2016-01-29T14:02:41-06:00 2015-04-30 410746749 CLIFTONLARSONALLEN LLP 114 E EVERETT DIXON IL 61021 990 2014-05-01 651293967 KISHWAUKEE PHYSICIAN GROUP INC KISH 8157561521 ONE KISH HOSPITAL DRIVE DEKALB IL 60115 LOREN FOELSKE VICE PRESIDENT - FINANCE, KHS 8157561521 2016-01-20 1 KELLY JACKSON HARDY P00747242 8152859300 2014 2016-04-25 22:37:26Z KISH HEALTHSYSTEM PHYSICIAN GROUP KEVIN P POORTEN ONE KISH HOSPITAL DRIVE DEKALB IL 60115 26498171 0 X WWW.KISHHEALTH.ORG X 2006 IL TO PROVIDE EXCELLENT AND INNOVATIVE HEALTH CARE TO ALL AREA RESIDENTS. 12 1 60 8 0 0 0 20750001 2068118 5424245 0 905 107535 323020 2175653 26498171 0 0 0 0 3601050 8119038 0 0 0 2197468 4429861 5798518 12548899 -3622865 13949272 2546815 20104004 737273 4319879 1809542 15784125 KISHWAUKEE PHYSICIAN GROUP EXISTS AS ONE OF THE AREA'S LEADING PHYSICIAN GROUPS, PROVIDING HEALTH CARE TO ALL AREA RESIDENTS. ALL CARE GIVEN IS CHARACTERIZED BY EXCELLENCE AND INNOVATION WITH THE GOAL OF KEEPING OUR COMMUNITIES HEALTHY. 0 0 9792935 0 5424245 KISHWAUKEE PHYSICIAN'S GROUP (KPG) WAS ESTABLISHED TO PROVIDE HIGH QUALITY HEALTH CARE TO PATIENTS AT A REASONABLE COST. KPG ALSO PROVIDES THE COMMUNITY WITH EDUCATION ACTIVITIES RELATED TO THE PROMOTION OF HEALTH AND PARTICIPATES IN ACTIVITIES SUCH AS PREVENTATIVE SCREENINGS AND HEALTH CLINICS INTENDED TO PROMOTE THE GENERAL HEALTH OF THE MEMBERS OF THE COMMUNITY. MEDICAL SERVICES ARE PROVIDED IN A NONDISCRIMINATORY MANNER, INCLUDING MEDICARE AND MEDICAID PATIENTS, AND TO LOW-INCOME PATIENTS PURSUANT TO THE ORGANIZATION'S CHARITY CARE POLICY. ALL OF THESE ACTIVITES ARE INTENDED TO SERVE AND IMPROVE THE COMMUNITY VIA REDUCED HEALTH CARE COSTS, IMPROVED ACCESS TO PHYSICIANS AND EXPANDED HEALTHCARE RESOURCES. 9792935 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 9 0 1 60 1 0 0 0 0 0 0 0 0 0 0 X 12 1 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X LOREN FOELSKE VP FINANCE 8157561521 ONE KISH HOSPITAL DRIVE DEKALB IL 60115 KEVIN POORTEN PRESIDENT & CEO, KISHHEALTH SYSTEM 5.00 50.00 X X 0 872800 129696 MICHAEL CULLEN CHAIR 5.00 6.00 X X 0 0 0 ERIK ENGLEHART MD VICE-CHAIR,PHYSICIAN FAMILY MEDICINE 45.00 0.00 X X 231616 0 32396 AZEEM HALEEM MD DIRECTOR, PHYSICIAN, UROLOGY 45.00 0.00 X 516666 0 24649 MICHAEL KULISZ DO DIRECTOR, CHIEF MEDICAL OFFICER 2.00 50.00 X 0 467070 73919 ABE CHACKO PRACTICE ADMINISTRATOR, EX OFFICIO 45.00 0.00 X 130967 0 22205 SHAKEEL AHMAD MD PHYSICIAN, FAMILY MEDICINE 40.00 0.00 X 0 0 0 SAJIT BUX MD PHYSICIAN, FAMILY MEDICINE 40.00 0.00 X 0 0 0 RAKESH PATEL MD PHYSICIAN, FAMILY MEDICINE 40.00 0.00 X 0 0 0 JACK WAGONER MD PHYSICIAN, FAMILY MEDICINE 40.00 0.00 X 0 0 0 TOM MATYA DIRECTOR 40.00 0.00 X 0 0 0 JOSEPH ROBERTS DIRECTOR 40.00 0.00 X 0 0 0 LOREN FOELSKE VP AND CFO, KISHHEALTH SYSTEM 3.00 49.00 X 0 328625 87932 JOSEPH DANT VP BUSINESS DEVELOPMENT 5.00 42.00 X 0 289274 42457 ROGER HEATH BELL VP AND CIO 10.00 37.00 X 0 292428 44585 MICHELE MCCLELLAND VP OF HUMAN RESOURCES 5.00 45.00 X 0 237252 40669 CHRISTINE WEIS PHYSICIAN, FAMILY MEDICINE 45.00 0.00 X 248489 0 28887 WILLIAM ASIHENE PHYSICIAN, GENERAL SURGEON 40.00 0.00 X 412963 0 19833 SHAUN MATHEN PHYSICIAN, FAMILY MEDICINE 40.00 0.00 X 231252 0 10742 GORI KHAN PHYSICIAN, INTERMAN MEDICINE 40.00 0.00 X 200524 0 29660 PITAMBER PERSAUD PHYSICIAN, INTERMAN MEDICINE 40.00 0.00 X 202988 0 37370 2175465 2487449 625000 9 0 1 0 KISHHEALTH SYSTEM ONE KISH HOSPITAL DRIVE DEKALB IL 60115 MANAGEMENT SERVICES 523002 REINHART BOERNER VANDEUREN 1000 N WATER STREET MILWAUKEE WI 53202 LEGAL SERVICES 209634 CHMB 901 WARRENVILLE ROAD LISLE IL 60532 BILLING SERVICES 138383 3 20750001 20750001 PATIENT FEES 621110 5424245 5424245 5424245 905 905 OTHER REVENUE 621110 323020 323020 323020 26498171 5424245 0 323925 925505 925505 5694462 5092513 601949 180536 160810 19726 930235 842134 88101 388300 352649 35651 275555 1702 273853 438784 438784 1045 1045 804225 220868 583357 125422 125422 122255 78788 43467 147213 848 146365 941367 619403 321964 33729 471 33258 47795 47795 694989 686495 8494 275774 273976 1798 MEDICAL SUPPLIES 365442 353966 11476 BAD DEBT EXPENSE 116555 116555 LICENSES AND DUES 32000 11402 20598 FOOD 7711 7055 656 12548899 9792935 2755964 0 502035 4360978 501116 2417385 3457 26268 381922 3677176 929664 1484752 2747512 10072895 32644 119855 2546815 20104004 505570 3199129 231703 1120750 737273 4319879 X 1809542 15784125 1809542 15784125 2546815 20104004 X 13949272 25311 X X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 115965 115965 455655 112858 342797 966655 361392 605263 2138901 455414 1683487 2747512 DUE TO AFFILIATES 1120750 1120750 X 5630710 0 5630710 20867461 20867461 26498171 12407033 0 12407033 141866 141866 12548899 PART X, LINE 2: KISHWAUKEE PHYSICIAN GROUP IS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. KISHWAUKEE PHYSICIAN GROUP FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE 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 INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). UBIT IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE 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 PERCENT LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING STATEMENTS OF FINANCIAL POSITION ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AT APRIL 30, 2015 AND 2014, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED. PART XI, LINE 4B - OTHER ADJUSTMENTS: RECLASSIFICATION OF BAD DEBT EXPENSE 116,555. CONTRIBUTIONS FROM KISHHEALTH SYSTEM 20,750,001. NONOPERATING INCOME 905. PART XII, LINE 4B - OTHER ADJUSTMENTS: TAX AMORTIZATION OF GOODWILL 25,311. RECLASSIFICATION OF BAD DEBT EXPENSE 116,555. 0 1 0 0 0 0 0 0 0 KEVIN POORTEN PRESIDENT & CEO, KISHHEALTH SYSTEM 0 616000 0 196800 0 60000 0 108400 0 21296 0 1002496 0 0 ERIK ENGLEHART MD VICE-CHAIR,PHYSICIAN FAMILY MEDICINE 182379 0 49237 0 0 0 7953 0 24443 0 264012 0 0 0 AZEEM HALEEM MD DIRECTOR, PHYSICIAN, UROLOGY 442437 0 74229 0 0 0 21740 0 2909 0 541315 0 0 0 MICHAEL KULISZ DO DIRECTOR, CHIEF MEDICAL OFFICER 0 366770 0 100300 0 0 0 54000 0 19919 0 540989 0 0 ABE CHACKO PRACTICE ADMINISTRATOR, EX OFFICIO 130967 0 0 0 0 0 4915 0 17290 0 153172 0 0 0 LOREN FOELSKE VP AND CFO, KISHHEALTH SYSTEM 0 277525 0 51100 0 0 0 69300 0 18632 0 416557 0 0 JOSEPH DANT VP BUSINESS DEVELOPMENT 0 234774 0 54500 0 0 0 22538 0 19919 0 331731 0 0 ROGER HEATH BELL VP AND CIO 0 246628 0 45800 0 0 0 19416 0 25169 0 337013 0 0 MICHELE MCCLELLAND VP OF HUMAN RESOURCES 0 199252 0 38000 0 0 0 20942 0 19727 0 277921 0 0 CHRISTINE WEIS PHYSICIAN, FAMILY MEDICINE 207422 0 24213 0 16854 0 13267 0 15620 0 277376 0 0 0 WILLIAM ASIHENE PHYSICIAN, GENERAL SURGEON 384363 0 28600 0 0 0 19424 0 409 0 432796 0 0 0 SHAUN MATHEN PHYSICIAN, FAMILY MEDICINE 180752 0 13000 0 37500 0 10421 0 321 0 241994 0 0 0 GORI KHAN PHYSICIAN, INTERMAN MEDICINE 185524 0 15000 0 0 0 9952 0 19708 0 230184 0 0 0 PITAMBER PERSAUD PHYSICIAN, INTERMAN MEDICINE 202988 0 0 0 0 0 11421 0 25949 0 240358 0 0 0 PART I, LINE 4B THE ORGANIZATION'S EXECUTIVES PARTICIPATE IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. CONTRIBUTIONS FOR CALENDAR YEAR 2014 RELATED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF KISHWAUKEE PHYSICIANS GROUP WERE $184,900. THIS CONTRIBUTION REFLECTS AMOUNTS DUE FOR THE FISCAL YEAR ENDING APRIL 30, 2015. THE ORGANIZATION'S CEO PARTICIPATES IN TWO ADDITIONAL NONQUALIFIED DEFERRED COMPENSATION PLAN. CONTRIBUTIONS FOR CALENDAR YEAR 2014 WERE $60,000. DURING CALENDAR YEAR 2014, THE CEO TOOK A DISTRIBUTION FROM THE DEFERRED COMPENSATION PLAN IN THE AMOUNT OF $60,000. THIS DISTRIBUTION IS INCLUDED AS W-2 WAGES, HOWEVER THE ACCRUAL OF THE DEFERRED COMPENSATION PAYMENTS HAS ALSO BEEN INCLUDED AS "OTHER COMPENSATION" ON PRIOR YEAR FORM 990S. SCHEUDLE J, PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED ONE OR MORE METHODS DESCRIBED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. CHRISTINE ENGLEHART MS. ENGLEHART IS A FAMILY MEMBER OF BOARD MEMBER DR. ERIK ENGLEHART 72125 COMPENSATION IN HER POSITION AS KPG AREA ADMINISTRATIVE COORDINATOR. 0 FORM 990, PART VI, SECTION A, LINE 4 THE BYLAWS WERE AMENDED TO CHANGE THE NUMBER OF BOARD MEMBERS FROM A MINIMUM OF THREE TO A MINIMUM OF EIGHT AND MAXIMUM OF EIGHT TO A MAXIMUM OF FOURTEEN. FORM 990, PART VI, SECTION A, LINE 6 KISHHEALTH SYSTEM IS THE SOLE MEMBER OF KISHWAUKEE PHYSICIANS GROUP, INC. FORM 990, PART VI, SECTION A, LINE 7A PER THE ORGANIZATION'S BY-LAWS, KISHHEALTH SYSTEM, AS SOLE MEMBER, RESERVES THE POWER TO ELECT OR REMOVE, WITH OR WITHOUT CAUSE, ANY MEMBERS OF THE BOARD AND APPROVE, EVALUATE OR REMOVE, WITH OR WITHOUT CAUSE, THE PRACTICE ADMINISTRATOR AND ANY KPG OFFICERS. FORM 990, PART VI, SECTION A, LINE 7B KISHHEALTH SYSTEM (KHS) SERVES AS THE SOLE MEMBER AND PARENT ORGANIZATION OF KISHWAUKEE PHYSICIANS GROUP (KPG). THE BYLAWS OF KPG STATE THAT KPG'S BOARD MAY NOT TAKE ACTION PERTAINING TO THE FOLLOWING WITHOUT APPROVAL FROM THE KHS BOARD: A. ADOPTING, AMENDING, ALTERING OR REPEALING KPG'S ORGANIZATIONAL DOCUMENTS B. FILING A VOLUNTARY PETITION OF BANKRUPTCY ON BEHALF OF KPG OR AUTHORIZING A VOLUNTARY DISSOLUTION OF KPG C. ELECTING OR REMOVING, WITH OR WITHOUT CAUSE, ANY MEMBERS OF THE BOARD AND APPROVING, EVALUATING OR REMOVING, WITH OR WITHOUT CAUSE, THE PRACTICE ADMINISTRATOR AND ANY KPG OFFICERS AND ESTABLISHING COMPENSATION FOR SUCH INDIVIDUALS, IF ANY. D. APPROVING THE STRATEGIC PLAN, ANNUAL OPERATING AND CAPITAL BUDGETS OF KPG AND MATERIAL DEVIATIONS FROM SUCH PLANS OR BUDGETS E. APPROVING ANY CHANGE IN CORPORATE MEMBERSHIP OF KPG OR ANY PLAN OF CONSOLIDATION OF KPG F. ESTABLISHING AN AFFILIATE OF KPG G. PURCHASING, SELLING, LEASING, PLEDGING OR HYPOTHECATING ANY KPG PROPERTY OR ENTERING INTO ANY CONTRACT FOR SUCH PURPOSE OTHER THAN IN THE ORDINARY COURSE OF KPG'S BUSINESS. H. ENTERING INTO ANY CONTRACT OR AGREEMENT THAT CONTEMPLATES KPG SPENDING IN EXCESS OF $100,000 IN ANY 12-MONTH PERIOD AND APPROVING ANY MANAGEMENT CONTRACT FOR THE FULL OPERATING OF KPG. I. APPROVING ALL COMPENSATION PAID TO PHYSICIAN EMPLOYEES AND/OR PHYSICIANS CONTRACTING WITH KPG, INCLUDING COMPENSATION FOR BOTH CLINICAL AND ADMINISTRATIVE DUTIES,THROUGH COMPENSATION PARAMETERS ESTABLISHED BY THE KHS BOARD'S COMPENSATION COMMITTEE; THE COMPENSATION COMMITTEE SHALL REVIEW SUCH PARAMETERS ANNUALLY TO ENSURE THAT PHYSICIAN COMPENSATION REPRESENTS FAIR MARKET VALUE FOR SERVICES RENDERED. J. EXERCISING ANY RIGHTS THAT KPG HAS AS A SHAREHOLDER OR MEMBER OF ANY SUBSIDIARY ENTITY, INCLUDING AN AFFILIATE. K. APPROVING AND/OR DETERMINING (1) THE CREATION OF NEW HEALTH SERVICES TO BE PROVIDED BY KPG AND THE LOCATION OF SUCH HEALTH SERVICES; (2) THE DISCONTINUANCE OF ANY HEALTH SERVICES PROVIDED BY KPG AND (3) THE THIRD-PARTY PAYOR ARRANGEMENTS (INCLUDING WITHOUT LIMITATION, MANAGED CARE PLANS) THAT KPG PARTICIPATES IN AND THE NEGOTIATION AND APPROVAL OF SUCH ARRANGEMENTS. L. APPROVING THE CREATION AND IMPLEMENTATION OF ARRANGEMENTS AMONG KPG, KHS, AND/OR ONE OR MORE AFFILIATES, INCLUDING TRANSFERRING MONEY OR PROPERTY AMONG SUCH ENTITIES. M. OVERSEEING THE QUALITY OF CARE PROVIDED TO PATIENTS OF KPG. N. APPROVING FINANCIAL, ACCOUNTING, HUMAN RESOURCES, EMPLOYEE BENEFIT, AND OTHER POLICIES AND PROCEDURES (EXCEPT PATIENT CARE POLICIES AND PROCEDURES) AND THE APPOINTMENT OF AUDITORS, LEGAL COUNSEL, VENDORS, CONTRACTORS AND CONSULTANTS FOR KPG. O. APPROVING PERSONNEL DECISIONS, INCLUDING, WITHOUT LIMITATION, DECISIONS TO HIRE OR TERMINATE THE EMPLOYMENT OF KPG PERSONNEL. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY OF FORM 990 IS PROVIDED TO THE GOVERNING BODY (BOARD OF DIRECTORS) AND THE GOVERANCE COMMITTEE FOR REVIEW BY THE RETURN PREPARER PRIOR TO FILING. THE ORGANIZATION'S CEO, CFO, AND OTHER MEMBERS OF THE ACCOUNTING DEPARTMENT ARE ALSO PROVIDED A COPY OF THE RETURN FOR THEIR REVIEW. THE CHAIR OF THE AUDIT COMMITTEE AND THE AUDIT COMMITTEE MEMBERS ARE ALSO PROVIDED DRAFT COPIES AND REVIEW. IF CHANGES ARE NECESSARY, THEY ARE REPORTED TO THE RETURN PREPARER AND INCORPORATED INTO THE FINAL RETURN. FORM 990, PART VI, SECTION B, LINE 12C INDIVIDUALS COVERED BY THE ORGANIZATION'S CONFLICT OF INTEREST POLICY AND CONSIDERED INTERESTED PERSONS, INCLUDE MEMBERS OF THE BOARD OF DIRECTORS OF ANY ENTITY WITHIN THE HEALTH SYSTEM, KISHHEALTH SYSTEM OFFICERS, ANY COMMITTEE MEMBER, ANY INDIVIDUAL WITH ULTIMATE RESPONSIBILITY FOR IMPLEMENTING BOARD DECISIONS OR SUPERVISING THE MANAGEMENT, ADMINISTRATION, OR OPERATION OF THE ORGANIZATION, AND IMMEDIATE FAMILY MEMBERS OF THOSE LISTED. IT IS THE DUTY OF THESE INTERESTED PERSONS TO SELF-DISCLOSE ANY CONFLICTS OF INTEREST. CONFLICTS OF INTEREST ARE INVESTIGATED BY APPOINTED MEMBERS OF THE KISHHEALTH SYSTEM GOVERNANCE COMMITTEE ON AN ONGOING BASIS. IF IT IS DETERMINED THAT AN INDIVIDUAL FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE INDIVIDUAL OF SUCH A BELIEF AND AFFORD HIM AN OPPORTUNITY TO EXPLAIN. AFTER SAID EXPLANATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION AS DEEMED NECESSARY. AN INTERESTED PERSON DEEMED TO HAVE A CONFLICT MUST NOT BE PRESENT DURING DISCUSSION OR VOTES RELATED TO THE TRANSACTION. THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD ANNUALLY AND UPDATED AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15 KISHWAUKEE PHYSICIAN GROUP, INC. IS NOT DIRECTLY INVOLVED IN DETERMINING THE COMPENSATION OF THE CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT, AS THE INDIVIDUALS ARE EMPLOYED THROUGH KISHHEALTH SYSTEM. KISHHEALTH SYSTEM DOES COMPLY WITH THE REQUIREMENTS NOTED ABOVE. THROUGH THE OVERSIGHT OF THE BOARD OF DIRECTORS EXECUTIVE COMPENSATION COMMITTEE, THE KISHHEALTH SYSTEM EXECUTIVE TOTAL COMPENSATION PROGRAM WILL BE COMPETITIVELY POSITIONED IN THE MARKET PLACE OF RELEVANT ORGANIZATIONS AND FALL WITHIN THE SAFE HARBOR GUIDELINES ESTABLISHED BY THE INTERMEDIATE SANCTIONS RULES. THE EXECUTIVE COMPENSATION COMMITTEE IS MADE UP OF THREE MEMBERS OF THE BOARD OF DIRECTORS WHO MEET THE BOARD APPROVED DEFINITION OF "INDEPENDENT DIRECTORS". ANNUALLY THE EXECUTIVE COMPENSATION COMMITTEE CONTRACTS WITH SULLIVAN, COTTER AND ASSOCIATES, AN INDEPENDENT HUMAN RESOURCES CONSULTING FIRM TO PROVIDE THE COMMITTEE ANALYSIS AND COMPARABILITY DATA. USING THE SUPPLIED DATA THE COMPENSATION COMMITTEE APPROVES EACH EXECUTIVE'S TOTAL CASH COMPENSATION AND PROVIDES CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. TOTAL CASH COMPENSATION IS DEFINED AS THE SUM OF BASE SALARIES PLUS INCENTIVE AWARDS. BASED ON THE COMPARABILITY DATA AND THE PERFORMANCE OF EACH EXECUTIVE IN MEETING GOALS AND STRATEGIC OBJECTIVES, THE EXECUTIVE COMPENSATION COMMITTEE APPROVES INCREASES AND INCENTIVE AWARDS FOR EACH EXECUTIVE WITHIN THE GUIDELINES ESTABLISHED. THE EXECUTIVE COMPENSATION COMMITTEE REPORTS ON ALL COMPENSATION MATTERS TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: BOOK/TAX DIFFERENCE IN AMORTIZATION OF INTANGIBLES 25,311. FORM 990, PART XI, LINE 2C, RESPONSIBILITY FOR OVERSIGHT OF FINANCIAL STMTS RESPONSIBILITY FOR OVERSIGHT OF FINANCIAL STATEMENTS: NO CHANGES IN THIS PROCESS WERE MADE DURING THE TAX YEAR. THE ORGANIZATION MAINTAINS AN INDEPENDENT AUDIT COMMITTEE WHICH IS RESPONSIBLE FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS. THIS COMMITTEE IS ALSO RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT AUDITOR. MEMBERS OF THE AUDIT COMMITTEE ARE ALSO MEMBERS OF THE KISHHEALTH SYSTEM BOARD OF DIRECTORS. KISHEALTH SYSTEM IS THE PARENT CORPORATION OF KISHWAUKEE PHYSICIANS GROUP, INC. KISHWAUKEE COMMUNITY HOSPITAL ONE KISH HOSPITAL DRIVE DEKALB IL 60115 237087041 HEALTHCARE SERVICES, PRIMARILY ACUTE CARE IL 501(C)(3) 3 KISHHEALTH SYSTEM 0 KISHHEALTH SYSTEM ONE KISH HOSPITAL DRIVE DEKALB IL 60115 363649080 PARENT CORPORATION OF 501(C)(3) HEALTH SYSTEM IL 501(C)(3) 11B N/A 0 KISHHEALTH FOUNDATION ONE KISH HOSPITAL DRIVE DEKALB IL 60115 363649077 SUPPORT OF CHARITABLE HEALTH ORGANIZATIONS IL 501(C)(3) 7 KISHHEALTH SYSTEM 0 VALLEY WEST COMMUNITY HOSPITAL ONE KISH HOSPITAL DRIVE DEKALB IL 60115 364244337 HEALTHCARE SERVICES, PRIMARILY ACUTE CARE IL 501(C)(3) 3 KISHHEALTH SYSTEM 0 DEKALB COUNTY HOSPICE ONE KISH HOSPITAL DRIVE DEKALB IL 60115 363164329 HEALTHCARE SERVICES, HOSPICE SERVICES IL 501(C)(3) 7 KISHHEALTH SYSTEM 0 COMMUNITY CARES CLINIC ONE KISH HOSPITAL DRIVE DEKALB IL 60115 800424001 HEALTHCARE SERVICES, PRIMARILY ACUTE CARE IL 501(C)(3) 3 KISHHEALTH SYSTEM 0 CENTER FOR FAMILY HEALTH MALTA ONE KISH HOSPITAL DRIVE MALTA IL 60150 800869393 HEALTHCARE SERVICES, PRIMARILY ACUTE CARE IL 501(C)(3) 3 KISHHEALTH SYSTEM 0 KISHHEALTH SYSTEM HOME CARE ONE KISH HOSPITAL DRIVE DEKALB IL 60115 371703513 HEALTHCARE SERVICES, HOME CARE IL 501(C)(3) 3 KISHHEALTH SYSTEM 0 HEALTH VENTURES LLC ONE KISH HOSPITAL DRIVE DEKALB IL 60115 753255958 RENTAL REAL ESTATE PROVIDED TO HEALTHCARE RELATED BUSINESSES IL N/A KISHWAUKEE AREA PHO ONE KISH HOSPITAL DRIVE DEKALB IL 60115 364205273 MEDICARE SERVICES IL N/A ILLINOIS REGIONAL CANCER CENTER 10 HEALTH SERVICES DRIVE DEKALB IL 60115 363847273 CANCER TREATMENT SERVICES IL N/A MIDLAND SURGICAL CENTER LLC 3085 WOLF COURT DEKALB IL 60115 352194610 SURGICAL SERVICES IL N/A HEALTH PROGRESS INC ONE KISH HOSPITAL DRIVE DEKALB IL 60115 363824138 INVESTMENT IN HEALTHCARE RELATED SMALL BUSINESSES IL N/A C 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 1 1 0 0