2012-11-07T15:49:32-00:00 2011-12-31 PricewaterhouseCoopers 2001 Market St Ste 1700 Philadelphia PA 19103 990 2011-01-01 363907436 Rockford Health Physicians ROCK 8159715000 2300 N Rockton Ave Rockford IL 61103 Henry M Seybold 2012-11-06 true Matthew Petroski 2673303000 2012-11-06 2011 2016-02-24 21:20:13Z Gary Kaatz 2400 N Rockton Ave Rockford IL 61103 84944793 false X WWW.RHSNET.ORG X 1993 IL 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. 15 8 764 8 0 35954 26723 81150885 84069085 22667 -54947 622692 508101 81832198 84548962 0 0 84105815 90705421 0 0 38398767 43534166 122504582 134239587 -40672384 -49690625 57821261 61311050 78177386 82651803 -20356125 -21340753 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. false false 96262040 69669010 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. 10046201 13526279 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. 866078 873796 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. 107174319 true false false false false false false false false true false false true false false false true false false false false false false false false false false false true true false false false false false false false false false false false false false false false true false true false false true 57 0 true 764 true false false false false false false false false false false false false X 15 8 false false false false true true false true true false false true true true false true true true true false false IL X X David Vola Controller 8159715000 2400 N Rockton Avenue Rockford IL 61103 X Duane RBach 000.10 X 0 0 0 Jack JBecherer 000.25 X 0 0 0 James WBreckenridge 039.00 X 454003 0 37875 Thomas DBudd 000.50 X 0 0 0 John WChadwick 000.30 X 0 0 0 Eleanor FDoar 000.10 X 0 0 0 John TDorsey 060.50 X 326375 0 51104 Pamela SFox 000.10 X 0 0 0 Jos LGonzalez 052.20 X 397162 0 54899 Curtis DWorden 000.10 X 0 0 0 Paul AGreen 000.10 X 0 0 0 Gary EKaatz 001.00 X X 0 1065011 210097 Dennis TUehara 030.00 X 469530 0 71890 Connie MVitali 000.10 X 0 0 0 Alphonso Goode 000.01 X 0 0 0 Henry MSeybold 001.00 X 0 494320 104980 Julie APeterson 002.00 X 0 77262 34984 Kevin Ruggles 000.10 X 656756 0 138910 James Sturm 040.00 X 773729 0 49673 Bharati Roy 040.00 X 700877 0 54816 Greg Nowak 040.00 X 694729 0 49792 Arthur Rettig 040.00 X 810885 0 81800 Craig Rogers 040.00 X 656638 0 67399 Dennis Oltz 040.00 X 221594 0 65818 John Rhoades 040.00 X 158705 0 13872 6320983 1636593 1087909 15 true true false 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 28 23318 3405 26723 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 84069085 21732 21732 507654 315516 192138 192138 192138 3636 80315 -76679 -76679 -76679 Partnership Income 621300 27621 27621 Purchase Discounts 900099 9743 9743 Support Services 561499 62670 62670 215929 215929 315963 84548962 84069085 453154 0 0 0 0 2750833 1972023 778810 0 73346503 66484806 6861697 3429564 3059142 370422 7884125 6856614 1027511 3294396 2989699 304697 1756991 1756991 149723 149723 89246 89246 0 0 7089984 6738583 351401 770461 57373 713088 2764856 1468582 1296274 2090793 1718941 371852 0 7355127 389351 6965776 59964 34850 25114 70711 40187 30524 0 970498 970498 0 4989424 1495100 3494324 2689226 2425354 263872 Bad Debt 4652884 4652884 Drugs and Medical Supplies 4608850 4607882 968 Other Purchased Services 2479036 1531656 947380 946392 651292 295100 134239587 107174319 27065268 0 18435 17615 3628746 2725571 7134367 7660257 628180 629688 598268 804328 90013101 44585092 41911635 45428009 325043 312977 3576587 3732605 57821261 61311050 50160155 54634572 28017231 28017231 78177386 82651803 X -20356125 -21340753 -20356125 -21340753 57821261 61311050 X -49690625 48705997 X X false true true X false X 0.00000 0.00000 0.00000 false 1539430 5739135 5561301 62289689 30980904 31308785 15891407 11314732 4576675 4553440 572192 3981248 45428009 Bond Insurance Costs 330581 Deferred Comp Valuation 3249934 Capital Accumulation Account 152090 3732605 X 2 Rockford Health System RHS adopted FIN 48 in 2007 and the impact in 2011 was not material therefore there is no audit footnote. X true true X X X X X true true false false false false false true false James WBreckenridge 452455 1548 20000 17875 491878 John TDorsey 325191 50 1134 42000 9104 377479 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 213224 2088 55255 83654 795665 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 38245 7731 32354 33465 287412 4704 John Rhoades 70318 88387 2160 11712 172577 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. Illinois Finance Authority 861091967 45000GFS5 2008-12-11 29792000 Refund 1994 Series Bonds, Issuance Costs, SWAP Payment false false 29792000 464742 16125 29311133 2008 true false true true false true true JP Morgan Chase 0000000010.300000000000 false false false false false X 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. 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 N/A false Van Matre Rehabilitation Center LLC 3660 Grandview Pkwy Birmingham AL 35243 364397130 Healthcare IL N/A NA false false Rockford Health Insurance LTD Wellesley House So 2nd Flr 90 Pitts Pembrooke HM BD 08 Insurance BD N/A C Corp false false false false false false false false false false false false false false false false false false 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