ROCKFORD HEALTH PHYSICIANS: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- ROCKFORD HEALTH PHYSICIANS (EIN 36-3907436)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-07
- IRS object ID
- 201203139349300010
- Schema version
- 2011v1.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-07T15:49:32-00:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 Market St Ste 1700 | AddressLine1 |
| City | Philadelphia | City |
| State | PA | State |
| ZIP Code | 19103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363907436 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rockford Health Physicians | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ROCK | NameControl |
| Phone | 8159715000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2300 N Rockton Ave | AddressLine1 |
| City | Rockford | City |
| State | IL | State |
| ZIP Code | 61103 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Henry M Seybold | Name |
| Title | Sr Vice President of Finance CFO | Title |
| Date Signed | 2012-11-06 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Matthew Petroski | Name |
| Phone | 2673303000 | Phone |
| Date Prepared | 2012-11-06 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Gary Kaatz | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 N Rockton Ave | AddressLine1 |
| City | Rockford | City |
| State | IL | State |
| ZIP Code | 61103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 84944793 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.RHSNET.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1993 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | To improve and protect the health and welfare of the community we have 175 providers skilled at 30 specialities. Our physicians also provide staff for Rockford Memorial Hospital patients needs i.e. Level I Trauma Center Brain Spine Center Level III Regional Perinatal Center 44-bed Neonatal ICU, etc. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 764 | TotalNbrEmployees |
| Total Nbr Volunteers | 8 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 35954 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 26723 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 81150885 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 84069085 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 22667 | InvestmentIncomePriorYear |
| Investment Income Current Year | -54947 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 622692 | OtherRevenuePriorYear |
| Other Revenue Current Year | 508101 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 81832198 | TotalRevenuePriorYear |
| Total Revenue Current Year | 84548962 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 84105815 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 90705421 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 38398767 | OtherExpensePriorYear |
| Other Expenses Current Year | 43534166 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 122504582 | TotalExpensesPriorYear |
| Total Expenses Current Year | 134239587 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -40672384 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -49690625 | RevenuesLessExpensesCY |
| Total Assets BOY | 57821261 | TotalAssetsBOY |
| Total Assets EOY | 61311050 | TotalAssetsEOY |
| Total Liabilities BOY | 78177386 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 82651803 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | -20356125 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -21340753 | NetAssetsOrFundBalancesEOY |
| Mission Description | The goal of Rockford Health Physicians RHPH is to improve and protect the health and welfare of the community in accordance with our mission Superior Care. Everyday. For all our patients. We will fulfill our committment through performance excellence, innovation, and lifelong learning. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 96262040 | Expense |
| Revenue | 69669010 | Revenue |
| Description | Rockford Health Physicans RHPH is a 175 multi-specialty physician group that has 10 satellite ambulatory offices as well as 5 convenient care locations that provide for non-life threatening emergencies after regular office hours. Our patients have access to board certified primary care physicians who coordinate care with board certified specialty physicians. In addition to ambulatory practices, many of our physicians provide inpatient services at Rockford Memorial Hospital, a Level I trauma center, a psychiatric unit, adult and pediatric intensive care units, a designated childrens medical center, and a Level III neonatal intensive care unit. Physicians are available on call 24-7. There were 402,006 office visits in 2011. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 10046201 | Expense |
| Revenue | 13526279 | Revenue |
| Description | Ancillary Medical Services were performed to allow physicians to provide the proper care to achieve the best outcome for each patient. There were 325,386 ancillary procedures performed during 2011. RHPH provided 277,598 tests and procedures in clincial areas such as laboratory and radiology including CT scans and mammography. Other support services included cardiac testing, genetic services, pulmonary function testing, bone scans, pain management, and physical therapy. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 866078 | Expense |
| Revenue | 873796 | Revenue |
| Description | The Clinical Research department participates in studies to provide additional benefits to our patients, i.e. tracking breast cancer survivors a pharmaceutical study to evaluate a drug that treats osteo/rheumatoid arthritis and another that studies gout. RHPH participates in a Medicare Physician Quality Report Incentive program to measure data for quality evaluation. RHPH is committed to providing services for Maternal and Child care through Illinois Health Connect, a means-tested program that helps kids and families get health care and stay healthy by choosing a medical home. RHPH partners with neighboring schools to provide free physicals and community organizations to provide free screenings. Staff and physicians participated in various health fairs and hosted educational forums in the communities to bring residents an awareness of health/wellness related topics - such as heart disease and prevention, healthy eating, childrens health concerns, and aging issues. RHPH also partners with a local church in the Bridge Clinic to serve uninsured and/or homeless people. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 107174319 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 57 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 764 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | false | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | David Vola Controller | NamePerson |
| Telephone Number | 8159715000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 N Rockton Avenue | AddressLine1 |
| City | Rockford | City |
| State | IL | State |
| ZIP Code | 61103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| Duane RBach | ||||||||
| Treas | 000.10 | X | 0 | 0 | 0 | |||
| Jack JBecherer | ||||||||
| Director | 000.25 | X | 0 | 0 | 0 | |||
| James WBreckenridge | ||||||||
| Director | 039.00 | X | 454003 | 0 | 37875 | |||
| Thomas DBudd | ||||||||
| Director | 000.50 | X | 0 | 0 | 0 | |||
| John WChadwick | ||||||||
| Director | 000.30 | X | 0 | 0 | 0 | |||
| Eleanor FDoar | ||||||||
| Vice Chair | 000.10 | X | 0 | 0 | 0 | |||
| John TDorsey | ||||||||
| Director | 060.50 | X | 326375 | 0 | 51104 | |||
| Pamela SFox | ||||||||
| Director | 000.10 | X | 0 | 0 | 0 | |||
| Jos LGonzalez | ||||||||
| Director | 052.20 | X | 397162 | 0 | 54899 | |||
| Curtis DWorden | ||||||||
| Director | 000.10 | X | 0 | 0 | 0 | |||
| Paul AGreen | ||||||||
| Chairman | 000.10 | X | 0 | 0 | 0 | |||
| Gary EKaatz | ||||||||
| President | 001.00 | X | 0 | 1065011 | 210097 | X | ||
| Dennis TUehara | ||||||||
| Director | 030.00 | X | 469530 | 0 | 71890 | |||
| Connie MVitali | ||||||||
| Director | 000.10 | X | 0 | 0 | 0 | |||
| Alphonso Goode | ||||||||
| Director | 000.01 | X | 0 | 0 | 0 | |||
| Henry MSeybold | ||||||||
| Treasurer | 001.00 | 0 | 494320 | 104980 | X | |||
| Julie APeterson | ||||||||
| Secretary | 002.00 | 0 | 77262 | 34984 | X | |||
| Kevin Ruggles | ||||||||
| Chief Phy Exec | 000.10 | 656756 | 0 | 138910 | X | |||
| James Sturm | ||||||||
| Physician | 040.00 | 773729 | 0 | 49673 | X | |||
| Bharati Roy | ||||||||
| Physician | 040.00 | 700877 | 0 | 54816 | X | |||
| Greg Nowak | ||||||||
| Physician | 040.00 | 694729 | 0 | 49792 | X | |||
| Arthur Rettig | ||||||||
| Physician | 040.00 | 810885 | 0 | 81800 | X | |||
| Craig Rogers | ||||||||
| Physician | 040.00 | 656638 | 0 | 67399 | X | |||
| Dennis Oltz | ||||||||
| VP Finance | 040.00 | 221594 | 0 | 65818 | X | |||
| John Rhoades | ||||||||
| COO | 040.00 | 158705 | 0 | 13872 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 6320983 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 1636593 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1087909 | TotalOtherCompensation |
| Number Individuals GT100 K | 15 | NumberIndividualsGT100K |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Bratislav Velimirovic | |||||
| 425 Dillingham Ln | Kalamazoo | MI | 49009 | Healthcare Services | 1307162 |
| Athena Health | |||||
| PO Box 7247-6482 | Philadelphia | PA | 19170 | Billing Services | 4060311 |
| Rock Valley Industries | |||||
| 5549 International Drive | Rockford | IL | 61109 | Janitorial Services | 628561 |
| NXC Imaging Inc | |||||
| 2118 Fourth Ave So | Minneapolis | MN | 55404 | Healthcare Services | 709150 |
| Schmeling Construction | |||||
| 5549 International Drive | Rockford | IL | 61109 | General Contractor | 1712423 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 28 | NumberOfContractorsGT100K |
| Related Organizations | 23318 | RelatedOrganizations |
| All Other Contributions | 3405 | AllOtherContributions |
| Total Contributions | 26723 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Physician Medical Services | 621110 | 43105805 | 43105805 |
| Ancillary Medical Services | 621400 | 8369017 | 8369017 |
| Medicare/Medicaid | 900099 | 31720467 | 31720467 |
| Clinical Research | 900099 | 83173 | 83173 |
| Health Connect, PQRI and MCH | 621400 | 790623 | 790623 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 84069085 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 21732 | TotalRevenueColumn |
| Exclusion | $21,732 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 507654 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 315516 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 192138 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 192138 | TotalRevenueColumn |
| Exclusion | $192,138 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 3636 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 80315 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -76679 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -76679 | TotalRevenueColumn |
| Exclusion | -$76,679 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| Partnership Income | 621300 | 27621 | $27,621 |
| Purchase Discounts | 900099 | 9743 | $9,743 |
| Support Services | 561499 | 62670 | $62,670 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 215929 | TotalRevenueColumn |
| Exclusion | $215,929 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 315963 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 84548962 | TotalRevenueColumn |
| Related Or Exempt Function Income | 84069085 | RelatedOrExemptFunctionIncome |
| Exclusion | $453,154 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2750833 | Total |
| Program Services | 1972023 | ProgramServices |
| Management And General | 778810 | ManagementAndGeneral |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 73346503 | Total |
| Program Services | 66484806 | ProgramServices |
| Management And General | 6861697 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3429564 | Total |
| Program Services | 3059142 | ProgramServices |
| Management And General | 370422 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7884125 | Total |
| Program Services | 6856614 | ProgramServices |
| Management And General | 1027511 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3294396 | Total |
| Program Services | 2989699 | ProgramServices |
| Management And General | 304697 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1756991 | Total |
| Management And General | 1756991 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 149723 | Total |
| Management And General | 149723 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89246 | Total |
| Management And General | 89246 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7089984 | Total |
| Program Services | 6738583 | ProgramServices |
| Management And General | 351401 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 770461 | Total |
| Program Services | 57373 | ProgramServices |
| Management And General | 713088 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2764856 | Total |
| Program Services | 1468582 | ProgramServices |
| Management And General | 1296274 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2090793 | Total |
| Program Services | 1718941 | ProgramServices |
| Management And General | 371852 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7355127 | Total |
| Program Services | 389351 | ProgramServices |
| Management And General | 6965776 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59964 | Total |
| Program Services | 34850 | ProgramServices |
| Management And General | 25114 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70711 | Total |
| Program Services | 40187 | ProgramServices |
| Management And General | 30524 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 970498 | Total |
| Management And General | 970498 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4989424 | Total |
| Program Services | 1495100 | ProgramServices |
| Management And General | 3494324 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2689226 | Total |
| Program Services | 2425354 | ProgramServices |
| Management And General | 263872 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Bad Debt | 4652884 | 4652884 | |
| Drugs and Medical Supplies | 4608850 | 4607882 | 968 |
| Other Purchased Services | 2479036 | 1531656 | 947380 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 946392 | Total |
| Program Services | 651292 | ProgramServices |
| Management And General | 295100 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 134239587 | Total |
| Program Services | 107174319 | ProgramServices |
| Management And General | 27065268 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18435 | BOY |
| EOY | 17615 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3628746 | BOY |
| EOY | 2725571 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7134367 | BOY |
| EOY | 7660257 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 628180 | BOY |
| EOY | 629688 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 598268 | BOY |
| EOY | 804328 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 90013101 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 44585092 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 41911635 | BOY |
| EOY | 45428009 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 325043 | BOY |
| EOY | 312977 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3576587 | BOY |
| EOY | 3732605 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57821261 | BOY |
| EOY | 61311050 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50160155 | BOY |
| EOY | 54634572 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 28017231 | BOY |
| EOY | 28017231 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78177386 | BOY |
| EOY | 82651803 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -20356125 | BOY |
| EOY | -21340753 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -20356125 | BOY |
| EOY | -21340753 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 57821261 | BOY |
| EOY | 61311050 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -49690625 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 48705997 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Public Support Pertcentage170 | 0.00000 | PublicSupportPertcentage170 |
| Public Support Percentage509 | 0.00000 | PublicSupportPercentage509 |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Included On FS | false | IncludedOnFS |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 1539430 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 5739135 | OtherCostOrOtherBasis |
| Book Value | 5561301 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 62289689 | OtherCostOrOtherBasis |
| Depreciation | 30980904 | Depreciation |
| Book Value | 31308785 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 15891407 | OtherCostOrOtherBasis |
| Depreciation | 11314732 | Depreciation |
| Book Value | 4576675 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4553440 | OtherCostOrOtherBasis |
| Depreciation | 572192 | Depreciation |
| Book Value | 3981248 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 45428009 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Bond Insurance Costs | 330581 |
| Deferred Comp Valuation | 3249934 |
| Capital Accumulation Account | 152090 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 3732605 | TotalBookValueOtherAssets |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | X | Identifier |
| Return Reference | 2 | ReturnReference |
| Explanation | Rockford Health System RHS adopted FIN 48 in 2007 and the impact in 2011 was not material therefore there is no audit footnote. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| James WBreckenridge | |||||||||||||
| 452455 | 1548 | 20000 | 17875 | 491878 | |||||||||
| John TDorsey | |||||||||||||
| 325191 | 1134 | 42000 | 9104 | 377479 | 50 | ||||||||
| Jos LGonzalez | |||||||||||||
| 396028 | 1134 | 36500 | 18399 | 452061 | |||||||||
| Gary EKaatz | |||||||||||||
| 627315 | 369197 | 68499 | 84178 | 125919 | 1275108 | 89051 | |||||||
| Dennis TUehara | |||||||||||||
| 467982 | 1548 | 58500 | 13390 | 541420 | |||||||||
| Henry MSeybold | |||||||||||||
| 357107 | 128327 | 8886 | 41536 | 63444 | 599300 | 24857 | |||||||
| Kevin Ruggles | |||||||||||||
| 441444 | 2088 | 55255 | 83654 | 795665 | 213224 | 72011 | |||||||
| James Sturm | |||||||||||||
| 773361 | 368 | 36500 | 13173 | 823402 | |||||||||
| Bharati Roy | |||||||||||||
| 700247 | 630 | 36500 | 18316 | 755693 | |||||||||
| Greg Nowak | |||||||||||||
| 694099 | 630 | 31500 | 18292 | 744521 | |||||||||
| Arthur Rettig | |||||||||||||
| 780475 | 30410 | 52596 | 29204 | 892685 | |||||||||
| Craig Rogers | |||||||||||||
| 653992 | 2646 | 53000 | 14399 | 724037 | |||||||||
| Dennis Oltz | |||||||||||||
| 175617 | 7731 | 32354 | 33465 | 287412 | 38245 | 4704 | |||||||
| John Rhoades | |||||||||||||
| 70318 | 88387 | 2160 | 11712 | 172577 | |||||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| I | 1a | - By policy Membership to the YWCA is paid for the CEO. Two social club memberships are paid for by the organization for the CEO and any personal use of these facilities is reimbursed in full. The actual cost of these memberships is prorated for personal vs business use and that percentage is added to taxable wages. |
| I | 4a | - Chief Operating Officer left the organization in 2010 and was given a severance payment that began in 2011. The expense for 2011 was71,596. |
| I | 4b | - The executive team receives annual additions to a non-qualified retirement plan. These amounts, accrued for 2010, are included in compensation and listed in detail in Part II for Gary Kaatz 97.196 John Rhoades 1,776 Kevin Ruggles 59,626 Dennis Oltz 4,757 and Henry Seybold 37,168. |
| I | 7 | - Physician compensation for productivity-based providers is calculated using wRVU worked Relative Value Units as defined by CMS-Centers for Medicare/Medicaid Services. Short term incentive opportunities, designating threshold, target and maximum annual awards are established for physicians and executives, driven by the strategic initiatives and priorities of RHS. If incentive thresholds are not met, CEO may grant discretionary bonuses for outstanding performance within certain parameters. |
| I | 3 | The board of directors has a compensation committee that reviews executive compensation. They also authorize an independent firm to provide data for analysis of the industry and the market. The committee reviews results and makes a recommendation to the board which acts upon this information to set compensation for the CEO. The employment contract is drafted by the COO and VP of Administration but authored by the chairman of the compensation committee and presented to the CEO. |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Illinois Finance Authority | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Issuer EIN | 861091967 | IssuerEIN |
| CUSIP Number | 45000GFS5 | CUSIPNumber |
| Date Issued | 2008-12-11 | DateIssued |
| Issue Price | 29792000 | IssuePrice |
| Description Of Purpose | Refund 1994 Series Bonds, Issuance Costs, SWAP Payment | DescriptionOfPurpose |
| Defeased | false | Defeased |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
Form990 Schedule K Part II Form990ScheduleKPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Proceeds | 29792000 | TotalProceeds |
| Issuance Costs From Proceeds | 464742 | IssuanceCostsFromProceeds |
| Credit Enhancement | 16125 | CreditEnhancement |
| Other Spent Proceeds | 29311133 | OtherSpentProceeds |
| Year Of Subst Completion | 2008 | YearOfSubstCompletion |
| Current Refunding | true | CurrentRefunding |
| Advance Refunding | false | AdvanceRefunding |
| Final Allocation Made | true | FinalAllocationMade |
| Adequate Books And Recds Maintaind | true | AdequateBooksAndRecdsMaintaind |
Form990 Schedule K Part IV Form990ScheduleKPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8038 T Filed | false | Form8038TFiled |
| Variable Rate Issue | true | VariableRateIssue |
| Hedge Identified In Books And Recds | true | HedgeIdentifiedInBooksAndRecds |
Name Of Hedge Provider NameOfHedgeProvider
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JP Morgan Chase | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Term Of Hedge | 0000000010.300000000000 | TermOfHedge |
| Superintegrated Hedge | false | SuperintegratedHedge |
| Hedge Terminated | false | HedgeTerminated |
| Gross Proceeds Invested In GIC | false | GrossProceedsInvestedInGIC |
| Gross Proceeds Invested | false | GrossProceedsInvested |
| Exception To Rebate | false | ExceptionToRebate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fed Tax Requirements Compliance | X | FedTaxRequirementsCompliance |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990 Part VI | 6,7a b | Rockford Health System RHS is the sole corporate member of Rockdford Health Physicians RHPH and has the authority to elect members to the board and ultimately has the authority to approve or deny all RHPH board actions |
| Form 990 Part VI | 11 | The date was gathered by the accounting staff with input from RHPH and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RHPH tax analyst. Once the Form 990 was made available it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intercompany website. A presentation of the return was made to the RHPH Finance Committee and at a meeting of the Board of Directors before filing. |
| Form 990 Part VI | 12b,c | RHS Compliance Department acting on behalf of RHPH is required to annually send out a copy of the policy with the Conflict of Interest form included. Each member is to complete the Financial Interest Disclosure Statement which is part of the policy. The RHS compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed, potential conflicts are reviewed and appropriate actions are taken as a result of the review. Employees are given the policy and statement to complete at the beginning of the year or as a new party is hired or joins the RHPH board. However the notices were delayed during 2011 anddid not go out until 2012. |
| Form 990 Part VI | 15 a,b | Compensation for executives is governed b the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for all executives from all related entities including RHPH. This board has established a compensation committe to establish and review all executive compensation annually based on the established philosophy. An independent external executive compensation firm provides consulting on RHS including RHPH salary ranges and compensation philosophy. The appropriate peer group for compensation comparison purposes is other not-for- profit healthcare systems similar in size and complexity. RHS generally conducts an analysis of total compensation every three years but may choose to vary from this schedule determined by the Compensation Committee. The RHPH board of directors concedes the authority to set compensation to RHS |
| Form 990 Part VI | 19 | Financial statements are available through the Illinois Attorney Generals office. Governing documents are available by request from Board Secretary. |
| Form 990 Part VII | - These members of the board were compensated by related organizations for other duties as well as unpaid service as board members James Breckenridge 3 hrs Chair of Anesthesiology at Rockford Memorial Hospital RMH and service to RMH and RHS boards, John Dorsey 1.1 hrs Lead Physician for Quality Internal Medicine and RMH and RHS boards, Jose Gonzalez 3.5 hrs Medical Director-Neonatology, RMH and RHS boards, Dennis Uehara 27 hrs Chairperson - Emergency Department, RMH and RHS and Foundation RMDF boards. Gary Kaatz had 43 additional hrs as President and CEO, Julie Peterson had 41.88 hrs as an executive secretary, and Henry Seybold had 43.5 hrs as CFO Sr VP of Finance these employees compensation includes duties within the RHPh organization and for supporting all of the related entities RHS/RMH/RMDF/VNA. | |
| Form 990 Part XI | 5 | - The additional change was a result of several changes in funds balances of Unrestricted Funds Cumulative Effective Chg in Pension funds of 129,874 the Post Retirement holdings of 56,723 and the transfer of funds to affiliates of 48,632,846 and rounding. |
| Form 990 Part XII | 2c | - RHPh is included as part of a consolidated audit performed for RHS by independent accountants. The RHS audit committee selects and recommends the independent auditors to the RHS board and annually reviews the audit. |
| Form 990 Part VI Section a Line 6,7a b Rockford Health System RHS is the sole corporate member of Rockdford Health Physicians RHPH and has the authority to elect members to the board and ultimately has the authority to approve or deny all RHPH board actions Form 990 Part VI Section B Line 11 The date was gathered by the accounting staff with input from RHPH and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RHPH tax analyst. Once the Form 990 was made available it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intercompany website. A presentation of the return was made to the RHPH Finance Committee and at a meeting of the Board of Directors before filing. Form 990 Part VI Section B Line 12b,c RHS Compliance Department acting on behalf of RHPH is required to annually send out a copy of the policy with the Conflict of Interest form included. Each member is to complete the Financial Interest Disclosure Statement which is part of the policy. The RHS compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed, potential conflicts are reviewed and appropriate actions are taken as a result of the review. Employees are given the policy and statement to complete at the beginning of the year or as a new party is hired or joins the RHPH board. However the notices were delayed during 2011 anddid not go out until 2012. Form 990 Part VI Section B Line 15 a,b Compensation for executives is governed b the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for all executives from all related entities including RHPH. This board has established a compensation committe to establish and review all executive compensation annually based on the established philosophy. An independent external executive compensation firm provides consulting on RHS including RHPH salary ranges and compensation philosophy. The appropriate peer group for compensation comparison purposes is other not-for- profit healthcare systems similar in size and complexity. RHS generally conducts an analysis of total compensation every three years but may choose to vary from this schedule determined by the Compensation Committee. The RHPH board of directors concedes the authority to set compensation to RHS Form 990 Part VI Section C Line 19 Financial statements are available through the Illinois Attorney Generals office. Governing documents are available by request from Board Secretary. Form 990 Part VII Section A - These members of the board were compensated by related organizations for other duties as well as unpaid service as board members James Breckenridge 3 hrs Chair of Anesthesiology at Rockford Memorial Hospital RMH and service to RMH and RHS boards, John Dorsey 1.1 hrs Lead Physician for Quality Internal Medicine and RMH and RHS boards, Jose Gonzalez 3.5 hrs Medical Director-Neonatology, RMH and RHS boards, Dennis Uehara 27 hrs Chairperson - Emergency Department, RMH and RHS and Foundation RMDF boards. Gary Kaatz had 43 additional hrs as President and CEO, Julie Peterson had 41.88 hrs as an executive secretary, and Henry Seybold had 43.5 hrs as CFO Sr VP of Finance these employees compensation includes duties within the RHPh organization and for supporting all of the related entities RHS/RMH/RMDF/VNA. Form 990 Part XI Line 5 - The additional change was a result of several changes in funds balances of Unrestricted Funds Cumulative Effective Chg in Pension funds of 129,874 the Post Retirement holdings of 56,723 and the transfer of funds to affiliates of 48,632,846 and rounding. Form 990 Part XII Line 2c - RHPh is included as part of a consolidated audit performed for RHS by independent accountants. The RHS audit committee selects and recommends the independent auditors to the RHS board and annually reviews the audit. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Rockford Memorial Hospital | |||||||||||
| 2400 N Rockton Ave | Rockford | IL | 61103 | 362167847 | Healthcare | IL | 501c3 | 3 | Rockford Health System | true | |
| Rockford Memorial Development Foundation | |||||||||||
| 2400 N Rockton Ave | Rockford | IL | 61103 | 363197918 | Support of Healthcare | IL | 501c3 | 11a | Rockford Health System | true | |
| Visiting Nurses Assn of the Rockford Area | |||||||||||
| 2400 N Rockton Ave | Rockford | IL | 61103 | 362167945 | Healthcare | IL | 501c3 | 9 | Rockford Health System | true | |
| Rockford Health System | |||||||||||
| 2400 N Rockton Ave | Rockford | IL | 61103 | 363197915 | Support of Healthcare | IL | 501c3 | 11c | false | N/A | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Van Matre Rehabilitation Center LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3660 Grandview Pkwy | AddressLine1 |
| City | Birmingham | City |
| State | AL | State |
| ZIP Code | 35243 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364397130 | EIN |
| Primary Activity | Healthcare | PrimaryActivity |
| Legal Domicile State | IL | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Predominant Income Type | NA | PredominantIncomeType |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | false | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rockford Health Insurance LTD | BusinessNameLine1 |
Address Foreign AddressForeign
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Wellesley House So 2nd Flr 90 Pitts | AddressLine1 |
| City | Pembrooke | City |
| Province Or State | HM | ProvinceOrState |
| Country | BD | Country |
| Postal Code | 08 | PostalCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activity | Insurance | PrimaryActivity |
| Legal Domicile Foreign Country | BD | LegalDomicileForeignCountry |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C Corp | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Rockford Memorial Hospital | ||
| k | 4857472 | Financial analysis |
| Rockford Memorial Hospital | ||
| l | 298526 | Financial analysis |
| Rockford Memorial Hospital | ||
| m | 406730 | Financial analysis |
| Rockford Memorial Hospital | ||
| n | 7651030 | Financial analysis |
| Rockford Memorial Hospital | ||
| o | 1618671 | Financial analysis |
| Rockford Memorial Hospital | ||
| h | 57071 | Financial analysis |
Comments