NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: NORTHWESTERN MEMORIAL HEALTHCARE (EIN 36-4244337)
Tax period: 2011-05-01 to 2012-04-30
Filed: 2012-12-17
IRS object ID: 201213529349300111
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule I
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-12-17T09:37:47-06:00	Timestamp
Tax Period End Date	2012-04-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Field	Value	IRS element (for citing)
EIN	410746749	EIN

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	114 E EVERETT	AddressLine1
City	DIXON	City
State	IL	State
ZIP Code	61021	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-05-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	364244337	EIN

Name Name

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

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

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	ONE KISH HOSPITAL DRIVE	AddressLine1
City	DEKALB	City
State	IL	State
ZIP Code	60115	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	LOREN FOELSKE	Name
Title	VICE PRESIDENT - FINANCE, KHS	Title
Phone	8157561521	Phone
Date Signed	2012-12-12	DateSigned
Authorize Third Party	1	AuthorizeThirdParty

Preparer Preparer

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

Field	Value	IRS element (for citing)
Tax Year	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	KEVIN P POORTEN	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	ONE KISH HOSPITAL DRIVE	AddressLine1
City	DEKALB	City
State	IL	State
ZIP Code	60115	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	56313483	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.VWCH.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1998	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING INPATIENT ACUTE AND NONACUTE CARE, AND VARIOUS OUTPATIENT SERVICES IN THE AREAS OF DEKALB, KENDALL, AND LASALLE COUNTIES.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	3	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	2	NbrIndependentVotingMembers
Total Nbr Employees	298	TotalNbrEmployees
Total Nbr Volunteers	65	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Net Unrelated Business Txbl Income	0	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	85728	ContributionsGrantsPriorYear
Contributions Grants Current Year	380934	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	45655170	ProgramServiceRevenuePriorYear
Program Service Revenue CY	48706320	ProgramServiceRevenueCY
Investment Income Prior Year	396789	InvestmentIncomePriorYear
Investment Income Current Year	729322	InvestmentIncomeCurrentYear
Other Revenue Prior Year	928513	OtherRevenuePriorYear
Other Revenue Current Year	857178	OtherRevenueCurrentYear
Total Revenue Prior Year	47066200	TotalRevenuePriorYear
Total Revenue Current Year	50673754	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	5000	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	19500	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	14697950	SalariesEtcPriorYear
Salaries Etc Current Year	14703466	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	28305660	OtherExpensePriorYear
Other Expenses Current Year	31329533	OtherExpensesCurrentYear
Total Expenses Prior Year	43008610	TotalExpensesPriorYear
Total Expenses Current Year	46052499	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	4057590	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	4621255	RevenuesLessExpensesCY
Total Assets BOY	59218227	TotalAssetsBOY
Total Assets EOY	61625713	TotalAssetsEOY
Total Liabilities BOY	10776741	TotalLiabilitiesBOY
Total Liabilities EOY	10500036	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	48441486	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	51125677	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING INPATIENT ACUTE AND NONACUTE CARE, AND VARIOUS OUTPATIENT SERVICES IN THE AREAS OF DEKALB, KENDALL, AND LASALLE COUNTIES. VALLEY WEST COMMUNITY HOSPITAL WILL STRIVE TO PROVIDE HIGH QUALITY PRIMARY CARE AND COMMUNITY HEALTH EDUCATION, WHILE PROMOTING COMMUNITY HEALTH SERVICES IN A FRIENDLY, CARING ENVIRONMENT. VALLEY WEST COMMUNITY HOSPITAL IS COMMITED TO PROVIDING HEALTH CARE IN ACCORDANCE WITH THE HIGHEST MEDICAL AND ETHICAL STANDARDS WITH CARE, COMPASSION, AND RESPECT FOR ALL, PROTECTING THE DIGNITY, AUTONOMY AND INTEGRITY OF ALL OUR PATIENTS, WHILE MANAGING THE MEDICAL RESOURCES AT OUR DISPOSAL WITH WISDOM AND FAIRNESS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	38602769	Expense
Grants	19500	Grants
Revenue	49443635	Revenue
Description	VALLEY WEST COMMUNITY HOSPITAL (VALLEY WEST), LOCATED IN SANDWICH, ILLINOIS, SERVES THE RESIDENTS OF SOUTHERN DEKALB, NORTHERN LASALLE AND WESTERN KENDALL COUNTIES BY OFFERING A NUMBER OF PROGRAMS AND SERVICES THAT GO BEYOND BASIC HEALTH CARE. VALLEY WEST BELIEVES THAT IN ORDER TO BE A TRUE "COMMUNITY" HOSPITAL, WE MUST BE A RESOURCE FOR PREVENTATIVE AND CURATIVE HEALTH INFORMATION, EDUCATION AND SERVICES AND THAT WE MUST SUPPORT THE EFFORTS OF OTHERS WHO ALSO ARE DOING WORK FOR THE COMMUNITY GOOD. DOING SO HELPS BUILD TRUST, RESPECT AND LOYALTY FOR OUR HOSPITAL AND STRENGTHENS OUR ROLE AS A PARTNER IN IMPROVING THE HEALTH OF OUR CITIZENS AND THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE.THE COMMUNITY BENEFIT OBJECTIVES OF VALLEY WEST INCLUDE PROGRAMS TO TO IMPROVE ACCESS TO HEALTH SERVICES BY REDUCING GEOGRAPHIC, FINANCIAL, LANGUAGE AND CULTURAL BARRIERS; IMPROVE AND ENHANCE PUBLIC HEALTH, ADVANCE GENERAL HEALTH KNOWLEDGE, AND RELIEVE THE GOVERNMENT BURDEN OF PROVIDING HEALTH SERVICES FOR THE COMMUNITY, AND FOR THE UNINSURED AND UNDERINSURED. COMMUNITY HEALTH NEEDS ARE IDENTIFIED AND ADDRESSED THROUGH COMMUNITY OUTREACH PROGRAMS, BY ADDING NEW SERVICES AND BY EXPANDING OTHERS. NEEDS ALSO ARE MET THROUGH OPERATIONAL PROGRAMS SUCH AS CHARITY CARE, SUBSIDIZED SERVICES AND PROVIDING CASH AND IN-KIND DONATIONS TO SUPPORT ORGANIZATIONS THAT ALSO STRIVE TO MEET COMMUNITY HEALTH AND QUALITY OF LIFE NEEDS. THE HOSPITAL IDENTIFIES COMMUNITY HEALTH NEEDS IN SEVERAL WAYS:* DEKALB COUNTY HEALTH DEPARTMENT I-PLAN* COMMUNITY HEALTH NEEDS SURVEY (LAST CONDUCTED FALL 2009)* U.S. HEALTHY PEOPLE 2010 AND 2020 OBJECTIVES* UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANKINGS & ROADMAPS* INTERNAL REVIEW OF OUTPATIENT AND INPATIENT TRENDS, ESPECIALLY EMERGENCY DEPARTMENT USAGE * INPUT FROM OTHER COMMUNITY PROVIDERS. THIS INCLUDES PROVIDING HOSPITAL LEADERS TO SERVE ON BOARDS AND COMMITTEES THAT DIRECTLY OR INDIRECTLY IMPACT COMMUNITY HEALTH OR HELP THE HOSPITAL CONNECT TO UNDERSERVED OR VULNERABLE POPULATIONS.USING ALL THESE RESOURCES, THE HOSPITAL FOCUSED ON THE FOLLOWING COMMUNITY HEALTH NEEDS IN FY12: * THE PREVALENCE OF OBESITY IN CHILDREN AND ADULTS* CARDIOVASCULAR DISEASE AND ADEQUATE HOSPITAL-BASED AND COMMUNITY OUTREACH SERVICES * CANCER CARE SERVICES, EDUCATION AND PREVENTION * AFFORDABLE ACCESS TO CHILDBIRTH EDUCATION AND OB HOSPITAL SERVICES* OTHER COMMUNITY OUTREACH AND WELLNESS SERVICES.ACTIVITIES IN THESE AREAS ARE DETAILED IN SCHEDULE H OF THIS REPORT. ADDITIONAL ACTIVITIES ARE LISTED BELOW.* COMMUNITY WELLNESS RV TRAVELS THROUGHOUT THE HOSPITAL MARKET, PROVIDING BLOOD PRESSURE SCREENING, KNOW YOUR NUMBERS AND BONE DENSITY SCREENINGS AT DIFFERENT COMMUNITY SITES.* COMMUNITY WELLNESS EDUCATORS TAUGHT HEALTH TOPICS IN AREA SCHOOLS, VISITING 489 CLASSROOMS WORKING WITH 13,892 STUDENTS. COMMUNITY WELLNESS EDUCATORS SERVED ON THE FOLLOWING COMMITTEES TO PROMOTE HEALTH AND WELLNESS: PLANO CHAMBER OF COMMERCE BOARD OF DIRECTORS, KENDALL COUNTY HEALTH INITIATIVES COUNCIL, KENDALL COUNTY IPLAN STEERING COMMITTEE, SANDWICH PROJECT SUCCESS COMMITTEE, OB PRACTICE COMMITTEE CO-CHAIR.* THE HOSPITAL ALSO PROVIDES COMMUNITY BENEFIT THROUGH: CHARITY CARE, GOVERNMENT-SPONSORED INDIGENT HEALTH CARE, BAD DEBT, SUBSIDIZED HEALTH SERVICES, LANGUAGE ASSISTANCE, VOLUNTEER SERVICES, EDUCATION AND WORKFORCE DEVELOPMENT, AND CASH AND IN-KIND DONATIONS. - CHARITY CARE: AS PART OF ITS CHARITABLE MISSION, THE HOSPITAL PROVIDES FINANCIAL ASSISTANCE, INCLUDING ACCESS TO PHARMACEUTICAL ASSISTANCE FOR PATIENTS WHO MET THE ELIGIBILITY CRITERIA ESTABLISHED IN ITS FINANCIAL ASSISTANCE POLICY. THE POLICY IS REVIEWED BY THE BOARD OF DIRECTORS ANNUALLY. THE HOSPITAL ALSO COORDINATES WITH THE ILLINOIS BREAST AND CERVICAL CANCER PROGRAM FOR ASSISTANCE WITH BREAST AND CERVICAL CANCER SCREENINGS AND TREATMENT. MORE PATIENTS QUALIFIED FOR CHARITY CARE IN FY 2012 THAN IN PREVIOUS YEARS DUE TO THE POOR ECONOMY AND ALSO TO REDUCE THE HOSPITAL'S BAD DEBT. THE HOSPITAL ALSO UNDERWROTE UNREIMBURSED COSTS OF TREATING MEDICAID AND MEDICARE PATIENTS. - SUBSIDIZED HEALTH SERVICES: A NUMBER OF PROGRAMS AND SERVICES WERE OPERATED AT A LOSS, BUT WERE SUBSIDIZED BECAUSE THEY IMPROVE THE HEALTH AND SAFETY OF THE COMMUNITY. - LANGUAGE ASSISTANCE: THE HOSPITAL EMPLOYS SPANISH INTERPRETERS AVAILABLE OR ON CALL 24/7 AND USE VIDEOCONFERENCING EQUIPMENT VIA LAPTOP TO COMMUNICATE WITH THE HEARING IMPAIRED AND DUAL HANDSET PHONE SYSTEM THAT PROVIDES INSTANT INTERPRETATION FOR PATIENTS WHO DO NOT SPEAK ENGLISH- VOLUNTEER SERVICES: VOLUNTEER OPPORTUNITIES ARE PROVIDED TO EMPLOYEES TO SERVE IN THE COMMUNITY AND TO COMMUNITY MEMBERS TO SERVE THE HOSPITAL. EMPLOYEES ARE ENCOURAGED TO USE PAYROLL DEDUCTION FOR DONATIONS TO UNITED WAY, COMMUNITY FUND, KISHHEALTH FOUNDATION AND DEKALB COUNTY HOSPICE. A VOLUNTEER SERVICES DEPARTMENT SCHEDULES MEMBERS OF THE VALLEY WEST AUXILIARY TO VOLUNTEER IN THE HOSPITAL. - EDUCATION AND WORKFORCE DEVELOPMENT: HOSPITAL EMPLOYEES PROVIDE CLINICAL TRAINING, JOB SHADOWING AND MENTORING OF COLLEGE AND HIGH SCHOOL STUDENTS. THE AUXILIARY AND KISHHEALTH FOUNDATION AWARD ANNUAL SCHOLARSHIPS FOR HEALTH CAREERS. HOSPITAL TOURS ARE GIVEN TO LOCAL SCHOOLS AND YOUTH GROUPS TO MAKE YOUTH AWARE OF HEALTHCARE CAREERS. CASH CONTRIBUTIONS ARE GIVEN TO LOCAL LIBRARIES, PUBLIC AND POST-SECONDARY EDUCATION FOUNDATIONS TO UNDERWRITE SCHOLARSHIPS, AND PURCHASE OR PROVIDE HEALTH-RELATED MATERIALS, EQUIPMENT AND ACTIVITIESCASH AND IN-KIND DONATIONS: EACH YEAR AN ALLOCATION IS MADE IN THE OPERATING BUDGET FOR DONATIONS TO COMMUNITY EVENTS AND ORGANIZATIONS THAT IMPROVE THE HEALTH, WELFARE AND QUALITY OF LIFE IN THE COMMUNITIES SERVED BY THE HOSPITAL. THE HOSPITAL WANTS TO SUPPORT COMMUNITY ACTIVITIES THAT ENCOURAGE CHILD AND ADULT PHYSICAL ACTIVITY; EFFORTS THAT REACH UNDERSERVED AND VULNERABLE POPULATIONS; YOUTH MENTORING, EDUCATION AND THE ARTS; DISEASE PREVENTION, AWARENESS, RESEARCH; MENTAL HEALTH; ECONOMIC DEVELOPMENT AND OTHER COMMUNITY BUILDING ACTIVITIES. IN-KIND DONATIONS AND SERVICES SUCH AS PERSONNEL TIME, SURPLUS SUPPLIES, FOOD, AND BOTTLED WATER ALSO ARE TRACKED.- CASH CONTRIBUTION HIGHLIGHTS: IN FY 12, VALLEY WEST ENTERED INTO A THREE YEAR AGREEMENT WITH FOX VALLEY OLDER ADULT SERVICES TO PROVIDE COMPUTER TRAINING TO SENIORS, ENTERED INTO AN AGREEMENT WITH THE FOX VALLEY FAMILY YMCA TO UNDERWRITE THE COST OF COMMUNITY FITNESS PROGRAMS, AND WAS THE MAJOR SPONSOR OF THE AMERICAN CANCER SOCIETYS LOWER FOX VALLEY RELAY FOR LIFE. IN-KIND DONATIONS INCLUDED FIRST AID KITS FOR YOUTH SPORT GROUPS. ALSO HIGH SCHOOL SPORTS BOOSTERS, YOUTH SPORTS, SCHOOL EDUCATION FOUNDATIONS, AND LOCAL CHAMBERS OF COMMERCE IN SANDWICH, PLANO, SOMONAUK AND OTHER COMMUNITIES.	Description
Total Program Service Expense	38602769	TotalProgramServiceExpense
Described In501 C3	1	DescribedIn501C3
Schedule B Required	1	ScheduleBRequired
Political Activities	0	PoliticalActivities
Lobbying Activities	1	LobbyingActivities
Subject To Proxy Tax	0	SubjectToProxyTax
Donor Advised Funds	0	DonorAdvisedFunds
Conservation Easements	0	ConservationEasements
Collections Of Art	0	CollectionsOfArt
Credit Counseling	0	CreditCounseling
Term Or Permanent Endowments	0	TermOrPermanentEndowments
Report Land Bldg Equip	1	ReportLandBldgEquip
Report Invest Oth Securities	0	ReportInvestOthSecurities
Report Prog Rel Invest	0	ReportProgRelInvest
Report Other Assets	0	ReportOtherAssets
Report Other Liabilities	1	ReportOtherLiabilities
Report Fin48 Footnote	0	ReportFin48Footnote
Independent Audit Financial Stmt	0	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	1	ConsolidatedAuditFinancialStmt
School	0	School
Foreign Office	0	ForeignOffice
Foreign Activities	0	ForeignActivities
More Than5000 K To Organizations	0	MoreThan5000KToOrganizations
More Than5000 K To Individuals	0	MoreThan5000KToIndividuals
Professional Fundraising	0	ProfessionalFundraising
Fundraising Activities	0	FundraisingActivities
Gaming	0	Gaming
Hospital	1	Hospital
Financial Stmt Attached	1	FinancialStmtAttached
Grants To Organizations	1	GrantsToOrganizations
Grants To Individuals	0	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	0	TaxExemptBonds
Excess Benefit Transaction	0	ExcessBenefitTransaction
Prior Excess Benefit Transaction	0	PriorExcessBenefitTransaction
Loan To Officer Or DQP	0	LoanToOfficerOrDQP
Grant To Related Person	0	GrantToRelatedPerson
Bsnss Rltnshp With Organization	0	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	0	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	1	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	0	DeductibleNonCashContributions
Deductible Contributions Of Art	0	DeductibleContributionsOfArt
Terminated	0	Terminated
Partial Liquidation	0	PartialLiquidation
Disregarded Entity	0	DisregardedEntity
Related Entity	1	RelatedEntity
Related Org Controlled Entity	0	RelatedOrgControlledEntity
Transaction Related Entity	0	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	0	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	0	ActivitiesConductedPartnership
Schedule O Required	1	ScheduleORequired
Number Forms Transmitted With1096	61	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	298	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	0	UnrelatedBusinessIncome
Foreign Financial Account	0	ForeignFinancialAccount
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTrans
Taxable Party Notification	0	TaxablePartyNotification
Non Deductible Contributions	0	NonDeductibleContributions
Quid Pro Quo Contributions	0	QuidProQuoContributions
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOf
Funds To Pay Premiums	0	FundsToPayPremiums
Premiums Paid	0	PremiumsPaid
Indoor Tanning Services	0	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	3	NbrVotingGoverningBodyMembers
Number Independent Voting Members	2	NumberIndependentVotingMembers
Family Or Business Relationship	1	FamilyOrBusinessRelationship
Delegation Of Management Duties	0	DelegationOfManagementDuties
Changes To Organizing Docs	0	ChangesToOrganizingDocs
Material Diversion Or Misuse	0	MaterialDiversionOrMisuse
Members Or Stockholders	1	MembersOrStockholders
Election Of Board Members	1	ElectionOfBoardMembers
Decisions Subject To Approval	1	DecisionsSubjectToApproval
Minutes Of Governing Body	1	MinutesOfGoverningBody
Minutes Of Committees	1	MinutesOfCommittees
Officer Mailing Address	0	OfficerMailingAddress
Local Chapters	0	LocalChapters
Form990 Provided To Governing Body	1	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	1	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	1	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	1	RegularMonitoringEnforcement
Whistleblower Policy	1	WhistleblowerPolicy
Document Retention Policy	1	DocumentRetentionPolicy
Compensation Process CEO	1	CompensationProcessCEO
Compensation Process Other	1	CompensationProcessOther
Investment In Joint Venture	0	InvestmentInJointVenture
States Where Copy Of Return Is Filed	IL	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

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

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

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	ONE KISH HOSPITAL DRIVE	AddressLine1
City	DEKALB	City
State	IL	State
ZIP Code	60115	ZIPCode

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	X	InfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Key EmployeeKeyEmployee	Highest Compensated EmployeeHighestCompensatedEmployee
TERRENCE DUFFY
CHAIR	1.00	X	X	0	0	0
KEVIN POORTEN
CEO, EX-OFFICIO VOTING MEM	1.00	X	X	0	698961	102663
ERIK ENGLEHART
VICE CHAIR (THRU 11/30)	1.00	X	X	0	42797	4625
JAGDISH PATEL
VICE CHAIR (AS OF 12/1)	1.00	X	X	38592	0	0
LOREN FOELSKE
VP FINANCE	10.00		X	0	316761	41819
BRAD COPPLE
PRESIDENT - VWCH AND KCH	20.00		X	0	365900	42075
PAM DUFFY
VP PATIENT CARE	20.00			0	241412	27266	X
JOE DANT
VP DEVELOPMENT	6.00			0	263727	41741	X
MIKE MUZZILLO
VP OPERATIONS - VWCH	40.00			0	179349	27579	X
MIKE KOKOTT
ASST. VP - MARKETING	10.00			0	198097	23734	X
ROGER HEATH BELL
VP - CHIEF INFORMATION OFF	15.00			0	253756	39782	X
DR MICHAEL KULISZ
CHIEF MEDICAL OFFICER	20.00			0	391391	22661	X
MARK THATE
VP HUMAN RESOURCES	10.00			0	197280	29354	X
CHERYL FISHER
ASST. VP - PATIENT CARE	20.00			0	150191	32889	X
SUE HOHENBERGER
DIR OF PHARMACY	40.00			141274	0	25634		X
ALTHEA R RUSSELL
RN	40.00			102836	0	30821		X
ALEX P LOMAHAN
PHARMACIST	40.00			121041	0	21879		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	403743	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	3299622	TotalReportableCompFrmRltdOrgs
Total Other Compensation	514522	TotalOtherCompensation
Number Individuals GT100 K	3	NumberIndividualsGT100K
Formers Listed	0	FormersListed
Total Comp GT150 K	1	TotalCompGT150K
Compensation From Other Sources	0	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
KISH HEALTH SYSTEM
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	MANAGEMENT FEES	4298442
ANESTHESIA ASSOCIATES LLC
88 W COUNTRYSIDE PARKWAY	YORKVILLE	IL	60560	HEALTH SERVICES	1046734
COMPREHENSIVE THERAPEUTICS LTD
3703 WEST LAKE STREET	GLENVIEW	IL	60025	PHYSICAL THERAPY SERVICES	1025277
DOCTORS OF EMERGENCY MEDICINE
2807 BRITTANY COURT	ST CHARLES	IL	60175	HEALTH SERVICES	583163
DIAGNOSTIC HEALTH SERVICES INC
2445 GATEWAY DR STE 100	IRVING	TX	75063	HEALTH SERVICES	502415

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	10	NumberOfContractorsGT100K
Related Organizations	70545	RelatedOrganizations
Government Grants	310389	GovernmentGrants
Total Contributions	380934	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	NET PATIENT SERVICE RE	Description
Business Code	621110	BusinessCode
Total Revenue Column	48706320	TotalRevenueColumn
Related Or Exempt Function Income	48706320	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Program Service Revenue	48706320	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	951930	TotalRevenueColumn
Exclusion	$951,930	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	121527	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	1664	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	119863	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	119863	TotalRevenueColumn
Exclusion	$119,863	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	5339677	Securities
Other	75780	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	5608136	Securities
Other	29929	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-268459	Securities
Other	45851	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-222608	TotalRevenueColumn
Exclusion	-$222,608	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
OTHER INCOME	621110	626111	626111
DIETARY/CAFETERIA SALE	621110	76383	76383
DISCOUNTS AND REBATES	621110	34821	34821

Field	Value	IRS element (for citing)
Total Other Revenue	737315	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	50673754	TotalRevenueColumn
Related Or Exempt Function Income	49443635	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	0	UnrelatedBusinessRevenue
Exclusion	$849,185	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	19500	Total
Program Services	19500	ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	38592	Total
Program Services	38592	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	10879051	Total
Program Services	10212596	ProgramServices
Management And General	666455	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	621421	Total
Program Services	583352	ProgramServices
Management And General	38069	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	2373973	Total
Program Services	2228542	ProgramServices
Management And General	145431	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	790429	Total
Program Services	742007	ProgramServices
Management And General	48422	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	3924864	Total
Management And General	3924864	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	42905	Total
Management And General	42905	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	3268	Total
Management And General	3268	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	100696	Total
Management And General	100696	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	8569565	Total
Program Services	8223631	ProgramServices
Management And General	345934	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	465054	Total
Program Services	22494	ProgramServices
Management And General	442560	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	5523073	Total
Program Services	5101005	ProgramServices
Management And General	422068	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	275025	Total
Program Services	1652	ProgramServices
Management And General	273373	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	1546399	Total
Program Services	1541132	ProgramServices
Management And General	5267	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	66664	Total
Program Services	66125	ProgramServices
Management And General	539	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	40362	Total
Management And General	40362	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	117347	Total
Management And General	117347	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	2749259	Total
Program Services	2749259	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	444332	Total
Program Services	259997	ProgramServices
Management And General	184335	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
BAD DEBT EXPENSE	5214395	5214395
PHYSICAN FEES AND RECRU	1430128	1092012	338116
FEDERAL AND STATE ASSES	456200	456200
COLLECTION FEES	251331		251331

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	108666	Total
Program Services	50278	ProgramServices
Management And General	58388	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	46052499	Total
Program Services	38602769	ProgramServices
Management And General	7449730	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	244359	BOY
EOY	219812	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	1280644	BOY
EOY	3745816	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	5492103	BOY
EOY	6321278	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	1381186	BOY
EOY	1428631	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	550210	BOY
EOY	1092870	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	36727914	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	18471314	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	19763617	BOY
EOY	18256600	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	26952150	BOY
EOY	28884626	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	1762108	BOY
EOY	238078	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	1791850	BOY
EOY	1438002	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	59218227	BOY
EOY	61625713	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	4017446	BOY
EOY	4758606	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	270100	BOY
EOY	228869	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	2261434	BOY
EOY	2009958	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	4227761	BOY
EOY	3502603	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	10776741	BOY
EOY	10500036	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	48372653	BOY
EOY	51076129	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	68833	BOY
EOY	49548	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	48441486	BOY
EOY	51125677	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	59218227	BOY
EOY	61625713	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	4621255	ReconcilationRevenueExpenses
Reconcilation Other Changes	-1937064	ReconcilationOtherChanges
Info In Schedule O Part XII	X	InfoInScheduleOPartXII
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	0	AccountantCompileOrReview
FS Audited	1	FSAudited
Audit Committee	1	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	0	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

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

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

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

Contributor Name Business ContributorNameBusiness

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

Contributor Address US ContributorAddressUS

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

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

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	0	Volunteers
Paid Staff Or Management	0	PaidStaffOrManagement
Media Advertisements	0	MediaAdvertisements
Mailings Members	0	MailingsMembers
Publications Or Broadcast	0	PublicationsOrBroadcast
Grants Other Organizations	0	GrantsOtherOrganizations
Direct Contact Legislators	1	DirectContactLegislators
Direct Contact Legislators	$0	DirectContactLegislatorsAmount
Rallies Demonstrations	0	RalliesDemonstrations
Other Activities	1	OtherActivities
Other Activities	$12,106	OtherActivitiesAmount
Total Lobbying Expenditures IIB	12106	TotalLobbyingExpendituresIIB
Not Described In501c3	0	NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

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

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1279463	OtherCostOrOtherBasis
Book Value	1279463	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	15159443	OtherCostOrOtherBasis
Depreciation	5646464	Depreciation
Book Value	9512979	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	420249	OtherCostOrOtherBasis
Depreciation	110072	Depreciation
Book Value	310177	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	19339880	OtherCostOrOtherBasis
Depreciation	12714778	Depreciation
Book Value	6625102	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	528879	OtherCostOrOtherBasis
Book Value	528879	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	18256600	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescription	AmountAmount
IBNR RESERVE	$162,911
LEASE OBLIGATION PAYABLE	$324,065
DUE TO AFFILIATES	$910,735
ESTIMATED SETTLEMENTS DUE	$2,102,653
OTHER LONG TERM LIABILITIES	$2,239

Field	Value	IRS element (for citing)
Total Of Amounts	3502603	TotalOfAmounts
Total Revenue	50673754	TotalRevenue
Total Expenses	46052499	TotalExpenses
Excess Or Deficit For Year	4621255	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-157253	NetUnrealizedGLOnInvestments
Other	-$1,779,811	OtherAmount
Total Adjustments	-1937064	TotalAdjustments
Excess Or Deficit Per FS	2684191	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	50145265	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-157253	NetUnrealizedGainsInvestments
Other Revenues	1664	OtherRevenues
Revenue Not Rptd F990	-155589	RevenueNotRptdF990
Revenue Subtotal	50300854	RevenueSubtotal
Other Revenues Not Included	372900	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	372900	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	50673754	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	45786813	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	1664	OtherExpensesIncluded
Expenses Not Rptd F990	1664	ExpensesNotRptdF990
Expenses Subtotal	45785149	ExpensesSubtotal
Other Expenses Not Included	267350	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	267350	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	46052499	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (6 entries)

IdentifierIdentifier	ExplanationExplanation
PART XI, LINE 8 - OTHER ADJUSTMENTS:	EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM, INC. -1,710,000. GRANT INCOME RECORDED AS OFFSET TO FIXED ASSET ACCOUNTS -35,005. CHANGE IN NET ASSETS OF KISHHEALTH FOUNDATION -34,806. TOTAL TO SCHEDULE D, PART XI, LINE 8: -1,779,811.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES NETTED WITH REVENUE FOR FORM 990 PURPOSES 1,664.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	CONTRIBUTION REVENUE FROM KISHHEALTH FOUNDATION 70,545. GRANTS NETTED WITH FIXED ASSETS FOR FINANCIAL STATEMENT PURPOSES 35,005. GRANT REVENUE NETTED WITH TELECOMMUNICATIONS COSTS FOR FINANCIAL STATEMENTS 267,350.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:	RENTAL EXPENSES NETTED WITH REVENUE FOR 990 PURPOSES 1,664.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:	GRANT REVENUE NETTED WITH TELECOMMUNICATIONS COSTS FOR FINANCIAL STATEMENTS 267,350.
	PART XI, LINE 10, EXCESS OR (DEFICIT) FOR THE YEAR PER FINANCIAL STATEMENTS: LINE 10 IDENTIFIES FINANCIAL STATEMENT INCOME AS EQUALING $2,684,191. FINANCIAL STATEMENT INCOME IS ACTUALLY $4,358,452. THE DIFFERENCE RELATES TO THE FOLLOWING ITEMS: 1. VALLEY WEST COMMUNITY HOSPITAL MADE A CAPITAL DISTRIBUTION OF $1,710,000 TO ITS PARENT CORPORATION, ANOTHER NON-PROFIT ENTITY (KISHHEALTH SYSTEM). 2. KISHHEALTH FOUNDATION (KHF), AN AFFILIATED ENTITY, RECEIVES CONTRIBUTIONS DESIGNATED FOR USE BY VALLEY WEST COMMUNITY HOSPITAL. THIS IS ALLOCATED TO VALLEY WEST, VIA AN ENTRY TO INCREASE VALLEY WEST'S INTEREST IN THE ASSETS OF KHF. A CORRESPONDING EQUITY ENTRY IS MADE ON VALLEY WEST'S GENERAL LEDGER. THE CURRENT YEAR INCREASE WAS $35,739, OF WHICH $(34,806) IS A DECREASE IN THE VWCH'S INTEREST IN THE ASSETS OF KHF AND $70,545 WERE ACTUAL CONTRIBUTIONS RECEIVED.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	1	CharityCarePolicy
Written Policy	1	WrittenPolicy
Policy Applied To All Hospitals	X	PolicyAppliedToAllHospitals
FPG Reference Free Care	1	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	1	FPGReferenceDiscountedCare
Pcent300	X	Pcent300
Free Disc Care Medically Indigent	1	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	1	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	1	ExpensesExceededBudget
Unable To Provide Care	0	UnableToProvideCare
Annual Community Benefit Report	1	AnnualCommunityBenefitReport
Report Publically Available	1	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1201039	TotalCommunityBenefitExpense
Direct Offsetting Revenue	456200	DirectOffsettingRevenue
Net Community Benefit Expense	744839	NetCommunityBenefitExpense
Percent Of Total Expense	0.01620	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	7657997	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2186526	DirectOffsettingRevenue
Net Community Benefit Expense	5471471	NetCommunityBenefitExpense
Percent Of Total Expense	0.11880	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8859036	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2642726	DirectOffsettingRevenue
Net Community Benefit Expense	6216310	NetCommunityBenefitExpense
Percent Of Total Expense	0.13500	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	2275748	TotalCommunityBenefitExpense
Direct Offsetting Revenue	35417	DirectOffsettingRevenue
Net Community Benefit Expense	2240331	NetCommunityBenefitExpense
Percent Of Total Expense	0.04860	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	89553	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	89553	NetCommunityBenefitExpense
Percent Of Total Expense	0.00190	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1109858	TotalCommunityBenefitExpense
Direct Offsetting Revenue	564146	DirectOffsettingRevenue
Net Community Benefit Expense	545712	NetCommunityBenefitExpense
Percent Of Total Expense	0.01180	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	135805	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	135805	NetCommunityBenefitExpense
Percent Of Total Expense	0.00290	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	3610964	TotalCommunityBenefitExpense
Direct Offsetting Revenue	599563	DirectOffsettingRevenue
Net Community Benefit Expense	3011401	NetCommunityBenefitExpense
Percent Of Total Expense	0.06520	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	12470000	TotalCommunityBenefitExpense
Direct Offsetting Revenue	3242289	DirectOffsettingRevenue
Net Community Benefit Expense	9227711	NetCommunityBenefitExpense
Percent Of Total Expense	0.20020	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$5,214,395	BadDebtExpenseAmount
Amount Attributable To	1001165	AmountAttributableTo
Amount Reimbursed By Medicare	11530577	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	11416413	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	114164	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

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

Name Name

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

Address Address

Field	Value	IRS element (for citing)
Address Line1	11 EAST PLEASANT AVE	AddressLine1
City	SANDWICH	City
State	IL	State
ZIP Code	60548	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

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

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
Eligibility Criteria Explained	1	EligibilityCriteriaExplained
Uses FPG Free	1	UsesFPGFree
FPG Free Percent	200.000000000000	FPGFreePercent
Uses FPG Discounted	1	UsesFPGDiscounted
FPG Discount Percent	300.000000000000	FPGDiscountPercent
Explains Basis	1	ExplainsBasis
Income Level	X	IncomeLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
State Regulation	X	StateRegulation
Explains Application Method	1	ExplainsApplicationMethod
Includes Publicity Measures	1	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	1	ActionsOnNonpayment
Permit Report To Credit Agency	X	PermitReportToCreditAgency
Permit Lawsuit	X	PermitLawsuit
Collection Activities	0	CollectionActivities
Nondiscrim Emergency Care Policy	1	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	0	AmountsGenerallyBilled
Gross Charges	0	GrossCharges

Form990 Schedule H Part VI Form990ScheduleHPartVI (11 entries)

ExplanationExplanation	IdentifierIdentifier	Return ReferenceReturnReference
PART II: NO COMMUNITY BUILDING ACTIVITIES ARE REPORTED IN PART II.
PART III, LINE 4: NET PATIENT SERVICE REVENUETHE HOSPITAL HAS AGREEMENTS WITH THIRD-PARTY PAYORS WHICH PROVIDE FOR REIMBURSEMENT TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. CONTRACTUAL ADJUSTMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS REPRESENT THE DIFFERENCE BETWEEN THE HOSPITAL'S BILLINGS AT LIST PRICE AND THE AMOUNTS REIMBURSED BY MEDICARE, MEDICAID, BLUE CROSS, AND CERTAIN OTHER THIRD-PARTY PAYORS;AND ANY DIFFERENCES BETWEEN ESTIMATED THIRD-PARTY REIMBURSEMENT SETTLEMENTS FOR PRIOR YEARS AND SUBSEQUENT FINAL SETTLEMENTS. CONTRACTUAL ADJUSTMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ARE ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. A SUMMARY OF THE BASIS OF REIMBURSEMENT WITH MAJOR THIRD-PARTY PAYORS FOLLOWS:MEDICARE: VALLEY WEST COMMUNITY HOSPITAL (VWCH) WAS DESIGNATED AS A CRITICAL ACCESS HOSPITAL DURING FISCAL YEAR 2005. THIS DESIGNATION PROVIDES FOR INPATIENT AND OUTPATIENT SERVICES TO BE REIMBURSED ON A COST BASIS METHODOLOGY. THE HOSPITAL IS REIMBURSED AT A TENTATIVE RATE WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL COST REPORTS BY THE HOSPITAL AND AUDITS THEREOF BY THE MEDICARE FISCAL INTERMEDIARY. THE HOSPITAL'S CLASSIFICATION OF PATIENTS UNDER THE MEDICARE PROGRAM AND THE APPROPRIATENESS OF THEIR ADMISSION ARE SUBJECT TO AN INDEPENDENT REVIEW BY A PEER REVIEW ORGANIZATION. CHANGES AS A RESULT OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES IMPLEMENTATION OF THE PROVISIONS OF THE FUTURE MEDICARE LEGISLATION MAY HAVE AN ADVERSE EFFECT ON THE HOSPITAL'S NET PATIENT SERVICE REVENUE. LAWS AND REGULATIONS GOVERNING THE MEDICARE PROGRAM ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIAMTES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR-TERM.MEDICAID: THE HOSPITAL IS REIMBURSED AT PROSPECTIVELY DETERMINED RATES FOR EACH MEDICAID INPATIENT DISCHARGE. OUTPATIENT SERVICES ARE REIMBURSED BASED ON ESTABLISHED FEE SCREENS. FOR INPATIENT ACUTE CARE SERVICES, PAYMENT RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. THE PROSPECTIVELY DETERMINED RATES ARE NOT SUBJECT TO RETROACTIVE ADJUSTMENT. THE HOSPITAL ALSO RECEIVES INCREMENTAL MEDICAID REIMBURSEMENT FOR SPECIFIC PROGRAMS AND SERVICES AT THE DISCRETION OF THE STATE OF ILLINOIS MEDICAID PROGRAM. MEDICAID REIMBURSEMENT MAY BE SUBJECT TO PERIODIC ADJUSTMENT, AS WELL AS TO CHANGES IN EXISTING PAYMENT LEVELS AND RATES, BASED ON THE AMOUNT OF FUNDING AVAILABLE TO THE MEDICAID PROGRAM. LAWS AND REGULATIONS GOVERNING THE MEDICAID PROGRAM ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR-TERM.IN DECEMBER 2004, THE FEDERAL CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) APPROVED STATE OF ILLINOIS (STATE) LEGISLATION FOR A MEDICAID HOSPITAL ASSESSMENT PROGRAM (PROGRAM). UNDER THE PROGRAM, THE HOSPITAL RECEIVES ADDITIONAL MEDICAID REIMBURSEMENT FROM THE STATE AND PAYS A RELATED ASSESSMENT TAX. THE PROGRAM HAS BEEN EXTENDED THROUGH DECEMBER 31, 2014. BLUE CROSS: THE SYSTEM ALSO PARTICIPATES AS A PROVIDER OF HEALTH CARE SERVICES UNDER A REIMBURSEMENT AGREEMENT WITH BLUE CROSS. THE PROVISIONS OF THIS AGREEMENT STIPULATE THAT INPATIENT SERVICES WILL BE REIMBURSED AT A TENTATIVE REIMBURSEMENT RATE AND THAT FINAL REIMBURSEMENT FOR THESE SERVICES IS DETERMINED AFTER THE SUBMISSION OF AN ANNUAL COST REPORT BY THE SYSTEM AND A REVIEW BY BLUE CROSS. MANAGED CARE ORGANIZATIONS: THE HOSPITAL HAS ALSO ENTERED INTO REIMBURSEMENT AGREEMENTS WITH CERTAIN COMMERCIAL INSURANCE CARRIERS, HEALTH MAINTENANCE ORGANIZATIONS, AND PREFERRED PROVIDER ORGANIZATIONS. THE BASIS FOR PAYMENT UNDER THESE AGREEMENTS INCLUDES DISCOUNTS FROM ESTABLISHED CHARGES AND PROSPECTIVELY DETERMINED PER DIEM RATES.INTERNAL REVENUE SERVICE WORKSHEET 2 (PER SCHEDULE H INSTRUCTIONS) WAS UTILIZED TO DETERMINE THE COST OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS.
PART III, LINE 8: NONE
PART III, LINE 9B: COLLECTION ACTIONS INVOLVING UNINSURED PATIENTS. KHS (KISHHEALTH SYSTEM, PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL) SHALL NOT PURSUE A COLLECTION ACTION AGAINST AN UNINSURED PATIENT, UNLESS THE PATIENT HAS BEEN GIVEN THE OPPORTUNITY TO ASSESS THE ACCURACY OF THE BILL; APPLY FOR FINANCIAL ASSISTANCE UNDER THE KHS FINANCIAL ASSISTANCE POLICY AND PROCEDURE; AND AVAIL HIMSELF OR HERSELF OF A REASONABLE PAYMENT PLAN. NOTWITHSTANDING THIS, KHS MAY NOT PURSUE THE COLLECTION ACTION UNDER THE FOLLOWING CIRCUMSTANCES: (A) IF THE PATIENT HAS INDICATED AN INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT, UNTIL KHS HAS OFFERED THE PATIENT A PAYMENT PLAN. KHS MAY REQUIRE THE PATIENT TO PROVIDE REASONABLE VERIFICATION OF HIS OR HER INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT.(B) IF KHS HAS REASON TO BELIEVE THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, UNTIL KHS HAS GIVEN THE PATIENT AT LEAST 60 DAYS FOLLOWING THE DATE OF DISCHARGE OR RECEIPT OF OUTPATIENT CARE TO SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. (C) IF THE PATIENT HAS AGREED TO A PAYMENT PLAN, UNTIL THE PATIENT HAS FAILED TO MAKE PAYMENTS IN ACCORDANCE WITH THAT PAYMENT PLAN. (D) IF THE PATIENT INFORMS KHS THAT HE OR SHE HAS APPLIED FOR HEALTH CARE COVERAGE UNDER MEDICAID, KIDCARE, OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAM (AND THERE IS A REASONABLE BASIS TO BELIEVE THAT THE PATIENT WILL QUALIFY FOR SUCH PROGRAM), BUT THE PATIENT'S APPLICATION IS DENIED.
PART V, SECTION B, LINE 19D: BASED ON COMPLIANCE WITH LAWS OF STATE OF ILLINOIS, SPECIFICALLY THE UNINSURED PATIENT DISCOUNT ACT.	VALLEY WEST COMMUNITY HOSPITAL
PART VI, LINE 2: VALLEY WEST COMMUNITY HOSPITAL, A CRITICAL ACCESS HOSPITAL, IDENTIFIES COMMUNITY HEALTH NEEDS IN SEVERAL WAYS:* DEKALB AND KENDALL COUNTY HEALTH DEPARTMENT I-PLANS* COMMUNITY HEALTH NEEDS SURVEY* U.S. GOVERNMENT HEALTHY PEOPLE 2010 AND 2010 GUIDELINES* UNIVERSITY OF WISCONSIN POPULATION HEALTH INSTITUTE COUNTY HEALTH RANKINGS & ROADMAPS* INTERNAL REVIEW OF OUTPATIENT AND INPATIENT TRENDS, ESPECIALLY EMERGENCY DEPARTMENT USAGE * INPUT FROM OTHER COMMUNITY PROVIDERS. THIS INCLUDES PROVIDING HOSPITAL LEADERS SERVING ON BOARDS AND COMMITTEES THAT DIRECTLY OR INDIRECTLY IMPACT COMMUNITY HEALTH OR HELP THE HOSPITAL CONNECT TO UNDERSERVED OR VULNERABLE POPULATIONS.
PART VI, LINE 3: INFORMATION IS PROVIDED AT REGISTRATION, VIA THE HOSPITAL WEBSITE, THROUGH CONSULTATIONS WITH FINANCIAL COUNSELORS, DURING THE BILLING PROCESS ON STATEMENTS, AND VIA PHONE CONVERSATIONS.
PART VI, LINE 4: VALLEY WEST COMMUNITY HOSPITAL SERVES ALL OF DEKALB COUNTY, IL, AND BORDER COMMUNITIES IN KENDALL AND LASALLE COUNTIES. THE POPULATION OF THE VALLEY WEST SERVICE AREA, BASED ON THE 2010 CENSUS, WAS 73,630. THIS GEOGRAPHIC AREA INCLUDES A GROWING HISPANIC POPULATION. THE HISPANIC POPULATION IS EXPECTED TO GROW BY 37% BY 2017. POVERTY LEVELS FOR VALLEY WEST'S PRIMARY MARKET AT SANDWICH, 5.5%; SOMONAUK, 10.6%; LELAND, 10.4%; AND PLANO, 6.9%.
PART VI, LINE 5: VALLEY WEST COMMUNITY HOSPITAL, A CRITICAL ACCESS HOSPITAL IN SANDWICH, IL, IS PART OF KISHHEALTH SYSTEM. THE HEALTH SYSTEM IS GOVERNED BY AN APPOINTED VOLUNTEER BOARD OF DIRECTORS, INDEPENDENT COMMUNITY LEADERS WHO RESIDE IN THE PRIMARY MARKETS SERVED BY THE HEALTH SYSTEM'S TWO HOSPITALS. THESE INDIVIDUALS ARE SELECTED FOR THE BOARD BECAUSE OF THEIR INTEREST AND EXPERTISE IN VARIOUS AREAS THAT CAN HELP MANAGEMENT CARRY OUT THE HEALTHY SYSTEM'S MISSION. MEMBERS OF THE BOARD ARE NOT COMPENSATED FOR THEIR TIME. THE MEDICAL STAFF IS OPEN TO PHYSICIANS WHO MEET CRITERIA ESTABLISHED BY THE MEDICAL STAFF BYLAWS. PHYSICIANS ARE GIVEN AND TAKE THE OPPORTUNITY TO VOLUNTEER TO DO FREE COMMUNITY WELLNESS PROGRAMS ON HEALTH TOPICS. SURPLUS FUNDS GO BACK INTO THE ORGANIZATION TO SUPPORT OPERATIONS, CAPITAL IMPROVEMENTS, THE HEALTH SYSTEM'S COMMITMENT TO EXCELLENCE, EDUCATION AND INNOVATION, AND TO PROVIDE MEDICAL CARE TO ALL REGARDLESS OF ABILITY TO PAY. A COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED IN THE FALL OF 2009, VIA A RANDOM TELEPHONE SURVEY. RESULTS ARE ONE COMPONENT USED FOR FY 12 ACTION PLANNING. A COMMUNITY NEEDS ASSESSMENT ALSO WAS DONE DURING THIS CURRENT FISCAL YEAR, THE RESULTS OF WHICH WILL BE REPORTED IN THE 990 REPORT FOR FY 13. BELOW ARE SPECIFIC EXAMPLES OF THE HOSPITAL'S EFFORTS TO PROMOTE HEALTH WITHIN THE COMMUNITY.COMMUNITY HEALTH NEEDS ASSESSMENT: IN COLLABORATION WITH DEKALB COUNTY HEALTH DEPARTMENT, VALLEY WEST COMMUNITY HOSPITAL UNDEWROTE THE COST OF THE DATA COLLECTION PROCESS FOR THE COMMUNITY HEALTH NEEDS ASSESSMENT. THE PREVALENCE OF OBESITY IN CHILDREN AND ADULTS: COMMUNITY WELLNESS INITIATIVE IS TO DECREASE OBESITY AND THE CHRONIC DISEASES ASSOCIATED WITH IT BY OFFERING TARGETED WELLNESS PROGRAMS AND PREVENTATIVE SCREENINGS TO HELP OUR COMMUNITY GET WELL AND STAY WELL. THREE HEALTH PROMOTION SPECIALISTS AND A HEALTHY CULINARY INSTRUCTOR WERE HIRED TO COLLABORATE WITH COMMUNITY ORGANIZATION, SCHOOLS AND TO WORK WITH THE COMMUNITY TO PROMOTE HEALTHY FOOD CHOICES, INCREASE FITNESS, AND DECREASE CHRONIC DISEASE. PROGRAMS INCLUDE FREE KNOW YOUR NUMBERS EVENTS, MANAGING YOUR CHOLESTEROL WITH TLC, FREE BLOOD PRESSURE CLINICS, TIME TO QUIT TOBACCO CLASSES, WELLNESS FOR KIDS PROGRAM IN THE SCHOOLS, WE CAN PROGRAM IN THE SCHOOLS TO HELP PARENTS ADDRESS THE ISSUE OF OVERWEIGHT CHILDREN, KIDS IN THE KITCHEN, LIVE FIT CHALLENGE WITH THE FOX VALLEY FAMILY YMCA, AM I HUNGRY MINDFUL EATING WORKSHOPS. SCHOOL PROGRAMS TOUCHED 13,892 STUDENTS.ACCESS TO AFFORDABLE PRIMARY CARE: NEW PHYSICIANS WHO RECEIVE RECRUITMENT ASSISTANCE FROM KISHHEALTH SYSTEM OR WHO ARE EMPLOYED BY KISHHEALTH SYSTEM ARE REQUIRED TO ACCEPT MEDICAID AND UNINSURED PATIENTS. DURING FY 12, THE HEALTH SYSTEM ESTABLISHED THE NON-PROFIT KISHHEALTH PHYSICIAN GROUP, EMPLOYING SEVEN PHYSICIANS WITH PRACTICES IN SANDWICH, DEKALB AND GENOA . A PEDIATRICIAN AND AN INTERNIST ARE UNDER CONTRACT WITH THE HEALTH SYSTEM TO PROVIDE PART-TIME OFFICE HOURS AT KISHHEALTH FAMILY & SPECIALTY CARE IN WATERMAN, PROVIDING THE RURAL AREAS OF WATERMAN, SHABBONA AND HINCKLEY ACCESS TO CONVENIENT PRIMARY CARE. THE WATERMAN OFFICE ALSO PROVIDES SERVICES FOR THE RURAL MEDICAID POPULATION.MENTAL HEALTH- OUTPATIENT SERVICES: SISTER HOPSITAL, KISHWAUKEE COMMUNITY HOSPITAL, MADE A $50,000 CONTRIBUTION TO BEN GORDON (MENTAL HEALTH) CENTER TO SUPPORT THE COST OF MENTAL HEALTH SERVICES FOR DEKALB COUNTY'S UNINSURED, INCLUDING SERVICES IN SANDWICH. DURING FY 12, CHILD DEVELOPMENT SERVICES OF KISHHEALTH SYSTEM'S BEHAVIORAL HEALTH DEPARTMENT WERE EXPANDED BY ADDING A CHILD PSYCHOLOGIST TO THE STAFF OF THE CHILD DEVELOPMENT CLINIC. THE CHILD DEVELOPMENT CLINIC NOW PROVIDES ASSESSMENT AND INTERVENTION OF CHILDHOOD DISORDERS INCLUDING AUTISM SPECTRUM DISORDERS, DEVELOPMENTAL DELAYS, SLEEP PROBLEMS, ANXIETY, DEPRESSION, AND OTHER MOOD DISORDERS, AS WELL AS COMMON SCHOOL, FAMILY, AND SOCIAL STRESSORS TYPICAL IN CHILDHOOD. IN ADDITION, THE CLINIC IS COLLABORATES WITH KISH HOSPITAL'S UNLIMITED PERFORMANCE REHABILITATION & SPORTS MEDICINE TO PROVIDE A MULTIDISCIPLINARY APPROACH TO THE EVALUATION AND TREATMENT OF CHILDREN WITH COMPLEX DEVELOPMENTAL CONCERNS. THIS UNIQUE AFFILIATION TAKES ADVANTAGE OF UP'S EXPERTISE IN SPEECH-LANGUAGE, GROSS MOTOR, AND FINE MOTOR DEVELOPMENT. THERE WERE 995 VISITS TO THE CHILD DEVELOPMENT CLINIC IN FY 12, A 20.3% INCREASE FROM THE PREVIOUS YEAR. IN ADDITION, PSYCHIATRY, COUNSELING AND EMPLOYEE ASSISTANCE PROGRAM SERVICES AT THE BEHAVIORAL HEALTH CENTER IN SYCAMORE AND AT THE VALLEY WEST COMMUNITY HOSPITAL MEDICAL OFFICE BUILDING HAD A 45% INCREASE OVER THE PREVIOUS YEAR. MENTAL HEALTH - OUTPATIENT SERVICES: DURING FY 12, TALKS WITH ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL, HOFFMAN ESTATES, TO ADDRESS THE NEED FOR INPATIENT MENTAL HEALTH SERVICES FOR KISH AND VALLEY HOSPITAL ER AND INPATIENTS. AN AGREEMENT WAS REACHED, TO BE IMPLEMENTED IN FY 13 THAT WILL FACILITATE TRANSFER OF KISH AND VALLEY WEST PATIENTS TO ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL. THE COST OF THAT CARE FOR UNINSURED PATIENTS WILL BE BORNE BY THE TWO HOSPITALS. TYPE II DIABETES: TO ADDRESS THE PREVALENCE OF DIABETES IN THE ADULT POPULATION, THE SYSTEM CONTINUED TO OPERATE DIABETES EDUCATION CENTERS AT KISH HOSPITAL AND VALLEY WEST WITH SATELLITE SERVICES AT KISHHEALTH FAMILY & SPECIALTY CARE IN GENOA. THE KISH HOSPITAL DIABETES EDUCATION CENTER HAD 8,879 CONSULTATIONS IN FY 12, A 31% INCREASE FROM THE PREVIOUS YEAR. IN FY12, KISH HOSPITAL HELD "THE ABCS OF DIABETES" IN CONJUNCTION WITH DEKALB CLINIC PROVIDING RESOURCES FOR PEOPLE WITH DIABETES. ABOUT 100 PEOPLE ATTENDED. CARDIOVASCULAR DISEASE AND HOSPITAL-BASED AND COMMUNITY OUTREACH SERVICES: COMMUNITY BENEFIT ACTIVITIES IN FY 12 THAT PROMOTED CARDIOVASCULAR HEALTH INCLUDED A WOMEN'S HEALTH EVENT AT VALLEY WEST IN FEBRUARY GREW FROM 250 ATTENDEES IN FY 11 TO 500 IN FY 12. KNOW YOUR NUMBERS EVENTS RESULTED IN 444 FREE SCREENINGS; NUMEROUS COMMUNITY WELLNESS PROGRAMS AND CLASSES'HEALTHY U SUMMER CAMPAIGN: THE SUMMER CAMPAIGN FOR VALLEY WEST AND KISHWAUKEE COMMUNITY HOSPITAL TOOK WELLNESS EDUCATION AND PREVENTION ON THE ROAD TO 69 EVENTS THROUGHOUT THE COMMUNITY AND FOR EMPLOYEES. BLOOD PRESSURE CLINICS: TOTAL FREE BLOOD PRESSURE CHECKS FOR VALLEY WEST WAS 1,396.CANCER CARE SERVICES: MARROW REGISTRY DRIVE AT VALLEY WEST ADDED 25 PEOPLE TO THE NATIONAL REGISTRY. PROVIDED FINANCIAL SUPPORT OF AMERICAN CANCER SOCIETY RELAYS FOR LIFE LOWER FOX VALLEY (KENDALL COUNTY). OTHER: ENTERED INTO AGREEMENTS WITH THE), FOX VALLEY YMCA (PLANO) AND THE SANDWICH PARK DISTRICT TO HELP UNDERWRITE THE COST OF FITNESS AND RECREATIONAL ACTIVITIES FOR COMMUNITY MEMBERS.
PART VI, LINE 6: KISHHEALTH SYSTEM AND ITS NON-PROFIT AFFILIATES, KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE, COMMUNITY CARES CLINIC, KISHHEALTH PHYSICIAN GROUP AND THE KISHHEALTH FOUNDATION, ALL PROMOTE THE HEALTH OF COMMUNITIES IN OUR REGION THROUGH DIRECT SERVICES, DONATIONS OF LEADERSHIP TIME ON VARIOUS COMMITTEES AND BOARDS, AND THROUGH CASH CONTRIBUTIONS.KISHHEALTH SYSTEM UNDERWROTE $500,000 IN OPERATIONAL LOSSES IN FY 12 FOR THE COMMUNITY CARES CLINIC, AND $690,000 FOR DEKALB COUNTY HOSPICE, BOTH VITAL SERVICES FOR THE HEALTH OF THE COMMUNITY. IT ALSO MADE $167,500 IN CONTRIBUTIONS TO SEVERAL ORGANIZATIONS IN FY12, NOTABLY A $50,000 GRANT TO DEKALB COUNTY GOVERNMENT FOR A FIBER OPTIC PROJECT THAT IS ESTABLISHING BROADBAND CONNECTIVITY THROUGHOUT DEKALB COUNTY. THIS PROJECT IS ENABLING HIGH SPEED ELECTRONIC COMMUNICATION TO RURAL AREAS AND TO COMMUNITY INSTITUTIONS SUCH AS SCHOOLS, LOCAL GOVERNMENT, LIBRARIES AND THE TWO KISHHEALTH SYSTEM HOSPITALS IN THE COUNTY. ALSO, $75,000 WAS GIVEN TO DEKALB COUNTY COMMUNITY FOUNDATION TO REMODEL A HISTORIC LANDMARK FOR OFFICES ; AND $25,000 WAS GIVEN TO THE NORTHERN ILLINOIS UNIVERSITY FOUNDATION TO SUPPORT CONSTRUCTION OF AN INDOOR ATHLETIC FACILITY. KISHHEALTH SYSTEM LEADERS SERVE ON THE BOARDS OF PIONEERING HEALTHY COMMUNITIES, KISHWAUKEE YMCA, KISHWAUKEE COLLEGE FOUNDATION, VOLUNTARY ACTION CENTER, DEKALB COUNTY YOUTH SERVICES BUREAU, DEKALB COUNTY EDC;DEKALB, SYCAMORE , GENOA, SANDWICH AND PLANO CHAMBERS OF COMMERCE AND EDCS; THE COMMUNITY CARES CLINIC, VOLUNTARY ACTION CENTER, FAMILY SERVICE AGENCY, FOX VALLEY OLDER ADULT SERVICES, KISHWAUKEE UNITED WAY, IN ADDITION, HEALTH SYSTEM EMPLOYEES CONTRIBUTED MORE THAN 2,400 HOURS OF IN-KIND SERVICE TO COMMUNITY ORGANIZATIONS, EDUCATIONAL INSTITUTIONS AND OTHER ACTIVITIES THAT PROMOTE HEALTH, EDUCATION AND QUALITY OF LIFE. VALLEY WEST COMMUNITY HOSPITAL IS A CRITICAL ACCESS HOSPITAL IN SANDWICH. DEKALB COUNTY HOSPICE, DEKALB, IL, PROVIDES FREE CARE AND SUPPORT FOR THE TERMINALLY ILL AS WELL AS GRIEF SUPPORT TO THE PUBLIC. COMMUNITY CARES CLINIC, DEKALB, IL IS A PRIMARY CARE CLINIC FOR MEDICAID AND UNINSURED; KISHHEALTH PHYSICIAN GROUP PROVIDES ACCESS TO MEDICAL SERVICES, ESPECIALLY THE RURAL AREAS AND ACCEPTS MEDICAID AND UNINSURED PATIENTS, AND KISHHEALTH FOUNDATION IN DEKALB, IL RAISES MONEY FOR KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE AND THE COMMUNITY CARES CLINIC AND FUNDS EQUIPMENT PURCHASES AND PATIENT SERVICES PARTICULARLY IN THE AREA OF CANCER CARE FOR THOSE WHO CANNOT AFFORD IT. KISHWAUKEE COMMUNITY HOSPITAL GAVE $50,000 TO BEN GORDON CENTER FOR MENTAL HEALTH SERVICES FOR THE UNINSURED; $25,000 GRANT TO A CONSTRUCTION PROJECT FOR THE HOPE HAVEN HOMELESS SHELTER; $25,000 TO HELP THE Y PROVIDE FITNESS AND HEALTH ACTIVITIES FOR THE LOW INCOME FAMILIES, $25,000 TO FAMILY SERVICE AGENCY TO SUPPORT BIG BROTHERS BIG SISTERS AND THE COURT APPOINTED SPECIAL ADVOCATE SERVICES FOR ABUSED AND NEGLECTED CHILDREN, AND $17,500 TO HELP KISHWAUKEE COLLEGE EDUCATE HEALTH PROFESSIONALS FOR THE FUTURE.
IL	REPORTS FILED WITH STATES	PART VI, LINE 7

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
FOX VALLEY FAMILY YMCA
3875 ELDAMAIN ROAD	PLANO	IL	60545	363028169	501(C)(3)	10500	UNDERWRITE COST OF HEALTH AND FITNESS PROGRAMS, INCLUDING DISCOUNT FOR EMPLOYEE MEMBERSHIPS
AMERICAN CANCER SOCIETY
143 FIRST STREET	BATAVIA	IL	60510	131788491	501(C)(3)	5000	SUPPORT FOR RELAY FOR LIFE PROGRAM WHICH RAISES FUNDS FOR CANCER RESEARCH AND EDUCATION
FOX VALLEY OLDER ADULT SERVICES
1406 SUYDAM ROAD	SANDWICH	IL	60548	362738669	501(C)(3)	4000	FIRST OF THREE YEAR $10,000 PLEDGE TO SUPPORT COMUPTER TRAINING FOR LOCAL SENIOR CITIZENS

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	3	TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

Field	Value	IRS element (for citing)
Identifier	PROCEDURE FOR MONITORING GRANTS IN THE U.S.:	Identifier
Return Reference	PART I, LINE 2:	ReturnReference
Explanation	SCHEDULE I, PART I, LINE 2: THE ORGANIZATION MAINTAINS SPECIFIC POLICIES AND QUALIFICATIONS FOR ALL GRANTS AVAILABLE. APPLICANTS MUST APPLY FOR THE RESPECTIVE GRANT AND BE APPROVED BY THE FUNDS GOVERNING BOARD. THE USE OF THE FUNDS IS MONITORED BY THE GOVERNING BOARD OF VALLEY WEST COMMUNITY HOSPITAL. REQUESTS FOR FINANCIAL ASSISTANCE FROM OTHER CHARITABLE ORGANIZATIONS ARE REVIEWED AND APPROVED BY THE VP - FINANCE OF KISHHEALTH SYSTEM. IF NECESSARY DUE TO THE DOLLAR AMOUNT OF THE REQUEST, THESE ITEMS MAY ALSO BE PRESENTED TO THE BOARD OF DIRECTORS. A BUDGET IS SET ANNUALLY FOR CHARITABLE ASSISTANCE TO OTHER ORGANIZATIONS	Explanation

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	0	SeverancePayment
Supplemental Nonqual Retire Plan	1	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	0	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	0	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	0	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	0	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	0	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	0	AnyNonFixedPayments
Initial Contract Exception	0	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)

Base Compensation Filing OrgBaseCompensationFilingOrg	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Filing OrgBonusFilingOrg	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Filing OrgOtherCompensationFilingOrg	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Filing OrgDeferredCompFilingOrg	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Filing OrgTotalCompensationFilingOrg	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KEVIN POORTEN
0	515921	0	183040	0	0	0	79288	0	23375	0	801624	0	0
LOREN FOELSKE
0	249213	0	67548	0	0	0	19288	0	22531	0	358580	0	0
BRAD COPPLE
0	287064	0	78836	0	0	0	19288	0	22787	0	407975	0	0
PAM DUFFY
0	196437	0	44975	0	0	0	18566	0	8700	0	268678	0	0
JOE DANT
0	204572	0	59155	0	0	0	19288	0	22453	0	305468	0	0
MIKE MUZZILLO
0	145011	0	34338	0	0	0	12707	0	14872	0	206928	0	0
MIKE KOKOTT
0	161458	0	36639	0	0	0	15303	0	8431	0	221831	0	0
ROGER HEATH BELL
0	191687	0	62069	0	0	0	17393	0	22389	0	293538	0	0
DR MICHAEL KULISZ
0	301391	0	90000	0	0	0	0	0	22661	0	414052	0	0
MARK THATE
0	159512	0	37768	0	0	0	14318	0	15036	0	226634	0	0
CHERYL FISHER
0	125884	0	24307	0	0	0	11004	0	21885	0	183080	0	0
SUE HOHENBERGER
133741	0	7533	0	0	0	10749	0	14885	0	166908	0	0	0

Form990 Schedule J Part III Form990ScheduleJPartIII

Field	Value	IRS element (for citing)
Return Reference	PART I, LINE 4B	ReturnReference
Explanation	THE ORGANIZATION'S CEO PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. CONTRIBUTIONS FOR CALENDAR YEAR 2011 WERE $60,000.	Explanation

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
KISHHEALTH SYSTEM
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, KHS IS PARENT ORGANIZATION OF VWCH	3924864	KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL. 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, BROTHER/SISTER AFFILIATE	70307	HEALTH PROGRESS, INC. IS AN AFFILIATE OF VALLEY WEST COMMUNITY HOSPITAL. HEALTH PROGRESS SUBLEASES OFFICE SPACE FROM VALLEY WEST COMMUNITY HOSPITAL.	0
KISHHEALTH FOUNDATION
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	70545	KISHHEALTH FOUNDATION WAS ORGANIZED TO SUPPORT CHARITABLE HEALTHCARE ORGANIZATIONS. THE FOUNDATION ANNUALLY MAKES CONTRIBUTIONS TO VALLEY WEST COMMUNITY HOSPITAL.	0
KISHHEALTH SYSTEM
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, KHS IS PARENT ORGANIZATION OF VWCH	1710000	DURING THE CURRENT YEAR, VALLEY WEST COMMUNITY HOSPITAL ALSO MADE AN EQUITY DISTRIBUTION BACK TO ITS PARENT ORGANIZATION.	0
KISHWAUKEE COMMUNITY HOSPITAL
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	5031688	VALLEY WEST COMMUNITY HOSPITAL ROUTINELY PURCHASES SUPPLIES AND SERVICES FROM A KISHWAUKEE COMMUNITY HOSPITAL AS PART OF ITS DAY-TO-DAY BUSINESS.	0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 2	KEVIN POORTEN AND LOREN FOELSKE ARE BOTH EMPLOYEES OF KISHHEALTH SYSTEM, THE PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL. 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, WHICH IS THE PARENT ORGANIZATION FOR ALL RELATED ENTITIES. BRAD COPPLE, AS THE PRESIDENT OF VWCH, IS CONSIDERED AN OFFICER. HE IS ALSO PRESIDENT OF KISHWAUKEE COMMUNITY HOSPITAL, A RELATED ENTITY, AND IS COMPENSATED BY KISHHEALTH SYSTEM. MR. POORTEN AND MR. FOELSKE ARE ALSO CONSIDERED OFFICERS OF KISHWAUKEE COMMUNITY HOSPITAL AND KISHHEALTH SYSTEM, AS DESCRIBED ABOVE. ERIK ENGLEHART AND TERRENCE DUFFY ARE MEMBERS OF THE VALLEY WEST COMMUNITY HOSPITAL BOARD OF DIRECTORS. THEY ALSO SERVE ON THE BOARD OF DIRECTORS OF KISHHEALTH SYSTEM, THE PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL. THE FOLLOWING INDIVIDUALS ARE OFFICERS OR KEY EMPLOYEES OF KISHHEALTH SYSTEM AND ARE ALSO CONSIDERED OFFICERS OR KEY EMPLOYEES OF VALLEY WEST 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 HEATH BELL, VP AND CHIEF INFORMATION OFFICER MARK THATE, VP HUMAN RESOURCES DR. MICHAEL KULISZ, CHIEF MEDICAL OFFICER MIKE MUZZILLO, VP OPERATIONS - VWCH
FORM 990, PART VI, SECTION A, LINE 6	KISHHEALTH SYSTEM IS THE SOLE MEMBER OF VALLEY WEST COMMUNITY HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	AS THE SOLE MEMBER AND PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL, KISHHEALTH SYSTEM HAS THE RIGHT TO APPROVE THE ELECTION OF MEMBERS OF THE HOSPITAL'S GOVERNING BOARD, PER THE HOSPITAL'S BYLAWS.
FORM 990, PART VI, SECTION A, LINE 7B	KISHHEALTH SYSTEM (KHS) SERVES AS THE SOLE MEMBER AND PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL (VWCH). PER THE BYLAWS, WITH RESPECT TO THE GOVERNANCE OF VWCH, THE FOLLOWING POWERS SHALL BE RESERVED TO THE SOLE CORPORATE MEMBER: A. ELECTING THE MEMBERS OF THE VWCH BOARD; B. APPROVING, EVALUATING AND/OR REMOVING THE PRESIDENT AND CEO AND REVIEWING AND APPROVING THE EMPLOYMENT CONTRACT OF THE PRESIDENT AND CEO AND ESTABLISHING COMPENSATION FOR SUCH OFFICE; C. APPROVING THE STRATEGIC PLAN FOR VWCH; D. APPROVING THE DISPOSITION OF ANY ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS FOR VWCH; E. APPROVING ANY CHANGE IN MEMBERSHIP OF VWCH; F. APPROVING THE ADOPTION OF AND AMENDMENTS TO THE ORGANIZATIONAL DOCUMENTS, INCLUDING THE ARTICLES OF INCORPORATION AND BYLAWS OF VWCH; G. APPROVING A PLAN OF MERGER OR A PLAN OF CONSOLIDATION OF VWCH OR ESTABLISHING A NEW SUBSIDIARY OR SISTER ENTITY; H. APPROVING A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF VWCH; I. INITIATING, TAKING ANY AND ALL ACTIONS, AND EXERCISING ALL APPROVAL RIGHTS OF THE DIRECTORS PURSUANT TO THE APPLICABLE MEDICAL STAFF BYLAWS; J. IMPLEMENTING AND MONITORING VWCH OPERATIONAL QUALITY IMPROVEMENT POLICIES AND PROGRAMS; K. ACCEPTING GIFTS, GRANTS, BEQUESTS AND DONATIONS ON BEHALF OF VWCH; L. APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGETS FOR VWCH; M. EXERCISING ANY RIGHTS THAT VWCH HAS AS A SHAREHOLDER OR MEMBER OF ANY SUBSIDIARY ENTITY; N. APPROVING ANY AFFILIATIONS OF VWCH; O. APPROVING AND/OR DETERMINING (I) THE CREATION OF NEW HEALTH SERVICES TO BE PROVIDED AND THE LOCATION OF SUCH HEALTH SERVICES AND (II) THE DISCONTINUANCE OF ANY HEALTH SERVICE; P. AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF VWCH; Q. AUTHORIZING THE VOLUNTARY DISSOLUTION OF VWCH, OR REVOKING THE PROCEEDINGS THEREOF; R. REQUIRING MINUTES OF MEETINGS, FINANCIAL RECORDS, AND SUCH OTHER INFORMATION AS MAY BE NECESSARY TO PROPERLY EVALUATE THE PERFORMANCE OF VWCH; S. INITIATING ACTION TO REMOVE OR REINSTATE A DIRECTOR WHEN, IN THE OPINION OF THE KHS BOARD, IT IS IN THE BEST INTERESTS OF KHS OR VWCH. ANY ACTION TO REMOVE OR REINSTATE SHALL REQUIRE A MAJORITY VOTE OF THOSE KHS DIRECTORS THEN IN OFFICE PRESENT AND VOTING AT A MEETING OF THE KHS BOARD AT WHICH A QUORUM IS PRESENT. IN ANY ACTION(S) TO REMOVE TAKEN BY THE KHS BOARD, THE DIRECTOR IN QUESTION SHALL BE ADVISED AT LEAST TWENTY (20) DAYS PRIOR TO THE MEETING THAT THE ACTION WILL BE CONSIDERED AND SHALL BE GIVEN THE OPPORTUNITY TO MAKE A STATEMENT, PRESENT WITNESSES ON HIS/HER BEHALF AND QUESTION THOSE PRESENTING REASONS FOR HIS/HER REMOVAL. ALL ACTIONS TO REMOVE SHALL BE TAKEN IN CLOSED SESSIONS OF THE KHS BOARD; AND T. TRANSFERRING MONEY OR PROPERTY AMONG VWCH, KHS AND/OR ONE OR MORE SUBSIDIARY CORPORATIONS AND TRANSFERRING MONEY OR PROPERTY FROM A SUBSIDIARY CORPORATION, INCLUDING REQUIRING THE DIRECTORS, OFFICERS, OR TRUSTEES OF ANY SUBSIDIARY CORPORATION TO TRANSFER MONEY OR OTHER PROPERTY TO KHS. SUBJECT TO THE POWERS OF THE BOARD OF DIRECTORS OF EACH SUBSIDIARY CORPORATION, THE KHS BOARD MAY INITIATE AND TAKE THE FOREGOING ACTIONS ON BEHALF OF KHS AND THE SUBSIDIARY CORPORATIONS.
FORM 990, PART VI, SECTION B, LINE 11	A DRAFT COPY OF FORM 990 IS PROVIDED TO THE GOVERNING BODY (BOARD OF DIRECTORS) AND THE GOVERANCE COMMITTEE FOR REVIEW BY THE RETURN PREPARER PRIOR TO FILING. THE ORGANIZATION'S CEO, CFO, AND OTHER MEMBERS OF THE ACCOUNTING DEPARTMENT ARE ALSO PROVIDED A COPY OF THE RETURN FOR THEIR REVIEW. THE CHAIR OF THE AUDIT COMMITTEE AND THE AUDIT COMMITTEE MEMBERS ARE ALSO PROVIDED DRAFT COPIES AND REVIEW. IF CHANGES ARE NECESSARY, THEY ARE REPORTED TO THE RETURN PREPARER AND INCORPORATED INTO THE FINAL RETURN.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICTS OF INTEREST ARE INVESTIGATED BY APPOINTED MEMBERS OF THE GOVERANCE COMMITTEE ON AN ONGOING BASIS. IF IT IS DETERMINED THAT AN INDIVIDUAL FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE INDIVIDUAL OF SUCH A BELIEF AND AFFORD HIM AN OPPORTUNITY TO EXPLAIN. AFTER SAID EXPLANATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION AS DEEMED NECESSARY. THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD ANNUALLY AND UPDATED AS NEEDED.
FORM 990, PART VI, SECTION B, LINE 15	THROUGH THE OVERSIGHT OF THE BOARD OF DIRECTORS EXECUTIVE COMPENSATION COMMITTEE, THE KISHHEALTH SYSTEM EXECUTIVE TOTAL COMPENSATION PROGRAM WILL BE COMPETITIVELY POSITIONED IN THE MARKET PLACE OF RELEVANT ORGANIZATIONS AND FALL WITHIN THE SAFE HARBOR GUIDELINES ESTABLISHED BY THE INTERMEDIATE SANCTIONS RULES. THE EXECUTIVE COMPENSATION COMMITTEE IS MADE UP OF THREE MEMBERS OF THE BOARD OF DIRECTORS WHO MEET THE BOARD APPROVED DEFINITION OF "INDEPENDENT DIRECTORS". ANNUALLY THE EXECUTIVE COMPENSATION COMMITTEE CONTRACTS WITH SULLIVAN, COTTER AND ASSOCIATES, AN INDEPENDENT HUMAN RESOURCES CONSULTING FIRM TO PROVIDE THE COMMITTEE ANALYSIS AND COMPARABILITY DATA. USING THE SUPPLIED DATA THE COMPENSATION COMMITTEE APPROVES EACH EXECUTIVE'S TOTAL CASH COMPENSATION AND PROVIDES CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. TOTAL CASH COMPENSATION IS DEFINED AS THE SUM OF BASE SALARIES PLUS INCENTIVE AWARDS. BASED ON THE COMPARABILITY DATA AND THE PERFORMANCE OF EACH EXECUTIVE IN MEETING GOALS AND STRATEGIC OBJECTIVES, THE EXECUTIVE COMPENSATION COMMITTEE APPROVES INCREASES AND INCENTIVE AWARDS FOR EACH EXECUTIVE WITHIN THE GUIDELINES ESTABLISHED. THE EXECUTIVE COMPENSATION COMMITTEE REPORTS ON ALL COMPENSATION MATTERS TO THE FULL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN WRITING TO ADMINISTRATION.
FORM 990, PART VII, COLUMN (B)	AVERAGE HOURS PER WEEK FOR THE INDIVIDUALS IDENTIFIED AS OFFICER'S ARE ESTIMATES OF THE INDIVIDUALS TOTAL TIME PER WEEK UTILIZED FOR WORK RELATED TO VALLEY WEST COMMUNITY HOSPITAL.	DESCRIPTION OF HOURS FOR RELATED ORGANIZATIONS
FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -157,253. EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM, INC. -1,710,000. GRANT INCOME RECORDED AS OFFSET TO FIXED ASSET ACCOUNTS -35,005. CHANGE IN NET ASSETS OF KISHHEALTH FOUNDATION -34,806. TOTAL TO FORM 990, PART XI, LINE 5: -1,937,064.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2C	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. KISHHEALTH SYSTEM IS THE PARENT CORPORATION OF VALLEY WEST COMMUNITY HOSPITAL.	REPONSIBILITY FOR OVERSIGHT OF FINANCIAL STATEMENTS

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Direct Controlling Entity NADirectControllingEntityNA	Controlled OrgControlledOrg
KISHHEALTH SYSTEM
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	363649080	PARENT CORPORATION OF 501(C)(3) HEALTH SYSTEM	IL	501(C)(3)	11B	N/A	0
KISHHEALTH FOUNDATION
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	363649077	SUPPORT OF CHARITABLE HEALTH ORGANIZATIONS	IL	501(C)(3)	7	N/A	0
KISHWAUKEE COMMUNITY HOSPITAL
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	237087041	HEALTHCARE SERVICES, PRIMARILY ACUTE CARE	IL	501(C)(3)	3	N/A	0
DEKALB COUNTY HOSPICE
2727 SYCAMORE ROAD	DEKALB	IL	60115	363164329	HOSPICE SERVICES	IL	501(C)(3)	7	N/A	0
COMMUNITY CARES CLINIC
3100 SYCAMORE ROAD	DEKALB	IL	60115	800424001	HEALTHCARE SERVICES, PRIMARY CARE	IL	501(C)(3)	3	N/A	0
KISHWAUKEE PHYSICIANS GROUP INC
2240 GATEWAY DRIVE	SYCAMORE	IL	60178	651293967	HEALTHCARE SERVICES, PRIMARILY FAMILY PRACTICE	IL	501(C)(3)	3	N/A	0

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

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

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	ONE KISH HOSPITAL DRIVE	AddressLine1
City	DEKALB	City
State	IL	State
ZIP Code	60115	ZIPCode

Field	Value	IRS element (for citing)
EIN	363824138	EIN
Primary Activity	INVESTMENT IN HEALTHCARE RELATED SMALL BUSINESSES	PrimaryActivity
Legal Domicile State	IL	LegalDomicileState
Direct Controlling Entity NA	N/A	DirectControllingEntityNA
Type Of Entity	C	TypeOfEntity

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