2019-05-10T10:35:56-05:00 2018-06-30 420714325 RSM US LLP One South Wacker Dr Ste 800 Chicago IL 606063392 990 2017-07-01 362222696 SwedishAmerican Hospital SWED 7796964727 1401 East State Street Rockford IL 611042298 Patricia DeWane Chief Financial Officer 7796964727 2019-05-10 1 Rebekuh Eley P01247672 3126343400 66.98.98.9 2019-05-10 08:51:06 CD P F6217F2D6ED5C2D75B43E0AF4E216B671259B073 64E34636FEC2DFD844E3D394C3B342543AC68841 2017 2019-02-21 02:37:17Z Michael Born MD 1313 East State Street Rockford IL 61104 745061962 0 X www.swedishamerican.org X 1911 IL Through excellence in healthcare and compassionate service, we care for our community. 26 19 3812 255 704574 142116 2007157 2144230 531739773 568533203 8580265 24722822 5410324 5695329 547737519 601095584 411503 607793 0 0 254810198 270353842 0 0 0 272348315 277697760 527570016 548659395 20167503 52436189 708282537 757629414 250827806 268695782 457454731 488933632 X Through excellence in healthcare and compassionate service, we care for our community. 0 0 330063268 607793 430792723 SwedishAmerican Hospital (SAH) operates two full service acute care hospitals with a combined total of 367 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 2018, we cared for 15,581 inpatients and performed 789,226 outpatient procedures. This includes 84,207 emergency room visits and 1,622 deliveries. We sponsor the University of Illinois - College of Medicine Program and provided $5.6 million in education for primary care residents. Our employees and volunteers provided over 26,000 hours in unpaid community services. SwedishAmerican recognizes its responsibility to all the people of our community, regardless of their ability to pay for care. 97827984 82093498 SwedishAmerican 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 2018, our physician encounters were 409,747. 38199358 53644566 SwedishAmerican 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 2018, our out-patient encounters were over 22,867. 7802644 6924642 SwedishAmerican 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. Our therapists provide assessments and treatments. Medical social workers assist with assessments, counseling and helping patients and their families' access available community resources. SNAs 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 2018, we recorded 27,382 visits. 7802644 6924642 473893254 1 1 0 1 0 0 0 0 0 1 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 1 0 1 362 0 1 3812 1 1 1 0 0 0 0 0 0 0 0 0 X 26 19 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL X Patricia DeWane 7796964727 1313 East State Street Rockford IL 61104 Michael J Born MD President & CEO 40.00 6.00 X X 554849 0 80938 Daniel T Ross Chairman of the Board 2.00 6.00 X X 100 0 0 William C Roop First Vice Chairman/Secretary 2.00 6.00 X X 100 0 0 Rev Dr Kenneth Board Second Vice Chairman/Asst. Secretary 2.00 6.00 X X 100 0 0 Thomas R Walsh Audit/Compliance Chairman 2.00 6.00 X 100 0 0 Patrick Derry Quality and Safety Chairman 2.00 6.00 X 100 0 0 Jeffrey J Kaney Sr Joint Conference Chairman 2.00 6.00 X 100 0 0 Michael E Dallman UWRDI Board Representative 2.00 55.00 X 0 445366 78250 Allen D Williams MD Trustee 40.00 6.00 X 280971 0 59510 Amy J Wilcox Trustee 2.00 6.00 X 100 0 0 Danny L Copeland MD Trustee 40.00 6.00 X 82933 0 6161 David R Rydell Trustee 2.00 6.00 X 100 0 0 Eric Fulcomer PhD Trustee 2.00 6.00 X 100 0 0 Frank E Walter Trustee 2.00 8.00 X 100 0 0 Gregory R Jury Trustee 2.00 8.00 X 100 0 0 Helen Chung Hill Trustee 2.00 6.00 X 100 0 0 Jeffrey S Hultman Trustee 2.00 6.00 X 100 0 0 Marco T Lenis Trustee 2.00 6.00 X 100 0 0 Michael K Broski Trustee 2.00 6.00 X 100 0 0 Michael J Houselog PhD Trustee 2.00 6.00 X 100 0 0 Robert Flannery Trustee 2.00 55.00 X 0 622795 98159 Steven C Sjogren Trustee 2.00 8.00 X 100 0 0 Kathleen Kelly MD Trustee 2.00 6.00 X 25479 0 0 Mark Cormier MD Medical Staff President 2.00 X 13000 0 0 Steven Ikenberry MD Medical Staff Vice President 2.00 X 6500 0 0 John Shiro MD Past Medical Staff President 2.00 X 0 0 0 Patricia DeWane Chief Financial Officer 40.00 8.00 X 455011 0 62105 Donald Daniels VP & Chief Operating Officer 40.00 8.00 X 511468 0 109857 Thomas Schiller MD Chief Clinical Integration Officer 40.00 X 491806 0 111223 Michael Polizzotto MD Chief Medical Officer/CMIO 40.00 X 341867 0 56592 Ann Gantzer MD Chief Nursing Officer 40.00 X 341793 0 81294 Gayatri Sonti DO Physician 40.00 X 747885 0 30566 Martin Gryfinski MD Physician 40.00 X 698092 0 28772 Mohamed Zeater MD Physician 40.00 X 896332 0 61454 Tarek Harb MD Physician 40.00 X 628015 0 46695 Steven Milos MD Physician 40.00 X 680621 0 60965 William R Gorski MD Former President & CEO 0.00 X 1222937 0 38437 Donald Haring Former Chief Financial Officer 0.00 X 200333 0 0 Richard Walsh Former Chief Operating Officer 0.00 X 193680 0 0 8375272 1068161 1010978 303 1 1 0 University of Illinois 28394 Network Place Chicago IL 60673 Physician Services 5049478 Ringland Johnson Construction 1725 Huntwood Drive Cherry Valley IL 61016 Construction Services 3829510 Sound Physicians of Illinois 401 S LaSalle Street Chicago IL 60605 Physician Services 2224959 Cannon Design 255 N Michigan Avenue Chicago IL 60601 Construction Consulting 2201255 Infinity Healthcare Physicians 111 E Wisconsin Avenue Milwaukee WI 53202 Physician Services 2158838 126 1980078 142976 21176 2144230 Patient Services 621990 340503590 340503590 Medicare/Medicaid 621990 226214256 226214256 1815357 1815357 568533203 8017361 8017361 37232 46053 -8821 -8821 -8821 160064576 561210 143244843 675482 16819733 -114272 16705461 16705461 Day Care Center 624410 1628611 1628611 Cafeteria & Vending 561000 1443600 1434055 9545 Interdept. Billing 561000 1370711 1370711 1261228 488849 695029 77350 5704150 601095584 573455429 704574 24791351 593793 593793 14000 14000 7029941 1660048 5369893 915614 915614 204280154 177665506 26614648 9570372 8683009 887363 34612198 33250258 1361940 13945563 12010930 1934633 1301943 1301943 196608 196608 110492 110492 540461 540461 41370980 34420572 6950408 2583270 50427 2532843 9139960 5193488 3946472 7864470 6564182 1300288 17434468 12965420 4469048 256710 221764 34946 483715 289073 194642 2967722 1182711 1785011 20951272 18806509 2144763 5531637 2437239 3094398 Patient Supplies 93366152 92061016 1305136 Bad Debts 44107529 44107529 IPA Provider Tax 13252034 13252034 Repairs & Maintenence 8637160 6537558 2099602 7601177 1926188 5674989 548659395 473893254 74766141 0 26964223 62095370 78044560 64618929 10019994 9792168 11706843 9897020 380743391 77592823 292423437 303150568 249998752 18472301 241728295 4348125 5073057 34776603 42801706 708282537 757629414 50562141 57593601 123122852 118346780 77142813 92755401 250827806 268695782 X 448285325 479241671 3073834 3461818 6095572 6230143 457454731 488933632 708282537 757629414 X 52436189 -20725069 -232219 X 0 1 X 1 0 X 0 0 0 0 0 0 0 0 1 110492 110492 0 Part II-B, Line 1: Portions of the 2017/2018 Illinois Health and Hospital Association and American Hospital Association dues are used for lobbying: $50,492. A law firm was engaged to review legislation affecting hospitals: $60,000. 6676376 90495 632791 327257 7072405 6662294 10754 480152 476824 6676376 7112945 10986 -203624 258013 6662294 7122296 -9351 7112945 7093718 15490 405420 392332 7122296 0.60700 0.27390 0.11910 0 1 1 13941941 13941941 236904167 24366501 212537666 21202625 5136580 16066045 108694658 48089742 60604916 303150568 Beneficial Interest in Investment Pool 241728295 F 241728295 Advance to American Restaurant Assoc. (ARA) 189268 Interest In Net Assets of Recipient Organization 19608200 Due from Affiliated Organization 14917165 Insurance Recoveries Recievable 8087073 42801706 Due to Third Party Payors 63397339 Reserve for Self Insurance 18230041 Deferred Compensation 5851656 Asbestos Retirement Obligation 426666 Current Maturities of Long-term Debt 4849699 92755401 X 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, 2018 and 2017, 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, 2015. 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 2779572 2779572 0.00550 102266518 74631806 27634712 0.05480 3553659 1759352 1794307 0.00360 108599749 76391158 32208591 0.06390 7476161 1938519 5537642 0.01100 30441341 1335454 29105887 0.05770 333158 333158 0.00070 1219375 213807 1005568 0.00200 39470035 3487780 35982255 0.07140 148069784 79878938 68190846 0.13530 1 44107529 6619129 74589757 91845340 -17255583 X 1 1 1 Featherstone Partnership LP Ambulatory Surgery Center 0.28570 0.00000 0.71430 2 Northern Illinois Vein Clinic LLC Outpatient Physician Clinic 0.50000 0.00000 0.50000 3 Forest City Diagnostic Imaging LLC Outpatient Diagnostic Imaging 0.49000 0.00000 0.51000 2 1 SwedishAmerican Hospital 1401 E State Street Rockford IL 61104 www.swedishamerican.org IL License: 0002725 X X X X X A 2 SwedishAmerican Medical Ctr Belvidere 1625 S State Street Belvidere IL 61008 www.swedishamerican.org IL License: 0005504 X X X A Facility Reporting Group - A 0 0 1 X X X X X X X X X 15 1 1 0 1 X www.swedishamerican.org/community-health-needs-assessment X 1 15 1 www.swedishamerican.org/community-health-needs-assessment 0 1 X 200.000000000000 600.000000000000 X X X X X X 1 1 X X X 1 X www.swedishamerican.org/patients/charity-assistance-program X www.swedishamerican.org/patients/charity-assistance-program X www.swedishamerican.org/patients/charity-assistance-program X X X X X X X 1 X 0 X X X X 1 X 0 0 Part V, Section B Facility 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: Primary data was obtained from the 2014 Healthy Community Study provided by Rockford Health Council, which contained results and analytics from both a Healthy Community Survey and the Key Informant Questionnaire. The 2014 Healthy Community Study consists of two sections. Section I contains questions relating to four categories (1) general health, (2) behavioral health, (3) maternal, prenatal, and early childhood health and (4) chronic disease and obesity. Section II contains six demographic questions. Surveys were developed in English and Spanish language format with written and electronic versions. The Surveys were distributed in three phases. In Phase 1, the surveys requesting parent survey participation were distributed to students in Rockford Public School District 205. In Phase 2, surveys were mailed to residents of Boone and Winnebago County through a third party vendor. In Phase 3, a postcard was delivered to a random sample of households in Winnebago County providing access information to the survey on the Rockford Health Council Website. The Rockford Health Council identified a group of 49 individuals as Key Informants and distributed a questionnaire to them that asked them to rate their awareness of efforts to address each of the key focus areas identified in the 2010 Healthy Community Study that needed improvement. Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 6a: SA Hospital has two hospital facilities, SwedishAmerican Hospital located in Rockford Illinois, and SwedishAmerican Medical Center Belvidere located in Belvidere, Illinois. The definition of the community for purposes of the Community Health Needs Assessment (CHNA) was based on the internal patient origin information by zip code for SAH and SAMC's combined emergency room and inpatient discharges. Both Hospital Facilities defined its community for the CHNA as Boone and Winnebago Counties, Illinois since over 89% of emergency room patients and 84% 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: Poverty and UnemploymentOur SwedishAmerican Foundation awarded community grants to a number of local not-for-profit organizations. Requests were made to alleviate homelessness, prevent hunger and un/under employment, improve wellness, expand early childhood development and improve offender rehabilitation/reintegration. Nearly $12,000 went to Mosaic for its durable medical equipment (DME) distribution program. The DME program fulfills dozens of request every year for people in need in our community by providing walkers to canes, wheelchairs to shower chairs, hospital beds, portable ramps and more. In addition, $16,000 went to Youth Services Network to support its Parenthood Promise program that provides family support in nine life domains: physical need and living environment, socialization, legal, education and vocation, family attachment, psychological and emotional, cultural and spiritual. The program ultimately focuses on high school graduation rates and school attendance as well as other life domains. In addition, the Foundation granted $17,000 to Rockford Area Habitat for Humanity to support its Midtown Home Rehabilitation. The grant will enable Habitat to make a significant, long-term investment in the Midtown area of our city, while giving families the opportunity to earn a healthier, more secure place to call home. Last fall, Aramark and SwedishAmerican employees, filled 200 backpacks with school supplies and delivered them to Remedies Domestic Violence shelter. This is the third year Aramark has partnered with our organization to provide backpacks to children staying at Remedies. Basic hygiene products, vouchers and bus passes also were part of the donation. In November, SwedishAmerican helped area homeless stay warm by hanging 125 bags each containing a hat, gloves and a scarf on the fence in front of the hospital. This is the fifth year SwedishAmerican has hung the bags out for the homeless. General Health and Wellness and ObesityIn 2018, our Better Life Wellness team offered 60+ classes to the community in the areas of weight management, healthy eating and shopping, smoking cessation and stress management. In addition, they also offered 295 fitness classes ranging from yoga to tightening and toning. In June, our wellness team hosted a Be-Well Fest for the community. A variety of booths were set-up in our Heart Hospital lobby and included groups like the YMCA of Rock River Valley, Fleet Feet Running Store and many other groups to help individuals explore health and wellness.In August, our Ryan Jury Child Development Learning Center hosted a FREE health fair, in conjunction with National Childhood Obesity Awareness Month. Families and children of all ages were invited to attend the FREE health fair that taught families and children new ways to be active, make good choices and stay healthy. The event featured kid-friendly "fun-n-fit" activities for children of all ages. Dieticians and providers from SwedishAmerican also were on-site to provide health information and answer questions.Heart DiseaseThis past year, SwedishAmerican offered free community events to address heart disease. In February, Dr. Srivani Sridhar, Family and Integrative Holistic Medicine, presented Caring for Your Heart the Holistic Way. Dr. Sridhar discussed the integrative & holistic management of hypertension & heart disease as well as cardiac disease prevention. Later that month, SwedishAmerican Interventional Cardiologist Dr. Rehmat Sheikh, gave a free community presentation called Prevention and Control of Heart Disease in the Community. Participants learned about how to prevent heart disease, the role of diet and optimal control of heart risk factors. In April, SwedishAmerican held a free health talk at St. Peter and Paul Church where one of our family physicians, Dr. Marden Torrijos, discussed hypertension and high blood pressure. Individuals learned if they were at risk, and discovered available treatment options and tips for families and individuals to stay healthy. Nurses from SwedishAmerican also were there to conduct free blood pressure checks.CancerIn June, SwedishAmerican Regional Cancer Center hosted National Cancer Survivor Day. All cancer survivors and their families were invited to attend and enjoy a special survivorship celebration. The day was filled with hope, inspiration and friendship and featured a variety of activities including scheduled speakers and educational booths from the American Cancer Society, Pink Heals Association, Livestrong, Leukemia & Lymphoma Society and more. 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: Primary data was obtained from the 2014 Healthy Community Study provided by Rockford Health Council which contained results and analytics from both a Healthy Community Survey and the Key Informant Questionnaire. The 2014 Healthy Community Study consists of two sections. Section I contains questions relating to four categories (1) general health, (2) behavioral health, (3) maternal, prenatal, and early childhood health and (4) chronic disease and obesity. Section II contains six demographic questions. Surveys were developed in English and Spanish language format with written and electronic versions. The Surveys were distributed in three phases. In Phase 1, the surveys requesting parent survey participation were distributed to students in Rockford Public School District 205. In Phase 2, surveys were mailed to residents of Boone and Winnebago County through a third party vendor. In Phase 3, a postcard was delivered to a random sample of households in Winnebago County providing access information to the survey on the Rockford Health Council Website. The Rockford Health Council identified a group of 49 individuals as Key Informants and distributed a questionnaire to them that asked them to rate their awareness of efforts to address each of the key focus areas identified in the 2010 Healthy Community Study that needed improvement. Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 6a: SA Hospital has two hospital facilities, SwedishAmerican Hospital located in Rockford Illinois, and SwedishAmerican Medical Center Belvidere located in Belvidere, Illinois. The definition of the community for purposes of the Community Health Needs Assessment (CHNA) was based on the internal patient origin information by zip code for SAH and SAMC's combined emergency room and inpatient discharges. Both Hospital Facilities defined its community for the CHNA as Boone and Winnebago Counties, Illinois since over 89% of emergency room patients and 84% 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: Poverty and UnemploymentOur SwedishAmerican Foundation awarded community grants to a number of local not-for-profit organizations. Requests were made to alleviate homelessness, prevent hunger and un/under employment, improve wellness, expand early childhood development and improve offender rehabilitation/reintegration. Nearly $12,000 went to Mosaic for its durable medical equipment (DME) distribution program. The DME program fulfills dozens of request every year for people in need in our community by providing walkers to canes, wheelchairs to shower chairs, hospital beds, portable ramps and more. In addition, $16,000 went to Youth Services Network to support its Parenthood Promise program that provides family support in nine life domains: physical need and living environment, socialization, legal, education and vocation, family attachment, psychological and emotional, cultural and spiritual. The program ultimately focuses on high school graduation rates and school attendance as well as other life domains. In addition, the Foundation granted $17,000 to Rockford Area Habitat for Humanity to support its Midtown Home Rehabilitation. The grant will enable Habitat to make a significant, long-term investment in the Midtown area of our city, while giving families the opportunity to earn a healthier, more secure place to call home. Last fall, Aramark and SwedishAmerican employees, filled 200 backpacks with school supplies and delivered them to Remedies Domestic Violence shelter. This is the third year Aramark has partnered with our organization to provide backpacks to children staying at Remedies. Basic hygiene products, vouchers and bus passes also were part of the donation. In November, SwedishAmerican helped area homeless stay warm by hanging 125 bags each containing a hat, gloves and a scarf on the fence in front of the hospital. This is the fifth year SwedishAmerican has hung the bags out for the homeless. General Health and Wellness and ObesityIn 2018, our Better Life Wellness team offered 60+ classes to the community in the areas of weight management, healthy eating and shopping, smoking cessation and stress management. In addition, they also offered 295 fitness classes ranging from yoga to tightening and toning. In June, our wellness team hosted a Be-Well Fest for the community. A variety of booths were set-up in our Heart Hospital lobby and included groups like the YMCA of Rock River Valley, Fleet Feet Running Store and many other groups to help individuals explore health and wellness.In August, our Ryan Jury Child Development Learning Center hosted a FREE health fair, in conjunction with National Childhood Obesity Awareness Month. Families and children of all ages were invited to attend the FREE health fair that taught families and children new ways to be active, make good choices and stay healthy. The event featured kid-friendly "fun-n-fit" activities for children of all ages. Dieticians and providers from SwedishAmerican also were on-site to provide health information and answer questions.Heart DiseaseThis past year, SwedishAmerican offered free community events to address heart disease. In February, Dr. Srivani Sridhar, Family and Integrative Holistic Medicine, presented Caring for Your Heart the Holistic Way. Dr. Sridhar discussed the integrative & holistic management of hypertension & heart disease as well as cardiac disease prevention. Later that month, SwedishAmerican Interventional Cardiologist Dr. Rehmat Sheikh, gave a free community presentation called Prevention and Control of Heart Disease in the Community. Participants learned about how to prevent heart disease, the role of diet and optimal control of heart risk factors. In April, SwedishAmerican held a free health talk at St. Peter and Paul Church where one of our family physicians, Dr. Marden Torrijos, discussed hypertension and high blood pressure. Individuals learned if they were at risk, and discovered available treatment options and tips for families and individuals to stay healthy. Nurses from SwedishAmerican also were there to conduct free blood pressure checks.CancerIn June, SwedishAmerican Regional Cancer Center hosted National Cancer Survivor Day. All cancer survivors and their families were invited to attend and enjoy a special survivorship celebration. The day was filled with hope, inspiration and friendship and featured a variety of activities including scheduled speakers and educational booths from the American Cancer Society, Pink Heals Association, Livestrong, Leukemia & Lymphoma Society and more. 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. 34 1 - Regional Cancer Center 3535 N Bell School Road Rockford IL 61114 Outpatient Clinic 2 - SwedishAmerican Heart Institute 1340 Charles Street Suite 300 Rockford IL 61104 Outpatient Clinic 3 - Stateline Clinic & Immediate Care 4282 E Rockton Road Roscoe IL 61073 Outpatient Clinic 4 - Lundholm Orthopedics 1340 Charles Street Suite 100 Rockford IL 61114 Outpatient Clinic 5 - Neuro and Headache Center 1340 Charles Street Suite 400 Rockford IL 61104 Outpatient Clinic 6 - Woodside Clinic 3775 N Mulford Road Rockford IL 61104 Outpatient Clinic 7 - Wound Care & Hyperbaric Clinics 1415 E State Street Ste 408 609 Rockford IL 61104 Outpatient Clinic 8 - Brookside Specialty Center 1253 N Alpine Road Rockford IL 61107 Outpatient Clinic 9 - Rockford Vascular Surgery at SA 1340 Charles Street Suite 200 Rockford IL 61104 Outpatient Clinic 10 - SAMG Obstetrics & Gynecology 209 9th Street Rockford IL 61104 Outpatient Clinic 11 - SwedishAmerican Home Health Care 2550 Charles Street Rockford IL 61108 Home Health 12 - Belvidere Clinic 1700 Henry Luckow Lane Belvidere IL 61008 Outpatient Clinic 13 - Pulmonary and Critical Care Clinic 1401 E State Street Rockford IL 61104 Outpatient Clinic 14 - Rockford Ambulatory Surgery Center 1016 Featherstone Road Rockford IL 61107 Ambulatory Surgery Center 15 - Five Points Clinic 2404 Charles Street Suite 800 Rockford IL 61108 Outpatient Clinic 16 - Valley Clinic 6824 Newburg Road Rockford IL 61108 Outpatient Clinic 17 - SA Immediate Care 2473 McFarland Road Rockford IL 61107 Outpatient Clinic 18 - Rock Valley Clinic 6861 Villagreen View Rockford IL 61107 Outpatient Clinic 19 - State St OBGYN 1415 E State Street Rockford IL 61104 Outpatient Clinic 20 - UW Health Surgery at SwedishAmerican 1340 Charles Street Suite 100 Rockford IL 61104 Outpatient Clinic 21 - Midtown Clinic 1340 E State Street Suite 405 Rockford IL 61104 Outpatient Clinic 22 - Davis Junction Clinic 5665 North Junction Way Davis Junction IL 61020 Outpatient Clinic 23 - Byron Clinic 220 W Blackhawk Drive Byron IL 61010 Outpatient Clinic 24 - Woodward Health Network Clinic 2473 McFarland Road Rockford IL 61107 Outpatient Clinic 25 - North Main Clinic 2601 N Main Street Rockford IL 61103 Outpatient Clinic 26 - Cardiothorasic Surgery 1340 Charles Street Suite 300 Rockford IL 61104 Outpatient Clinic 27 - Northern Illinois Vein Clinic 1340 Charles Street Suite 404 Rockford IL 61104 Outpatient Clinic 28 - Rochelle Clinic 380 Illinois Route 38 East Rochelle IL 61068 Outpatient Clinic 29 - Maternal Fetal Medicine 1401 E State Street Rockford IL 61114 Outpatient Clinic 30 - Diabetes Self-Management Center 1415 E State St Suite 700 Rockford IL 61104 Outpatient Clinic 31 - Infectious Disease Consultants 1340 Charles St Suite 404 Rockford IL 61104 Outpatient Clinic 32 - Strathmoor Pediatrics 5695 Strathmoor Drive Rockford IL 61005 Outpatient Clinic 33 - Woodward Occup Health Loves Park 5001 N 2nd Street Loves Park IL 61111 Outpatient Clinic 34 - Woodward Occupational Health Rock Cut 1 Woodward Way Loves Park IL 61111 Outpatient Clinic 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: $25,563,504Emergency department physicians: $1,260,487Total: $26,823,991 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 $44,107,529. Part I, Line 7: 7a and 7f costs were calculated using the 2018 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. Those 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 14.2% of the population is below the poverty level, the median household income was $51,110 and a household size of 2.47, Boone County 8.8% of the population is below the poverty level, the median household income was $62,701 and a household size of 2.85. The 2018 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 $41,560 is 200% of the poverty level and $124,680 is 600% of the poverty level. Approximately 79% of our charity write-offs are for patients without insurance while 65% of our bad debt write-offs are for patients without insurance. In 2018 only 6% 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: Patient accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the hospital identifies troubled accounts, reviews historical experience and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patientswith deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts. 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: ($17,255,583)Medicare shortfall physician programs: ($14,532,793)Total Medicare Shortfall ($31,788,376) 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 patientcooperates with the requirements of the charity care policy, collection efforts are ceased. Part VI, Line 2: SA hospital has provided monetary support for the 2014 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 April of 2015, 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 Service Area (MSA) and the counties of Winnebago, Boone, and to a lesser degree Ogle and Stephenson Counties. Ogle and Winnebago counties have medically underserved area (MUA) designations for the White Rock Service Area (MUA 916) and Winnebago Service Area (MUA 7011). The U.S. Census bureau had the 2015 estimated population for the Rockford MSA at 340,663. Today, the unemployment rate of the Rockford MSA is 5.8%, 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 14.7%. 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 10.3%. Of the patients served by SA Hospital at all facilities, 28.4% are uninsured or Medicaid recipients. 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 2014 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 also focuses on three other areas of need identified by Rockford Health Council. They are: 1) Behavioral Health 2) Maternal, Prenatal, and Early Childhood Health 3) Chronic Disease and ObesityGeneral Health:Both Boone and Winnebago counties have a lower rate of primary care physicians (PCP) 78% compared to the state 96% and the nation 86% and the rate of access to PCP is lower for Boone County 59% than for Winnebago Counties 82%. 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 half 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 20% believe there is a lack of social or emotional support for the region, which is consistent with that of the state and national rates.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 5% and below state and national rates but not for Winnebago County at 8% and above the state and national rates per 1,000 live births. Additionally, the teen birth rate for Boone County 30% is lower than the state 35% and Winnebago County at 46% and the incidences of teen birth rate for all comparative groups have declined over a 10 year period between 2002 and 2012.Chronic Disease: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. However, the Study illustrates less than 5% of Boone County and 11% of Winnebago County live within a half mile of a park and for each 100,000 it is estimated that 5 facilities exist in Boone County and 9 facilities in Winnebago County with an estimated regional population of 350,000.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 SA Hospital'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. Ourorganization 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 serves 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 SA Hospital teams.For example, 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 organization-led efforts to improve the quality of life in our community are not exclusively health-related. One example is the partnership we formed twenty 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 wellbeing 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. Part VI, Line 6: SA Hospital a division of UW Health offers services at two acute care hospital facilities, physician clinics, physician emergency services, and home health care. SwedishAmerican Foundation is a subsidiary of SA Hospital and supports it through fundraising activities.Following a campus renovation project that began in 2000, the SwedishAmerican Foundation (SAF) implemented a massive neighborhood revitalization and replacement initiative to transform a large areasurrounding the hospital campus into "a neighborhood of choice...not chance." This project brought together the forces of SwedishAmerican, SAF, the City of Rockford and countless charitable and commercial entities to improve the quality and availability of area housing.In March of 2015, the program was recognized by The United Way of Rock River Valley with the inaugural Strong Neighbor Award. Because strong neighborhoods make a strong community, United Way is leading a place based strategy that will dramatically improve the quality of life for children and families. Two of the region's most challenged neighborhoods (Ellis Heights and Midtown District) are the strategic focus of thisplan. SwedishAmerican was cited for being a vital partner to the Strong Neighborhoods initiative and for building better neighborhoods for our children and families. United Way noted SwedishAmerican's commitment to transforming the area surrounding the Hospital from an at-risk, predominantly rental-occupied part of Rockford to a stable, owner occupied neighborhood.SwedishAmerican's neighborhood revitalization effort includes:Habitat for Humanity Homes: Several years ago SwedishAmerican entered into a formal agreement with the Rockford Habitat for Humanity Chapter to construct new area homes. By the end of 2015, dozens of Habitat for Humanity homes have now been completed and sold to low-income home owners who qualify through Habitat For Humanity. Habitat For Humanity now holds annual application seminars on SwedishAmerican campus for our employees and members of the neighborhood.Midtown Community Work Day: In June 2016 SwedishAmerican Foundation collaborated and co-sponsored the first annual Midtown Community work day. Together with Rockford Habitat for Humanity and Thrivent Financial we initiated an exterior home improvement grant application for Midtown District homeowners. This was a one day event that utilized volunteers from Swedes, Habitat, Rockford Police, Thrivent, East High School, Rockford Fire and community members to work with grant recipients to help complete exterior repairs to 10 homes which totaled $25,000 of improvements to the community since inception! SwedishAmerican again teamed up with Rockford Area Habitat for Humanity and Thrivent Financial to give four $2,500 grants to homeowners to help improve the exterior of their homes. The homeowners had to provide $100 toward the renovation and participate in the improvement process.Neighborhood Playground and Parks: Because area children did not have a safe place to play, SAF purchased three contiguous pieces of property, removed existing commercial and residential structures and partnered with two local charities to construct a new neighborhood playground. Since the completion of these projects, SwedishAmerican Foundation maintains their appearances with regular visits from our landscaping company. This ensures we maintain the beauty of the parks and playgrounds for our neighborhood to enjoy.Homeowner Grants to Employees: Since 2004, SwedishAmerican has offered $5,000 down payment assistance to employees to help encourage home ownership in the six-block area surrounding the hospital. This initiative includes a five-year forgivable grant to employees in good standing-with no income restrictions. Since inception, this program has assisted 34 employees purchase homes in the SwedishAmerican neighborhood.Home Restoration: Beginning in 2004, SAF has purchased dozens of homes in the neighborhood target area, rehabbed them and made them available to employees, firefighters, police officers and public school teachers, at discount (less than the cost of purchase and repairs). In 2015, 14 additional properties were identified and work completed. In 2017, SwedishAmerican tore down the home at 1505 7th Avenue and sold the land to the neighbor so they could have a larger yard. Strong Neighborhood House:In 2017, SwedishAmerican Foundation and the Rockford Police Department celebrated three years of success in the first-ever community "Strong Neighborhood House." In May 2016, SwedishAmerican purchased and renovated the house and licensed it to the Rockford Police Department as a place for officers to build a closer relationship with neighbors. Additionally, it is a space where officers can help facilitate problem solving and ultimately reduce crime in the neighborhood. The house has set office hours each morning, Monday through Friday. Officers patrol the neighborhood throughout the day and evening and stop by the house at any time. Showing a strong police presence in the neighborhood has given residents a hope for change and a better future.Over the last year the Rockford Community Police Officer has been working hard to increase programing and utilization of the house to better serve the needs of the neighborhood. Jackson Oaks Neighborhood Association holds monthly meetings at the Strong House. Other organizations hold meetings there such as The Fatherhood Project, and Girl Scouts of Northern Illinois. Lifestyle Medicine and Wellness Programs:SwedishAmerican 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 Fire and Police Departments 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.Better Life Wellness/YMCA Partnership: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 members and the general public, including: Wellness educational programs, classes and support groups Screenings and health risk assessments Personal health coaching Weight management programs Therapeutic massages, Reiki and reflexology Healthy cooking classes and grocery tours Smoking cessation classes Relaxation and stress management education Healthy Heart screensBetterLife expands our capacity to help people of all ages, physical abilities and limitations lead healthier lives. Our unique holistic health experience and expertise will be incorporated into the individualized wellness prescriptions and coaching offered to our participants. 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 well-being and bring a measureable impact upon improving the overall health of our community. Part VI, Line 6 Continued: Academic & Career Promotion:In 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 Expo: In 2018, 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. Scholarships: Physicians, Practitioners and The Foundation Partner To Change Kids' Futures For many years, SwedishAmerican Medical Group (SAMG) has supported a special fund within the Foundation, the SAMG Community Benefit Fund. Through this, we have pooled resources to aid organizations in need throughout the community. A new initiative is supporting scholarships through Rockford Promise, an organization whose vision is to change the community by ensuring the secondary education of its youth. In April 2017, we presented two students with fully funded, two-year scholarships to Rock Valley College.Health Education:According 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 31.3 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. 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 challenges rates, SwedishAmerican is committed to educating public and professional audiences within our community about matters of prevention, detection and treatment.Cardiac Care Professional and Public Events: In its community assessment, the Rockford Health Council found that chest pain and heart failure were leading reasons for hospitalization in the Rockford area. In response to community needs SwedishAmerican created a large-scale educational event in 1999 to help healthcare professionals stay current on patient care and inform the public about heart disease prevention and treatment.Heart Care: Ask the Experts is two free public events: a heart health fair and an educational program. The fair allows our community to learn more about prevention, screenings, treatment, technologies and complementary care at more than 30 exhibits. The program, which varies each year, has included heart-healthy cooking demos, live open-heart surgery beamed via satellite from SwedishAmerican Hospital and panel discussions that allow dialogue between the audience and SwedishAmerican physicians. Community response has been tremendous, with annual attendance exceeding 500. Although Heart Care is an evening event, its health impact is real; many people requested a referral to either a primary care physician or cardiologist.Breast Cancer Awareness Event/Partnership with A Silver Lining Foundation:National statistics indicate that one in nine women will be diagnosed with breast cancer during her lifetime. The aforementioned community assessment revealed that, of the nearly 1,600 cases of cancer that occur in the Rockford area each year, breast cancer is the leading site among women. To provide area women with vital information on breast cancer prevention, detection and treatment, SwedishAmerican annually hosts a free breast cancer awareness event. For 19 years, this event has given breast cancer survivors, the newly diagnosed and those at high risk due to family history an opportunity to hear the latest clinical recommendations. This event has included both national speakers and expert panels of primary care physicians, radiologists, oncologists, surgeons and allied health professionals that engage the audience. Over the years, we have enhanced the program by targeting underserved minority populations for this program and offering discounted mammogram coupons to encourage screenings. More than 500 women attend this annual event. In 2015, SwedishAmerican partnered with A Silver Lining Foundation (ASLF) to offer free mammograms for women and men who can't afford one. Screenings took place at three SwedishAmerican locations in and around Rockford. The foundation was launched more than a decade ago with a mission to ensure dignified, respectful and equal access to quality cancer education and services for all. ASLF ensures that socioeconomic status does not affect an individual's ability to obtain information, timely cancer screening and diagnosis. SwedishAmerican is excited to partner with an organization such as ASLF because the more people who get screened, the more people we can educate and the more lives we can save.Ryan Jury Learning Center FREE Health FairMore than 23 million children and teenagers in the United States between the ages of 2 and 19 are obese or overweight. To help combat this problem, SwedishAmerican's Ryan Jury Child Development Learning Center hosted a FREE health fair in September 2017, in conjunction with National Childhood Obesity Awareness Month. The event took place at the UW Health Sports Factory in downtown Rockford, Illinois.Child's Safety Fair:In May, SwedishAmerican hosted the 8th 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.Community ServiceCommunity Paramedic Programs:In 2017, 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 Department. 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.From August 2016 to December 2017, SwedishAmerican patients enrolled in the program experiences a reduction of Emergency Department (ED) visits by 35%, ambulance runs by 42% and hospital admission by 40%.Rockford Fire firefighter Brian Park is currently the MIH Manager for the program. Brian is both an eleven year veteran of the department and a Registered Nurse (RN) in the community for the past 11 years. Through the MIH program, he works directly with SwedishAmerican case managers, EMS department, pharmacists, physician and nurses at the hospital to identify patients and develop individualized care plans for each of them. Part VI, Line 6 Continued: Brian currently sees 20 patients on a weekly basis often times accompanied by a SwedishAmerican nurse case manager. Each patient receives regularly scheduled home visits where Brian provides a medical assessment, ensures the patient is taking their prescribed medications and is following up with their primary care provider. He offers community resource support to help improve the patients' health and wellbeing. In addition, he checks smoke detectors, CO2 detectors and any hazards that may exist in the patient's home.In addition to the MIH program with Rockford Fire Department, SwedishAmerican has an MIH program in place with Byron, Harlem-Roscoe and Rockton Fire Departments.Fall and Spring Neighborhood Association Group Summits and GatheringsOur city is faced with challenges, but along with challenges comes many opportunities for our community. That's why in May 2017, the SwedishAmerican Foundation, Rockford Police Department and Keith Creek Neighborhood Association hosted a Strong Neighborhood Association Groups Gathering. The Summit was FREE and open to local community members. Judge Rosemary Collins discussed domestic violence. She also shared how the community can work together to help find solutions to this growing issue. In October 2017, the SwedishAmerican Foundation, Rockford Police Department and Neighborhood Association's from Jackson Oaks, Keith Creed, North Highland, Rockview and South Highland hosted a Fall Neighborhood Association Group Summit at another location with the same availability to the community. The Great Neighborhoods Project piloted by urban planners engages neighborhoods to focus on the assets that they have to build relationships thereby strengthening their neighborhoods.Little Free Libraries:The 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, weatherproof 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. Part VI, Line 7: SA Hospital files a community benefit report with the Illinois Attorney General. 1 Aunt Martha's Youth Service Center Inc 19990 Governors Hwy Olympia Fields IL 60461 237188150 501(c)(3) 334320 Federally qualified health center that provides health services to uninsured and underserved in our community Illinois Hospital Research & Education Foundation 1151 East Warrenville Road Naperville IL 60566 237421930 501(c)(3) 259473 Quality healthcare for Illinois 2 0 Scholarship - educational scholarship for children of non-management employees. 14 14000 Part I, Line 2: IHREF is a tax-exempt research entity whose mission is to provide educational opportunities and grants designed to foster and encourage the provision of the highest standard of patient care by hospitals in Illinois. Aunt Martha's Youth Service Center, Inc. is a federally qualified health center that provides health services to uninsured and underserved in our community. SA Hospital works closely with both grantee organizations or receives reports from them as appropriate. 0 1 0 0 0 0 0 1 0 Michael J Born MD President & CEO 447672 0 78479 0 28698 0 55296 0 25642 0 635787 0 0 0 Michael E Dallman UWRDI Board Representative 0 399241 0 44337 0 1788 0 61281 0 16969 0 523616 0 0 Allen D Williams MD Trustee 280971 0 0 0 0 0 19575 0 39935 0 340481 0 0 0 Robert Flannery Trustee 0 555603 0 60775 0 6417 0 72672 0 25487 0 720954 0 0 Patricia DeWane Chief Financial Officer 334697 0 63823 0 56491 0 52427 0 9678 0 517116 0 0 0 Donald Daniels VP & Chief Operating Officer 382918 0 88467 0 40083 0 82027 0 27830 0 621325 0 0 0 Thomas Schiller MD Chief Clinical Integration Officer 371178 0 62111 0 58517 0 74006 0 37217 0 603029 0 0 0 Michael Polizzotto MD Chief Medical Officer/CMIO 301188 0 17221 0 23458 0 21625 0 34967 0 398459 0 0 0 Ann Gantzer MD Chief Nursing Officer 274627 0 42090 0 25076 0 41091 0 40203 0 423087 0 0 0 Gayatri Sonti DO Physician 747885 0 0 0 0 0 6895 0 23671 0 778451 0 0 0 Martin Gryfinski MD Physician 698092 0 0 0 0 0 9720 0 19052 0 726864 0 0 0 Mohamed Zeater MD Physician 896332 0 0 0 0 0 13500 0 47954 0 957786 0 0 0 Tarek Harb MD Physician 628015 0 0 0 0 0 12420 0 34275 0 674710 0 0 0 Steven Milos MD Physician 680621 0 0 0 0 0 17332 0 43633 0 741586 0 0 0 William R Gorski MD Former President & CEO 469388 0 188137 0 565412 0 26100 0 12337 0 1261374 0 454953 0 Donald Haring Former Chief Financial Officer 0 0 20892 0 179441 0 0 0 0 0 200333 0 167484 0 Richard Walsh Former Chief Operating Officer 0 0 20892 0 172788 0 0 0 0 0 193680 0 160831 0 Part I, Line 3 All 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, Line 4b Contributions to the 457(f) plan during 2017 include: Michael Born M.D. - $42,876; Donald Daniels - $42,427; Patricia DeWane - $30,827; Thomas Schiller, M.D. - $34,406; Ann Gantzer $23,884; Michael Polizzotto M.D. $11,905. Payments from the 457(f) plan during 2017 include: William Gorski, M.D. - $454,953; Rich Walsh - $160,831 and Donald Haring - $167,484. These payments are reported as taxable income on Part II, column (B)(iii). Part I, Line 7 SwedishAmerican 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). A Illinois Finance Authority - 2012 861091967 45203HLW0 2012-09-27 41833485 See Part IV 0 0 0 B Illinois Finance Authority - 2015 861091967 45203HY89 2015-03-27 76980000 See Part IV 0 0 0 C Illinois Finance Authority - 2010A 861091967 2016-10-11 8820000 See Part IV 0 0 0 D Illinios Finance Authority - 2010B 861091967 2016-10-26 8370000 See Part IV 0 0 0 A 41888629 648001 41240628 2013 0 0 0 1 B 9840000 76980000 76980000 2007 1 0 0 1 C 1260000 8820000 8820000 2010 1 0 0 1 D 930000 8370000 8370000 2010 1 0 0 1 A 0 0 0 0 0 0 1 B 0 0 0 0 0 0 1 C 0 0 0 0 0 0 1 D 0 0 0 0 0 0 1 A 0 0 0 1 0 0 0 0 1 B 0 0 1 0 0 0 0 0 1 C 0 0 1 0 0 0 0 0 1 D 0 0 1 0 0 0 0 0 1 A 1 B 1 C 1 D 1 Date Rebate Computation Performed Issuer 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. 2015 Bond: Construction & Equipment Cardiac pavilion, renovate operating room & catheterization lab completed in 2007. The bond was remarketed on 3/27/15. 2010A and 2010B Bonds: Original bond issue in 2005 for Construction & Equipment Cardiac pavilion, renovation of operating room & catheterization lab completed in 2007. Bond was re-issued in 2010 as a direct bank placement, and reissued in 2016. Andrea Fulcomer See Part V 58873 See Part V 0 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 Form 990, Part VI, Section A, line 2 Michael Broski, Jeffrey Hultman and Frank Walter have a business relationship. Form 990, Part VI, Section A, line 6 SwedishAmerican Health System Corporation (SAHSC) is the sole corporate member of SwedishAmerican Hospital. Form 990, Part VI, Section A, line 7a SwedishAmerican Health System Corporation is the sole corporate member of SwedishAmerican Hospital and as such appoints all trustees. Form 990, Part VI, Section A, line 7b SAHSC 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 11b A draft version of the Form 990 was reviewed by Legal Counsel and the Chief Financial Officer. Subsequently, the Audit/Compliance Committee of the Board of Directors of SwedishAmerican Health System reviewed a final draft of the Form 990 and were provided with the opportunity to comment and ask questions. 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 12c The 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 15 All 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 19 The 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 1,331,846. Joint Ventures Book/Tax Difference 416,013. Transfer from SwedishAmerican Foundation -1,980,078. University of WI Hospital and Clinics Authority 600 Highland Avenue Madison WI 53792 391835630 Hospital and Clinics WI 501(c)(3) Line 6 N/A 0 University of WI Medical Foundation 600 Highland Avenue Madison WI 53792 391824445 Physician Services WI 501(c)(3) Line 10 University of WI Hospital and Clinics Authority 0 Regional Division Inc 301 South Westfield Road Suite 320 Madison WI 53717 391446049 Regional Parent Corp. to manage and direct activities of entities WI 501(c)(3) Line 12a University of WI Hospital and Clinics Authority 0 University Health Care Inc 301 South Westfield Road Suite 320 Madison WI 53717 472553196 Support Organization WI 501(c)(3) Line 12a University of WI Hospital and Clinics Authority 0 SwedishAmerican Health System Corporation 1401 East State Street Rockford IL 61104 363241458 Parent Corporation to manage and direct activites of entities IL 501(c)(3) Line 12a Regional Division Inc 0 SwedishAmerican Foundation 1415 East State Street Rockford IL 61104 363097493 Supports fundraising for SwedishAmerican Hospital IL 501(c)(3) Line 7 SwedishAmerican Hospital 1 SwedishAmerican Realty Corporation 1313 East State Street Rockford IL 61104 363248013 Title Holding Company IL 501(c)(2) SwedishAmerican Health System Corporation 1 SwedishAmerican Hospital Self Insurance Trust 1401 East State Street Rockford IL 61104 366652702 Hospital Malpractice Trust IL 501(c)(3) Line 12a SwedishAmerican Hospital 1 Wisconsin Therapies Inc 600 Highland Avenue Madison WI 53792 391807425 Infusion Therapy WI 501(c)(3) Line 12d University of WI Hospital and Clinics Authority 0 Generations Fertility Care 2365 Deming Way Middleton WI 53562 273496527 Reproductive endocrinology and infertility services WI 501(c)(3) Line 10 N/A 0 Wisconsin Dialysis 3034 Fish Hatchery Road Fitchburg WI 53713 300072647 Dialysis Services WI 501(c)(3) Line 12c N/A 0 Madison Surgery Center 7974 UW Health Court Middleton WI 53562 391940656 Health care services and training WI 501(c)(3) Line 10 N/A 0 UW Health ACO Inc 7974 UW Health Court Middleton WI 53562 455490584 Accountable Care Organization WI 501(c)(3) Line 10 University of WI Hospital and Clinics Authority 0 Gundersen Health Plan Minnesota Inc 3190 Gundersen Drive Onalaska WI 54650 452633920 Health Insurance MN 501(c)(4) Gundersen Health Plan Inc 0 Gundersen Health Plan Inc 3190 Gundersen Drive Onalaska WI 54650 391807071 Health Insurance WI 501(c)(4) University Health Care Inc 0 Three Rivers Partners LLC 1313 East State Street Rockford IL 61104 262231757 Information Technology Services IL N/A N/A 0 0 Northern Illinois Vein Clinic 2550 Charles Street Rockford IL 61108 201642329 Outpatient Health Services IL N/A RELATED 30708 129474 0 1 0.50000 Chartwell Wisconsin Enterprises LLC 2241 Pinehurst Drive Middleton WI 53562 391796267 Parent entity of CMW and CMW-HR WI N/A N/A 0 0 Madison Medical Center LLP 7974 UW Health Court Middleton WI 53562 391329429 Real Estate WI N/A N/A 0 0 Sixth Street Medical LLC 7974 UW Health Court Middleton WI 53562 472705724 Real Estate WI N/A N/A 0 0 SARI Insurance Company 76 St Paul Street Suite 500 Burlington VT 054014477 030308753 Captive Insurance Company VT N/A C 1 State & Charles Inc 1313 East State Street Rockford IL 61104 363321193 Holding Company IL N/A C 1 SwedishAmerican Health Management Corp 1401 East State Street Rockford IL 61104 363246511 Management Services IL N/A C 1 Unity Health Plans Insurance Corporation 840 Carolina Street Sauk City WI 53583 391450766 Health Maintenance Organization WI N/A C 0 Health Professionals of Wisconsin 301 South Westfield Road Madison WI 53717 391806711 Real Estate WI N/A C 0 Physician's Care Network 1313 East State Street Rockford IL 61104 363455791 Health Services IL N/A C 1 Quartz Holding Company 840 Carolina Street Sauk City WI 53583 821728929 Holding Company WI N/A C 0 Quartz Health Solutions 840 Carolina Street Sauk City WI 53583 465710709 Insurance WI N/A C 0 Physicians Plus Insurance Corporation 840 Carolina Street Sauk City WI 53583 391565691 Health Maintenance Organization WI N/A C 0 One South Park Parking Condominium Association Inc 1 South Park Street Madison WI 53701 Condominium Association WI N/A C 0 Charitable Remainder Unitrusts (3) Trust IL N/A T 1 0 0 1 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 SwedishAmerican Foundation C 1980078 Cost SwedishAmerican Hospital Self Insurance Trust Q 419090 Cost SwedishAmerican Hospital Self Insurance Trust R 5747941 Cost SwedishAmerican Realty Corporation K 6693343 Cost Three Rivers Partners LLC J 335133 Cost University of WI Medical Foundation P 3608186 Cost University of WI Hospital and Clinics P 7067218 Cost Regional Division Inc K 240995 Cost Regional Division Inc Q 1366421 Cost Regional Division Inc P 446537 Cost