2024-07-17T13:27:43-05:00 2023-09-30 450250958 Eide Bailly LLP 800 Nicollet Mall Ste 1300 Minneapolis MN 554027033 990 2022-10-01 371211780 Illinois Valley Community Hospital Foundation ILLI 8156641328 600 E First Street Spring Valley IL 61362 Timothy A Muntz President & CEO 8156641328 2024-07-09 1 Timothy Muntz 999009999 1 Mayumi Stella P00970938 6122536500 2024-07-08 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z X Timothy A Muntz 600 E First Street Spring Valley IL 61362 153354 0 X www.aboutsmh.org X 1986 IL Provide financial support for St. Margaret's Health - Peru and its related health services. 3 0 0 0 0 0 12925 21025 0 0 93640 132329 0 0 106565 153354 7500 2999388 0 0 0 0 0 0 0 3726 2532 11226 3001920 95339 -2848566 3115509 313782 89755 0 3025754 313782 None 0 0 2999388 2999388 The Illinois Valley Community Hospital Foundation's goal is to raise funds where they're needed most. Gifts create a lasting impact for the community by helping to continually improve St. Margaret's Health - Peru's hospital and clinics, as well as provide the dedicated physicians and nurses with progressive technology and equipment needed to continually deliver extraordinary care. The Foundation also helps reimburse for some of the hundreds of thousands of dollars of uncompensated medical care the hospital delivers each year. 2999388 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 X 3 0 0 0 0 0 1 1 1 1 0 0 0 0 1 1 1 1 1 0 0 0 IL X Lisa Lynch 8156641328 600 E First Street Spring Valley IL 61362 Timothy A Muntz Chair/President & CEO 1.00 60.00 X X 0 575673 55573 Lisa Lynch VP Finance 1.00 60.00 X X 0 237738 25938 Kim Santman Director 1.00 0.00 X 0 132575 6877 Tommy Hobbs Former VP Operations 0.00 0.00 X 0 284242 47818 0 1230228 136206 0 1 1 0 0 21025 21025 35699 35699 96630 0 96630 96630 96630 153354 0 0 132329 2999388 2999388 2500 2500 32 32 3001920 2999388 2532 0 120125 44282 25459 25459 0 0 2995384 269500 3115509 313782 89755 0 89755 0 X 2292889 33532 732865 280250 3025754 313782 3115509 313782 -2848566 136594 0 X 0 0 0 X X X 3 St Margaret's Health - Peru 362852553 3 1 2999388 0 St Margaret's Health - Spring Valley 362167884 3 1 0 0 Sisters of Mary of the Presentation Health Ministry 813757471 1 1 0 0 3 2999388 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 Schedule A, Part IV, Section A, Line 1: The supported organizations are Sisters of Mary of the Presentation Health Ministry (Ministry), St. Margaret's Health - Peru, and St. Margaret's Health - Spring Valley and a class of other supported entities affiliated with Ministry. The Ministry, St. Margaret's Health - Peru, and St. Margaret's Health - Spring Valley are listed in the governing documents by name and the class of organizations are listed based on affiliation with Ministry. Specifically, the class is defined as other not-for-profit organizations controlled by or affiliated with the Sisters of Mary of the Presentation Health Ministry that are exempt as organizations described in Section 501(c)(3) of the Code and described in either Section 509(a)(1) or Section 509(a)(2) of the Code. Schedule A, Part IV, Section A, Line 2: Sisters of Mary of the Presentation Health Ministry is organized as a canonical public juridic person. Sisters of Mary of the Presentation Health Ministry does not have a determination letter from the IRS. The organization falls under the tax exemption of the US Conference of Catholic Bishops (USCCB) and the organization appears in the OCD (Official Catholic Directory). The organization has the USCCB Group Ruling letter and is listed in the OCD. The Organization is considered a tax exempt 501(c)(3) organization under the USCCB. Form 990, Schedule A, Part IV, Line 5a: St. Margaret's Health - Spring Valley and St. Margaret's Health - Peru filed for bankruptcy and ceased operations during the fiscal year. Schedule A, Part IV, Section B, Line 1: IV HealthCorp, Inc., the sole member, has exclusive authority to elect and remove, with or without cause, the Board of Directors of the Foundation or any member of the Board of Directors. Sisters of Mary of the Presentation Health Ministry is the parent organization of IV HealthCorp, St. Margaret's Health - Spring Valley, and St. Margaret's Health - Peru. St. Margaret's Health is a regional parent and appoints the board of IV HealthCorp and St. Margaret's Health - Spring Valley. IV HealthCorp is the sole member of St. Margaret's Health - Peru as it has authority to appoint the board. Therefore, IV HealthCorp has substantial management and authority over the supported organizations. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25459 25459 0 0 1 St Margaret's Health - Peru 925 W St Peru IL 61354 362852553 501(c)(3) 2999388 0 Operational support 1 0 Part I, Line 2: St. Margaret's Health - Peru is a supported organization of Illinois Valley Community Hospital Foundation. The Foundation's mission is to support the Hospital. Funds were transferred to the Hospital for operational support. The board had a close working relationship ensuring funds were used appropriately. 0 1 0 0 0 0 0 0 0 Timothy A Muntz Chair/President & CEO 0 484000 0 48258 0 43415 0 30499 0 27405 0 633577 0 0 Tommy Hobbs Former VP Operations 0 246742 0 31500 0 6000 0 25020 0 24342 0 333604 0 0 Lisa Lynch VP Finance 0 237738 0 0 0 0 0 9030 0 21581 0 268349 0 0 Part I, Line 3 Illinois Valley Community Hospital Foundation does not pay compensation to the President & CEO. This individual is compensated by Sisters of Mary of the Presentation Health System, a related organization, for services to a related hospital. Sisters of Mary of the Presentation Health System uses one or more of the methods on Part I, question 3 to determine compensation. Part I, Line 4b SMP Health has a nonqualified deferred compensation plan that complies with Section 409A of the IRC. SMP Health begins contributions into the plan after the employee's first year of service. The employee is vested based on a 20 year vesting schedule or becomes fully vested in the event of death, disability or reaching the age of 65. Employee name and amounts included on Schedule J are as follows: Name Part II, column B (iii) Part II, column (c) Timothy A. Muntz 37,415 Tommy Hobbs 11,298 Form 990, Part VI, Section A, line 6 The sole member of the Corporation is IV HealthCorp, Inc. Form 990, Part VI, Section A, line 7a IV HealthCorp, Inc., the sole member, has exclusive authority to elect and remove, with or without cause, the Board of Directors of the Corporation or any member of the Board of Directors. Form 990, Part VI, Section A, line 7b The authority to act on the following matters shall be exclusively vested in the Member, and no recommendation of the Board with respect to such matters shall be final or effective and until it is approved by the Member: (a) To establish, approve, or modify the philosophy, vision, values and mission according to which the Corporation operates; (b) To lease, sell, encumber or otherwise alienate any real property or interest in real property of the Corporation; (c) To approve any transfer, lease, sale or encumbrance of personal property of the Corporation except in the ordinary course of business; (d) To approve any purchase or other acquisition by the Corporation that is not included in its operating and capital budgets and exceeds $100,000.00; (e) To approve any borrowing or debt financing on behalf of the Corporation, to structure and restructure indebtedness of the Corporation, and to enter into and amend agreements relating to indebtedness of the Corporation; (f) To require a certified audit of the finances of the Corporation and to appoint the certified public accountant to perform any audit; (g) To approve the engagement of and to dismiss any outside legal counsel to represent the Corporation on a regular basis or in connection with any matter deemed by Member to have significance for the Member and/or its affiliates; (h) To elect and remove, with or without cause, the board of directors of the Corporation or any member of the board of directors of the Corporation; (i) To merge or consolidate the Corporation with other entities, to merge other entities into the Corporation, or to dissolve the Corporation, in accordance with applicable law; (j) To amend the bylaws and Articles of Incorporation of the Corporation in accordance with applicable law; (k) To expand, consolidate, terminate or close any of the facilities and services of the Corporation; (l) To hire, appoint, enter into an employment contract with, discipline, remove or terminate the Corporation President/Chief Executive Officer and to appoint and remove the Corporation Chairperson, Vice Chairperson, Secretary and Chief Financial Officer; (m) To approve strategic plan and management objectives for the Corporation, which will be developed by the Corporation and recommended to Member; (n) To adopt or modify the operating budget and capital budget for any fiscal year for the Corporation, which will be developed by the Corporation and recommended to Member; (o) To give preliminary approval prior to the development of, and to give final approval prior to the execution of, all documents to which the Corporation will be a party to joint ventures and other affiliations with third parties, and approve the creation, formation, organization, or termination of any legal entity in which the Corporation will have any ownership interest, membership interest, power to elect or appoint board members or officers, or any other formal participation arrangement, whether acting alone or in conjunction with any other person or entity; (p) To approve appointments to governing bodies of joint ventures between the Corporation and third parties and other legal entities in which the Corporation has any power to elect or appoint board members or officers; and (q) To take any and all actions deemed necessary, in the sole judgment of the Member, to protect and preserve the tax-exempt status and public charity status of the Member and any tax-exempt affiliate of the Member (including federal and state income tax exemptions, property tax exemptions, and sales tax exemptions); provided the Member has given a written request to the Corporation to take action or refrain from taking action, which would have sufficiently protected and preserved such tax-exempt and public charity status, and the Corporation has failed to promptly take such action or refrain from taking such action. Form 990, Part VI, Section A, line 8b The Foundation does not have committees with authority to act on behalf of the governing body. Form 990, Part VI, Section B, line 11b The VP of Finance reviews the 990 prior to submission to the IRS. The final version of the Form 990 is e-mailed or hand delivered to each board member for their review to answer questions regarding the 990 after submission. Form 990, Part VI, Section B, line 12c The officers and directors of Illinois Valley Community Hospital Foundation are covered under the conflict of interest policy and have a duty to disclose actual or possible conflicts of interest. All persons covered under the policy are required to annually complete a conflict of interest questionnaire and disclose any interest that could give rise to conflicts. Transactions with covered persons, or entities in which a covered person has any type of interest, must be an arms length transaction. The board of directors will review any transactions in question and determine if a conflict exists. The interested person may make a presentation, but must leave the meeting during discussion of, and the vote on, the transaction. If a conflict of interest exists, the board of directors may appoint a disinterested person or committee to investigate alternatives to the proposed transaction, determine if there's a more advantageous transaction that would not give rise to a conflict, or vote to determine if the transaction is in the foundation's best interest and whether it is fair and reasonable. If the board of directors has reasonable cause to believe that a member has failed to disclose a possible conflict of interest, the board will inform the member of the basis of such belief and afford the member an opportunity to explain. Further investigation maybe be warranted, and the board shall take appropriate disciplinary and corrective action as needed. Form 990, Part VI, Section C, line 19 The organization makes its governing documents, conflict of interest policy and financial statements available to the public upon request. Sisters of Mary of the Presentation Health Ministry 1202 Page Drive SW Fargo ND 58106 320617468 Supports SMP Health and the related entities ND Canonical Entity N/A 0 Sisters of Mary of the Presentation Health System dba SMP Health 1202 Page Drive SW Fargo ND 58103 450359620 Support related ND Catholic Health Care System ND 501(c)(3) Line 12a, I SMP Health Ministry 0 St Aloisius Medical Center dba SMP Health - St Aloisius 325 E Brewster St Harvey ND 58341 450226729 Provision of health care services ND 501(c)(3) Line 3 SMP Health 0 St Andrew's Health Center dba SMP Health - St Andrew's 316 Ohmer St Bottineau ND 58318 450226426 Provision of health care services ND 501(c)(3) Line 3 SMP Health 0 St Andrew's Hospital Foundation dba SMP Health St Andrew's Foundation Inc 316 Ohmer St Bottineau ND 58318 450413201 Support SMP Health - St. Andrew's ND 501(c)(3) Line 12a, I SMP Health 0 Presentation Medical Center dba SMP Health - St Kateri 213 2nd Ave NE Rolla ND 58367 450227391 Provision of health care services ND 501(c)(3) Line 3 SMP Health 0 Sisters of Mary of the Presentation Prairieland Home Care dba Prairieland H 1102 Page Drive SW Fargo ND 58106 450391192 Home health and supportive services ND 501(c)(3) Line 10 SMP Health 0 Sisters of Mary of the Presentation Long Term Care dba SMP Health - Long Te 1202 Page Drive SW Fargo ND 58106 752999939 Provide extended care and medically related services ND 501(c)(3) Line 10 SMP Health 0 St Margaret's Hospital Foundation 600 E 1st St Spring Valley IL 61362 364042262 Support SMP Health - St. Margaret's IL 501(c)(3) Line 12a, I SMP Health 0 SMP Illinois Region Health System dba St Margaret's Health 600 E 1st St Spring Valley IL 61362 842023121 Support related Illinois health care entities IL 501(c)(3) Line 12a, I SMP Health 0 IV HealthCorp Inc 925 W St Peru IL 61354 371211890 Support SMP affiliated entities IL 501(c)(3) Line 12a, I St Margaret's Health 0 St Margaret's Health - Spring Valley 600 E 1st St Spring Valley IL 61362 362167884 Provision of health care services IL 501(c)(3) Line 3 St Margaret's Health 0 St Margaret's Health - Peru 925 W St Peru IL 61354 362852553 Provision of health care services IL 501(c)(3) Line 3 IV HealthCorp Inc 0 Valley Health Enterprises Inc 925 W St Peru IL 61354 363476877 Home medical equipment IL N/A C 0 SMP Enterprises PO Box 10007 Fargo ND 58106 363486506 Collection Agency ND N/A C 0 Illinois Valley Health Services Inc 925 W St Peru IL 61354 364050682 Inative IL N/A C 0 IVCH General Professional Liab Loss Fund 925 W St Peru IL 61354 366673231 Inactive IL N/A T 0 Health Care Building Corp 925 W St Peru IL 61354 363306917 Inactive IL N/A C 0 0 1 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 Form 990, Schedule R, Part II: The following organizations ceased operations during 2023. St. Margaret's Health - Spring Valley St. Margaret's Health - Peru Prairieland Home Care, Inc.