KISHHEALTH SYSTEM: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- KISHHEALTH SYSTEM (EIN 36-3649080)
- Tax period
- 2013-05-01 to 2014-04-30
- Filed
- 2015-01-12
- IRS object ID
- 201500129349300885
- Schema version
- 2013v4.0
- 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
- Form 990
- Schedule A
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-01-12T09:14:18-06:00 | ReturnTs |
| Tax Period End | 2014-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 114 E EVERETT | AddressLine1 |
| City | DIXON | City |
| State | IL | State |
| ZIP Code | 61021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363649080 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KISHHEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KISH | BusinessNameControlTxt |
| Phone | 8157561521 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE KISH HOSPITAL DRIVE | AddressLine1 |
| City | DEKALB | City |
| State | IL | State |
| ZIP Code | 60115 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LOREN FOELSKE | PersonNm |
| Person Title | VICE PRESIDENT - FINANCE, KHS | PersonTitleTxt |
| Phone | 8157561521 | PhoneNum |
| Signature | 2014-12-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KELLY JACKSON HARDY | PreparerPersonNm |
| PTIN | P00747242 | PTIN |
| Phone | 8152859300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN P POORTEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE KISH HOSPITAL DRIVE | AddressLine1 |
| City | DEKALB | City |
| State | IL | State |
| ZIP Code | 60115 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,555,864 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.KISHHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1988 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | MANAGEMENT AND PARENT ORGANIZATION PROVIDING SERVICES TO 501(C)(3) HEALTH SYSTEM | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 115 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,928,735 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,492,028 | CYProgramServiceRevenueAmt |
| PY Investment Income | $232,584 | PYInvestmentIncomeAmt |
| CY Investment Income | $424,505 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$129,031 | PYOtherRevenueAmt |
| CY Other Revenue | -$148,808 | CYOtherRevenueAmt |
| PY Total Revenue | $18,032,288 | PYTotalRevenueAmt |
| CY Total Revenue | $20,767,725 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $39,269 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $18,207 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,664,059 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,451,561 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,147,351 | PYOtherExpensesAmt |
| CY Other Expenses | $8,043,649 | CYOtherExpensesAmt |
| PY Total Expenses | $17,850,679 | PYTotalExpensesAmt |
| CY Total Expenses | $20,513,417 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $181,609 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $254,308 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,826,655 | TotalAssetsBOYAmt |
| Total Assets EOY | $30,814,855 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,659,013 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,171,240 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,167,642 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,643,615 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MANAGEMENT AND PARENT ORGANIZATION PROVIDING SERVICES TO 501 (C) (3) HEALTH SYSTEM. WE ARE THE CORNERSTONE OF HEALTH CARE FOR THE COMMUNITIES WE SERVE-THE FIRST CHOICE FOR SERVICE, COMFORT AND SAFETY. AS A COMMUNITY-OWNED HEALTH SYSTEM, THE KISH FAMILY UNSELFISHLY COMMITS TO EXCELLENCE, EDUCATION AND INNOVATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,724,643 | ExpenseAmt |
| Grant | $18,207 | GrantAmt |
| Revenue | $20,492,028 | RevenueAmt |
| Desc | KISHHEALTH SYSTEM (KHS) IS THE NON-PROFIT CORPORATE UMBRELLA FOR TWO HOSPITALS, A HOSPICE, CLINIC, HOME HEALTH CARE SERVICE, AND A HEALTH FOUNDATION PREDOMINATELY SERVING RESIDENTS OF DEKALB, KENDALL AND LASALLE COUNTIES IN ILLINOIS. THE MISSION OF THE HEALTH SYSTEM IS TO BE "THE CORNERSTONE OF HEALTH CARE FOR THE COMMUNITIES WE SERVE-THE FIRST CHOICE FOR SERVICE, COMFORT AND SAFETY. AS A COMMUNITY-OWNED HEALTH SYSTEM, THE KISH FAMILY UNSELFISHLY COMMITS TO EXCELLENCE, EDUCATION AND INNOVATION." IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE, CENTER FOR FAMILY HEALTH CLINIC, KISHHEALTH HOME CARE, AND KISHHEALTH FOUNDATION, THE HEALTH SYSTEM'S CORPORATE OFFICE PROVIDES COMMUNITY BENEFIT IN THE FOLLOWING AREAS:* KISH HEALTH SYSTEM UNDERWROTE $3,598,000 FOR KISH HEALTH SYSTEM PHYSICIAN GROUP, $504,000 FOR THE TWO CENTERS FOR FAMILY HEALTH CLINICS, $446,000 FOR KISHHEALTH SYSTEM HOMECARE, AND $299,000 FOR KISHHEALTH SYSTEM HOSPICE (DEKALB COUNTY HOSPICE) FOR OPERATIONAL LOSSES IN FISCAL YEAR 2014, ALL VITAL SERVICES FOR THE HEALTH OF THE COMMUNITY. IN ADDITION TO CONTRIBUTIONS MADE BY KISHWAUKEE HOSPITAL AND VALLEY WEST HOSPITAL TO OTHER ORGANIZATIONS WITHIN THEIR COMMUNITIES, KISH HEALTH SYSTEM CONTRIBUTED IN EXCESS OF $18,000 TO OTHER ORGANIZATIONS WITHIN THE COMMUNITY.KISHHEALTH SYSTEM EMPLOYEES CONTRIBUTED 772 HOURS OF IN-KIND SERVICE TO COMMUNITY ORGANIZATIONS, EDUCATIONAL INSTITUTIONS AND OTHER ACTIVITIES THAT PROMOTE HEALTH AND EDUCATION. KISH HEALTH SYSTEM LEADERS SERVE ON THE BOARDS OF DIRECTORS FOR LIVE HEALTHY DEKALB COUNTY, FORMERLY KNOWN AS PIONEERING HEALTHY COMMUNITIES, KISHWAUKEE FAMILY YMCA, KISHWAUKEE COLLEGE FOUNDATION, OPPORTUNITY HOUSE, VOLUNTARY ACTION CENTER, DEKALB COUNTY YOUTH SERVICES BOARD, DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION; DEKALB, SYCAMORE, GENOA, SANDWICH, AND PLANO CHAMBERS OF COMMERCE; THE CENTER FOR FAMILY HEALTH, FOX VALLEY OLDER ADULT SERVICES, NORTHERN ILLINOIS UNIVERSITY, WABAUNSEE COMMUNITY COLLEGE, AND ST. ANTHONY SCHOOL OF NURSING ADVISORY BOARDS.THE HEALTH SYSTEM'S NON-PROFIT ENTITIES ARE KISHWAUKEE HOSPITAL, A 98-BED HOSPITAL IN DEKALB, IL, SERVING ALL OF DEKALB COUNTY AND BEYOND, VALLEY WEST HOSPITAL, A 25-BED CRITICAL ACCESS HOSPITAL IN SANDWICH; KISH HEALTH SYSTEM HOSPICE, DEKALB, IL, WHICH PROVIDES FREE CARE AND SUPPORT FOR THE TERMINALLY ILL AS WELL AS GRIEF SUPPORT TO THE PUBLIC; CENTER FOR FAMILY HEALTH MALTA, IL, PRIMARY CARE CLINIC FOR MEDICAID AND UNINSURED; KISH HEALTH SYSTEM PHYSICIAN GROUP, WHICH PROVIDES ACCESS TO MEDICAL SERVICES, ESPECIALLY THE RURAL AREAS AND ACCEPTS MEDICAID AND UNINSURED PATIENTS, KISH HEALTH SYSTEM HOMECARE, DEKALB, IL, WHICH PROVIDES HOME HEALTH SERVICES PREVIOUSLY OFFERED THROUGH THE COUNTY HEALTH DEPARTMENT, AND KISH HEALTH FOUNDATION IN DEKALB, IL, WHICH RAISES MONEY FOR THE HEALTH SYSTEM AND FUNDS EQUIPMENT PURCHASES AND PATIENT SERVICES PARTICULARLY IN THE AREA OF CANCER CARE FOR THOSE WHO CANNOT AFFORD. | Desc |
| Total Program Service Expenses | $1,724,643 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 115 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Excess Business Holdings | 0 | ExcessBusinessHoldingsInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOREN FOELSKE VP - FINANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8157561521 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE KISH HOSPITAL DRIVE | AddressLine1 |
| City | DEKALB | City |
| State | IL | State |
| ZIP Code | 60115 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MICHAEL CULLEN | |||||||||
| DIRECTOR | 2.00 | 9.00 | Yes (X) | $0 | $0 | $0 | |||
| TERRENCE DUFFY | |||||||||
| DIRECTOR | 2.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL LARSON | |||||||||
| PAST CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOHN MOULTON | |||||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| THOMAS MATYA | |||||||||
| CHAIR | 2.00 | 3.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARY LYNN MCARTOR | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| KEVIN POORTEN | |||||||||
| DIRECTOR/PRESIDENT & CEO - KISHHEALTH SYSTEM | 30.00 | 25.00 | Yes (X) | $849,820 | $0 | $223,339 | Yes (X) | ||
| JAGDISH PATEL MD | |||||||||
| DIRECTOR | 2.00 | 1.00 | Yes (X) | $0 | $34,425 | $0 | |||
| PROMOD VOHRA | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS CHOICE | |||||||||
| 2ND VICE CHAIR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| PHOTINE LIAKOS MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LEONETTA RIZZI | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARC STRAUSS | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ANN WEST MD | |||||||||
| DIRECTOR | 2.00 | 1.00 | Yes (X) | $0 | $1,250 | $0 | |||
| TIMOTHY RUETTEN MD | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $22,616 | $0 | |||
| LOREN FOELSKE | |||||||||
| VP FINANCE - KISHHEALTH SYSTEM | 15.00 | 37.00 | $322,928 | $0 | $86,194 | Yes (X) | |||
| BRAD COPPLE | |||||||||
| PRESIDENT - KH & VWH | 7.00 | 46.00 | $295,129 | $0 | $58,014 | Yes (X) | |||
| JOSEPH DANT | |||||||||
| VP BUSINESS DEVELOPMENT | 37.00 | 10.00 | $280,047 | $0 | $43,152 | Yes (X) | |||
| MICHAEL KOKOTT | |||||||||
| ASST. VP MKTG & PLANNING | 25.00 | 20.00 | $204,285 | $0 | $28,155 | Yes (X) | |||
| ROGER HEATH BELL | |||||||||
| VP AND CIO | 12.00 | 35.00 | $270,954 | $0 | $45,501 | Yes (X) | |||
| PAM DUFFY | |||||||||
| VP PATIENT CARE SVCS | 20.00 | 25.00 | $262,869 | $0 | $31,539 | Yes (X) | |||
| MARK THATE | |||||||||
| VP - HUMAN RESOURCES (RETIRED 12/2013) | 25.00 | 20.00 | $262,257 | $0 | $23,704 | Yes (X) | |||
| DR MICHAEL KULISZ | |||||||||
| CHIEF MEDICAL OFFICER | 20.00 | 32.00 | $418,350 | $0 | $72,044 | Yes (X) | |||
| DAVID PROULX | |||||||||
| VP OPERATIONS - VWH | 3.00 | 50.00 | $185,981 | $0 | $55,134 | Yes (X) | |||
| CHERYL FISHER | |||||||||
| DIRECTOR OF RISK MANAGEMENT | 45.00 | 0.00 | $144,386 | $0 | $36,608 | Yes (X) | |||
| CRAIG VILLACORTA | |||||||||
| DIRECTOR OF INFORMATION SYSTEMS | 45.00 | 0.00 | $120,906 | $0 | $33,789 | Yes (X) | |||
| JEFFERY REIFSTECK | |||||||||
| TECHNICAL OPERATIONS MANAGEMENT | 45.00 | 0.00 | $111,271 | $0 | $37,860 | Yes (X) | |||
| TODD BARROWCLIFT | |||||||||
| SENIOR DIRECTOR OF PHYSICIAN OPERATIONS | 45.00 | 0.00 | $165,443 | $0 | $35,877 | Yes (X) | |||
| RICHARD LOVITT | |||||||||
| DIRECTOR OF ACCOUNTING | 45.00 | 0.00 | $101,859 | $0 | $11,871 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,996,485 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $58,291 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $822,781 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| REINHART BOERNER VANDEUREN | |||||
| PO BOX 2965 | MILWAUKEE | IL | 532012965 | LEGAL SERVICES | $1,067,030 |
| PLUNKETT RAYSICH ARCHITECTS LLP | |||||
| 11000 WEST PARK PLACE | MILWAUKEE | WI | 53224 | ARCHITECTURAL SERVICES | $697,388 |
| AURORA RADIOLOGY | |||||
| 1870 WEST GALENA BLVD | AURORA | IL | 60506 | MEDICAL SERVICES | $348,540 |
| KAUFMAN HALL & ASSOCIATES | |||||
| 5202 OLD ORCHARD ROAD | SKOKIE | IL | 60077 | CONSULTING SERVICES | $230,841 |
| BE SMITH ASSOCIATES INC | |||||
| DEPARTMENT 300 | KANSAS CITY | MO | 64121 | STAFFING SERVICES | $199,974 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | KHS ADMINISTRATION HEALTH SYSTEM | Desc |
| Business | 551112 | BusinessCd |
| Total Revenue Column | $20,492,028 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,492,028 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,492,028 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $244,992 | TotalRevenueColumnAmt |
| Exclusion | $244,992 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $290,809 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $439,724 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$148,915 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$148,915 | TotalRevenueColumnAmt |
| Exclusion | -$148,915 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,190,548 | SecuritiesAmt |
| Other | $337,380 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $3,182,491 | SecuritiesAmt |
| Other | $165,924 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,057 | SecuritiesAmt |
| Other | $171,456 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $179,513 | TotalRevenueColumnAmt |
| Exclusion | $179,513 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 551112 | BusinessCd |
| Total Revenue Column | $107 | TotalRevenueColumnAmt |
| Exclusion | $107 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $107 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,767,725 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,492,028 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $275,697 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,207 | TotalAmt |
| Program Services | $18,207 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,019,398 | TotalAmt |
| Management And General | $4,019,398 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,304,489 | TotalAmt |
| Program Services | $57,024 | ProgramServicesAmt |
| Management And General | $5,247,465 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,540 | TotalAmt |
| Program Services | $2,775 | ProgramServicesAmt |
| Management And General | $305,765 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,300,484 | TotalAmt |
| Program Services | $15,720 | ProgramServicesAmt |
| Management And General | $2,284,764 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,650 | TotalAmt |
| Program Services | $3,282 | ProgramServicesAmt |
| Management And General | $515,368 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $780,462 | TotalAmt |
| Management And General | $780,462 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,484 | TotalAmt |
| Management And General | $108,484 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,000 | TotalAmt |
| Management And General | $10,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,974,000 | TotalAmt |
| Management And General | $1,974,000 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,598 | TotalAmt |
| Management And General | $239,598 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $512,923 | TotalAmt |
| Management And General | $512,923 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,756,403 | TotalAmt |
| Management And General | $1,756,403 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $538,177 | TotalAmt |
| Management And General | $538,177 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $361,656 | TotalAmt |
| Management And General | $361,656 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,723 | TotalAmt |
| Management And General | $22,723 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,627,635 | TotalAmt |
| Program Services | $1,627,635 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $476 | TotalAmt |
| Management And General | $476 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|
| DUES AND SUBSCRIPTIONS | $101,953 | $101,953 |
| MISCELLANEOUS EXPENSE | $9,159 | $9,159 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,513,417 | TotalAmt |
| Program Services | $1,724,643 | ProgramServicesAmt |
| Management And General | $18,788,774 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,231,333 | BOYAmt |
| EOY | $1,583,852 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,892 | BOYAmt |
| EOY | $79,841 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $697 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $522,939 | BOYAmt |
| EOY | $729,653 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,097,812 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,852,587 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,962,753 | BOYAmt |
| EOY | $8,245,225 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,767,925 | BOYAmt |
| EOY | $7,968,396 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,049,472 | BOYAmt |
| EOY | $7,146,680 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,187,644 | BOYAmt |
| EOY | $5,061,208 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,826,655 | BOYAmt |
| EOY | $30,814,855 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,515,671 | BOYAmt |
| EOY | $10,937,009 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,962 | BOYAmt |
| EOY | $756,321 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $885,380 | BOYAmt |
| EOY | $3,477,910 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,659,013 | BOYAmt |
| EOY | $15,171,240 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,167,642 | BOYAmt |
| EOY | $15,643,615 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,167,642 | BOYAmt |
| EOY | $15,643,615 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,826,655 | BOYAmt |
| EOY | $30,814,855 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $254,308 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$254,309 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $475,974 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type2 | Yes (X) | SupportingOrgType2Ind |
| Certification | Yes (X) | CertificationInd |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Contribution Controller | 0 | ContributionControllerInd |
| Contribution Family | 0 | ContributionFamilyInd |
| Contribution35 Controlled | 0 | Contribution35ControlledInd |
Supported Org Information SupportedOrgInformationGrp (8 entries)
| EINEIN | Organization TypeOrganizationTypeDesc | Governing Document ListedGoverningDocumentListedInd | Supported Org NotifiedSupportedOrgNotifiedInd | US OrganizedUSOrganizedInd | SupportSupportAmt |
|---|---|---|---|---|---|
| KISHWAUKEE COMMUNITY HOSPITAL | |||||
| 237087041 | 03 | Yes (1) | Yes (1) | Yes (1) | $0 |
| VALLEY WEST COMMUNITY HOSPITAL | |||||
| 364244337 | 03 | Yes (1) | Yes (1) | Yes (1) | $0 |
| DEKALB COUNTY HOSPICE | |||||
| 363164329 | 07 | Yes (1) | Yes (1) | Yes (1) | $825,000 |
| KISHHEALTH FOUNDATION | |||||
| 363649077 | 07 | Yes (1) | Yes (1) | Yes (1) | $500,000 |
| CENTER FOR FAMILY HEALTH | |||||
| 800424001 | 03 | Yes (1) | Yes (1) | Yes (1) | $40,000 |
| KISHWAUKEE PHYSICIANS GROUP INC | |||||
| 651293967 | 03 | Yes (1) | Yes (1) | Yes (1) | $4,100,000 |
| CENTER FOR FAMILY HEALTH - MALTA | |||||
| 800869393 | 03 | Yes (1) | Yes (1) | Yes (1) | $250,000 |
| KISHHEALTH HOME CARE | |||||
| 371703513 | 03 | Yes (1) | Yes (1) | Yes (1) | $420,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 8 | SupportedOrganizationsTotalCnt |
| Support Sum | $6,135,000 | SupportSumAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | Yes (1) | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $10,000 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $10,000 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | KISHHEALTH SYSTEM MADE A $10,000 CONTRIBUTION TO COALITION TO PROTECT AMERICAS HEATH CARE. THE ORGANIZATION INDICATED THAT THIS CONTRIBUTION WAS FOR LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,713,988 | OtherCostOrOtherBasisAmt |
| Book Value | $1,713,988 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,527,804 | OtherCostOrOtherBasisAmt |
| Depreciation | $189,281 | DepreciationAmt |
| Book Value | $1,338,523 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,235,983 | OtherCostOrOtherBasisAmt |
| Depreciation | $423,685 | DepreciationAmt |
| Book Value | $812,298 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,531,758 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,239,621 | DepreciationAmt |
| Book Value | $2,292,137 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,088,279 | OtherCostOrOtherBasisAmt |
| Book Value | $2,088,279 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,245,225 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $5,928,149 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
Other Securities OtherSecuritiesGrp (3 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| CASH EQUIVALENTS | $319,603 | F |
| CERTIFICATES OF DEPOSIT | $850,484 | F |
| ACCRUED INTEREST | $48,444 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $7,146,680 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE FROM SUBSIDIARY ORGANIZATIONS | Desc |
| Book Value | $5,061,208 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,061,208 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO SUBSIDIARY ORGANIZATIONS | Desc |
| Amt | $3,477,910 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,477,910 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $37,678 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$254,309 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $439,724 | OtherRevenueAmt |
| Revenue Not Reported | $185,415 | RevenueNotReportedAmt |
| Revenue Subtotal | -$147,737 | RevenueSubtotalAmt |
| Other Revenues Not Included | $20,915,462 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $20,915,462 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $20,767,725 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $461,113 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $439,724 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $439,724 | ExpensesNotReportedAmt |
| Expenses Subtotal | $21,389 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $20,492,028 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $20,492,028 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,513,417 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE SYSTEM, KH, VWH, KHF, KPG, KHH, CFHP (CCC), CFHM, AND KHC ARE TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HPI IS A TAXABLE ORGANIZATION AND FILES A CORPORATE INCOME TAX RETURN, WHICH INCLUDES OPT, IRCC, AND HVL. THE SYSTEM FILES VARIOUS FORM 990'S (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, 2014 AND 2013, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES NETTED WITH INCOME FOR FORM 990 439,724. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | LOSS ON SUBSIDIARY, HPI, REPORTED ON SEPARATE COMPANY RETURN 423,432. MANAGEMENT FEES PAID TO KHS, REPORTED AS EXPENSES ON FINANCIAL STATEMENTS 20,492,028. ROUNDING 2. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES NETTED WITH INCOME FOR FORM 990 439,724. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | MANAGEMENT FEES PAID TO KHS, REPORTED AS EXPENSES ON FINANCIAL STATEMENTS 20,492,028. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2 |
|---|---|---|---|---|---|---|---|---|
| OSF SAINT ANTHONY MEDICAL CENTER FOUNDATION | ||||||||
| 5666 E STATE STREET | ROCKFORD | IL | 61108 | 371259284 | 501(C)(3) | $7,500 | TO PROVIDE FINANCIAL ASSISTANCE IN CONNECTION WITH SUPPORT OF PHILANTHROPIC EFFORTS THAT IMPACT THE CARE OF PATIENTS FROM OUR COMMUNITY. | |
| COALITION TO PROTECT AMERICAS HEALTH CARE | ||||||||
| 800 10TH STREET NW TWO CITYCENTER | WASHINGTON | DC | 20001 | 522253225 | 501(C)(4) | $10,000 | TO PROVIDE SUPPORT TO ORGANIZATION WHICH PROVIDES EDUCTION AND INFORMATION TO THE PUBLIC AND POLICY MAKERS REGARDING HEALTHCARE ISSUES. | 400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | REQUESTS FOR FINANCIAL ASSISTANCE FROM OTHER CHARITABLE ORGANIZATIONS ARE REVIEWED AND APPROVED BY THE CEO OF KISHHEALTH SYSTEM. IF NECESSARY DUE TO THE DOLLAR AMOUNT OF THE REQUEST, THESE ITEMS MAY ALSO BE PRESENTED TO THE BOARD OF DIRECTORS. A BUDGET IS SET ANNUALLY FOR CHARITABLE ASSISTANCE TO OTHER ORGANIZATIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN POORTEN | ||||||||||||||
| DIRECTOR/PRESIDENT & CEO - KISHHEALT | $575,560 | $0 | $185,669 | $0 | $88,591 | $0 | $202,577 | $0 | $20,762 | $0 | $1,073,159 | $0 | $88,591 | $0 |
| LOREN FOELSKE | ||||||||||||||
| VP FINANCE - KISHHEALTH SYSTEM | $260,902 | $0 | $62,026 | $0 | $0 | $0 | $66,193 | $0 | $20,001 | $0 | $409,122 | $0 | $0 | $0 |
| BRAD COPPLE | ||||||||||||||
| PRESIDENT - KH & VWH | $295,129 | $0 | $0 | $0 | $0 | $0 | $37,780 | $0 | $20,234 | $0 | $353,143 | $0 | $0 | $0 |
| JOSEPH DANT | ||||||||||||||
| VP BUSINESS DEVELOPMENT | $216,567 | $0 | $63,480 | $0 | $0 | $0 | $23,222 | $0 | $19,930 | $0 | $323,199 | $0 | $0 | $0 |
| MICHAEL KOKOTT | ||||||||||||||
| ASST. VP MKTG & PLANNING | $165,020 | $0 | $39,265 | $0 | $0 | $0 | $15,470 | $0 | $12,685 | $0 | $232,440 | $0 | $0 | $0 |
| ROGER HEATH BELL | ||||||||||||||
| VP AND CIO | $217,987 | $0 | $52,967 | $0 | $0 | $0 | $20,300 | $0 | $25,201 | $0 | $316,455 | $0 | $0 | $0 |
| PAM DUFFY | ||||||||||||||
| VP PATIENT CARE SVCS | $213,438 | $0 | $49,431 | $0 | $0 | $0 | $23,947 | $0 | $7,592 | $0 | $294,408 | $0 | $0 | $0 |
| MARK THATE | ||||||||||||||
| VP - HUMAN RESOURCES (RETIRED 12/201 | $163,242 | $0 | $44,815 | $0 | $54,200 | $0 | $6,375 | $0 | $17,329 | $0 | $285,961 | $0 | $0 | $0 |
| DR MICHAEL KULISZ | ||||||||||||||
| CHIEF MEDICAL OFFICER | $322,866 | $0 | $95,484 | $0 | $0 | $0 | $51,900 | $0 | $20,144 | $0 | $490,394 | $0 | $0 | $0 |
| DAVID PROULX | ||||||||||||||
| VP OPERATIONS - VWH | $149,727 | $0 | $36,254 | $0 | $0 | $0 | $35,583 | $0 | $19,551 | $0 | $241,115 | $0 | $0 | $0 |
| CHERYL FISHER | ||||||||||||||
| DIRECTOR OF RISK MANAGEMENT | $135,172 | $0 | $9,214 | $0 | $0 | $0 | $8,124 | $0 | $28,484 | $0 | $180,994 | $0 | $0 | $0 |
| CRAIG VILLACORTA | ||||||||||||||
| DIRECTOR OF INFORMATION SYSTEMS | $116,346 | $0 | $4,560 | $0 | $0 | $0 | $6,812 | $0 | $26,977 | $0 | $154,695 | $0 | $0 | $0 |
| TODD BARROWCLIFT | ||||||||||||||
| SENIOR DIRECTOR OF PHYSICIAN OPERATI | $165,443 | $0 | $0 | $0 | $0 | $0 | $8,885 | $0 | $26,992 | $0 | $201,320 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | KISHHEALTH SYSTEM PROVIDES PAYMENT FOR SOCIAL CLUB DUES FOR THE CEO AND PRESIDENT - KH & VWH OF THE ORGANIZATION. KISHHEALTH SYSTEM ALSO PROVIDES PAYMENT FOR AUTOMOBILE ALLOWANCE FOR THE CEO, PRESIDENT - KH & VWH, VP BUSINESS DEVELOPMENT, AND THE AVP PLANNING & MARKETING OF THE ORGANIZATION. SUCH PAYMENTS ARE REPORTED AS TAXABLE COMPENSATION ON THE INDIVIDUAL'S FORM W-2. |
| PART I, LINE 4B | THE ORGANIZATION'S EXECUTIVES PARTICIPATE IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. CONTRIBUTIONS FOR CALENDAR YEAR 2013 RELATED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF KISHHEALTH SYSTEM WERE $253,600. THIS CONTRIBUTION REFLECTS AMOUNTS DUE FOR THE FISCAL YEAR ENDING APRIL 30, 2013. THE ORGANIZATION'S CEO PARTICIPATES IN TWO ADDITIONAL NONQUALIFIED DEFERRED COMPENSATION PLANS. CONTRIBUTIONS FOR CALENDAR YEAR 2013 WERE $99,777. DURING FY14, THE CEO TOOK A DISTRIBUTION FROM THE DEFERRED COMPENSATION PLAN IN THE AMOUNT OF $88,591. THE 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. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| HEALTH PROGRESS INC | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | $91,976 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. THE PURPOSE OF KHS IS TO PROVIDE MANAGEMENT AND SUPPORT SERVICES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH PROVIDE HEALTHCARE SERVICES. FEES PAID TO KHS ARE IN EXCHANGE FOR THESE SERVICES, INCLUDING THE ORGANIZATIONS SHARE OF COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. | 0 |
| HEALTH PROGRESS INC | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | $496,800 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. KHS LEASES BUILDING SPACE FROM HEALTH PROGRESS, INC. | 0 |
| ANJU VOHRA | |||
| SPOUSE OF MEMBER OF THE BOARD OF DIRECTORS | $144,455 | MRS. VOHRA IS THE SPOUSE OF PROMOD VOHRA, WHO IS A MEMBER OF THE BOARD OF DIRECTORS OF KISHHEALTH SYSTEM. SHE IS PAID FOR PROFESSIONAL SERVICES. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | KEVIN POORTEN AND LOREN FOELSKE ARE BOTH EMPLOYEES OF KISHHEALTH SYSTEM. HOWEVER, THEY ALSO SERVE ON THE BOARD OF DIRECTORS OR AS OFFICERS OF THE RELATED TAX-EXEMPT SUBSIDIARY ORGANIZATIONS, INCLUDING KISHWAUKEE HOSPITAL, VALLEY WEST HOSPITAL, KISHHEALTH SYSTEM HOSPICE, KISHWAUKEE PHYSICIAN GROUP, CENTER FOR FAMILY HEALTH, CENTER FOR FAMILY HEALTH MALTA, KISHHEALTH HOME CARE, AND KISHHEALTH FOUNDATION. MR. POORTEN IS PRESIDENT AND CEO OF KISHHEALTH SYSTEM AND SERVES AS AN EX-OFFICIO DIRECTOR FOR ALL ORGANIZATIONS RELATED TO KISHHEALTH SYSTEM. MR. FOELSKE SERVES AS THE VICE-PRESIDENT - FINANCE OF KISHHEALTH SYSTEM, AND SERVES AS THE TOP FINANCIAL OFFICIAL FOR ALL RELATED ENTITIES. THE FOLLOWING INDIVIDUALS ARE OFFICERS OR KEY EMPLOYEES OF KISHHEALTH SYSTEM AND ARE ALSO CONSIDERED KEY EMPLOYEES OF VALLEY WEST COMMUNITY HOSPITAL AND KISHWAUKEE COMMUNITY HOSPITAL. THEY ARE ALL COMPENSATED BY KISHHEALTH SYSTEM: BRAD COPPLE, PRESIDENT KH & VWH PAM DUFFY, VP PATIENT CARE JOE DANT, VP DEVELOPMENT MIKE KOKOTT, ASST. VP MARKETING ROGER HEALTH BELL, VP AND CHIEF INFORMATION OFFICER MARK THATE, VP HUMAN RESOURCES (RETIRED DECEMBER 2013) DR. MICHAEL KULISZ, CHIEF MEDICAL OFFICER DAVID PROULX, VP OPERATIONS, VWH SEVERAL MEMBERS OF THE KISHHEALTH SYSTEM BOARD OF DIRECTORS ALSO SERVE ON THE BOARD OF DIRECTORS FOR A RELATED ENTITY. ALL ENTITIES ARE WHOLLY OWNED SUBSIDIARIES OF KISHHEALTH SYSTEM. THESE MEMBERS INCLUDE: MICHAEL CULLEN, ALSO SERVES ON KISHWAUKEE HOSPITAL, CENTER FOR FAMILY HEALTH, CENTER FOR FAMILY HEALTH MALTA, AND KISHWAUKEE PHYSICIANS GROUP BOARDS. TERRENCE DUFFY, ALSO SERVES ON VALLEY WEST COMMUNITY HOSPITAL BOARD JOE DANT, ALSO SERVES ON CENTER FOR FAMILY HEALTH, CENTER FOR FAMILY HEALTH MALTA, KISH HEALTH HOME CARE AND HEALTH PROGRESS, INC BOARDS. ANN WEST, ALSO SERVES ON KISHHEALTH FOUNDATION BOARD DR. MICHAEL KULISZ, ALSO SERVES ON BOARDS OF KISHWAUKEE PHYSICIANS GROUP AND KISH HEALTH HOME CARE PAM DUFFY ALSO SERVES ON THE BOARD OF KISH HEALTH HOME CARE JAGDISH PATEL ALSO SERVES ON THE VALLEY WEST HOSPITAL BOARD. TOM MATYA, ALSO SERVES ON KISHHEALTH FOUNDATION BOARD AND KISHWAUKEE HOSPITAL BOARD JOHN MOULTON, ALSO SERVES ON HEALTH PROGRESS, INC. BOARD IN ADDITION, PROMOD VOHRA SERVES AS A DIRECTOR OF KHS. HIS WIFE IS AN EMPLOYEE OF KHS. DR. PHOTINE LIAKOS, ALSO SERVES AS A BOARD DIRECTOR OWNS AN INTEREST IN MIDLAND SUGICAL CENTER. KISHWAUKEE HOSPITAL, A SUBSIDIARY OF KHS, OWNS A 74.5% INTEREST IN THIS ENTITY. |
| FORM 990, PART VI, SECTION A, LINE 6 | KISHHEALTH SYSTEM MAINTAINS SEVERAL CLASSES OF MEMBERS. THEY ARE AS FOLLOWS: KHS SHALL HAVE HONORARY MEMBERS WHO SHALL NOT HAVE VOTING RIGHTS IN THE CORPORATION. HONORARY MEMBERS SHALL CONTINUE AS HONORARY MEMBERS PROVIDED THEY HAVE SATISFIED THE REQUIREMENTS OF MEMBERSHIP. HONORARY MEMBERS SHALL NOT HAVE MEETINGS EXCEPT THAT (I) HONORARY MEMBERS SHALL BE INVITED TO ATTEND INFORMATIONAL MEETINGS AS CALLED BY THE BOARD OF DIRECTORS FROM TIME TO TIME; AND (II) HONORARY MEMBERS SHALL BE INVITED TO ATTEND A SPECIAL INFORMATIONAL MEETING PRIOR TO THE ADOPTION BY THE KHS BOARD OF ANY OF THE ACTIONS THAT ARE DESCRIBED IN SECTION 4.1.D, G, H OR Q BELOW (WITH RESPECT TO KHS, KH OR VWH). ANY PERSON (WHICH TERM SHALL INCLUDE, FOR PURPOSES OF THIS SECTION 3.1, INDIVIDUALS AND FIRMS, CORPORATIONS, ASSOCIATIONS, CLUBS, OR SOCIETIES FOR THE DURATION OF THEIR EXISTENCE) MAY BECOME AN HONORARY MEMBER OF KHS PERMANENTLY OR FROM TIME TO TIME, AS THE CASE MAY BE, BY MEETING THE QUALIFICATIONS FOR ONE OF THE FOLLOWING CATEGORIES OF MEMBERS: A. PARTICIPATING MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING $100 OR MORE BUT LESS THAN $500 IN VALUE TO KHS, KH, VWH OR THE HEALTH FOUNDATION SHALL BE A PARTICIPATING MEMBER OF KHS. ANY PERSON DESIGNATED A PARTICIPATING MEMBER SHALL RETAIN SUCH DESIGNATION FOR ONE YEAR FOLLOWING THE DATE OF HIS, HER OR ITS QUALIFYING CONTRIBUTION. B. CONTRIBUTING MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING $500 OR MORE BUT LESS THAN $5,000 IN VALUE TO KHS, KH, VWH OR THE HEALTH FOUNDATION SHALL BE A CONTRIBUTING MEMBER OF KHS. ANY PERSON DESIGNATED A CONTRIBUTING MEMBER SHALL RETAIN SUCH DESIGNATION FOR ONE YEAR FOLLOWING THE DATE OF HIS, HER OR ITS QUALIFYING CONTRIBUTION. C. LIFE MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING AT ANY TIME $5,000 OR MORE BUT LESS THAN $10,000 IN VALUE TO KHS, KH, VWH OR THE HEALTH FOUNDATION SHALL BE A LIFE MEMBER OF KHS. ANY PERSON DESIGNATED A LIFE MEMBER SHALL RETAIN SUCH DESIGNATION. D. FOUNDER. ANY PERSON WHO HAS CONTRIBUTED OR PLEDGED PROPERTY OR CASH OR BOTH AGGREGATING AT ANY TIME $10,000 OR MORE IN VALUE TO KHS, KH, VWH OR THE HEALTH FOUNDATION SHALL BE A FOUNDER OF KHS. ANY PERSON DESIGNATED A FOUNDER SHALL RETAIN SUCH DESIGNATION. E. SERVICE MEMBER. (1) ANY PERSON WHO HAS CONTRIBUTED AT LEAST 60 HOURS ON A FISCAL YEAR BASIS OF UNPAID VOLUNTARY SERVICE TO KH OR VWH SHALL BECOME A SERVICE MEMBER OF KHS. (2) ANY PERSON WHO SERVES ON THE KHS BOARD OR ON ANY GOVERNING BOARD OF ANY SUBSIDIARY CORPORATION OF KHS SHALL BE A SERVICE MEMBER OF KHS WHILE SERVING ON THE KHS BOARD OR SUCH SUBSIDIARY CORPORATION BOARD. |
| 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 | 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 ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN WRITING TO ADMINSTRATION. |
| FORM 990, PART XI, LINE 9: | LOSS ON EQUITY METHOD SUBSIDIARY REPORTED ON SEPARATE COMPANY RETURN - HPI -423,434. EQUITY CONTRIBUTION TO SUBSIDIARIES -1,325,000. EQUITY DISTRIBUTION FROM SUBSIDIARIES 9,361,000. LOSS ON EQUITY METHOD SUBSIDIARY REPORTED ON SEPARATE COMPANY RETURNS -4,286,095. ADJUSTMENT TO ADJUST SUBSIDIARY BALANCES TO ACTUAL -3,010,497. EQUITY DISTRIBUTION FROM LIQUIDATED SUBSIDIARY 160,000. |
| FORM 990, PART XI, LINE 3C: RESPONSIBILITY FOR OVERSIGHT OF FINANCIAL STMTS | 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| KISHWAUKEE COMMUNITY HOSPITAL | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 237087041 | HEALTHCARE SERVICES, PRIMARILY ACUTE CARE | IL | 501(C)(3) | 3 | KISHHEALTH SYSTEM | Yes (1) |
| VALLEY WEST COMMUNITY HOSPITAL | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 364244337 | HEALTHCARE SERVICES, PRIMARILY ACUTE CARE | IL | 501(C)(3) | 3 | KISHHEALTH SYSTEM | Yes (1) |
| DEKALB COUNTY HOSPICE | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 363164329 | HEALTHCARE SERVICES, PRIMARILY HOSPICE SERVICES | IL | 501(C)(3) | 7 | KISHHEALTH SYSTEM | Yes (1) |
| KISHHEALTH FOUNDATION | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 363649077 | SUPPORT OF KISHWAUKEE HEALTH SYSTEM NOT FOR PROFIT ENTITIES | IL | 501(C)(3) | 7 | KISHHEALTH SYSTEM | Yes (1) |
| COMMUNITY CARES CLINIC | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 800424001 | HEALTHCARE SERVICES, PRIMARILY ACUTE CARE | IL | 501(C)(3) | 7 | KISHHEALTH SYSTEM | Yes (1) |
| KISHWAUKEE PHYSICIAN GROUP INC | ||||||||||
| ONE KISH HOSPITAL DRIVE | SYCAMORE | IL | 60178 | 651293967 | HEALTHCARE SERVICES, PRIMARILY FAMILY PRACTICE | IL | 501(C)(3) | 3 | KISHHEALTH SYSTEM | Yes (1) |
| CENTER FOR FAMILY HEALTH - MALTA | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 800869393 | HEALTHCARE SERVICES, PRIMARILY ACUTE CARE | IL | 501(C)(3) | 3 | KISHHEALTH SYSTEM | Yes (1) |
| KISHHEALTH SYSTEM HOME CARE | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 371703513 | HEALTHCARE SERVICES, HOME CARE | IL | 501(C)(3) | 3 | KISHHEALTH SYSTEM | Yes (1) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (4 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTH VENTURES LLC | ||||||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 753255958 | RENTAL REAL ESTATE PROVIDED TO HEALTHCARE RELATED BUSINESSES | IL | HEALTH PROGRESS INC | RELATED | $14,735 | $316,694 | 0 | Yes (1) | 0.51000 | |
| 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 | HEALTH PROGRESS INC | RELATED | $435,769 | $1,358,701 | 0 | 0 | 0.51000 | |
| MIDLAND SURGICAL CENTER LLC | ||||||||||||||
| 3085 WOLF COURT | DEKALB | IL | 60115 | 352194610 | SURGICAL SERVICES | IL | KISHWAUKEE COMMUNITY HOSPITAL | RELATED | $1,137,271 | $1,351,528 | 0 | 0 | 0.74500 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH PROGRESS INC | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE KISH HOSPITAL DRIVE | AddressLine1 |
| City | DEKALB | City |
| State | IL | State |
| ZIP Code | 60115 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363824138 | EIN |
| Primary Activities | INVESTMENT IN HEALTHCARE RELATED SMALL BUSINESS | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KISHHEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | -$344,650 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $3,803,532 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (33 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| C | $5,382,800 | FAIR MARKET VALUE |
| VALLEY WEST COMMUNITY HOSPITAL | ||
| C | $3,978,200 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| O | $16,518,149 | FAIR MARKET VALUE |
| VALLEY WEST COMMUNITY HOSPITAL | ||
| O | $3,557,321 | FAIR MARKET VALUE |
| DEKALB COUNTY HOSPICE | ||
| O | $77,212 | FAIR MARKET VALUE |
| KISHHEALTH FOUNDATION | ||
| O | $40,138 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| O | $91,976 | FAIR MARKET VALUE |
| VALLEY WEST COMMUNITY HOSPITAL | ||
| Q | $1,800,915 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| Q | $568,832 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| Q | $12,425,306 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| J | $117,911 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| P | $6,398 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| P | $35,072,922 | FAIR MARKET VALUE |
| KISHHEALTH FOUNDATION | ||
| P | $3,496 | FAIR MARKET VALUE |
| VALLEY WEST COMMUNITY HOSPITAL | ||
| P | $8,223,021 | FAIR MARKET VALUE |
| COMMUNITY CARES CLINIC INC | ||
| Q | $5,177 | FAIR MARKET VALUE |
| DEKALB COUNTY HOSPICE | ||
| P | $672,629 | FAIR MARKET VALUE |
| CENTER FOR FAMILY HEALTH - MALTA | ||
| B | $250,000 | FAIR MARKET VALUE |
| CENTER FOR FAMILY HEALTH | ||
| B | $40,000 | FAIR MARKET VALUE |
| KISHWAUKEE PHYSICIANS GROUP | ||
| B | $4,100,000 | FAIR MARKET VALUE |
| KISHWAUKEE PHYSICIANS GROUP | ||
| P | $2,205,322 | FAIR MARKET VALUE |
| KISHWAUKEE PHYSICIANS GROUP | ||
| Q | $15,536 | FAIR MARKET VALUE |
| KISHHEALTH FOUNDATION | ||
| B | $500,000 | FAIR MARKET VALUE |
| KISHHEALTH HOME CARE | ||
| B | $420,000 | FAIR MARKET VALUE |
| KISHHEALTH HOME CARE | ||
| O | $65,810 | FAIR MARKET VALUE |
| KISHWAUKEE PHYSICIANS GROUP | ||
| O | $141,791 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| K | $625,824 | FAIR MARKET VALUE |
| COMMUNITY CARES CLINIC INC | ||
| P | $8,576 | FAIR MARKET VALUE |
| CENTER FOR FAMILY HEATLH - MALTA | ||
| P | $2,345 | FAIR MARKET VALUE |
| KISHHEALTH SYSTEM HOME CARE | ||
| P | $484,532 | FAIR MARKET VALUE |
| DEKALB COUNTY HOSPICE | ||
| B | $825,000 | FAIR MARKET VALUE |
| KISHWAUKEE PHYSICIANS GROUP | ||
| J | $40,571 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| A | $496,800 | FAIR MARKET VALUE |
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