Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (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 | |||||
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Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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 | ||||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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.) | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2020 | (b) 2021 | (c) 2022 | (d) 2023 | (e) 2024 | (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.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 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) |
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| 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): |
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| 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 | ||||
| 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 2024 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-2024 |
(iii) Distributable Amount for 2024 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2024 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2024 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2024: | ||||
| a From 2019....... | ||||
| b From 2020....... | ||||
| c From 2021....... | ||||
| d From 2022....... | ||||
| e From 2023....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2024 distributable amount | ||||
|
i
Carryover from 2019 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2024 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2024 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2024, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2024. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2025. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2020..... | ||||
| b Excess from 2021..... | ||||
| c Excess from 2022..... | ||||
| d Excess from 2023..... | ||||
| e Excess from 2024..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4A | ILLINI COMMUNITY HOSPITAL TREATED PATIENTS THROUGH THE FOLLOWING SERVICES DURING FISCAL YEAR 2025: INPATIENT ADMISSIONS 456 OBSERVATION ADMISSIONS 222 OUTPATIENT VISITS 2,236 TOTAL SURGERIES 313 EMERGENCY VISITS 6,146 LABORATORY TESTS 73,222 RESPIRATORY TREATMENTS 1,345 RADIOLOGY PROCEDURES 10,278 REHAB THERAPY PROCEDURES 2,748 OTHER OUTPATIENT PROCEDURES 4,241 RURAL HEALTH CLINIC & XPRESS VISITS 22,945 IN ADDITION TO THESE HEALTHCARE SERVICES, ILLINI COMMUNITY HOSPITAL PROVIDED 320,999 IN CHARITY CARE AND INCURRED MEDICARE SHORTFALLS OF 96,715. THE HOSPITAL PROVIDED ADDITIONAL BENEFITS DURING FISCAL YEAR 2025 AS FOLLOWS: 1)HEALTH PROFESSIONALS EDUCATION - 3,352 COLLEGE SCHOLARSHIPS PRECEPTORS/CLINICAL ROTATIONS 2)IN-KIND CONTRIBUTIONS AND DONATIONS - 18,225 ICAHN PIKE CEO PCCEDC TWO RIVERS FOOD PROCESSING COUNTY FAIRS AND OTHER LOCAL EVENTS/ORGANIZATIONS 3)COMMUNITY HEALTH IMPROVEMENT PROGRAMS AND SERVICES - 55,608 WEEKLY WELLNESS INFORMATION TRANSPORT VANS CHARITY PRESCRIPTIONS PATIENT SERVICES FOOD DISTRIBUTIONS VOLUNTEER SERVICE HOURS |
| FORM 990, PART VI | BLESSINGCARE CORPORATION (BCC) CONTRACTS WITH BLESSING CORPORATE SERVICES, INC.(BCS) TO EXECUTE THE DUTIES NORMALLY PERFORMED BY MANAGEMENT. BCS'S MANAGEMENT TEAM CARRIES OUT MANY OF THE GOVERNING DECISIONS OF BCS (AS SOLE MEMBER) AND BCC'S BOARD OF TRUSTEES, SIMILAR TO THE ROLE AND FUNCTIONS OF AN EMPLOYEE-OFFICER. BCS PAID COMPENSATION TO VARIOUS EMPLOYEES COLLECTIVELY ACTING AS MANAGEMENT. THE COMPENSATION PAID TO THOSE EMPLOYEES IS DISCLOSED ON PART VII. |
| FORM 990, PAGE 6, PART VI, LINE 3 | IN ORDER TO ACHIEVE COST EFFICIENCIES, BLESSINGCARE CORPORATION (BCC) AND ITS SOLE MEMBER, BLESSING CORPORATE SERVICES, INC. (BCS), HAVE ENTERED INTO AN INTERCOMPANY MANAGEMENT SERVICES AGREEMENT WHEREBY BCS PROVIDES MANAGEMENT SERVICES TO BCC. IN ADDITION, MANAGEMENT OF BCC IS VESTED BY THE ARTICLES OF INCORPORATION AND BYLAWS IN BCS AS BCC'S SOLE MEMBER, SUBJECT TO OVERSIGHT BY AND ADVICE FROM BCC'S BOARD OF TRUSTEES. |
| FORM 990, PAGE 6, PART VI, LINE 4 | THE BYLAWS OF BLESSINGCARE CORPORATION WERE AMENDED AND RESTATED ON DECEMBER 19, 2024. THE CORPORATION'S BYLAWS WERE AMENDED TO PROVIDE THAT BLESSING CORPORATE SERVICES, INC. (BCS), AS THE SOLE MEMBER OF THE CORPORATION, WILL MANAGE THE CORPORATION; ITS RIGHTS AND RESPONSIBILITIES INCLUDE, BUT ARE NOT LIMITED TO: A. APPOINTING AND REMOVING TRUSTEES AND THE PRESIDENT B. APPROVING ALL AMENDMENTS TO THE ARTICLES AND BYLAWS C. APPROVING BUDGETS, SALES AND PURCHASES, AND CONTRACTS D. MAKING INVESTMENT DECISIONS E. SELECTING AUDITORS AND LEGAL COUNSEL F. APPROVING CHARITY CARE AND COMMUNITY BENEFIT-RELATED POLICIES G. MAKING OTHER BUSINESS DECISIONS AND TAKING OTHER BUSINESS ACTIONS BLESSINGCARE CORPORATION'S BOARD RETAINS AN OVERSIGHT AND ADVISORY ROLE. FURTHER, THE CORPORATION'S SEPARATE OPERATIONS AND FINANCE COMMITTEE WAS ELIMINATED; THE CORPORATION'S BOARD CHAIR MAY APPOINT ONE OR MORE TRUSTEES TO SERVE ON BLESSING HEALTH SYSTEM-WIDE COMMITTEES; AND THE CONFLICTS OF INTEREST AND INDEMNIFICATION PROVISIONS WERE UPDATED TO CONFORM TO THE POLICIES AND PRACTICES OF BCS AS THE SOLE MEMBER. THERE WERE OTHER NON- SUBSTANTIVE CHANGES TO NOMENCLATURE AND PROCEDURAL MEETING MATTERS. BLESSINGCARE CORPORATION'S ARTICLES OF INCORPORATION WERE AMENDED TO CONFORM TO THE FOREGOING CHANGES. |
| FORM 990, PAGE 6, PART VI, LINE 6 | BLESSING CORPORATE SERVICES, INC., AN ILLINOIS NOT FOR PROFIT CORPORATION, IS THE SOLE VOTING MEMBER OF BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL. |
| FORM 990, PAGE 6, PART VI, LINE 7A | BLESSING CORPORATE SERVICES, INC., THE SOLE VOTING MEMBER OF BLESSINGCARE CORPORATION (CORPORATION), SHALL POSSESS THE EXCLUSIVE RIGHTS AND RESPONSIBILITIES TO APPOINT AND/OR REMOVE ALL THE TRUSTEES OF THE CORPORATION AND THE CORPORATION'S PRESIDENT. |
| FORM 990, PAGE 6, PART VI, LINE 7B | BLESSING CORPORATE SERVICES, INC., THE SOLE VOTING MEMBER OF BLESSINGCARE CORPORATION (CORPORATION), SHALL POSSESS THE EXCLUSIVE RIGHTS AND RESPONSIBILITIES TO: A. APPROVE EXPRESSLY ALL AMENDMENTS TO THE CORPORATION'S ARTICLES OF INCORPORATION AND BYLAWS BEFORE THEY MAY BECOME EFFECTIVE; B. APPROVE AND OVERSEE CAPITAL AND OPERATING BUDGETS, LONG-TERM DEBT, LONG-RANGE PLANS, THE SALE OR PURCHASE OF REAL ESTATE, AND CONTRACTS ENTERED INTO BY THE CORPORATION, THE REASONABLE VALUE OF WHICH EXCEEDS AN AMOUNT SET FORTH IN THE BYLAWS OF THE VOTING MEMBER; C. APPROVE MATERIAL INVESTMENT DECISIONS, INCLUDING WITHOUT LIMITATION ESTABLISHMENT AND MODIFICATION OF INVESTMENT POLICIES, ENGAGEMENT AND REMOVAL OF INVESTMENT MANAGERS AND ADVISORS, AND CHANGES IN INVESTMENT ALLOCATIONS NOT PERMITTED BY AN EXISTING INVESTMENT POLICY; D. APPROVE THE PARAMETERS FOR TERMS OF EMPLOYMENT OF PROVIDERS, INCLUDING PROVIDER COMPENSATION PLANS, AND ANY MATERIAL VARIANCES FROM SUCH PARAMETERS FOR INDIVIDUAL PROVIDERS; E. APPROVE THE SELECTION OF AUDITORS AND LEGAL COUNSEL AND OVERSEE AUDITS; F. APPROVE THE FORMATION OF SUBSIDIARY ENTITIES AND/OR JOINT VENTURES; G. APPROVE THE FILING OF A PETITION IN BANKRUPTCY, MAKING AN ASSIGNMENT FOR THE BENEFIT OF CREDITORS, OR APPLYING FOR PROTECTION UNDER ANY INSOLVENCY LAWS; H. APPROVE THE PARTICIPATION IN ANY MERGER, COMBINATION, CONSOLIDATION, LIQUIDATION, DISSOLUTION, OR OTHER CORPORATE OR BUSINESS ENTITY RESTRUCTURING; I. ENACT AND IMPLEMENT SUCH POLICIES AND PROCEDURES AS THE MEMBER DEEMS NECESSARY OR ADVISABLE FOR THE MANAGEMENT OF THE CORPORATION; J. COMPEL THE CORPORATION'S BOARD, OFFICERS, AND AGENTS TO ENFORCE AND/OR PERFORM ANY CONTRACTUAL OR OTHER OBLIGATIONS AND/OR TAKE ANY ACTION THE MEMBER DEEMS NECESSARY OR ADVISABLE FOR THE MANAGEMENT OF THE CORPORATION; K. APPROVE THE DEVELOPMENT, IMPLEMENTATION, MONITORING, AND REPORTING ON THE COMMUNITY BENEFITS PLANS, PROGRAMS, AND OTHER ACTIVITIES OF THE CORPORATION, INCLUDING, BUT NOT LIMITED TO, THE COMMUNITY NEEDS ASSESSMENT; L. APPROVE ADVOCACY EFFORTS ON BEHALF OF PATIENTS, THE COMMUNITY, AND THE CORPORATION REGARDING THE ALLOCATION OF EXTERNAL AND INTERNAL RESOURCES TO THE COMMUNITY HEALTH NEEDS; M. DETERMINE TRUSTEE COMPENSATION, IF ANY. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FOLLOWING MANAGEMENT AND LEGAL REVIEW, THE FORM 990 WAS PROVIDED TO THE BOARD OF TRUSTEES OF BLESSINGCARE CORPORATION DBA ILLINI COMMUNITY HOSPITAL FOR REVIEW AND COMMENT PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | A COPY OF THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO BE READ, SIGNED, AND RETURNED TO THE ORGANIZATION. THE SIGNED POLICIES ARE RETAINED IN THE CORPORATE ADMINISTRATIVE FILES. IN ADDITION, EACH OFFICER, DIRECTOR, OR TRUSTEE IS REQUIRED TO DECLARE ANY CONFLICT OF INTEREST IN REGARDS TO AGENDA ITEMS BEING PRESENTED AT THE START OF EACH BOARD MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THESE DOCUMENTS ARE LOCATED IN THE CORPORATE ADMINISTRATIVE OFFICE AND ARE AVAILABLE UPON REQUEST FOR PUBLIC INSPECTION. |
| Software ID: | |
| Software Version: |