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Nonprofiteer
← PEKIN MEMORIAL HOSPITAL

Form 990 for tax year 2022

Filed by PEKIN MEMORIAL HOSPITAL.

Totals

Total revenue
$59,332,218
Total expenses
$50,719,915
Contributions and grants received
$2,901,070
Grants paid
$7,740
Program service revenue
$55,465,168
Investment income
$110,846
Other revenue
$855,134
Total assets, end of year
$58,132,827
Total liabilities, end of year
$21,951,841
Net assets or fund balances, end of year
$36,180,986
Program services expenses (Part IX)
$48,569,400
Management and general expenses
$2,150,515
Fundraising expenses
$0
Program service expenses (Part III)
$48,569,400

Program services were 95.8% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $288,904

  • 1e · Government grants (contributions)

    $710,322

  • 1f · All other contributions, gifts and grants

    $1,901,844

  • 2a · Program service revenue: NET PATIENT REVENUE

    total $55,465,168 · related or exempt $55,465,168

  • 3 · Investment income

    total $308,375 · excluded $308,375

  • 7a · Gross sales of assets other than inventory

    other assets $150,754

  • 7b · Less cost or other basis and sales expenses

    securities $331,294 · other assets $16,989

  • 7c · Gain or loss

    securities -$331,294 · other assets $133,765

  • 7d · Net gain or loss

    total -$197,529 · excluded -$197,529

  • 11a · Other revenue: SHARED SAVINGS REVENUE

    total $495,036 · related or exempt $495,036

  • 11b · Other revenue: CAFETERIA/FOOD SVCS

    total $253,646 · related or exempt $33,031 · excluded $220,615

  • 11c · Other revenue: MISCELLANEOUS

    total $106,452 · related or exempt $106,452

  • 11e · Other revenue, total

    $855,134

Functional expenses

Part IX, the statement of functional expenses.

  • 2 · Grants to domestic individuals

    total $7,740 · program services $7,740

  • 6 · Compensation of disqualified persons

    total $48,232 · management and general $48,232

  • 7 · Other salaries and wages

    total $19,188,397 · program services $17,614,297 · management and general $1,574,100

  • 8 · Pension plan contributions

    total $586,458 · program services $538,349 · management and general $48,109

  • 9 · Other employee benefits

    total $2,383,138 · program services $2,187,640 · management and general $195,498

  • 10 · Payroll taxes

    total $1,163,317 · program services $1,067,885 · management and general $95,432

  • 11a · Fees: management

    total $5,453,000 · program services $5,453,000

  • 11b · Fees: legal

    total $56,962 · management and general $56,962

  • 11f · Fees: investment management

    total $34,886 · program services $7,350 · management and general $27,536

  • 11g · Fees: other

    total $4,296,996 · program services $4,289,764 · management and general $7,232

  • 12 · Advertising and promotion

    total $115 · program services $84 · management and general $31

  • 13 · Office expenses

    total $743,864 · program services $714,820 · management and general $29,044

  • 16 · Occupancy

    total $855,091 · program services $855,040 · management and general $51

  • 17 · Travel

    total $3,423 · program services $2,849 · management and general $574

  • 19 · Conferences, conventions and meetings

    total $2,496 · program services $1,997 · management and general $499

  • 20 · Interest

    total $402,236 · program services $402,236

  • 22 · Depreciation, depletion and amortization

    total $2,508,567 · program services $2,454,896 · management and general $53,671

  • 23 · Insurance

    total $1,143,931 · program services $1,140,042 · management and general $3,889

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $5,463,120 · program services $5,452,862 · management and general $10,258

  • 24b · Other expenses: MEDICAID PROVIDER ASSES

    total $3,558,814 · program services $3,558,814

  • 24c · Other expenses: MISCELLANEOUS EXPENSE

    total $2,820,442 · program services $2,819,735 · management and general $707

  • 24d · Other expenses: INCOME TAXES

    total -$1,310 · management and general -$1,310

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $8,305,279 · end of year $2,804,958

  • 2 · Savings and temporary cash investments

    beginning of year $3,822,827 · end of year $2,067,260

  • 4 · Accounts receivable

    beginning of year $6,809,938 · end of year $7,492,876

  • 7 · Other notes and loans receivable

    beginning of year $15,577,927 · end of year $17,218,683

  • 8 · Inventories for sale or use

    beginning of year $1,440,646 · end of year $1,551,113

  • 9 · Prepaid expenses and deferred charges

    beginning of year $157,067 · end of year $495,465

  • 10a · Land, buildings and equipment: cost or other basis

    $97,235,503

  • 10b · Land, buildings and equipment: accumulated depreciation

    $72,404,158

  • 10c · Land, buildings and equipment, net

    beginning of year $25,209,950 · end of year $24,831,345

  • 11 · Investments: publicly traded securities

    beginning of year $8,726,474 · end of year $1,671,127

  • 17 · Accounts payable and accrued expenses

    beginning of year $3,273,031 · end of year $3,311,541

  • 19 · Deferred revenue

    beginning of year $4,242,184

  • 24 · Unsecured notes and loans payable

    beginning of year $5,923,134 · end of year $107

  • 25 · Other liabilities

    beginning of year $21,213,908 · end of year $18,640,193

  • 27 · Net assets without donor restrictions

    beginning of year $35,397,851 · end of year $36,180,986

Mission and programs · 2022

Mission

TO IMPROVE THE HEALTH AND WELL-BEING OF OUR COMMUNITY AND TO DO SO WITH LOVE, COMPASSION AND EXTRAORDINARY MEDICAL CARE.

Activities or mission (Part I)

IMPROVE HEALTH AND WELL-BEING OF COMMUNITY WITH LOVE, COMPASSION AND EXTRAORDINARY MEDICAL CARE.

  • HEALTH-CARE SERVICESPEKIN MEMORIAL HOSPITAL IS AN IMPORTANT ELEMENT OF THE HEALTH-CARE DELIVERY SYSTEM THAT THE PEKIN, ILLINOIS AND SURROUNDING COMMUNITIES RELY ON EVERY DAY. IT IS COMMITTED TO PROVIDING QUALITY HEALTH CARE AND TO USING ITS RESOURCES TO THE GREATEST COMMUNITY BENEFIT. PEKIN MEMORIAL HOSPITAL PROVIDES INPATIENT AND OUTPATIENT MEDICAL SERVICES TO TREAT INDIVIDUALS WITH DISEASES, ILLNESS AND INJURIES WITH VARYING COMPLEXITIES. IT PROVIDES SERVICES TO IMPROVE THE HEALTH OF PATIENTS AND TO BETTER THEIR QUALITY OF LIFE. ALL SERVICES ARE PROVIDED REGARDLESS OF AN INDIVIDUAL'S RACE, CREED, SEX, NATIONALITY, HANDICAP, AGE OR ABILITY TO COMPENSATE FOR SERVICES RENDERED. THESE INCLUDE, BUT ARE NOT LIMITED TO, GENERAL ACUTE CARE, SURGERIES, INTENSIVE CARE AND CRITICAL CARE AND EMERGENCY SERVICES. SOME OF THE SERVICES PROVIDED DO NOT GENERATE ENOUGH INCOME TO OFFSET THEIR COST. IN THE FISCAL PERIOD ENDED DECEMBER 31, 2022, PEKIN MEMORIAL HOSPITAL ADMITTED 1,660 PATIENTS RESULTING IN A TOTAL OF 8.346 PATIENT DAYS. OUTPATIENT VISITS TOTALED 60,679 AND TOTAL OUTPATIENT SURGERY REGISTRATIONS FOR THE SAME PERIOD WERE 1,319. THERE WERE ALSO 25,442 EMERGENCY ROOM VISITS.

    Expenses $45,672,279 · Revenue $56,099,687

  • COMMUNITY BENEFIT, INCLUDING CHARITY CARECHARITY CARE AND MEANS-TESTED PROGRAMS: PEKIN MEMORIAL HOSPITAL PROVIDES CHARITY CARE AND OTHER MEANS-TESTED PROGRAMS WITH THE GOAL TO IMPROVE THE COMMUNITY'S OVERALL HEALTH AND ACCESS TO CARE. THIS INCLUDES HEALTH-CARE SERVICES REGARDLESS OF THE PATIENT'S INSURANCE COVERAGE OR FINANCIAL STATUS. CHARITY CARE AND PARTIAL TO FULL FINANCIAL ASSISTANCE IS PROVIDED TO PATIENTS ON A CASE-BY-CASE BASIS. CHARITY CARE WAS MADE AVAILABLE AT A VALUE OF $209,102 IN 2022. OFTENTIMES, PEKIN MEMORIAL HOSPITAL RECEIVES PAYMENTS FROM PAYORS OR PATIENTS THAT ARE LESS THAN IT CHARGES FOR SERVICES. PEKIN MEMORIAL HOSPITAL PARTICIPATES IN MEDICAID AND OTHER GOVERNMENT-SPONSORED HEALTH-CARE PROGRAMS. PEKIN MEMORIAL HOSPITAL'S NET COST OF PROVIDING CARE FOR WHICH IT RECEIVES PAYMENT BELOW ITS COST IS $2,371,505 FOR 2022. TOTAL CHARITY CARE AND MEANS-TESTED PROGRAMS REPORTED VALUE: $2,580,607.OTHER BENEFITS: PEKIN MEMORIAL HOSPITAL PROVIDES SEVERAL OTHER BENEFITS THAT ASSIST THE COMMUNITY. PROGRAMS MAY INCLUDE, BUT ARE NOT LIMITED TO, COMMUNITY HEALTH IMPROVEMENT SERVICES AND COMMUNITY BENEFIT OPERATIONS SUCH AS PREVENTION AND HEALTH SCREENINGS; CONTINUING EDUCATION FOR HEALTH PROFESSIONALS; SUBSIDIZED HEALTH SERVICES; RESEARCH; AND CASH AND IN-KIND CONTRIBUTIONS TO COMMUNITY GROUPS. PEKIN MEMORIAL HOSPITAL COLLABORATES WITH OTHER HOSPITALS, CHURCHES, SCHOOLS, CHAMBERS OF COMMERCE AND DAYCARE CENTERS TO IMPROVE COMMUNITY HEALTH AND EXPAND ACCESS TO HEALTH CARE. PEKIN MEMORIAL HOSPITAL HAS DEDICATED STAFF TO ASSIST COMMUNITY BENEFIT EFFORTS. TOTAL OTHER BENEFITS REPORTED VALUE: $316,514.

    Expenses $2,897,121 · Grants $7,740

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Kevin Barbier

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Jerry Bell PhD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Ronald Champagne MD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Jenna Cicciarelli-Wiesner

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Amy Darling

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Rusty Dunn

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Peter Johnsen PhD

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Aaron Kilgore

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Keith Knepp MD

    BOARD MEMBER/PRESIDENT & CEO

    Total calculated
    $883,163
    From this org
    $0
    From related orgs
    $739,283
    Other
    $143,880
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $554,435 related
    Bonus
    $0 + $167,497 related
    Other
    $0 + $17,351 related
    Deferred
    $0 + $116,984 related
    Nontaxable benefits
    $0 + $26,896 related
    Filer's total
    $0 + $883,163 related

  • Rich Kriegsman

    BOARD VICE CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • David Mueller

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Dirk Roecker

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Jamie Stevenson

    BOARD MEMBER

    Total calculated
    $11,000
    From this org
    $0
    From related orgs
    $11,000
    Other
    $0
    Hours/week
    1 + 1 related

  • Karen Stumpe

    BOARD MEMBER

    Total calculated
    $2,500
    From this org
    $0
    From related orgs
    $2,500
    Other
    $0
    Hours/week
    1 + 1 related

  • Dennis Triggs

    BOARD MEMBER

    Total calculated
    $11,000
    From this org
    $0
    From related orgs
    $11,000
    Other
    $0
    Hours/week
    1 + 1 related

  • John Wieland

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • Melissa Yoder

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    1 + 1 related

  • John Peters

    SECRETARY/TREASURER/CFO

    Total calculated
    $482,395
    From this org
    $0
    From related orgs
    $445,945
    Other
    $36,450
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $352,914 related
    Bonus
    $0 + $81,201 related
    Other
    $0 + $11,830 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $21,200 related
    Filer's total
    $0 + $482,395 related

  • Jeanine Spain

    VP COO & CNE

    Total calculated
    $566,343
    From this org
    $0
    From related orgs
    $530,763
    Other
    $35,580
    Hours/week
    1 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $361,894 related
    Bonus
    $0 + $86,457 related
    Other
    $0 + $82,412 related
    Deferred
    $0 + $15,250 related
    Nontaxable benefits
    $0 + $20,330 related
    Filer's total
    $0 + $566,343 related

  • Sarah Daly

    REGISTERED NURSE ER

    Total calculated
    $137,901
    From this org
    $124,872
    From related orgs
    $0
    Other
    $13,029
    Hours/week
    40

  • Destiny Hart

    NURSING SUPERVISOR

    Total calculated
    $179,347
    From this org
    $143,627
    From related orgs
    $0
    Other
    $35,720
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $112,355
    Bonus
    $28,171
    Other
    $3,101
    Deferred
    $7,519
    Nontaxable benefits
    $28,201
    Filer's total
    $179,347

  • Ashokkumar Patel

    PHARMACIST

    Total calculated
    $170,620
    From this org
    $147,648
    From related orgs
    $531
    Other
    $22,441
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $145,395 + $531 related
    Bonus
    $2,193
    Other
    $60
    Deferred
    $7,557 + $28 related
    Nontaxable benefits
    $14,804 + $52 related
    Filer's total
    $170,009 + $611 related

  • Matthew Reeb

    PHARMACIST

    Total calculated
    $171,019
    From this org
    $144,409
    From related orgs
    $0
    Other
    $26,610
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $143,877
    Bonus
    $442
    Other
    $90
    Deferred
    $5,646
    Nontaxable benefits
    $20,964
    Filer's total
    $171,019

  • Kaitlyn Szmania

    PHARMACIST

    Total calculated
    $146,065
    From this org
    $129,695
    From related orgs
    $0
    Other
    $16,370
    Hours/week
    40

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4B
NONQUALIFIED RETIREMENT PLAN CONTRIBUTIONS: THE FOLLOWING INDIVIDUAL(S) PARTICIPATED IN AND RECEIVED CONTRIBUTIONS IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN: KEITH KNEPP, MD $101,734.

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • ADVANCED IMAGING CENTER LLC

    DIAGNOSTIC RADIOLOGY CENTER · IA · general or managing partner

  • ANKENY MEDICAL PARK SURGERY CENTER LC

    AMBULATORY SURGERY CENTER · IA · general or managing partner

  • CENTRAL IOWA CARDIOVASCULAR CO-MANAGEMENT CO LLC

    CARDIOVASCULAR MANAGEMENT & ADMINISTRATIVE SERVICES · IA · general or managing partner

  • CENTRAL IOWA ONCOLOGY CO-MANAGEMENT COMPANY

    ONCOLOGY MANAGEMENT & ADMINISTRATIVE SERVICES · IA · general or managing partner

  • CENTRAL IOWA PHYSIO LLC

    PHYSICAL THERAPY SERVICES · IA · general or managing partner

  • CENTRAL IOWA SURGICAL SERVICES CO-MANAGEMENT CO LLC

    SURGICAL MANAGEMENT & ADMINISTRATIVE SERVICES · IA · general or managing partner

  • DUBUQUE ENDOSCOPY CENTER LC

    AMBULATORY SURGERY CENTER · IA · general or managing partner

  • EASTERN IOWA SLEEP SUPPLY LLC

    MEDICAL EQUIPMENT RETAIL SALES · IA · general or managing partner

  • HEALTH CARE AFFILIATES OF THE TRI-STATES LLC

    PROVIDE ACCESS TO LICENSED SOFTWARE · IA · general or managing partner

  • IOWA DIAGNOSTIC IMAGING AND PROCEDURE CENTER LC

    OUTPATIENT DIAGNOSTIC IMAGING · IA · general or managing partner

  • IOWA HEALTH SYSTEM CONTRACTING SERVICES LC

    GROUP PURCHASING · IA · general or managing partner

  • LAKEVIEW SURGERY CENTER LC

    SURGERY CENTER · IA · general or managing partner

  • MR ASSOCIATES LLP

    OWN AND OPERATE MR UNIT · IA · general or managing partner

  • ORTHOPAEDIC OUTPATIENT SURGERY CENTER LC

    AMBULATORY SURGERY CENTER · IA · general or managing partner

  • REHABILITATION THERAPY SERVICES LLC

    REHABILATION THERAPY · IL · general or managing partner

  • THE OUTPATIENT SURGERY CENTER OF CEDAR RAPIDS LLC

    AMBULATORY SURGERY CENTER. · IA · general or managing partner

  • UNITED MEDICAL PARK ASC LLC DBA THE SURGERY CENTER AT UNITED MEDICAL PARK

    AMBULATORY SURGERY CENTER · IA · general or managing partner

  • UPHT-SCA HOLDINGS LLC

    AMBULATORY SURGERY CENTER INVESTMENT · DE

  • WEST HOSPITAL ORTHOPEDIC CO-MANAGEMENT COMPANY LLC

    ORTHOPEDIC SERVICE LINES MANAGEMENT · IA · general or managing partner

  • WEST LAKES SLEEP CENTER LLC

    SLEEP DISORDER DIAGNOSTIC TESTING FACILITY · IA · general or managing partner

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

  • ABBE MANAGEMENT CORPORATION

    C · MANAGEMENT SERVICES · IA

  • BELCREST SERVICES LTD

    C · MEDICAL SERVICES · IL

  • BROADBAND INC

    C · INFORMATION TECHNOLOGY MGMT. · IA

  • DELHI POINT CONDO ASSOCIATION

    C · REAL ESTATE MANAGEMENT · IA

  • HCP CORPORATION

    C · REAL ESTATE RENTAL · WI

  • HANSEN CHARITABLE REMAINDER ANNUITY TRUST

    T · INVESTMENT · IA

  • HANSEN CHARITABLE REMAINDER UNITRUST

    T · INVESTMENT · IA

  • HEALTH ADVANTAGE PLUS INC

    C · PHYSICAL THERAPY · IA

  • HEALTH PLUS INC

    C · MANAGED CARE ADMINISTRATION · IL

  • HNC SERVICES

    C · FIBER OPTIC NETWORK SERVICES · IA

  • MEDIMORE INC

    C · MANAGED CARE · IA

  • MERITER HEALTH ENTERPRISES INC

    C · MANAGEMENT SERVICES · WI

  • MERITER MANAGEMENT SERVICES INC

    C · ADMINISTRATIVE SERVICES · WI

  • METHODIST HEALTH VENTURES INC & SUB

    C · PHARMACY/OFFICE STAFFING · IL

  • OPTIMUM HEALTH SOLUTIONS INC

    C · HEALTH & WELLNESS CONSULTING · IA

  • PEKIN PROHEALTH INC

    C · CLINIC · IL

  • PRECEDENCE INC

    C · MANAGED MENTAL CARE · IA

  • PRECEDENCE PLUS INC

    C · MANAGED MENTAL CARE · IA

  • PROVIDER RESOURCE MANAGEMENT INC

    C · RESOURCE MANAGEMENT · IL

  • STL HEALTH RESOURCES CO

    C · PHYSICIAN OFFICE RENTAL · IA

  • TRINITY HEALTH ENTERPRISES INC

    C · RETAIL DURABLE MEDICAL EQUIPMENT & PHARMACY · IL

Provenance

Return type
form_990
Tax year
2022
Filed
8 November 2023
IRS schema version
2022v5.0
Source object
202313189349307551

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