2012-11-07T15:44:53-00:00 2011-12-31 PricewaterhouseCoopers 2001 Market St Ste 1700 Philadelphia PA 19103 990 2011-01-01 363197915 Rockford Health System ROCK 8159715000 2400 N Rockton Ave Rockford IL 61103 Henry M Seybold 2012-11-06 false Matthew Petroski 2673303000 2012-11-06 2011 2016-02-24 21:20:13Z Gary Kaatz 2400 N Rockton Ave Rockford IL 61103 6077648 false X www.rhsnet.org X 1982 IL The mission is to improve and protect the health and welfare of the community, with superior care, everyday, for all patients. 15 8 305 11 0 484065 195935 5967391 5881713 -1207 0 0 6450249 6077648 57574 0 0 4715086 4879633 0 0 3963123 8700142 8735783 13579775 -2285534 -7502127 19531913 19011931 7638731 9434363 11893182 9577568 Rockford Health System is responsible for supporting the entities that comprise the system Rockford Memorial Hospital, Rockford Health Physicians the Visiting Nurses Assn. of the Rockford Area, and Rockford Memorial Development Foundation-to support and enable them to fulfill their commitment to the RHS vision with performance excellence, innovation, and lifelong learning. false false 3988564 4004722 RHS provides support for Rockford Memorial Hospital RMH, which cared for 12,849 inpatients in 2011, with 1,579 deliveries, 380,441outpatients treated, including 50,980 who visited the emergency room, and processed close to 1.5 million laboratory tests. RMH is the Regional Disaster Preparedness Center for northern Illinois and provides training and education for community preparedness and assists 14 other hospitals with their emergency preparedness. RMH has a Level I Trauma Center, operates a state-designated Perinatal Center with the only Level III Neonatal Intensive Care Unit in northern Illinois with 46 beds, plus an 8 bed Pediatric Intensive Care Unit. Through the Auxiliary, RMH is able to provide extra funds and services to support its mission. The Auxiliary has 368 volunteers who logged 35,381 hours to enhance RMH experience for patients. RHM provides outreach lab services, has state-of-the-art robotic surgery available, and the only regional genetic services and cytogenetics laboratory. 1756991 1756991 RHS provides support for Rockford Health Physicians RHPH which includes staffing for RMHs specialized units such as the NICU and the PICU, adult and pediatric hospitalists, as well as neurologists, neuro and trauma surgeons. RHPH also provides anesthesiologists to assist the RMH surgical program. RHPH physicians, with specialties in brain, spine, and orthopedics as well as trained Emergency Medicine specialists are available 24/7 to staff the Emergency Department and fill immediate needs in the Level I Trauma Center. RHPH employs over 150 physicians of varying specialties and continues to assess and respond to the community needs when recruiting new physicians. RHPH had a total of 402,006 office visits in 2011 and provided 325,386 ancillary procedures and 251,212 clinical tests in areas such as pulmonary function, bone scans, Radiology, CT scans, mammography and physical therapy. 120000 120000 The RHS commitment to support the entities within the system includes collaboration with community partners in both time staff volunteers and money to improve the quality of life. To fulfill the vision, RHS provides support for the Visiting Nurses Association of the Rockford Area VNA serving the community with hospice care 12,453 days, elder adult counseling/services over 7,000, and home health care 28,500 visits and therapists/aides 11,824 visits for care that allows people to stay in their own home to recover and recuperate. 63 VNA volunteers gave 3,641 hrs to meet needs of the elderly. Staff participated in community health/wellness events to bring awareness, education and medical screenings to over 100 events. RHS also provides support for Rockford Memorial Development Foundation which, through fundraising activities, provides resources to enhance all areas of RHS. RMDF funds are used for special capital projects, assisting VNA in hospice and home care, adding comfort and extended care items for RMH and RHPH, as well as crisis support and education for employees. 5865555 true false false false false false false false false true false false false true false false false false false false false false false false false false false false true false false false false false false false false false false false false false true false false false false true 90 0 true 0 false false false false false false false false false false X 15 8 false false false false false false false true true false false true true true false true true true true false IL X David E Vola Controller 8159715000 2400 N Rockton Avenue Rockford IL 61103 X Jack J Becherer 000.25 X 0 0 0 James WBreckenridge 002.00 X 0 454003 37875 Thomas DBudd 000.50 X 0 0 0 John WChadwick 000.01 X 0 0 0 Eleanor FDoar 002.80 X 0 0 0 John TDorsey 000.60 X 0 326375 51104 Pamela SFox 000.01 X 0 0 0 Jos LGonzalez 001.00 X 0 397162 54899 Alphonso NGoode 000.01 X 0 0 0 Duane RBach 001.00 X X 0 0 0 Dennis TUehara 004.00 X 0 469530 71890 Connie MVitali 000.75 X 0 0 0 Curtis DWorden 001.80 X 0 0 0 Paul AGreen 001.00 X X 0 0 0 James Evans 030.00 X 353231 0 78819 Milton G Schmitt Jr 010.00 X 278233 0 50776 Gary EKaatz 035.00 X X 1065011 0 210096 Henry MSeybold 041.00 X 494320 0 104980 Julie APeterson 038.25 X 77262 0 34984 Kerry Hill 007.50 X 243925 0 87263 Al Mowbray 034.00 X 289246 0 38710 Dan Parod 001.00 X 398441 0 90152 Dennis L'Heureux 055.00 X 334801 0 102236 Steven Strode 040.00 X 347919 0 76330 3882389 1647070 1090114 72 false true true Datamation Imaging PO Box 98347 Chicago IL 60693 IT Support Services 477183 McDermott Will & Emery 227 W Monroe St Chicago IL 60606 Legal Services 4258193 Epic Systems Corp 1979 Milky Way Verona WI 53593 License/Maintenance 3297582 MAXIT Healthcare LLC PO Box 643600 Pittsburgh PA 15264 IT Support Services 720030 Oxford Global Resources PO Box 3256 Boston MA 002413256 IT Support Services 576908 31 195935 195935 Coordinate and support affiliate activities 561000 5881713 5881713 5881713 6077648 5881713 0 0 0 0 2785796 2785796 0 1631940 1631940 36365 36365 323279 323279 102253 102253 0 128 128 0 0 0 8185419 8185419 0 39225 39225 0 0 110484 110484 15788 15788 78985 78985 0 0 0 25928 25928 46205 46205 Recruiting/Retention/Employee appreciation 88586 88586 Supplies 5121 5121 Equipment Rental 4739 4739 Miscellaneous 99534 99534 0 5865555 -5865555 13579775 5865555 7714220 0 3700128 4600425 313769 44417 157780 160736 2435937 2325498 43154713 31939512 12214043 11215201 710256 665654 19531913 19011931 6953435 8795564 685296 638799 7638731 9434363 X 11893182 9577568 11893182 9577568 19531913 19011931 X -7502127 5186513 X false true true X false X X X false false false Rockford Memorial Hospital 362167847 3 true true true 3988564 Rockford Health Physicians 363097436 3 true true true 1756991 Visiting Nurses Assn of the Rockford Area 362167945 9 true true true 60000 3 5805555 0.00000 0.00000 0.00000 false 592271 202102 390169 37945319 31326671 6618648 4617123 410739 4206384 11215201 Capital Accumulation Liability 482675 Life Insurance Liability 156124 638799 X 2 FIN48 ASC 740 was adopted by Rockford Health System board of directors in 2007. There was then and is now, no material impact and therefore no footnote was included in 2011. X true true X X X X X true true false false false false false true false James WBreckenridge 409662 42793 1548 20000 17875 491878 John TDorsey 323591 1650 1134 42000 9105 377480 Jos LGonzalez 394428 1600 1134 36500 18399 452061 Dennis TUehara 455767 12215 1548 58500 13390 541420 James Evans 280929 70629 1674 34306 44513 432051 Milton G Schmitt Jr 200633 66014 11586 35017 15760 329010 15185 Gary EKaatz 627315 369197 68499 84178 125918 1275107 89051 Henry MSeybold 357107 128327 8886 41536 63444 599300 24857 Kerry Hill 196865 44801 2259 51383 35881 331189 8353 Al Mowbray 219294 68446 1506 20000 18711 327957 Dan Parod 276968 120303 1170 44319 45832 488592 32720 Dennis L'Heureux 251595 80715 2491 58096 44141 437038 38500 Steven Strode 255399 91441 1080 31915 44414 424249 15798 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 - Future increase in severance for Gary Kaatz was 26,082 by contract. I 4b - The executive team receives annual additions to a non-qualified retirement plan. These amounts, accrued for 2011, are included in compensation and listed in detail in Part II for Gary Kaatz 97,196 Dennis LHeureux 9,527 Dan Parod 29,168 Steven Strode 17,542 Kerry Hill 9,932 Jim Evans 25,444 and Henry Seybold 37,168. I 7 - Short term incentive opportunities, designating threshold, target and maximum annual awards are established for all 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 to our Compensation committee. The committee reviews the results and makes a recommendation to the board who then acts upon this information to set compensation for teh CEO. Then the Director of Compensation Benefits produces an employment contract for the CEO. Form 990 Part VI 11a - The data was gathered by the accounting staff with input from the executive staff. The data was reviewed and the Form 990 prepared by the RHS tax analyst. Once the Form 990 was completed, it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intracompany website. A presentation of the return was made to the RHS Finance Committee and at a meeting of the Board of Directors before filing Form 990 Part VI 12c - RHS Compliance Department generally sends out a copy of the policy with the Conflict of Interest form included each year. Each member completes the Financial Interest Disclosure Statement which is a part of the policy. The RHS Compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed. Employees are given the policy and a statement to complete at the beginning of the year or as a new party is hired or joins the board. The procedure was inadvertently overlooked in 2011 and notices were sent in 2012. Form 990 Part VI 15 a,b - Compensation for executives is governed by the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for all executives. This Board has established a Compensation Committee to establish and review all executive compensation annually based on the established philosophy. An external executive compensation firm provides consulting on RHS 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 as determined by the Compensation Committee. Form 990 Part VI 19c - Financial statements are available through the Illinois Attorney Generals Office. Policies including the Conflict of Interest policy are available on our Intracompany Website and are not accessible to the general public. Governing documents are available by request from Board Secretary. Form 990 Part VII 1 - Some members of the board were also compensated by related organizations James Breckenridge 40 hrs physician/Chair Anesthesiology, John Dorsey 61 hrs physician/Lead Physician for Quality Internal Medicine, Jose Gonzalez 52.5 physician/Medical Director-Neonatology Alan Mowbray 17 hrs practicing physican /IT and EMR Implementation, and Dennis Uehara 53 hrs physician/Chair Emergency Dept and RMDF Rockford Memorial Development Foundation board member they were compensated as physicians by RHPH Rockford Health Physiciansand for administrative duties by RMH Rockford Memorial Hospital. Gary Kaatz as President and CEO11 hrs for related organizations, Julie Peterson - 3.8 hrs as executive secretary, Henry Seybold -3.5 hrs as CFO/Sr VP of Finance, Milt Schmitt - 10 hrs as board liason on multiple RMH and RHPH committees, as well as VanMatre Partnerships governing Chair. Form 990 Part XI 5 - This amount 5,186,513 is net transfers from affiliated organizations. Form 990 Part VI Section B Line 11a - The data was gathered by the accounting staff with input from the executive staff. The data was reviewed and the Form 990 prepared by the RHS tax analyst. Once the Form 990 was completed, it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intracompany website. A presentation of the return was made to the RHS Finance Committee and at a meeting of the Board of Directors before filing Form 990 Part VI Section B Line 12c - RHS Compliance Department generally sends out a copy of the policy with the Conflict of Interest form included each year. Each member completes the Financial Interest Disclosure Statement which is a part of the policy. The RHS Compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed. Employees are given the policy and a statement to complete at the beginning of the year or as a new party is hired or joins the board. The procedure was inadvertently overlooked in 2011 and notices were sent in 2012. Form 990 Part VI Section B Line 15 a,b - Compensation for executives is governed by the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for all executives. This Board has established a Compensation Committee to establish and review all executive compensation annually based on the established philosophy. An external executive compensation firm provides consulting on RHS 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 as determined by the Compensation Committee. Form 990 Part VI Section C Line 19c - Financial statements are available through the Illinois Attorney Generals Office. Policies including the Conflict of Interest policy are available on our Intracompany Website and are not accessible to the general public. Governing documents are available by request from Board Secretary. Form 990 Part VII Section A Line 1 - Some members of the board were also compensated by related organizations James Breckenridge 40 hrs physician/Chair Anesthesiology, John Dorsey 61 hrs physician/Lead Physician for Quality Internal Medicine, Jose Gonzalez 52.5 physician/Medical Director-Neonatology Alan Mowbray 17 hrs practicing physican /IT and EMR Implementation, and Dennis Uehara 53 hrs physician/Chair Emergency Dept and RMDF Rockford Memorial Development Foundation board member they were compensated as physicians by RHPH Rockford Health Physiciansand for administrative duties by RMH Rockford Memorial Hospital. Gary Kaatz as President and CEO11 hrs for related organizations, Julie Peterson - 3.8 hrs as executive secretary, Henry Seybold -3.5 hrs as CFO/Sr VP of Finance, Milt Schmitt - 10 hrs as board liason on multiple RMH and RHPH committees, as well as VanMatre Partnerships governing Chair. Form 990 Part XI Line 5 - This amount 5,186,513 is net transfers from affiliated organizations. Rockford Memorial Hospital 2400 N Rockton Ave Rockford IL 61103 362167847 Healthcare IL 501c3 3 Rockford Health System true Rockford Health Physicians 2300 N Rockton Ave Rockford IL 61103 363097436 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 Van Matre Rehabilitation Center LLC 3660 Grandview Ste 200 Birmingham AL 35243 364397130 Healthcare IL Rockford Memorial Hospital false false Rockford Health Insurance LTD Wellesley House So 2nd Flr 90 Pitts Pembrooke HM BD 08 Insurance BD Rockford Memorial Hospital false false false false false false false false false false false false true true false true true true Rockford Memorial Hospital n 14133655 Financial Analysis Rockford Memorial Hospital p 13789292 Financial Analysis Rockford Memorial Hospital r 19000000 Financial Analysis Rockford Memorial Development Foundation n 89077 Financial Analysis Rockford Health Physicians m 110484 Financial Analysis Rockford Health Physicians n 4943722 Financial Analysis Rockford Health Physicians p 4589644 Financial Analysis Rockford Health Physicians q 19000000 Financial Analysis Visiting Nurses Association n 404942 Financial Analysis Visiting Nurses Association p 307808 Financial Analysis Visiting Nurses Association r 492540 Financial Analysis