Form990


Department of the TreasuryInternal Revenue Service
Return of Organization Exempt From Income Tax
Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)
MediumBullet Do not enter social security numbers on this form as it may be made public.
MediumBullet Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
A For the 2021 calendar year, or tax year beginning 07-01-2022 , and ending 06-30-2023
BCheck if applicable:
CName of organization
SARAH BUSH LINCOLN HEALTH CENTER
 
 
Doing business as
 
 
Number and street (or P.O. box if mail is not delivered to street address)
1000 HEALTH CENTER DR
 
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
MATTOON, IL619380372
D Employer identification number

23-7098532
E Telephone number

G Gross receipts $ 718,236,939
F Name and address of principal officer:
JERRY ESKER
1000 HEALTH CENTER DR
MATTOON,IL619380372
I
Tax-exempt status: (   ) LeftBullet (insert no.) or
J
Website:MediumBullet
WWW.SARAHBUSH.ORG
H(a)
Is this a group return for
subordinates?
H(b)
Are all subordinates
included?
If "No," attach a list. See instructions.
H(c)
Group exemption number MediumBullet  
K Form of organization:  
L Year of formation: 1977
M State of legal domicile: IL
Part I
Summary
Activities & Governance 1 Briefly describe the organization’s mission or most significant activities: THE MISSION OF SARAH BUSH LINCOLN HEALTH CENTER IS TO PROVIDE EXCEPTIONAL CARE FOR ALL AND CREATE HEALTHY COMMUNITIES.
2 Check this box MediumBullet
3 Number of voting members of the governing body (Part VI, line 1a) ........ 3 15
4 Number of independent voting members of the governing body (Part VI, line 1b) ..... 4 12
5 Total number of individuals employed in calendar year 2021 (Part V, line 2a) ...... 5 3,275
6 Total number of volunteers (estimate if necessary) ............. 6 165
7a Total unrelated business revenue from Part VIII, column (C), line 12 ........ 7a 7,491,757
b Net unrelated business taxable income from Form 990-T, Part I, line 11 ......... 7b 0
Revenues Prior Year Current Year
8 Contributions and grants (Part VIII, line 1h) ......... 1,140,480 2,183,347
9 Program service revenue (Part VIII, line 2g) ......... 460,860,421 511,435,296
10 Investment income (Part VIII, column (A), lines 3, 4, and 7d ) .... 11,085,877 14,784,875
11 Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e) 40,978,692 39,759,136
12 Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12) 514,065,470 568,162,654
Expenses; 13 Grants and similar amounts paid (Part IX, column (A), lines 1–3 )... 39,460 50,460
14 Benefits paid to or for members (Part IX, column (A), line 4)..... 0 0
15 Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10) 270,887,339 308,478,956
16a Professional fundraising fees (Part IX, column (A), line 11e) ..... 0 0
b Total fundraising expenses (Part IX, column (D), line 25) MediumBullet0    
17 Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e).... 188,710,899 221,079,919
18 Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25) 459,637,698 529,609,335
19 Revenue less expenses. Subtract line 18 from line 12....... 54,427,772 38,553,319
Net Assets or Fund Balances; Beginning of Current Year End of Year
20 Total assets (Part X, line 16)............. 852,757,377 962,233,540
21 Total liabilities (Part X, line 26)............. 235,801,087 288,424,925
22 Net assets or fund balances. Subtract line 21 from line 20..... 616,956,290 673,808,615
Part II
Signature Block
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than officer) is based on all information of which preparer has any knowledge.
Sign Here
JumboBullet
Signature of officer Date
JumboBullet
Type or print name and title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's signature
Date
PTIN
Firm's name MediumBullet

Firm's EIN MediumBullet
Firm's address MediumBullet



Phone no.
May the IRS discuss this return with the preparer shown above? (see instructions) ..........
For Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11282Y Form 990 (2021)
Form 990 (2021)
Page 2
Part III
Statement of Program Service Accomplishments
Check if Schedule O contains a response or note to any line in this Part III..............
1
Briefly describe the organization’s mission: THE MISSION OF SARAH BUSH LINCOLN HEALTH CENTER IS TO PROVIDE EXCEPTIONAL CARE FOR ALL AND CREATE HEALTHY COMMUNITIES. SARAH BUSH LINCOLN HEALTH CENTER PROVIDES INPATIENT, OUTPATIENT, AND EMERGENCY CARE SERVICES TO THE RESIDENTS OF MATTOON AND CHARLESTON, ILLINOIS AND SURROUNDING COUNTIES.
2
Did the organization undertake any significant program services during the year which were not listed on
the prior Form 990 or 990-EZ? .....................
If "Yes," describe these new services on Schedule O.
3
Did the organization cease conducting, or make significant changes in how it conducts, any program
services? ...........................
If "Yes," describe these changes on Schedule O.
4
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. Section 501(c)(3) and 501(c)(4) organizations are required to report the amount of grants and allocations to others, the total expenses, and revenue, if any, for each program service reported.
4a (Code:   ) (Expenses $ 481,896,246 including grants of $ 50,460 ) (Revenue $ 511,435,296 )
SOCIAL ACCOUNTABILITY 2023AS A NOT-FOR-PROFIT PROVIDER OF HEALTHCARE, SARAH BUSH LINCOLN HEALTH CENTER LEADERSHIP AND STAFF HAPPILY SHOULDER THE SOCIAL RESPONSIBILITY TO PROVIDE CARE AND RESOURCES TO MEMBERS OF THE COMMUNITY WHO ARE IN NEED-- REGARDLESS OF THEIR PERSONAL CIRCUMSTANCES. THE PUBLIC TRUSTS US TO CONSERVE OUR RESOURCES AND USE THEM WISELY, WHILE IT LOOKS TO US FOR LEADERSHIP, PARTNERSHIP AND COLLABORATION ON A VARIETY OF PROJECTS.[CONTINUED ON SCHEDULE O]
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 expensesMediumBullet481,896,246
Form 990 (2021)
Form 990 (2021)
Page 3
Part IV
Checklist of Required Schedules
Yes
No
1
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)? If "Yes," complete Schedule AClick to see attachment
List of Attached Documents:
// Content
.....................
1
Yes
 
2
Is the organization required to complete Schedule B, Schedule of Contributors? See instructions. Click to see attachment
List of Attached Documents:
// Content
...
2
Yes
 
3
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office? If "Yes," complete Schedule C, Part IClick to see attachment
List of Attached Documents:
// Content
.............
3
 
No
4
Section 501(c)(3) organizations. Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part IIClick to see attachment
List of Attached Documents:
// Content
.........
4
Yes
 
5
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Rev. Proc. 98-19? If "Yes," complete Schedule C, Part IIIClick to see attachment
List of Attached Documents:
// Content
..
5
 
No
6
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts? If "Yes," complete Schedule D, Part IClick to see attachment
List of Attached Documents:
// Content
.........................
6
 
No
7
Did the organization receive or hold a conservation easement, including easements to preserve open space,
the environment, historic land areas, or historic structures? If "Yes," complete Schedule D, Part IIClick to see attachment
List of Attached Documents:
// Content
....
7
 
No
8
Did the organization maintain collections of works of art, historical treasures, or other similar assets? If "Yes,"
complete Schedule D, Part IIIClick to see attachment
List of Attached Documents:
// Content
..............
8
 
No
9
Did the organization report an amount in Part X, line 21 for escrow or custodial account liability; serve as a custodian for amounts not listed in Part X; or provide credit counseling, debt management, credit repair, or debt negotiation services? If "Yes," complete Schedule D, Part IVClick to see attachment
List of Attached Documents:
// Content
..............
9
 
No
10
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi endowments? If "Yes," complete Schedule D, Part V......
10
Yes
 
11
If the organization’s answer to any of the following questions is "Yes," then complete Schedule D, Parts VI, VII, VIII, IX, or X, as applicable.
a
Did the organization report an amount for land, buildings, and equipment in Part X, line 10? If "Yes," complete
Schedule D, Part VI. Click to see attachment
List of Attached Documents:
// Content
...................
11a
Yes
 
b
Did the organization report an amount for investments—other securities in Part X, line 12 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIClick to see attachment
List of Attached Documents:
// Content
.......
11b
Yes
 
c
Did the organization report an amount for investments—program related in Part X, line 13 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part VIIIClick to see attachment
List of Attached Documents:
// Content
.......
11c
 
No
d
Did the organization report an amount for other assets in Part X, line 15 that is 5% or more of its total assets reported in Part X, line 16? If "Yes," complete Schedule D, Part IXClick to see attachment
List of Attached Documents:
// Content
............
11d
 
No
e
Did the organization report an amount for other liabilities in Part X, line 25? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11e
Yes
 
f
Did the organization’s separate or consolidated financial statements for the tax year include a footnote that addresses the organization’s liability for uncertain tax positions under FIN 48 (ASC 740)? If "Yes," complete Schedule D, Part XClick to see attachment
List of Attached Documents:
// Content
11f
Yes
 
12a
Did the organization obtain separate, independent audited financial statements for the tax year? If "Yes," complete
Schedule D, Parts XI and XIIClick to see attachment
List of Attached Documents:
// Content
......................
12a
 
No
b
Was the organization included in consolidated, independent audited financial statements for the tax year? If "Yes," and if the organization answered "No" to line 12a, then completing Schedule D, Parts XI and XII is optional Click to see attachment
List of Attached Documents:
// Content
12b
Yes
 
13
Is the organization a school described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E
13
 
No
14a
Did the organization maintain an office, employees, or agents outside of the United States? .....
14a
 
No
b
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more? If "Yes," complete Schedule F, Parts I and IV.........Click to see attachment
List of Attached Documents:
// Content
14b
Yes
 
15
Did the organization report on Part IX, column (A), line 3, more than $5,000 of grants or other assistance to or for any foreign organization? If “Yes,” complete Schedule F, Parts II and IV.....Click to see attachment
List of Attached Documents:
// Content
15
 
No
16
Did the organization report on Part IX, column (A), line 3, more than $5,000 of aggregate grants or other assistance to or for foreign individuals? If “Yes,” complete Schedule F, Parts III and IV...Click to see attachment
List of Attached Documents:
// Content
16
 
No
17
Did the organization report a total of more than $15,000 of expenses for professional fundraising services on Part IX, column (A), lines 6 and 11e? If "Yes," complete Schedule G, Part I. See instructions. ....
17
 
No
18
Did the organization report more than $15,000 total of fundraising event gross income and contributions on Part VIII, lines 1c and 8a? If "Yes," complete Schedule G, Part II............
18
 
No
19
Did the organization report more than $15,000 of gross income from gaming activities on Part VIII, line 9a? If "Yes," complete Schedule G, Part III...................
19
 
No
20a
Did the organization operate one or more hospital facilities? If "Yes," complete Schedule H....Click to see attachment
List of Attached Documents:
// Content
20a
Yes
 
b
If "Yes" to line 20a, did the organization attach a copy of its audited financial statements to this return? Click to see attachment
List of Attached Documents:
// Content
20b
Yes
 
21
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government on Part IX, column (A), line 1? If “Yes,” complete Schedule I, Parts I and II.....Click to see attachment
List of Attached Documents:
// Content
21
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 4
Part IV
Checklist of Required Schedules (continued)
Yes
No
22
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals on Part IX, column (A), line 2? If “Yes,” complete Schedule I, Parts I and III........Click to see attachment
List of Attached Documents:
// Content
22
 
No
23
Did the organization answer "Yes" to Part VII, Section A, line 3, 4, or 5, about compensation of the organization’s current and former officers, directors, trustees, key employees, and highest compensated employees? If "Yes," complete Schedule J....................... Click to see attachment
List of Attached Documents:
// Content
23
Yes
 
24a
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002? If “Yes,” answer lines 24b through 24d and complete Schedule K. If “No,” go to line 25a...............Click to see attachment
List of Attached Documents:
// Content
24a
Yes
 
b
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?...
24b
 
No
c
Did the organization maintain an escrow account other than a refunding escrow at any time during the year
to defease any tax-exempt bonds? ...............
24c
 
No
d
Did the organization act as an "on behalf of" issuer for bonds outstanding at any time during the year?...
24d
 
No
25a
Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in an excess benefit transaction with a disqualified person during the year? If "Yes," complete Schedule L, Part I .... Click to see attachment
List of Attached Documents:
// Content
25a
 
No
b
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization’s prior Forms 990 or 990-EZ? If "Yes," complete Schedule L, Part I.......................Click to see attachment
List of Attached Documents:
// Content
25b
 
No
26
Did the organization report any amount on Part X, line 5 or 22 for receivables from or 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? If "Yes," complete Schedule L, Part IIClick to see attachment
List of Attached Documents:
// Content
...........
26
 
No
27
Did the organization provide a grant or other assistance to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or employee thereof, a grant selection committee member, or to a 35% controlled entity (including an employee thereof) or family member of any of these persons?
If "Yes," complete
Schedule L, Part IIIClick to see attachment
List of Attached Documents:
// Content
.........................
27
 
No
28
Was the organization a party to a business transaction with one of the following parties (see the Schedule L, Part IV instructions for applicable filing thresholds, conditions, and exceptions):
a
A current or former officer, director, trustee, key employee, creator or founder, or substantial contributor? If "Yes," complete Schedule L, Part IV......................Click to see attachment
List of Attached Documents:
// Content
28a
 
No
b
A family member of any individual described in line 28a? If "Yes," complete Schedule L, Part IV.....Click to see attachment
List of Attached Documents:
// Content
28b
Yes
 
c
A 35% controlled entity of one or more individuals and/or organizations described in line 28a or 28b? If "Yes," complete Schedule L, Part IV.....................
28c
 
No
29
Did the organization receive more than $25,000 in non-cash contributions? If "Yes," complete Schedule M..
29
 
No
30
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions? If "Yes," complete Schedule M .................
30
 
No
31
Did the organization liquidate, terminate, or dissolve and cease operations? If "Yes," complete Schedule N, Part I
31
 
No
32
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets? If "Yes," complete Schedule N, Part II........................
32
 
No
33
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3? If "Yes," complete Schedule R, Part I............Click to see attachment
List of Attached Documents:
// Content
33
 
No
34
Was the organization related to any tax-exempt or taxable entity? If "Yes," complete Schedule R, Part II, III, or IV, and Part V, line 1.........................Click to see attachment
List of Attached Documents:
// Content
34
Yes
 
35a
Did the organization have a controlled entity within the meaning of section 512(b)(13)?
35a
Yes
 
b
If ‘Yes’ to line 35a, did the organization receive any payment from or engage in any transaction with a controlled entity within the meaning of section 512(b)(13)? If "Yes," complete Schedule R, Part V, line 2 ...Click to see attachment
List of Attached Documents:
// Content
35b
 
No
36
Section 501(c)(3) organizations. Did the organization make any transfers to an exempt non-charitable related organization? If "Yes," complete Schedule R, Part V, line 2............. Click to see attachment
List of Attached Documents:
// Content
36
 
No
37
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes? If "Yes," complete Schedule R, Part VIClick to see attachment
List of Attached Documents:
// Content
37
 
No
38
Did the organization complete Schedule O and provide explanations on Schedule O for Part VI, lines 11b and 19? Note. All Form 990 filers are required to complete Schedule O. ............
38
Yes
 
Part V
Statements Regarding Other IRS Filings and Tax Compliance
Check if Schedule O contains a response or note to any line in this Part V...........
Yes
No
1a
Enter the number reported in box 3 of Form 1096. Enter -0- if not applicable ..
1a
253
b
Enter the number of Forms W-2G included on line 1a. Enter -0- if not applicable .
1b
0
c
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners? ..................
1c
Yes
 
Form 990 (2021)
Form 990 (2021)
Page 5
Part V
Statements Regarding Other IRS Filings and Tax Compliance (continued)
2a
Enter the number of employees reported on Form W-3, Transmittal of Wage and
Tax Statements, filed for the calendar year ending with or within the year covered by this return ..................
2a
3,275
b
If at least one is reported on line 2a, did the organization file all required federal employment tax returns?
Note. If the sum of lines 1a and 2a is greater than 250, you may be required to e-file. See instructions.
2b
Yes
 
3a
Did the organization have unrelated business gross income of $1,000 or more during the year?...
3a
Yes
 
b
If “Yes,” has it filed a Form 990-T for this year? If “No” to line 3b, provide an explanation in Schedule O...
3b
Yes
 
4a
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)? ..
4a
Yes
 
b
If "Yes," enter the name of the foreign country: MediumBulletCJ , BD
See instructions for filing requirements for FinCEN Form 114, Report of Foreign Bank and Financial Accounts (FBAR).
5a
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year? ..
5a
 
No
b
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?
5b
 
No
c
If "Yes," to line 5a or 5b, did the organization file Form 8886-T? ............
5c
 
 
6a
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions? ...
6a
 
No
b
If "Yes," did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible? ......................
6b
 
 
7
Organizations that may receive deductible contributions under section 170(c).
a
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor? ....................
7a
 
No
b
If "Yes," did the organization notify the donor of the value of the goods or services provided? .....
7b
 
 
c
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282? .........................
7c
 
No
d
If "Yes," indicate the number of Forms 8282 filed during the year ....
7d
 
e
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?
7e
 
No
f
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract? ..
7f
 
No
g
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required? ......................
7g
 
 
h
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C? ..........................
7h
 
 
8
Sponsoring organizations maintaining donor advised funds. Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year? ........
8
 
 
9
Sponsoring organizations maintaining donor advised funds.
a
Did the sponsoring organization make any taxable distributions under section 4966?........
9a
 
 
b
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?...
9b
 
 
10
Section 501(c)(7) organizations. Enter:
a
Initiation fees and capital contributions included on Part VIII, line 12 ...
10a
 
b
Gross receipts, included on Form 990, Part VIII, line 12, for public use of club facilities
10b
 
11
Section 501(c)(12) organizations. Enter:
a
Gross income from members or shareholders .........
11a
 
b
Gross income from other sources. (Do not net amounts due or paid to other sources against amounts due or received from them.) ..........
11b
 
12a
Section 4947(a)(1) non-exempt charitable trusts. Is the organization filing Form 990 in lieu of Form 1041?
12a
 
 
b
If "Yes," enter the amount of tax-exempt interest received or accrued during the year.
12b
 
13
Section 501(c)(29) qualified nonprofit health insurance issuers.
a
Is the organization licensed to issue qualified health plans in more than one state? .........
Note. See the instructions for additional information the organization must report on Schedule O.
13a
 
 
b
Enter the amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans ....
13b
 
c
Enter the amount of reserves on hand ............
13c
 
14a
Did the organization receive any payments for indoor tanning services during the tax year?.....
14a
 
No
b
If "Yes," has it filed a Form 720 to report these payments? If "No," provide an explanation in Schedule O..
14b
 
 
15
Is the organization subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or excess parachute payment(s) during the year? ....................
If "Yes," see the instructions and file Form 4720, Schedule N.
15
 
No
16
Is the organization an educational institution subject to the section 4968 excise tax on net investment income? ..
If "Yes," complete Form 4720, Schedule O.
16
 
No
17
Section 501(c)(21) organizations. Did the trust, any disqualified person, or mine operator engage in any activities that would result in the imposition of an excise tax under section 4951, 4952, or 4953? ..
If "Yes," complete Form 6069.
17
 
 
Form 990 (2021)
Form 990 (2021)
Page 6
Part VI
Governance, Management, and Disclosure. For each "Yes" response to lines 2 through 7b below, and for a "No" response to lines 8a, 8b, or 10b below, describe the circumstances, processes, or changes in Schedule O. See instructions.
Check if Schedule O contains a response or note to any line in this Part VI..............
Section A. Governing Body and Management
Yes
No
1a
Enter the number of voting members of the governing body at the end of the tax year
1a
15
If there are material differences in voting rights among members of the governing body, or if the governing body delegated broad authority to an executive committee or similar committee, explain in Schedule O.
b
Enter the number of voting members included in line 1a, above, who are independent
1b
12
2
Did any officer, director, trustee, or key employee have a family relationship or a business relationship with any other officer, director, trustee, or key employee? .................
2
Yes
 
3
Did the organization delegate control over management duties customarily performed by or under the direct supervision of officers, directors or trustees, or key employees to a management company or other person? .
3
 
No
4
Did the organization make any significant changes to its governing documents since the prior Form 990 was filed? .
4
 
No
5
Did the organization become aware during the year of a significant diversion of the organization’s assets? .
5
 
No
6
Did the organization have members or stockholders? ................
6
Yes
 
7a
Did the organization have members, stockholders, or other persons who had the power to elect or appoint one or more members of the governing body? ....................
7a
Yes
 
b
Are any governance decisions of the organization reserved to (or subject to approval by) members, stockholders, or persons other than the governing body? ...................
7b
Yes
 
8
Did the organization contemporaneously document the meetings held or written actions undertaken during the year by the following:
a
The governing body? .......................
8a
Yes
 
b
Each committee with authority to act on behalf of the governing body? ............
8b
Yes
 
9
Is there any officer, director, trustee, or key employee listed in Part VII, Section A, who cannot be reached at the organization’s mailing address? If "Yes," provide the names and addresses in Schedule O.......
9
 
No
Section B. Policies (This Section B requests information about policies not required by the Internal Revenue Code.)
Yes
No
10a
Did the organization have local chapters, branches, or affiliates? ............
10a
 
No
b
If "Yes," did the organization have written policies and procedures governing the activities of such chapters, affiliates, and branches to ensure their operations are consistent with the organization's exempt purposes?
10b
 
 
11a
Has the organization provided a complete copy of this Form 990 to all members of its governing body before filing the form? ............................
11a
Yes
 
b
Describe on Schedule O the process, if any, used by the organization to review this Form 990. .....
12a
Did the organization have a written conflict of interest policy? If "No," go to line 13.......
12a
Yes
 
b
Were officers, directors, or trustees, and key employees required to disclose annually interests that could give rise to conflicts? ..........................
12b
Yes
 
c
Did the organization regularly and consistently monitor and enforce compliance with the policy? If "Yes," describe on Schedule O how this was done...................
12c
Yes
 
13
Did the organization have a written whistleblower policy? ...............
13
Yes
 
14
Did the organization have a written document retention and destruction policy? .........
14
Yes
 
15
Did the process for determining compensation of the following persons include a review and approval by independent persons, comparability data, and contemporaneous substantiation of the deliberation and decision?
a
The organization’s CEO, Executive Director, or top management official ...........
15a
Yes
 
b
Other officers or key employees of the organization ................
15b
Yes
 
If "Yes" to line 15a or 15b, describe the process on Schedule O. See instructions.
16a
Did the organization invest in, contribute assets to, or participate in a joint venture or similar arrangement with a taxable entity during the year? ......................
16a
 
No
b
If "Yes," did the organization follow a written policy or procedure requiring the organization to evaluate its participation in joint venture arrangements under applicable federal tax law, and take steps to safeguard the organization’s exempt status with respect to such arrangements? ............
16b
 
 
Section C. Disclosure
17
List the states with which a copy of this Form 990 is required to be filedMediumBullet
IL
18
Section 6104 requires an organization to make its Form 1023 (1024 or 1024-A, if applicable), 990, and 990-T (section 501(c)(3)s only) available for public inspection. Indicate how you made these available. Check all that apply.
19
Describe in Schedule O whether (and if so, how) the organization made its governing documents, conflict of interest policy, and financial statements available to the public during the tax year.
20
State the name, address, and telephone number of the person who possesses the organization's books and records:
MediumBulletDENNIS PLUARD1000 HEALTH CENTER DR   MATTOON,IL619380372 (217) 258-2514
Form 990 (2021)
Form 990 (2021)
Page 7
Part VII
Compensation of Officers, Directors,Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
Check if Schedule O contains a response or note to any line in this Part VII..............
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
1a Complete this table for all persons required to be listed. Report compensation for the calendar year ending with or within the organization’s tax year.
RoundBullet List all of the organization’s current officers, directors, trustees (whether individuals or organizations), regardless of amount
of compensation. Enter -0- in columns (D), (E), and (F) if no compensation was paid.

RoundBullet List all of the organization’s current key employees, if any. See the instructions for definition of "key employee."
RoundBullet List the organization’s five current highest compensated employees (other than an officer, director, trustee or key employee)
who received reportable compensation (box 5 of Form W-2, Form 1099-MISC, and/or box 1 of Form 1099-NEC) of more than $100,000 from the
organization and any related organizations.

RoundBullet List all of the organization’s former officers, key employees, or highest compensated employees who received more than $100,000
of reportable compensation from the organization and any related organizations.

RoundBullet List all of the organization’s former directors or trustees that received, in the capacity as a former director or trustee of the
organization, more than $10,000 of reportable compensation from the organization and any related organizations.

See the instructions for the order in which to list the persons above.
Check this box if neither the organization nor any related organization compensated any current officer, director, or trustee.
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(1) BARB HALL......................................................................
CHAIRPERSON
 1.00
.................
3.00 		X   X       0 0 0
(2) STEVE CHILDERS......................................................................
VICE CHAIRPERSON
 1.00
.................
3.00 		X   X       0 0 0
(3) TINA STOVALL......................................................................
SECRETARY
 1.00
.................
2.00 		X   X       0 0 0
(4) JOSH BULLOCK......................................................................
TREASURER
 1.00
.................
1.00 		X   X       0 0 0
(5) DALE BOYER......................................................................
DIRECTOR
 1.00
.................
1.00 		X           0 0 0
(6) LUCAS CATT......................................................................
DIRECTOR
 54.00
.................
1.00 		X           527,203 0 75,709
(7) MIKE GENTA......................................................................
DIRECTOR
 1.00
.................
1.00 		X           0 0 0
(8) DAVID GLASSMAN......................................................................
COMMITTEE COMMUNITY MEMBER
 1.00
.................
0.00 		X           0 0 0
(9) PHILLIP KEPP......................................................................
DIRECTOR
 1.00
.................
1.00 		X           0 0 0
(10) JOHN LAUER......................................................................
DIRECTOR
 54.00
.................
2.00 		X           526,280 0 56,871
(11) JAY MARKWELL......................................................................
DIRECTOR
 1.00
.................
1.00 		X           0 0 0
(12) ALAN METZGER......................................................................
DIRECTOR
 1.00
.................
1.00 		X           0 0 0
(13) DIDI OMIYI......................................................................
DIRECTOR
 54.00
.................
1.00 		X           1,108,614 0 35,285
(14) ANYA SCHUETZ......................................................................
DIRECTOR
 1.00
.................
1.00 		X           0 0 0
(15) JIM ZIMMER......................................................................
DIRECTOR
 1.00
.................
1.00 		X           0 0 0
(16) JERRY ESKER......................................................................
PRESIDENT
 40.00
.................
15.00 		    X       594,308 0 80,102
(17) DENNIS PLUARD......................................................................
CHIEF FINANCE OFFICER
 52.00
.................
3.00 		    X       574,225 0 78,856
Form 990 (2021)
Form 990 (2021)
Page 8
Part VII
Section A. Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees (continued)
(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
Individual Trustee or Director; Institutional Trustee; OfficerInd; Key Employee; Highest compensated employee; FormerOfcrDirectorTrusteeInd;
(18) SANDRA MILLER........................................................................
VP PATIENT CARE
 55.00
.......................0.00 		    X       360,232 0 57,559
(19) GREGORY TAYLOR........................................................................
VP PRACTICE MANAGEMENT
 55.00
.......................0.00 		    X       0 0 0
(20) BROOKE ZERRUSEN........................................................................
VP PRACTICE MANAGEMENT
 54.00
.......................1.00 		    X       252,497 0 73,550
(21) DEBORAH SADDORIS........................................................................
VP HUMAN RESOURCES
 55.00
.......................0.00 		    X       354,456 0 76,228
(22) BRIAN MURPHY........................................................................
VP INFORMATION SYSTEMS
 55.00
.......................0.00 		    X       366,244 0 76,181
(23) KIM UPHOFF........................................................................
PRESIDENT
 40.00
.......................15.00 		    X       664,708 0 74,980
(24) DWIGHT PENTZIEN........................................................................
VP MEDICAL AFFAIRS
 55.00
.......................0.00 		    X       554,480 0 76,867
(25) ERICA STOLLARD........................................................................
VP OPERATIONS
 55.00
.......................0.00 		    X       203,905 0 46,281
(26) COLLEEN SWICK........................................................................
VP PATIENT CONTINUUM CARE
 55.00
.......................0.00 		    X       138,202 0 21,728
(27) KAREN DYER........................................................................
CEO FAYETTE COUNTY HOSPITAL
 0.00
.......................55.00 		    X       193,317 0 8,235
(28) COLT GUTHRIDGE........................................................................
VP SURGICAL SERVICES
 55.00
.......................0.00 		    X       331,723 0 76,450
(29) MATTHEW JONES........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   1,815,652 0 78,014
(30) ERIC BREWER........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   1,669,079 0 76,911
(31) JOSHUA GARRETT........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   1,731,862 0 76,757
(32) AZIZ AHMED........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   1,717,137 0 13,871
(33) LOUIS MENDELLA........................................................................
PHYSICIAN
 50.00
.......................0.00 		        X   1,629,181 0 79,594
1b Sub-Total................MediumBullet
c Total from continuation sheets to Part VII, Section A....MediumBullet
d Total (add lines 1b and 1c)...........MediumBullet 15,313,305 0 1,240,029
2
Total number of individuals (including but not limited to those listed above) who received more than $100,000 of reportable compensation from the organization MediumBullet352
Yes
No
3
Did the organization list any former officer, director or trustee, key employee, or highest compensated employee on line 1a? If "Yes," complete Schedule J for such individual ..............
3
 
No
4
For any individual listed on line 1a, is the sum of reportable compensation and other compensation from the organization and related organizations greater than $150,000? If "Yes," complete Schedule J for such
individual...........................
4
Yes
 
5
Did any person listed on line 1a receive or accrue compensation from any unrelated organization or individual for services rendered to the organization? If "Yes," complete Schedule J for such person ........
5
 
No
Section B. Independent Contractors
1
Complete this table for your five highest compensated independent contractors that received more than $100,000 of compensation from the organization. Report compensation for the calendar year ending with or within the organization’s tax year.
(A)
Name and business address 		(B)
Description of services 		(C)
Compensation
MCCARTHY BUILDING COMPANIES

3117 BIG BEND BOULEVARD
ST LOUIS,MO63143 		CONSTRUCTION CONTRACTOR 16,317,261
ASAWA

611 CAYMAN WAY
SAVOY,IL61874 		CONTRACT SERVICES 7,497,209
VENTURA MEDSTAFF LLC

2909 N 118TH ST STE 200
OMAHA,NE68164 		HEALTH CARE STAFFING 5,621,591
CERNER CORPORATION

PO BOX 959156
ST LOUIS,MO63195 		SOFTWARE SERVICE 3,501,826
MEDICAL SOLUTIONS

1010 N 102ND ST
OMAHA,NE68114 		HEALTH CARE STAFFING 1,867,666
2
Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization MediumBullet225
Form 990 (2021)
Form 990 (2021)
Page 9
Part VIII
Statement of Revenue
Check if Schedule O contains a response or note to any line in this Part VIII.............
(A)
Total revenue 		(B)
Related or
exempt
function
revenue 		(C)
Unrelated
business
revenue 		(D)
Revenue
excluded from
tax under sections
512 - 514
Contributions, Gifts, Grants, and OtherAmt Similar Amounts 1a Federated campaigns..1a  
b Membership dues..1b  
c Fundraising events..1c  
d Related organizations1d 1,501,916
e Government grants (contributions)1e  
f All other contributions, gifts, grants, and similar amounts not included above1f 681,431
g Noncash contributions included in lines 1a - 1f:$ 1g  
h Total. Add lines 1a-1f.......MediumBullet 2,183,347
Program Service RevenueAmt Business Code
2a NET PATIENT REVENUE 621399 441,984,137 441,984,137    
b NET PROVIDER REVENUE 621399 69,424,542 69,424,542    
c OUTREACH REVENUE 621399 26,617 26,617    
d
e
f All other program service revenue.        
g Total. Add lines 2a–2f .....MediumBullet 511,435,296
OtherAmtRevenueAmt 3 Investment income (including dividends, interest, and othersimilar amounts) ......MediumBullet 9,885,301   39,038 9,846,263
4 Income from investment of tax-exempt bond proceedsMediumBullet        
5 Royalties...........MediumBullet        
(ii) Personal (i) Real
6a Gross rents   271,086 6a
b Less: rental expenses   0 6b
c Rental income or (loss)   271,086 6c
d Net rental income or (loss).......MediumBullet 271,086     271,086
(ii) Other (i) Securities
7a Gross amount from sales of assets other than inventory   154,973,859 7a
b Less: cost or other basis and sales expenses 30,639 150,043,646 7b
c Gain or (loss) -30,639 4,930,213 7c
d Net gain or (loss).........MediumBullet 4,899,574     4,899,574
8a Gross income from fundraising events (not including $   of contributions reported on line 1c). See Part IV, line 18 ....
8a  
b Less: direct expenses ... 8b  
c Net income or (loss) from fundraising events..MediumBullet      
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..MediumBullet        
10a Gross sales of inventory, less
returns and allowances ..
10a  
b Less: cost of goods sold .. 10b  
c Net income or (loss) from sales of inventory..MediumBullet        
Business Code Miscellaneous Revenue
11a REFERENCE LAB 621511 6,614,480   6,614,480  
b PEACE MEAL PROGRAM REV 900099 1,771,198     1,771,198
c CAFETERIA & CATERING 722320 1,025,342     1,025,342
d All other revenue .... 30,077,030   838,239 29,238,791
e Total. Add lines 11a–11d ...... MediumBullet 39,488,050
12 Total revenue. See instructions.....MediumBullet 568,162,654 511,435,296 7,491,757 47,052,254
Form 990 (2021)
Form 990 (2021)
Page 10
Part IX
Statement of Functional Expenses
Section 501(c)(3) and 501(c)(4) organizations must complete all columns. All other organizations must complete column (A).Check if Schedule O contains a response or note to any line in this Part IX..............
Do not include amounts reported on lines 6b,
7b, 8b, 9b, and 10b of Part VIII. 		(A)
Total expenses 		(B)
Program service expenses 		(C)
Management and general expenses 		(D)
Fundraising
expenses
1 Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 .... 50,460 50,460
2 Grants and other assistance to domestic individuals. See Part IV, line 22 ...........    
3 Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............    
4 Benefits paid to or for members .......    
5 Compensation of current officers, directors, trustees, and key employees ........... 7,661,727   7,661,727  
6 Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ......... 63,425   63,425  
7 Other salaries and wages........ 236,856,092 222,078,691 14,777,401  
8 Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) .... 9,014,911 8,452,473 562,438  
9 Other employee benefits ....... 41,862,167 39,250,395 2,611,772  
10 Payroll taxes ........... 13,020,634 12,208,279 812,355  
11 Fees for services (non-employees):        
a Management ......        
b Legal ......... 493,293   493,293  
c Accounting ........... 170,004   170,004  
d Lobbying ........... 46,551   46,551  
e Professional fundraising services. See Part IV, line 17    
f Investment management fees ......        
g Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) 44,427,581 41,980,701 2,446,880  
12 Advertising and promotion .... 1,559,005 1,559,005    
13 Office expenses ....... 103,302,826 96,857,785 6,445,041  
14 Information technology ...... 4,332,161 4,061,878 270,283  
15 Royalties ..        
16 Occupancy ........... 6,177,357 5,791,953 385,404  
17 Travel ............ 1,539,676 1,443,616 96,060  
18 Payments of travel or entertainment expenses for any federal, state, or local public officials .        
19 Conferences, conventions, and meetings .... 1,343,619 1,259,791 83,828  
20 Interest ........... 2,009,214 2,009,214    
21 Payments to affiliates .......        
22 Depreciation, depletion, and amortization .. 27,880,603 26,141,138 1,739,465  
23 Insurance ... 8,608,693   8,608,693  
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 IL HOSPITAL TAX ASSESSM 10,199,348 10,199,348    
b MAINTENANCE/PREVENTATIV 5,832,345 5,468,466 363,879  
c RECRUITMENT EXPENSES 1,221,467 1,221,467    
d DUES AND SUBSCRIPTIONS 740,618 740,618    
e All other expenses 1,195,558 1,120,968 74,590  
25 Total functional expenses. Add lines 1 through 24e 529,609,335 481,896,246 47,713,089 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 MediumBullet if following SOP 98-2 (ASC 958-720).        
Form 990 (2021)
Form 990 (2021)
Page 11
Part X
Balance Sheet
Check if Schedule O contains a response or note to any line in this Part IX..............
(A)
Beginning of year 		(B)
End of year
Assets 1 Cash–non-interest-bearing ........ 16,653 1 18,280
2 Savings and temporary cash investments ......... 155,019,492 2 182,347,598
3 Pledges and grants receivable, net ......   3  
4 Accounts receivable, net ............. 49,904,039 4 50,971,702
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 ...........   7  
8 Inventories for sale or use ............ 10,417,950 8 10,650,266
9 Prepaid expenses and deferred charges ...... 90,267,595 9 107,303,649
10a Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D 10a 516,807,754
b Less: accumulated depreciation 10b 241,802,634 247,989,272 10c 275,005,120
11 Investments—publicly traded securities . 233,177,880 11 260,970,327
12 Investments—other securities. See Part IV, line 11 ..... 42,128,091 12 52,628,000
13 Investments—program-related. See Part IV, line 11 ..   13  
14 Intangible assets ............... 2,926,781 14 2,492,844
15 Other assets. See Part IV, line 11 ........... 20,909,624 15 19,845,754
16 Total assets. Add lines 1 through 15 (must equal line 33)... 852,757,377 16 962,233,540
Liabilities 17 Accounts payable and accrued expenses ..... 64,530,212 17 82,049,083
18 Grants payable ...   18  
19 Deferred revenue .........   19  
20 Tax-exempt bond liabilities ......... 42,120,968 20 99,783,770
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 .. 28,957,340 23  
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 100,192,567 25 106,592,072
26 Total liabilities. Add lines 17 through 25.. 235,801,087 26 288,424,925
Net Assets or Fund Balance Organizations that follow FASB ASC 958, check here MediumBullet and complete lines 27, 28, 32, and 33.
27 Net assets without donor restrictions .......... 612,105,478 27 668,957,803
28 Net assets with donor restrictions ........... 4,850,812 28 4,850,812
Organizations that do not follow FASB ASC 958, check here MediumBullet 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 ........... 616,956,290 32 673,808,615
33 Total liabilities and net assets/fund balances ........ 852,757,377 33 962,233,540
Form 990 (2021)
Form 990 (2021)
Page 12
Part XI
Reconcilliation of Net Assets
Check if Schedule O contains a response or note to any line in this Part XI..............
1
Total revenue (must equal Part VIII, column (A), line 12) ............
1
568,162,654
2
Total expenses (must equal Part IX, column (A), line 25) ............
2
529,609,335
3
Revenue less expenses. Subtract line 2 from line 1 ..............
3
38,553,319
4
Net assets or fund balances at beginning of year (must equal Part X, line 32, column (A)) ..
4
616,956,290
5
Net unrealized gains (losses) on investments ...............
5
18,299,006
6
Donated services and use of facilities .................
6
 
7
Investment expenses .....................
7
 
8
Prior period adjustments .....................
8
 
9
Other changes in net assets or fund balances (explain in Schedule O) ........
9
0
10
Net assets or fund balances at end of year. Combine lines 3 through 9 (must equal Part X, line 32, column (B))
10
673,808,615
Part XII
Financial Statements and Reporting
Check if Schedule O contains a response or note to any line in this Part XII.............
Yes
No
1
Accounting method used to prepare the Form 990:  
If the organization changed its method of accounting from a prior year or checked "Other," explain on
Schedule O.
2a
Were the organization’s financial statements compiled or reviewed by an independent accountant?
2a
 
No
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were compiled or reviewed on a separate basis, consolidated basis, or both:
b
Were the organization’s financial statements audited by an independent accountant?
2b
Yes
 
If ‘Yes,’ check a box below to indicate whether the financial statements for the year were audited on a separate basis, consolidated basis, or both:
c
If "Yes," to line 2a or 2b, does the organization have a committee that assumes responsibility for oversight of the audit, review, or compilation of its financial statements and selection of an independent accountant?
2c
Yes
 
If the organization changed either its oversight process or selection process during the tax year, explain in Schedule O.
3a
As a result of a federal award, was the organization required to undergo an audit or audits as set forth in the Single Audit Act and OMB Circular A-133?
3a
Yes
 
b
If "Yes," did the organization undergo the required audit or audits? If the organization did not undergo the required audit or audits, explain why in Schedule O and describe any steps taken to undergo such audits.
3b
Yes
 
Form 990 (2021)
Form 990 (2021)
Additional Data


Software ID:  
Software Version:  
Form 990, Special Condition Description:
Special Condition Description
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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
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.)
1
2
3
4
5
6
7
8
9
10
11
12
a
b
c
d
e
f
Enter the number of supported organizations ...............................  
g
Provide the following information about the supported organization(s).
(i) Name of supported organization (ii) EIN (iii) Type of organization (described on lines 1- 10 above (see instructions)) (iv) Is the organization listed in your governing document? (v) Amount of monetary support (see instructions) (vi) Amount of other support (see instructions)
Yes No
Total
 
   
For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.
Cat. No. 11285F
Schedule A (Form 990) 2022

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) right arrow (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) right arrow (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  
12
12
 
13
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
14
14
 
15
15
 
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
b
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
b
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
18
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

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) right arrow (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) right arrow (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.)..            
14
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
15
15
 
16
16
 
Section D. Computation of Investment Income Percentage
17
17
 
18
18
 
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
b
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
20
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

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
No
1
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.
1
 
 
2
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).
2
 
 
3a
Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.
3a
 
 
b
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.
3b
 
 
c
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.
3c
 
 
4a
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.
4a
 
 
b
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.
4b
 
 
c
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.
4c
 
 
5a
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).
5a
 
 
b
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?
5b
 
 
c
Substitutions only. Was the substitution the result of an event beyond the organization's control?
5c
 
 
6
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.
6
 
 
7
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) .
7
 
 
8
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).
8
 
 
9a
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.
9a
 
 
b
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.
9b
 
 
c
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.
9c
 
 
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
 
 
b
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

Schedule A (Form 990) 2022
Page 5
Part IV
Supporting Organizations (continued)
Yes
No
11
Has the organization accepted a gift or contribution from any of the following persons?
a
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
 
 
b
A family member of a person described on 11a above?
11b
 
 
c
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
No
1
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.
1
 
 
2
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.
2
 
 
Section C. Type II Supporting Organizations
Yes
No
1
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).
1
 
 
Section D. All Type III Supporting Organizations
Yes
No
1
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?
1
 
 
2
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).
2
 
 
3
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.
3
 
 
Section E. Type III Functionally-Integrated Supporting Organizations
1
Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):
a
b
c
2
Activities Test. Answer lines 2a and 2b below.
Yes
No
a
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.
2a
 
 
b
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.
2b
 
 
3
Parent of Supported Organizations. Answer lines 3a and 3b below.
a
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.
3a
 
 
b
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.
3b
 
 
Schedule A (Form 990) 2022

Schedule A (Form 990) 2022
Page 6
Part V
Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations
1
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  
7
Schedule A (Form 990) 2022

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:  
Schedule B
(Form 990)
Department of the Treasury
Internal Revenue Service
Schedule of Contributors

Arrow Bullet Attach to Form 990, 990-EZ, or 990-PF.
Arrow Bullet Go to www.irs.gov/Form990 for the latest information.
OMB No. 1545-0047
2022
Name of the organization
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
Organization type (check one):
Filers of:
Section:
Form 990 or 990-EZ






Form 990-PF




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
Special Rules
......... 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
SARAH BUSH LINCOLN HEALTH CENTER
  		Employer identification number
23-7098532
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


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
(a)
No.		 (b)
Name, address, and ZIP + 4		 (c)
Total contributions		 (d)
Type of contribution
 
 
 
 

$  


(Complete Part II for noncash contributions.)
Schedule B (Form 990) (2022)
Schedule B (Form 990) (2022)
Page 3
Name of organization
SARAH BUSH LINCOLN HEALTH CENTER
  		Employer identification number

23-7098532
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
SARAH BUSH LINCOLN HEALTH CENTER
  		Employer identification number

23-7098532
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 $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet$  
Use duplicate copies of Part III if additional space is needed.
(a)
No. from Part I		 (b) Purpose of gift (c) Use 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 (c) Use 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 (c) Use 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 (c) Use 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:  
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 BulletGo 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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
Part I-A
Complete if the organization is exempt under section 501(c) or is a section 527 organization.

1
Provide a description of the organization’s direct and indirect political campaign activities in Part IV. See instructions for definition of “political campaign activities."

2
Political campaign activity expenditures. See instructions ....................................................................SchCMd Bullet
$  
3
Volunteer hours for political campaign activities. See instructions ..................................................................
 

Part I-B
Complete if the organization is exempt under section 501(c)(3).
1
Enter the amount of any excise tax incurred by the organization under section 4955 ................................SchCMd Bullet
$  
2
Enter the amount of any excise tax incurred by organization managers under section 4955 .......................SchCMd Bullet
$  
3
If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................
4a
Was a correction made? ......................................................................................................................
b
If "Yes," describe in Part IV.
Part I-C
Complete if the organization is exempt under section 501(c), except section 501(c)(3).
1
Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet
$  
2
Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................SchCMd Bullet

$  
3
Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b...........SchCMd Bullet

$  
4
Did the filing organization file Form 1120-POL for this year? ...................................................................
5
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

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 Bulletexpenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet
Limits on Lobbying Expenditures
(The term "expenditures" means amounts paid or incurred.) 		(a) Filing
organization's
totals 		(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? ...................................................................................................................

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


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
1
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:
a
Volunteers? ...........................................................................................................
 
No
b
Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........
 
No
c
Media advertisements? ...................................................................................................
 
No
 
d
Mailings to members, legislators, or the public? .............................................................................
 
No
 
e
Publications, or published or broadcast statements? ...........................................................
 
No
 
f
Grants to other organizations for lobbying purposes? ..........................................................
 
No
 
g
Direct contact with legislators, their staffs, government officials, or a legislative body? .......................
 
No
 
h
Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................
 
No
 
i
Other activities? ...................................................................................................................
Yes
 
46,551
j
Total. Add lines 1c through 1i ....................................................................................................
46,551
2a
Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....
 
No
b
If "Yes," enter the amount of any tax incurred under section 4912 ...........................................
 
c
If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................
 
d
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
No
1
Were substantially all (90% or more) dues received nondeductible by members? ...............................................
1
 
 
2
Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................
2
 
 
3
Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................
3
 
 
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."
1
Dues, assessments and similar amounts from members ......................................................................
1
 
2
Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).
a
Current year .............................................................................................................................
2a
 
b
Carryover from last year ............................................................................................................
2b
 
c
Total ...........................................................................................................................................
2c
 
3
Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .
3
 
4
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? ......................................................................................................................
4
 
5
Taxable amount of lobbying and political expenditures. See Instructions .........................................
5
 
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
PART II-B, LINE 1: THIS IS THE PORTION OF THE IHA/AHA DUES THAT IS OFFSET AND ALLOCATED TO LOBBYING PURPOSES. THE LOBBYING PERCENTAGE THAT WAS PUBLISHED BY THE AMERICAN HOSPITAL ASSOCIATION WAS DETERMINED TO BE 27.29% OF THE ANNUAL MEMBERSHIP DUES AND THE PERCENTAGE BY IHA WAS DETERMINED TO BE 43.50% OF THEIR DUES.
Schedule C (Form 990) 2021


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SCHEDULE D
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Financial Statements
SchDMd Bullet 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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
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 ........    
5
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? ............
6
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? ...................................
Part II
Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.
1
Purpose(s) of conservation easements held by the organization (check all that apply).
2
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.
Held at the End of the 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  
3
Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet  
4
Number of states where property subject to conservation easement is located SchDMd Bullet  
5
Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............
6
Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet  
7
Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet $  
8
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)? .............................
9
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.
1a
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.
b
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 $  
2
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:
a
Revenue included on Form 990, Part VIII, line 1 ..........................SchDMd Bullet $  
b
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

Schedule D (Form 990) 2021
Page 2
Part III
Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)
3
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):
a
d
b
e
 
c
4
Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.
5
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?...
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.
1a
Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................
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  
2a
Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...
b
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 .... 12,079,796 13,465,323 6,529,883 5,901,732 5,734,498
b Contributions ... 461,697 966,241 5,496,380 581,156 86,458
c Net investment earnings, gains, and losses 1,313,333 -2,351,768 1,439,060 46,995 80,776
d Grants or scholarships ...          
e Other expenditures for facilities
and programs ... 		         
f Administrative expenses ....          
g End of year balance ...... 13,854,826 12,079,796 13,465,323 6,529,883 5,901,732
2
Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:
a
Board designated or quasi-endowment SchDMd Bullet32.950 %
b
Permanent endowment SchDMd Bullet46.510 %
c
Term endowment SchDMd Bullet20.540 %
The percentages on lines 2a, 2b, and 2c should equal 100%.
3a
Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes
No
(i) Unrelated organizations .................
3a(i)
 
No
(ii) Related organizations .................
3a(ii)
Yes
 
b
If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........
3b
Yes
 
4
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 .....   8,216,675 8,216,675
b Buildings ....   275,428,684 103,334,038 172,094,646
c Leasehold improvements   498,573 329,923 168,650
d Equipment ....   187,331,974 135,490,746 51,841,228
e Other .....   45,331,848 2,647,927 42,683,921
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..SchDMdBullet 275,005,120
Schedule D (Form 990) 2021

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) HEDGE FUNDS		 52,628,000 C
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)Small Bullet 52,628,000
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.)Small Bullet  
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.)...........Small Bullet  
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  
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)Small Bullet 106,592,072
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

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  
2 Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a Net unrealized gains (losses) on investments .... 2a  
b Donated services and use of facilities ......... 2b  
c Recoveries of prior year grants ........... 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d ..................... 2e  
3 Subtract line 2e from line 1.................. 3  
4 Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b . 4a  
b Other (Describe in Part XIII.) ........... 4b  
c Add lines 4a and 4b.................... 4c  
5 Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ...... 5  
Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1 Total expenses and losses per audited financial statements ........... 1  
2 Amounts included on line 1 but not on Form 990, Part IX, line 25:
a Donated services and use of facilities ......... 2a  
b Prior year adjustments ............ 2b  
c Other losses ................ 2c  
d Other (Describe in Part XIII.) ............ 2d  
e Add lines 2a through 2d.................... 2e  
3 Subtract line 2e from line 1................... 3  
4 Amounts included on Form 990, Part IX, line 25, but not on line 1:
a Investment expenses not included on Form 990, Part VIII, line 7b .. 4a  
b Other (Describe in Part XIII.) ............ 4b  
c Add lines 4a and 4b..................... 4c  
5 Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ...... 5  
Part XIII
Supplemental Information
Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.
Return Reference Explanation
PART V, LINE 4: ALL FUNDS ARE HELD BY A RELATED ORGANIZATION, SARAH BUSH LINCOLN HEALTH FOUNDATION. PER THE DONORS SPECIFIED INTENTIONS, PERMANENT AND TEMPORARY ENDOWMENT FUNDS MAY BE USED FOR CHARITABLE, BENEVOLENT, EDUCATIONAL AND SCIENTIFIC PURPOSES TO SUPPORT SARAH BUSH LINCOLN HEALTH CENTER. THE PURPOSE OF THE BOARD DESIGNATED FUNDS IS TO PROVIDE FINANCIAL SUPPORT FOR ACTIVITIES OF THE SARAH BUSH LINCOLN HEALTH SYSTEM OR EXPENSES ASSOCIATED WITH MANAGING THE FOUNDATION.
PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE SYSTEM AND RECOGNIZE A TAX LIABILITY IF THE SYSTEM HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY VARIOUS FEDERAL AND STATE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE SYSTEM AND HAS CONCLUDED THAT AS OF JUNE 30, 2023 AND 2022, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. THE SYSTEM IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THESE ENTITIES HAVE FILED THEIR FEDERAL AND STATE INCOME TAX RETURNS FOR PERIODS THROUGH JUNE 30, 2022. THESE INCOME TAX RETURNS ARE GENERALLY OPEN TO EXAMINATION BY THE RELEVANT TAXING AUTHORITIES FOR A PERIOD OF THREE YEARS FROM THE LATER OF THE DATE THE RETURN WAS FILED OR ITS DUE DATE (INCLUDING APPROVED EXTENSIONS).
Schedule D (Form 990) 2021


Additional Data


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SCHEDULE F(Form 990)
Department of the Treasury
Internal Revenue Service
Statement of Activities Outside the United States
Right pointing arrow large image Complete if the organization answered "Yes" to Form 990, Part IV, line 14b, 15, or 16.Right pointing arrow large image Attach to Form 990.Right pointing arrow large image 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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
Part I
General Information on Activities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 14b.
1
For grantmakers. Does the organization maintain records to substantiate the amount of its grants and
other assistance, the grantees’ eligibility for the grants or assistance, and the selection criteria used
to award the grants or assistance? . . . . . . . . . . . . . . . . . . . . . . . . .
2
For grantmakers. Describe in Part V the organization’s procedures for monitoring the use of its grants and other assistance outside the United States.
3
Activites per Region. (The following Part I, line 3 table can be duplicated if additional space is needed.)
(a) Region (b) Number of offices in the region (c) Number of employees, agents, and independent contractors in the region (d) Activities conducted in region (by type) (such as, fundraising, program services, investments, grants to recipients located in the region) (e) If activity listed in (d) is a program service, describe specific type of
service(s) in the region		 (f) Total expenditures
for and investments
in the region
CENTRAL AMERICAN/CARIBBEAN     INVESTMENTS   26,032,000
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
           
3a Sub-total .... 0 0 26,032,000
b Total from continuation sheets to Part I ... 0 0 0
c Totals (add lines 3a and 3b) 0 0 26,032,000
For Paperwork Reduction Act Notice, see the Instructions for Form 990.Cat. No. 50082W Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 2
Part II
Grants and Other Assistance to Organizations or Entities Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 15, for any recipient who received more than $5,000. Part II can be duplicated if additional space is needed.
1 (a) Name of organization (b) IRS code section
and EIN (if applicable)		 (c) Region (d) Purpose of
grant 		(e) Amount of
cash grant 		(f) Manner of
cash
disbursement 		(g) Amount
of noncash
assistance 		(h) Description
of noncash
assistance 		(i) Method of
valuation
(book, FMV,
appraisal, other)
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
             
2 Enter total number of recipient organizations listed above that are recognized as charities by the foreign country, recognized as tax-exempt by the IRS, or for which the grantee or counsel has provided a section 501(c)(3) equivalency letter .......MediumBullet
 
3 Enter total number of other organizations or entities .......................MediumBullet
 
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022Page 3
Part III
Grants and Other Assistance to Individuals Outside the United States. Complete if the organization answered "Yes" on Form 990, Part IV, line 16.
Part III can be duplicated if additional space is needed.
(a) Type of grant or assistance (b) Region (c) Number of recipients (d) Amount of
cash grant 		(e) Manner of cash
disbursement 		(f) Amount of
noncash
assistance 		(g) Description
of noncash
assistance 		(h) Method of
valuation
(book, FMV,
appraisal, other)
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
               
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 4
Part IV
Foreign Forms
1 Was the organization a U.S. transferor of property to a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 926, Return by a U.S. Transferor of Property to a Foreign Corporation (see Instructions for Form 926). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 Did the organization have an interest in a foreign trust during the tax year? If "Yes," the organization may be required to separately file Form 3520, Annual Return to Report Transactions with Foreign Trusts and Receipt of Certain Foreign Gifts, and/or Form 3520-A, Annual Information Return of Foreign Trust With a U.S. Owner (see Instructions for Forms 3520 and 3520-A; don't file with Form 990). . . . . . . . . . . . . . . . . . . . . . . .
3 Did the organization have an ownership interest in a foreign corporation during the tax year? If "Yes," the organization may be required to file Form 5471, Information Return of U.S. Persons with Respect to Certain Foreign Corporations. (see Instructions for Form 5471). . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 Was the organization a direct or indirect shareholder of a passive foreign investment company or a qualified electing fund during the tax year? If “Yes,” the organization may be required to file Form 8621, Information Return by a Shareholder of a Passive Foreign Investment Company or Qualified Electing Fund. (see Instructions for Form 8621) .
5 Did the organization have an ownership interest in a foreign partnership during the tax year? If "Yes," the organization may be required to file Form 8865, Return of U.S. Persons with Respect to Certain Foreign Partnerships (see Instructions for Form 8865). . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6 Did the organization have any operations in or related to any boycotting countries during the tax year? If "Yes," the organization may be required to separately file Form 5713, International Boycott Report (see Instructions for Form 5713; don't file with Form 990).. . . . . . . . . . . . . . . . . . . . . . . . . . . .
Schedule F (Form 990) 2022
Schedule F (Form 990) 2022
Page 5
Part V
Supplemental Information
Provide the information required by Part I, line 2 (monitoring of funds); Part I, line 3, column (f) (accounting method; amounts of investments vs. expenditures per region); Part II, line 1 (accounting method); Part III (accounting method); and Part III, column (c) (estimated number of recipients), as applicable. Also complete this part to provide any additional information. See instructions.
ReturnReference Explanation
PART III ACCOUNTING METHOD:  
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule F (Form 990) 2022
Additional Data


Software ID:  
Software Version:  



SCHEDULE H
(Form 990)
Department of the Treasury
Internal Revenue Service
Hospitals
MediumBullet 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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
Part I
Financial Assistance and Certain Other Community Benefits at Cost
Yes
No
1a
Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .
1a
Yes
 
b
If "Yes," was it a written policy? ......................
1b
Yes
 
2
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.
3
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.
a
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:
3a
Yes
 
b
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: . . . . . . . .
3b
Yes
 
%
c
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.
4
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"? . . . . . . . . . . . . .

4

Yes

 
5a
Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

5a

Yes

 
b
If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .
5b
Yes
 
c
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? . . . . . . . . . . . . .
5c
 
No
6a
Did the organization prepare a community benefit report during the tax year? . . . . . . . . .
6a
Yes
 
b
If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .
6b
Yes
 
Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.
7
Financial Assistance and Certain Other Community Benefits at Cost
Financial Assistance and
Means-Tested
Government Programs
 (a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community benefit expense (d) Direct offsetting revenue (e) Net community benefit expense (f) Percent of total expense
a Financial Assistance at cost
(from Worksheet 1) . . . 		    3,560,090   3,560,090 0.670 %
b Medicaid (from Worksheet 3, column a) . . . . .     101,523,877 45,048,332 56,475,545 10.660 %
c Costs of other means-tested government programs (from Worksheet 3, column b) . .            
d Total Financial Assistance and Means-Tested Government Programs . . . . .     105,083,967 45,048,332 60,035,635 11.330 %
Other Benefits
e Community health improvement services and community benefit operations (from Worksheet 4).     685,694   685,694 0.130 %
f Health professions education (from Worksheet 5) . . .            
g Subsidized health services (from Worksheet 6) . . . .            
h Research (from Worksheet 7) .            
i Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .     350,486   350,486 0.070 %
j Total. Other Benefits . .     1,036,180   1,036,180 0.200 %
k Total. Add lines 7d and 7j .     106,120,147 45,048,332 61,071,815 11.530 %
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.
(a) Number of activities or programs (optional) (b) Persons served (optional) (c) Total community building expense (d) Direct offsetting
revenue 		(e) Net community building expense (f) Percent of total expense
1 Physical improvements and housing            
2 Economic development     27,500   27,500 0.010 %
3 Community support            
4 Environmental improvements            
5 Leadership development and
training for community members		            
6 Coalition building            
7 Community health improvement advocacy            
8 Workforce development            
9 Other            
10 Total     27,500   27,500 0.010 %
Part III
Bad Debt, Medicare, & Collection Practices
Section A. Bad Debt Expense
Yes
No
1
Did the organization report bad debt expense in accordance with Healthcare Financial Management Association Statement No. 15? ..........................
1
Yes
 
2
Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......
2
10,958,648
3
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. ......
3
 
4
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
5
Enter total revenue received from Medicare (including DSH and IME).....
5
142,268,579
6
Enter Medicare allowable costs of care relating to payments on line 5.....
6
72,104,213
7
Subtract line 6 from line 5. This is the surplus (or shortfall)........
7
70,164,366
8
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:
Section C. Collection Practices
9a
Did the organization have a written debt collection policy during the tax year? ..........
9a
Yes
 
b
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 .........................

9b

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
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) 		Licensed Hospital General Medical and Surgical Children's Hospital Teaching Hospital Critical Access Hospital Research Facility ER-24Hours ER-Other Other (describe) Facility reporting group
1 SARAH BUSH LINCOLN HEALTH CENTER
1000 HEALTH CENTER DRIVE
MATTOON,IL61938
WWW.SARAHBUSH.ORG
0003392 		X X         X      
Schedule H (Form 990) 2022
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)
SARAH BUSH LINCOLN HEALTH CENTER
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): 		1
Yes No
Community Health Needs Assessment
1 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?........................ 1   No
2 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............... 2   No
3 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...................... 3 Yes  
If "Yes," indicate what the CHNA report describes (check all that apply):
a
b
c
d
e
f
g
h
i
j
4 Indicate the tax year the hospital facility last conducted a CHNA: 20 21
5 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 ................. 5 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.................................. 6a   No
b 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. ............................ 6b   No
7 Did the hospital facility make its CHNA report widely available to the public?.............. 7 Yes  
If "Yes," indicate how the CHNA report was made widely available (check all that apply):
a
b
c
d
8 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. .............. 		8 Yes  
9 Indicate the tax year the hospital facility last adopted an implementation strategy: 20 21
10 Is the hospital facility's most recently adopted implementation strategy posted on a website?......... 10   No
a If "Yes" (list url):  
b If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ...... 10b   No
11 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   No
b If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........ 12b    
c 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
Schedule H (Form 990) 2022
Page 5
Part VFacility Information (continued)

Financial Assistance Policy (FAP)
SARAH BUSH LINCOLN HEALTH CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
Did the hospital facility have in place during the tax year a written financial assistance policy that:
13 Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care? 13 Yes  
If “Yes,” indicate the eligibility criteria explained in the FAP:
a
b
c
d
e
f
g
h
14 Explained the basis for calculating amounts charged to patients?................. 14 Yes  
15 Explained the method for applying for financial assistance?................... 15 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):
a
b
c
d
e
16 Was widely publicized within the community served by the hospital facility?........ 16 Yes  
If "Yes," indicate how the hospital facility publicized the policy (check all that apply):
a
SEE PART V, PAGE 8
b
SEE PART V, PAGE 8
c
d
e
f
g
h
i
j
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 6
Part VFacility Information (continued)

Billing and Collections
SARAH BUSH LINCOLN HEALTH CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
17 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?.................................. 17 Yes  
18 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:
a
b
c
d
e
f
19 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?............ 19   No
If "Yes," check all actions in which the hospital facility or a third party engaged:
a
b
c
d
e
20 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):
a
b
c
d
e
f
Policy Relating to Emergency Medical Care
21 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?.................. 21 Yes  
If "No," indicate why:
a
b
c
d
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 7
Part VFacility Information (continued)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)
SARAH BUSH LINCOLN HEALTH CENTER
Name of hospital facility or letter of facility reporting group  
Yes No
22 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.
a
b
c
d
23 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? ............................... 23   No
If "Yes," explain in Section C.
24 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? ........................... 24   No
If "Yes," explain in Section C.
Schedule H (Form 990) 2022
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
SARAH BUSH LINCOLN HEALTH CENTER PART V, SECTION B, LINE 5: A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN TAX YEAR 2021. COMMUNITY INPUT WAS PROVIDED THROUGH 10 KEY INFORMANTS, INCLUDING REPRESENTATIVE OF PUBLIC HEALTH, PHYSICIANS AND OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. PARTICIPANTS INCLUDED A REPRESENTATIVE OF PUBLIC HEALTH, AS WELL AS SEVERAL INDIVIDUALS WHO WORK WITH LOW-INCOME, MINORITY OR OTHER MEDICALLY UNDERSERVED POPULATIONS, AND THOSE WHO WORK WITH PERSONS WITH CHRONIC DISEASE CONDITIONS. SPECIFIC NAMES/TITLES OF THE PARTICIPANTS ARE AVAILABLE UPON REQUEST.
SARAH BUSH LINCOLN HEALTH CENTER PART V, SECTION B, LINE 11: PRIORITY 1:MAXIMIZE ACCESS TO CARE: EXPAND ACCESS TO MENTAL HEALTH SERVICES, IMPROVE PATIENT ACCESS AND SERVICE THROUGH THE USE OF TECHNOLOGY AND OTHER MEANS, AND EXPAND ACCESS TO CARE FOR UNDERSERVED POPULATIONS.PRIORITY 2:ADDRESS SOCIAL DETERMINANTS OF HEALTH: PROMOTE ECONOMIC STABILITY TO ADDRESS SOCIAL DETERMINANTS OF HEALTH IN SBL COMMUNITIES AND SUSTAIN EXISTING SBL PROGRAMS THAT ADDRESS SOCIAL DETERMINANTS OF HEALTH.NEEDS NOT BEING ADDRESSED:SUBASTANCE ABUSE: THE SUBSTANCE ABUSE NEEDS OF THE COMMUNITY ARE PRIMARILY REFERRED TO AND ADDRESSED BY THE CENTRAL EAST ALCOHOLISM AND DRUG (CEAD) COUNCIL. CEAD PROVIDES A COMPREHENSIVE ARRAY OF SERVICES TO ADDRESS CHEMICAL ABUSE, DEPENDENCY AND OTHER THERAPUTIC NEEDS.TRANSPORTATION: THE TRANSPORTATION NEEDS OF THE COMMUNITY ARE CURRENTLY BEING ADDRESSED BY OTHER COMMUNITY AGENCIES SUCH AS ILLINOIS PUBLIC TRANSIT, RIDES MASS TRANSIT DISTRICT, DIAL-A-RIDE PROGRAM AND RIDES PLUS. THESE PUBLIC TRANSPORTATION OPTIONS PROVIDE DOOR-TO-DOOR SERVICES AS WELL AS FIXED ROUTES AND ARE AVAILABLE TO ANYONE NEEDING ACCESS TO TRANSPORTATION.
SARAH BUSH LINCOLN HEALTH CENTER: SCHEDULE H, PART V, LINE 7A:HTTPS://WWW.SARAHBUSH.ORG/ABOUT/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
SARAH BUSH LINCOLN HEALTH CENTER: SCHEDULE H, PART V, LINE 16A:HTTPS://WWW.SARAHBUSH.ORG/HOSPITAL-SERVICES/FINANCIAL-ASSISTANCE/SCHEDULE H, PART V, LINE 16B:HTTPS://WWW.SARAHBUSH.ORG/HOSPITAL-SERVICES/FINANCIAL-ASSISTANCE/SCHEDULE H, PART V, LINE 16C:HTTPS://WWW.SARAHBUSH.ORG/HOSPITAL-SERVICES/FINANCIAL-ASSISTANCE/
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
   
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 9
Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility
(list in order of size, from largest to smallest)
How many non-hospital health care facilities did the organization operate during the tax year?19
Name and address Type of Facility (describe)
1 1 - SBL ARCOLA CLINIC
241 W SPRINGFIELD RD
ARCOLA,IL61920 		CLINIC
2 2 - SBL ARTHUR CLINIC
211 S WALNUT
ARTHUR,IL61911 		CLINIC
3 3 - SBL CASEY CLINIC
934 NORTH RT 49 PO BOX 460
CASEY,IL62420 		CLINIC
4 4 - SBL CHARLESTON FAMILY PRACTICE
116 WEST BUCHANAN AVE
CHARLESTON,IL61920 		CLINIC
5 5 - SBL FAMILY MEDICAL CENTER
200 RICHMOND AVE
MATTOON,IL61928 		CLINIC
6 6 - SBL NEOGA CLINIC
650 OAK AVE PO BOX 640
NEGOA,IL62447 		CLINIC
7 7 - SBL SULLIVAN CLINIC
7 HAWTHORNE LANE
SULLIVAN,IL61951 		CLINIC
8 8 - SBL TOLEDO CLINIC
168 COURTHOUSE SQUARE PO BOX 99
TOLEDO,IL62468 		CLINIC
9 9 - SBL EFFINGHAM CLINIC
905 N MAPLE
EFFINGHAM,IL62401 		CLINIC
10 10 - SBL MATTOON WALK-IN CLINIC
200 DETTRO DRIVE
MATTOON,IL61938 		CLINIC
11 11 - SBL NEWTON CLINIC
910 SOUTH BUREN ST
NEWTON,IL62448 		CLINIC
12 12 - SBL CHARLESTON WALK-IN CLINIC
2040 EAST LINCOLN
CHARLESTON,IL61920 		CLINIC
13 13 - SBL SHELBYVILLE CLINIC
207 S PINE ST SUITE 10
SHELBYVILLE,IL62565 		CLINIC
14 14 - SBL TUSCOLA CLINIC
1100 TUSCOLA BLVD
TUSCOLA,IL61953 		CLINIC
15 15 - SBL MARTINSVILLE CLINIC
890 RIDGELAWN ROAD
MARTINSVILLE,IL62442 		CLINIC
16 16 - ALTAMONT MEDICAL CENTER
8 NORTH THIRD STREET
ALTAMONT,IL62411 		CLINIC
17 17 - BONUTTI CLINIC
1303 W EVERGREEN AVE
EFFINGHAM,IL62401 		CLINIC
18 18 - CHARLESTON CLINIC EAST
2040 LINCOLN AVE SUITE 101
CHARLESTON,IL61920 		CLINIC
19 19 - EFFINGHAM FAMILY PRACTICE
901 MEDICAL PARK DR SUITE 101
EFFINGHAM,IL62401 		CLINIC
Schedule H (Form 990) 2022
Schedule H (Form 990) 2022
Page 10
Part VI
Supplemental Information
Provide the following information.
1 Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2 Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3 Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4 Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5 Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6 Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7 State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.
Form and Line Reference Explanation
PART I, LINE 3C: SEE PART V, LINE 13 FOR OTHER CRITERIA USED TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE.
PART I, LINE 7: THE COSTING METHODOLOGY THAT WAS USED TO CALCULATE THESE AMOUNTS WAS THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2 OF THE WORKING PAPERS.
PART II, COMMUNITY BUILDING ACTIVITIES: COLES TOGETHER IS A NOT-FOR-PROFIT CORPORATION FOUNDED FOR AND TO PROMOTE ECONOMIC DEVELOPMENT FOR NEW AND EXISTING INDUSTRY IN OUR COUNTY, COLES COUNTY, ILLINOIS. OUR HOSPITAL BOARD HAS MADE A COMMITMENT TO SUPPORT THIS ORGANIZATION WHOSE COMMUNITY DEVELOPMENT EFFORTS BENEFIT OUR ORGANIZATION AS WELL AS OTHER ORGANIZATIONS IN OUR COMMUNITY THAT WOULD ULTIMATELY IMPACT AND KEEP OUR HOSPITAL A VIABLE ORGANIZATION. SUPPORT IS PROVIDED FINANCIALLY AND THROUGH PARTICIPATION ON THEIR BOARD. ADDITIONALLY, DONATIONS WERE MADE TO A VARIETY OF NON-PROFIT GROUPS TO HELP OUR COMMUNITY WITH ECONOMIC DEVELOPMENT.
PART III, LINE 2: USED THE RATIO OF PATIENT CARE COST TO CHARGES (0.3249) AS COMPUTED ON WORKSHEET 2 OF THE ACCOUNTING WORKPAPERS TO CALCULATE THE BAD DEBT EXPENSE (10,958,648) AT COST (3,560,465). WE REDUCE BAD DEBT EXPENSE BY THE DISCOUNTS AND PAYMENTS ON PATIENT ACCOUNTS.
PART III, LINE 4: SEE THE PATIENT ACCOUNTS RECEIVABLE NOTE ON PAGE 6 OF THE ATTACHED FINANCIAL STATEMENTS.
PART III, LINE 8: ALTHOUGH SBL DOES NOT TREAT SHORTFALL FOR MEDICARE AS A COMMUNITY BENEFIT, THERE COULD BE A CASE MADE THAT NOT BEING FULLY REIMBURSED FOR TREATING THE ELDERLY IS CONSIDERED TO BE THE PROVISION OF A BENEFIT TO THE COMMUNITY. THE COSTING METHODOLOGY USED TO DETERMINE THE AMOUNT REPORTED ON LINE 6 WAS THE RATIO OF PATIENT CARE COST TO CHARGES CALCULATED ON WORKSHEET 2 AND ALSO DETAILED ON WORKSHEET C OF THE WORKING PAPERS.
PART VI, LINE 2: NEEDS ASSESSMENT:EVERY THREE YEARS, SARAH BUSH LINCOLN ASSESSES THE HEALTH CARE NEEDS OF THE COMMUNITIES IT SERVES THROUGH A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT. THIS ASSESSMENT INCORPORATES DATA FROM BOTH QUANTITATIVE AND QUALITATIVE SOURCES. QUANTITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH (COMMUNITY HEALTH SURVEY THAT IS BASED LARGELY ON THE CENTER FOR DISEASE CONTROL AND PREVENTION (CDC), BEHAVIORAL RISK FACTOR SURVEILLANCE SYSTEM (BRFSS)) AND SECONDARY RESEARCH (VITAL STATISTICS AND OTHER EXISTING HEALTH-RELATED DATA); THESE QUANTITATIVE COMPONENTS ALLOW FOR COMPARISON TO BENCHMARK DATA AT THE STATE AND NATIONAL LEVELS. QUALITATIVE DATA INPUT INCLUDES PRIMARY RESEARCH GATHERED THROUGH A SERIES OF KEY INFORMANT FOCUS GROUPS. BASED ON THE RESULTS OF THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, SBL DETERMINED TO FOCUS ON DEVELOPING AND/OR SUPPORTING STRATEGIES AND INITIATIVES TO IMPROVE ACCESS TO HEALTH SERVICES, ACTIVATE HEALTHY CHOICES AMOUNG ADULTS, CANCER, TOBACCO USE AND ORAL HEALTH.
PART VI, LINE 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:WHEN A PATIENT IS PRIVATE PAY (OR SHOWS CONCERN ABOUT PAYING THE BILL), OUR REGISTRATION CLERK INFORMS THEM OF OUR FINANCIAL ASSISTANCE POLICY AT THE TIME OF REGISTRATION. ALL STAFF ARE ORIENTED AS TO HOW THE PROGRAM WORKS DURING NEW EMPLOYEE ORIENTATION. WE ALSO HAVE FINANCIAL ASSISTANCE REPRESENTATIVES AVAILABLE DURING NORMAL BUSINESS HOURS TO SPEAK WITH THE PATIENT IF THERE ARE QUESTIONS BEYOND THE REGISTRATION CLERK'S KNOWLEDGE. PATIENTS ARE INFORMED (NOT NECESSARILY AT REGISTRATION) THEY NEED TO APPLY FOR MEDICAID SHOULD THEY HAVE ANY PRE-QUALIFIERS FOR THE PROGRAM (IE: BLIND, DISABLED, DEPENDENT CHILDREN IN THE HOME, ETC.). THIS INFORMATION IS IN THE FINANCIAL ASSISTANCE BROCHURE WITH THE APPLICATION AS WELL. IF A PATIENT NEEDS TO APPLY FOR MEDICAID PRIOR TO FINANCIAL ASSISTANCE, WE PROVIDE THEM THE INFORMATION AND ASSISTANCE TO APPLY AT THE PUBLIC AID OFFICE. ADDITIONALLY, OUR SBL FINANCIAL ASSISTANCE PROGRAM BROCHURES ARE IN EVERY DEPARTMENT AND CLINIC IN THE SYSTEM AND WIDELY AVAILABLE THROUGHOUT THE FACILITY. THE INFORMATION IS ALSO AVAILABLE ON OUR WEBSITE (INCLUDING APPLICATIONS) WITH A DEDICATED PHONE NUMBER.
PART VI, LINE 4: COMMUNITY INFORMATION:SARAH BUSH LINCOLN (SBL) SERVES RURAL COMMUNITIES IN EAST CENTRAL ILLINOIS. SBL'S SERVICE AREA ENCOMPASSES 10 COUNTIES INCLUDING: CLARK, COLES, CUMBERLAND, DOUGLAS, EDGAR, EFFINGHAM, FAYETTE, JASPER, MOULTRIE AND SHELBY. THE 2023 US CENSUS POPULATION ESTIMATE FOR SBL'S 10-COUNTY SERVICE AREA IS 206,921. THE REGION IS PREDOMINANTLY WHITE, WITH LESS THAN 10 PERCENT OF THE POPULATION IN EACH COUNTY IDENTIFYING THEMSELVES AS A RACE OTHER THAN "WHITE ALONE". THE REGION IS RURAL, WITH 59% OF THE POPULATION LIVING IN COMMUNITIES LESS THAN 2,500. THE MEDIAN AGE IN EACH COUNTY, EXCEPT COLES AND DOUGLAS, IS HIGHER THAN THE ILLINOIS MEDIAN OF 38.7 YEARS. OVER 24,000 PEOPLE (11.6%) IN SBL'S SERVICE AREA LIVE IN POVERTY. OVER 12,000 PEOPLE (7.2%) UNDER THE AGE OF 65 ARE WITHOUT HEALTH INSURANCE. ACCORDING TO THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES, 8 OF THE 10 COUNTIES IN SBL'S SERVICE AREA ARE DESIGNATED AS A PRIMARY CARE HEALTH PROFESSIONAL SHORTAGE AREA AND 9 OF 10 COUNTIES ARE DESIGNATED AS A MENTAL HEALTH PROFESSIONAL SHORTAGE AREA (2024).
PART VI, LINE 5: PROMOTION OF COMMUNITY HEALTH:SARAH BUSH LINCOLN HEALTH CENTER HAS AN OPEN MEDICAL STAFF AS WELL AS A COMMUNITY BOARD.
SCHEDULE H, PART I, LINE 7, COLUMN F: THE ORGANIZATION INCURRED BAD DEBT EXPENSE IN THE AMOUNT OF 15,000,261. HOWEVER, IT HAS BEEN DISREGARDED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN.
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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number
23-7098532
Part I
General Information on Grants and Assistance
1
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? ........................
2
Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.
Part II
Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient
that received more than $5,000. Part II can be duplicated if additional space is needed.
(a) Name and address of organization
or government		 (b) EIN (c) IRC section
(if applicable)		 (d) Amount of cash grant (e) Amount of non-cash
assistance		 (f) Method of valuation
(book, FMV, appraisal,
other)		 (g) Description of
noncash assistance		 (h) Purpose of grant
or assistance
(1) COLES TOGETHER
400 AIRPORT ROAD
MATTOON,IL61938 		37-1243664 501(C)(6) 37,500 0     PROGRAM SUPPORT
(2) COLES COUNTY COUNCIL ON AGING
11021 E CR 800 N
CHARLESTON,IL61920 		23-7414779 501(C)(3) 10,000 0     PROGRAM SUPPORT
2
Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image
1
3
Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image
1
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50055P
Schedule I (Form 990) 2022

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)
(2)
(3)
(4)
(5)
(6)
(7)
Part IV
Supplemental Information. Provide the information required in Part I, line 2; Part III, column (b); and any other additional information.
Return Reference Explanation
PART I, LINE 2: DISTRIBUTIONS ARE SELECTED DURING THE BUDGET PROCESS. MONTHLY REQUESTS ARE RECEIVED FOR SPECIAL PURPOSES. ALL DISTRIBUTIONS ARE APPROVED BY THE SARAH BUSH LINCOLN HEALTH CENTER BOARD. DOCUMENTATION IS RECORDED FOR ALL GRANTS MADE.
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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
Part I
Questions Regarding Compensation
Yes
No
1a
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.
b
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 .....
1b
Yes
 
2
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? ....
2
Yes
 
3
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.
4
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:
a
Receive a severance payment or change-of-control payment? .............
4a
 
No
b
Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........
4b
Yes
 
c
Participate in, or receive payment from, an equity-based compensation arrangement? .........
4c
 
No
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.
5
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:
a
The organization? ....................
5a
 
No
b
Any related organization? .......................
5b
 
No
If "Yes," on line 5a or 5b, describe in Part III.
6
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:
a
The organization? ..................
6a
 
No
b
Any related organization? ......................
6b
 
No
If "Yes," on line 6a or 6b, describe in Part III.
7
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 ............
7
Yes
 
8
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 ..........................
8
 
No
9
If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................
9
 
 
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50053T
Schedule J (Form 990) 2022

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
(i) Base
compensation 		(ii) Bonus & incentive
compensation 		(iii) Other reportable compensation
1MATTHEW JONES
PHYSICIAN 		(i)

(ii)		 893,076
-------------
0 		824,102
-------------
0 		98,474
-------------
0 		10,250
-------------
0 		67,764
-------------
0 		1,893,666
-------------
0 		0
-------------
0
2JOSHUA GARRETT
PHYSICIAN 		(i)

(ii)		 892,069
-------------
0 		740,649
-------------
0 		99,144
-------------
0 		10,250
-------------
0 		66,507
-------------
0 		1,808,619
-------------
0 		0
-------------
0
3ERIC BREWER
PHYSICIAN 		(i)

(ii)		 691,922
-------------
0 		566,222
-------------
0 		410,935
-------------
0 		10,250
-------------
0 		66,661
-------------
0 		1,745,990
-------------
0 		0
-------------
0
4AZIZ AHMED
PHYSICIAN 		(i)

(ii)		 900,006
-------------
0 		723,665
-------------
0 		93,466
-------------
0 		10,250
-------------
0 		3,621
-------------
0 		1,731,008
-------------
0 		0
-------------
0
5LOUIS MENDELLA
PHYSICIAN 		(i)

(ii)		 852,397
-------------
0 		678,125
-------------
0 		98,659
-------------
0 		10,250
-------------
0 		69,344
-------------
0 		1,708,775
-------------
0 		0
-------------
0
6DIDI OMIYI
DIRECTOR 		(i)

(ii)		 900,378
-------------
0 		158,400
-------------
0 		49,836
-------------
0 		10,250
-------------
0 		25,035
-------------
0 		1,143,899
-------------
0 		0
-------------
0
7KIM UPHOFF
PRESIDENT 		(i)

(ii)		 418,532
-------------
0 		93,704
-------------
0 		152,472
-------------
0 		10,250
-------------
0 		64,730
-------------
0 		739,688
-------------
0 		0
-------------
0
8JERRY ESKER
PRESIDENT 		(i)

(ii)		 530,731
-------------
0 		400
-------------
0 		63,177
-------------
0 		10,250
-------------
0 		69,852
-------------
0 		674,410
-------------
0 		0
-------------
0
9DENNIS PLUARD
CHIEF FINANCE OFFICER 		(i)

(ii)		 383,896
-------------
0 		114,162
-------------
0 		76,167
-------------
0 		10,250
-------------
0 		68,606
-------------
0 		653,081
-------------
0 		0
-------------
0
10DWIGHT PENTZIEN
VP MEDICAL AFFAIRS 		(i)

(ii)		 393,658
-------------
0 		109,124
-------------
0 		51,698
-------------
0 		10,250
-------------
0 		66,617
-------------
0 		631,347
-------------
0 		0
-------------
0
11LUCAS CATT
DIRECTOR 		(i)

(ii)		 338,631
-------------
0 		145,914
-------------
0 		42,658
-------------
0 		10,250
-------------
0 		65,459
-------------
0 		602,912
-------------
0 		0
-------------
0
12JOHN LAUER
DIRECTOR 		(i)

(ii)		 401,862
-------------
0 		69,492
-------------
0 		54,926
-------------
0 		10,250
-------------
0 		46,621
-------------
0 		583,151
-------------
0 		0
-------------
0
13BRIAN MURPHY
VP INFORMATION SYSTEMS 		(i)

(ii)		 260,336
-------------
0 		72,531
-------------
0 		33,377
-------------
0 		10,250
-------------
0 		65,931
-------------
0 		442,425
-------------
0 		0
-------------
0
14DEBORAH SADDORIS
VP HUMAN RESOURCES 		(i)

(ii)		 249,943
-------------
0 		74,652
-------------
0 		29,861
-------------
0 		10,250
-------------
0 		65,978
-------------
0 		430,684
-------------
0 		0
-------------
0
15SANDRA MILLER
VP PATIENT CARE 		(i)

(ii)		 252,288
-------------
0 		74,635
-------------
0 		33,309
-------------
0 		10,250
-------------
0 		47,309
-------------
0 		417,791
-------------
0 		0
-------------
0
16COLT GUTHRIDGE
VP SURGICAL SERVICES 		(i)

(ii)		 257,928
-------------
0 		46,084
-------------
0 		27,711
-------------
0 		10,250
-------------
0 		66,200
-------------
0 		408,173
-------------
0 		0
-------------
0
17BROOKE ZERRUSEN
VP PRACTICE MANAGEMENT 		(i)

(ii)		 201,273
-------------
0 		30,934
-------------
0 		20,290
-------------
0 		8,373
-------------
0 		65,177
-------------
0 		326,047
-------------
0 		0
-------------
0
18ERICA STOLLARD
VP OPERATIONS 		(i)

(ii)		 176,592
-------------
0 		14,016
-------------
0 		13,297
-------------
0 		8,793
-------------
0 		37,488
-------------
0 		250,186
-------------
0 		0
-------------
0
19KAREN DYER
CEO FAYETTE COUNTY HOSPITAL 		(i)

(ii)		 174,876
-------------
0 		17,009
-------------
0 		1,432
-------------
0 		7,030
-------------
0 		1,205
-------------
0 		201,552
-------------
0 		0
-------------
0
20COLLEEN SWICK
VP PATIENT CONTINUUM CARE 		(i)

(ii)		 121,622
-------------
0 		14,314
-------------
0 		2,266
-------------
0 		4,356
-------------
0 		17,372
-------------
0 		159,930
-------------
0 		0
-------------
0
Schedule J (Form 990) 2022

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
PART I, LINE 1A HEALTH OR SOCIAL CLUB DUES AND COMPANION TRAVEL. COUNTRY CLUB DUES ARE REPORTED AS TAXABLE COMPENSATION FOR OUR PRESIDENT AND CEO, MR. JERRY ESKER. TRAVEL FOR COMPANIONS IS PROVIDED PER THE EMPLOYMENT AGREEMENT WITH THE PRESIDENT AND CEO, JERRY ESKER. ANY PERSONAL ITEMS, EXTRA DAYS, AND MEALS FOR BOTH ARE PAID FOR USING HIS PERSONAL CREDIT CARD.
PART I, LINE 7 ADDITIONAL COMPENSATION TO OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION ARE DEPENDENT ON SPECIFIC ORGANIZATIONAL AND INDIVIDUAL GOALS. THESE GOALS INCLUDE FINANCIAL, QUALITY, CUSTOMER SERVICE, AND OTHER GOALS RELATED TO THE ORGANIZATION'S STRATEGIC PLAN.
SCHEDULE J, PART I, LINE 4B: SARAH BUSH LINCOLN HEALTH CENTER CURRENTLY MAINTAINS A NONQUALIFIED, UNFUNDED, DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN, ON BEHALF OF CERTAIN DESIGNATED MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES. THE PLAN IS INTENDED TO BE AN UNFUNDED DEFERRED COMPENSATION PLAN FOR A SELECT GROUP OF MANAGEMENT OR HIGHLY COMPENSATED EMPLOYEES, AS DESCRIBED IN THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974, AS AMENDED ("ERISA"). THE FOLLOWING PERSONS LISTED IN FORM 990, PART VII ARE PARTICIPANTS IN THE PLAN: DR. JOHN LAUER - $33,810 DR. LUCAS CATT - $32,500 SANDRA MILLER - $24,494 DEBORAH SADDORIS - $24,483 BRIAN MURPHY - $24,536 DENNIS PLUARD - $61,535 JERRY ESKER - $138,445 GREGORY TAYLOR - $28,612 DR. JAMES HILDEBRANDT - $ KIMBERLY UPHOFF - $46,628 DR. JOSHUA GARRET - $85,001 DR. LOUIS MENDELLA - $84,999 DR. AZIZ AHMED - $85,001 DR. LORI CUDONE - $45,001 DR. MATTHEW JONES - $85,001 DR. CONSTATINE KATSAMAKIS - $40,206 GREG STARNES - $14,166 DWIGHT PENTZIEN - $37,253 DIDI OMIYI - $47,501
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
SchKMediumBullet 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.
SchKMediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public
Inspection
Name of the organization
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number
23-7098532
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
Yes No Yes No Yes No
A ILLINOIS FINANCE AUTHORITY
  		86-1091967   03-18-2011 45,000,000 SEE PART VI   X   X   X
B ILLINOIS FINANCE AUTHORITY
  		86-1091967   09-01-2020 28,000,000 SEE PART VI   X   X   X
C ILLINOIS FINANCE AUTHORITY
  		86-1091967   12-07-2021 35,000,000 SEE PART VI   X   X   X
Part Ⅱ
Proceeds
A B C D
1 Amount of bonds retired .................. 34,720,000 2,305,000    
2 Amount of bonds legally defeased ..............        
3 Total proceeds of issue .................. 45,000,000 28,000,000 45,000,000  
4 Gross proceeds in reserve funds .............        
5 Capitalized interest from proceeds .............        
6 Proceeds in refunding escrows ...............        
7 Issuance costs from proceeds ............... 517,777   343,517  
8 Credit enhancement from proceeds .............        
9 Working capital expenditures from proceeds .............        
10 Capital expenditures from proceeds ............. 26,444,431 28,000,000 44,656,483  
11 Other spent proceeds ............. 18,037,792      
12 Other unspent proceeds .............        
13 Year of substantial completion ............. 2014 2020 2021
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    
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    
16 Has the final allocation of proceeds been made? .......... X     X X      
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? .................. X   X   X      
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E
Schedule K (Form 990) 2021

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    
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............   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    
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?                
c Are there any research agreements that may result in private business use of bond-financed property? .............   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 ....SchKMediumBullet        
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 ......... SchKMediumBullet        
6 Total of lines 4 and 5 .............        
7 Does the bond issue meet the private security or payment test? ...   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    
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      
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    
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......   X   X   X    
b Exception to rebate? ........ X   X   X      
c No rebate due? .........   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      
Schedule K (Form 990) 2021

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    
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    
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    
7 Has the organization established written procedures to monitor the requirements of section 148? ... 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      
Part Ⅵ
Supplemental Information. Provide additional information for responses to questions on Schedule K. (See instructions).
Return Reference Explanation
SCHEDULE K, PART I, LINE B, COLUMN F: BONDS BORROWED FOR REIMBURSING THE HEATLH CENTER FOR EQUIPPING CERTAIN FACILITIES IN THE HOSPITAL.
SCHEDULE K, PART I, LINE A, COLUMN F: REFINANCE OLD BONDS AND CONSTRUCTION OF MASTER FACILITY PLAN.
SCHEDULE K, PART I, LINE C, COLUMN F: REFINANCE OLD BONDS WHICH WERE FOR REIMBURSING THE HEALTH CENTER FOR RENOVATION AND EXPANSION.
SCHEDULE K, PART I LINE D, COLUMN F: BUILDING & CONSTRUCTION OF NEW SARAH BUSH LINCOLN CLINIC IN EFFINGHAM.
Schedule K (Form 990) 2021

Additional Data


Software ID:  
Software Version:  

Schedule L
(Form 990)
Department of the Treasury
Internal Revenue Service
Transactions with Interested Persons
MediumBullet 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.
MediumBulletGo to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2021
Open to Public Inspection
Name of the organization
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
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 (b) Relationship between disqualified person and organization (c) Description of transaction (d) Corrected?
Yes No
2
Enter the amount of tax incurred by the organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image$
 
3
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?
To From Yes No Yes No Yes No
Total ...............Small Bullet $  
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
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?
Yes No
(1) SARAH MILLER
  		DAUGHTER OF SANDRA MILLER 63,425 EMPLOYED BY THE HEALTH CENTER   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:  




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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
Return Reference Explanation
FORM 990, PART III, LINE 4A: SOCIAL ACCOUNTABILITY 2023 CONTINUED: TO THAT END, WE PROVIDE HIGH QUALITY HEALTHCARE TO PEOPLE REGARDLESS OF THEIR RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES IS CRITICAL TO THE OPERATION AND STABILITY OF SBLHC, WE RECOGNIZE THAT NOT EVERYONE IS ABLE TO AFFORD ESSENTIAL MEDICAL SERVICES. SINCE IT IS OUR MISSION TO PROVIDE HEALTHCARE AND EDUCATION TO ALL MEMBERS OF THE COMMUNITY, WE PROVIDE: -BOTH FREE AND SUBSIDIZED CARE, -CARE TO PERSONS COVERED BY GOVERNMENT PROGRAMS AT BELOW-COST REIMBURSEMENT AND, -HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT THE COMMUNITY AT LARGE DURING THE FISCAL YEAR THAT ENDED JUNE 30, 2023, WE SERVED 7,975 INPATIENTS AND PROVIDED 470,666 OUTPATIENT SERVICES. WE SPONSORED NUMEROUS WELLNESS AND COMMUNITY EDUCATION PROGRAMS, SPECIAL PROGRAMS FOR OLDER RESIDENTS AND THE MEDICALLY UNDERSERVED, AND A WIDE VARIETY OF COMMUNITY SUPPORT ACTIVITIES. THIS INFORMATION OUTLINES THE MANY PROGRAMS AND SERVICES PROVIDED BY SBLHC DURING FISCAL YEAR 2023, MOST OF WHICH ARE ON-GOING. WE MAKE THIS INFORMATION AVAILABLE TO YOU SO YOU HAVE A BETTER UNDERSTANDING OF OUR MISSION, INCLUDING THE WAYS IN WHICH OUR RESOURCES ARE USED WITHIN THE COMMUNITY. WE ARE FIRMLY COMMITTED TO PROVIDING EXCEPTIONAL CARE AND CREATING HEALTHY COMMUNITIES, AND WE TRUST YOU'LL SEE THAT OUR ACTIONS MATCH OUR WORDS. SUMMARY WE HAVE CATEGORIZED OUR COMMUNITY SOCIAL RESPONSIBILITY STATEMENT TO CORRESPOND WITH OUR STRATEGIC GOALS. THE FOLLOWING IS A SNAPSHOT OF OUR ACTIVITIES FOR FISCAL YEAR 2023. EACH PROGRAM IS FURTHER DESCRIBED THROUGHOUT THIS BOOKLET. IMPROVE PATIENT EXPERIENCE AND LOYALTY $21,750 -ADVANTAGE 50 -DINE WITH A DOC IMPROVE CLINICAL AND OPERATIONAL QUALITY $830,000 -COMMUNITY HEALTH SCREENS -HEALTH EDUCATION -REGIONAL BEHAVIORAL HEALTH NETWORK -SARAH BUSH LINCOLN WEBSITE -LIVING WITH DIABETES -SUPPORT GROUPS ENHANCE HUMAN CAPITAL $25,986 -HEALTH OCCUPATIONS CREATE HEALTHY COMMUNITIES $517,579 -COMMUNITY AID -ORGANIZATIONAL SUPPORT -HEALTHY KIDS -SPORTS PHYSICALS MAINTAIN FINANCIAL VIABILITY $52,346,659 -FINANCIAL ASSISTANCE -GOVERNMENTAL INSURANCE PROGRAMS IMPROVE PATIENT EXPERIENCE AND LOYALTY ADVANTAGE 50 THIS FREE MEMBERSHIP GROUP IS OPEN TO ANYONE 50 YEARS OLD OR BETTER. IT PROVIDES HEALTH INFORMATION AND SOCIAL OUTINGS, AS WELL AS A VARIETY OF DISCOUNTS. THE NON-REIMBURSED COST TO SBLHC IS $17,200. DINE WITH A DOC DOCTORS/MID-LEVELS HOSTED A SERIES OF LUNCH PROGRAMS FOCUSING ON A WIDE VARIETY OF HEALTH TOPICS. THE NON-REIMBRUSED COST TO SBLHC IS $4,550. IMPROVE CLINICAL AND OPERATIONAL QUALITY COMMUNITY HEALTH SCREENS PREVENTIVE HEALTH SCREENS ARE AVAILABLE FOR FREE AND AT REDUCED COSTS BOTH AT THE HEALTH CENTER AND AT OUTREACH LOCATIONS. TESTS SCREEN FOR VARIOUS CANCERS AND MEASURE CHOLESTEROL LEVELS, PULMONARY FUNCTION, BONE DENSITY, BLOOD PRESSURE AND BODY FAT. BLOOD SUGAR ANALYSIS AND VISION/GLAUCOMA SCREENINGS ARE ALSO PROVIDED, AS ARE WORKSHOPS FOCUSED ON LIFESTYLE MODIFICATION. THE NET NON-REIMBURSED COST OF THESE SERVICES AFTER DISCOUNTED FEES AND GRANT FUNDING WAS APPROXIMATELY $82,748. HEALTH EDUCATION HEALTH-RELATED EDUCATIONAL PROGRAMS ARE OFFERED IN MANY SETTINGS THROUGHOUT THE COMMUNITY ON SUCH TOPICS AS NUTRITION, DIABETES, DEPRESSION, EATING DISORDERS, SLEEP DISORDERS, OSTEOPOROSIS, HYPERTENSION, EXERCISE, CARDIAC HEALTH, CANCER, BEREAVEMENT, LIVING WILLS AND PRE- AND POST-NATAL CARE OF MOTHERS AND INFANTS. HEALTH STYLES, THE HEALTH CENTER'S QUARTERLY OUTREACH MAGAZINE, PROVIDES HEALTH INFORMATION AND IS DISTRIBUTED TO 97,000 HOUSEHOLDS IN A TEN-COUNTY AREA AT A COST OF $145,820. HEART TO HEART COMMUNITY SCREENING PROGRAM HEART TO HEART IS A COMMUNITY CARDIAC SCREENING PROGRAM THAT PROVIDES AFFORDABLE HEART DISEASE SCREENING AND EDUCATION. IT INCLUDES BASELINE EKG, BLOOD PRESSURE, CORONARY CT CALCIUM SCORING, LIPID PROFILE, RENAL FUNCTION TESTING, ETC. FOR A $95 CHARGE THAT DOES NOT COVER COSTS FOR TESTING, ADMINISTRATION OF THE PROGRAM AND PROGRAM PROMOTION. THE NET NON-REIMBURSED COST OF THIS SERVICE TO SBLHS IS $31,972. REGIONAL BEHAVIORAL HEALTH NETWORK SARAH BUSH LINCOLN, THE COLES COUNTY MENTAL HEALTH CENTER (NOW LIFE LINKS) AND THE HUMAN RESOURCES CENTER OF EDGAR AND CLARK COUNTIES JOINED FORCES TO CREATE THE REGIONAL BEHAVIORAL HEALTH NETWORK, AN ORGANIZATION THAT STREAMLINES ACCESS TO MENTAL HEALTHCARE FOR PEOPLE IN CRISIS. TOGETHER, THE THREE ORGANIZATIONS ESTIMATE THEY RESPOND TO ABOUT 3,000 CRISES INQUIRES FOR BEHAVIORAL HEALTH SERVICES ANNUALLY. THE COLLABORATIVE EFFORT IS PARTIALLY FUNDED BY GRANTS. THE HEALTH CENTER'S DIRECT AND IN-KIND NON-REIMBURSED COST WAS $74,000. SARAH BUSH LINCOLN WEBSITE THE HEALTH CENTER'S WEBSITE, WWW.SARAHBUSH.ORG, PROVIDES AREA RESIDENTS WITH ACCESS TO ACCURATE MEDICAL INFORMATION ABOUT ILLNESSES, TESTS AND TREATMENTS, AND IT OFFERS THEM A PLACE TO STORE THEIR OWN HEALTH INFORMATION. THE COST OF MAINTAINING THE SITE WAS $136,317. SUPPORT GROUPS SUPPORT GROUPS ASSIST THOSE AFFECTED BY CANCER, OSTOMY, STROKE, ADD, ADHD, POOR PULMONARY FUNCTION, LOSS OF A CHILD THROUGH MISCARRIAGE AND STILLBIRTH, NUTRITION AND CERTAIN CARDIAC EVENTS. THE NON-REIMBURSED COST OF PROVIDING EDUCATION AND RESOURCES WAS APPROXIMATELY $27,508. ENHANCE HUMAN CAPITAL HEALTH OCCUPATIONS THE HEALTH OCCUPATIONS PROGRAM PROVIDES AREA HIGH SCHOOL STUDENTS WITH THE OPPORTUNITY TO LEARN MORE ABOUT HEALTHCARE. THE COLLABORATIVE PROGRAM RUNS THROUGHOUT THE SCHOOL YEAR, PROVIDES JOB SHADOWING FOR STUDENTS AND FREQUENT INTERACTION WITH PRACTICING PROFESSIONALS. STUDENTS GRADUATE WITH A CERTIFIED NURSE ASSISTANT CERTIFICATE. THE NON-REIMBURSED COST OF PROVIDING CLASSROOM SPACE FOR TRAINING WAS $25,986. CREATE HEALTHY COMMUNITIES COMMUNITY AID SBLHC ASSISTED MISSIONS IN VARIOUS AREAS AND LOCAL PROJECTS WITH HEALTHCARE NEEDS BY DONATING MEDICAL SUPPLIES AND EQUIPMENT. THE COST WAS APPROXIMATELY $232,811. ORGANIZATIONAL SUPPORT (CASH AND IN-KIND GIFTS) BEING A GOOD NEIGHBOR MEANS SUPPORTING THE EFFORTS OF LOCAL AND REGIONAL ORGANIZATIONS WITH SIMILAR MISSIONS. THE HEALTH SYSTEM GAVE DIRECT FINANCIAL SUPPORT, STAFF TIME, THE USE OF HEALTH CENTER FACILITIES, AND OTHER RESOURCES IN EXCESS OF $106,229 TO COMMUNITY ORGANIZATIONS AND/OR PROJECTS, INCLUDING BUT NOT LIMITED TO: -COLES COUNTY DIAL-A-RIDE, A SERVICE THAT TRANSPORTS LOCAL RESIDENTS TO THEIR PHYSICIANS' OFFICES -AMERICAN HEART ASSOCIATION HEART WALK, TO SUPPORT CARDIOVASCULAR RESEARCH -AMERICAN CANCER SOCIETY'S RELAY FOR LIFE, TO SUPPORT CANCER RESEARCH -COLES COUNTY 4-H AUCTION, TO SUPPORT EDUCATION -HOPE HOUSE, HOMELESS SHELTERS AND FOOD PANTRIES, AN AREA SCHOOL THROUGH OUR ADOPT-A-SCHOOL PROGRAM TO SUPPORT EDUCATION, MULTIPLE SPORTS TEAMS IN CHARLESTON, MATTOON, NEOGA, AND CASEY TO HELP FOSTER ACTIVE LIFESTYLES IN OUR YOUTH -YMCA RUN FOR BAGEL, TO SUPPORT HEALTH AND TOURISM -CHARLESTON COMMUNITY THEATRE, TO SUPPORT THE ARTS -AMERICAN DIABETES ASSOCIATION WALK, TO SUPPORT RESEARCH -MARCH OF DIMES WALK, TO SUPPORT RESEARCH -HABITAT FOR HUMANITY, TO HELP BUILD AFFORDABLE, QUALITY HOMES -VARIOUS COMMUNITY FESTIVALS, TO SUPPORT FITNESS AND TOURISM -PEACEMEAL, TO DELIVER MEALS TO THE COMMUNITIES
FORM 990, PART III, LINE 4A: [CONTINUED] WE ALSO LEND SUPPORT TO COLES COUNTY UNITED WAY, ROTARY INTERNATIONAL, CCAR INDUSTRIES, COLES TOGETHER, COLES COMMUNITY HEALTH PLAN, AREA CHAMBERS OF COMMERCE, AND OTHER AGENCIES BY PARTICIPATING IN THEIR FUNDRAISING EVENTS, BOARDS AND COMMITTEES. IN ADDITION, SBLHC SUPPORTS A WIDE VARIETY OF SCHOOL ACTIVITIES BY SPONSORING PROGRAMS AND NEWSLETTERS SO STUDENTS HAVE A MORE FULFILLING SCHOOL EXPERIENCE. HEALTHY KIDS IN OUR SEVEN COUNTY SERVICE AREA THERE ARE APPROXIMATELY 9,000 CHILDREN WHO ARE CONSIDERED OVERWEIGHT OR OBESE. THAT IS AROUND 36%! (THE NATIONAL AVERAGE IS CLOSER TO 32%) OVERWEIGHT ADOLESCENTS HAVE A 70% CHANCE OF BECOMING OVERWEIGHT ADULTS. THIS INCREASES TO 80% IF ONE OR BOTH PARENTS ARE OVERWEIGHT OR OBESE. 70% OF OBESE YOUTH HAVE AT LEAST ONE RISK FACTOR FOR CARDIOVASCULAR DISEASE. THAT'S WHY WE CREATED OUR HEALTHY KIDS PROGRAMS; WE WANTED TO SEE THIS NUMBER DECREASE. WE WANT TO SEE KIDS LIVE HEALTHY LONG LIVES. THE MISSION OF THE HEALTHY KIDS PROGRAM IS "BRINGING AWARENESS TO FAMILIES IN OUR COMMUNITY ABOUT CHILDHOOD OBESITY AND PROMOTE HEALTHY LIFESTYLE CHOICES." OVER THE YEARS OUR HEALTHY KIDS PROGRAMS HAVE GROWN TO SERVE APPROXIMATELY 5,000 STUDENTS EACH MONTH. IN FY 2023, WE PROVIDED EDUCATIONAL EXPERIENCES TO 46,157 STUDENTS. (SOME STUDENTS ARE REPEATED VISITS EACH MONTH.) THE COST OF THIS PROGRAM TO SBLHC IS $165,579. SPORTS PHYSICALS ORTHOPEDIC SURGEONS AND FAMILY PRACTICE PHYSICIANS PARTNER WITH AREA SCHOOLS TO PROVIDE SPORTS PHYSICALS FOR ATHLETES. STUDENTS PAY $20 PER PHYSICAL, A FEE THAT IS THEN DONATED TO THEIR SCHOOLS' BOOSTER CLUBS BY SBLHC. SOME 648 SPORTS PHYSICALS WERE PROVIDED AT A COST OF $12,960. MAINTAIN FINANCIAL VIABILITY FINANCIAL ASSISTANCE TRADITIONAL CHARITY CARE COVERS SERVICES PROVIDED TO PERSONS WHO CANNOT AFFORD TO PAY FOR THEIR HEALTHCARE. THE HEALTH SYSTEM PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER THE FINANCIAL ASSISTANCE POLICIES WITHOUT CHARGE OR AT AMOUNTS LESS THAN THEIR ESTABLISHED RATES. EFFECTIVE JANUARY 1, 2005, THE HEALTH SYSTEM ADOPTED A NEW CHARITY CARE POLICY THAT SIGNIFICANTLY EXPANDED THE AVAILABILITY OF FINANCIAL ASSISTANCE FOR PATIENTS OF THE SYSTEM. THE POLICY GIVES FINANCIAL ASSISTANCE IN SOME CASES AT FOUR TIMES THE FEDERAL POVERTY GUIDELINES. THE AMOUNT OF CHARGES FOREGONE FOR SERVICES AND SUPPLIES FURNISHED WAS $10,959,000 FOR THE YEAR AND THE COST OF THOSE SERVICES AFTER CONTRIBUTIONS AND OTHER DIRECT ASSISTANCE WAS $2,646,051. IN FY 2023, 1,701 PEOPLE RECEIVED FINANCIAL ASSISTANCE. GOVERNMENTAL INSURANCE PROGRAM UNPAID COST OF PUBLIC PROGRAMS FOR TREATING MEDICARE, MEDICAID, AND OTHER GOVERNMENTAL PROGRAMS IN EXCESS OF GOVERNMENT PAYMENTS WAS $56,475,545 DURING THE YEAR.
FORM 990, PART VI, SECTION A, LINE 2 JERRY ESKER, KIM UPHOFF, JOHN LAUER, DIDI OMIYI, DWIGHT PENTZIEN AND LUCAS CATT HAVE BUSINESS RELATIONSHIPS WITH EACH OTHER AS A RESULT OF ALL SERVING AS BOARD MEMBERS OF SBL ACO, A FOR-PROFIT AFFILIATE OF THE ORGANIZATION. ALL MEMBERS OF THE HEALTH CENTER BOARD HAVE DUAL MEMBERSHIP WITH THE HEALTH SYSTEM BOARD.
FORM 990, PART VI, SECTION A, LINE 6 THE SOLE CORPORATE MEMBER OF THE ORGANIZATION IS SARAH BUSH LINCOLN HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7A BOARD MEMBERS WILL AID IN THE SELECTION FOR THE NOMINATION OF NEW BOARD MEMBERS WHEN VACANCIES OCCUR OR WHEN TERMS WILL EXPIRE, BUT THE FINAL APPROVAL OF THE CANDIDATES IS MADE BY THE SOLE MEMBER OF THE CORPORATION, SARAH BUSH LINCOLN HEALTH SYSTEM.
FORM 990, PART VI, SECTION A, LINE 7B THE SARAH BUSH HEALTH SYSTEM BOARD, THE SOLE MEMBER OF THE HEALTH CENTER BOARD, RETAINS CERTAIN RESERVED POWERS INCLUDING; AMENDING ARTICLES OF INCORPORATION OR BYLAWS, APPROVING THE ANNUAL OPERATING BUDGET AND LONG RANGE STRATEGIC PLAN, APPROVAL OF ANY TRANSACTIONS REQUIRING A CERTIFICATE OF NEED, APPROVAL OF THE BORROWING OF FUNDS AND INCURRING DEBT, APPROVAL OF MERGERS, CONSOLIDATIONS, SALE, OF ALL OR SUBSTANTIALLY ALL ASSETS, SELECTING AUDITORS, CREATING OR ACQUIRING SUBSIDIARY OR AFFILIATE CORPORATIONS, DISSOLVING THE CORPORATION, APPOINTING, EVALUATING AND REMOVAL OF PRESIDENT/CEO, AND ELECTING BOARD MEMBERS.
FORM 990, PART VI, SECTION B, LINE 11B THE SENIOR ACCOUNTING STAFF REVIEWS ALL ELEMENTS OF THE 990 BASED ON PRIOR KNOWLEDGE AND INTERVIEWS WITH OTHER INDIVIDUALS IN THE ORGANIZATION. IN ADDITION, BOARD MEMBERS SUBMIT DETAILED QUESTIONNAIRES WITH REGARDS TO THEIR RELATIONSHIPS WITH THE ORGANIZATION. THE FINAL FORM 990 IS MADE AVAILABLE TO THEM ONLINE VIA A WEB PORTAL AND AT THEIR BOARD MEETING FOR REVIEW AND QUESTIONS PRIOR TO SUBMITTING TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12C MEMBERS OF THE BOARD OF DIRECTORS ANNUALLY COMPLETE A CERTIFICATION STATEMENT WHICH IDENTIFIES POSSIBLE CONFLICTS OF INTEREST RELATED TO THEIR PROFESSIONAL AND PERSONAL LIVES. DURING DELIBERATIONS AND DECISIONS ON WHICH THERE APPEARS TO BE A CONFLICT OF INTEREST, THE BOARD MEMBER IS EXCUSED FROM THE DISCUSSION AND DELIBERATION, SHALL NOT VOTE ON, NOR USE HIS PERSONAL INFLUENCE ON OR BE COUNTED IN DETERMINING THE EXISTENCE OF A QUORUM IN RESPECT TO THE TRANSACTION OR CONTRACT.
FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS DETERMINED FOR THE PRESIDENT & CEO, VP MEDICAL AFFAIRS, VP FINANCE, VP OPERATIONS, VP PRACTICE MANAGEMENT, VP PATIENT CARE SERVICES, VP INFORMATION SERVICES, VP HUMAN RESOURCES, AND THE VP SURGICAL SERVICES BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THE COMMITTEE IS COMPRISED OF MEMBERS OF THE SBL BOARD. AN INDEPENDENT CONSULTANT, HAY GROUP, INC., REVIEWED CURRENT COMPENSATION FOR EACH POSITION AND COMPARED IT TO SIMILAR POSITIONS IN LIKE ORGANIZATIONS. THE COMMITTEE APPROVED COMPENSATION CONSISTENT WITH THE BOARD-APPROVED EXECUTIVE COMPENSATION PHILOSOPHY. THIS PROCESS IS DONE ANNUALLY, BETWEEN JUNE AND AUGUST, FOR ALL THE LISTED POSITIONS.
FORM 990, PART VI, SECTION C, LINE 19 FINANCIAL STATEMENTS, GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART XII, LINE 2C, OVERSIGHT OF AUDIT: THE SOLE CORPORATE MEMBER ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF THE FINANCIAL STATEMENTS AND SELECTION OF THE INDEPENDENT ACCOUNTANT; AND NO PROCESSES HAVE CHANGED FROM PRIOR YEAR.
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:  
SCHEDULE R
(Form 990)
Department of the Treasury
Internal Revenue Service
Related Organizations and Unrelated Partnerships
MediumBulletComplete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBulletAttach 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
SARAH BUSH LINCOLN HEALTH CENTER
 
Employer identification number

23-7098532
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?
Yes No
(1)SARAH BUSH LINCOLN HEALTH SYSTEM
1000 HEALTH CENTER DRIVE

MATTOON,IL61938
37-1136714 		PARENT COMPANY IL 501(C)(3) LINE 12B, II N/A
 
No
(2)SARAH BUSH LINCOLN HEALTH CENTER FOUNDATION
1000 HEALTH CENTER DRIVE

MATTOON,IL61938
37-1136713 		FUNDRAISING IL 501(C)(3) LINE 12A, I SARAH BUSH LINCOLN HEALTH SYSTEM
 
 
No
(3)HEARTLAND HEALTH SYSTEM INC
1000 HEALTH CENTER DRIVE

MATTOON,IL61938
20-1890414 		HEALTHCARE IL 501(C)(3) LINE 3 SARAH BUSH LINCOLN HEALTH CENTER
 
Yes
 








For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50135Y
Schedule R (Form 990) 2021
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



 		(e)
Predominant income(related, unrelated, excluded from tax under sections 512-514)

(f)
Share of total income




 		(g)
Share of end-of-year
assets



 		(h)
Disproprtionate allocations?




 		(i)
Code V-UBI
amount in box 20 of
Schedule K-1
(Form 1065)
 		(j)
General or
managing
partner?



 		(k)
Percentage
ownership
Yes No Yes 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?
Yes No
(1) SARAH BUSH LINCOLN CAPTIVE INSURANCE

18 FORUM LANE 2ND FLOOR PO BOX 69
GEORGE TOWN    
CJ
INSURANCE CJ N/A
 C         No
(2) SBL PRACTICE ACQUISITIONS INC

1000 HEALTH CENTER DRIVE
MATTOON,IL61938
82-4716884 		MANAGEMENT IL N/A
 C         No
(3) BONUTTI ORTHOPEDIC SVCS INC

1303 W EVERGREEN AVE
EFFINGHAM,IL62401
37-1257387 		HEALTHCARE IL N/A
 C         No








Schedule R (Form 990) 2021
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
No
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 .....................
1a
 
No
b Gift, grant, or capital contribution to related organization(s) ............................
1b
 
No
c Gift, grant, or capital contribution from related organization(s) ............................
1c
Yes
 
d Loans or loan guarantees to or for related organization(s) ............................
1d
 
No
e Loans or loan guarantees by related organization(s) ............................
1e
 
No
f Dividends from related organization(s) ............................
1f
 
No
g Sale of assets to related organization(s) ............................
1g
 
No
h Purchase of assets from related organization(s) ............................
1h
 
No
i Exchange of assets with related organization(s) ............................
1i
 
No
j Lease of facilities, equipment, or other assets to related organization(s) .......................
1j
 
No
k Lease of facilities, equipment, or other assets from related organization(s) ......................
1k
 
No
l Performance of services or membership or fundraising solicitations for related organization(s) .....................
1l
 
No
m Performance of services or membership or fundraising solicitations by related organization(s) .................
1m
 
No
n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................
1n
 
No
o Sharing of paid employees with related organization(s) ............................
1o
 
No
p Reimbursement paid to related organization(s) for expenses ............................
1p
 
No
q Reimbursement paid by related organization(s) for expenses ............................
1q
 
No
r Other transfer of cash or property to related organization(s) ............................
1r
 
No
s Other transfer of cash or property from related organization(s) ............................
1s
 
No
2
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) SARAH BUSH LINCOLN HEALTH CENTER FOUNDATION

 C 1,501,916 BOOK VALUE





Schedule R (Form 990) 2021
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) 		(d)
Predominant income (related, unrelated, excluded from tax under sections 512-514)

(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
Yes No Yes No Yes No






























Schedule R (Form 990) 2021
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


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