNIBAL CLINIC INC 100 MEDICAL DRIVE HANNIBAL,MO63401 43-1033473	MED SVCS	MO	BCS INC	C CORP					No
(4) BLESSING ASSURANCE COMPANY PO BOX 1159 GRAND CAYMAN,CAYMAN ISLANDSKY1-1102 CJ 98-1454767	SELF-INSUR	CJ	BCS INC BCS INC	C CORP					No
(5) THE BROWN DRUG COMPANY 1121 MAINE STREET QUINCY,IL62301 37-0193505	PHARMACY	IL	BCS INC	S CORP					No
(6) KEOKUK AREA MEDICAL EQUIP & SUPPLY 420 NORTH 17TH STREET KEOKUK,IA52632 42-1237312	MED EQUIP	IA	KHS INC	C CORP					No

Schedule R (Form 990) 2021

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) ............................

Yes

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

Yes

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

Yes

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) .......................

Yes

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) ...................

Yes

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

Yes

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) ............................

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) DENMAN SERVICES INC	A	139,740	FMV
(2) DENMAN SERVICES INC	Q	2,387,286	FMV
(3) DENMAN SERVICES INC	M	3,639,682	FMV

Schedule R (Form 990) 2021

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) 2021

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) 2021

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: BLESSING HOSPITAL'S MISSION IS TO IMPROVE THE HEALTH OF OUR COMMUNITIES.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	13
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	8
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	4,427
6	Total number of volunteers (estimate if necessary) .............	6	367
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	1,317,554
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	20,999,788	7,210,581
9	Program service revenue (Part VIII, line 2g) .........	521,131,079	580,508,670
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	17,374,383	4,001,220
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	30,763,275	33,346,506
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	590,268,525	625,066,977
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	3,972,987	3,839,987
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)	280,383,617	327,112,608
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)....	252,000,419	271,155,525
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	536,357,023	602,108,120
19	Revenue less expenses. Subtract line 18 from line 12.......	53,911,502	22,958,857
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	685,386,611	758,035,073
21	Total liabilities (Part X, line 26).............	232,628,047	264,680,169
22	Net assets or fund balances. Subtract line 21 from line 20.....	452,758,564	493,354,904

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 459,106,795 including grants of $ 3,839,987 ) (Revenue $ 580,508,670 )
	SINCE IT WAS FOUNDED IN 1873, BLESSING HOSPITAL HAS PROVIDED QUALITY HEALTH CARE SERVICES TO ALL PATIENTS REGARDLESS OF RACE, SEX, NATIONAL ORIGIN, AGE, OR ABILITY TO PAY. IN SERVING ALL MEMBERS OF ITS COMMUNITIES, BLESSING HOSPITAL CONTINUES THIS TRADITION BY PROVIDING FREE/SUBSIDIZED CARE, CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT LESS THAN FULL CHARGES, AND COMMUNITY HEALTH/EDUCATION/WELLNESS PROGRAMS. FOR FISCAL YEAR 2023, THE COST OF CHARITY CARE PROVIDED WAS 5,375,920 AND MEDICARE SHORTFALLS WERE 88,592,740. BLESSING HOSPITAL TREATED PATIENTS THROUGH THE FOLLOWING SERVICES DURING FISCAL YEAR 2023: 39,575 EMERGENCY CENTER VISITS; 457,960 OUTPATIENT VISITS; 14,536 SURGICAL OPERATIONS, INCLUDING 180 OPEN HEART SURGERIES, 14,858 INPATIENT ADMISSIONS, AND 1,164 BABIES. OUTPATIENT SERVICES INCLUDED 94,998 CARDIOPULMONARY/CARDIOLOGY PROCEDURES, 1,295,149 LABORATORY TESTS, 95,174 RADIOLOGY PROCEDURES, AND 136,849 PHYSICAL THERAPY/REHABILITATION VISITS. BLESSING HOSPITAL PROVIDED ADDITIONAL BENEFITS OF 6,937,211 TO THE COMMUNITY DURING FISCAL YEAR 2023 AS FOLLOWS: HEALTH PROFESSIONALS EDUCATION SIU RESIDENCY PROGRAM 2,457,659 BLESSING-RIEMAN COLLEGE OF NURSING 2,000,993 NURSING EDUCATIONAL PRECEPTORS 23,829 SUB TOTAL HEALTH PROFESSIONALS EDUCATION 4,482,481 COMMUNITY HEALTH IMPROVEMENT SERVICES PSYCHIATRIC SERVICES TO SIU CENTER FOR FAMILY MEDICINE - QUINCY, CHADDOCK, AND TRANSITIONS OF WESTERN ILLINOIS 200,978 ADAMS COUNTY HEALTH DEPARTMENT DENTAL PROGRAM 100,000 PATIENT TRANSPORTATION AND LODGING 365,348 CHARITY PHARMACY PRESCRIPTIONS 167,079 HEALTH SCREENINGS/TESTS 94,262 MEDICAL SUPPLIES/SERVICES FOR PATIENTS 42,883 BEHAVIORAL HEALTH EDUCATIONAL PROGRAMS 8,825 MEDICAL INTERPRETING SERVICES 25,719 SUB TOTAL COMMUNITY HEALTH IMPROVEMENT SERVICES 1,005,094 SIU CENTER FOR FAMILY MEDICINE - QUINCY, CHADDOCK, AND TRANSITIONS OF WESTERN ILLINOIS SUBSIDIZED HEALTH SERVICES CARE COORDINATION 1,189,621 HOME HEALTHCARE 149,785 SUB TOTAL SUBSIDIZED HEALTH SERVICES 1,339,406 IN-KIND CONTRIBUTIONS/DONATIONS DONATIONS/SPONSORSHIPS 110,230 SUB TOTAL IN-KIND CONTRIBUTIONS/DONATIONS 110,230 BLESSING HOSPITAL'S STRATEGIC OBJECTIVES FOR THE UPCOMING YEARS ARE AS FOLLOWS: 1) QUALITY OUTCOMES/METRICS AND ZERO HARM GOALS A) REDUCE PATIENT HARM EVENTS BY 15% PER YEAR 2) BEST PLACE TO WORK/EMPLOYEE ENGAGEMENT/RECRUITMENT/RETENTION B) INCREASE EMPLOYEE SATISFICATION TO 80TH PERCENTILE C) REDUCE CONTRACT LABOR BY 80% BY END OF FY 3) PHYSICIAN/PROVIDER SATISFICATION A) 90TH PERCENTILE 4) PATIENT SATISFACTION A) 90TH PERCENTILE 5) ACCESS TO CARE A) INCREASE MARKET SHARE IN MISSOURI BY 15% B) DECREASE OUTMIGRATION C) ENHANCE DIGITAL FRONT DOOR D) ALWAYS SAY YES 6) TURNAROUND PLAN EXECUTION 7) FISCAL HEALTH A) CONTROL EXPENSES B) INCREASE REVENUE C) GREATER THAN 200 DAYS CASH ON HAND D) GREATER THAN 3.5% OPERATING MARGIN 8) PREPARE FOR ELECTRONIC HEALTH RECORD CHANGE IN 2 YEARS

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 expenses459,106,795

(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)		(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) JULIE BRINK........................................................................ BOARD CHAIR	1.00 .......................0.00	X	X	0	0	0
(19) TIMOTHY D KOONTZ........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(20) DR THOMAS H MILLER........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(21) BEN VAN NESS........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0
(22) CHRISTOPHER J NIEMANN........................................................................ TRUSTEE	1.00 .......................0.00	X		0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	9,900,725	2,199,880	848,258

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	2,026,293
e	Government grants (contributions)		1e	3,550,475

f	All other contributions, gifts, grants, and similar amounts not included above		1f	1,633,813

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

h Total. Add lines 1a-1f.......		7,210,581

		Business Code
2a	NET PATIENT SERVICE REVENUE	621110	575,421,322	575,421,322
b	COLLEGE OF NURSING	621110	4,683,458		4,683,458
c	PHYSICAL THERAPY	621110	403,890	403,890
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		580,508,670

3 Investment income (including dividends, interest, and othersimilar amounts) ......			6,005,604			6,005,604
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		2,746,791	6a
b	Less: rental expenses			6b
c	Rental income or (loss)		2,746,791	6c
d	Net rental income or (loss).......			2,746,791		48,560	2,698,231
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	183,290	40,261,348	7a
b	Less: cost or other basis and sales expenses	510,033	41,938,989	7b
c	Gain or (loss)	-326,743	-1,677,641	7c
d	Net gain or (loss).........			-2,004,384	-326,743		-1,677,641
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a	62,500
b	Less: direct expenses ...		8b	56,073
c	Net income or (loss) from fundraising events..			6,427			6,427
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	21,769,290
b	Less: cost of goods sold ..		10b	15,695,785
c	Net income or (loss) from sales of inventory..			6,073,505		1,268,994	4,804,511
Business Code			Miscellaneous Revenue
11a	MANAGEMENT & ACCNTG FEES		900099	14,623,206			14,623,206
b	OTHER		541610	3,908,406			3,908,406
c	SALE OF FOOD		722100	3,139,518			3,139,518
d	All other revenue ....			2,848,653	22,553		2,826,100
e	Total. Add lines 11a–11d ......			24,519,783
12	Total revenue. See instructions.....			625,066,977	575,521,022	1,317,554	41,017,820

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	2,094,550	2,094,550
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........	1,745,437	1,745,437
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 ...........	3,689,168	2,959,880	729,288
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	264,024,331	211,831,077	52,193,254
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	7,493,179	6,011,901	1,481,278
9	Other employee benefits .......	36,734,917	29,473,030	7,261,887
10	Payroll taxes ...........	15,171,013	12,171,954	2,999,059
11	Fees for services (non-employees):
a	Management ......	20,628,187		20,628,187
b	Legal .........	11,202		11,202
c	Accounting ...........	169,262	19,339	149,923
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	601,511		601,511
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	37,279,781	30,489,827	6,789,954
12	Advertising and promotion ....	1,041,842	1,041,842
13	Office expenses .......	250,339	167,154	83,185
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	4,479,354	310,534	4,168,820
17	Travel ............	809,629	617,731	191,898
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	95,363	61,829	33,534
20	Interest ...........	3,746,030	3,746,030
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	27,157,652	18,956,998	8,200,654
23	Insurance ...	7,556,714	6,451,956	1,104,758
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	SUPPLIES	88,290,343	84,917,950	3,372,393
b	EQUIPMENT RENTAL & MAINT.	16,882,630	11,408,853	5,473,777
c	SOFTWARE	16,649,733	2,098,184	14,551,549
d	ILLINOIS PROVIDER TAX	14,152,759	14,152,759
e	All other expenses	31,353,194	18,377,980	12,975,214
25	Total functional expenses. Add lines 1 through 24e	602,108,120	459,106,795	143,001,325	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 ........			85,575,714	1	75,725,969
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			84,245,265	4	102,058,815
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 .......
					5
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) ...
					6
7	Notes and loans receivable, net ...........			12,786,651	7	15,526,552
8	Inventories for sale or use ............			10,295,928	8	12,080,841
9	Prepaid expenses and deferred charges ......			10,943,425	9	8,309,439
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	644,478,196
b	Less: accumulated depreciation	10b	296,194,169	317,894,708	10c	348,284,027
11	Investments—publicly traded securities .			97,295,899	11	110,397,431
12	Investments—other securities. See Part IV, line 11 .....			57,357,171	12	63,365,154
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			8,991,850	15	22,286,845
16	Total assets. Add lines 1 through 15 (must equal line 33)...			685,386,611	16	758,035,073

17	Accounts payable and accrued expenses .....	15,382,992	17	15,435,466
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	112,670,000	20	126,645,000
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 .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..	3,651,789	23	7,435,093
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	100,923,266	25	115,164,610
26	Total liabilities. Add lines 17 through 25..	232,628,047	26	264,680,169

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	445,031,966	27	487,188,074
28	Net assets with donor restrictions ...........	7,726,598	28	6,166,830
	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 ...........	452,758,564	32	493,354,904
33	Total liabilities and net assets/fund balances ........	685,386,611	33	758,035,073