NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: NORTHWESTERN MEMORIAL HEALTHCARE (EIN 23-7087041)
Tax period: 2012-05-01 to 2013-04-30
Filed: 2014-02-04
IRS object ID: 201410359349300221
Schema version: 2012v2.1
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 B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule K
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-02-04T09:59:08-06:00	Timestamp
Tax Period End Date	2013-04-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	410746749	EIN

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

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	ReturnType
Tax Period Begin Date	2012-05-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	237087041	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	KISHWAUKEE COMMUNITY HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	KISH	NameControl
Phone	8157561521	Phone

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

Officer Officer

Field	Value	IRS element (for citing)
Name	LOREN FOELSKE	Name
Title	VICE-PRESIDENT - FINANCE, KHS	Title
Phone	8157561521	Phone
Date Signed	2014-01-27	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	KELLY JACKSON HARDY	Name
PTIN	P00747242	PTIN
Phone	8152842285	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	KEVIN P POORTEN	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

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	256062578	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.KISHHOSPITAL.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1970	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING INPATIENT ACUTE AND NONACUTE CARE, AND VARIOUS OUTPATIENT SERVICES IN THE AREA OF DEKALB COUNTY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	3	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	2	NbrIndependentVotingMembers
Total Nbr Employees	1241	TotalNbrEmployees
Total Nbr Volunteers	300	TotalNbrVolunteers
Total Gross UBI	102287	TotalGrossUBI
Net Unrelated Business Txbl Income	-44511	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	930478	ContributionsGrantsPriorYear
Contributions Grants Current Year	498254	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	174560488	ProgramServiceRevenuePriorYear
Program Service Revenue CY	183790492	ProgramServiceRevenueCY
Investment Income Prior Year	4533345	InvestmentIncomePriorYear
Investment Income Current Year	8160848	InvestmentIncomeCurrentYear
Other Revenue Prior Year	2395820	OtherRevenuePriorYear
Other Revenue Current Year	2013451	OtherRevenueCurrentYear
Total Revenue Prior Year	182420131	TotalRevenuePriorYear
Total Revenue Current Year	194463045	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	317643	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	326958	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	59347491	SalariesEtcPriorYear
Salaries Etc Current Year	63821467	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	7373	TotalFundrsngExpCurrentYear
Other Expense Prior Year	103689576	OtherExpensePriorYear
Other Expenses Current Year	109778090	OtherExpensesCurrentYear
Total Expenses Prior Year	163354710	TotalExpensesPriorYear
Total Expenses Current Year	173926515	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	19065421	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	20536530	RevenuesLessExpensesCY
Total Assets BOY	294914074	TotalAssetsBOY
Total Assets EOY	319597870	TotalAssetsEOY
Total Liabilities BOY	104281500	TotalLiabilitiesBOY
Total Liabilities EOY	107654934	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	190632574	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	211942936	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING INPATIENT ACUTE AND NONACUTE CARE, AND VARIOUS OUTPATIENT SERVICES IN THE AREA OF DEKALB COUNTY. KISHWAUKEE COMMUNITY HOSPITAL (KCH) SERVES ALL PEOPLE WITH SKILL AND COMPASSION WHILE RESPECTING THEIR DIGNITY, RIGHTS, AND CHOICES BY OFFERING ACCESS TO HIGH-QUALITY PREVENTIVE, CURATIVE, AND REHABILITATIVE CARE DELIVERED IN A COST EFFECTIVE MANNER. KISHWAUKEE COMMUNITY HOSPITAL RECOGNIZES THE NEED TO EFFECTIVELY MANAGE RESOURCES FOR PRESENT AND FUTURE GENERATIONS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	145547580	Expense
Grants	326958	Grants
Revenue	183709344	Revenue
Description	KISHWAUKEE COMMUNITY HOSPITAL (KCH), LOCATED IN DEKALB, ILLINOIS, SERVES THE RESIDENTS OF DEKALB COUNTY AND THE SURROUNDING AREAS BY OFFERING A NUMBER OF PROGRAMS AND SERVICES FOR COMMUNITY BENEFIT, INCLUDING CHARITY CARE. KISHWAUKEE COMMUNITY HOSPITAL BELIEVES THAT IN ORDER TO BE A TRUE "COMMUNITY" HOSPITAL, WE MUST BE A RESOURCE FOR PREVENTATIVE AND CURATIVE HEALTH INFORMATION, EDUCATION AND SERVICES AND THAT WE MUST SUPPORT THE EFFORTS OF OTHERS WHO ALSO ARE DOING WORK FOR THE COMMUNITY GOOD. DOING SO HELPS BUILD TRUST, RESPECT AND LOYALTY FOR OUR HOSPITAL AND STRENGTHENS OUR ROLE AS A PARTNER IN IMPROVING THE HEALTH OF OUR CITIZENS AND THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE.THE OBJECTIVES OF HOSPITAL'S COMMUNITY BENEFIT PROGRAM ARE TO IMPROVE ACCESS TO HEALTH SERVICES BY REDUCING GEOGRAPHIC, FINANCIAL, LANGUAGE AND CULTURAL BARRIERS; IMPROVE AND ENHANCE PUBLIC HEALTH, ADVANCE GENERAL HEALTH KNOWLEDGE, AND RELIEVE THE GOVERNMENT BURDEN OF PROVIDING HEALTH SERVICES FOR THE COMMUNITY, AND FOR THE UNINSURED AND UNDERINSURED. COMMUNITY HEALTH NEEDS ARE IDENTIFIED AND ADDRESSED THROUGH COMMUNITY OUTREACH PROGRAMS, BY ADDING NEW SERVICES AND BY EXPANDING OTHERS. NEEDS ALSO ARE MET THROUGH OPERATIONAL PROGRAMS SUCH AS CHARITY CARE, SUBSIDIZED SERVICES AND PROVIDING CASH AND IN-KIND DONATIONS TO SUPPORT ORGANIZATIONS THAT ALSO STRIVE TO MEET COMMUNITY HEALTH AND QUALITY OF LIFE NEEDS. THE HOSPITAL IDENTIFIES COMMUNITY HEALTH NEEDS IN SEVERAL WAYS:* DEKALB COUNTY HEALTH DEPARTMENT I-PLAN* KENDALL COUNTY HEALTH DEPARTMENT I-PLAN* KISHHEALTH SYSTEM, PRC COMMUNITY HEALTH NEEDS SURVEY 2009* U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES, HEALTHY PEOPLE 2010 & 2020* UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANKINGS & ROADMAPS* ILLINOIS DEPARTMENT OF PUBLIC HEALTH, HOSPITAL DATA* ILLINOIS HOSPITAL ASSOCIATION* INTERNAL REVIEW OF OUTPATIENT AND INPATIENT TRENDS, ESPECIALLY EMERGENCY DEPARTMENT USAGE * INPUT FROM OTHER COMMUNITY PROVIDERS. THIS INCLUDES PROVIDING HOSPITAL LEADERS TO SERVE ON BOARDS AND COMMITTEES THAT DIRECTLY OR INDIRECTLY IMPACT COMMUNITY HEALTH OR HELP THE HOSPITAL CONNECT TO UNDERSERVED OR VULNERABLE POPULATIONS,USING ALL THESE RESOURCES, KISHHEALTH SYSTEM FOCUSED ON THE FOLLOWING COMMUNITY HEALTH NEEDS IN FY2013:* THE PREVALENCE OF OBESITY IN CHILDREN AND ADULTS* ACCESS TO AFFORDABLE PRIMARY HEALTH CARE IN THE DEKALB/SYCAMORE AREA AND OUTLYING RURAL AREAS* TYPE II DIABETES* CARDIOVASCULAR DISEASE AND ADEQUATE HOSPITAL BASED AND COMMUNITY OUTREACH SERVICES* CANCER CARE SERVICES, EDUCATION AND PREVENTION* AFFORDABLE ACCESS TO CHILDBIRTH EDUCATION AND OB HOSPITAL SERVICES* OTHER COMMUNITY OUTREACH AND WELLNESS SERVICESCOMMUNITY COLLABORATION / OUTREACH / SCHOOL & WELLNESS PROGRAMS THE HOSPITAL'S COMMUNITY WELLNESS DEPARTMENT PROVIDES A VARIETY OF EDUCATIONAL ACTIVITIES AND PROGRAMS IN THE COMMUNITY. DEKALB COUNTY SCHOOLS ARE VISITED THROUGHOUT THE ACADEMIC YEAR, WITH HEALTH EDUCATORS PROVIDING EDUCATION ON NUTRITION, FITNESS ACTIVITIES, SCREEN TIME REDUCTION, HAND WASHING, DENTAL CARE, POISON PREVENTION, AND IN GENERAL LIVING A HEALTHY LIFESTYLE. ONE WAY THAT THIS IS ACCOMPLISHED IS IN COLLABORATION WITH NORTHERN ILLINOIS UNIVERSITY'S STUDENTS TRAINED TO SERVE AS CATCH INSTRUCTORS. CATCH (COORDINATED APPROACH TO CHILD HEALTH) IS AN EVIDENCE BASED CURRICULUM FOR CHILDREN PROMOTING HEALTHY LIFESTYLES THROUGH ITS MATERIALS. IN ADDITION, THE COMMUNITY HEALTH LIAISON SERVES ON THE DEKALB AND SYCAMORE SCHOOL DISTRICTS HEALTH & WELLNESS COMMITTEES. IN ADDITION, COMMUNITY WELLNESS PROVIDED SAFE SITTER INSTRUCTION TO 8 CHILDREN IN THE SYCAMORE SCHOOLS DISTRICT SPARTAN PROGRAM. COMMUNITY WELLNESS HEALTH EDUCATORS VISITED 225 CLASSROOMS WORKING WITH 5,944 STUDENTS.STAFF FROM COMMUNITY WELLNESS COLLABORATE WITH OR SERVE ON COMMITTEES AND PROMOTED HEALTH AND WELLNESS THOUGH THESE PARTNERSHIPS: DEKALB LEADERSHIP ACADEMY, LIVE HEALTHY DEKALB COUNTY (FORMERLY PIONEERING HEALTHIER COMMUNITIES), YMCA AND ITS DIABETES PREVENTION PROGRAM, SYCAMORE AND DEKALB SCHOOL DISTRICTS' HEALTH & WELLNESS COMMITTEES, LATINO ACTION GROUP, AMERICAN HEART ASSOCIATION, GO RED LUNCHEON, KISHWAUKEE COMMUNITY HOSPITAL'S CANCER CENTER, CANCER COMMITTEE.OPERATIONAL COMMUNITY BENEFITTHE HOSPITAL ALSO PROVIDED COMMUNITY BENEFIT THROUGH CHARITY CARE, GOVERNMENT-SPONSORED INDIGENT HEALTH CARE, BAD DEBT, SUBSIDIZED HEALTH SERVICES, LANGUAGE ASSISTANCE, VOLUNTEER SERVICES, EDUCATION AND WORKFORCE DEVELOPMENT, CASH AND IN-KIND DONATIONS, AND OTHER. CHARITY CARE AS PART OF ITS CHARITABLE MISSION, THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE, INCLUDING ACCESS TO PHARMACEUTICAL ASSISTANCE FOR PATIENTS WHO MET THE ELIGIBILITY CRITERIA ESTABLISHED IN ITS FINANCIAL ASSISTANCE POLICY. THE POLICY IS REVIEWED BY THE BOARD OF DIRECTORS ANNUALLY. THE HOSPITAL ALSO COORDINATED WITH THE ILLINOIS BREAST AND CERVICAL CANCER PROGRAM FOR ASSISTANCE WITH BREAST AND CERVICAL CANCER SCREENINGS AND TREATMENT. MORE PATIENTS QUALIFIED FOR CHARITY CARE IN FY 2013 THAN IN PREVIOUS YEARS DUE TO THE POOR ECONOMY AND ALSO TO REDUCE THE HOSPITAL'S BAD DEBT. THE HOSPITAL ALSO UNDERWROTE UNREIMBURSED COSTS OF TREATING MEDICAID AND MEDICARE PATIENTS. SUBSIDIZED HEALTH SERVICES A NUMBER OF PROGRAMS AND SERVICES WERE OPERATED AT A LOSS, BUT WERE SUBSIDIZED BECAUSE THEY IMPROVE THE HEALTH AND SAFETY OF THE COMMUNITY. LANGUAGE ASSISTANCE THE HOSPITAL EMPLOYS SPANISH INTERPRETERS AVAILABLE OR ON CALL 24/7 AND USED VIDEOCONFERENCING EQUIPMENT, VIA LAPTOP, TO COMMUNICATE WITH THE HEARING IMPAIRED AND DUAL HANDSET PHONE SYSTEM THAT PROVIDED INSTANT INTERPRETATION FOR PATIENTS WHO DO NOT SPEAK ENGLISH.VOLUNTEER SERVICES VOLUNTEER OPPORTUNITIES ARE PROVIDED TO EMPLOYEES TO SERVE IN THE COMMUNITY AND FOR COMMUNITY MEMBERS TO SERVE THE HOSPITAL. THERE WERE ROUGHLY 863 OF VOLUNTEER HOURS RECORDED BY EMPLOYEES. A VOLUNTEER SERVICES DEPARTMENT SCHEDULED MEMBERS OF THE VOLUNTEERS IN THE HOSPITAL. EDUCATION & WORKFORCE DEVELOPMENT A MEDICAL LIBRARY WAS MAINTAINED FOR PHYSICIAN, STAFF AND PATIENT USE. HOSPITAL EMPLOYEES PROVIDED CLINICAL TRAINING, JOB SHADOWING AND MENTORING OF COLLEGE AND HIGH SCHOOL STUDENTS. THE AUXILIARY AND KISHHEALTH FOUNDATION AWARDED ANNUAL SCHOLARSHIPS FOR HEALTH CAREERS. HOSPITAL TOURS WERE GIVEN TO LOCAL SCHOOLS AND YOUTH GROUPS TO EDUCATE YOUTH ON HEALTHCARE CAREERS. CASH CONTRIBUTIONS WERE GIVEN TO LOCAL LIBRARIES, PUBLIC AND POST-SECONDARY EDUCATION FOUNDATIONS TO UNDERWRITE SCHOLARSHIPS, AND PURCHASE OR PROVIDE HEALTH-RELATED MATERIALS, EQUIPMENT AND ACTIVITIES.CASH AND IN-KIND DONATIONSAN ALLOCATION WAS MADE IN THE OPERATING BUDGET FOR DONATIONS TO COMMUNITY EVENTS AND ORGANIZATIONS THAT IMPROVE THE HEALTH, WELFARE AND QUALITY OF LIFE IN THE COMMUNITIES SERVED BY THE HOSPITAL. THE HOSPITAL SUPPORTED COMMUNITY ACTIVITIES THAT ENCOURAGE CHILD AND ADULT PHYSICAL ACTIVITY; EFFORTS THAT REACH UNDERSERVED AND VULNERABLE POPULATIONS; YOUTH MENTORING, EDUCATION; DISEASE PREVENTION, AWARENESS, RESEARCH; MENTAL HEALTH; ECONOMIC DEVELOPMENT AND OTHER COMMUNITY BUILDING ACTIVITIES. IN-KIND DONATIONS AND SERVICES SUCH AS PERSONNEL TIME, SURPLUS SUPPLIES, FOOD, AND BOTTLED WATER WERE ALSO TRACKED.DONATION HIGHLIGHTS THE HOSPITAL PROVIDED SUBSTANTIAL CASH CONTRIBUTIONS TO: BEN GORDON CENTER TO SUPPORT MENTAL HEALTH SERVICES FOR THE LOW INCOME, KISHWAUKEE FAMILY YMCA TO SUPPORT STRONG KIDS SCHOLARSHIP PROGRAM AND SPONSOR HEALTH AND WELLNESS ACTIVITIES FOR FAMILIES; FAMILY SERVICE AGENCY TO SUPPORT BIG BROTHERS/BIG SISTERS, COURT APPOINTED SPECIAL ADVOCATES; SENIOR SERVICES AND FAMILY COUNSELING; KISHWAUKEE COLLEGE FOUNDATION TO SUPPORT ITS NURSING AND RADIOLOGY TRAINING PROGRAMS; KISHWAUKEE UNITED WAY TO SUPPORT SOCIAL SERVICE AGENCIES THAT PROMOTE NUTRITION AND HEALTH ESPECIALLY AMONG THE LOW INCOME; VOLUNTARY ACTION CENTER TO SUPPORT MEALS ON WHEELS, TRANSPORTATION SERVICES AND DAY CARE LUNCH PROGRAMS; DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION; DEKALB, SYCAMORE, AND GENOA CHAMBERS OF COMMERCE TO SUPPORT THE BUSINESS COMMUNITY AND ECONOMIC DEVELOPMENT FOR THE REGION; AREA HIGH SCHOOL SPORTS BOOSTERS TO SUPPORT SCHOLARSHIPS FOR STUDENTS TO PARTICIPATE IN SCHOOL ATHLETICS, DEKALB, SYCAMORE, GENOA EDUCATION FOUNDATION; AND DEKALB LIBRARIES TO SUPPORT THE PURCHASE OF HEALTH-RELATED BOOKS; NUMEROUS YOUTH SPORTS ORGANIZATIONS AND CLUBS TO SUPPORT SCHOLARSHIPS FOR THOSE WHO OTHERWISE COULD NOT AFFORD TO PARTICIPATE; DEKALB COUNTY YOUTH SERVICE BUREAU; DEKALB COUNTY RED CROSS; MIDWEST MUSEUM OF NATURAL HISTORY TO UNDERWRITE THE COST OF FREE ADMISSION DAYS PLUS SUPPLIES FOR YOUTH SPONSORED PROGRAMS; ILLINOIS POISON CONTROL CENTER; DISEASE RESEARCH, PREVENTION AND EDUCATION THROUGH THE AMERICAN CANCER SOCIETY, AMERICAN HEART ASSOCIATION, DIABETES EDUCATION ASSOCIATION, AND MARCH OF DIMES.	Description
Total Program Service Expense	145547580	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	1	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	0	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	121	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1241	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	3	NbrVotingGoverningBodyMembers
Number Independent Voting Members	2	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IL	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	LOREN FOELSKE VP OF FINANCE	BusinessNameLine1

Field	Value	IRS element (for citing)
Telephone Number	8157561521	TelephoneNumber

Address US AddressUS

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)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
MICHAEL CULLEN
VICE CHAIR	2.00	9.00	X	X	0	0	0
KEVIN POORTEN
PRESIDENT & CEO, KHS	10.00	45.00	X	X	0	966472	220153
THOMAS MATYA
CHAIR	2.00	3.00	X	X	0	0	0
LOREN FOELSKE
VP FINANCE	25.00	22.00		X	0	284734	117504
BRAD COPPLE
PRESIDENT - KCH & VWCH	21.00	25.00			0	359637	72184	X
PAM DUFFY
CNO & VP PATIENT CARE	10.00	35.00			0	249153	30870	X
JOE DANT
VP BUSINESS DEVELOPMENT	5.00	40.00			0	255673	45841	X
MIKE KOKOTT
ASST VP - MARKETING	15.00	30.00			0	194828	34842	X
ROGER HEATH BELL
VP - CIO	10.00	37.00			0	273572	51107	X
DR MICHAEL KULISZ
CHIEF MEDICAL OFFICER	15.00	37.00			0	402706	99258	X
MARK THATE
VP - HUMAN RESOURCES	12.00	33.00			0	273139	26286	X
MICHAEL MUZZILLO THRU 62912
VP OPERATIONS - VWCH	16.00	34.00			0	229519	12427	X
THOMAS W TILTON DO
OPTHAMOLOGIST	40.00				414769	0	32116		X
THOMAS WARZECHA
DIRECTOR OF PHARMACY	40.00				143361	0	25199		X
KENYA M WILLIAMS MD
OPTHAMOLOGIST	40.00				245831	0	7539		X
JASMEET DHALIWAL
OPTHAMOLOGIST	40.00				745524	0	30951		X
LISA ACKLAND
DIRECTOR OF SURGERY/CARDIO	40.00				140939	0	21882		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1690424	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	3489433	TotalReportableCompFrmRltdOrgs
Total Other Compensation	828159	TotalOtherCompensation
Number Individuals GT100 K	43	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
KISHHEALTH SYSTEM
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	MANAGEMENT SERVICES	13946136
DOCTORS OF EMERGENCY MEDICINE
2807 BRITTANY COURT	ST CHARLES	IL	60175	EMERGENCY MEDICINE SERVICES	7067990
POWER CONSTRUCTION COMPANY LLC
2360 NORTH PALMER DRIVE	SCHAUMBURG	IL	60173	CONSTRUCTION SERVICES	5536284
SIDDIQUI SABET MD PC
10 MORAINE TERRACE	DEKALB	IL	60115	MEDICAL SERVICES	1700000
SODEXO INC & AFFILIATES
4880 PAYSPHERE CIRCLE	CHICAGO	IL	60674	CONSULTING SERVICES	1498562

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	40	NumberOfContractorsGT100K
Membership Dues	773	MembershipDues
Related Organizations	313028	RelatedOrganizations
Government Grants	35582	GovernmentGrants
All Other Contributions	148871	AllOtherContributions
Noncash Contributions	3172	NoncashContributions
Total Contributions	498254	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	NET PATIENT SERVICE REVENUE	Description
Business Code	621110	BusinessCode
Total Revenue Column	183790492	TotalRevenueColumn
Related Or Exempt Function Income	183709344	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	81148	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Program Service Revenue	183790492	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	5245670	TotalRevenueColumn
Exclusion	$5,245,670	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	307680	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	258938	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	48742	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	48742	TotalRevenueColumn
Exclusion	$48,742	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	63976073	Securities
Other	208240	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	61232950	Securities
Other	36185	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	2743123	Securities
Other	172055	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	2915178	TotalRevenueColumn
Exclusion	$2,915,178	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	113175	GrossSalesOfInventory
Cost Of Goods Sold	71460	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	41715	TotalRevenueColumn
Exclusion	$41,715	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
OTHER SERVICES	621110	766945	21139	$745,806
CAFETERIA SALES	621110	721586		$721,586
INCOME PASSTHROUGH - MIDLAND SURG	621110	233354		$233,354

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	201109	TotalRevenueColumn
Exclusion	$201,109	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	1922994	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	194463045	TotalRevenueColumn
Related Or Exempt Function Income	183709344	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	102287	UnrelatedBusinessRevenue
Exclusion	$10,153,160	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	306958	Total
Program Services	306958	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	20000	Total
Program Services	20000	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	45094522	Total
Program Services	43169903	ProgramServices
Management And General	1924619	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2286535	Total
Program Services	2188946	ProgramServices
Management And General	97589	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	10430172	Total
Program Services	9985016	ProgramServices
Management And General	445156	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	6010238	Total
Program Services	5753723	ProgramServices
Management And General	256515	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	13362767	Total
Management And General	13362767	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	261414	Total
Management And General	261414	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	323	Total
Management And General	323	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	458803	Total
Management And General	458803	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	17450418	Total
Program Services	16279959	ProgramServices
Management And General	1170459	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	975957	Total
Program Services	55776	ProgramServices
Management And General	920181	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	31454302	Total
Program Services	30313107	ProgramServices
Management And General	1137089	ManagementAndGeneral
Fundraising	4106	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1999468	Total
Program Services	532846	ProgramServices
Management And General	1466622	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3190744	Total
Program Services	3149791	ProgramServices
Management And General	40953	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	212874	Total
Program Services	203050	ProgramServices
Management And General	9824	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	18710	Total
Program Services	18710	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	3670612	Total
Management And General	3670612	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	11962633	Total
Program Services	11962633	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	3197446	Total
Program Services	960046	ProgramServices
Management And General	2237400	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices
UNRELATED BUSINESS INCO	10437	10437
BAD DEBT EXPENSE	16881477		16881477
FEDERAL AND STATE ASSES	2019408		2019408
PHYSICIAN RECRUITMENT	1603973	22084	1581889

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	1046324	Total
Program Services	164342	ProgramServices
Management And General	878715	ManagementAndGeneral
Fundraising	3267	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	173926515	Total
Program Services	145547580	ProgramServices
Management And General	28371562	ManagementAndGeneral
Fundraising	7373	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	15302921	BOY
EOY	11234100	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	251766	BOY
EOY	80478	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	28815521	BOY
EOY	32318217	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3725696	BOY
EOY	3873075	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2901412	BOY
EOY	3292374	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	177032753	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	76823422	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	106921581	BOY
EOY	100209331	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	118483018	BOY
EOY	150226426	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	8089823	BOY
EOY	10222071	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	10422336	BOY
EOY	8141798	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	294914074	BOY
EOY	319597870	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	13536946	BOY
EOY	29692939	EOY

Grants Payable GrantsPayable

Field	Value	IRS element (for citing)
EOY	727790	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	743742	BOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	63685000	BOY
EOY	63685000	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1226938	BOY
EOY	1204610	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	25088874	BOY
EOY	12344595	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	104281500	BOY
EOY	107654934	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	186447120	BOY
EOY	207748100	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4185454	BOY
EOY	4194836	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	190632574	BOY
EOY	211942936	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	294914074	BOY
EOY	319597870	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	20536530	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	4296478	ReconciliationUnrealizedInvest
Reconcilation Other Changes	-3522646	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	1	AuditCommittee
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$36,605	OtherActivitiesAmount
Total Lobbying Expenditures IIB	36605	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	EXPLANATION OF LOBBYING ACTIVITIES:	Identifier
Return Reference	PART II-B, LINE 1:	ReturnReference
Explanation	LOBBYING EXPENSES ARE ALLOCATED THROUGH MEMBERSHIP DUES WITH ILLINOIS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. NO OTHER LOBBYING ACTIVITIES WERE CONDUCTED.	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5255089	OtherCostOrOtherBasis
Book Value	5255089	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	114748211	OtherCostOrOtherBasis
Depreciation	34101825	Depreciation
Book Value	80646386	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	584334	OtherCostOrOtherBasis
Depreciation	190059	Depreciation
Book Value	394275	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	54976029	OtherCostOrOtherBasis
Depreciation	42531538	Depreciation
Book Value	12444491	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1469090	OtherCostOrOtherBasis
Book Value	1469090	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	100209331	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
THIRD PARTY PAYABLES	$5,860,534
DUE TO AFFILIATES	$1,238,490
ACCRUED INTEREST PAYABLE	$304,327
OTHER PAYABLES - LONG TERM	$4,941,244

Field	Value	IRS element (for citing)
Total Of Amounts	12344595	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt	181980800	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	4296478	NetUnrealizedGainsInvestments
Other Revenues	-16881477	OtherRevenues
Revenue Not Rptd F990	-12584999	RevenueNotRptdF990
Revenue Subtotal	194565799	RevenueSubtotal
Other Revenues Not Included	-102754	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	-102754	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	194463045	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	157375467	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	330429	OtherExpensesIncluded
Expenses Not Rptd F990	330429	ExpensesNotRptdF990
Expenses Subtotal	157045038	ExpensesSubtotal
Other Expenses Not Included	16881477	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	16881477	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	173926515	TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (5 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:	PART X, LINE 2:	THE SYSTEM, KCH, VWCH, KHF, KPG, DCH, CFHP, 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, 2013 AND 2012, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED.
PART XI, LINE 2D - OTHER ADJUSTMENTS:		RECLASSIFICATION OF BAD DEBT EXPENSE (NETTED WITH REVENUE ON F/S) -16,881,477.
PART XI, LINE 4B - OTHER ADJUSTMENTS:		BOOK/TAX DIFFERENCE ON INCOME FROM PASSTHROUGH ENTITIES - KISH AREA PHO -32. CONTRIBUTION REVENUE FROM KISHHEALTH FOUNDATION 313,028. BOOK/TAX DIFFERENCE ON INCOME FROM PASSTHROUGH ENTITIES - MIDLAND SURGICAL -236,551. RECLASSIFICATION OF COST OF GOODS SOLD -71,460. RECLASSIFICATION OF RENTAL EXPENSES -258,939. RECLASSIFICATION OF GAIN ON SALE OF MIDLAND SURGICAL CENTER INTEREST 151,200.
PART XII, LINE 2D - OTHER ADJUSTMENTS:		RECLASSIFICATION OF COST OF GOODS SOLD 71,460. RECLASSIFICATION OF RENTAL EXPENSES 258,939. OTHER ADJUSTMENT 30.
PART XII, LINE 4B - OTHER ADJUSTMENTS:		RECLASSIFICATION OF BAD DEBT EXPENSE (NETTED WITH REVENUE ON F/S) 16,881,477.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	600.000000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7033083	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2041416	DirectOffsettingRevenue
Net Community Benefit Expense	4991667	NetCommunityBenefitExpense
Percent Of Total Expense	0.02870	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17191031	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9960140	DirectOffsettingRevenue
Net Community Benefit Expense	7230891	NetCommunityBenefitExpense
Percent Of Total Expense	0.04160	PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	24224114	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12001556	DirectOffsettingRevenue
Net Community Benefit Expense	12222558	NetCommunityBenefitExpense
Percent Of Total Expense	0.07030	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	5691204	TotalCommunityBenefitExpense
Direct Offsetting Revenue	843098	DirectOffsettingRevenue
Net Community Benefit Expense	4848106	NetCommunityBenefitExpense
Percent Of Total Expense	0.02790	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	953644	TotalCommunityBenefitExpense
Direct Offsetting Revenue	20620	DirectOffsettingRevenue
Net Community Benefit Expense	933024	NetCommunityBenefitExpense
Percent Of Total Expense	0.00540	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1408513	TotalCommunityBenefitExpense
Direct Offsetting Revenue	444495	DirectOffsettingRevenue
Net Community Benefit Expense	964018	NetCommunityBenefitExpense
Percent Of Total Expense	0.00550	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	502680	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	502680	NetCommunityBenefitExpense
Percent Of Total Expense	0.00290	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8556041	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1308213	DirectOffsettingRevenue
Net Community Benefit Expense	7247828	NetCommunityBenefitExpense
Percent Of Total Expense	0.04170	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	32780155	TotalCommunityBenefitExpense
Direct Offsetting Revenue	13309769	DirectOffsettingRevenue
Net Community Benefit Expense	19470386	NetCommunityBenefitExpense
Percent Of Total Expense	0.11200	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$16,943,873	BadDebtExpenseAmount
Amount Attributable To	1956561	AmountAttributableTo
Amount Reimbursed By Medicare	32118634	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	51410682	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-19292048	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	KISHWAUKEE COMMUNITY HOSPITAL	BusinessNameLine1

Address Address

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)
Website Address	WWW.KISHHEALTH.ORG	WebsiteAddress
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	KISHWAUKEE COMMUNITY HOSPITAL	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	1	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Identifying Process	X	IdentifyingProcess
Consulting Process	X	ConsultingProcess
Information Gaps	X	InformationGaps
Needs Assessment Conducted	12	NeedsAssessmentConducted
Take Into Account	1	TakeIntoAccount
Other Facilities	1	OtherFacilities
CHNA Widely Available	1	CHNAWidelyAvailable
Own Website	X	OwnWebsite
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	0	AllNeedsAddressed
Organization Incur Excise Tax	0	OrganizationIncurExciseTax
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	600.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Collection Activities	0	CollectionActivities
Notify Upon Admission	X	NotifyUponAdmission
Notify Before Discharge	X	NotifyBeforeDischarge
Notified All Patients	X	NotifiedAllPatients
Documented Determination	X	DocumentedDetermination
Other Actions Taken	X	OtherActionsTaken
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART I, LINE 7: THE RESPECTIVE IRS WORKSHEET, AS PROVIDED IN THE INSTRUCTIONS FOR SCHEDULE H, WERE USED TO CALCULATE THE COSTS OF ITEMS WITHIN THE TABLE ABOVE.
PART II: NO COMMUNITY BUILDING ACTIVITIES ARE REPORTED IN PART II.
PART III, LINE 4: SEE FOOTNOTE 3 (PAGE 15) IN THE ATTACHED FINANCIAL STATEMENTS FOR A DESCRIPTION OF BAD DEBT EXPENSE.INTERNAL REVENUE SERVICE WORKSHEET 2 (PER SCHEDULE H INSTRUCTIONS) WAS UTILIZED TO DETERMINE THE COST OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS.
PART III, LINE 8: FOR THE 4/30/13 FISCAL YEAR, KCH PROVIDED BILLED CHARGES TO MEDICARE PATIENTS TOTALING $168,172,730. HOWEVER, DUE TO THE MEDICARE INPATIENT AND OUTPATIENT PAYMENT METHODOLOGIES, THE ACTUAL CASH PAYMENTS RECEIVED FROM PROVIDING CARE TO THOSE PATIENTS WAS JUST $32,118,634, OR 19% OF BILLED CHARGES. THE COST OF PROVIDING THIS CARE, PER THE MEDICARE COST REPORT, WAS $51,410,682. THUS, THE PAYMENTS RECEIVED FROM MEDICARE WERE $19,292,048 LESS THAN COST, OR 62% OF COST. TRULY THIS $19,292,048 SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. AS APPROXIMATELY 45% OF ALL KISHWAUKEE COMMUNITY HOSPITAL CHARGES GENERATED ARE FROM MEDICARE PATIENTS, THIS SHORTFALL PLACES A TREMENDOUS FINANCIAL BURDEN ON OUR HOSPITAL.KISHWAUKEE COMMUNITY HOSPITAL, LIKE OTHER NOT-FOR-PROFIT HOSPITALS, MUST ACCEPT MEDICARE PAYMENTS AS PAYMENT IN FULL FOR SERVICES PROVIDED, WITH THE EXCEPTION OF COLLECTING ON DEDUCTIBLES AND CO-INSURANCE AMOUNTS. HOSPITALS CANNOT BILL MEDICARE PATIENTS FOR THE DIFFERENCE BETWEEN THE BILLED CHARGES AND MEDICARE PAYMENTS.KISHWAUKEE COMMUNITY HOSPITAL PROVIDES SERVICES TO ALL PATIENTS WHO NEED CARE, ABIDING BY THE FEDERAL EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA) REGULATION. IT REQUIRES HOSPITALS AND AMBULANCE SERVICES TO PROVIDE CARE TO ANYONE NEEDING EMERGENCY HEALTHCARE TREATMENT REGARDLESS OF CITIZENSHIP, LEGAL STATUS OR ABILITY TO PAY.KCH UTILIZED THE CALCULATION OF MEDICARE COST FROM THE ANNUAL MEDICARE COST REPORT. THIS APPROACH ALLOCATES COST FROM NON REVENUE PRODUCING DEPARTMENTS TO THE REVENUE GENERATING DEPARTMENTS, BASED ON STEP DOWN STATISTICAL COST FINDING. WHILE NOT AS COMPREHENSIVE AS A TRUE COST ACCOUNTING SYSTEM, THIS PROCESS RESULTS IN AN ACCEPTABLE BASIS OF THE DEPARTMENTAL COST FOR PROVIDING SERVICES. RECALL THAT PRIOR TO MEDICARE PROSPECTIVE PAYMENT SYSTEM (PPS), THIS METHODOLOGY WAS THE BASIS FOR THE REIMBURSEMENT TO HOSPITALS.
PART III, LINE 9B: COLLECTION ACTIONS INVOLVING UNINSURED PATIENTS. KHS (KISHHEALTH SYSTEM, PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL) SHALL NOT PURSUE A COLLECTION ACTION AGAINST AN UNINSURED PATIENT, UNLESS THE PATIENT HAS BEEN GIVEN THE OPPORTUNITY TO ASSESS THE ACCURACY OF THE BILL; APPLY FOR FINANCIAL ASSISTANCE UNDER THE KHS FINANCIAL ASSISTANCE POLICY AND PROCEDURE; AND AVAIL HIMSELF OR HERSELF OF A REASONABLE PAYMENT PLAN. NOTWITHSTANDING THIS, KHS MAY NOT PURSUE THE COLLECTION ACTION UNDER THE FOLLOWING CIRCUMSTANCES: (A) IF THE PATIENT HAS INDICATED AN INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT, UNTIL KHS HAS OFFERED THE PATIENT A PAYMENT PLAN. KHS MAY REQUIRE THE PATIENT TO PROVIDE REASONABLE VERIFICATION OF HIS OR HER INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT.(B) IF KHS HAS REASON TO BELIEVE THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, UNTIL KHS HAS GIVEN THE PATIENT AT LEAST 60 DAYS FOLLOWING THE DATE OF DISCHARGE OR RECEIPT OF OUTPATIENT CARE TO SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. (C) IF THE PATIENT HAS AGREED TO A PAYMENT PLAN, UNTIL THE PATIENT HAS FAILED TO MAKE PAYMENTS IN ACCORDANCE WITH THAT PAYMENT PLAN. (D) IF THE PATIENT INFORMS KHS THAT HE OR SHE HAS APPLIED FOR HEALTH CARE COVERAGE UNDER MEDICAID, KIDCARE, OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAM (AND THERE IS A REASONABLE BASIS TO BELIEVE THAT THE PATIENT WILL QUALIFY FOR SUCH PROGRAM), BUT THE PATIENT'S APPLICATION IS DENIED.
PART V, SECTION B, LINE 3: INDIVIDUALS REPRESENTING KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HEALTH DEPARTMENT AND LIVE HEALTHY DEKALB COUNTY (FORMERLY KNOWN AS PIONEERING HEALTHIER COMMUNITIES), SERVED AS STEERING COMMITTEE MEMBERS. STEERING COMMITTEE MEMBERS MET MONTHLY FROM MAY 2012 TO NOVEMBER 2012 AND REVIEWED POPULATION DEMOGRAPHICS, BIRTH AND DEATH DATA AND SOCIAL AND HEALTH INDICATORS IN ORDER TO PRIORITIZE HEALTH PROBLEMS FOR THE DEKALB COUNTY COMMUNITY HEALTH PLAN AND KISHWAUKEE COMMUNITY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT. THE STEERING COMMITTEE WAS CHARGED WITH FURTHER PRIORITIZING THESE ISSUES BASED ON A MORE IN-DEPTH EXPLORATION AND A STANDARDIZED PROCESS. IN SEPTEMBER OF 2012, THE STEERING COMMITTEE PRESENTED HEALTH PRIORITIES TO THE EXTERNAL COMMITTEE MEMBERS, WHO INCLUDED A VARIETY OF INDIVIDUALS FROM LOCAL AND STATE GOVERNMENTAL AGENCIES, LEADERS FROM COMMUNITY BASED ORGANIZATIONS, FOUNDATIONS, SCHOOL DISTRICTS, COLLEGES, AND LOCAL NON-PROFIT ORGANIZATIONS. THESE PARTICIPANTS ARE EXPERTS IN HEALTH CARE, SOCIAL DETERMINANTS OF HEALTH AND HEALTH AND SOCIAL SERVICES. THE INPUT FROM THE EXTERNAL GROUP HELPED TO ENSURE THAT NEEDS WERE IDENTIFIED AND WILL BE RESPONDED TO. AFTER THOROUGH REVIEW OF THE DATA, KISHHEALTH SYSTEM COMMUNITY BENEFIT TEAM MEMBERS WERE GIVEN THE OPPORTUNITY TO DISCUSS THE INFORMATION AND FURTHER REVIEW HEALTH PROBLEMS FACING THE COUNTY. FOLLOWING A LENGTHY DISCUSSION, KISHHEALTH SYSTEM COMMUNITY BENEFIT TEAM MEMBERS IDENTIFIED PRIORITIES FOR CONSIDERATION FOR THE COMMUNITY BENEFIT IMPLEMENTATION PLAN. THE FULL LIST OF PARTICIPANTS IN TEH ASSESSMENT PROCESS INCLUDES:STEERING COMMITTEE MEMBERS (PARTICIPANTS LISTED ALPHABETICALLY)* BETH BUSCHING, MANAGER, COMMUNITY WELLNESS, KISHWAUKEE COMMUNITY HOSPITAL* BETTE CHILTON, DEAN OF HEALTH AND EDUCATION, KISHWAUKEE COMMUNITY COLLEGE* DAWN ROZNOWSKI, COMMUNITY ENGAGEMENT ADVISOR, KISHHEALTH SYSTEM* JANE LUX, DIRECTOR, DEKALB COUNTY HEALTH DEPARTMENT* KIM JASS-RAMIREZ, SENIOR DIRECTOR OF HEALTHY LIVING, KISHWAUKEE YMCA* LISA CUMINGS, COMMUNITY HEALTH LIAISON, KISHWAUKEE COMMUNITY HOSPITAL* MARCY ZANELLATO, HEALTH EDUCATION DIVISION, DEKALB COUNTY HEALTH DEPARTMENT* SHELLY JOHNSON, DIRECTOR, COMMUNITY CARES CLINIC AND CENTER FOR FAMILY HEALTH, EMPLOYEE HEALTH, COMMUNITY WELLNESS, KISHHEALTH SYSTEMEXTERNAL COMMITTEE MEMBERS* ERICA BARNES, LCPC, COUNSELOR/OUTREACH COORDINATOR, NORTHERN ILLINOIS UNIVERSITY COUNSELING AND STUDENT DEVELOPMENT* JAMES BRISCOE, SUPERINTENDENT, DEKALB SCHOOL DISTRICT #428* CINDY CAPEK, EXECUTIVE DIRECTOR, DEKALB PARK DISTRICT* BETTE CHILTON, DEAN OF HEALTH & EDUCATION, KISHWAUKEE COMMUNITY COLLEGE* BRENDA COURTNEY, DIRECTOR OF ADMINISTRATIVE SERVICES, DEKALB COUNTY HEALTH DEPARTMENT* KATHY COUNTRYMAN, SUPERINTENDENT, SYCAMORE SCHOOL DISTRICT #427* MICHAEL KOKOTT, ASSISTANT VICE PRESIDENT, MARKETING & PLANNING, KISHHEALTH SYSTEM* DAWN LITLEFIELD, EXECUTIVE DIRECTOR, KISHWAUKEE YMCA* CRISTY MEYER, PRINCIPAL, JEFFERSON ELEMENTARY SCHOOL* DONNA MOULTON, EXECUTIVE DIRECTOR, COMMUNITY MENTAL HEALTH BOARD & COMMUNITY SERVICES, DEKALB COUNTY* GABRIELA ORTIZ, PUBLIC HEALTH NURSE, DEKALB COUNTY HEALTH DEPARTMENT* MARY PRITCHARD, PHD., ASSOCIATE DEAN, NORTHERN ILLINOIS UNIVERSITY, COLLEGE OF HEALTH & HUMAN SCIENCES* TED STRACK, PRESIDENT, SYCAMORE PARK DISTRICT* DAN TEMPLIN, EXECUTIVE DIRECTOR, DEKALB COUNTY COMMUNITY FOUNDATION * ROB WILKINSON, CEO, KISHWAUKEE YMCAKISHHEALTH SYSTEM COMMITTEE MEMBERS* KEVIN POORTEN, PRESIDENT & CEO, KISHHEALTH SYSTEM* ALLISON BRYAN, COMMUNITY RELATIONS, VALLEY WEST COMMUNITY HOSPITAL* BECKIE FRIEDERS, EMPLOYEE WELLNESS COORDINATOR, KISHHEALTH SYSTEM* BETH BUSCHING, MANAGER, COMMUNITY WELLNESS, KISHWAUKEE COMMUNITY HOSPITAL* BETH GALE, DIRECTOR, CONTINUITY OF CARE* CINDY JOHNSTON, DIRECTOR, COMMUNITY WELLNESS, VALLEY WEST COMMUNITY HOSPITAL* DAVID WESTER, PHYSICIAN ASSISTANT, CENTER FOR FAMILY HEALTH* DAWN ROZNOWSKI, COMMUNITY ENGAGEMENT ADVISOR, KISHHEALTH SYSTEM* DR. MICHAEL KULISZ, PHYSICIAN, CHIEF MEDICAL OFFICER, KISHHEALTH SYSTEM* JENNIFER RENFER, READMISSION NURSE* KAREN ROUSE, DIRECTOR, OUTPATIENT CLINICS* MICHAEL KOKOTT, ASSISTANT VICE PRESIDENT OF MARKETING AND PLANNING, KISHHEALTH SYSTEM* PAMELA DUFFY, VICE PRESIDENT, PATIENT CARE SERVICES AND CHIEF NURSING OFFICER* SHELLY JOHNSON, DIRECTOR, COMMUNITY CARES CLINIC AND CENTER FOR FAMILY HEALTH, EMPLOYEE HEALTH, COMMUNITY WELLNESS, KISHHEALTH SYSTEM* THERESA KOMITAS, COMMUNITY RELATIONS, KISHWAUKEE COMMUNITY HOSPITAL	KISHWAUKEE COMMUNITY HOSPITAL
PART V, SECTION B, LINE 4: OTHER HOSPITAL FACILITIES INCLUDE VALLEY WEST COMMUNITY HOSPITAL	KISHWAUKEE COMMUNITY HOSPITAL
PART V, SECTION B, LINE 7: NINE OTHER TOPIC AREAS (ACCIDENTS, ALCOHOL/DRUG USE, ALLERGIES, CRIME, JOB AVAILABILITY, ORAL HEALTH, SUICIDE AND UNEMPLOYMENT) WERE IDENTIFIED FOR DATA COLLECTION, REVIEW AND PRIORITY SETTING. BELOW ARE THE AREAS IDENTIFIED AND A BRIEF DESCRIPTION WHY THE HOSPITAL DID NOT SELECT TO ADDRESS.PRIORITY IDENTIFIED: ACCIDENTSSUPPORTING DATA: 2007-2009 CENTERS FOR DISEASE CONTROL AND PREVENTION, LISTS ACCIDENTS (MOTOR VEHICLE, FALLS AND POISONING) AS THE THIRD LEADING CAUSE OF DEATH FOR DEKALB COUNTY RESIDENTS. EXPLANATION FOR NOT ADDRESSING: KISHWAUKEE COMMUNITY HOSPITAL DOES NOT HAVE THE EXPERTISE OR INFRASTRUCTURE TO SERVE AS A LEAD AROUND THIS AREA OF NEED.PRIORITY IDENTIFIED: ALCOHOL/DRUG USE SUPPORTING DATA: ILLINOIS DEPARTMENT OF PUBLIC HEALTH BEHAVIORAL RISK FACTOR SURVEILLANCE SURVEY INDICATED 22.4% OF THE POPULATION REPORT RISK FOR ACUTE/BINGE DRINKING. PER ILLINOIS SECRETARY OF STATE, THERE WERE 585 ARRESTS FOR DRIVING UNDER THE INFLUENCE IN 2010.* IN 2009, ILLINOIS STATE POLICE REPORTS INDICATE THERE WERE 571 ARRESTS FOR DRUG OFFENSES.* BASED ON ILLINOIS DEPARTMENT OF HUMAN SERVICES, DIVISION OF ALCOHOLISM AND SUBSTANCE ABUSE REPORT, AS ESTIMATED 13,155 (15.6%) OF DEKALB COUNTY RESIDENTS AGED 16 AND OLDER WERE IN NEED OF ALCOHOL TREATMENT, AS WELL AS 2,024 PERSONS IN NEED OF DRUG ABUSE TREATMENT. EXPLANATION FOR NOT ADDRESSING: KISHWAUKEE COMMUNITY HOSPITAL DOES NOT HAVE THE EXPERTISE OR INFRASTRUCTURE TO SERVE AS A LEAD AROUND THIS AREA OF NEED. KISHWAUKEE COMMUNITY HOSPITAL WILL SUPPORT COMMUNITY AGENCIES SUCH AS BEN GORDON CENTER YOUTH SERVICES BUREAU, DCPSAFE AND OTHER COMMUNITY PROGRAMS TO ADDRESS ISSUES NOT DIRECTLY ADDRESSED BY THE HEALTH SYSTEM.PRIORITY IDENTIFIED: ALLERGIES SUPPORTING DATA: 62% OF RESPONDENTS TO THE COMMUNITY HEALTH NEEDS ASSESSMENT ONLINE SURVEY INDICATED ALLERGIES AS A MODERATE TO SEVERE PROBLEM IN DEKALB COUNTY. EXPLANATION FOR NOT ADDRESSING: KISHWAUKEE COMMUNITY HOSPITAL DID NOT CHOOSE THIS AS A PRIORITY TO ADDRESS, HOWEVER, IT MAY BE INDIRECTLY ADDRESSED AS A RESULT OF WORK ON OTHER IDENTIFIED HEALTH PRIORITIES LIKE ACCESS TO CARE, CARDIOVASCULAR DISEASE, RESPIRATORY DISEASE AND OVERWEIGHT/OBESITY IN ADULTS/CHILDREN.PRIORITY IDENTIFIED: CRIMESUPPORTING DATA: 71% OF RESPONDENTS TO THE COMMUNITY HEALTH NEEDS ASSESSMENT ONLINE SURVEY INDICATED THAT CRIME IS A MODERATE TO SERIOUS CONCERN IN DEKALB COUNTY. ALSO, ILLINOIS STATE POLICE REPORT THAT FOR 2009, CITY OF DEKALB WAS HIGHEST AT 3,573.8 PER 100,000 POPULATION, FOLLOWED BY SOMONAUK (2093.9) AND SYCAMORE (1763.5).EXPLANATION FOR NOT ADDRESSING: KISHWAUKEE COMMUNITY HOSPITAL DOES NOT HAVE THE EXPERTISE OR INFRASTRUCTURE TO SERVE AS A LEAD AROUND THIS AREA OF NEED.PRIORITY IDENTIFIED: JOB AVAILABILITYSUPPORTING DATA: 75% OF RESPONDENTS TO THE COMMUNITY HEALTH NEEDS ASSESSMENT ONLINE SURVEY INDICATED THAT JOB AVAILABILITY IS A MODERATE TO SERIOUS CONCERN IN DEKALB COUNTY.EXPLANATION FOR NOT ADDRESSING: KISHWAUKEE COMMUNITY HOSPITAL DOES NOT HAVE THE EXPERTISE OR INFRASTRUCTURE TO SERVE AS A LEAD AROUND THIS AREA OF NEED. KISHWAUKEE COMMUNITY HOSPITAL WILL SUPPORT COMMUNITY AGENCIES SUCH AS ILLINOIS EMPLOYMENT TRAINING CENTER, DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION AND OTHER COMMUNITY PROGRAMS TO ADDRESS ISSUES NOT DIRECTLY ADDRESSED BY THE HEALTH SYSTEM.PRIORITY IDENTIFIED: ORAL HEALTHSUPPORTING DATA: 71.6% OF DEKALB COUNTY RESIDENTS HAVE DENTAL INSURANCE, HIGHER THAN THE STATE AVERAGE AT 61.9%. HOWEVER, 25.3% OF DEKALB COUNTY RESIDENTS CANNOT AFFORD DENTAL CARE WITHIN THE PAST YEAR.EXPLANATION FOR NOT ADDRESSING: KISHWAUKEE COMMUNITY HOSPITAL DOES NOT HAVE THE EXPERTISE OR INFRASTRUCTURE TO SERVE AS A LEAD AROUND THIS AREA OF NEED. PRIORITY IDENTIFIED: SUICIDESUPPORTING DATA: FOR THE PERIOD OF 2007-2009, SUICIDE RANKED AS THE 10TH LEADING CAUSE OF DEATH FOR DEKALB COUNTY RESIDENTS, AND THE SECOND LEADING CAUSE OF DEATH AMONG RESIDENTS AGED 15-44 YEARS OF AGE, PER THE CENTERS FOR DISEASE CONTROL AND PREVENTION. EXPLANATION FOR NOT ADDRESSING: KISHWAUKEE COMMUNITY HOSPITAL DOES NOT HAVE THE EXPERTISE OR INFRASTRUCTURE TO SERVE AS A LEAD AROUND THIS AREA OF NEED. KISHWAUKEE COMMUNITY HOSPITAL WILL SUPPORT COMMUNITY AGENCIES SUCH AS BEN GORDON CENTER YOUTH SERVICES BUREAU, DCPSAFE AND OTHER COMMUNITY PROGRAMS TO ADDRESS ISSUES NOT DIRECTLY ADDRESSED BY THE HEALTH SYSTEM.PRIORITY IDENTIFIED: UNEMPLOYMENTSUPPORTING DATA: 74% OF RESPONDENTS TO THE COMMUNITY HEALTH NEEDS ASSESSMENT ONLINE SURVEY INDICATED THAT UNEMPLOYMENT IS A MODERATE TO SERIOUS CONCERN IN DEKALB COUNTY. ILLINOIS DEPARTMENT OF EMPLOYMENT SECURITY REPORTS 9.2% OF DEKALB COUNTY RESIDENTS AS BEING UNEMPLOYED, LOWER THAN BOTH THE STATE AND U.S. RATES. EXPLANATION FOR NOT ADDRESSING: KISHWAUKEE COMMUNITY HOSPITAL DOES NOT HAVE THE EXPERTISE OR INFRASTRUCTURE TO SERVE AS A LEAD AROUND THIS AREA OF NEED. KISHWAUKEE COMMUNITY HOSPITAL WILL SUPPORT COMMUNITY AGENCIES SUCH AS ILLINOIS EMPLOYMENT TRAINING CENTER, DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION AND OTHER COMMUNITY PROGRAMS TO ADDRESS ISSUES NOT DIRECTLY ADDRESSED BY THE HEALTH SYSTEM.	KISHWAUKEE COMMUNITY HOSPITAL
PART V, SECTION B, LINE 18E: POSTING OF FINANCIAL ASSISTANCE POLICY TO SYSTEM'S WEBSITE.	KISHWAUKEE COMMUNITY HOSPITAL
PART V, SECTION B, LINE 20D: BASED ON COMPLIANCE WITH LAWS OF STATE OF ILLINOIS, SPECIFICALLY THE UNINSURED PATIENT DISCOUNT ACT.	KISHWAUKEE COMMUNITY HOSPITAL
PART VI, LINE 2: KISHWAUKEE COMMUNITY HOSPITAL IDENTIFIES COMMUNITY HEALTH NEEDS IN SEVERAL WAYS:* DEKALB AND KENDALL COUNTY HEALTH DEPARTMENT I-PLANS* KISHHEALTH SYSTEM, PRC COMMUNITY HEALTH NEEDS SURVEY 2009* U.S. GOVERNMENT HEALTHY PEOPLE 2010 AND 2020 GUIDELINES* UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANKINGS & ROADMAPS* ILLINOIS DEPARTMENT OF PUBLIC HEALTH, HOSPITAL DATA* ILLINOIS HOSPITAL ASSOCIATION* INTERNAL REVIEW OF OUTPATIENT AND INPATIENT TRENDS, ESPECIALLY EMERGENCY DEPARTMENT USAGE * INPUT FROM OTHER COMMUNITY PROVIDERS. THIS INCLUDES PROVIDING HOSPITAL LEADERS SERVING ON BOARDS AND COMMITTEES THAT DIRECTLY OR INDIRECTLY IMPACT COMMUNITY HEALTH OR HELP THE HOSPITAL CONNECT TO UNDERSERVED OR VULNERABLE POPULATIONS.
PART VI, LINE 3: INFORMATION IS PROVIDED AT REGISTRATION, VIA THE HOSPITAL WEBSITE, THROUGH CONSULTATIONS WITH FINANCIAL COUNSELORS FOR SOME OUTPATIENTS AS WELL AS INPATIENTS, DURING THE BILLING PROCESS ON STATEMENTS AND VIA PHONE CONVERSATIONS.
PART VI, LINE 4: KISHWAUKEE COMMUNITY HOSPITAL SERVES ALL OF DEKALB COUNTY, IL, AND BORDER COMMUNITIES IN KANE AND OGLE COUNTIES. POPULATION OF THE HOSPITAL'S SERVICE AREA, BASED ON 2010 CENSUS, IS 127,307. THIS GEOGRAPHIC AREA INCLUDES A GROWING HISPANIC POPULATION. A UNIQUE POPULATION IN OUR SERVICE AREA IS NORTHERN ILLINOIS UNIVERSITY STUDENTS (22,900 ENROLLED IN 2012), INCLUDING FOREIGN STUDENTS AND VISITORS. THE HISPANIC POPULATION IS EXPECTED TO DECREASE BY 16% BY 2017. THE POVERTY LEVELS IN THE HOSPITAL'S PRIMARY MARKET ARE DEKALB, 15.9%; SYCAMORE, 7.0%; AND CORTLAND, 13.4%.
PART VI, LINE 5: KISHWAUKEE COMMUNITY HOSPITAL IN DEKALB, IL, IS PART OF KISHHEALTH SYSTEM. THE HEALTH SYSTEM IS GOVERNED BY AN APPOINTED VOLUNTEER BOARD OF DIRECTORS, INDEPENDENT COMMUNITY LEADERS WHO RESIDE IN THE PRIMARY MARKETS SERVED BY THE HEALTH SYSTEM'S TWO HOSPITALS. THESE INDIVIDUALS ARE SELECTED FOR THE BOARD BECAUSE OF THEIR INTEREST AND EXPERTISE IN VARIOUS AREAS THAT CAN HELP MANAGEMENT CARRY OUT THE HEALTH SYSTEM'S MISSION. MEMBERS OF THE BOARD ARE NOT COMPENSATED FOR THEIR TIME. THE MEDICAL STAFF IS OPEN TO PHYSICIANS WHO MEET CRITERIA ESTABLISHED BY MEDICAL STAFF BYLAWS. PHYSICIANS ARE GIVEN THE OPPORTUNITY TO VOLUNTEER TO DO FREE COMMUNITY WELLNESS PROGRAMS ON HEALTH TOPICS. SURPLUS FUNDS GO BACK INTO THE ORGANIZATION TO SUPPORT OPERATIONS, CAPITAL IMPROVEMENTS, THE HEALTH SYSTEM'S COMMITMENT TO EXCELLENCE, EDUCATION AND INNOVATION, AND TO PROVIDE MEDICAL CARE TO ALL REGARDLESS OF ABILITY TO PAY. A COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED IN THE FALL OF 2009, VIA A RANDOM TELEPHONE SURVEY. RESULTS ARE ONE COMPONENT USED FOR FY 13 ACTION PLANNING FOR. A COMMUNITY NEEDS ASSESSMENT ALSO WAS DONE DURING THIS CURRENT FISCAL YEAR, THE RESULTS OF WHICH WILL ARE REPORTED IN THE CURRENT YEAR FORM 990. BELOW ARE SPECIFIC EXAMPLES OF THE HOSPITAL'S EFFORTS TO PROMOTE HEALTH WITHIN THE COMMUNITY.COMMUNITY HEALTH NEEDS ASSESSMENT: IN COLLABORATION WITH DEKALB COUNTY HEALTH DEPARTMENT, KISHWAUKEE COMMUNITY HOSPITAL UNDEWROTE THE COST OF THE DATA COLLECTION PROCESS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT.THE PREVALENCE OF OBESITY IN CHILDREN AND ADULTS: COMMUNITY WELLNESS INITIATIVE IS TO DECREASE OBESITY AND THE CHRONIC DISEASES ASSOCIATED WITH IT BY OFFERING TARGETED WELLNESS PROGRAMS AND PREVENTATIVE SCREENINGS TO HELP OUR COMMUNITY GET WELL AND STAY WELL. THREE HEALTH PROMOTION SPECIALISTS AND A HEALTHY CULINARY INSTRUCTOR ARE EMPLOYED TO COLLABORATE WITH COMMUNITY ORGANIZATION, SCHOOLS AND TO WORK WITH THE COMMUNITY TO PROMOTE HEALTHY FOOD CHOICES, INCREASE FITNESS, AND DECREASE CHRONIC DISEASE. PROGRAMS INCLUDE FREE KNOW YOUR NUMBERS EVENTS, FREE BLOOD PRESSURE CLINICS, TIME TO QUIT TOBACCO CLASSES, WELLNESS FOR KIDS PROGRAM IN THE SCHOOLS, COORDINATED APPROACH TO CHILD HEALTH (CATCH) PROGRAM IN THE SCHOOLS TO PROMOTE PHYSICAL ACTIVITY, HEALTHIER EATING AND TO DECREASE SCREEN TIME, LIVEHEALTHY TEAM CHALLENGE WITH THE YMCA, AND INGREDIENTS FOR HEALTH LIVING SERIES. THE CATCH PROGRAM WAS NEW IN FY13 AND IS A PLANNED, SYSTEMATIC APPROACH TO CREATE BEHAVIORAL AND ENVIRONMENTAL CHANGE TO IMPROVE NUTRITION, PHYSICAL ACTIVITY, AND REDUCE SCREEN TIME TO DECREASE OBESITY RATES. THE CATCH PROGRAM IS EVIDENCE BASED AND DEVELOPED BY THE CENTERS FOR DISEASE CONTROL. DURING THE YEAR, 131 INDIVIDUALS WERE TRAINED TO TEACH CATCH. OF THE SCHOOL PROGRAMS MENTIONED ABOVE, IN EXCESS OF 21,468 STUDENTS WERE INSTRUCTED. ACCESS TO AFFORDABLE PRIMARY CARE: NEW PHYSICIANS WHO RECEIVE RECRUITMENT ASSISTANCE FROM KISHHEALTH SYSTEM OR WHO ARE EMPLOYED BY KISHHEALTH SYSTEM ARE REQUIRED TO ACCEPT MEDICAID AND UNINSURED PATIENTS. DURING FY 13, KISHHEALTH PHYSICIAN GROUP EMPLOYED SEVEN PHYSICIANS WITH PRACTICES IN SANDWICH, DEKALB AND GENOA . MENTAL HEALTH- DURING FY 13, THE CHILD DEVELOPMENT CLINIC NOW PROVIDES ASSESSMENT AND INTERVENTION OF CHILDHOOD DISORDERS INCLUDING AUTISM SPECTRUM DISORDERS, DEVELOPMENTAL DELAYS, SLEEP PROBLEMS, ANXIETY, DEPRESSION, AND OTHER MOOD DISORDERS, AS WELL AS COMMON SCHOOL, FAMILY, AND SOCIAL STRESSORS TYPICAL IN CHILDHOOD. THERE WERE 1525 VISITS TO THE CHILD DEVELOPMENT CLINIC IN FY 12. IN ADDITION, PSYCHIATRY, COUNSELING AND EMPLOYEE ASSISTANCE PROGRAM SERVICES ARE PROVIDED AT THE BEHAVIORAL HEALTH CENTER IN SYCAMORE AND AT THE VALLEY WEST COMMUNITY HOSPITAL MEDICAL OFFICE BUILDING. THERE WERE OVER 6,200 BEHAVIORAL HEALTH PATIENT VISITS IN FY13. TYPE II DIABETES: TO ADDRESS THE PREVALENCE OF DIABETES IN THE ADULT POPULATION, THE SYSTEM CONTINUED TO OPERATE DIABETES EDUCATION CENTERS AT KISH HOSPITAL AND VALLEY WEST WITH SATELLITE SERVICES AT KISHHEALTH FAMILY & SPECIALTY CARE IN GENOA. THE KISHWAUKEE COMMUNITY HOSPITAL DIABETES EDUCATION CENTER HAD 7,915 CONSULTATIONS IN FY13. ON AVERAGE, 36 INPATIENTS A MONTH AT KCH WERE DIAGNOSED WITH DIABETES. IN FY13, KISH HOSPITAL HELD "THE ABCS OF DIABETES" IN CONJUNCTION WITH DEKALB CLINIC PROVIDING RESOURCES FOR PEOPLE WITH DIABETES. ABOUT 150 PEOPLE ATTENDED. RESULTS OF THE KISHHEALTH SYSTEM PRC COMMUNITY HEALTH NEEDS SURVEY 2009 INDICATED THAT AMONG SURVEYED ADULTS IN THE VWCH SERVICE AREA, 8.2% REPORT HAVING BEEN DIAGNOSED WITH DIABETES, EQUAL TO STATE BUT LOWER THAN NATIONAL PROPORTIONS. CARDIOVASCULAR DISEASE AND HOSPITAL-BASED AND COMMUNITY OUTREACH SERVICES: COMMUNITY BENEFIT ACTIVITIES IN FY 13 THAT PROMOTED CARDIOVASCULAR HEALTH INCLUDED A WOMEN'S HEALTH EVENT AT KCH IN FEBRUARY WHICH HAD 1,300 ATTENDEES AND KNOW YOUR NUMBERS EVENTS RESULTED IN 234 FREE SCREENINGS. BLOOD PRESSURE CLINICS: TOTAL FREE BLOOD PRESSURE CHECKS FOR KCH WAS 2,430.CANCER CARE SERVICES: PROVIDED FREE SKIN CANCER SCREENINGS AT WOMEN'S HEALTH EVENT RESULTING IN 75 SKIN CANCER SCREENINGS AT KCH. MORE THAN 30 MAMMOGRAMS WERE ALSO PROVIDED TO UNINSURED WOMEN AT A "WOMEN MATTER" EVENT AT THE HOSPITAL. PROVIDED FINANCIAL SUPPORT OF AMERICAN CANCER SOCIETY RELAYS FOR LIFE DEKALB COUNTY AND NORTHERN ILLINOIS UNIVERSITY. OTHER: ENTERED INTO AGREEMENTS WITH THE KISHWAUKEE FAMILY YMCA TO HELP UNDERWRITE THE COST OF FITNESS AND RECREATIONAL ACTIVITIES FOR COMMUNITY MEMBERS. IN ADDITION, COMMUNITY WELLNESS EDUCATORS VISITED 225 CLASSROOMS AND WORKED WITH 5,944 STUDENTS.AFFORDABLE ACCESS TO CHILDBIRTH EDUCATION AND OBSTETRIC HOSPITAL SERVICES: THE BREASTFEEDING CENTER OPERATED ITS FIRST FULL YEAR AT KISHWAUKEE COMMUNITY HOSPITAL, WHICH PROVIDED FREE IN-PERSON LACTATION COUNSELING, ONLINE, AND OVER THE PHONE, AS WELL AS, SUPPORT GROUPS. THE TOTAL NUMBER OF TELEPHONE CALLS RECEIVED AT THE BREASTFEEDING CENTER WAS 754. THERE WERE 270 INITIAL LACTATION VISITS TO THE BREASTFEEDING CENTER AND 319 FOLLOW-UP VISITS. KCH OFFERED 72 TUITION WAIVERS FOR INFANT AND CHILDBIRTH CLASSES FOR CLIENTS OF THE DEKALB COUNTY HEALTH DEPARTMENT IN THE WIC PROGRAM AND HEALTHY MOMS/HEALTHY KIDS PROGRAM AND PROVIDED FREE PREPARED CHILDBIRTH CLASSES FOR YOUNG MOMS. MONTHLY MOMS BREASTFEEDING SUPPORT GROUP WAS HELD FOR 134 PARTICIPANTS AND WAS LED BY A LACTATION CONSULTANT.FARMERS MARKET VOUCHERS: DURING THE SUMMER OF FY13, KISHWAUKEE COMMUNITY HOSPITAL WORKING WITH THE DEKALB COUNTY HEALTH DEPARTMENT'S WIC PROGRAM AND THE FAMILY SERVICE AGENCY'S SENIOR SERVICES, VOUCHERS WERE PROVIDED TO LOW INCOME INDIVIDUALS. THE VOUCHERS WERE USED TO PURCHASE FRUITS, VEGETABLES, AND HERBS FROM PARTICIPATING VENDORS. THE VENDORS TURNED THE VOUCHERS IN TO THE HOSPITAL, WHICH ISSUED PAYMENT. MORE THAN $6,000 IN FRUITS AND VEGETABLES WERE PURCHASED. CASH AND IN-KIND DONATIONS: EACH YEAR AN ALLOCATION IS MADE IN THE OPERATING BUDGET FOR DONATIONS TO COMMUNITY EVENTS AND ORGANIZATIONS THAT IMPROVE THE HEALTH, WELFARE, AND QUALITY OF LIFE IN THE COMMUNITIES SERVED BY KISHHEALTH SYSTEM. THE SYSTEM ESPECIALLY WANTS TO SUPPORT COMMUNITY ACTIVITIES THAT ENCOURAGE CHILD AND ADULT PHYSICAL ACTIVITY; EFFORTS THAT REACH UNDERSERVED AND VULNERABLE POPULATIONS; YOUTH MENTORING, EDUCATION, AND THE ARTS; DISEASE PREVENTION, AWARENESS, AND RESEARCH; MENTAL HEALTH; ECONOMIC DEVELOPMENT, AND OTHER COMMUNITY BUILDING ACTIVITIES. IN-KIND DONATIONS AND SERVICES SUCH AS PERSONNEL TIME, SURPLUS SUPPLIES, FOOD, AND BOTTLED WATER ALSO ARE TRACKED.
PART VI, LINE 6: KISHHEALTH SYSTEM AND ITS NON-PROFIT AFFILIATES, KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE, CENTER FOR FAMILY HEALTH, CENTER FOR FAMILY HEALTH-MALTA, KISHHEALTH HOME CARE, KISHHEALTH PHYSICIAN GROUP AND THE KISHHEALTH FOUNDATION, ALL PROMOTE THE HEALTH OF COMMUNITIES IN OUR REGION THROUGH DIRECT SERVICES, DONATIONS OF LEADERSHIP TIME ON VARIOUS COMMITTEES AND BOARDS, AND THROUGH CASH CONTRIBUTIONS.KISHHEALTH SYSTEM UNDERWROTE $1,190,000 IN OPERATIONAL LOSSES IN FY 13 FOR THE TWO CENTERS FOR FAMILY HEALTH, AND $3,000,000 FOR KISHWAUKEE PHYSICIANS GROUP, BOTH VITAL SERVICES FOR THE HEALTH OF THE COMMUNITY. KCH ALSO MADE $462,240 IN CONTRIBUTIONS TO SEVERAL ORGANIZATIONS IN FY13, NOTABLY $135,000 TO KISHWAUKEE COLLEGE FOUNDATION, $25,000 TO KISHWAUKEE FAMILY YMCA, $22,240 TO THE ILLINOIS HOSPITAL RESEARCH AND EDUCATION FOUNDATION, AND $8,180 TO THE KISHWAUKEE UNITED WAY. IN ADDITION, HEALTH SYSTEM EMPLOYEES CONTRIBUTED MORE THAN 2,032 HOURS OF IN-KIND SERVICE TO COMMUNITY ORGANIZATIONS, EDUCATIONAL INSTITUTIONS AND OTHER ACTIVITIES THAT PROMOTE HEALTH, EDUCATION AND QUALITY OF LIFE. VALLEY WEST COMMUNITY HOSPITAL IS A CRITICAL ACCESS HOSPITAL IN SANDWICH. DEKALB COUNTY HOSPICE, DEKALB, IL, PROVIDES FREE CARE AND SUPPORT FOR THE TERMINALLY ILL AS WELL AS GRIEF SUPPORT TO THE PUBLIC. COMMUNITY CARES CLINIC, DEKALB, IL IS A PRIMARY CARE CLINIC FOR MEDICAID AND UNINSURED; KISHHEALTH PHYSICIAN GROUP PROVIDES ACCESS TO MEDICAL SERVICES, ESPECIALLY THE RURAL AREAS AND ACCEPTS MEDICAID AND UNINSURED PATIENTS, AND KISHHEALTH FOUNDATION IN DEKALB, IL RAISES MONEY FOR KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE AND THE CENTERS FOR FAMILY HEALTH AND FUNDS EQUIPMENT PURCHASES AND PATIENT SERVICES.
IL	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Records Maintained	1	RecordsMaintained

Recipient Table RecipientTable (16 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
AMERICAN CANCER SOCIETY
143 FIRST STREET	BATAVIA	IL	60510	131788491	501(C)(3)	19659	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO CANCER RESEARCH AND EDUCATION
AMERICAN HEART ASSOCIATION
PO BOX 4002902	DES MOINES	IA	50340	135613797	501(C)(3)	15000	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO HEART HEALTH RESEARCH AND EDUCATION
BEN GORDON CENTER
12 HEALTH SERVICES DRIVE	DEKALB	IL	60115	362771343	501(C)(3)	25000	TO PROVIDE FINANCIAL ASSISTANCE FOR MENTAL HEALTH SERVICES FOR UNDER OR UNINSURED
DEKALB COUNTY AMERICAN RED CROSS
2727 SYCAMORE ROAD SUITE 2A	DEKALB	IL	60115	530196605	501(C)(3)	5000	TO PROVIDE FINANCIAL ASSISTANCE FOR LOCAL DISASTER RELIEF
DEKALB COUNTY YOUTH SERVICES BUREAU
330 GROVE STREET	DEKALB	IL	60115	363034427	501(C)(3)	7500	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO YOUTH SERVICES
GENOA CHAMBER OF COMMERCE
327 W MAIN STREET	GENOA	IL	60135	362355846	501(C)(6)	5700	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO PROMOTION OF GENOA AREA ECONOMIC DEVELOPMENTTO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO PROMOTION OF GENOA AREA ECONOMIC VITALITYTO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO PROMOTION OF GENOA AREA ECONOMIC VITALITY
IHREF
24676 NETWORK PLACE	CHICAGO	IL	60673	237421930	501(C)(3)	22240	TO PROVIDE RELIEF FOR HOPSITALS NEGATIVELY AFFECTED BY ASSESSMENTS
KISHWAUKEE COLLEGE FOUNDATION
21193 MALTA ROAD	MALTA	IL	60150	237433949	501(C)(3)	135000	TO PROVIDE FINANCIAL ASSISTANCE FOR PROMOTION OF HEALTHCARE EDUCATION
KISHWAUKEE FAMILY YMCA
2500 BETHANY ROAD	SYCAMORE	IL	60178	362379643	501(C)(3)	25000	TO PROVIDE FINANCIAL ASSISTANCE RELATED TO HEALTH AND FITNESS ACTIVITES FOR LOW INCOME CHILDREN AND FAMILIES
KISHWAUKEE UNITED WAY
PO BOX 311 115 N FIRST STREET	DEKALB	IL	60115	366158489	501(C)(3)	8179	TO PROVIDE FINANCIAL ASSISTANCE IN SUPPORT OF COMMUNITY SOCIAL SERVICES
MARCH OF DIMES
5411 E STATE STREET STE 10	SYCAMORE	IL	60178	131846366	501(C)(3)	7405	TO PROVIDE FINANCIAL ASSISTANCE IN SUPPORT OF PRE-NATAL EDUCATION AND RESEARCH
MIDWEST MUSEUM OF NATURAL HISTORY
425 WEST STATE STREET	SYCAMORE	IL	60178	611402985	501(C)(3)	6000	TO PROVIDE FINANCIAL ASSISTANCE IN SUPPORT OF PRODUCING EDUCATION MATERIALS FOR THE MUSEUM
NORTHERN ILLINOIS FOOD BANK
273 DEARBORN COURT	GENEVA	IL	60134	363203648	501(C)(3)	5000	TO PROVIDE FINANCIAL ASSISTANCE IN SUPPORT OF A FOOD PANTRY FOR THE COMMUNITY
VOLUNTARY ACTION CENTER
1606 BETHANY ROAD	SYCAMORE	IL	60178	362798257	501(C)(3)	8000	TO PROVIDE FINANCIAL ASSISTANCE IN SUPPORT OF MEALS ON WHEELS AND TRANSPORTATION SERVICES FOR LOW INCOME AND ELDERLY
OPPORTUNITY HOUSE
202 LUCAS STREET PO BOX 9	SYCAMORE	IL	60178	362476231	501(C)(3)	5000	TO PROVIDE ASSISTANCE IN SUPPORT OF SPECIAL OLYMPICS
SYCAMORE CHAMBER OF COMMERCE
407 W STATE STREET STE 10	SYCAMORE	IL	60178	361848940	501(C)(6)	7275	TO PROVIDE FINANCIAL ASSISTANCE TO PROMOTE SYCAMORE ECONOMIC VITALITY AND DEVELOPMENT

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	14	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	2	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII

Field	Value	IRS element (for citing)
Type Of Grant	KISHWAUKEE COMMUNITY HOSPITAL AUXILIARY SCHOLARSHIP PROGRAM	TypeOfGrant
Number Of Recipients	23	NumberOfRecipients
Amount Of Cash Grant	20000	AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: THE ORGANIZATION MAINTAINS SPECIFIC POLICIES AND QUALIFICATIONS FOR ALL GRANTS AVAILABLE. APPLICANTS MUST APPLY FOR THE RESPECTIVE GRANT AND BE APPROVED BY THE FUNDS GOVERNING BOARD. THE USE OF THE FUNDS IS MONITORED BY THE GOVERNING BOARD OF KISHWAUKEE COMMUNITY HOSPITAL. REQUESTS FOR FINANCIAL ASSISTANCE FROM OTHER CHARITABLE ORGANIZATIONS ARE REVIEWED AND APPROVED BY THE VP - FINANCE 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	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (15 entries)

TitleTitle	Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEVIN POORTEN
PRESIDENT & CEO, KHS	0	548333	0	168139	0	250000	0	196100	0	24053	0	1186625	0	0
LOREN FOELSKE
VP FINANCE	0	256230	0	28504	0	0	0	94286	0	23218	0	402238	0	0
BRAD COPPLE
PRESIDENT - KCH & VWCH	0	290654	0	68983	0	0	0	48700	0	23484	0	431821	0	0
PAM DUFFY
CNO & VP PATIENT CARE	0	205275	0	43878	0	0	0	21863	0	9007	0	280023	0	0
JOE DANT
VP BUSINESS DEVELOPMENT	0	215055	0	40618	0	0	0	22696	0	23145	0	301514	0	0
MIKE KOKOTT
ASST VP - MARKETING	0	164639	0	30189	0	0	0	19424	0	15418	0	229670	0	0
ROGER HEATH BELL
VP - CIO	0	216114	0	57458	0	0	0	22712	0	28395	0	324679	0	0
DR MICHAEL KULISZ
CHIEF MEDICAL OFFICER	0	310004	0	92702	0	0	0	75900	0	23358	0	501964	0	0
MARK THATE
VP - HUMAN RESOURCES	0	175149	0	40790	0	57200	0	10707	0	15579	0	299425	0	0
MICHAEL MUZZILLO THRU 62912
VP OPERATIONS - VWCH	0	107905	0	31214	0	90400	0	11876	0	551	0	241946	0	0
THOMAS W TILTON DO
OPTHAMOLOGIST	347770	0	66999	0	0	0	10146	0	21970	0	446885	0	0	0
THOMAS WARZECHA
DIRECTOR OF PHARMACY	137901	0	5460	0	0	0	3309	0	21890	0	168560	0	0	0
KENYA M WILLIAMS MD
OPTHAMOLOGIST	216756	0	29075	0	0	0	7184	0	355	0	253370	0	0	0
JASMEET DHALIWAL
OPTHAMOLOGIST	294054	0	451470	0	0	0	8995	0	21956	0	776475	0	0	0
LISA ACKLAND
DIRECTOR OF SURGERY/CARDIO	130787	0	10152	0	0	0	0	0	21882	0	162821	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Return Reference	PART I, LINE 4B	ReturnReference
Explanation	THE ORGANIZATION'S EXECUTIVES PARTICIPATE IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. CONTRIBUTIONS FOR CALENDAR YEAR 2012 RELATED TO OFFICERS, DIRECTORS, AND KEY EMPLOYEES OF KISHHEALTH FOUNDATION WERE $334,200. THIS CONTRIBUTION REFLECTS AMOUNTS DUE FOR BOTH THE FISCAL YEARS ENDING APRIL 30, 2011 AND APRIL 30, 2012, WITH 50% OF THE CONTRIBUTION BEING ALLOCATED TO EACH YEAR. THE ORGANIZATION'S CEO PARTICIPATES IN AN ADDITIONAL NONQUALIFIED DEFERRED COMPENSATION PLAN. CONTRIBUTIONS FOR CALENDAR YEAR 2012 WERE $60,000. DURING FY13, THE CEO TOOK A DISTRIBUTION FROM THE DEFERRED COMPENSATION PLAN IN THE AMOUNT OF $250,000. THIS DISTRIBUTION IS INCLUDED AS W-2 WAGES, HOWEVER THE ACCRUAL OF THE DEFERRED COMPENSATION PAYMENTS HAS ALSO BEEN INCLUDED AS "OTHER COMPENSATION" ON PRIOR YEAR FORM 990S.	Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CITY OF SYCAMORE DEKALB COUNTY ILLINOIS HEALTH FACILITIES REVENUE BOND	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	861091967	IssuerEIN
CUSIP Number	452032AJ4	CUSIPNumber
Date Issued	2008-08-01	DateIssued
Issue Price	63685000	IssuePrice
Description Of Purpose	CONSTRUCTION OF NEW FACILITY FOR KISHWAUKEE COMMUNITY HOSPITAL	DescriptionOfPurpose
Defeased	1	Defeased
On Behalf Of Issuer	1	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Total Proceeds	63371994	TotalProceeds
Issuance Costs From Proceeds	328434	IssuanceCostsFromProceeds
Year Of Subst Completion	2007	YearOfSubstCompletion
Current Refunding	0	CurrentRefunding
Advance Refunding	1	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Bond Iss Meet Prvt Security Pay Test	0	BondIssMeetPrvtSecurityPayTest
Change In Use Bond Financed Prop	0	ChangeInUseBondFinancedProp
Non Qualified Bond Remed Procdrs	0	NonQualifiedBondRemedProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	0	Form8038TFiled
Rebate Not Due Yet	1	RebateNotDueYet
Exception To Rebate	0	ExceptionToRebate
No Rebate Due	1	NoRebateDue
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Written Proc To Monitor Reqs	0	WrittenProcToMonitorReqs

Form990 Schedule K Part V Form990ScheduleKPartV

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Proc To Undertk Corrective Action	0	ProcToUndertkCorrectiveAction

Form990 Schedule K Part VI Form990ScheduleKPartVI

Field	Value	IRS element (for citing)
Identifier	SCHEDULE K PART IV, ARBITRAGE, LINE 2C	Identifier
Return Reference	DATE REBATE COMPUTATION PERFORMED	ReturnReference
Explanation	ISSUER NAME: CITY OF SYCAMORE, DEKALB COUNTY, ILLINOIS HEALTH FACILITIES RE DATE THE REBATE COMPUTATION WAS PERFORMED: 07/31/2013	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (12 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	KEVIN POORTEN AND LOREN FOELSKE ARE BOTH EMPLOYEES OF KISHHEALTH SYSTEM, THE PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL. MR. POORTEN IS PRESIDENT AND CEO OF KISHWHEALTH 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, WHICH IS THE PARENT ORGANIZATION FOR ALL RELATED ENTITIES. BRAD COPPLE, AS THE PRESIDENT OF KISHWAUKEE COMMUNITY HOSPITAL, IS CONSIDERED AN OFFICER. HE IS ALSO PRESIDENT OF VALLEY WEST COMMUNITY HOSPITAL, A RELATED ENTITY, AND IS COMPENSATED BY KISHHEALTH SYSTEM. MR. POORTEN AND MR. FOELSKE ARE ALSO CONSIDERED OFFICERS OF KISHWAUKEE COMMUNITY HOSPITAL AND KISHHEALTH SYSTEM, AS DESCRIBED ABOVE. TOM MATYA AND MICHAEL CULLEN ARE MEMBERS OF THE KISHWAUKEE COMMUNITY HOSPITAL BOARD OF DIRECTORS. THEY ALSO SERVE ON THE BOARD OF DIRECTORS OF KISHHEALTH SYSTEM, THE PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL. THE FOLLOWING INDIVIDUALS ARE OFFICERS OR KEY EMPLOYEES OF KISHHEALTH SYSTEM AND ARE ALSO CONSIDERED OFFICERS OR KEY EMPLOYEES OF KISHWAUKEE COMMUNITY HOSPITAL. THEY ARE ALL COMPENSATED BY KISHHEALTH SYSTEM: BRAD COPPLE, PRESIDENT KCH & VWCH PAM DUFFY, VP PATIENT CARE JOE DANT, VP DEVELOPMENT MIKE KOKOTT, ASST. VP MARKETING HEATH BELL, VP AND CHIEF INFORMATION OFFICER MARK THATE, VP HUMAN RESOURCES DR. MICHAEL KULISZ, CHIEF MEDICAL OFFICER DAVE PROULX, VP OPERATIONS VWCH MICHAEL MUZZILLO, VP OPERATIONS VWCH (TERMINATED EMPLOYMENT IN 2012)
FORM 990, PART VI, SECTION A, LINE 6	KISHHEALTH SYSTEM IS THE SOLE MEMBER OF KISHWAUKEE COMMUNITY HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	AS THE SOLE MEMBER AND PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL, KISHHEALTH SYSTEM HAS THE RIGHT TO APPROVE THE ELECTION OF MEMBERS OF THE HOSPITAL'S GOVERNING BOARD, PER THE HOSPITAL'S BYLAWS.
FORM 990, PART VI, SECTION A, LINE 7B	KISHHEALTH SYSTEM (KHS) SERVES AS THE SOLE MEMBER AND PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL (VWCH). PER THE BYLAWS, WITH RESPECT TO THE GOVERNANCE OF VWCH, THE FOLLOWING POWERS SHALL BE RESERVED TO THE SOLE CORPORATE MEMBER. PER THE BYLAWS, WITH RESPECT TO THE GOVERNANCE OF KCH, THE FOLLOWING POWERS SHALL BE RESERVED TO THE SOLE CORPORATE MEMBER: A. ELECTING THE MEMBERS OF THE KCH BOARD; B. APPROVING, EVALUATING AND/OR REMOVING THE PRESIDENT AND CEO AND REVIEWING AND APPROVING THE EMPLOYMENT CONTRACT OF THE PRESIDENT AND CEO AND ESTABLISHING COMPENSATION FOR SUCH OFFICE; C. APPROVING THE STRATEGIC PLAN FOR KCH; D. APPROVING THE DISPOSITION OF ANY ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS FOR KCH; E. APPROVING ANY CHANGE IN MEMBERSHIP OF KCH; F. APPROVING THE ADOPTION OF AND AMENDMENTS TO THE ORGANIZATIONAL DOCUMENTS, INCLUDING THE ARTICLES OF INCORPORATION AND BYLAWS OF KCH; G. APPROVING A PLAN OF MERGER OR A PLAN OF CONSOLIDATION OF KCH OR ESTABLISHING A NEW SUBSIDIARY OR SISTER ENTITY; H. APPROVING A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF KCH; I. INITIATING, TAKING ANY AND ALL ACTIONS, AND EXERCISING ALL APPROVAL RIGHTS OF THE DIRECTORS PURSUANT TO THE APPLICABLE MEDICAL STAFF BYLAWS; J. IMPLEMENTING AND MONITORING KCH OPERATIONAL QUALITY IMPROVEMENT POLICIES AND PROGRAMS; K. ACCEPTING GIFTS, GRANTS, BEQUESTS AND DONATIONS ON BEHALF OF KCH; L. APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGETS FOR KCH; M. EXERCISING ANY RIGHTS THAT KCH HAS AS A SHAREHOLDER OR MEMBER OF ANY SUBSIDIARY ENTITY; N. APPROVING ANY AFFILIATIONS OF KCH; O. APPROVING AND/OR DETERMINING (I) THE CREATION OF NEW HEALTH SERVICES TO BE PROVIDED AND THE LOCATION OF SUCH HEALTH SERVICES AND (II) THE DISCONTINUANCE OF ANY HEALTH SERVICE; P. AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF KCH; Q. AUTHORIZING THE VOLUNTARY DISSOLUTION OF KCH, OR REVOKING THE PROCEEDINGS THEREOF; R. REQUIRING MINUTES OF MEETINGS, FINANCIAL RECORDS, AND SUCH OTHER INFORMATION AS MAY BE NECESSARY TO PROPERLY EVALUATE THE PERFORMANCE OF KCH; S. INITIATING ACTION TO REMOVE OR REINSTATE A DIRECTOR WHEN, IN THE OPINION OF THE KHS BOARD, IT IS IN THE BEST INTERESTS OF KHS OR KCH. ANY ACTION TO REMOVE OR REINSTATE SHALL REQUIRE A MAJORITY VOTE OF THOSE KHS DIRECTORS THEN IN OFFICE PRESENT AND VOTING AT A MEETING OF THE KHS BOARD AT WHICH A QUORUM IS PRESENT. IN ANY ACTION(S) TO REMOVE TAKEN BY THE KHS BOARD, THE DIRECTOR IN QUESTION SHALL BE ADVISED AT LEAST TWENTY (20) DAYS PRIOR TO THE MEETING THAT THE ACTION WILL BE CONSIDERED AND SHALL BE GIVEN THE OPPORTUNITY TO MAKE A STATEMENT, PRESENT WITNESSES ON HIS/HER BEHALF AND QUESTION THOSE PRESENTING REASONS FOR HIS/HER REMOVAL. ALL ACTIONS TO REMOVE SHALL BE TAKEN IN CLOSED SESSIONS OF THE KHS BOARD; AND T. TRANSFERRING MONEY OR PROPERTY AMONG KCH, KHS AND/OR ONE OR MORE SUBSIDIARY CORPORATIONS AND TRANSFERRING MONEY OR PROPERTY FROM A SUBSIDIARY CORPORATION, INCLUDING REQUIRING THE DIRECTORS, OFFICERS, OR TRUSTEES OF ANY SUBSIDIARY CORPORATION TO TRANSFER MONEY OR OTHER PROPERTY TO KHS. SUBJECT TO THE POWERS OF THE BOARD OF DIRECTORS OF EACH SUBSIDIARY CORPORATION, THE KHS BOARD MAY INITIATE AND TAKE THE FOREGOING ACTIONS ON BEHALF OF KHS AND THE SUBSIDIARY CORPORATIONS.
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	CONFLICTS OF INTEREST ARE INVESTIGATED BY APPOINTED MEMBERS OF THE GOVERANCE 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. THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD ANNUALLY AND UPDATED AS NEEDED.
FORM 990, PART VI, SECTION B, LINE 15	KISHWAUKEE COMMUNITY HOSPITAL IS NOT DIRECTLY INVOLVED IN DETERMINING THE COMPENSATION OF THE CEO, EXECUTIVE DIRECTOR, OR TOP MANAGEMENT, AS THE INDIVIDUALS ARE EMPLOYED THROUGH KISHHEALTH SYSTEM. KISHHEALTH SYSTEM DOES COMPLY WITH THE REQUIREMENTS NOTED ABOVE. THROUGH THE OVERSIGHT OF THE BOARD OF DIRECTORS EXECUTIVE COMPENSATION COMMITTEE, THE KISHHEALTH SYSTEM EXECUTIVE TOTAL COMPENSATION PROGRAM WILL BE COMPETITIVELY POSITIONED IN THE MARKET PLACE OF RELEVANT ORGANIZATIONS AND FALL WITHIN THE SAFE HARBOR GUIDELINES ESTABLISHED BY THE INTERMEDIATE SANCTIONS RULES. THE EXECUTIVE COMPENSATION COMMITTEE IS MADE UP OF THREE MEMBERS OF THE BOARD OF DIRECTORS WHO MEET THE BOARD APPROVED DEFINITION OF "INDEPENDENT DIRECTORS". ANNUALLY THE EXECUTIVE COMPENSATION COMMITTEE CONTRACTS WITH SULLIVAN, COTTER AND ASSOCIATES, AN INDEPENDENT HUMAN RESOURCES CONSULTING FIRM TO PROVIDE THE COMMITTEE ANALYSIS AND COMPARABILITY DATA. USING THE SUPPLIED DATA THE COMPENSATION COMMITTEE APPROVES EACH EXECUTIVE'S TOTAL CASH COMPENSATION AND PROVIDES CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. TOTAL CASH COMPENSATION IS DEFINED AS THE SUM OF BASE SALARIES PLUS INCENTIVE AWARDS. BASED ON THE COMPARABILITY DATA AND THE PERFORMANCE OF EACH EXECUTIVE IN MEETING GOALS AND STRATEGIC OBJECTIVES, THE EXECUTIVE COMPENSATION COMMITTEE APPROVES INCREASES AND INCENTIVE AWARDS FOR EACH EXECUTIVE WITHIN THE GUIDELINES ESTABLISHED. THE EXECUTIVE COMPENSATION COMMITTEE REPORTS ON ALL COMPENSATION MATTERS TO THE FULL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN WRITING TO ADMINISTRATION.
FORM 990, PART VII, COLUMN (B)	AVERAGE HOURS PER WEEK FOR THE INDIVIDUALS IDENTIFIED AS OFFICER'S ARE ESTIMATES OF THE INDIVIDUALS TOTAL TIME PER WEEK UTILIZED FOR WORK RELATED TO KISHWAUKEE COMMUNITY HOPSITAL.	DESCRIPTION OF HOURS FOR RELATED ORGANIZATIONS
FORM 990, PART IX, LINE 11G	PURCHASED PERSONNEL : PROGRAM SERVICE EXPENSES 900,374. MANAGEMENT AND GENERAL EXPENSES 6,822. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 907,196. OTHER CONTRACTED SERVICES : PROGRAM SERVICE EXPENSES 3,034,628. MANAGEMENT AND GENERAL EXPENSES 659,715. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,694,343. OTHER CONSULTING : PROGRAM SERVICE EXPENSES 40,741. MANAGEMENT AND GENERAL EXPENSES 250,522. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 291,263. MEDICAL DIRECTOR FEES : PROGRAM SERVICE EXPENSES 383,873. MANAGEMENT AND GENERAL EXPENSES 75,000. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 458,873. BROKER FEES : PROGRAM SERVICE EXPENSES 7,368. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,368. SERVICE CONTRACTS : PROGRAM SERVICE EXPENSES 654,028. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 654,028. LAB FEES : PROGRAM SERVICE EXPENSES 904,053. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 904,053. PHYSICIAN FEES : PROGRAM SERVICE EXPENSES 10,354,894. MANAGEMENT AND GENERAL EXPENSES 178,400. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,533,294.	OTHER FEES
FORM 990, PART XI, LINE 9:	EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM -3,573,000. CHANGE OF INTEREST IN NET ASSETS OF KISHHEALTH FOUNDATION 4,979. BOOK/TAX DIFFERENCES IN K-1 PASSTHROUGH ENTITIES 236,584. OTHER EQUITY ADJUSTMENT -8,246. CUMULATIVE EQUITY ADJUSTMENT -182,933. ROUNDING -30.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 3C	NO CHANGES IN THIS PROCESS WERE MADE DURING THE TAX YEAR. THE ORGANIZATION MAINTAINS AN INDEPENDENT AUDIT COMMITTEE WHICH IS RESPONSIBLE FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS. THIS COMMITTEE IS ALSO RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT AUDITOR. MEMBERS OF THE AUDIT COMMITTEE ARE ALSO MEMBERS OF THE KISHHEALTH SYSTEM BOARD OF DIRECTORS. KISHEALTH SYSTEM IS THE PARENT CORPORATION OF KISHWAUKEE COMMUNITY HOSPITAL.	RESPONSIBILITY FOR OVERSIGHT OF FINANCIAL STATEMENTS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg	Business Name Line1DirectControllingEntityName/BusinessNameLine1
KISHHEALTH SYSTEM
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	363649080	PARENT ORGANIZATION OF 501(C)(3) HEALTH SYSTEM	IL	501(C)(3)	11B	N/A	0
VALLEY WEST COMMUNITY HOSPITAL
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	364244337	HEALTHCARE SERVICES, PRIMARILY ACUTE CARE	IL	501(C)(3)	3		0	KISHHEALTH SYSTEM
DEKALB COUNTY HOSPICE
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	363164329	HEALTHCARE SERVICES, HOSPICE SERVICES	IL	501(C)(3)	7		0	KISHHEALTH SYSTEM
KISHHEALTH FOUNDATION
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	363649077	SUPPORT OF KISHWAUKEE HEALTH SYSTEM NOT FOR PROFIT ENTITIES	IL	501(C)(3)	7		0	KISHHEALTH SYSTEM
COMMUNITY CARES CLINIC
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	800424001	HEALTHCARE SERVICES, PRIMARY CARE	IL	501(C)(3)	3		0	KISHHEALTH SYSTEM
KISHWAUKEE PHYSICIANS GROUP INC
2240 GATEWAY DRIVE	SYCAMORE	IL	60178	651293967	HEALTHCARE SERVICES, PRIMARILY FAMILY PRACTICE	IL	501(C)(3)	3		0	KISHHEALTH SYSTEM
CENTER FOR FAMILY HEALTH - MALTA
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	800869393	HEALTHCARE SERVICES, PRIMARILY ACUTE CARE	IL	501(C)(3)	3		0	KISHHEALTH SYSTEM
KISHHEALTH SYSTEM HOME CARE
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	371703513	HEALTHCARE SERVICES, HOME CARE	IL	501(C)(3)	3		0	KISHHEALTH SYSTEM

Form990 Schedule R Part III Form990ScheduleRPartIII (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership	Direct Controlling Entity NADirectControllingEntityNA
KISHWAUKEE AREA PHO
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	364205273	MEDICARE SERVICES	IL	KISHWAUKEE COMMUNITY HOSPITAL	INVESTMENT	-20496	5326	0	0	0.50000
THE MIDLAND SURGICAL CENTER LLC
3085 WOLF COURT	DEKALB	IL	60115	352194610	SURGICAL SERVICES	IL	KISHWAUKEE COMMUNITY HOSPITAL	INVESTMENT	233354	291962	0	0	0.74500
HEALTH VENTURES LLC
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	753255958	RENTAL REAL ESTATE PROVIDED TO HEALTHCARE RELATED BUSINESSES	IL								N/A
ILLINOIS REGIONAL CANCER CENTER
10 HEALTH SERVICES DRIVE	DEKALB	IL	60115	363847273	CANCER TREATMENT SERVICES	IL								N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	HEALTH PROGRESS INC	BusinessNameLine1

Address US AddressUS

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 Activity	INVESTMENT IN HEALTHCARE RELATED SMALL BUSINESS	PrimaryActivity
Legal Domicile State	IL	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Type Of Entity	C	TypeOfEntity
Controlled Org	0	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	0	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	1	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	1	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	0	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	0	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	0	DividendsRelatedOrganization
Sale Of Assets To Other Org	0	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	0	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	0	ExchangeOfAssets
Rental Of Facilities To Other Orgs	1	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	1	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	0	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	0	PerformOfServicesByOtherOrgs
Sharing Of Facilities	0	SharingOfFacilities
Sharing Of Paid Employees	1	SharingOfPaidEmployees
Reimbursement Paid To Other Org	1	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	1	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	1	OtherTransferToOtherOrg
Other Transfer From Other Org	1	OtherTransferFromOtherOrg