SWEDISHAMERICAN HOSPITAL: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
SWEDISHAMERICAN HOSPITAL (EIN 36-2222696)
Tax period
2019-07-01 to 2020-06-30
Filed
2021-08-16
IRS object ID
202112289349302741
Schema version
2019v5.2
Note
A later return for the same period supersedes this one.
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2021-08-16T13:23:36-05:00ReturnTs
Tax Period End2020-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line130 South Wacker Dr Ste 3300AddressLine1Txt
CityChicagoCityNm
State AbbreviationILStateAbbreviationCd
ZIP606063392ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362222696EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SwedishAmerican HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSWEDBusinessNameControlTxt
Phone7796964727PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11401 East State StreetAddressLine1Txt
CityRockfordCityNm
State AbbreviationILStateAbbreviationCd
ZIP611042298ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPatricia DeWanePersonNm
Person TitleChief Financial OfficerPersonTitleTxt
Phone7796964727PhoneNum
Signature2021-08-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRebekuh EleyPreparerPersonNm
PTINP01247672PTIN
Phone3126343400PhoneNum
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnYes (X)AmendedReturnInd
Principal OfficerThomas O'ConnorPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11313 East State StreetAddressLine1Txt
CityRockfordCityNm
State AbbreviationILStateAbbreviationCd
ZIP61104ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$638,871,717GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.swedishamerican.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1911FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionThrough excellence in healthcare and compassionate service, we care for our community.ActivityOrMissionDesc
Voting Members Governing Body23VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee4027TotalEmployeeCnt
Total Volunteers262TotalVolunteersCnt
Total Gross UBI$230,622TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$20,193NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$928,787PYContributionsGrantsAmt
CY Contributions Grants$2,157,310CYContributionsGrantsAmt
PY Program Service Revenue$606,746,310PYProgramServiceRevenueAmt
CY Program Service Revenue$616,063,023CYProgramServiceRevenueAmt
PY Investment Income$15,060,969PYInvestmentIncomeAmt
CY Investment Income$12,572,317CYInvestmentIncomeAmt
PY Other Revenue$6,037,255PYOtherRevenueAmt
CY Other Revenue$6,233,212CYOtherRevenueAmt
PY Total Revenue$628,773,321PYTotalRevenueAmt
CY Total Revenue$637,025,862CYTotalRevenueAmt
PY Grants And Similar Paid$413,463PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$254,495CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$287,735,495PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$298,560,801CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$306,895,628PYOtherExpensesAmt
CY Other Expenses$328,861,070CYOtherExpensesAmt
PY Total Expenses$595,044,586PYTotalExpensesAmt
CY Total Expenses$627,676,366CYTotalExpensesAmt
PY Revenues Less Expenses$33,728,735PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,349,496CYRevenuesLessExpensesAmt
Total Assets BOY$927,080,480TotalAssetsBOYAmt
Total Assets EOY$973,707,288TotalAssetsEOYAmt
Total Liabilities BOY$403,241,239TotalLiabilitiesBOYAmt
Total Liabilities EOY$446,467,974TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$523,839,241NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$527,239,314NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThrough excellence in healthcare and compassionate service, we care for our community.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$363,517,614ExpenseAmt
Grant$254,495GrantAmt
Revenue$402,711,866RevenueAmt
DescSwedishAmerican Hospital (SAH) operates two full service acute care hospitals with a combined total of 383 licensed beds serving the greater Rockford region, Northern Illinois and Southern Wisconsin. Our vision is to develop a fully integrated healthcare delivery network that will continuously set the standard for quality care and service, accept responsibility for building a healthier population, provide regional access, improve resource utilization through collaboration with key stakeholders, and manage patient care and our resources in such a way that we create value for our patients and benefit for our community. During 2020, we cared for 14,469 inpatients and performed 1,121,453 outpatient procedures. This includes 69,882 emergency room visits and 1,635 deliveries. We sponsor the University of Illinois - College of Medicine Program and provided $4.9 million in education for primary care residents. Our employees and volunteers provided near 19,000 hours in unpaid community services. SwedishAmerican recognizes its responsibility to all the people of our community, regardless of their ability to pay for care.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$108,964,824ExpenseAmt
Grant$0GrantAmt
Revenue$159,016,180RevenueAmt
DescSwedishAmerican Hospital employs primary care and specialty physicians who practice at 34 locations throughout our service area. We employ specialists in orthopedics, cardiology, cardiothoracic surgery, endocrinology, allergy, neurology, neurosurgery, pulmonology/critical care, hematology/oncology, obstetrics and gynecology, maternal fetal medicine, rheumatology, psychiatry, podiatry, otolaryngology, as well as internal medicine, family practice, immediate care and pediatric physicians. During 2020, our physician encounters were 388,407.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$44,501,270ExpenseAmt
Grant$0GrantAmt
Revenue$54,200,215RevenueAmt
DescSwedishAmerican Regional Cancer Center opened to the public in October 2013 and has been providing leading edge cancer care treatment for the Rock River Valley. The center is part of a collaborative with UW Health and its nationally recognized University of Wisconsin Carbone Cancer Center. The two-story facility offers radiation therapy, medical oncology, chemotherapy and infusion services. Patients have access to clinical trials, state-of-the-art linear acceleratory treatments such as IGRT, IMRT, Rapid Arc, OBI and stereotactic services, and advanced medical imaging. The Regional Cancer Center is staffed by medical and radiation oncologists, physicists, dosimetrists, radiation therapists and nurses. During 2020, our out-patient encounters were over 25,681.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$7,839,349ExpenseAmt
Grant$0GrantAmt
Revenue$6,148,772RevenueAmt
DescSwedishAmerican Home Health Care is a quality leader in providing individualized care in patients' homes. Working in partnership with a patient's doctor, our certified, trained staff provides a wide range of services and specializes in helping patients to remain independent and comfortable. Our experienced caregivers include registered nurses; certified nursing assistants, dietitians; physical, occupational and speech therapists; and medical social workers. RNs provide assessments, treatments and medication administration and patient education/teaching. Our therapists provide assessments and treatments. Medical social workers assist with assessments, counseling and helping patients and their families' access available community resources. CNAs provide baths and personal grooming. Our staff has the credentials and advanced training needed to assure that patients receive the highest quality of care possible. During 2020, we recorded 24,119 visits.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$7,839,349TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$6,148,772TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$524,823,057TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit TransYes (1)EngagedInExcessBenefitTransInd
PY Excess Benefit TransYes (1)PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document306IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee4027EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtYes (1)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members23GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint VentureYes (1)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (1)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonPatricia DeWanePersonNm
Phone7796964727PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11313 East State StreetAddressLine1Txt
CityRockfordCityNm
State AbbreviationILStateAbbreviationCd
ZIP61104ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (37 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndKey EmployeeKeyEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Elizabeth Bolt
Trustee2.0055.00Yes (X)$0$1,418,724$166,226
Michael J Born MD
President & CEO (until 10/29/19)40.006.00Yes (X)$1,001,213$0$45,198Yes (X)
Jateen Patel MD
Physician40.000.00$944,414$0$36,234Yes (X)
Mohamed Zeater MD
Physician40.000.00$870,089$0$56,542Yes (X)
Tarek Harb MD
Physician40.000.00$796,031$0$56,775Yes (X)
Gayatri Sonti DO
Physician40.000.00$750,504$0$35,369Yes (X)
Ann Gantzer MD
Chief Nursing Officer40.000.00$663,137$0$103,096Yes (X)
Michael E Dallman
UW RDI Rep. (until 6/22/20)2.0055.00Yes (X)$0$647,480$109,548
Yaser Siraj MD
Physician40.000.00$708,094$0$22,274Yes (X)
Patricia DeWane
Chief Financial Officer40.008.00$576,411$0$61,347Yes (X)
William Cunningham MD
Medical Staff 1st Vice President40.000.00Yes (X)$567,868$0$44,685
Donald Daniels
VP & Chief Operating Officer40.008.00$466,333$0$106,594Yes (X)
Michael Polizzotto MD
Chief Medical Officer/CMIO40.000.00$470,873$0$78,467Yes (X)
Allen D Williams MD
Trustee40.006.00Yes (X)$301,163$0$56,909
Thomas Schiller MD
Former Chief Clinical Integ. Off.0.000.00$318,004$0$35,926Yes (X)
Tiffanie Ferry MD
Trustee40.006.00Yes (X)$210,724$0$42,838
Jennifer Maher
Interim President & CEO40.006.00Yes (X)$80,589$0$151Yes (X)
Mark Cormier MD
Medical Staff Past President2.000.00Yes (X)$13,000$0$0
Steven Ikenberry MD
Medical Staff President2.000.00Yes (X)$6,500$0$0
William C Roop
Chairman of the Board2.006.00Yes (X)$0$0$0Yes (X)
Jeffrey J Kaney Sr
1st Vice Chairman/Secretary2.006.00Yes (X)$0$0$0Yes (X)
Daniel T Ross
2nd Vice Chairman/Asst.Secretary2.006.00Yes (X)$0$0$0Yes (X)
Rev Dr Kenneth Board
2nd Vice Chairman (until 9/1/19)2.006.00Yes (X)$0$0$0Yes (X)
Thomas R Walsh
Audit/Compliance Chairman2.006.00Yes (X)$0$0$0
Patrick Derry
Quality and Safety Chairman2.006.00Yes (X)$0$0$0
Marco T Lenis
Chairman of HR Committee2.006.00Yes (X)$0$0$0
Amy J Wilcox
Trustee2.006.00Yes (X)$0$0$0
David R Rydell
Trustee (until 10/3/19)2.006.00Yes (X)$0$0$0
Eric Fulcomer PhD
Trustee2.006.00Yes (X)$0$0$0
Frank E Walter
Trustee2.008.00Yes (X)$0$0$0
Gregory R Jury
Trustee2.008.00Yes (X)$0$0$0
Helen Chung Hill
Trustee2.006.00Yes (X)$0$0$0
Jeffrey S Hultman
Trustee2.006.00Yes (X)$0$0$0
Michael K Broski
Trustee2.006.00Yes (X)$0$0$0
Steven C Sjogren
Trustee2.008.00Yes (X)$0$0$0
Kathleen Kelly MD
Trustee2.006.00Yes (X)$0$0$0
Anqunette Parham
Trustee2.006.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,744,947TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,066,204TotReportableCompRltdOrgAmt
Total Other Compensation$1,058,179TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K376IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Ringland Johnson Construction
1725 Huntwood DriveCherry ValleyIL61016Construction Services$29,313,718
Scandroli Construction Company
823 North Madison StreetRockfordIL61107Construction Services$12,115,475
University of Illinois
28394 Network PlaceChicagoIL60673Physician Services$4,930,474
Schmeling Construction
315 Harrison AvenueRockfordIL61104Construction Services$4,923,101
Sound Physicians of Illinois
401 S Lasalle StreetChicagoIL60605Physician Services$3,834,298
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K120CntrctRcvdGreaterThan100KCnt
Related Organizations$1,413,247RelatedOrganizationsAmt
Government Grants$744,063GovernmentGrantsAmt
Total Contributions$2,157,310TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Services621990$387,383,107$387,383,107
Medicare/Medicaid621990$214,676,094$214,676,094
CARES Act Revenue900099$11,928,647$11,928,647

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,075,175TotalRevenueColumnAmt
Related Or Exempt Func Income$2,075,175RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$616,063,023TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,443,603TotalRevenueColumnAmt
Exclusion$8,443,603ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$3,961RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$15,381RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real-$11,420RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column-$11,420TotalRevenueColumnAmt
Exclusion-$11,420ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,627,198SecuritiesAmt
Other$331,990OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$1,722,318SecuritiesAmt
Other$108,156OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$3,904,880SecuritiesAmt
Other$223,834OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,128,714TotalRevenueColumnAmt
Exclusion$4,128,714ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Day Care Center624410$1,668,122$1,668,122
Interdept. Billing561000$1,339,209$1,339,209
Cafeteria & Vending722514$1,299,407$1,290,791$8,616

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,937,894TotalRevenueColumnAmt
Related Or Exempt Func Income$1,715,888RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$222,006UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$6,244,632OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$637,025,862TotalRevenueColumnAmt
Related Or Exempt Func Income$622,077,033RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$230,622UnrelatedBusinessRevenueAmt
Exclusion$12,560,897ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$242,495TotalAmt
Program Services$242,495ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$12,000TotalAmt
Program Services$12,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$7,560,395TotalAmt
Program Services$1,107,600ProgramServicesAmt
Management And General$6,452,795ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$400,649TotalAmt
Program Services$232,941ProgramServicesAmt
Management And General$167,708ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$230,559,249TotalAmt
Program Services$193,716,275ProgramServicesAmt
Management And General$36,842,974ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$9,593,594TotalAmt
Program Services$1,117,955ProgramServicesAmt
Management And General$8,475,639ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$35,053,879TotalAmt
Program Services$28,074,179ProgramServicesAmt
Management And General$6,979,700ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$15,393,035TotalAmt
Program Services$12,839,149ProgramServicesAmt
Management And General$2,553,886ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$422,576TotalAmt
Management And General$422,576ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$232,875TotalAmt
Management And General$232,875ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$119,573TotalAmt
Management And General$119,573ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$514,506TotalAmt
Management And General$514,506ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$44,338,333TotalAmt
Program Services$35,603,500ProgramServicesAmt
Management And General$8,734,833ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,438,571TotalAmt
Program Services$55,989ProgramServicesAmt
Management And General$2,382,582ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,915,025TotalAmt
Program Services$3,988,040ProgramServicesAmt
Management And General$2,926,985ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$7,682,916TotalAmt
Program Services$1,546,859ProgramServicesAmt
Management And General$6,136,057ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$18,773,946TotalAmt
Program Services$14,388,556ProgramServicesAmt
Management And General$4,385,390ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$242,219TotalAmt
Program Services$177,785ProgramServicesAmt
Management And General$64,434ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$331,326TotalAmt
Program Services$111,870ProgramServicesAmt
Management And General$219,456ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,690,770TotalAmt
Program Services$1,720,909ProgramServicesAmt
Management And General$969,861ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$24,237,308TotalAmt
Program Services$20,431,187ProgramServicesAmt
Management And General$3,806,121ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,665,578TotalAmt
Program Services$2,742,783ProgramServicesAmt
Management And General$3,922,795ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Patient Supplies$105,644,149$103,964,241$1,679,908
Bad Debts$69,772,185$69,772,185
IPA Provider Tax$20,904,024$20,904,024
UBI Tax Expense$86,000$86,000

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$16,849,190TotalAmt
Program Services$12,072,535ProgramServicesAmt
Management And General$4,776,655ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$627,676,366TotalAmt
Program Services$524,823,057ProgramServicesAmt
Management And General$102,853,309ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$54,385,312BOYAmt
EOY$97,707,394EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$77,871,483BOYAmt
EOY$56,586,593EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$9,974,419BOYAmt
EOY$10,710,309EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$10,703,505BOYAmt
EOY$11,448,658EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$518,952,913LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$121,892,037LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$356,402,094BOYAmt
EOY$397,060,876EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$17,137,505BOYAmt
EOY$23,007,677EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$255,730,451BOYAmt
EOY$265,847,805EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$4,893,255BOYAmt
EOY$4,738,682EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$139,982,456BOYAmt
EOY$106,599,294EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$927,080,480BOYAmt
EOY$973,707,288EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$72,174,763BOYAmt
EOY$86,591,974EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$235,758,501BOYAmt
EOY$234,244,199EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$95,307,975BOYAmt
EOY$125,631,801EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$403,241,239BOYAmt
EOY$446,467,974EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$514,170,379BOYAmt
EOY$518,480,740EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,668,862BOYAmt
EOY$8,758,574EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$523,839,241BOYAmt
EOY$527,239,314EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$927,080,480BOYAmt
EOY$973,707,288EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$9,349,496ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$4,270,759NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$1,678,664OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$119,573OtherActivitiesAmt
Total Lobbying Expenditures$119,573TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart II-B, Line 1:FormAndLineReferenceDesc
ExplanationPortions of the 2019/2020 Illinois Health and Hospital Association and American Hospital Association dues are used for lobbying: $59,573. A law firm was engaged to review legislation affecting hospitals: $60,000.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,189,894BeginningYearBalanceAmt
Contributions$10,679ContributionsAmt
Investment Earnings Or Losses-$13,961InvestmentEarningsOrLossesAmt
Other Expenditures$275,099OtherExpendituresAmt
End Year Balance$6,911,513EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,072,405BeginningYearBalanceAmt
Contributions$12,701ContributionsAmt
Investment Earnings Or Losses$320,291InvestmentEarningsOrLossesAmt
Other Expenditures$215,503OtherExpendituresAmt
End Year Balance$7,189,894EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,676,376BeginningYearBalanceAmt
Contributions$90,495ContributionsAmt
Investment Earnings Or Losses$632,791InvestmentEarningsOrLossesAmt
Other Expenditures$327,257OtherExpendituresAmt
End Year Balance$7,072,405EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$6,662,294BeginningYearBalanceAmt
Contributions$10,754ContributionsAmt
Investment Earnings Or Losses$480,152InvestmentEarningsOrLossesAmt
Other Expenditures$476,824OtherExpendituresAmt
End Year Balance$6,676,376EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$7,112,945BeginningYearBalanceAmt
Contributions$10,986ContributionsAmt
Investment Earnings Or Losses-$203,624InvestmentEarningsOrLossesAmt
Other Expenditures$258,013OtherExpendituresAmt
End Year Balance$6,662,294EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.62800BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.27900PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.09300TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgYes (1)EndowmentsHeldRelatedOrgInd
Related Org List Sch RYes (1)RelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,343,856OtherCostOrOtherBasisAmt
Book Value$9,343,856BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$284,830,415OtherCostOrOtherBasisAmt
Depreciation$38,330,305DepreciationAmt
Book Value$246,500,110BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,782,368OtherCostOrOtherBasisAmt
Depreciation$8,847,207DepreciationAmt
Book Value$12,935,161BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$192,675,128OtherCostOrOtherBasisAmt
Depreciation$71,825,556DepreciationAmt
Book Value$120,849,572BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,321,146OtherCostOrOtherBasisAmt
Depreciation$2,888,969DepreciationAmt
Book Value$7,432,177BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$397,060,876TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescBeneficial Interest in Investment PoolDesc
Book Value$265,847,805BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$265,847,805TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
Advance to American Restaurant Assoc. (ARA)$189,268
Interest In Net Assets of Recipient Organization$19,068,974
Due from Affiliated Organization$16,798,931
Insurance Recoveries Recievable$11,817,202
Bond Project Fund$58,724,919
FieldValueIRS element (for citing)
Total Book Value Other Assets$106,599,294TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Due to Third Party Payors$101,007,062
Reserve for Self Insurance$18,070,902
Deferred Compensation$5,160,626
Asbestos Retirement Obligation$143,211
Current Maturities of Long-term Debt$1,250,000
FieldValueIRS element (for citing)
Total Liability$125,631,801TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4:The Hospital's endowment consists of 12 Individual funds established for a variety of purposes. 1) Medical and Non-medical health improvement initiatives 2) Rehabilitation or orthopedic programming and services within the greater Rockford community 3) Oncology patient services 4) Educational materials for the families of oncology patients 5) Chaplaincy program including grief services and counseling 6) Cardiology services 7) Medical programs and care for children 8) Cardiac education for women 9) Ongoing support of surgical service and education of surgical technicians
Part X, Line 2:The Hospital has received a determination letter from the Internal Revenue Service (IRS) stating it is tax-exempt under Section 501(c)(3) of the Code. The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When this return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to hospitals include such matters as the following: tax-exempt status of each entity, the continued tax-exempt status of bonds issued by the obligated group, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business taxable income (UBTI). UBTI is reported on Internal Revenue Service Form 990-T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the tax position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with the tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. At June 30, 2020 and 2019, there were no unrecognized tax benefits identified or recorded as liabilities. The Forms 990 and 990-T filed by the Hospital are subject to examination for up to three years from the extended due date of each return. These returns are no longer subject to examination for tax years ended before June 30, 2017.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other600.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,834,363TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$2,834,363NetCommunityBenefitExpnsAmt
Total Expense0.00510TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$99,509,477TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$83,888,370DirectOffsettingRevenueAmt
Net Community Benefit Expns$15,621,107NetCommunityBenefitExpnsAmt
Total Expense0.02800TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,633,550TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$4,027,936DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,605,614NetCommunityBenefitExpnsAmt
Total Expense0.00290TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$107,977,390TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$87,916,306DirectOffsettingRevenueAmt
Net Community Benefit Expns$20,061,084NetCommunityBenefitExpnsAmt
Total Expense0.03600TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$296,016TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$296,016NetCommunityBenefitExpnsAmt
Total Expense0.00050TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$7,475,735TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,533,594DirectOffsettingRevenueAmt
Net Community Benefit Expns$4,942,141NetCommunityBenefitExpnsAmt
Total Expense0.00890TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$31,865,735TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$2,511,947DirectOffsettingRevenueAmt
Net Community Benefit Expns$29,353,788NetCommunityBenefitExpnsAmt
Total Expense0.05260TotalExpensePct

Research ResearchGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$434,413TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$434,413NetCommunityBenefitExpnsAmt
Total Expense0.00080TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$706,337TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$164,165DirectOffsettingRevenueAmt
Net Community Benefit Expns$542,172NetCommunityBenefitExpnsAmt
Total Expense0.00100TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$40,778,236TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$5,209,706DirectOffsettingRevenueAmt
Net Community Benefit Expns$35,568,530NetCommunityBenefitExpnsAmt
Total Expense0.06380TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$148,755,626TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$93,126,012DirectOffsettingRevenueAmt
Net Community Benefit Expns$55,629,614NetCommunityBenefitExpnsAmt
Total Expense0.09980TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$69,772,185BadDebtExpenseAmt
Bad Debt Expense Attributable$10,465,828BadDebtExpenseAttributableAmt
Reimbursed By Medicare$70,498,171ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$77,197,122CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$6,698,951MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (3 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPctOfcr Etc Profit Or OwnershipOfcrEtcProfitOrOwnershipPctPhysicians Profit Or OwnershipPhysiciansProfitOrOwnershipPct
1 Featherstone Partnership LP
Ambulatory Surgery Center0.285700.000000.71430
2 Northern Illinois Vein Clinic LLC
Outpatient Physician Clinic0.500000.000000.50000
3 Forest City Diagnostic Imaging LLC
Outpatient Diagnostic Imaging0.490000.000000.51000
FieldValueIRS element (for citing)
Hospital Facilities2HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNumAddress Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdWebsite AddressWebsiteAddressTxtState LicenseStateLicenseNumLicensed HospitalLicensedHospitalIndGeneral Medical And SurgicalGeneralMedicalAndSurgicalIndTeaching HospitalTeachingHospitalIndResearch FacilityResearchFacilityIndEmergency Room24 HrsEmergencyRoom24HrsIndFacility Reporting GroupFacilityReportingGroupCd
SwedishAmerican Hospital
11401 East State StreetRockfordIL61104www.swedishamerican.orgIL License: 0002725Yes (X)Yes (X)Yes (X)Yes (X)Yes (X)A
SwedishAmerican Medical Ctr Belvidere
21625 S State StreetBelvidereIL61008www.swedishamerican.orgIL License: 0005504Yes (X)Yes (X)Yes (X)A

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Facility Reporting Group - ABusinessNameLine1Txt
FieldValueIRS element (for citing)
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted18CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.swedishamerican.org/community-health-needs-assessmentOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt18ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (1)StrategyPostedWebsiteInd
Strategy Website URLwww.swedishamerican.org/community-health-needs-assessmentStrategyWebsiteURLTxt
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care600.000000000000FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.swedishamerican.org/patients/financial-assistance-policyFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.swedishamerican.org/patients/financial-assistance-policyFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.swedishamerican.org/patients/financial-assistance-policyFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
Other PublicityYes (X)OtherPublicityInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection Activities0CollectionActivitiesInd
Provided Written NoticeYes (X)ProvidedWrittenNoticeInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Section BFacility Reporting Group A
Facility Reporting Group A consists of:- Facility 1: SwedishAmerican Hospital, - Facility 2: SwedishAmerican Medical Ctr. Belvidere
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 5:SwedishAmerican Hospital (SAH) participated in the Rockford Regional Health Council 2017 Healthy Community Study and provided funding to the RRHC for the purpose of conducting this study. Primary data was collected from Community Analysis, Household and Key Informant Surveys. The Hospital also engaged a third party to collect secondary data on a broad array of health indicators and demographic information. The Community Study consisted of six sections including demographics, social and economic characteristics, physical environment, clinical care, health behaviors, and health outcomes. The Household Survey was conducted via telephone, email, and conventional mail to a random cross section of residents living within Winnebago and Boone Counties. A total of 1,602 individuals completed the Household Survey for a response rate of 13% and 28 organizations completed the Key Informant Survey for a response rate of 42%.
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 6a:SwedishAmerican Hospital (SAH) in Rockford, Illinois and SwedishAmerican Medical Center (SAMC) in Belvidere, Illinois collaborated for the purposes of executing the Community Health Needs Assessment. Both hospital facilities defined their communities geographically in the same way, serve the same demographic and geographic areas, work with the same community organizations and strategic partners, and in the same arenas for community benefit activities. Both Hospital Facilities defined its community for the CHNA as Boone and Winnebago Counties, Illinois since over 80% of inpatients draw from this area. The CHNA was conducted together for both facilities.
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 11:Top 4 areas of need identified in the SwedishAmerican Community Health Needs Implementation Planinclude:Cancer CareWe are expanding our clinical programs to better serve cancer patients from our primary and secondary service areas through:1) Expansion of radiation oncology procedures to include those sought out but not yet offered in this area;2) Sustain and support a multidisciplinary lung and cancer team with a mission to improve patient experience;3) Sustain and support the comprehensive breast care team by working toward distinction with the National Accreditation Program for Breast Centers (NAPBC) from the American College of Surgeons (ACS);4) Provide health education through multiple events hosted throughout the region with a special focus on topics including cancer care, supportive and rehabilitative care, and palliative care.ObesityOur goal is to build a healthier Rockford by helping at-risk individuals within our community. Progress is measured via participation in fitness walks, lowered cholesterol, medical appointments with health coaches and smoking cessation rates. We partner with:1) Area employers to offer many opportunities to combat adult and child obesity, stress management and smoking cessation through increased awareness and encouragement of fitness participation;2) Area independent senior living centers to incentivize low income 55 and older residents to attend educational classes, receive chair massages, and meet with an RN for smoking cessation, diabetes management and goal setting;3) Employer based wellness initiative programs to encourage daily activity, healthy eating, stress management, and smoking cessation;4) Increase awareness and utilization of SA diabetic programs through onsite promotion and distribution of monthly health event calendars including food prep classes, nutrition and diabetic education, smoking cessation and much more.Poverty and UnemploymentSwedishAmerican Foundation Grant and Operating Committee provide grant funds to area not-for-profit agencies whose missions closely align that of SwedishAmerican Hospital Rockford & Belvidere. Through these third party grantees, SwedishAmerican serves as a critical safety net for services provided to indigent, self-pay and Medicaid patients with special emphasis on those needing maternity and behavioral healthcare. Each year we provide thousands of dollars in grants to area organizations dedicated to alleviating hunger, homelessness, unemployment or under employed, improving wellness, expanding early childhood development and improving offender rehabilitation and reintegration. In addition, SwedishAmerican provides free mammography screenings for the uninsured and underinsured. Additional areas of funding include providing free civil legal services to senior citizens and those with low incomes in Northern Illinois.Access to Medical CareGoal: Ensure that at least 48% of new primary care patients are scheduled for appointment within 10 days from initial contact.Measurement: Measurement will be achieved through the hospital's tracking software and regularly reported to leadership who monitor metrics pertaining to access to medical care.This is being accomplished through:1) Addressing primary care physician shortage by partnering with University of Illinois College of Medicine Rockford. We commit more than $4 million Annually to UICOM-R and provide a teaching site for their practice residency program to ensure that more primary care physicians are educated to treat the growing number of patients;2) Support the Rockford Health Council's efforts to improve our region's health through education, action and advocacy. We sustain our commitment as both a major sponsor and participant in the health council's efforts to be a catalyst for healthcare access and quality for all;3) We provide case management of our ER population to prevent overuse and provided a $160,000 grant to City of Rockford Fire Department EMTs to better connect individuals to primary care services;4) We strategically built 3 new clinics in areas of our city that were in need of increased primary care & OB services and allow same day access to medical professional to allow for greater access and ease of scheduling for our patients;5) We collaborate with a Federal Qualified Health Center (FQHC) to better meet the primary care needs of those who are underserved or uninsured in our community.
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 16j:The hospital's financial assistance policy is transparent and available to all, at all points in the continuum, in languages appropriate for Hospital's service area. The hospital's financial assistance policy, application form, signage, and financial counselor contact information are available in English and Spanish. Signage is posted prominently at all points of admission and registration (including the emergency department). Written information about the hospital's financial assistance policy and copies of the financial assistance form are available in admission and registration areas. The hospital's financial assistance policy, application form and financial counselor contact information are also posted on the hospital's website. The hospital will make efforts to publicize its policy in print and television media, wherever practicable. Patient billing communications also inform patients of the availability of financial assistance. Each bill, invoice, or other summary of charges to an uninsured patient includes with it, or on it, a prominent statement that an uninsured patient who meets certain income requirements may qualify for financial assistance and information on how to apply for consideration under the hospital's financial assistance policy. All third-party agents who submit or collect bills on behalf of hospital are required to follow this policy.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 5:SwedishAmerican Hospital (SAH) participated in the Rockford Regional Health Council 2017 Healthy Community Study and provided funding to the RRHC for the purpose of conducting this study. Primary data was collected from Community Analysis, Household and Key Informant Surveys. The Hospital also engaged a third party to collect secondary data on a broad array of health indicators and demographic information. The Community Study consisted of six sections including demographics, social and economic characteristics, physical environment, clinical care, health behaviors and health outcomes. The Household Survey was conducted via telephone, email and conventional mail to a random cross section of residents living within Winnebago and Boone Counties. A total of 1,602 individuals completed the Household Survey for a response rate of 13% and 28 organizations completed the Key Informant Survey for a response rate of 42%.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 6a:SwedishAmerican Hospital (SAH) in Rockford, Illinois and SwedishAmerican Medical Center (SAMC) in Belvidere, Illinois collaborated for the purposes of executing the Community Health Needs Assessment. Both hospital facilities defined their communities geographically in the same way, serve the same demographic and geographic areas, work with the same community organizations and strategic partners, and in the same arenas for community benefit activities. Both Hospital Facilities defined its community for the CHNA as Boone and Winnebago Counties, Illinois since over 80% of inpatients draw from this area. The CHNA was conducted together for both facilities.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 11:Top 4 areas of need identified in the SwedishAmerican Community Health Needs Implementation Planinclude:Cancer CareWe are expanding our clinical programs to better serve cancer patients from our primary and secondary service areas through:1) Expansion of radiation oncology procedures to include those sought out but not yet offered in this area;2) Sustain and support a multidisciplinary lung and cancer team with a mission to improve patient experience;3) Sustain and support the comprehensive breast care team by working toward distinction with the National Accreditation Program for Breast Centers (NAPBC) from the American College of Surgeons (ACS);4) Provide health education through multiple events hosted throughout the region with a special focus on topics including cancer care, supportive and rehabilitative care, and palliative care.ObesityOur goal is to build a healthier Rockford by helping at-risk individuals within our community. Progress is measured via participation in fitness walks, lowered cholesterol, medical appointments with health coaches and smoking cessation rates. We partner with:1) Area employers to offer many opportunities to combat adult and child obesity, stress management and smoking cessation through increased awareness and encouragement of fitness participation;2) Area independent senior living centers to incentivize low income 55 and older residents to attend educational classes receive chair massages and meet with an RN for smoking cessation, diabetes management and goal setting;3) Employer based wellness initiative programs to encourage daily activity, healthy eating, stress management and smoking cessation;4) Increase awareness and utilization of SA diabetic programs through onsite promotion and distribution of monthly health event calendars including food prep classes, nutrition and diabetic education, smoking cessation and much more.Poverty and UnemploymentSwedishAmerican Foundation Grant and Operating Committee provide grant funds to area not-for-profit agencies whose missions closely align that of SwedishAmerican Hospital Rockford & Belvidere. Through these third party grantees, SwedishAmerican serves as a critical safety net for services provided to indigent, self-pay and Medicaid patients with special emphasis on those needing maternity and behavioral healthcare. Each year we provide thousands of dollars in grants to area organizations dedicated to alleviating hunger, homelessness, unemployment or under employed, improving wellness, expanding early childhood development and improving offender rehabilitation and reintegration. In addition, SwedishAmerican provides free mammography screenings for the uninsured and underinsured. Additional areas of funding include providing free civil legal services to senior citizens and those with low incomes in Northern Illinois.Access to Medical CareGoal: Ensure that at least 48% of new primary care patients are scheduled for appointment within 10 days from initial contact.Measurement: Measurement will be achieved through the hospital's tracking software and regularly reported to leadership who monitor metrics pertaining to access to medical care.This is being accomplished through:1) Addressing primary care physician shortage by partnering with University of Illinois College of Medicine Rockford. We commit more than $4 million Annually to UICOM-R and provide a teaching site for their practice residency program to ensure that more primary care physicians are educated to treat the growing number of patients;2) Support the Rockford Health Council's efforts to improve our region's health through education, action and advocacy. We sustain our commitment as both a major sponsor and participant in the health council's efforts to be a catalyst for healthcare access and quality for all;3) We provide case management of our ER population to prevent overuse and provided a $160,000 grant to City of Rockford Fire Department EMTs to better connect individuals to primary care services;4) We strategically built 3 new clinics in areas of our city that were in need of increased primary care & OB services and allow same day access to medical professional to allow for greater access and ease of scheduling for our patients;5) We collaborate with a Federal Qualified Health Center (FQHC) to better meet the primary care needs of those who are underserved or uninsured in our community.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 16j:The hospital's financial assistance policy is transparent and available to all, at all points in the continuum, in languages appropriate for Hospital's service area. The hospital's financial assistance policy, application form, signage, and financial counselor contact information are available in English and Spanish. Signage is posted prominently at all points of admission and registration (including the emergency department). Written information about the hospital's financial assistance policy and copies of the financial assistance form are available in admission and registration areas. The hospital's financial assistance policy, application form and financial counselor contact information are also posted on the hospital's website. The hospital will make efforts to publicize its policy in print and television media, wherever practicable. Patient billing communications also inform patients of the availability of financial assistance. Each bill, invoice, or other summary of charges to an uninsured patient includes with it, or on it, a prominent statement that an uninsured patient who meets certain income requirements may qualify for financial assistance and information on how to apply for consideration under the hospital's financial assistance policy. All third-party agents who submit or collect bills on behalf of hospital are required to follow this policy.
FieldValueIRS element (for citing)
Facility36FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (36 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Regional Cancer Center
3535 N Bell School RoadRockfordIL61114Outpatient Clinic
2 - SwedishAmerican Heart Institute
1340 Charles Street Suite 300RockfordIL61104Outpatient Clinic
3 - Wound Care & Hyperbaric Clinics
1415 E State Street Ste 101 609RockfordIL61104Outpatient Clinic
4 - Creekside Medical Center
3505 N Bell School RoadRockfordIL61114Outpatient Clinic
5 - Lundholm Orthopedics
1340 Charles Street Suite 100RockfordIL61114Outpatient Clinic
6 - Stateline Clinic & Immediate Care
4282 E Rockton RoadRoscoeIL61073Outpatient Clinic
7 - Neuro and Headache Center
1340 Charles Street Suite 400RockfordIL61104Outpatient Clinic
8 - Physical Therapy Center
209 9th Street Suite 201RockfordIL61104Outpatient Clinic
9 - SAMG Obstetrics & Gynecology
209 9th Street Ste 200RockfordIL61104Outpatient Clinic
10 - Brookside Specialty Center
1253 N Alpine RoadRockfordIL61107Outpatient Clinic
11 - Rockford Vascular Surgery
1340 Charles Street Suite 200RockfordIL61104Outpatient Clinic
12 - SwedishAmerican Home Health Care
2550 Charles StreetRockfordIL61108Home Health Care
13 - Belvidere Clinic
1700 Henry Luckow LaneBelvidereIL61008Outpatient Clinic
14 - UW Health Surgery at SwedishAmerican
1340 Charles Street Suite 100RockfordIL61104Outpatient Clinic
15 - Rockford Ambulatory Surgery Center
1016 Featherstone RoadRockfordIL61107Ambulatory Surgery Center
16 - SA Immediate Care
2473 McFarland RoadRockfordIL61107Outpatient Clinic
17 - State St OBGYN
1415 E State StreetRockfordIL61104Outpatient Clinic
18 - Valley Clinic
6824 Newburg RoadRockfordIL61108Outpatient Clinic
19 - Five Points Clinic
2404 Charles Street Suite 800RockfordIL61108Outpatient Clinic
20 - Woodward Health Network Clinic
2473 McFarland RoadRockfordIL61107Outpatient Clinic
21 - Byron Clinic
220 W Blackhawk DriveByronIL61010Outpatient Clinic
22 - Davis Junction Clinic
5665 North Junction WayDavis JunctionIL61020Outpatient Clinic
23 - River West Clinic
815 Marchesnano DriveRockfordIL61102Outpatient Clinic
24 - North Main Internal Medicine Clinic
2601 N Main StreetRockfordIL61103Outpatient Clinic
25 - Northern Illinois Vein Clinic
1340 Charles Street Suite 404RockfordIL61104Outpatient Clinic
26 - Cardiothorasic Surgery
1340 Charles Street Suite 300RockfordIL61104Outpatient Clinic
27 - Rochelle Clinic
380 Illinois Route 38 EastRochelleIL61068Outpatient Clinic
28 - Woodside Clinic COVID DriveThru Facility
3775 N Mulford RoadRockfordIL61104COVID Drive Thru Facility
29 - Diabetes Self-Management Center
1415 E State Street Suite 700RockfordIL61104Outpatient Clinic
30 - Partners Health Clinic
2601 N Main StreetRockfordIL61103Outpatient Clinic
31 - Midtown Clinic
1340 E State Street Ste 405RockfordIL61104Outpatient Clinic
32 - Edgewater Medical Center
2909 N Main StreetRockfordIL61103Outpatient Clinic
33 - Infectious Disease Consultants
1340 Charles Street Suite 404RockfordIL61104Outpatient Clinic
34 - Winnebago County Employee & Family Welln
526 W State StreetRockfordIL61107Employer Based Clinic
35 - Woodward Occupational Health Rock Cut
1 Woodward WayLoves ParkIL61111Employer Based Clinic
36 - Woodward Occup Health Loves Park
5001 N 2nd StreetLoves ParkIL61111Employer Based Clinic

Supplemental Information Detail SupplementalInformationDetail (16 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 7g:The following subsidized health services are for physicians. These physicians are necessary to serve the community, are difficult to recruit, and the reimbursement does not cover the cost of the services.Hospital based physicians' specialty clinics and coverage payments: $22,984,910Emergency department physicians: $3,040,239Total: $26,025,149
Part I, Ln 7 Col(f):The bad debt expense on Part IX, Column A subtracted for the purpose of calculating the percentage of expense is $69,772,185.
Part I, Line 7:7a and 7f costs were calculated using the 2020 Medicare cost report cost to charge ratio. Lines 7b and 7c costs were calculated using the cost accounting system. The cost accounting system addresses all patient segments. All other amounts in Line 7 were calculated using direct costs.
Part III, Line 2:Methodology for determining bad debt expense: It is our practice to identify, to the extent possible, charity cases at the time of service. If a patient provides documentation they meet our charity care policy, they are not sent to collection. Patients who do not meet presumptive eligibility and fail to apply or provide documentation are sent to collection after 90 days. The organization and its agents follow the fair patient billing act. If during the collection process we or our agents become aware of a patient qualifying for charity care or financial assistance and the patient cooperates with the requirements of the charity care policy, collection efforts are ceased and the account is written off to charity. Bad debt expense reported on line 2 represents the allowance for doubtful accounts. It is determined based on historical experience of uncollectible amounts, after contractual discounts, patient payments and amounts qualifying under charity assistance policy.
Part III, Line 3:SwedishAmerican Hospital's charity policy allows a 100% charity write-off for those with household income of 200% or less of the federal poverty level and partial charity write-off for those up to 600% of the poverty level. The latest data from the U.S. Census bureau QuickFacts for Winnebago and Boone counties, which are the counties served by the healthcare facilities, indicates the following: Winnebago County 16.1% of the population is below the poverty level, the median household income was $54,489 and a household size of 2.44, Boone County 8.9% of the population is below the poverty level, the median household income was $69,272 and a household size of 2.86. The 2020 poverty guidelines per the Office of Assistant Secretary for Planning and Evaluation, (https://aspe.hhs.gov/poverty-guidelines) indicate for the household size of 3, and income of $43,440 is 200% of the poverty level and $130,320 is 600% of the poverty level. Approximately 87% of our charity write-offs are for patients without insurance while 84% of our bad debt write-offs are for patients without insurance. During FY2020 only 2% of all accounts written off to bad debt were recovered. This portion was not included as community benefit in Part I because it is an estimate based on the small percentage of bad debt this is recovered and the demographics of our service area.
Part III, Line 4:Please refer to Pages 9 and 11 of the attached audit report for footnotes describing accounts receivable and patient service revenue.
Part III, Line 8:SA Hospital must treat patients regardless of their ability to pay. The government sets non-negotiable Medicare rates and the reimbursement from Medicare has not kept pace with the rising cost of providing those services. The cost of care has increased due to: wages and benefits necessary to keep high demand skilled practitioners, medical supplies in particular cardiovascular and orthopedic implants and pharmaceuticals, malpractice insurance costs, and capital equipment. SA Hospital's treatment of Medicare beneficiaries relieves the federal government burden of directly providing medical care which by law they are required to provide to eligible beneficiaries. Due to the requirement to provide care and the inability of Medicare reimbursement to keep pace with the cost of providing services, we feel the loss from services provided to Medicare beneficiaries is a part of our mission and is a benefit to our community. The following is a reconciliation of the shortfall from Medicare reported on the cost report on Line 7 to the Medicare shortfall from all of the Medicare programs at SA Hospital. These shortfalls were calculated using the cost to charge ratio. Medicare shortfall hospital programs Part III, line 7: ($6,698,951)Medicare shortfall physician programs: ($31,160,400)Total Medicare Shortfall ($37,859,351)
Part III, Line 9b:The organization and its agents follow the fair patient billing act. If during the collection process we or our agents become aware of a patient qualifying for charity care of financial assistance and the patient cooperates with the requirements of the charity care policy, collection efforts are ceased.
Part VI, Line 2:SA hospital has provided monetary support for the 2017 Healthy Community Study, conducted by the Rockford Health council. The Council consists of the major health care providers in our metropolitan area such as the three hospitals, Crusader Clinic (a federally qualified healthcare clinic), the University of Illinois College of Medicine, Janet Wattles Mental Health Center, Rosecrance Substance Abuse Center as well as several representatives of not-for-profit agencies, and member of the corporate community. Since 2001, an assessment has been completed every three years to identify and track trends as well as areas to address. These stakeholders understand the need for a comprehensive community study that is focused on the overall needs of the community. SA has used this data to launch innovative programs and collaborative partnerships such as cardiac screenings within minority communities. In June of 2019, SA Hospital contracted with RSM-US LLP to complete a three year follow-up Community Health Needs Assessment (CHNA) for both SA Hospital and SA Medical Center Belvidere as required by the Internal Revenue Code, Section 501(r). An implementation strategy has been adopted to meet the prioritized needs identified by the CHNA.
Part VI, Line 3:For services provided in the hospital, our employees and our agents follow the fair patient billing act and provide information regarding the availability of charity and financial assistance at all points during the collection process. We have posted signage disclosing the availability of charity care and financial assistance in emergency rooms and on our website. Inpatients are provided various written communications regarding the availability of charity care and financial assistance and any uninsured discount eligibility. For services provided in physician offices, financial counselors are instructed to make the patients aware of the charity care and financial assistance policy during the collection process and educate them on the process of applying for Medicaid. For services provided by home health, social workers assist patients by screening for Medicaid eligibility and completing the application, completing charity care application, assisting in applying for Medicare and social security disability benefits, and assisting with applications for food stamp, low income energy assistance, and circuit breaker/Illinois cares prescription programs.
Part VI, Line 4:The communities served by SA Hospital include the Rockford Metropolitan Statistical Area (MSA) and the Counties of Winnebago and Boone. Winnebago County has medically underserved area (MUA) designations for the Winnebago Service Area (MUA 7011). The U.S. Census bureau had the 2019 estimated population for the Rockford MSA at 282,572. Today, the unemployment rate of the Rockford MSA is 7.3%, ranking in the bottom 10% of the nation. SA Hospital is located in the City of Rockford, Illinois, in Winnebago County, where the percentage of households below the poverty level is 16.1%. SwedishAmerican Medical Center Belvidere is located in the city of Belvidere, Illinois, in Boone County, where the percentage of households below the poverty level is 8.9%. Five different facilities exist in the community to address inpatient needs, all of which offer discounts or charity care to uninsured and needy patients. There is one federally qualified healthcare facility. SA Hospital helped fund the 2017 Rockford Healthy Community Study in partnership with the University of Illinois, College of Medicine at Rockford and the Rockford Health Council. In addition to general health issues, the study focuses on five other areas of need identified by Rockford Health Council. They are:1) Access to Care and Health Equity2) Behavioral Health3) Chronic Disease Cardiovascular Health4) Maternal, Prenatal, and Early Childhood Health5) Substance AbuseGeneral Health:Both Boone and Winnebago counties have a lower rate of primary care physicians (PCP) 80% compared to the state 97% and the nation 88% and the rate of access to PCP is lower for Boone County 54% than for Winnebago Counties 84%. In contrast, the percentage of adults in the region without a regular doctor 14% is lower than the state 18% and the nation 22%. Nevertheless, 54% of Boone and Winnebago population has been identified as living within an area where there is a shortage of healthcare professionals.Behavioral Health:The Study revealed that 45% of the respondents know where to find resources for mental health and suicide issues and almost half believe that both issues have no impact on their neighborhoods. Approximately 37% could find access to care during a crisis but only 29% were satisfied with available treatment and rehabilitation resources.Chronic Disease - Cardiovascular Health and Obesity:In the community served by SwedishAmerican Hospital Rockford and Belvidere, 25% of adults with high blood pressure were not taking their medication compared to 22% for Illinois and the nation. Per the 2017 Healthy Community Study 'the lack of active prevention is relevant in decreasing the likelihood of developing future health problems.'Respondents to the Healthy Community Study recognize that obesity plays a significant role in chronic disease and that it has an impact on their neighborhood. More than half acknowledge that healthy food options and access to community parks, recreational areas and fitness facilities are crucial to a reduction in chronic disease and obesity. According to the CDC, hypertension in adults age 18 and over was similar for both Illinois and national levels at 32%. Over the last decade, heart disease has been the leading cause of death in the state of Illinois, including Boone and Winnebago Counties and is related to high blood pressure, high cholesterol and heart attacks.Maternal, Prenatal, and Early Childhood Health:The Study found that most respondents believe that regular prenatal care is necessary and that it is easy for mothers and their children to access these types of resources within their neighborhoods. Only 6% of mothers in the region are without prenatal care or receive it late in their pregnancy compared to 5% for the state and 17% for the nation. This is further supported by low infant mortality rates for Boone County 4% and below state and national rates but not for Winnebago County at 7% and above the state and national rates per 1,000 live births. Additionally, the teen birth rate for Boone County 19 per 1000 is lower than the state 30 per 1000 and Winnebago County at 31 per 1000. For those born in Winnebago County 10% were considered premature and with a low birthweight of less than 2,500 grams (5.5 pounds).Substance Abuse:Substance abuse is a concern of the community. Nationally, the population aged 18 and older involved with illicit drugs (Marijuana, Cocaine, Crack, Heroin, and LSD) has steadily increased except for PCP, which seems to be on the decline since 2002. The numbers of those entering emergency rooms due to drug-related incidents has been on the rise in the report area with the largest increase in Winnebago County from 190 visits in 2010 to 280 in 2014 - a 47% increase.The Healthy 2020 Target for the rate of overdose deaths is less than or equal to 10. Boone County reports 12 deaths per 100,000 in the population due to drug poisoning, which is almost on target. However, Winnebago County reports more than twice the numbers of deaths at 24 in 2014. While Boone County is below the national average, it is still higher than the statewide average. Unfortunately, these deaths are on the increase. The most common age groups were 25-44 and over 55 years of age, and primarily Non-Hispanic White and Black populations. The CDC believes the drastic increase is due to a worsening opioid overdose epidemic.By virtue of its mission, location in the central city and relationships with other providers, SwedishAmerican serves the needs of many of the community's underserved. Finding ways to improve the health of all and to make Rockford a model community in which to live, work and worship are significant and strategic initiatives for SA Hospital.
Part VI, Line 5:Although SwedishAmerican's community service efforts reach a broad segment of the population throughout northern Illinois, the hospital devotes a great deal of its energy and resources to serving the city's neediest people, many of whom live in the urban core where SwedishAmerican is located. Our organization contributes millions of dollars to charity and Medicaid care each year.Recognizing that healthy communities are characterized by strong interconnections between residents, infrastructure, organizations and services, we have worked in partnership with other community-based organizations as part of the non-profit Rockford Health Council Inc. The council seeks to build and improve community health through education, action, dialogue and legislative activity and serve as a catalyst and coordinator for agency and individual action to ensure access, cost effectiveness and quality. Beyond our work with the council, some of our initiatives take place in concert with other individual community organizations and healthcare providers, while others are carried out by SwedishAmerican Hospital teams.In the past, SwedishAmerican has worked with the City of Rockford and other area development groups - including ZION Development, Habitat for Humanity and Kids Around the World - to serve as a catalyst for revitalizing the area surrounding our campus with homes, green space and commerce. A large part of this movement was a $100 million campus expansion and renovation project. Despite economic and strategic pressures to move eastward, as many businesses in our area have done, SwedishAmerican joined several other area organizations and made a commitment to remain in central Rockford. One immediate benefit of our redevelopment effort was the expansion of the hospital's emergency department. Among the state's busiest, this is where many of our community's underserved residents come for medical care.In order to improve the low rate of home ownership identified in the healthy community studies, SwedishAmerican initiated a Neighborhood Revitalization Program in an 81-block area adjacent to our hospital campus. Working with the City of Rockford and local Habitat for Humanity officials, we have replaced substandard dwellings with new Habitat homes. Additionally, we partnered with the William Charles Charitable Trust and Kids Around the World to build a new playground that allows neighborhood children the opportunity for play, without having to cross major thoroughfares and traffic hazards.In the past decade, The Foundation purchased two, 12-unit apartment buildings adjacent to the hospital campus which were in a state of disrepair. Approximately three-quarters of a million dollars were invested in these two buildings to bring them to "market rate" status.Encouraged by our commitment to renovate our campus and revitalize the surrounding area, a number of commercial developments have occurred. Among them is a Walgreens' drug store, which returned retail pharmacy services to the area for the first time in years. A three-story office building south of the new Walgreens' was completed, followed by a 60,000-square-foot medical office building south of the hospital.SwedishAmerican has sought to improve the community's health by taking effective lifestyle modification programs to the people who need them most. Although this applies to the community at large, we have taken special efforts to bring these strategies to the city's elderly and underserved residents. This is demonstrated by our successful program to improve the health of residents at Longwood Plaza, a senior housing facility located two blocks from our hospital's campus. Finally, beyond lifestyle modification our ongoing community health initiatives involve research-based health screening programs, as well as unique health education events that target both at-risk members of the community and healthcare providers.SwedishAmerican's organization-led efforts to improve the quality of life in our community are not exclusively health-related. One example is the partnership we formed 20 years ago with nearby public schools, where a very high percentage of the students come from underserved families. The long-term and ongoing goal of our partnership with area schools has been to improve the academic and socioemotional well-being of the school environment and student body. While SwedishAmerican has come forward with a number of ideas and proposals for additional ways in which it can impact the students and faculty at area schools, it always has been sensitive to the wishes and desires of the community in implementing only those programs that correspond with the school's agenda and strategic goals.Beyond large-scale, organization-led initiatives, our employees independently devote extensive amounts of time and resources to a large number of programs, services and activities throughout northern Illinois.We continue to recognize that improving the health of our community means investing in our community. Following a detailed assessment of the region's population trends and projected healthcare needs, and keeping in line with our well-thought-out strategic planning process, SwedishAmerican announced plans for a $165 million investment in our community. This major construction, modernization and expansion project will help us continue to provide the outstanding, top-quality healthcare that residents of Rockford and surrounding communities expect and deserve. SwedishAmerican's building, renovation and modernization project promises to benefit the community in a number of important ways. Starting in the spring of 2018 with the Women's and Children's Tower expected to be completed in 2020, SwedishAmerican's 225,000-square-foot project will conclude in 2022. The total project consists of these major components:Four-Story Women's and Children's Tower. With nearly 2,000 deliveries and growing each year, we've designed this new facility to provide state-of-the-art care for new mothers and their infants. The Tower will be home to the region's newest Level III NICU, and will include in-house specialists from the University of Wisconsin American Family Children's Hospital. The facility will feature private labor and delivery suites and mother/baby suites as well as outpatient pediatric specialty clinics.New and Expanded Behavioral Health Services. Despite the increase of psychiatric afflictions such as depression and personality disorders, and the presence of a massive opioid epidemic sweeping our nation, many communities have downsized or eliminated behavioral health services. SwedishAmerican has chosen to go in a different direction. In response to the increased need for these services, we will expand our behavioral health program to 42 beds. This expansion includes a new, much-needed, 14-bed child and adolescent unita service that has not been available in Rockford for over 15 years.Three Additional Rockford Clinics. SwedishAmerican opened two primary care clinics in 2019 (Riverwest Clinic on the southwest side of Rockford and Creekside Medical Center on the north east side) and one in 2020 (Edgewater Medical Center on the north west side), illustrating the organization's unwavering commitment to provide services where they are most needed.Community Benefits Plan SummarySwedishAmerican Hospital's Community Benefits Plan is focused on five objectives:1. Neighborhood Revitalization2. Lifestyle Medicine and Wellness3. Academic & Career Promotion4. Health Education5. Community ServiceInitiatives designed to meet these objectives are on the following pages. Together, they illustrate our concerted effort to make improvements in the lives of residents at every life stage and income level. These programs reach young children, the elderly and underserved, people who are at risk for chronic diseases and healthcare professionals.
Part VI, Line 6:In 2020, SwedishAmerican Foundation announced it would award grants through its third annual Caring For Our Community grant program. The Foundation provides financial support to not-for-profit organizations, particularly those that complement the SwedishAmerican Foundation's mission and vision.This unique opportunity was available for not-for-profit entities or organizations that serve or represent the Rockford community or communities within the service area of SwedishAmerican. Projects supported alleviating homelessness, hunger and un(under)employment; improving health and wellness; expanding early childhood development; and improving offender rehabilitation/reintegration.In June, $64,000 in six grants was awarded to local not-for-profits through the SwedishAmerican Foundation. This year's Caring For Our Community grants, included:1) $15,000 to Boys and Girls Club of Rockford for its Academic Success Program. The program's aim is to ensure that all club members graduate from high school on time, ready for a post-secondary education and a 21st Century career.2) $17,735 to Family Counseling Services for Counseling During Troubled Times. Family Counseling Services provides counseling, psychotherapy and family life education to individuals and families in Winnebago and Boone counties with a belief in the need to preserve the family unit and reestablish family values and accountability through early intervention.3) $10,000 to Rockford Area Habitat for Humanity for its Expansion of Community Partnership. Habitat is dedicated to building homes, neighborhoods and lives through improved housing opportunity for families who are ready to make a life-changing commitment to become homeowners.4) $6,265 to Rockford Barbell for its Youth Outreach Program. Rockford Barbell is committed to the development of school age children to improve their cardiovascular risk profile, facilitate weight control, strengthen bones, enhance psychosocial well-being, improve motor performance skills and increase resistance to sports-related injuries.5) $10,000 to Rockford Park District Foundation for its Healthy Kids are Happy Kids Program. Rockford Park District facilities and parks provide the opportunity to improve physical and mental well-being through exercise or recreation, which leads to an enhanced quality of life.6) $5,000 to Rockford Sexual Assault Counseling for its Crisis Intervention Programming, which is a 24-hour crisis hotline maintained by master's level therapists and available to those that sexual assault has impacted. Last year's grant recipients were Awaken 815 for its pre-employment program, KFACT to support their Lady All-Star Holistic Mentoring program, Rockford Area Lutheran Ministries to support its Park Players program, and Stateline Youth for Christ to support its Juvenile Justice Ministry.In addition to the SwedishAmerican Foundation Grants, SwedishAmerican donated more than $160,000 to support and sponsor more than 75 organizations throughout the region. Beneficiaries included the African American Resource Center at Booker, Alignment Rockford, American Cancer Society, American Heart Association, GiGi's Playhouse, Golden Apple Foundation, Northern Illinois Hospice, Rockford Area Convention and Visitor's Bureau, RAMM, Rockford University, The Haven Network, UIC College of Medicine, Winnebago County CASA, Winnebago County Medical Society Alliance, YMCA Rock River Valley, YWCA Northwestern Illinois and the Chamber of Commerce organizations from Rockford, Loves Park, Rochelle, Stateline and Byron.Lifestyle Medicine and Wellness ProgramsSwedishAmerican is committed to building a healthier community of senior adults. In 2001, the health system and ZION Development Corporation began discussing the unique health needs of low-income senior residents living at Longwood Plaza, a 65-unit facility located two blocks from SwedishAmerican Hospital's campus. The two partners wanted to not only provide a way for seniors to have safe housing; they also wanted to equip residents with the tools and education for living healthier lives. With the assistance of a generous donation by the Walter D. Williams estate, SwedishAmerican and ZION created a wellness program to meet the needs of seniors' right where they lived. The program has been going strong since 2001.Every week, participants check in with a registered nurse for blood pressure, weight and fasting glucose if needed. Current health status, medication adherence, diet and nutrition are some of the topics discussed. Twice weekly, participants receive a therapeutic massage and meet individually with a fitness trainer for exercise. Monthly, healthy meals and nutrition presentations are held. Periodically, speakers from the community such as the fire and police department provide presentations. Several participants take advantage of the Licensed Clinic Professional Counselor that the program provides. As an incentive for participation, residents receive up to $40 off of their monthly rent. Like many projects, the program has been on hold during COVID-19 but will resume at full strength when the pandemic eases.Better Life Wellness/YMCA PartnershipIn 2014, SwedishAmerican created a medical wellness center called BetterLife Wellness within the downtown Rockford YMCA. In 2018, the medical wellness center moved to the lower level of Camelot Tower on the hospital campus. The center offers a variety of services for SwedishAmerican associates, corporate partners and the general public, including:1) Wellness educational programs, classes and support groups2) Screenings and health risk assessments3) Personal health coaching4) Healthy cooking classes and grocery tours5) Relaxation and stress management education6) Weight management programs7) Nutrition education8) Therapeutic Massage9) Smoking Cessation programs10) Interactive customized wellness web portalBetterLife expands our capacity to help people of all ages, physical abilities and limitations lead healthier lives. The powerful combination of active medical oversight, experienced and credentialed staff, and the utilization of an individual's personal health status are intended to reduce health risks, improve wellbeing and bring a measureable impact upon improving the overall health of our community.Academic & Career PromotionIn order to help young people understand the economics of life and open their minds to career possibilities within the business world, SwedishAmerican has made a major commitment to the community's public school system. Our employees have shared their professional experiences in the classroom and served as volunteers to tutor students. We've partnered with area schools as a part of our mission to care for our community through compassionate service. We realize that a stronger neighborhood, with achieving children and fully functioning families, is an environment where tomorrow's leaders may be nurtured and protected. As a major corporate anchor in the neighborhood and a source of influence within the greater community, SwedishAmerican believes that it has a responsibility to help create an environment at area schools that enables it to serve as an agent for growth, maturation and positive change. A SwedishAmerican representative has been involved with the schools' planning process since our partnerships began two decades ago. Over the last 20 years SwedishAmerican has positively impacted students and faculty in a number of ways, including:Academy ExpoDuring FY2020, we continued our efforts as a key community partner in expanding Rockford's Academy Expo. The purpose of the Academy Expo was to expose Rockford Public Schools 9th, 10th and 11th graders to a variety of careers to assist them in making an academy and forge a relevant link between high school curriculum and future careers. Unlike a job fair where students visit companies, the Academy Expo invited companies to present career options for students to explore. The main focus of the event, therefore, was to showcase a broad spectrum of possible careers. Students at the Academy Expo learned about classroom curriculum that will prompt them to develop professional behaviors and to evaluate their strengths/interests related to careers. This event was postponed in 2020 due to COVID-19, but SwedishAmerican will remain a committed partner when it is safe to plan it again.Employees' Children Scholarship ProgramIn 2020, SwedishAmerican awarded 12 one-year $1,000 scholarships to children of SwedishAmerican associates. The Associates' Children Scholarship Program is designed to assist children of SwedishAmerican associates pursue higher education.
SwedishAmerican Hosts Medical Career Exploring PostSwedishAmerican Hospital hosted a Medical Career Exploring Post to area youth, ages 14-20, through the Boy Scouts. The Exploring program assists youth in learning more about career fields they are interested in, while developing leadership skills. Programs involved tours, job shadowing, youth leadership opportunities and meeting people in the professional community that they are interested in pursuing. The 2020 Exploring Post was interrupted due to COVID-19, but SwedishAmerican remains committed to bring back the program when the pandemic eases.Swedes ReadsThis is the second year that more than a dozen SwedishAmerican staff volunteered their time to help Lincoln middle school students improve their reading skills with our "Swedes Reads" program. The partnership will continue when the pandemic is over.Health EducationAccording to the Community Assessment, cancer and heart disease are the leading causes of death in the three-county area surrounding SwedishAmerican Hospital. These conditions also are leading contributors to "years of life lost" before age 65. In the last decade, the number of baby boomers born between 1946 and 1964 increased more than 31 percent in the Rockford area. As this demographic segment continues to age, it will result in an increased incidence of disease, as well as a range of health issues affecting midlife women. According to the Rockford Health Council's 2017 Healthy Community Study, among the 202,808 people living in Winnebago County, 9,823, or 4.8%, reported having been diagnosed with heart disease. The Illinois average is 3.8% while the nation is slightly higher at 4.4%. Because of these rates, SwedishAmerican is committed to educating public and professional audiences within our community about matters of prevention, detection and treatment.Child's Safety FairIn May, SwedishAmerican hosted the 9th annual SAM's Safety Fair on the grounds of our hospital campus. More than thirty different agencies were represented at the event, which was held in conjunction with Emergency Medical Services Week. Kids were able to explore the inside of an ambulance; learn about bicycle safety; poison prevention; water and sun safety; sports safety; and animal safety. Children also could visit the splinting and casting station. Engine and ladder trucks from local fire departments, as well as the Rockford Fire Department Smoke House, were on site for kids to explore. Bicycle safety rodeo and car-seat safety checks rounded out the offerings. The Safety Fair provides a place for families to learn about safety and healthy habits. This event is a great place for parents and caregivers to learn what safety resources are available in our community. COVID-19 prevented the festival from happening in 2020, but SwedishAmerican is committed to bringing SAM's Safety Fair back to our community when the pandemic ends.Community ServiceSwedishAmerican Partners with IDPH in Fight against Opioid AddictionSwedishAmerican has been recognized by the Illinois Department of Human Services (IDHS) as one of only 14 Illinois hospitals that will participate in its Warm Hand-off Program to combat opioid addiction. The IDHS Hospital Warm Hand-off Program connects recovery support specialists directly to patients with opioid use disorder while they are in the hospital recovering from an overdose or receiving other hospital treatment. SwedishAmerican will now have a recovery specialist that will do a Warm Hand-off with a patient when they leave the hospital to enter a treatment center. The grant will allow SwedishAmerican to hire and train nine new employees to be involved in the collaborative relationship between the patient and recovery support specialist.Community Paramedic ProgramsIn 2016, SwedishAmerican, a division of UW Health continued to help connect underutilized resources to the underserved population at SwedishAmerican through its Mobile Integrated Healthcare (MIH) program with Rockford Fire. Officials from both SwedishAmerican and Rockford Fire provided the community with an update on its partnership and the benefits it's had on the city of Rockford and surrounding communities.SwedishAmerican patients enrolled in the program experienced a reduction of Emergency Department (ED) visits by 35 percent, ambulance runs by 42 percent and hospital admissions by 40 percent.Rockford Fire firefighter Brian Park is currently the MIH Manager for the program. Brian is both an eleven year veteran of the department and he's been a Registered Nurse (RN) in the community for the past 11 years. Through the MIH program, he works directly with SwedishAmerican's case managers, EMS department, pharmacists, physicians and nurses at the hospital to identify patients and develop individualized care plans for each of them.In 2018 the patients enrolled in the program came from referrals made by the Case Management program. During this time the MIH Manager saw 20 patients on a weekly basis often accompanied by a SwedishAmerican nurse case manager. Each patient received regularly scheduled home visits where the MIH Manager provided a medical assessment, ensured the patient was taking their prescribed medications and was following up with their primary care provider. The MIH Manager offered community resource support to help improve the patients' health and wellbeing. In addition, the MIH Manager checked smoke detectors, CO2 detectors and any hazards that may exist in the patient's home.Additionally, in 2018 expanded to include a partnership with Humana Inc., a large health insurance provider. With an expanded population to serve, an additional MIH Manager was appointed in April. MIH Managers made nearly 500 patient visits in 2018, and served 250 individual patients. The MIH Program's success can be measured by both evaluating the impact on the enrollee's overall health, and the cost savings to the healthcare system.1) MIH Patients had a 50% decrease in ED arrival by ambulance.2) MIH Patients had a 22% decrease in hospital admissions.3) Rockford Fire and Swedish American realized a cost savings of $3,289.77 per enrolled MIH Patient.The MIH program began a program called "Knock and Talk" in 2018 to begin addressing the opioid epidemic in Rockford. This initiative was put in place due to a 28% increase in overdose deaths in Winnebago County from 2017 to 2018. This program involves an MIH Manager visiting an overdose patient transported by Rockford Fire within 72 hours to provide Naloxone. Naloxone is the only medication that is able to reverse an opioid overdose. This program is offered in conjunction with the Winnebago County Health Department Drug Overdose Prevention Program. Through a grant the Health Department is able to provide the Naloxone at no charge to the patient. Naloxone distribution through the MIH program was expanded to include patients who were active in their addiction, attempting to be in recovery, and many community groups. In all, the MIH program distributed over 2,000 Naloxone kits in the community including many SwedishAmerican staff who work in the hospital and SwedishAmerican clinics in order to raise awareness of the program and the local epidemic. In 2019, instead of the prediction of another year with increased overdose deaths, Winnebago County experienced a 27% reduction of overdose deaths.MIH also continued to provide in home patient visits providing over 600 patient interventions for patient education, medication reconciliation, connections to local resources such as food banks and housing, and home safety inspections. While 2020 has been a challenging year for in-home visits the MIH program has continued with the programs that began in 2019. In addition to the referrals from SwedishAmerican Case Management there has been an increase of referrals from within Rockford Fire as well. An additional MIH Manager was hired. The program began a pilot utilizing an MIH Manager and SwedishAmerican nursing staff from the Center for Mental Health. Connections with local resources have expanded to include Community Services for the homeless population.
Little Free LibrariesThe percentage of children in grade 4 whose reading skills tested below the "proficient" level for the English Language Arts portion of the state-specific standardized test are relevant because an inability to read English well is linked to poverty, unemployment, and barriers to healthcare access, provider communications, and health literacy/education. In the Healthy Community Study, nearly two-thirds of 4th-graders (65.6%) were found to not be proficient with reading skills in 2015. This was higher than the state rate of 60.7% and much higher than the national rate of 45.6%.To help combat this, SwedishAmerican maintains four Little Free Libraries around the SwedishAmerican Hospital campus and its surrounding neighborhoods. Little Free Libraries are an international movement where people place small, weather proof boxes in their communities. These boxes are stocked with books which are free to the public to take, return, or add to the collection. The hope is that when someone takes a book, they will return it or replace it with another book.Since inception of this program, we have added two more Little Free Libraries at the Regional Cancer Center and the other on the campus of the SwedishAmerican Hospital in Belvidere. Over the last three years, five Little Free Libraries have been strategically placed within the adjoining SwedishAmerican neighborhoods allowing easy access to books and library materials by those who wish to take advantage of this wonderful resource. The Little Free Libraries are stocked throughout the year through the SwedishAmerican Foundation.Drives and DonationsSwedishAmerican employees have long been committed to serving the community by organizing several drives and donations throughout the year. Even during their challenging and busy schedules created by COVID-19 in 2020, employees have given back to the community in multiple ways, including:1) Rock River Valley Food Pantry Holiday Drive2) Miss Carly's Drive to provide food and items for the homeless community 3) Face Coverings Drive benefitting Rockford Public Schools students4) Pregnancy Care Center Donation 5) Rock House Kids Donation6) Angel Tree Donations7) Hat, Scarf and Mittens Drive to benefit the local homeless community and the Rockford Rescue Mission8) Riverwest Clinic Backpack Drive9) Riverwest Clinic Trunk or Treat
Part VI, Line 7:SA Hospital files a community benefit report with the Illinois Attorney General.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtPurpose Of GrantPurposeOfGrantTxt
Aunt Martha's Youth Service Center Inc
19990 Governors HwyOlympia FieldsIL60461237188150501(c)(3)$117,495Federally qualified health center that provides health services to uninsured and underserved in our community
City of Rockford Fire Department
PO Box 15537RockfordIL61132366006082City of Rockford$125,000Funding for a paramedic for the mobile integrated healthcare program
FieldValueIRS element (for citing)
Total501c3 Org2Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeScholarship - educational scholarship for children of non-management employees.GrantTypeTxt
Recipient12RecipientCnt
Cash Grant$12,000CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Line 2:FormAndLineReferenceDesc
ExplanationAunt Martha's Youth Service Center, Inc. is a federally qualified health center that provides health services to uninsured and under served in our community. SA Hospital works closely with the grantee organization or receives reports from them as appropriate.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (16 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Elizabeth Bolt
Trustee$0$862,060$0$213,019$0$343,645$0$135,030$0$31,196$0$1,584,950$0$337,301
Michael J Born MD
President & CEO (until 10/29/19)$566,972$0$97,903$0$336,338$0$21,940$0$23,258$0$1,046,411$0$254,575$0
Jateen Patel MD
Physician$944,414$0$0$0$0$0$19,323$0$16,911$0$980,648$0$0$0
Mohamed Zeater MD
Physician$870,089$0$0$0$0$0$14,000$0$42,542$0$926,631$0$0$0
Tarek Harb MD
Physician$796,031$0$0$0$0$0$16,940$0$39,835$0$852,806$0$0$0
Gayatri Sonti DO
Physician$750,504$0$0$0$0$0$12,880$0$22,489$0$785,873$0$0$0
Ann Gantzer MD
Chief Nursing Officer$334,147$0$84,917$0$244,073$0$65,811$0$37,285$0$766,233$0$244,073$0
Michael E Dallman
UW RDI Rep. (until 6/22/20)$0$516,457$0$128,310$0$2,713$0$80,076$0$29,472$0$757,028$0$0
Yaser Siraj MD
Physician$708,094$0$0$0$0$0$7,280$0$14,994$0$730,368$0$0$0
Patricia DeWane
Chief Financial Officer$362,409$0$101,823$0$112,179$0$50,934$0$10,413$0$637,758$0$112,179$0
William Cunningham MD
Medical Staff 1st Vice President$567,868$0$0$0$0$0$20,300$0$24,385$0$612,553$0$0$0
Donald Daniels
VP & Chief Operating Officer$399,326$0$67,007$0$0$0$81,087$0$25,507$0$572,927$0$0$0
Michael Polizzotto MD
Chief Medical Officer/CMIO$353,825$0$75,581$0$41,467$0$44,144$0$34,323$0$549,340$0$41,467$0
Allen D Williams MD
Trustee$301,163$0$0$0$0$0$20,300$0$36,609$0$358,072$0$0$0
Thomas Schiller MD
Former Chief Clinical Integ. Off.$288,962$0$0$0$29,042$0$22,400$0$13,526$0$353,930$0$29,042$0
Tiffanie Ferry MD
Trustee$210,724$0$0$0$0$0$14,474$0$28,364$0$253,562$0$0$0

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3All compensation is determined by the Executive Compensation Committee of SwedishAmerican Health System Corporation and is paid by SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the President & CEO and other Officers, SwedishAmerican Health System Corporation follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by SwedishAmerican Health System Corporation's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes.
Part I, Lines 4a-bMichael Born received severance payments of $81,763 during 2019 that was reported as taxable compensation on Part II, column (B)(iii). Terms of the severance agreement are available to the IRS upon request. Contributions to the 457(f) plan during 2019 include: Donald Daniels - $39,686; Patricia DeWane - $28,534; Ann Gantzer - $26,511; Michael Polizzotto, M.D. - $28,028; Elizabeth Bolt - $113,610; Michael E. Dallman - $58,656 Payments from the 457(f) plan during 2019 include: Michael Born, M.D. $254,575; Ann Gantzer $244,073; Patricia Dewane $112,179; Michael Polizzotto, M.D. $41,467; Thomas Schiller M.D. $29,042; and Elizabeth Bolt $337,301. These payments are reported as taxable income on Part II, Column (B)(iii).
Part I, Line 7SwedishAmerican Hospital has a formal plan for short-term incentives and bonuses. The incentives are paid based on a combination of both individual goal achievement and corporate goal achievement (i.e. the Pillar goals). The Executive Compensation Committee, comprised of Board members, has discretion to approve the incentives and bonuses.
Part II, Column F:The amounts shown in column F were reported as deferred compensation in prior years but paid out in the current year. The amounts are also included in column B(iii).

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (4 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
Illinois Finance Authority - 2012
A86109196745203HLW02012-09-27$41,833,485See Part IV000
Illinois Finance Authority - 2010A
B8610919672016-10-11$8,820,000See Part IV000
Illinios Finance Authority - 2010B
C8610919672016-10-26$8,370,000See Part IV000
University of Wisconsin Hospitals and Clinics Authority - 2018A
D391835630915260CQ42018-11-15$120,913,330See Part IV00Yes (1)

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (4 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrRefunding Tax Exempt BondsRefundingTaxExemptBondsIndRefunding Taxable BondsRefundingTaxableBondsIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmt
A$99,338$41,900,852$648,001$41,252,851201300Yes (1)Yes (1)
B$2,520,000$8,820,0002010Yes (1)0Yes (1)Yes (1)$8,820,000
C$2,170,000$8,370,0002010Yes (1)0Yes (1)Yes (1)$8,370,000
D$1,283,776$125,291,824$913,330$65,653,5752021000Yes (1)$58,724,919

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (4 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A000000Yes (1)
B000000Yes (1)
C000000Yes (1)
D000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (4 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)0000Yes (1)
B00Yes (1)00000Yes (1)
C00Yes (1)00000Yes (1)
D0Yes (1)000000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (4 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)
CYes (1)
DYes (1)

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Date Rebate Computation PerformedIssuer Name: Illinois Finance Authority - 2012 Date the Rebate Computation was Performed: 09/27/2017
Part I, column (f):2012 Bond: Construction & Equipment Regional Cancer Center The arbitrage rebate computation was performed on September 27, 2017. 2010A and 2010B Bonds: Original bond issue in 2005 for Construction & Equipment Cardiac pavilion, renovation of operating room & catheterization lab completed in 2004. Bond was re-issued in 2010 as a direct bank placement and reissued in 2016. 2018A Bond: UWHCA parent of SAHS issued on behalf of Hospital fixed rate revenue bonds to fund the Master Facility Plan. Used for construction and equipment for Women's and Children's tower, and three new clinics. 2018C Bond: UWHCA parent of SAHS issued on behalf of Hospital fixed rate revenue bonds to refund the Hospital Series 2004 bonds.
Part I, column (e):The issue price for the 2018A and 2018C Bonds is the allocated portion from the total issue price on the Form 8038.
Part II, Line 3:The total proceeds of the 2012 and 2018A Bond issues received is different than the amounts reported on Part I, column (e) because of investment earnings.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1University of Wisconsin Hospitals and Clinics Authority - 2018CBusinessNameLine1Txt
FieldValueIRS element (for citing)
Bond Issuer EIN391835630BondIssuerEIN
CUSIP915260CQ4CUSIPNum
Bond Issued2018-11-15BondIssuedDt
Issue Price$63,918,493IssuePriceAmt
PurposeSee Part IVPurposeDesc
Defeased0DefeasedInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Pool FinancingYes (1)PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Retired$363,493RetiredAmt
Total Proceeds$63,918,493TotalProceedsAmt
Issuance Costs From Proceeds$363,493IssuanceCostsFromProceedsAmt
Other Spent Proceeds$63,555,000OtherSpentProceedsAmt
Substantial Completion2007SubstantialCompletionYr
Refunding Tax Exempt BondsYes (1)RefundingTaxExemptBondsInd
Refunding Taxable Bonds0RefundingTaxableBondsInd
Final Allocation MadeYes (1)FinalAllocationMadeInd
Adequate Books And Rec MaintYes (1)AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Owning Bond Financed Property0OwningBondFinancedPropertyInd
Any Lease Arrangements0AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop0MgmtContractBondFincdPropInd
Any Research Agreements0AnyResearchAgreementsInd
Bond Iss Meet Prvt Sec Pymt Test0BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop0ChangeInUseBondFinancedPropInd
Procs Nonqualified Bond RemdtdYes (1)ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Form8038 T Filed0Form8038TFiledInd
Rebate Not Due Yet0RebateNotDueYetInd
Exception To RebateYes (1)ExceptionToRebateInd
No Rebate Due0NoRebateDueInd
Variable Rate IssueYes (1)VariableRateIssueInd
Hedge Identified In Bks And Rec0HedgeIdentifiedInBksAndRecInd
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGICInd
Gross Proceeds Invested0GrossProceedsInvestedInd
Written Proc To Monitor ReqsYes (1)WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

FieldValueIRS element (for citing)
Bond ReferenceABondReferenceCd
Procedures Corrective ActionYes (1)ProceduresCorrectiveActionInd

Schedule L IRS990ScheduleL

Disqualified Person Ex Bnft Tr DisqualifiedPersonExBnftTrGrp (2 entries)

Rln Disqualified Person OrgRlnDisqualifiedPersonOrgTxtTransactionTransactionDescTransaction CorrectedTransactionCorrectedInd
Julie Wiest
See Part VSee Part V0
Chad Jury
See Part VSee Part V0
FieldValueIRS element (for citing)
Tax Imposed$8,549TaxImposedAmt
Tax Reimbursed$0TaxReimbursedAmt

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonAndrea FulcomerPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionSee Part VRelationshipDescriptionTxt
Transaction$65,232TransactionAmt
TransactionSee Part VTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Sch L, Part I, Excess Benefit Transactions:(a) Name of Person: Julie Wiest(b) Relationship with Disqualified Person: Family member of trustee(c) Unpaid Child Care Services(a) Name of Person: Chad Jury(b) Relationship with Disqualified Person: Family member of trustee(c) Unpaid Child Care ServicesOrganization Managers:Donald Daniels, VP & Chief Operating OfficerGerard Guinane, VP Human ResourcesGregory R. Jury, Trustee
Sch L, Part IV, Business Transactions Involving Interested Persons:(b) Relationship Between Interested Person and Organization:Spouse of trustee Eric Fulcomer(d) Description of Transaction: Compensation

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Explanation for filing Amended Form 990:The Form 990 has been amended for the following change from the previously filed return: - Schedule L, Part I, Line 2 Increased from 6,106 to 8,549 to report 2,443 excise tax incurred by organization managers The Form 990 was previously amended to report excess benefit transactions that came to the attention of SwedishAmerican Hospital after the original return was filed. The following were the changes on the previously amended return: - Part IV, Line 25a - Changed from "No" to "Yes" - Part IV, Line 25b - Changed from "No" to "Yes" - Schedule L, Part I - Reports details for excess benefit transactions not reported on originally filed return
Form 990, Part VI, Section A, line 2Michael Broski, Jeffrey Hultman and Frank Walter have a business relationship.
Form 990, Part VI, Section A, line 6SwedishAmerican Health System Corporation (SAHSC) is the sole corporate member of SwedishAmerican Hospital.
Form 990, Part VI, Section A, line 7aSwedishAmerican Health System Corporation is the sole corporate member of SwedishAmerican Hospital and as such appoints all trustees.
Form 990, Part VI, Section A, line 7bSAHSC shall have powers and voting rights to do the following: (a) Appoint all the Trustees of the Hospital. (b) Elect the President and Chief Executive Officer of SAHSC, who shall automatically become the Hospital's President and Chief Executive Officer (this officer is sometimes also referred to in these Bylaws as the "President"). (c) Approve expressly all amendments to the Hospital's Articles of Incorporation and Bylaws. (d) Approve annual budgets, and strategic, long-range and health manpower development plans of the Hospital. (e) Approve all contracts of indebtedness that exceed One Million Dollars ($1,000,000.00) in principal amount or that are effective for longer than sixty (60) months. "Contracts of Indebtedness" shall mean notes, bonds or other written evidences of borrowings. (f) Approve all plans of merger or consolidation of the Hospital; or the sale, lease, exchange, mortgage, pledge or other disposition of all or substantially all, the property and assets of the Hospital; or a voluntary dissolution of the Hospital. (g) Require the Hospital's Board of Trustees to take any action (including amending the Hospital's Articles of Incorporation or Bylaws), or to modify or rescind an action already taken, if either the Hospital or SAHSC receives notification from a federal agency that failure to take the action, or to modify or rescind an action already taken, may result in the Hospital's failure to obtain or maintain its exemption as an organization described m Section 501(c)(3) of the Code; provided, however, that: (i) SAHSC shall exercise this authority only to the extent necessary to eliminate the basis for the federal agency's position and only after the Hospital and/ or SAHSC have exhausted other alternative means available to each of them to address the matter (to the extent the exhaustion of such other alternatives will not, through lapse of time or otherwise, cause the Hospital not to obtain or maintain its federal tax exemption); and (ii) in the event SAHSC is required to exercise this authority, prior to or as soon as possible thereafter, the Hospital's Board of Trustees and SAHSC jointly shall use their best efforts to develop a mutually acceptable plan of action to appropriately address the objections of the Hospital's Board of Trustees, if any, to the actions of SAHSC.
Form 990, Part VI, Section B, line 11bA draft version of the Form 990 was reviewed by Legal Counsel and the Chief Financial Officer. The entire Board of Trustees were provided with a copy of the Form 990 before it was filed.
Form 990, Part VI, Section B, line 12cThe organization regularly and consistently monitors and enforces compliance with its conflict of interest policies, which apply to all members of the Board of Trustees and to all employees. Procedures are in place to identify conflicts of both trustees and employees. Trustee conflicts are handled by Board deliberation and Board vote from which the interested director is excluded. Employee conflicts are handled by the compliance department and in certain instances may require separate Board action. The Board is provided with periodic compliance reports regarding conflicts of interest.
Form 990, Part VI, Section B, line 15All compensation is determined by the Executive Compensation Committee of SwedishAmerican Health System Corporation and is paid by SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the President & CEO and other Officers, SwedishAmerican Health System Corporation follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by SwedishAmerican Health System Corporation's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes.
Form 990, Part VI, Section C, line 19The governing documents, conflict of interest policy and financial statements have not been previously made available to the public. The consolidated audited financial statements of SwedishAmerican Hospital are available from the Illinois Attorney General Website and from the U.S. Securities and Exchange Commission electronic municipal market access system through MSRB.org.
Form 990, Part XI, line 9:Interest in SwedishAmerican Foundation -1,322,703. Joint Ventures Book/Tax Difference -320,531. Other Net Asset Adjustment -35,430.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (16 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
University of WI Hospital and Clinics Authority
7974 UW Health CourtMiddletonWI53562391835630Hospital and ClinicsWI501(c)(3)Line 3N/A0
University of WI Medical Foundation
7974 UW Health CourtMiddletonWI53562391824445Physician ServicesWI501(c)(3)Line 100University of WI Hospital and Clinics Authority
Regional Division Inc
7974 UW Health Court No MC1020MiddletonWI53562391446049Regional Parent Corp. to manage and direct activities of entitiesWI501(c)(3)Line 12a, I0University of WI Hospital and Clinics Authority
University Health Care Inc
7974 UW Health CourtMiddletonWI53562472553196Support OrganizationWI501(c)(3)Line 12a, I0University of WI Hospital and Clinics Authority
SwedishAmerican Health System Corporation
1401 East State StRockfordIL61104363241458Parent Corporation to manage and direct activites of entitiesIL501(c)(3)Line 12a, I0Regional Division Inc
SwedishAmerican Foundation
1415 East State StRockfordIL61104363097493Supports fundraising for SwedishAmerican HospitalIL501(c)(3)Line 7Yes (1)SwedishAmerican Hospital
SwedishAmerican Realty Corporation
1313 East State StreetRockfordIL61104363248013Title Holding CompanyIL501(c)(2)Yes (1)SwedishAmerican Health System Corporation
SwedishAmerican Hospital Self Insurance Trust
1401 East State StreetRockfordIL61104366652702Hospital Malpractice TrustVT501(c)(3)Line 12a, IYes (1)SwedishAmerican Hospital
Wisconsin Therapies Inc
7974 UW Health CourtMiddletonWI53562391807425Infusion TherapyWI501(c)(3)Line 12a, I0University of WI Hospital and Clinics Authority
Generations Fertility Care
2365 Deming WayMiddletonWI53562273496527Reproductive endocrinology and infertility servicesWI501(c)(3)Line 10N/A0
Wisconsin Dialysis
3034 Fish Hatchery RoadFitchburgWI53713300072647Dialysis ServicesWI501(c)(3)Line 12c, III-FIN/A0
Madison Surgery Center
7974 UW Health CourtMiddletonWI53562391940656Health care services and trainingWI501(c)(3)Line 10N/A0
UW Health ACO Inc
7974 UW Health CourtMiddletonWI53562455490584Accountable Care OrganizationWI501(c)(3)Line 100University of WI Hospital and Clinics Authority
Quartz Health Plan MN Corporation
840 Carolina StreetSauk CityWI53583452633920Health InsuranceWI501(c)(4)0Quartz Health Plan Corp
Quartz Health Plan Corporation
840 Carolina StreetSauk CityWI53583491807071Health Maintenance OrganizationWI501(c)(4)0University Health Care Inc
Isthmus Project Inc
600 Highland AvenueMadisonWI53792832278676Research and innovationWI501(c)(3)Line 12a, I0University of WI Hospital and Clinics Authority

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdPredominant Income TypePredominantIncomeTypeTxtDisproportionate AllocationsDisproportionateAllocationsIndGeneral Or Managing PartnerGeneralOrManagingPartnerIndShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPct
Three Rivers Partners LLC
1313 East State StreetRockfordIL61104262231757Information Technology ServicesILN/AN/A00
Northern Illinois Vein Clinic
2550 Charles StreetRockfordIL61108201642329Outpatient Health ServicesILN/ARELATED0Yes (1)$41,081$304,0580.50000
Chartwell Wisconsin Enterprises LLC
2241 Pinehurst DriveMiddletonWI53562391796267Infusion TherapyWIN/AN/A00
Madison Medical Center LLP
7974 UW Health CourtMiddletonWI53562391329429Specialized Medical CenterWIN/AN/A00
Sixth Street Medical LLC
7974 UW Health CourtMiddletonWI53562472705724Real EstateWIN/AN/A00

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
SARI Insurance Company
76 St Paul Street Suite 500BurlingtonVT054014477030308753Captive Insurance CompanyVTN/ACYes (1)
State & Charles Inc
1313 East State StreetRockfordIL61104363321193Holding CompanyILN/ACYes (1)
SwedishAmerican Health Management Corp
1401 East State StreetRockfordIL61104363246511Management ServicesILN/ACYes (1)
Unity Health Plans Insurance Corporation
840 Carolina StreetSauk CityWI53583391450766Health Maintenance OrganizationWIN/AC0
Health Professionals of Wisconsin
301 South Westfield RoadMadisonWI53717391806711Real EstateWIN/AC0
Physician's Care Network
1313 East State StreetRockfordIL61104363455791Health ServicesILN/ACYes (1)
Quartz Holding Company
840 Carolina StreetSauk CityWI53583821728929Holding CompanyWIN/AC0
Quartz Health Solutions
840 Carolina StreetSauk CityWI53583465710709InsuranceWIN/AC0
Quartz Health Insurance Corporation
840 Carolina StreetSauk CityWI53583391565691Health Maintenance OrganizationWIN/AC0
Charitable Remainder Unitrusts (6)
TrustILN/ATYes (1)
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth OrgYes (1)RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (11 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
SwedishAmerican Foundation
C$1,413,247Cost
SwedishAmerican Hospital Self Insurance Trust
Q$1,188,394Cost
SwedishAmerican Hospital Self Insurance Trust
R$1,317,197Cost
SwedishAmerican Realty Corporation
K$6,743,572Cost
Three Rivers Partners LLC
J$277,251Cost
University of WI Medical Foundation
P$4,839,157Cost
University of WI Hospital and Clinics
P$10,677,136Cost
Regional Division Inc
K$51,489Cost
Regional Division Inc
Q$3,300,994Cost
Regional Division Inc
P$453,702Cost
University of WI Hospital and Clinics
E$176,686,241Cost

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