NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
NORTHWESTERN MEMORIAL HEALTHCARE (EIN 36-2338884)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-12
IRS object ID
201641339349305329
Schema version
2014v6.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2016-05-12T15:42:03-05:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1191 West Nationwide Blvd Ste 500AddressLine1Txt
CityColumbusCityNm
State AbbreviationOHStateAbbreviationCd
ZIP432152568ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362338884EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Northern Illinois Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% DAVID TOMLINSONInCareOfNm
Business Name ControlNORTBusinessNameControlTxt
Phone8157885800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14201 Medical Center DriveAddressLine1Txt
CityMcHenryCityNm
State AbbreviationILStateAbbreviationCd
ZIP60050ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID TOMLINSONPersonNm
Person TitleSVP, CIO, CFOPersonTitleTxt
Phone8772368472PhoneNum
Signature2016-05-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMOLLIE P LONGHOUSEPreparerPersonNm
PTINP00294881PTIN
Phone6142492300PhoneNum
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMichael S EesleyPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1385 Millennium DriveAddressLine1Txt
CityCrystal LakeCityNm
State AbbreviationILStateAbbreviationCd
ZIP60012ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$319,990,192GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.centegra.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1956FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionSee Schedule OActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee1503TotalEmployeeCnt
Total Volunteers265TotalVolunteersCnt
Total Gross UBI$395,949TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$34,591NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$286,949PYContributionsGrantsAmt
CY Contributions Grants$9,089CYContributionsGrantsAmt
PY Program Service Revenue$230,928,713PYProgramServiceRevenueAmt
CY Program Service Revenue$256,904,977CYProgramServiceRevenueAmt
PY Investment Income$5,805,848PYInvestmentIncomeAmt
CY Investment Income$12,272,162CYInvestmentIncomeAmt
PY Other Revenue$5,804,995PYOtherRevenueAmt
CY Other Revenue$7,503,826CYOtherRevenueAmt
PY Total Revenue$242,826,505PYTotalRevenueAmt
CY Total Revenue$276,690,054CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$86,072,442PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$92,540,073CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$139,786,632PYOtherExpensesAmt
CY Other Expenses$151,438,802CYOtherExpensesAmt
PY Total Expenses$225,859,074PYTotalExpensesAmt
CY Total Expenses$243,978,875CYTotalExpensesAmt
PY Revenues Less Expenses$16,967,431PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$32,711,179CYRevenuesLessExpensesAmt
Total Assets BOY$301,995,790TotalAssetsBOYAmt
Total Assets EOY$297,525,658TotalAssetsEOYAmt
Total Liabilities BOY$124,474,340TotalLiabilitiesBOYAmt
Total Liabilities EOY$124,325,097TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$177,521,450NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$173,200,561NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionSee Schedule OMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$220,496,015ExpenseAmt
Revenue$257,488,063RevenueAmt
DescSee Schedule ODesc
Total Program Service Expenses$220,496,015TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee1503EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDAVID TOMLINSONPersonNm
Phone8157885800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1385 MILLENNIUM DRIVEAddressLine1Txt
CityCrystal LakeCityNm
State AbbreviationILStateAbbreviationCd
ZIP60012ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Michael S Eesley
CEO0.040.0Yes (X)Yes (X)$0$1,758,472$143,057
Charie Zanck
Director0.02.0Yes (X)$0$0$0
Charles Ruth
Director0.02.0Yes (X)$0$0$0
Chris Newkirk
Director0.01.0Yes (X)$0$0$0
Jack Porter
Director0.01.0Yes (X)$0$0$0
Kathy Powell
Director0.04.0Yes (X)$0$0$0
Luke Johnsos
Director0.02.0Yes (X)$0$0$0
Micheal Luecht
Secretary/Treasurer0.04.0Yes (X)$0$0$0
Mike Curran
Chairman0.02.0Yes (X)$0$0$0
Pat Morehead
Director0.04.0Yes (X)$0$0$0
Richard Lind
Director0.01.0Yes (X)$0$381,037$21,386
Terrence J Bugno
Director0.04.0Yes (X)$0$0$0
Tom Carey
Vice Chairman0.03.0Yes (X)$0$0$0
William Cox
Director0.02.0Yes (X)$0$0$0
Lisa Glosson MD
Director0.01.0Yes (X)$0$240,373$30,204
David Tomlinson
SVP/CIO/CFO0.040.0Yes (X)$0$532,558$58,217
Jason R Sciarro
President/COO0.040.0Yes (X)$0$955,765$90,238
Rachel Sebastian
VP Site Administrator40.00.0$355,872$0$58,949Yes (X)
Belinda A Wagner
Pharmacist40.00.0$149,895$0$6,434Yes (X)
Connie K Secor
Director40.00.0$172,618$0$6,480Yes (X)
John G Geinopolos
Medical Physicist40.00.0$176,469$0$27,326Yes (X)
Susan H Corcoran
Pharmacist40.00.0$140,962$0$26,671Yes (X)
Debra A Brasier
Coordinator - Anti-Coag0.00.0$139,424$0$25,795Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,135,240TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$3,868,205TotReportableCompRltdOrgAmt
Total Other Compensation$494,757TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K50IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Medline Industries
One Medline PlaceMUNDELEINIL60060Hospital Supplies$5,230,556
Sodexo Inc Affliates
4880 Payshere CircleCHICAGOIL60674Management Services$3,129,615
Precyse Solutions LLC
1275 Drummers Lane Ste 200WAYNEPA19087Coding Services$2,060,607
Gilcor Contruction Corp
232 Harrison StreetBARRINGTONIL60010Construction Serv$1,576,565
Carefusion Pyxis
25082 Network PlaceCHICAGOIL606731250Inventory Supply$1,206,742
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K33CntrctRcvdGreaterThan100KCnt
Government Grants$9,089GovernmentGrantsAmt
Total Contributions$9,089TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
ANCILLARY OUTPATIENT SERVICES621110$157,628,863$157,628,863
ROUTINE PATIENT SERIVCES621110$82,260,733$82,260,733
ANCILLARY INPATIENT SERVICES621110$22,056,157$22,056,157
IDPA PROVIDER TAX REVENUE621110$10,540,933$10,540,933
CHARITY CARE/ADMIN ALLOWANCE621110-$15,581,709-$15,581,709
FieldValueIRS element (for citing)
Total Program Service Revenue$256,904,977TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,729,525TotalRevenueColumnAmt
Exclusion$7,729,525ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$185TotalRevenueColumnAmt
Exclusion$185ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$47,841,079SecuritiesAmt
Other$1,511OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$43,300,138SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$4,540,941SecuritiesAmt
Other$1,511OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,542,452TotalRevenueColumnAmt
Exclusion$4,542,452ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
CAFETERIA SERVICES AND EDUCATION900099$1,084,948$1,084,948
CHILD DAY CARE CENTER624410$763,302$399,402$363,900
RELATED COMPANY REVENUE900099$600,915$600,915

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,054,661TotalRevenueColumnAmt
Related Or Exempt Func Income$583,086RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$32,049UnrelatedBusinessRevenueAmt
Exclusion$4,439,526ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$7,503,826OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$276,690,054TotalRevenueColumnAmt
Related Or Exempt Func Income$257,488,063RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$395,949UnrelatedBusinessRevenueAmt
Exclusion$18,796,953ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$468,373TotalAmt
Management And General$468,373ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$74,317,762TotalAmt
Program Services$65,243,343ProgramServicesAmt
Management And General$9,074,419ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,192,554TotalAmt
Program Services$1,046,940ProgramServicesAmt
Management And General$145,614ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$11,446,826TotalAmt
Program Services$10,049,134ProgramServicesAmt
Management And General$1,397,692ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$5,114,558TotalAmt
Program Services$4,490,055ProgramServicesAmt
Management And General$624,503ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$884,380TotalAmt
Management And General$884,380ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$42,029TotalAmt
Management And General$42,029ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$10,961,667TotalAmt
Program Services$10,160,437ProgramServicesAmt
Management And General$801,230ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$31,068TotalAmt
Program Services$31,068ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$41,749,836TotalAmt
Program Services$41,221,749ProgramServicesAmt
Management And General$528,087ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$13,656TotalAmt
Program Services$9,754ProgramServicesAmt
Management And General$3,902ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,712,712TotalAmt
Program Services$1,400,661ProgramServicesAmt
Management And General$1,312,051ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$208,782TotalAmt
Program Services$191,253ProgramServicesAmt
Management And General$17,529ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$94,882TotalAmt
Program Services$73,105ProgramServicesAmt
Management And General$21,777ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$3,684,045TotalAmt
Program Services$3,234,212ProgramServicesAmt
Management And General$449,833ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$9,517,395TotalAmt
Program Services$8,355,293ProgramServicesAmt
Management And General$1,162,102ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,419,657TotalAmt
Program Services$3,002,107ProgramServicesAmt
Management And General$417,550ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
RELATED COMPANY - CHS$45,647,361$40,521,763$5,125,598
BAD DEBT$8,594,280$8,594,280
RELATED COMPANY - LAB$5,649,212$5,649,212
IDPA PROVIDER TAX$7,589,544$7,589,544

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$10,638,296TotalAmt
Program Services$9,632,105ProgramServicesAmt
Management And General$1,006,191ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$243,978,875TotalAmt
Program Services$220,496,015ProgramServicesAmt
Management And General$23,482,860ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$50,285BOYAmt
EOY$34,682EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$18,364,355BOYAmt
EOY$12,913,819EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$38,059,244BOYAmt
EOY$40,334,050EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$4,224,410BOYAmt
EOY$6,001,456EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,590,094BOYAmt
EOY$2,071,362EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$209,583,533LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$146,482,590LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$64,140,996BOYAmt
EOY$63,100,943EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$107,369,678BOYAmt
EOY$99,840,363EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$6,135,475BOYAmt
EOY$7,953,557EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$74,009BOYAmt
EOY$37,013EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$61,987,244BOYAmt
EOY$65,238,413EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$301,995,790BOYAmt
EOY$297,525,658EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$24,625,530BOYAmt
EOY$25,926,914EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$96,263,546BOYAmt
EOY$95,880,611EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,585,264BOYAmt
EOY$2,517,572EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$124,474,340BOYAmt
EOY$124,325,097EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$174,778,073BOYAmt
EOY$168,453,765EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,743,377BOYAmt
EOY$4,746,796EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$177,521,450BOYAmt
EOY$173,200,561EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$301,995,790BOYAmt
EOY$297,525,658EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$32,711,179ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$14,805,063NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$22,227,005OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$42,029OtherActivitiesAmt
Total Lobbying Expenditures$42,029TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDescription of Lobbying ActivitiesFormAndLineReferenceDesc
ExplanationSchedule C, Part II-B, Line 1i As part of our dues payments to the Illinois Hospital Association, American Hospital Association and Metropolitan Chicago Healthcare Council, approximately 34.5% of dues, on average, are allocable to lobbying activities.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
Incl Escrow Custodial Acct LiabfalseInclEscrowCustodialAcctLiabInd
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$65,000OtherCostOrOtherBasisAmt
Book Value$65,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$83,339,494OtherCostOrOtherBasisAmt
Depreciation$42,346,002DepreciationAmt
Book Value$40,993,492BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,764,249OtherCostOrOtherBasisAmt
Depreciation$1,715,118DepreciationAmt
Book Value$49,131BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$123,084,976OtherCostOrOtherBasisAmt
Depreciation$102,421,470DepreciationAmt
Book Value$20,663,506BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,329,814OtherCostOrOtherBasisAmt
Book Value$1,329,814BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$63,100,943TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
INTERCOMPANY RECEIVABLES$62,627,517
OTHER RECEIVABLES$2,610,896
FieldValueIRS element (for citing)
Total Book Value Other Assets$65,238,413TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescPROFESSIONAL LIABILITYDesc
Amt$2,517,572Amt
FieldValueIRS element (for citing)
Total Liability$2,517,572TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceFIN 48 (ASC 740) FootnoteFormAndLineReferenceDesc
ExplanationSchedule D, Part X, Line 2 ACS Topic 740, Income Taxes, addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded on the consolidated financial statements. Under ACS Topic 740, the Health System must recgonize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financials statements from such a position are measured based on the largest benefit that has the greater than fifty percent likelihood of being realized upon ultimate settlement. ASC Topic 740 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. As of June 30, 2015 and 2014 the Health System does not have a liability for unrecognized tax benefits.ExplanationTxt

Schedule H IRS990ScheduleH

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

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

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

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,253,613TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,253,613NetCommunityBenefitExpnsAmt
Total Expense0.01380TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$22,831,978TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,728,198DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,103,780NetCommunityBenefitExpnsAmt
Total Expense0.04720TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$26,085,591TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,728,198DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,357,393NetCommunityBenefitExpnsAmt
Total Expense0.06100TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs10ActivitiesOrProgramsCnt
Persons Served3007PersonsServedCnt
Total Community Benefit Expns$95,417TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,401DirectOffsettingRevenueAmt
Net Community Benefit Expns$78,016NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Activities Or Programs6ActivitiesOrProgramsCnt
Persons Served284PersonsServedCnt
Total Community Benefit Expns$416,272TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$416,272NetCommunityBenefitExpnsAmt
Total Expense0.00180TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs16ActivitiesOrProgramsCnt
Persons Served3291PersonsServedCnt
Total Community Benefit Expns$511,689TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,401DirectOffsettingRevenueAmt
Net Community Benefit Expns$494,288NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs16ActivitiesOrProgramsCnt
Persons Served3291PersonsServedCnt
Total Community Benefit Expns$26,597,280TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$11,745,599DirectOffsettingRevenueAmt
Net Community Benefit Expns$14,851,681NetCommunityBenefitExpnsAmt
Total Expense0.06310TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$2,466,558BadDebtExpenseAmt
Bad Debt Expense Attributable$1,715,504BadDebtExpenseAttributableAmt
Reimbursed By Medicare$81,505,924ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$92,808,999CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$11,303,075MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)

Primary ActivitiesPrimaryActivitiesTxtOrg Profit Or OwnershipOrgProfitOrOwnershipPct
Algon Rd Surgery Ctr
Outpatient Surgical Services0.12750
ARSC Real Estate
Property Management0.25000
FieldValueIRS element (for citing)
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Northern Illinois Medical CenterBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14201 Medical Center DriveAddressLine1Txt
CityMcHenryCityNm
State AbbreviationILStateAbbreviationCd
ZIP60050ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Critical Access HospitalYes (X)CriticalAccessHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherCancer CenterOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Northern Illinois Medical CenterBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted14CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (true)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.centegra.orgOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLwww.co.mchenry.il.usOtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt14ImplementationStrategyAdptYr
Strategy Posted WebsitefalseStrategyPostedWebsiteInd
Strategy Website URLN/AStrategyWebsiteURLTxt
Strategy AttachedYes (true)StrategyAttachedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care600.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Other CriteriaYes (X)OtherCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Provided Nonprofit ContactYes (X)ProvidedNonprofitContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLwww.centegra.orgFAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLwww.centegra.orgFAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLwww.centegra.orgFAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Account Input from Person Who Represent the CommunitySchedule H, Part V, Line 5 The Health Systems works with the Department of Public Health and other area Hospitals to conduct the assessment. Community Survey. A description of community issues and problems based on a sample of McHenry County residents. The survey was conducted online with the link widely broadcast by partner organizations, and supplemented by a paper version disseminated at numerous events and locations. Survey respondents numbered 744 with a 60/40 split between online and paper respondents. Questions in the survey covered: * Community features * Financial issues * Health status - perception of health and prevalence of diseases and conditions (physical and mental) * Access to care * Health insurance status * Abuse, suicide, care of other persons Key Informants. Interviews with 21 community leaders, agency directors, and other people considered experts in their field based on professional expertise, knowledge of local human services system or position of influence. As selected by the partners, many key informants or their predecessors at their organizations had been interviewed for the 2010 study. Interview questions focused on community assets, challenges, target groups in need of services, and perception of strengths and weaknesses of health and human services delivery. Key informants were interviewed by four volunteer interviewers, recorded, and transcribed by Health Systems Research staff. CHNA conducted with other hospital facilities Schedule H, Part V, Line 6a Advocate Good Shepherd Hospital and Advocate Sherman Hospital
CHNA conducted with other facilitiesSchedule H, Part V, Line 6b McHenry County Department of Health, Family Alliance Inc., McHenry County College, McHenry County Community Foundation, McHenry County Mental Health Board, Pioneer Center for Human Services, Senior Services Associates, Inc., United Way of Greater McHenry County, Woodstock Consolidated Unit School District 200.
Needs not addressedSchedule H, Part V, Line 11 The ways in which Centegra Health System is addressing the significant needs identified in its most recently conducted CHNA are thoroughly described in the attached implementation strategy. There are certain needs identified in the CHNA that are not being addressed by Centegra Health System. These needs include areas of which Centegra Health System has no expertise, and fall outside the scope of care in which Centegra Health System provides to the community. Several of Centegra Health System's CHNA partner organizations are addressing these needs.
Income Level other than FPGSchedule H, Part V, Line 13b In addition to the documented 200% of FPG, we also provide a sliding scale discount of 80% for those who have FPG up to 350%. In addition we have presumption charity which allows for charity discounts/financial assistance to those who currently meet Medicaid eligibility or other state programs based on FPG who may not have had insurance coverage at the time of the service we provided.
Other Factors used in determining amounts charged patientsSchedule H, Part V, Line 13h All patients are charged the same for services rendered. Patients may qualify for free or discounted care as described in Part VI, Line 3. Eligibility for financial assistance depends on factors such as income level, assset level and medical indigency.
Other Billing Determination of Individuals without insuranceSchedule H, Part VI, Line 22D See Part VI Supplemental Information for Billing and Collection Policies regarding persons eligible for financial assistance.
FieldValueIRS element (for citing)
Facility21FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (21 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
Crystal Lake Medical Arts Imaging Center
360 Station Drive Suite 150Crystal LakeIL60014Medical Imaging Center
Gavers Breast Center
360 N Terra Cotta RoadCrystal LakeIL60012Medical Imaging and Breast Care Center
NIMC Rehab & Sports Medicine Clinic
200 Congress ParkwayCrystal LakeIL60014Sports Medicine and Rehabilitation Clinic
NIMC Neuro-Rehabilitation Center
500 Coventry LaneCrystal LakeIL60014Neurotrauma Day Treatment Center
NIMC Rehab & Sports Medicine Clinic
2507 N Richmond RoadMcHenryIL60050Physical Rehabilitation Clinic
Centegra Health Center - Huntley
10350 Haligus RoadHuntleyIL60142Anticoagulation Clinic, Medical Imaging, & Bariatric Center
Centegra Home Health Care
213 North Front Street Suite 2McHenryIL60050Home Health Care
Centegra Home Medical Equipment
213 Front Street Suite 2McHenryIL60050Medical Equipment
Centegra Home Medical Equipment
1118 North Main StreetAlgonquinIL60102Medical Equipment
Centegra Milestone Therapy
394 Federal DriveCrystal LakeIL60014Therapy
Centegra Physician Care - Fox Lake
248 E Grand AvenueFox LakeIL60020Physician Care
Centegra Physician Care - Fox Valley
650 Dakota Street Suite ACrystal LakeIL60012Physician Care
Centegra Physician Care - Fox Valley
1465 Commerce DriveAlgonquinIL60102Physician Care
Centegra Physician Care - Neurology
750 E Terra Cotta AvenueCrystal LakeIL60014Physician Care
Centegra Physician Care - Spring Grove
1906 Holian DriveSpring GroveIL60081Physician Care
Centegra Physician Care - Surgical Assoc
690 E Terra Cotta Avenue Suite ACrystal LakeIL60014Physician Care
Centegra Physician Care - Gavers
360 N Terra Cotta Avenue Suite ACrystal LakeIL60014Physician Care
Centegra Physician Care - Woodstock
3707 Doty Road Suites C D E GWoodstockIL60098Physician Care
Centegra Rehab & Sports Med Cl - McHenry
333 Front StreetMcHenryIL60050Sports Rehabilitation Medicine
Centegra Rehab & Sport Md Cl - Woodstock
201 N Throop StreetWoodstockIL60098Sports Rehabilitation Medicine
Centegra Rehab & Sports Med Cl - Huntley
10450 Algonquin RoadHuntleyIL60142Sports Rehabilitation Medicine

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 7Line 7a-7c dollars ARE CALCULATED USING THE MEDICARE COST TO CHARGE RATIO. LINE 7E-7I AMOUNTS ARE CALCULATED FROM COMMUNITY BENEFIT REPORTS THAT ARE SUBMITTED BY THE HOSPITAL DEPARTMENTS FOR VARIOUS ACTIVITIES AND SUPPORT GROUPS THAT BENEFIT THE COMMUNITY.
Schedule H, Part I, Line 7, Column FBad Debt Expense in the amount of $8,594,280 is included on Form 990, Part IX, Line 24(B), Column A, but was subtracted for purposes of calculating the percentages in Schedule H, Part I, Line 7, Column (f).
Methodology of Est Amount & Rational for Including in Community BenefitSchedule H, Part III, Line 2 The actual gross bad debt write-offs of $8,594,280 were multiplied by the cost to charge ratio of .2870 to estimate the cost of bad debt.
Methodology of Est Amount & Rational for Including in Community BenefitSchedule H, Part III, Line 3 The estimated amount of bad debt expense (at cost) which could be reasonably attributable to patients who would likely qualify for financial assistance under the organization's charity care policy if sufficient information had been available to make a determination of their eligibility was based on the self pay patient accounts which were written off as bed debts. These amounts were then multiplied by the cost to charge ratio. Any payments received during the fiscal year on these accounts were deducted from the cost. The amount of cost that exceeds reimbursement is actual cost to treat patients and is therefore treated as a community benefit.
Bad Debt ExpenseSchedule H, Part III, Line 4 In estimating allowances for doubtful accounts, the Health System analyzes past history, existing trends, and payer sources to determine the reserves needed. Please REFERENCE pages 13 and 17-18 of the audited financial statements for notes on the allowances for doubtful accounts.
Explanation of Shortfall as Community BenefitSchedule H, Part III, Line 8 The amount of cost that exceeds reimbursement is actual cost to treat patients and is therefore treated as a community benefit.
Provisions On Collection Practices For Qualified PatientsSchedule H, Part III, Line 9b Centegra provides patients with consistent information on payment expectations and assists them in meeting their financial obligations. A written explanation of the payment requirements categorized by type of payor is given prior to admission/registration or upon admission/registration of each Centegra Health System (CHS) patient. Centegra will bill the patient's insurance carrier. Procedures will be implemented over time and by area to collect as much as possible of the time of service unless payor contracts require billing (i.e., no assignments). 1. Admission reservation/outpatient appointment made by physician/patient. Walk-in and Emergency Department patients present for service. 2. Perform the patient pre-registration for applicable scheduled registrations. 3. Patient verbal consent obtained and annotated except where prohibited by law. On (date) at about (time), (patient or representative) orally authorized (Site Name) to release information concerning the patient's medical care, treatment and diagnosis to employers, insurance companies, government agencies or third-party payors and their agents, for verification of benefits and pre-certification. I (the Pre-Registrar) did not obtain a written consent signed by the patient, due to the patient not being physically present and limited time constraints. This statement would be signed and dated by the Pre-Registrar. Patient refusal to provide oral consent requires patient notification of potential penalties and places the burden on the patient to complete payor requirements. 4. Complete insurance verification and initiate pre-certification. 5. Estimate the approximate cost of services and advise the responsible party. Explanation of the cost will fluctuate based on services ordered by the physicians. 6. Discuss the financial requirements, including payment expectations with the patient/guarantor prior to admission/registration when applicable. 7. Interview conducted by Financial Counselor of patients who express difficulty in meeting Centegra's payment requirements. 8. Admission/registration of patient is completed. Patient/guarantor signature for the Consent to Release Information obtained. 9. Collect the estimated patient share. The deductible and co-payments and any non-covered amounts quoted by the carrier are due from inpatients prior to discharge and where possible, for outpatients prior to or at the time of registration. 10. Self-Pay accounts are to be paid in full or screened by the Financial Counselor for potential State or Federal Program, Financial Assistance application or payment plan. 11. Policy regarding non-compliance with respect to payment arrangements or plans: Self-Pay: Patients who have not completed arrangements for one of the payment options within 120 days of the billing date will be automatically turned over to a collection agency. Broken Promise/Defaults: Patients with delinquent payments, 15 or more days late, will be turned over to a collection agency. After Insurance: Processing patients who have not made payments or enrolled in one of the payment options for co-insurance and deductible amounts within 120 days of insurance payment will be turned over to a collection agency.
Needs AssessmentSchedule H, Part VI, Line 2 CENTEGRA HEALTH SYSTEM IDENTIFIES COMMUNITY HEALTH CARE PRIORITIES AND DEVELOPS ACTIVITIES AND STRATEGIES TO MEET THE HEALTH CARE NEEDS OF AT RISK POPULATIONS WITHIN ITS SERVICE AREA. THESE COMMUNITY BENEFIT PROGRAMS PROMOTE COMMUNITY WELLNESS AND DISEASE PREVENTION, ENHANCE COMMUNITY HEALTH EDUCATION, AND IMPROVE THE QUALITY OF CLINICAL EDUCATION. IN 2013, CENTEGRA HEALTH SYSTEM PARTNERED WITH THE MCHENRY COUNTY HEALTH DEPARTMENT, UNITED WAY OF MCHENRY COUNTY AND OTHER HOSPITALS AND ORGANIZATIONS TO CONDUCT THE 2014 MCHENRY COUNTY HEALTHY COMMUNITY STUDY. THE INTENT OF THE NEEDS ASSESSMENT WAS TO UNDERSTAND AND ADDRESS THE COUNTY'S MOST PRESSING NEEDS, INVOLVING PARTNERS FROM DIVERSE ORGANIZATIONS, IN ORDER TO IMPROVE THE HEALTH OF COUNTY RESIDENTS. A THOROUGH UNDERSTANDING OF THE COUNTY'S HEALTH WAS MEASURED USING FOUR ASSESSMENTS, EACH FROM A DIFFERENT PERSPECTIVE INCLUDING RESIDENTS, POPULATIONS IN NEED OF SERVICES, COMMUNITY LEADERS, AND DESCRIPTORS USING SECONDARY DATA SOURCES. THROUGH THE ASSESSMENTS, KNOWLEDGE WAS GAINED ABOUT THE CURRENT HEALTH STATUS OF COUNTY RESIDENTS, DEMOGRAPHIC TRENDS, SOCIAL AND ECONOMIC INDICATORS, HEALTH BEHAVIORS, AND UTILIZATION OF HEALTH SERVICES. THE ASSESSMENTS ALSO ATTEMPTED TO UNDERSTAND THE PERCEPTIONS OF COMMUNITY STRENGTHS AND WEAKNESSES AS WELL AS ANSWER QUESTIONS ABOUT THE HEALTH AND HUMAN SERVICES DELIVERY SYSTEM, UNMET NEEDS, GAPS, AND BARRIERS TO CARE.
Patient Education of Eligibility of AssistanceSchedule H, Part VI, Line 3 Uninsured patients arriving at our emergency department and/or direct admits are screened at time of service by either an Emergency Department Financial Counselor or the Health System's In-Patient Financial Counseling Team, Public Aid Representatives, and a Medication Assistance Coordinator to identify eligibility guidelines for federal, state and local government programs, as well as charity care. CHS's Self Pay Process includes a screening which is completed by using hospital form C910050 03-09 prompting an interview offering payment options and eligibility guidelines. It is at this time that a patient becomes aware of the Hospital Uninsured Patient Discount Act, Medicaid, Medication Assistance Programs, Crime Victims, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of timeline for completing application processes at time of service in person. Appropriate scripting is followed by CHS Associates. Discounts were established following the 200%, 350% and 600% federal poverty guidelines to assist in determining charity adjustments. Applications were designed by CHS Self Pay Committee in accordance to our Financial Policy (Policy Number 9850-2) identifying qualifications for the medically needy/catastrophic aid. Uninsured patients opting for elective services are contacted by phone prior to their date of service by the CHS Outpatient Financial Counseling Team. CHS's Self Pay Process is followed and includes a screening for federal, state and local government programs as well as charity care. An interview offering payment options and eligibility guidelines using hospital form C910050 03/09 prompts a quick eligibility determination. It is at this time that a patient becomes aware of the Uninsured Patient Discount Act, Medicaid, Medication Assistance Programs, Crime Victims, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of time line for completing application processes prior to their elective services via phone. Appropriate scripting is followed by CHS Associates. Discounts were established following the 200%, 350% and 600% federal poverty guidelines to assist in determining charity adjustments. Applications were designed by CHS Self Pay Committee in accordance to our Financial Policy (Policy Number 9850-2) identifying qualifications for the medically needy/catastrophic aid. Our health system's website offers FAQ's and answers as well as encourages patients to contact our Customer Service Team when they are unable to pay for services. Our health system's statements also identify detailed account and billing information encouraging the patient to contact our Customer Service Team and inquire about Financial Assistance options. Documentation is essential in effective communication. Follow up teams will then move forward in a timely manner with the appropriate actions to insure all necessary documents (if applicable) are received for eligibility determinations. CHS advertises a Price Line encouraging patients to inquire about estimated costs for future services. The Price is manned by our outpatient financial counselors from 8:00am to 7:00pm. When calls are returned with estimated costs, a conversation ensues to identify a possible financial hardship. Our Self Pay Process is put into effect at this time. Site Registrars will notify the CHS Financial Counseling Team when a financial hardship is identified. Emergency Department Financial Counseling positions have been created to meet the needs of our ED patients. In addition to these new roles, a full time Financial Counselor position was created to meet the special needs of our cancer patients. A Financial Assistance Coordinator reviews all financial applications, gathers needed documents, determines financial assistance and prepares each patient file for leadership approval.
Community InformationSchedule H, Part VI, Line 4 Centegra Health System defines its primary service area as McHenry County, an area of approximately 603 square miles and 327,502 residents. This county is among the fastest growing counties in Illinois with an 18.7% population growth from 2000-2010. The age groups with projected population growth from 2012 to 2017 are the 20-44 with 0.4% and the 65+ age group with 15.8% growth. The county's overall population is projected to increase by 0.9% in the next five years (2013 to 2018). For 2010, the age distribution of the population was as follows: 30% 0-19, 32% 20-44, 28% 45-64, and 10% 65+. McHenry County has relatively high socioeconomic status compared to the rest of Illinois. Median household income for 2012 was $76,683 compared to the IL state median income of $55,137. The March 2014 unemployment rate was 7.8% which is lower than the state average of 8.3%. For 2012, the percentage of the county's population holding a high school diploma or higher was 92.0%, while the percentage holding a bachelor's degree or higher was 33.1%. The McHenry County uninsured rate in 2012 was 9.8% compared to the state uninsured rate of 12.8%.
Promotion of community healthSchedule H, Part VI, Line 5 Please see Schedule O for a detailed description of the Medical Center's program service accomplishments.
Affiliated health care systemSchedule H, Part VI, Line 6 Northern Illinois Medical Center of McHenry, IL is affiliated with Memorial Medical Center of Woodstock, IL. Both Hospitals are acute care facilities serving the greater McHenry County area. Centegra Health System is the parent of both Northern Illinois Medical Center and Memorial Medical Center. Northern Illinois Medical Center is affiliated with Health Bridge Fitness Centers in Crystal Lake, and the Medical Center provides outpatient physical rehabilitation services to the community from a clinic within that location. The Centegra Health System Foundation supports Hospital operations through fundraising activities. Please see schedule R for complete listing of all affiliated organizations. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 IL
Facility reporting group(s)Schedule H, Part VI Northern Illinois Medical Center is a 179 bed facility with a Level II nursery and a center for cancer care, Sage Cancer Center. In addition, NIMC operates four off-site physical rehabilitation centers offering therapy services, as noted in Part V. NIMC also operates two sites where medical imaging services are offered, as noted in Part V.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Michael S Eesley
CEO$0$886,904$0$572,117$0$299,451$0$123,550$0$19,507$0$1,901,529$0$0
Richard Lind
Director$0$381,037$0$0$0$0$0$0$0$21,386$0$402,423$0$0
David Tomlinson
SVP/CIO/CFO$0$410,838$0$118,720$0$3,000$0$32,533$0$25,684$0$590,775$0$0
Jason R Sciarro
President/COO$0$633,906$0$320,770$0$1,089$0$64,349$0$25,889$0$1,046,003$0$0
Rachel Sebastian
VP Site Administrator$308,070$0$47,802$0$0$0$27,171$0$31,778$0$414,821$0$0$0
Belinda A Wagner
Pharmacist$149,895$0$0$0$0$0$3,350$0$3,084$0$156,329$0$0$0
Connie K Secor
Director$161,210$0$11,408$0$0$0$4,189$0$2,291$0$179,098$0$0$0
John G Geinopolos
Medical Physicist$176,469$0$0$0$0$0$1,776$0$25,550$0$203,795$0$0$0
Susan H Corcoran
Pharmacist$140,962$0$0$0$0$0$1,531$0$25,140$0$167,633$0$0$0
Debra A Brasier
Coordinator - Anti-Coag$139,424$0$0$0$0$0$2,876$0$22,919$0$165,219$0$0$0
Lisa Glosson MD
Director$0$227,492$0$0$0$12,881$0$6,747$0$23,457$0$270,577$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceReceived Severance, Supplemental NQ Retirement, equity-Based CompensationFormAndLineReferenceDesc
ExplanationSchedule J, Part I, Line 4b The following people received the following amounts as part of a supplemental nonqualified retirement plan: Michael Eesley $117,500 Jason Sciarro $58,449 Rachel Sebastian $20,923 David Tomlinson $26,674ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)

Relationship DescriptionRelationshipDescriptionTxtTransactionTransactionAmtTransactionTransactionDescSharing Of RevenuesSharingOfRevenuesInd
Rachel Sebastian
Family member$468,373Employeefalse
Carey Electric
Board Member is Owner$102,215Electrical Servicesfalse
Carey Electric
Board Member is Owner$10,932,300Electrical Srvcs-Huntley Hospfalse
Curran Contracting Company
Board Member is Officer$137,537Construction-Huntley Hospitalfalse
Alliance Contractors
Board Member is President$189,000Construction-Huntley Hospitalfalse

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceBusiness Transactions Involving Interested PersonsFormAndLineReferenceDesc
ExplanationSchedule L, Part IV All business transactions are arms length transactions. See conflict of interest disclosures in Schedule O for Form 990, part VI, Line 2. Northern Illinois Medical Center made payments for construction costs of Huntley Hospital.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Organization's MissionForm 990, Part III, Line 1 The primary mission of Northern Illinois Medical Center is to provide quality health care services with innovative and responsible use of resources and promote wellness for the greater McHenry County area. Northern Illinois Medical Center's services include, but are not limited to: 179 licensed-bed Comprehensive Medical Center (42,467 patient days in fiscal year ending June 30, 2015), Level Two Trauma Center, 24 hr Emergency Medicine Physicians, On-site Flight for Life Helicopter (347 flights in fiscal year ending June 30, 2015), Portable TDD (Telephone Device for the Deaf) on site, Center for New Life including Level Two Nursery (3,547 newborn patient days in fiscal year ending June 30, 2015), Antenatal Testing Center, Prenatal Classes, Hello Daddy and Dial-A-Dad pagers, Very Important Sibling Classes, Lamaze Classes, Breastfeeding Classes, Intensive and Intermediate Care Units, Sage Cancer Center (16,305 radiation oncology procedures and 2,780 medical oncology visits in fiscal year ending June 30, 2015), Cardiac Surveillance, Cardiac Catherization Suite, Three-level Cardiac Rehabilitation Program (22,589 visits in fiscal year ending June 30, 2015), Heart Failure Clinic, Full-body CT Scanner and Magnetic Resonance Imaging (MRI) (19,804 CT Scans and 3,352 MRI procedures performed in fiscal year ending June 30, 2015), PET/CT scans, Women's Diagnostic Services (In Medical Imaging), Center for Physical Rehabilitation (6,692 patient days in fiscal year ending June 30, 2015), Inpatient unit, Independence Square, Occupational, Physical and Speech Therapies, Outpatient Therapies, Respiratory Therapy, Home Health Care (32,119 visits in fiscal year ending June 30, 2015, Neurotrauma Day Treatment Program, Sports Medicine Clinic, Occupational Health, Patient Express! Transporation, Extra Touch Program, Pastoral Care, Social Service, Community Education Programs, Support Programs/Groups, and Nutritional Therapy Services.
Form 990, Part III, Program Service AccomplishmentsEXECUTIVE SUMMARY Centegra Health System (Centegra) coordinates the delivery of health care services by assisting in the management of Centegra Hospital- McHenry (Northern Illinois Medical Center) and Centegra Hospital - Woodstock (Memorial Medical Center), (The Medical Centers), and Centegra Health System Foundation, Health Bridge Corporation and NIMED Corporation (Affiliates). In March 2014 Centegra Health System broke ground at Centegra Hospital - Huntley. Centegra's mission is to inspire and engage our community in their health and wellness. We provide quality health care services with innovative and responsible use of resources and promote wellness for the greater McHenry County area in Illinois. During its fiscal year 2015, Centegra Health System sponsored 230 community events. These events touched more than 232,000 individuals. The Medical Centers provide optimum quality health care, delivered by competent hospital and medical center staff, to all whom seek its services regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The primary mission of the Medical Centers is to enhance the health of the community as the preferred health care organization providing outstanding service and value. It is the Medical Centers' objective to serve the community with respect to providing health care services and education. Although reimbursement for services rendered is critical to the operation and stability of the Medical Centers, it is recognized that not all individuals possess the ability to purchase essential medical services. Therefore, in keeping with the Medical Centers' commitment to serve all members of its community, free care and/or subsidized care will be considered where the need and/or an individual's inability to pay exist. Medical Services are provided in a dignified manner to Medicare, Medicaid and indigent patients. System-wide, community benefits included approximately $5.9 million of charity care, over $45 million of government sponsored indigent health care, approximately $4.7 million of other community benefits, and over 89,000 community benefit hours. *The Medical Centers' services include, but are not limited to: Centegra Hospital-McHenry is a 179-bed facility located about 50 miles outside of Chicago. The hospital is the region's leading provider of advanced cardiovascular treatments through the Centegra Cardiovascular & Thoracic Center. It is also home to the Centegra Hip & Knee Replacement Center, the Centegra Sage Cancer Center and the Centegra Family Birth Center. As part of Centegra Health System, Centegra Hospital-McHenry achieved Magnet designation for nursing excellence. Centegra Hospital-McHenry provides sophisticated treatments and advanced technology to address the most serious medical conditions. These include: *Open-heart surgery and heart catheterizations *Joint replacement surgeries *A Level II Trauma Center and on-site Flight for Life helicopter *Certified chest pain and stroke centers *Advanced cancer treatments including radiation and oncology and infusion services *Labor and delivery and on-site 24/7 obstetrics hospitalists and neonatologists *Intensive care *Medical-Surgical care and 24/7 hospitalist care *Outpatient surgery Centegra Hospital-Woodstock is a 106-bed facility located about 60 miles outside of Chicago. The hospital provides exceptional inpatient and outpatient care and has won top awards for patient safety and satisfaction. As part of Centegra Health System, Centegra Hospital-Woodstock achieved Magnet designation for nursing excellence. Centegra Hospital - Woodstock provides sophisticated treatments and advanced technology to address the most serious medical conditions, including: *A Level II Trauma Center and on-site Flight for Life helicopter *Certified chest pain and stroke centers *Intensive care *Medical-Surgical care and 24/7 hospitalist care *Outpatient surgery *Inpatient behavioral health services *Weight-loss surgery through the Centegra Healthy Living Institute *State-of-the-art medical imaging Centegra Health System Foundation provides fund-raising services for Centegra Health System in conjunction with the Medical Centers. The proceeds of these activities are used to purchase medical equipment and supplies, therefore enabling the Medical Centers to better serve the community. Health Bridge Corporation provides various rehabilitation services for the Medical Centers in conjunction with Centegra Health System, by providing a fitness center and pool that serves the community in various capacities and sponsors and hosts assorted educational programs. NIMED Corporation aids in the management of the Medical Centers and several satellite locations within the Centegra Health System organization. The Medical Centers' and the Affiliates' program accomplishments are summarized below. SUPPORT GROUPS Centegra Health System, in conjunction with the Medical Centers and Affiliates, sponsors or hosts many support groups for its patients as well as the community. The following ongoing support groups are held at the Medical Centers, Affiliates or in the community and are free of charge. By supporting these groups, the Medical Centers and Affiliates are able to provide one or all of the following: Staff professionals who either act as facilitators of the group or function as "Guest Speakers," *Space offered free of charge, *Free marketing to educate the community about these services. Programs sponsored by the Medical Centers and or Affiliates in conjunction with Centegra Health System include: *Alcoholics' Anonymous is a twelve-step program for individuals recovering from alcohol dependence. *Alcoholics' Anonymous, Women's Group is a special group for women. *Al-Anon is a twelve-step program group for codependent individuals. *Arthritis Support Group is for individuals with arthritis. *A.W.A.K.E. Support Group is for those individuals with sleep apnea *Better Breathers Club is for those individuals with pulmonary disease and their families. *Cancer Transitions focuses on the needs of cancer survivors who have finished treatment within the last two years. *Caregivers' Support Group is for those who care for someone with a chronic or life-threatening illness. *Creating Expressions links artistic experience with the emotional benefits of cancer management. *Diabetes Support Group is for individuals with Diabetes and their families. *Epilepsy Support Group is for individuals with Epilepsy and their families. *Families' Anonymous is a support group for families with chemically dependent members. *Fibromyalgia Support Group is for those suffering from Fibromyalgia. *Get Help Live Longer is a smoking cessation education and support group. *Hat's Off is a group for women diagnosed with any type of cancer meeting every month. *Headwinds is a support group offered to survivors of traumatic brain injury and their family members and caregivers. *HOPE: High on Positive Energy is for women living with breast cancer *Participation in conjunction with the Pioneer Center, providing information on topics such as managing behavioral problems and the financial issues of long-term care. *Infertility Support Group is a group for couples or individuals experiencing infertility problems. *Living with Grief, sponsored by Centegra Pastoral Care, offers support for adults grieving the loss of a loved one. *Looking Beyond is for people diagnosed with Cancer, their family members, and friends. *Look Good Feel Better is a free program offered by the American Cancer Society and teaches beauty techniques to women who are currently undergoing cancer treatment. *Make Today Count is a group for anyone with a life-threatening illness as well as their family and friends. *McHenry County Crisis Line provides 24-hour mental health information, referral services, and crisis assistance. *Multiple Sclerosis (MS) Support Group is under the Illinois Chapter of the National Multiple Sclerosis Society. The group is open to persons with MS, their family members and others interested in the treatment and management of the disease. *Narcotics Anonymous is a twelve-step support program for those recovering from narcotics dependence. *Nuts and Bolts is a unique support group for stroke survivors who are 55 years of age or younger. The emphasis of this group is on assisting the families as they adapt to the special lifestyle changes of the young stroke survivor. *Pathfinders is a support group for adults with any cancer diagnosis. *Partnering Through Care is for those living with cancer and their care partners. *Partners in Cancer Transitions is a monthly educational support group for cancer survivors and their care partners. *Perinatal Grief Support Group is for anyone who has experienced the loss of a newborn or an infant through miscarriage, ectopic pregnancy, or Sudden Infant Death Syndrome (SIDS). *St. Peregrine's Cancer Support Group is a non-denominational support group for patients and their familie
FORM 990, PART IV, LINE 24NORTHERN ILLINOIS MEDICAL CENTER HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, CENTEGRA HEALTH SYSTEM. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON CENTEGRA HEALTH SYSTEM'S FORM 990. Business or Family Relationship of Officers, Directors, Etc. Form 990, Part VI, Line 2 Northern Illinois Medical Center, (NIMC), adopted specific conflict of interest policies for its governing and management staff. The policy includes, but is not limited to, when an individual, governor, committee member, officer, agent or employee believes that he or she, or a member of his or her immediate family might have or does have a real or apparent conflict, he or she should in addition to filing the disclosure notice required, abstain from making motions, voting, executing agreements, or taking any other similar direct action on behalf of the Medical Center. During fiscal year 2015, Northern Illinois Medical Center purchased certain goods and/or services from organizations with director affiliation. All transactions were competitively bid and were conducted at arms length. The fees paid were at fair market value. During Fiscal year 2015, Director Michael Curran is an officer/director of Curran Contracting Company. Director Kathy Powell is an employee and Vice President of Home State Bank. Director Patrick Morehead is on the Board of Directors and a 1% owner of Home State Bank. Director Charie Zanck is a Director of American Community Bank & Trust. Director Charles Ruth is the Board Chairman of American Community Bank & Trust. Director Chris Newkirk is a shareholder of American Community Bank & Trust.Tom Carey is Vice President of Carey Electric. Vice President Rachel Sebastian is the daughter of CEO Michael Eesley.
Description of Delegated Duties to Management CompanyForm 990, Part VI, Line 3 Management companies were used for the daily operations and management of the following services for the health system: Sodexho Inc. & Affiliates was used to manage Food & Nutrition and Environmental Services work. Perot (Dell) provided management and support services for the Information Systems area. None of the outsourced managers or directors are executive level staff, and none of them need to be named in Part VII.
Explanation of Classes of Members or ShareholderForm 990, Part VI, Line 6 Centegra Health System is the sole member of NIMC. Centegra Health System has a single class of members.
How Members or Shareholders Elect Governing BodyForm 990, Part VI, Line 7a The powers and duties of the Centegra Health System members in fulfilling the purposes and objectives of the Corporation shall include, but not be limited to, the taking of action with respect to the following matters: The election of governors and the filling of vacancies on the Board of Governors, which shall be in accordance with the procedures set forth in the Bylaws. The Nominating Committee shall select one candidate for each position on the Board having a term to be voted upon for the office of governor at the next annual meeting of members. The Nominating Committee shall consider and approve a list of candidates and submit such list to the Board of Governors not less than 10 days prior to the date of the last meeting of the Board of Governors prior to the date on which notice of the annual meeting of members is to be sent, and the candidates set forth on such list shall be subject to approval by the Board of Governors. The names of the candidates so selected by the Nominating Committee and approved by the Board of Governors shall be included in the notice of the annual meeting of the members of the Corporation and shall be presented to the members of the Corporation at the annual meeting. The voting members of the Corporation may nominate candidates for the positions on the Board of Governors. Nominations by such members may be effected by means of written nomination signed by not less than 20 voting members in good standing, accompanied by a written statement of such nominee indicating a willingness to serve as a governor of the Corporation if elected. Any such nomination must be received by the Nominating Committee of the Corporation not less than 60 days prior to the annual meeting of members in order to be considered at such annual meeting. All elections shall be by secret ballot if there are more nominees than vacancies to be filled on the Board. All voting members present in person or by proxy at a meeting at which an election occurs shall be entitled to vote for governors. To be valid a ballot must not have more votes than there are vacancies. If there are more nominees than vacancies to be filled on the Board, those nominees who receive the most votes shall be elected to the Board of Governors. Members shall not be entitled to cumulate their votes in the election of governors.
Form 990 Review ProcessForm 990, Part VI, Line 11b The Form 990 and related schedules are compiled by CHS staff. The review process for the 990 includes detailed review by an outside auditor, bond counsel, Controller, and Chief Financial Officer, prior to submission to the IRS. The tax return will be made available for the Board to review after submission to the IRS.
Explanation of Monitoring and Enforcement of ConflictsForm 990, Part VI, Line 12c As stated in Centegra's Bylaws, the Bylaws recognize that both real and apparent conflicts of interest sometimes naturally occur in the course of conducting daily affairs. Conflicts occur because the many persons associated with Centegra should be expected to have and do, in fact, generally have multiple interests and affiliations and various positions of responsibility within the community. The long-range interests of Centegra do not require the termination of all association with persons who may have real or apparent conflicts if a prescribed and effective method can render such conflicts harmless to all concerned. Centegra Health System has a conflict of interest policy that is intended to address such matters. 1. Duty to Disclose: In connection with any actual or possible conflicts of interest, an interested person or other person subject to this policy must disclose the existence and nature of his or her financial interest in writing to the President of Centegra or the Chief Corporate Responsibility Officer or designee, who shall provide such written disclosure to the Governors Affairs Committee of Centegra, which shall consider all conflicts of interest issues and, if appropriate, to the directors and members of committees with board-delegated powers considering the proposed transaction or arrangement. The disclosure must occur, at minimum, annually, with a Conflict of Interest Disclosure Statement being submitted no later than January 31st of each year. Copies of disclosure statements filed by Board members shall be distributed to the Board annually at the February Board meeting. 2. Determining Whether a Conflict of Interest Exists: When a conflict of interest is disclosed at meeting of the board or committee thereof, after disclosure of the financial interest, the interested person shall leave the board or committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. The interested person's leaving such meeting shall not affect whether a quorum exists at such meeting. 3. Procedures for Addressing the Transaction or Arrangement from Which the Conflict Arose: A. The chairperson of the board or committee shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. B. After exercising due diligence, the board or committee shall determine whether Centegra can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or entity that would not give rise to a conflict of interest. C. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the board or committee shall determine by a majority vote of the disinterested directors whether the transaction or arrangement is in Centegra's best interest and for its own benefit and whether the transaction is fair and reasonable to Centegra and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. 4. Violations of the Conflicts of Interest Policy: A. If the administration, the board, or a committee has a reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose. B. If, after hearing the response of the member and making such further investigation as may be warranted in the circumstances, the board or committee determines that the member has, in fact, failed to disclose an actual or possible conflict of interest, it shall refer the matter to the Governors Affairs Committee for consideration, which shall subsequently recommend appropriate disciplinary and corrective action to such board or committee.
Compensation Review & Approval Process - Officers and & Key EmployeesForm 990, Part VI, Line 15b The Board of Directors of Centegra Health System, through the Compensation Committee comprised of independent members free of conflict, reviewed executive compensation levels and other features of the compensation plan in accordance with the organization's approved compensation philosophy and strategy. The Committee is comprised of members of the Board of Directors, who are independent of Centegra management, have no personal interest in the compensation arrangements, are not related to, or under the control of any individual whose compensation arrangement is being reviewed and have no material business relationship with Centegra. The C-Suite's compensation is determined by the Compensation Committee in relation to comparable peers based on 990 market data. Compensation for other members of the executive staff is recommended by the CEO, reviewed by the Committee, and evaluated against market data. The compensation Committee approves all compensation decisions in advance of their implementation and documents its determinations and discussions. Its decisions and deliberations are thoroughly documented and meeting minutes are kept and distributed to the Committee members (for historical reference). The Compensation Committee uses a number of external resources and comparisons, and their review includes total compensation (cash compensation, plus benefits provided by Centegra) in relation to organizational performance and prevailing industry practices of comparably-sized organizations. They have engaged the services of a compensation consulting firm (Sullivan Cotter) specializing in the not-for-profit sector that has worked with Centegra and reports directly to the Compensation Committee. Reasonableness letters and documentation are provided to the organization after each review.
Other Organization Documents Publicly AvailableForm 990, Part VI, Line 19 All governing documents, policies, and financial statements are available upon request.
Form 990, Part IX, Line 24aIt should be noted that the Related Company expenses in Form 990, Part IX, line 24a are allocated at 65% of total expense of the related company (Centegra Health System, FEIN 36-3196559). The allocation method is reviewed annually. Expense detail is as follows: Salaries $15,566,044; Benefits $3,269,782; Payroll Taxes $1,022,086; Purchased Services/Professional Fees $13,667,089; IT Expenses $4,618,399; Office Expenses $1,370,116; Advertising and Promotional $1,393,654; Other Expenses $4,740,184.
Other changes in net assetsFORM 990, PART XI, LINE 9 AFFILIATE TRANSFERS $(26,000,000) INTEREST IN FOUNDATION $3,772,995 ------------- TOTAL $(22,227,005)

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
Centegra Health System
385 Millennium DriveCrystal LakeIL60012363196559Health SystemIL501(c)(3)11cNAfalse
Centegra Health System Foundation
385 Millennium DriveCrystal LakeIL60012363723610FundraisingIL501(c)(3)11aCentegra HSfalse
NIMED Corporation
385 Millennium DriveCrystal LakeIL60012363119911Property MgmtIL501(c)(3)11cCentegra HSfalse
Health Bridge Corporation
385 Millennium DriveCrystal LakeIL60012363196550Health FT CTRIL501(c)(3)11cCentegra HSfalse
Oak Creek Lodge
385 Millennium DriveCrystal LakeIL60012363591359HospitalIL501(c)(3)3Centegra HSfalse
Centegra Hospital Huntley
10400 Haligus RoadHuntleyIL60142453449737HospitalIL501(c)(3)3Centegra HSfalse
Memorial Medical Center
3701 Doty RoadWoodstockIL60098362179764HospitalIL501(c)(3)3Centegra HSfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1noneBusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Centegra Management ServicesBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1385 Millenium DriveAddressLine1Txt
CityCrystal LakeCityNm
State AbbreviationILStateAbbreviationCd
ZIP60012ZIPCd
FieldValueIRS element (for citing)
EIN364028114EIN
Primary ActivitiesManagementPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Centegra HSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CorpEntityTypeTxt
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

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