FURP.ORG / PUBLIC DATA EXPLORER

KISHHEALTH SYSTEM: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
KISHHEALTH SYSTEM (EIN 36-3649080)
Tax period
2012-05-01 to 2013-04-30
Filed
2013-12-12
IRS object ID
201323469349300032
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-12-12T15:11:20-06:00Timestamp
Tax Period End Date2013-04-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN410746749EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1114 E EVERETTAddressLine1
CityDIXONCity
StateILState
ZIP Code61021ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN363649080EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1KISHHEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlKISHNameControl
Phone8157561521Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE KISH HOSPITAL DRIVEAddressLine1
CityDEKALBCity
StateILState
ZIP Code60115ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLOREN FOELSKEName
TitleVICE PRESIDENT - FINANCE, KHSTitle
Phone8157561521Phone
Date Signed2013-12-10DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKELLY JACKSON HARDYName
PTINP00747242PTIN
Phone8152842285Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKEVIN P POORTENNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1ONE KISH HOSPITAL DRIVEAddressLine1
CityDEKALBCity
StateILState
ZIP Code60115ZIPCode
FieldValueIRS element (for citing)
Gross Receipts21043173GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.KISHHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionMANAGEMENT AND PARENT ORGANIZATION PROVIDING SERVICES TO 501(C)(3) HEALTH SYSTEMActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees108TotalNbrEmployees
Total Nbr Volunteers14TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year17094568ProgramServiceRevenuePriorYear
Program Service Revenue CY17928735ProgramServiceRevenueCY
Investment Income Prior Year251703InvestmentIncomePriorYear
Investment Income Current Year232584InvestmentIncomeCurrentYear
Other Revenue Prior Year-90650OtherRevenuePriorYear
Other Revenue Current Year-129031OtherRevenueCurrentYear
Total Revenue Prior Year17255621TotalRevenuePriorYear
Total Revenue Current Year18032288TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year167500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY39269GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year11328378SalariesEtcPriorYear
Salaries Etc Current Year11664059SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5542178OtherExpensePriorYear
Other Expenses Current Year6147351OtherExpensesCurrentYear
Total Expenses Prior Year17038056TotalExpensesPriorYear
Total Expenses Current Year17850679TotalExpensesCurrentYear
Revenues Less Expenses Prior Year217565RevenuesLessExpensesPriorYear
Revenues Less Expenses CY181609RevenuesLessExpensesCY
Total Assets BOY22577087TotalAssetsBOY
Total Assets EOY27826655TotalAssetsEOY
Total Liabilities BOY13116831TotalLiabilitiesBOY
Total Liabilities EOY12659013TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9460256NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY15167642NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionMANAGEMENT AND PARENT ORGANIZATION PROVIDING SERVICES TO 501 (C) (3) HEALTH SYSTEM. WE ARE THE CORNERSTONE OF HEALTH CARE FOR THE COMMUNITIES WE SERVE-THE FIRST CHOICE FOR SERVICE, COMFORT AND SAFETY. AS A COMMUNITY-OWNED HEALTH SYSTEM, THE KISH FAMILY UNSELFISHLY COMMITS TO EXCELLENCE, EDUCATION AND INNOVATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense1675999Expense
Grants39269Grants
Revenue17928735Revenue
DescriptionKISHHEALTH SYSTEM (KHS) IS THE NON-PROFIT CORPORATE UMBRELLA FOR TWO HOSPITALS, A HOSPICE, CLINIC, HOME HEALTH CARE SERVICE, AND A HEALTH FOUNDATION PREDOMINATELY SERVING RESIDENTS OF DEKALB, KENDALL AND LASALLE COUNTIES IN ILLINOIS. THE MISSION OF THE HEALTH SYSTEM IS TO BE "THE CORNERSTONE OF HEALTH CARE FOR THE COMMUNITIES WE SERVE-THE FIRST CHOICE FOR SERVICE, COMFORT AND SAFETY. AS A COMMUNITY-OWNED HEALTH SYSTEM, THE KISH FAMILY UNSELFISHLY COMMITS TO EXCELLENCE, EDUCATION AND INNOVATION." IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE, CENTER FOR FAMILY HEALTH, CENTER FOR FAMILY HEALTH MALTA, KISHHEALTH HOME CARE, AND KISHHEALTH FOUNDATION, THE HEALTH SYSTEM'S CORPORATE OFFICE PROVIDES COMMUNITY BENEFIT IN THE FOLLOWING AREAS:* KISHHEALTH SYSTEM UNDERWROTE MORE THAN $900,000 IN OPERATIONAL LOSSES IN FY 13 FOR THE CENTER FOR FAMILY HEALTH, $215,100 FOR CENTER FOR FAMILY HEALTH-MALTA, $863,100 FOR KISHHEALTH HOME CARE, AND MORE THAN $3,000,000 FOR KISHWAUKEE PHYSICIAN'S GROUP, ALL VITAL SERVICES FOR THE HEALTH OF THE COMMUNITY. IT ALSO MADE OVER $30,000 IN CONTRIBUTIONS TO SEVERAL ORGANIZATIONS IN FY13. NOTABLE CONTRIBUTIONS INCLUDE THOSE MADE TO HELP THE DEKALB CHAMBER OF COMMERCE, AND RENEW DEKALB.KISHHEALTH SYSTEM EMPLOYEE CONTRIBUTED 1,144 OF HOURS OF IN-KIND SERVICE TO COMMUNITY ORGANIZATIONS, EDUCATIONAL INSTITUTIONS AND OTHER ACTIVITIES THAT PROMOTE HEALTH AND EDUCATION. KISHHEALTH SYSTEM LEADERS SERVE ON THE BOARDS OF DIRECTORS FOR LIVE HEALTHY DEKALB COUNTY, FORMERLY KNOWN AS PIONEERING HEALTHY COMMUNITIES, KISHWAUKEE FAMILY YMCA, KISHWAUKEE COLLEGE FOUNDATION, OPPORTUNITY HOUSE, VOLUNTARY ACTION CENTER, DEKALB COUNTY YOUTH SERVICES BOARD, DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION; DEKALB, SYCAMORE GENOA, SANDWICH AND PLANO CHAMBERS OF COMMERCE; THE CENTER FOR FAMILY HEALTH, FOX VALLEY OLDER ADULT SERVICES, NORTHERN ILLINOIS UNIVERSITY, WABAUNSEE COMMUNITY COLLEGE AND ST. ANTHONY SCHOOL OF NURSING ADVISORY BOARDS.* THE HEALTH SYSTEM'S NON-PROFIT ENTITIES ARE KISHWAUKEE COMMUNITY HOSPITAL, A 98-BED HOSPITAL IN DEKALB IL, SERVING ALL OF DEKALB COUNTY AND BEYOND; VALLEY WEST COMMUNITY HOSPITAL, A 25-BED CRITICAL ACCESS HOSPITAL IN SANDWICH; DEKALB COUNTY HOSPICE, DEKALB, IL, WHICH PROVIDES FREE CARE AND SUPPORT FOR THE TERMINALLY ILL AS WELL AS GRIEF SUPPORT TO THE PUBLIC; CENTER FOR FAMILY HEALTH, DEKALB AND MALTA, IL, PRIMARY CARE CLINICS FOR MEDICAID AND UNINSURED; KISHHEALTH PHYSICIAN GROUP, WHICH PROVIDES ACCESS TO MEDICAL SERVICES, ESPECIALLY THE RURAL AREAS AND ACCEPTS MEDICAID AND UNINSURED PATIENTS; KISHHEALTH HOME CARE, DEKALB, IL, WHICH PROVIDES HOME HEALTH SERVICES PREVIOUSLY OFFERED THROUGH THE COUNTY HEALTH DEPARTMENT, AND KISHHEALTH FOUNDATION IN DEKALB, IL, WHICH RAISES MONEY FOR THE HEALTH SYSTEM AND FUNDS EQUIPMENT PURCHASES AND PATIENT SERVICES PARTICULARLY IN THE AREA OF CANCER CARE FOR THOSE WHO CANNOT AFFORD.Description
Total Program Service Expense1675999TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities1ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member1BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109628NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees108NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1LOREN FOELSKE VP - FINANCEBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8157561521TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KISH HOSPITAL DRIVEAddressLine1
CityDEKALBCity
StateILState
ZIP Code60115ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (30 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
MICHAEL CULLEN
PAST CHAIR2.009.00XX000
TERRENCE DUFFY
DIRECTOR2.001.00X000
MICHAEL LARSON
CHAIR2.00XX000
JOHN MOULTON
2ND VICE CHAIR2.001.00XX000
THOMAS MATYA
VICE CHAIR2.003.00XX000
MARY LYNN MCARTOR
DIRECTOR2.00X000
KEVIN POORTEN
DIRECTOR/PRESIDENT & CEO -30.0025.00XX9664720220153
BRADLEY WALLER
DIRECTOR (THRU JAN 2013)2.00X000
JAGDISH PATEL MD
DIRECTOR2.001.00X0369750
PROMOD VOHRA
DIRECTOR2.00X000
THOMAS CHOICE
DIRECTOR2.00X000
UMESH GOSWAMI MD
DIRECTOR (THRU NOV 2012)2.00X000
PHOTINE LIAKOS MD
DIRECTOR2.00X000
LEONETTA RIZZI
DIRECTOR2.00X000
ANN WEST MD
DIRECTOR2.001.00X000
TIMOTHY RUETTEN MD
DIRECTOR2.00X000
LOREN FOELSKE
VP FINANCE9.0037.00X2847340117504
BRAD COPPLE
PRESIDENT - KCH & VWCH4.0043.00X359637072184
JOSEPH DANT
VP BUSINESS DEVELOPMENT30.0015.00255673045841X
MICHAEL KOKOTT
ASST. VP MKTG & PLANNING15.0030.00194828034842X
ROGER HEATH BELL
VP AND CIO20.0027.00273572051107X
PAM DUFFY
VP PATIENT CARE SVCS20.0025.00249153030870X
MARK THATE
VP - HUMAN RESOURCES25.0020.00273139026286X
MICHAEL MUZZILLO THRU 62912
VP OPERATIONS - VWCH4.0047.00229519012427X
DR MICHAEL KULISZ
CHIEF MEDICAL OFFICER20.0032.00402706099258X
CHERYL FISHER
DIRECTOR OF RISK MANAGEMENT45.00156287030649X
CRAIG VILLACORTA
DIRECTOR OF INFORMATION SY45.00114534030568X
JEFFERY REIFSTECK
TECHNICAL OPERATIONS MANAG45.00110215031791X
SHELLY JOHNSON
DIRECTOR OF CENTER FOR FAMILY HEALTH4.0037.00100621028073X
PHILIP JOHNSON THRU 7612
DIRECTOR OF ACCOUNTING (TERMINATED DURING FY 13)45.00105606011511X
FieldValueIRS element (for citing)
Total Reportable Comp From Org4076696TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs36975TotalReportableCompFrmRltdOrgs
Total Other Compensation843064TotalOtherCompensation
Number Individuals GT100 K16NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
REINHART BOERNER VANDEUREN
PO BOX 2965MILWAUKEEIL532012965LEGAL SERVICES1192485
AURORA RADIOLOGY
1870 WEST GALENA BLVDAURORAIL60506MEDICAL SERVICES440185
MICROSOFT
PO BOX 842467DALLASTX75284INFORMATION TECHNOLOGY SERVICES343543
CLIFTONLARSONALLEN
114 E EVERETTDIXONIL61021ACCOUNTING SERVICES161450
POWER CONSTRUCTION COMPANY LLC
2360 NORTH PALMER DRIVESCHAUMBURGIL60173CONSTRUCTION SERVICES130999
FieldValueIRS element (for citing)
Number Of Contractors GT100 K6NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionKHS ADMINISTRATION HEALTH SYSTEMDescription
Business Code551112BusinessCode
Total Revenue Column17928735TotalRevenueColumn
Related Or Exempt Function Income17928735RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue17928735TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column237568TotalRevenueColumn
Exclusion$237,568ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real120421Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real250115Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-129694Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-129694TotalRevenueColumn
Exclusion-$129,694ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2755786Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2760770Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-4984Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-4984TotalRevenueColumn
Exclusion-$4,984ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS INCOMEDescription
Business Code551112BusinessCode
Total Revenue Column663TotalRevenueColumn
Exclusion$663ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue663TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column18032288TotalRevenueColumn
Related Or Exempt Function Income17928735RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$103,553ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total39269Total
Program Services39269ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4114925Total
Management And General4114925ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total5137392Total
Program Services134587ProgramServices
Management And General5002805ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total337059Total
Program Services7481ProgramServices
Management And General329578ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1514174Total
Program Services27906ProgramServices
Management And General1486268ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total560509Total
Program Services8580ProgramServices
Management And General551929ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total772529Total
Management And General772529ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total120000Total
Management And General120000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total822611Total
Management And General822611ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total161600Total
Management And General161600ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total491708Total
Management And General491708ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1392371Total
Management And General1392371ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total591120Total
Program Services87648ProgramServices
Management And General503472ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total255771Total
Management And General255771ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total23001Total
Management And General23001ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1364407Total
Program Services1364407ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total6651Total
Program Services6121ProgramServices
Management And General530ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneral
DUES AND SUBSCRIPTIONS9035090350
RECRUITMENT FEES5396353963
MISCELLANEOUS EXPENSE12691269

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total17850679Total
Program Services1675999ProgramServices
Management And General16174680ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2304447BOY
EOY2231333EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY82832BOY
EOY103892EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY185BOY
EOY697EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY598705BOY
EOY522939EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis8847014LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2884261LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5533547BOY
EOY5962753EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY7909893BOY
EOY8767925EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY4412256BOY
EOY9049472EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1735222BOY
EOY1187644EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY22577087BOY
EOY27826655EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10255691BOY
EOY11515671EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY440206BOY
EOY257962EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2420934BOY
EOY885380EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY13116831BOY
EOY12659013EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY9460256BOY
EOY15167642EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9460256BOY
EOY15167642EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY22577087BOY
EOY27826655EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses181609ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-48241ReconciliationUnrealizedInvest
Reconcilation Other Changes5574018ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type2XSupportingOrg509a3Type2
Certification CheckboxXCertificationCheckbox
Written IRS DeterminationXWrittenIRSDetermination
Contrib By Controlling Individual0ContribByControllingIndividual
Contribution By Related Party0ContributionByRelatedParty
Contrib By35 Controlled Entity0ContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (8 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
KISHWAUKEE COMMUNITY HOSPITAL
23708704103111$0
VALLEY WEST COMMUNITY HOSPITAL
36424433703111$0
DEKALB COUNTY HOSPICE
36316432907111$0
KISHHEALTH FOUNDATION
36364907707111$550,000
CENTER FOR FAMILY HEALTH
80042400103111$900,000
KISHWAUKEE PHYSICIANS GROUP INC
65129396704111$3,000,000
CENTER FOR FAMILY HEALTH - MALTA
80086939303111$215,100
KISHHEALTH HOME CARE
37170351303111$863,100
FieldValueIRS element (for citing)
Total Number Of Supported Orgs8TotalNumberOfSupportedOrgs
Sum Of Amounts5528200SumOfAmounts

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1713988OtherCostOrOtherBasis
Book Value1713988BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1496912OtherCostOrOtherBasis
Depreciation109339Depreciation
Book Value1387573BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis1126618OtherCostOrOtherBasis
Depreciation310801Depreciation
Book Value815817BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3662118OtherCostOrOtherBasis
Depreciation2464121Depreciation
Book Value1197997BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis847378OtherCostOrOtherBasis
Book Value847378BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5962753TotalOfBookValueLandBuildings

Closely Held Equity Interests CloselyHeldEquityInterests

FieldValueIRS element (for citing)
Book Value8533209BookValue
Method Of ValuationCMethodOfValuation

Other Securities OtherSecurities (3 entries)

DescriptionDescriptionBook ValueBookValueMethod Of ValuationMethodOfValuation
CASH EQUIVALENTS5469F
CERTIFICATES OF DEPOSIT455255F
ACCRUED INTEREST55539F
FieldValueIRS element (for citing)
Total Of Book Value Securities9049472TotalOfBookValueSecurities

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDUE TO SUBSIDIARY ORGANIZATIONSDescription
Amount$885,380Amount
FieldValueIRS element (for citing)
Total Of Amounts885380TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt-495555TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-48241NetUnrealizedGainsInvestments
Revenue Not Rptd F990-48241RevenueNotRptdF990
Revenue Subtotal-447314RevenueSubtotal
Other Revenues Not Included18479602OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt18479602RevenueNotRptdOnFinStmt
Total Revenue Per Form99018032288TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt172059TotExpensesEtcAuditedFinclStmt
Other Expenses Included250115OtherExpensesIncluded
Expenses Not Rptd F990250115ExpensesNotRptdF990
Expenses Subtotal-78056ExpensesSubtotal
Other Expenses Not Included17928735OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt17928735ExpensesNotRptdOnFinStmt
Total Expenses Per Form99017850679TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE SYSTEM, KCH, VWCH, KHF, KPG, DCH, CFHP (CCC), CFHM, AND KHC ARE TAX-EXEMPT ORGANIZATIONS UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HPI IS A TAXABLE ORGANIZATION AND FILES A CORPORATE INCOME TAX RETURN, WHICH INCLUDES OPT, IRCC, AND HVL. THE SYSTEM FILES VARIOUS FORM 990'S (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). UBIT IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50 PERCENT LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING STATEMENTS OF FINANCIAL POSITION ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AT APRIL 30, 2013 AND 2012, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED.
PART XI, LINE 4B - OTHER ADJUSTMENTS:LOSS ON SUBSIDIARY, HPI, REPORTED ON SEPARATE COMPANY RETURN 800,982. MANAGEMENT FEES PAID TO KHS, REPORTED AS EXPENSES ON FINANCIAL STATEMENTS 17,928,735. RENTAL EXPENSES NETTED WITH INCOME FOR FORM 990 -250,115.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENTAL EXPENSES NETTED WITH INCOME FOR FORM 990 250,115.
PART XII, LINE 4B - OTHER ADJUSTMENTS:MANAGEMENT FEES PAID TO KHS, REPORTED AS EXPENSES ON FINANCIAL STATEMENTS 17,928,735. ROUNDING

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
RENEW DEKALB
111 S SECOND STREET 201DEKALBIL60115760834191501(C)(3)5000TO PROVIDE FINANCIAL ASSISTANCE FOR ECONOMIC DEVELOPMENT PROGRAMS AND ACTIVITIES RELATED TO DOWNTOWN DEKALB RENEWAL
OSF SAINT ANTHONY MEDICAL CENTER FOUNDATION
5666 E STATE STREETROCKFORDIL61108371259284501(C)(3)7500TO PROVIDE FINANCIAL ASSISTANCE IN CONNECTION WITH SUPPORT OF PHILANTHROPIC EFFORTS THAT IMPACT THE CARE OF PATIENTS FROM OUR COMMUNITY.
DEKALB COUNTY CHAMBER OF COMMERCE
164 E LINCOLNWAYDEKALBIL60115360961630501(C)(6)7000TO PROVIDE FINANCIAL ASSISTANCE FOR SERVING AND ADVANCING BUSINESS INTERESTS IN THE DEKALB REGION.
DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION
421 N CALIFORNIA STREET STE 200SYCAMOREIL60178363524353501(C)(3)14375TO PROVIDE FINANCIAL ASSISTANCE FOR PROMOTING THE VALUE OF THE DEKALB COUNTY ECONOMY.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: REQUESTS FOR FINANCIAL ASSISTANCE FROM OTHER CHARITABLE ORGANIZATIONS ARE REVIEWED AND APPROVED BY THE CEO OF KISHHEALTH SYSTEM. IF NECESSARY DUE TO THE DOLLAR AMOUNT OF THE REQUEST, THESE ITEMS MAY ALSO BE PRESENTED TO THE BOARD OF DIRECTORS. A BUDGET IS SET ANNUALLY FOR CHARITABLE ASSISTANCE TO OTHER ORGANIZATIONS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment1SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEVIN POORTEN
DIRECTOR/PRESIDENT & CEO -54833301681390250000019610002405301186625000
LOREN FOELSKE
VP FINANCE256230028504000942860232180402238000
BRAD COPPLE
PRESIDENT - KCH & VWCH290654068983000487000234840431821000
JOSEPH DANT
VP BUSINESS DEVELOPMENT215055040618000226960231450301514000
MICHAEL KOKOTT
ASST. VP MKTG & PLANNING164639030189000194240154180229670000
ROGER HEATH BELL
VP AND CIO216114057458000227120283950324679000
PAM DUFFY
VP PATIENT CARE SVCS20527504387800021863090070280023000
MARK THATE
VP - HUMAN RESOURCES1751490407900572000107070155790299425000
MICHAEL MUZZILLO THRU 62912
VP OPERATIONS - VWCH10790503121409040001187605510241946000
DR MICHAEL KULISZ
CHIEF MEDICAL OFFICER310004092702000759000233580501964000
CHERYL FISHER
DIRECTOR OF RISK MANAGEMENT13145602483100087640218850186936000

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

Return ReferenceReturnReferenceExplanationExplanation
PART I, LINE 1AKISHHEALTH SYSTEM PROVIDES PAYMENT FOR SOCIAL CLUB DUES FOR THE CEO AND PRESIDENT - KCH & VWCH OF THE ORGANIZATION. KISHHEALTH SYSTEM ALSO PROVIDES PAYMENT FOR AUTOMOBILE ALLOWANCE FOR THE CEO, PRESIDENT - KCH & VWCH, VP BUSINESS DEVELOPMENT, AND THE AVP PLANNING & MARKETING OF THE ORGANIZATION. SUCH PAYMENTS ARE REPORTED AS TAXABLE COMPENSATION ON THE INDIVIDUAL'S FORM W-2.
PART I, LINES 4A-BPHILLIP JOHNSON, DIRECTOR OF ACCOUNTING, RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF $54,070 DURING FY13. HE TERMINATED EMPLOYMENT WITH KISHWAUKEE HEALTH SYSTEM ON 7/6/2012. 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 SYSTEM 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.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
HEALTH PROGRESS INC
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION319327KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. THE PURPOSE OF KHS IS TO PROVIDE MANAGEMENT AND SUPPORT SERVICES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH PROVIDE HEALTHCARE SERVICES. FEES PAID TO KHS ARE IN EXCHANGE FOR THESE SERVICES, INCLUDING THE ORGANIZATIONS SHARE OF COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES.0
HEALTH PROGRESS INC
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION486096KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. KHS LEASES BUILDING SPACE FROM HEALTH PROGRESS, INC.0
HEALTH PROGRESS INC
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION1025000KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. DURING THE FISCAL YEAR, KHS MADE AN EQUITY CONTRIBUTION TO HEALTH PROGRESS, INC.0
ANJUL VOHRA
SPOUSE OF MEMBER OF THE BOARD OF DIRECTORS155402MRS. VOHRA IS THE SPOUSE OF PROMOD VOHRA, WHO IS A MEMBER OF THE BOARD OF DIRECTORS OF KISHHEALTH SYSTEM.0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2KEVIN POORTEN AND LOREN FOELSKE ARE BOTH EMPLOYEES OF KISHHEALTH SYSTEM. HOWEVER, THEY ALSO SERVE ON THE BOARD OF DIRECTORS OR AS OFFICERS OF THE RELATED TAX-EXEMPT SUBSIDIARY ORGANIZATIONS, INCLUDING KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE, CENTER FOR FAMILY HEALTH, CENTER FOR FAMILY HEALTH MALTA, KISHHEALTH HOME CARE, AND KISHHEALTH FOUNDATION. MR. POORTEN IS PRESIDENT AND CEO OF KISHHEALTH SYSTEM AND SERVES AS AN EX-OFFICIO DIRECTOR FOR ALL ORGANIZATIONS RELATED TO KISHHEALTH SYSTEM. MR. FOELSKE SERVES AS THE VICE-PRESIDENT - FINANCE OF KISHHEALTH SYSTEM, AND SERVES AS THE TOP FINANCIAL OFFICIAL FOR ALL RELATED ENTITIES. THE FOLLOWING INDIVIDUALS ARE OFFICERS OR KEY EMPLOYEES OF KISHHEALTH SYSTEM AND ARE ALSO CONSIDERED KEY EMPLOYEES OF VALLEY WEST COMMUNITY HOSPITAL AND KISHWAUKEE COMMUNITY HOSPITAL. THEY ARE ALL COMPENSATED BY KISHHEALTH SYSTEM: BRAD COPPLE, PRESIDENT KCH & VWCH PAM DUFFY, VP PATIENT CARE JOE DANT, VP DEVELOPMENT MIKE KOKOTT, ASST. VP MARKETING ROGER HEALTH BELL, VP AND CHIEF INFORMATION OFFICER MARK THATE, VP HUMAN RESOURCES DR. MICHAEL KULISZ, CHIEF MEDICAL OFFICER MICHAEL MUZZILLO, VP OPERATIONS, VWCH (TERMINATED DURING FY13) SEVERAL MEMBERS OF THE KISHHEALTH SYSTEM BOARD OF DIRECTORS ALSO SERVE ON THE BOARD OF DIRECTORS FOR A RELATED ENTITY. ALL ENTITIES ARE WHOLLY OWNED SUBSIDIARIES OF KISHHEALTH SYSTEM. THESE MEMBERS INCLUDE: MICHAEL CULLEN, ALSO SERVES ON KISHWAUKEE COMMUNITY HOSPITAL, CENTER FOR FAMILY HEALTH, CENTER FOR FAMILY HEALTH MALTA, AND KISHWAUKEE PHYSICIANS GROUP BOARDS. TERRENCE DUFFY, ALSO SERVES ON VALLEY WEST COMMUNITY HOSPITAL BOARD JOE DANT, ALSO SERVES ON CENTER FOR FAMILY HEALTH, CENTER FOR FAMILY HEALTH MALTA, KISH HEALTH HOME CARE AND HEALTH PROGRESS, INC BOARDS. ANN WEST, ALSO SERVES ON KISHHEALTH FOUNDATION BOARD DR. MICHAEL KULISZ, ALSO SERVES ON BOARDS OF KISHWAUKEE PHYSICIANS GROUP AND KISH HEALTH HOME CARE PAM DUFFY ALSO SERVES ON THE BOARD OF KISH HEALTH HOME CARE JAGDISH PATEL ALSO SERVES ON THE VALLEY WEST COMMUNITY HOSPITAL BOARD. TOM MATYA, ALSO SERVES ON KISHHEALTH FOUNDATION BOARD AND KISHWAUKEE COMMUNITY HOSPITAL BOARD JOHN MOULTON, ALSO SERVES ON HEALTH PROGRESS, INC. BOARD IN ADDITION, PROMOD VOHRA SERVES AS A DIRECTOR OF KHS. HIS WIFE IS AN EMPLOYEE OF KHS. DR. PHOTINE LIAKOS, ALSO SERVES AS A BOARD DIRECTOR OWNS AN INTEREST IN MIDLAND SUGICAL CENTER. KISHWAUKEE COMMUNITY HOSPITAL, A SUBSIDIARY OF KHS, OWNS A 74.5% INTEREST IN THIS ENTITY.
FORM 990, PART VI, SECTION A, LINE 6KISHHEALTH SYSTEM MAINTAINS SEVERAL CLASSES OF MEMBERS. THEY ARE AS FOLLOWS: KHS SHALL HAVE HONORARY MEMBERS WHO SHALL NOT HAVE VOTING RIGHTS IN THE CORPORATION. HONORARY MEMBERS SHALL CONTINUE AS HONORARY MEMBERS PROVIDED THEY HAVE SATISFIED THE REQUIREMENTS OF MEMBERSHIP. HONORARY MEMBERS SHALL NOT HAVE MEETINGS EXCEPT THAT (I) HONORARY MEMBERS SHALL BE INVITED TO ATTEND INFORMATIONAL MEETINGS AS CALLED BY THE BOARD OF DIRECTORS FROM TIME TO TIME; AND (II) HONORARY MEMBERS SHALL BE INVITED TO ATTEND A SPECIAL INFORMATIONAL MEETING PRIOR TO THE ADOPTION BY THE KHS BOARD OF ANY OF THE ACTIONS THAT ARE DESCRIBED IN SECTION 4.1.D, G, H OR Q BELOW (WITH RESPECT TO KHS, KCH OR VWCH). ANY PERSON (WHICH TERM SHALL INCLUDE, FOR PURPOSES OF THIS SECTION 3.1, INDIVIDUALS AND FIRMS, CORPORATIONS, ASSOCIATIONS, CLUBS, OR SOCIETIES FOR THE DURATION OF THEIR EXISTENCE) MAY BECOME AN HONORARY MEMBER OF KHS PERMANENTLY OR FROM TIME TO TIME, AS THE CASE MAY BE, BY MEETING THE QUALIFICATIONS FOR ONE OF THE FOLLOWING CATEGORIES OF MEMBERS: A. PARTICIPATING MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING $100 OR MORE BUT LESS THAN $500 IN VALUE TO KHS, KCH, VWCH OR THE HEALTH FOUNDATION SHALL BE A PARTICIPATING MEMBER OF KHS. ANY PERSON DESIGNATED A PARTICIPATING MEMBER SHALL RETAIN SUCH DESIGNATION FOR ONE YEAR FOLLOWING THE DATE OF HIS, HER OR ITS QUALIFYING CONTRIBUTION. B. CONTRIBUTING MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING $500 OR MORE BUT LESS THAN $5,000 IN VALUE TO KHS, KCH, VWCH OR THE HEALTH FOUNDATION SHALL BE A CONTRIBUTING MEMBER OF KHS. ANY PERSON DESIGNATED A CONTRIBUTING MEMBER SHALL RETAIN SUCH DESIGNATION FOR ONE YEAR FOLLOWING THE DATE OF HIS, HER OR ITS QUALIFYING CONTRIBUTION. C. LIFE MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING AT ANY TIME $5,000 OR MORE BUT LESS THAN $10,000 IN VALUE TO KHS, KCH, VWCH OR THE HEALTH FOUNDATION SHALL BE A LIFE MEMBER OF KHS. ANY PERSON DESIGNATED A LIFE MEMBER SHALL RETAIN SUCH DESIGNATION. D. FOUNDER. ANY PERSON WHO HAS CONTRIBUTED OR PLEDGED PROPERTY OR CASH OR BOTH AGGREGATING AT ANY TIME $10,000 OR MORE IN VALUE TO KHS, KCH, VWCH OR THE HEALTH FOUNDATION SHALL BE A FOUNDER OF KHS. ANY PERSON DESIGNATED A FOUNDER SHALL RETAIN SUCH DESIGNATION. E. SERVICE MEMBER. (1) ANY PERSON WHO HAS CONTRIBUTED AT LEAST 60 HOURS ON A FISCAL YEAR BASIS OF UNPAID VOLUNTARY SERVICE TO KCH OR VWCH SHALL BECOME A SERVICE MEMBER OF KHS. (2) ANY PERSON WHO SERVES ON THE KHS BOARD OR ON ANY GOVERNING BOARD OF ANY SUBSIDIARY CORPORATION OF KHS SHALL BE A SERVICE MEMBER OF KHS WHILE SERVING ON THE KHS BOARD OR SUCH SUBSIDIARY CORPORATION BOARD.
FORM 990, PART VI, SECTION B, LINE 11A 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 12CCONFLICTS 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 15THROUGH 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 19THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN WRITING TO ADMINSTRATION.
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 KISHHEALTH SYSTEM.DESCRIPTION OF HOURS FOR RELATED ORGANIZATIONS
FORM 990, PART XI, LINE 9:LOSS ON EQUITY METHOD SUBSIDIARY REPORTED ON SEPARATE COMPANY RETURN - HPI -800,982. EQUITY CONTRIBUTION TO SUBSIDIARIES -550,000. EQUITY DISTRIBUTION FROM SUBSIDIARIES 6,925,000.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 3CNO 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.RESPONSIBILITY FOR OVERSIGHT OF FINANCIAL STATEMENTS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (8 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
KISHWAUKEE COMMUNITY HOSPITAL
ONE KISH HOSPITAL DRIVEDEKALBIL60115237087041HEALTHCARE SERVICES, PRIMARILY ACUTE CAREIL501(C)(3)3KISHHEALTH SYSTEM1
VALLEY WEST COMMUNITY HOSPITAL
ONE KISH HOSPITAL DRIVEDEKALBIL60115364244337HEALTHCARE SERVICES, PRIMARILY ACUTE CAREIL501(C)(3)3KISHHEALTH SYSTEM1
DEKALB COUNTY HOSPICE
ONE KISH HOSPITAL DRIVEDEKALBIL60115363164329HEALTHCARE SERVICES, PRIMARILY HOSPICE SERVICESIL501(C)(3)7KISHHEALTH SYSTEM1
KISHHEALTH FOUNDATION
ONE KISH HOSPITAL DRIVEDEKALBIL60115363649077SUPPORT OF KISHWAUKEE HEALTH SYSTEM NOT FOR PROFIT ENTITIESIL501(C)(3)7KISHHEALTH SYSTEM1
COMMUNITY CARES CLINIC
ONE KISH HOSPITAL DRIVEDEKALBIL60115800424001HEALTHCARE SERVICES, PRIMARILY ACUTE CAREIL501(C)(3)7KISHHEALTH SYSTEM1
KISHWAUKEE PHYSICIAN GROUP INC
ONE KISH HOSPITAL DRIVESYCAMOREIL60178651293967HEALTHCARE SERVICES, PRIMARILY FAMILY PRACTICEIL501(C)(3)3KISHHEALTH SYSTEM1
CENTER FOR FAMILY HEALTH - MALTA
ONE KISH HOSPITAL DRIVEDEKALBIL60115800869393HEALTHCARE SERVICES, PRIMARILY ACUTE CAREIL501(C)(3)3KISHHEALTH SYSTEM1
KISHHEALTH SYSTEM HOME CARE
ONE KISH HOSPITAL DRIVEDEKALBIL60115371703513HEALTHCARE SERVICES, HOME CAREIL501(C)(3)3KISHHEALTH SYSTEM1

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnershipDirect Controlling Entity NADirectControllingEntityNA
HEALTH VENTURES LLC
ONE KISH HOSPITAL DRIVEDEKALBIL60115753255958RENTAL REAL ESTATE PROVIDED TO HEALTHCARE RELATED BUSINESSESILHEALTH PROGRESS INCRELATED15187305083010.51000
KISHWAUKEE AREA PHO
ONE KISH HOSPITAL DRIVEDEKALBIL60115364205273MEDICARE SERVICESILN/A
ILLINOIS REGIONAL CANCER CENTER
10 HEALTH SERVICES DRIVEDEKALBIL60115363847273CANCER TREATMENT SERVICESILHEALTH PROGRESS INCRELATED3737931309751000.51000
MIDLAND SURGICAL CENTER LLC
3085 WOLF COURTDEKALBIL60115352194610SURGICAL SERVICESILKISHWAUKEE COMMUNITY HOSPITALRELATED233354291962000.74500
(no name)
N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1HEALTH PROGRESS INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1ONE KISH HOSPITAL DRIVEAddressLine1
CityDEKALBCity
StateILState
ZIP Code60115ZIPCode
FieldValueIRS element (for citing)
EIN363824138EIN
Primary ActivityINVESTMENT IN HEALTHCARE RELATED SMALL BUSINESSPrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1KISHHEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of Total Income-800982ShareOfTotalIncome
Share Of EOY Assets4236564ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
Controlled Org1ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (35 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
KISHWAUKEE COMMUNITY HOSPITAL
S3573000FAIR MARKET VALUE
VALLEY WEST COMMUNITY HOSPITAL
S3352000FAIR MARKET VALUE
KISHWAUKEE COMMUNITY HOSPITAL
O13362767FAIR MARKET VALUE
VALLEY WEST COMMUNITY HOSPITAL
O3893917FAIR MARKET VALUE
DEKALB COUNTY HOSPICE
O90713FAIR MARKET VALUE
KISHHEALTH FOUNDATION
O47716FAIR MARKET VALUE
HEALTH PROGRESS INC
O319327FAIR MARKET VALUE
DEKALB COUNTY HOSPICE
Q90000FAIR MARKET VALUE
VALLEY WEST COMMUNITY HOSPITAL
Q1685338FAIR MARKET VALUE
HEALTH PROGRESS INC
Q533634FAIR MARKET VALUE
KISHWAUKEE COMMUNITY HOSPITAL
Q9275343FAIR MARKET VALUE
KISHWAUKEE COMMUNITY HOSPITAL
J87648FAIR MARKET VALUE
HEALTH PROGRESS INC
P104470FAIR MARKET VALUE
KISHWAUKEE COMMUNITY HOSPITAL
P50390811FAIR MARKET VALUE
KISHHEALTH FOUNDATION
P6769FAIR MARKET VALUE
VALLEY WEST COMMUNITY HOSPITAL
P8780389FAIR MARKET VALUE
COMMUNITY CARES CLINIC INC
Q116491FAIR MARKET VALUE
DEKALB COUNTY HOSPICE
P725790FAIR MARKET VALUE
HEALTH PROGRESS INC
K486086FAIR MARKET VALUE
CENTER FOR FAMILY HEALTH - MALTA
B215100FAIR MARKET VALUE
CENTER FOR FAMILY HEALTH
B900000FAIR MARKET VALUE
HEALTH PROGRESS INC
B1025000FAIR MARKET VALUE
KISHWAUKEE PHYSICIANS GROUP
B3000000FAIR MARKET VALUE
KISHWAUKEE PHYSICIANS GROUP
P1862313FAIR MARKET VALUE
KISHWAUKEE PHYSICIANS GROUP
Q150000FAIR MARKET VALUE
KISHHEALTH FOUNDATION
B550000FAIR MARKET VALUE
KISHHEALTH HOME CARE
B863100FAIR MARKET VALUE
KISHHEALTH HOME CARE
O42727FAIR MARKET VALUE
KISHWAUKEE PHYSICIANS GROUP
O171569FAIR MARKET VALUE
KISHWAUKEE COMMUNITY HOSPITAL
K17375FAIR MARKET VALUE
CENTER FOR FAMILY HEALTH - MALTA
S96686FAIR MARKET VALUE
COMMUNITY CARES CLINIC INC
P3953FAIR MARKET VALUE
CENTER FOR FAMILY HEATLH - MALTA
P93070FAIR MARKET VALUE
KISHHEALTH SYSTEM HOME CARE
P302025FAIR MARKET VALUE
KISHHEALTH SYSTEM HOME CARE
Q10048FAIR MARKET VALUE