2012-11-07T15:57:14-00:00 2011-12-31 PricewaterhouseCoopers 2001 Market St Ste 1700 Philadelphia PA 19103 990 2011-01-01 362167847 Rockford Memorial Hospital ROCK 8159715000 2400 N Rockton Ave Rockford IL 61103 Henry M Seybold 2012-11-06 true Matthew Petroski 2673303000 2011 2016-02-24 21:20:13Z Gary Kaatz 2400 N Rockton Ave Rockford IL 61103 472436585 false X www.rhsnet.org X 1905 IL To improve and protect the health and welfare of the community in accordance with our mission Superior Care, Every Day, For all our patients. A 396-bed hospital with a Level 1 Trauma Center, Level III Neonatal Intensive Care Unit, regions only Pediatric Intensive Care Unit designated Disaster POD hospital. 14 7 2808 368 686584 -67770 4003677 5435291 349978108 339566034 6026508 2459256 164128 1986709 360172421 349447290 845017 580004 0 137556563 144424398 0 0 146852556 153454823 285254136 298459225 74918285 50988065 372867851 363793401 208340079 206619071 164527772 157174330 X The Mission of Rockford Health System and Rockford Memorial Hospital is Superior Care, Every Day, For All Our Patients. We will fulfill our commitment through performance excellence, innovation, and lifelong learning. false false 162083950 207940086 Rockford Memorial Hospital is a not-for-profit charitable healthcare institution that functions in accordance with all applicable laws and regulations. In the course of operations, RMH is committed to provide superior care every day for all its patients. RMH is a 396-bed regional referral hospital which includes a Level I Trauma Center, Level III Neonatal Intensive Care Unit and the regions only Pediatric Intensive Care Unit. In 2011 patient care was rendered to 12,849 individuals who presented themselves for service including 1,529 deliveries and 3,673 inpatient surgeries along with supporting 50,800 emergency visits. 74655776 128814607 RMH is designated by the IL Dept of Health as the Disaster POD hospital for the Northern IL EMS region. As a Level I Trauma Center, RMH provides patient care, diagnostic and therapeutic services 24/7 to all who present themselves for service. In 2011 that included 1,261 visits to the sleep lab 89,946 diagnostic radiology procedures or tests 8,029 Radiation Oncology treatments 35,044 cardiac prodcures or tests 5,089 visits to the Pain Clinic and 200,374 respiratory therapy treatments. Through the outreach services of Rockford Health Medical Laboratories RHML, RMH has provided timely and responsive lab services to other hospitals, physicians offices, and government agencies, while the in-house laboratory provides testing for all who present themselves at the hospital for treatment. In 2011, RHML performed 1,474,737 tests. 4456509 420004 64642 RMH has provided health education and putreach in a variety of forms within the eleven country area that includes several school partnerships, mentoring, health programs, teaching, job shadowing and volunteering. RMH hosts support groups, training classses, and lectures series for health and safety related topics. Employees staff community health fairs and open health screenings. In a program jointly sponsored with Ronald McDonald Charities, RMH staffs the Caremobiles which provided 711 health and dental checkups and basic health services to 496 underinsured and uninsured chilldren. RMH also provides both foreign language and hearing impaired assistance to patients and their families to help them communicate with medical personnal for treatment. Funds were also used to improve general healthcare conditions throughout the state. 820140 160000 388931 242016375 true true false false false false false false false true true false false true true false false true false false false false false false false false true true true false true true false false false false false true true true false false false false true true true true true false true 193 0 2808 true true true true BD false false false false false false false false X 14 7 false false false false true true true true true false false true true true false true true true true true false IL X David Vola Controller 8159715000 2400 N Rockton Avenue Rockford IL 61103 X James WBreckenridge 001.00 X 0 454003 37875 Thomas DBudd 000.30 X 0 0 0 John WChadwick 000.30 X 0 0 0 Eleanor FDoar 001.00 X 0 0 0 John TDorsey 000.10 X 0 326375 51104 Pamela SFox 000.10 X 0 0 0 Jos LGonzalez 000.70 X 0 397162 54899 Alphonso NGoode 001.00 X 0 0 0 Jack WPackard 000.50 X 0 0 0 Dennis TUehara 020.50 X 0 469530 71890 Connie MVitali 002.00 X 0 0 0 Curtis DWorden 000.50 X 0 0 0 Paul AGreen 001.00 X X 0 0 0 Duane RBach 000.10 X X 0 0 0 Gary EKaatz 001.00 X X 0 1065011 210096 Henry MSeybold 003.00 X 0 494320 104980 Julie APeterson 001.00 X 0 77262 34984 Gordon Langejans 031.30 X 313003 0 53612 Kerry Hill 040.00 X 0 243925 87263 Carolyn Bengtson 040.00 X 331849 0 71478 Michael Tyrkus 040.00 X 226874 0 54374 Susan Schreier 040.00 X 252442 0 67288 Curt Lesher 040.00 X 186569 0 38928 Lawrence Verfurth 040.00 X 344624 0 70608 Dan Parod 040.00 X 0 398441 90152 1655361 3926029 1099531 15 true true false Philips Medical System PO Box 100355 Atlanta GA 30384 Contract Maintenance 2066730 Cardiac Surgery Associates PO Box 1285 Joliet IL 604341285 Healthcare Provider 1200000 Schmeling Construction Co 315 Harrison Ave Rockford IL 61104 General Contractors 2391554 HLS Wheeling LLC 45 W Hintz Wheeling IL 600906073 Laundry Services 1112330 Air Methods Corp PO Box 676592 Dallas TX 752676592 Helicopter Pilot/Services 1213288 69 855610 4577402 2279 5435291 Inpatient Routine Ancillary 900099 95781125 95781125 Outpatient Emergency 621400 77980458 77980458 Diagnostic Medical Laboratory 621500 11592548 10922229 670319 Medicare/Medicaid 900099 149839565 149839565 4372338 1856087 11425 2493400 339566034 942146 942146 501884 328376 173508 173508 142218 31290 124164954 13075 122630955 29964 1533999 -16889 1517110 1517110 Cafeteria/Food Service/Catering 722320 1813201 4840 1808361 1813201 349447290 336521682 686584 6792307 580004 580004 0 0 0 369086 369086 0 107475700 85795649 21680051 7875308 3433571 4441737 21494708 19799336 1695372 7209596 6243896 965700 4028495 18688 4009807 170195 170195 177702 177702 0 722261 722261 869474 376209 493264 984572 3305 981267 9968619 6234613 3734006 8878695 3733206 5145489 0 9665537 6233824 3431713 161014 129975 31039 0 625743 181816 443927 2664447 2664447 0 16035682 10308375 5727307 5401312 4274318 1126994 Medicaid Assessment Tax 9947850 9947850 Supplies/Drugs 47898838 47653459 245379 Healthcare Services 12069966 12069966 Bad Debt Expense 15733857 15733857 7450564 6600011 850553 298459225 242016375 56442849 0 3500 4300 56353959 24657024 494476 393042 44815243 63598137 12713 8339 6056539 6499050 6805891 6476302 285367409 196889444 79293676 88477965 158236077 153262728 20795777 20416514 372867851 363793401 108410765 113099756 70987769 67936205 685072 174834 28256473 25408276 208340079 206619071 X 156330922 148928034 5571691 5621137 2625159 2625159 164527772 157174330 372867851 363793401 X 50988065 -58341507 X false true true X true true X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false 4630241 857889 -82645 170000 687889 28254 4519342 4309770 748599 347198 190000 558599 26727 4630241 3472212 555556 938002 250000 381821 24179 4309770 4463526 800219 -1259075 200000 305881 26577 3472212 1.00000 false true true 468730 2111708 2580438 5460891 48690900 37693422 16458369 99060 91690 7370 212480448 153714230 58766218 16055672 5390102 10665570 88477965 Deferred Financing Costs 591145 Other 5113654 Land Held for Future Use 6422260 Partnerships 8289455 Deposits 20416514 Post Retirement 5379032 Basic Pension 19706195 Capital Lease 323049 25408276 X 2 - Rockford Memorial Hospital as a part of RHS Rockford Health System adopted FIN 48 in 2007 and the impact was not material. Therefore there was no audit footnote in 2011. true true X true X 0000000175.000000000000 true X true true true false true true 8668477 8668477 0.02820 75103382 83356760 -8253378 83771859 83356760 415099 0.02820 1660967 734255 926712 0.00310 1854173 179627 1674546 0.00560 25696858 22760647 2936211 0.00980 485891 485891 0.00160 29697889 23674529 6023360 0.02010 113469748 107031289 6438459 0.04830 true 15761729 82677418 84499414 -1821996 X true true VanMatre Health South Rehab Hospital 0.50000 2 1 Rockford Memorial Hospital

2400 N Rockton Avenue Rockford IL 61103

X X X X X X 2 VanMatre Health South

950 S Mulford Rockford IL 61108

X Rehabilitation Part I line 3c Rockford Memorial Hospital RMH offers two charity care programs - HUPDA and our traditional charity care program. We will process charity care for whichever provides the highest percentage of discount. These criteria are determined as early as possible, preferably before or at the time of service. HUPDA is the Illinois Hospital Uninsured Patient Discount Act for all uninsured patients. Eligibility consists of being an uninsured Illinois resident, income below 600 of FPG, being Part I line 3c continued treated for a medically necessary condition or event, limited to 25 of annual income. Patients submit proof of income including tax returns/pay stubs within 60 days of discharge. Traditional discounts follow our internal traditional charity care program for those who are uninsured or are insured with a patient liability. This income limit is 300 of FPG. Patient must submit proof of income that includes tax returns. Underinsured patients may be eligible for other Part I line 3c continued discounts towards the patient liability. There are also potential discounts for Catastrophic Financial Assistance and/or Prompt Pay. Extenuating circumstances may also be taken into account. Our partner hospital VMHS is a for-profit hospital that is part of a larger health organization. Therefore most of the responses concern only the RMH process and procedures. Part I line 6a Rockford Health System prepares an annual Hospital Community Benefit Report as required by the State of Illinois. The report includes data for Rockford Memorial Hospital RMH as well as the other four related tax-exempt organizations. The report is distributed within the health system and is also available upon request. Part I line 6a continued Our partner hospital VMHS is a for-profit hospital that is part of a larger health organization. As such, they do not prepare a community benefit report. This and most of the following responses concern only the RMH process and procedures. Part I line 7 The hospital utilized both the Medicare Cost Report CCR cost-to-charge ratio and our cost accounting system to determine the cost of charges, bad debt and charity care expense included in Line 7. The subsidized programs also include the costs based on a calculated CCR from our physician clinic because there are no physicians costs included in the hospital cost accounting analysis. Bad debt and charity at cost have been removed from lines 7e/7f/7g since those costs were previously included. Part III line 4 Rockford Health System Consolidated Audit reports The Systems policy is to provide medically necessary health care services regardless of the patients ability to pay for such care. RHS maintains records to identify and monitor the charity, uncompensated care and community benefit it provides. These records include the cost for services and supplies furnished under its policies as well as the estimated difference between the cost of the services provided to Medicaid patients and the reimbursement received from the state for this care. The costs of service are estimated using the annual cost-to-charge ratio. Part III line 4 cont During the years ended December 31, 2011 and 2010, the following levels of charity care and community service, including serviced for which the System received no reimbursement or was reimbursed below cost, were provided. Estimated costs and expenses incurred for charity care in 000s 2011 -10,185 2010 - 10,772. Estimated cost over reimbursement for Medicaid patients care 2011 - 9,388 2010 - 4,299. Cost of other Charity Care and Community Benefits 2011 - 25,385 2010 - 21,668. Part III line 4 cont In addition to the above, the System received no reimbursement or is reimbursed below cost for these services, for the years ended December 31, 2011 and 2010 Estimated cost over reimbursement for Medicare patients care 2011 - 32,608 2010 - 26,273. Estimated costs for bad debt 2011 - 9,029 2010 - 7,847. Part III line 4 cont Total cost of Charity, Uncompensated Care Other Community Services 2011 - 67,022 2010 - 55,788 community service, research and education 2011 - 5,812 2010 - 6,597. The System actively sponsors community benefits that respond to community needs. These programs focus on the underserved with the intention of improving the overall health of the entire community. Examples of this outreach include mobile clinics, partnering with local schools and employers to provide health Part III line 4 cont screenings, support and health education providing social services, such as multi-faith ministry, intepreters and support groups providing emergency medical training to other providers across the region and serving as the regions emergency disaster response center. Our 24 hour emergency room, mental health services, and multiple convenient care locations provide for various Part III line 4 cont and timely health care needs throughout the region. Since bad debt is often difficult to distinguish from charity care due to insufficient data provided by the patient, RMH continues to provide superior care to all patients as a part of its mission and considers the cost of bad debt writeoffs as a substantial benefit to the community. Part III line 4 continued Van Matre Health South is a partnership 50 owned by Rockford Health System Ventures LLC, a disregarded entity owned 100 by Rockford Memorial Hospital. It is a for-profit organization that does not report any separate footnote regarding charity care or bad debt. Part III line 8 The data reported for Medicare charges and payments is from the final Management Report produced by the firm that prepared the 2011 Cost Report as submitted to the Fiscal Intermediary in 2012 in compliance with all current regulations. Reported on Line 6 are allowable Medicare Costs provided by the Cost Report. Medicare costs are eliminated from the Subsidized Programs on Part 1 Ln 7g as calculated by our cost accounting analysis. Part III line 8 continued A combination of cost accounting and the Medicare CCR was used for the computation of subsidized programs. This Section B-Medicare also includes 50 of the Medicare activity from Van Matre Health South VMHS and the corresponding cost based entirely on their Medicare CCR. Part III line 9b Rockford Memorial Hospital has a strong commitment to provide quality patient care for all individuals. Our mission is to provide health care to everyone who comes to our door, regardless of their ability to pay. We will submit a claim to all 3rd party payors on behalf of the patient. We help patients apply for all possible insurance or assistance such as crime victims, an automobile accident, workers compensation, Medicaid, COBRA, local assistance and/or hospital financial assistance. Part III line 9b cont If they do not qualify for any of these, we can extend payment options such as monthly payments, credit card payments or financial assistance. This is offered to patients who are experiencing legitimate financial hardships and are unable to pay for all or part of the patients medical care. Forgiveness may apply to an amount after applying all payments such as any insurance company, health plan or personal payments, any negotiated discounts or any uninsured discounts. Part III line 9b cont If a patient eligible for charity care or partial financial assistance still has a portion of the outstanding balance due, other arrangements are made. RMH accepts a variety of payments and alternative payment plans. Monthly statements are sent as payment reminders for contracted arrangements. In case of default, additional letters and calls are made to bring it to a current status. An account is turned over to a collection agency only after non-payment or no contact in 120 days. Part III line 9b Our partner hospital VMHS is a for-profit hospital that is part of a larger health organization. Much of the information that would normally be required for a non-profit is not pertinent. Therefore most of the responses concern only the RMH process and procedures. Part V Line 3 - In 2011 The Rockford Health Council produced a regional health needs assessment with extensive interviews and surveys taken during 2010. Contacts included Focus groups, health care providers, Community analysis, Household surveys all of which included local and state government organizations, local businesses, and local educators pre-school through college. Part V Line 3 cont The survey was done with funding, cooperation, participation and assistance from all three Rockford hospitals - RMH, SwedishAmerican Hospital and St. Anthonys Medical Center. Survey is available and was promulgated within the community by the Rockford Health Council, survey participants and was made available on several websites. Part V Line 19 d - All patient accounts are reviewed for insurance, for other potential providers or government assistance. Then all discounts available to either insured, self-pay, underinsured or uninsured people are applied. After determining the liability for each person at the time of billing, Part V Line 19 d cont - other requests for financial assistance are processed, further assistance may be offered and discounts applied, payment plans are set up, and payment agreements reached. Then, after 120 days of no contact or inactivity on a past due balance, the account may be turned over to a collection agency. Part V Line 20 - All charges for any service provided by Rockford Memorial Hospital are the very same for every individual, regardless of whether it is for emergent or standard care and regardless of the patients ability to pay. Once a patient is determined to be eligible for financial assistance, the applicable discounts are applied to his/her account. Part V Line 21 - The charges billed are always uniform, the amount collected amounts may vary depending on applicable discounts. Part V General information regarding Hospital 2 - Our partner hospital VMHS is a for-profit hospital that is part of a larger health organization. Much of the information that would normally be required for a non-profit is not pertinent. Therefore most of the detailed responses concern only the RMH process and procedures. Part VI Line 2 In 2010 the Rockford Health Council began to gather data from the Northern Illinois region encompassing Winnebago and Boone Counties. RHS support was financial, technical and included significant representation on both the Rockford Health Council Board of Directors and the surveying staff. This collaborative effort, partnering healthcare and education, gathered, analyzed and reported on the health needs of the community. The other two area hospitals both supported and participated Part VI Line 2 to produce a major effort which was released to the community in July 2011. It revealed trends, changes and unmet needs. The survey is available on the Rockford Health Council website. This assessment serves as a blueprint for future health care initiatives and points toward growth in our region.The priorities identified were used as the framework in the development of the RHS Community Benefit Plan. Each priority has a specific overriding strategy with stated detailed tactics Part VI Line 2 and measureable objectives. An executive summary detailing the process and findings, the RHS Community Plan document, and a partial inventory detailing many of the significant programs and initiatives that support RHS commitment to improving the overall health and well-being of the community residents were included. In December 2011, the Board of Directors approved the resolution to adopt of the Rockford Health System Community Benefit Part VI Line 2 Plan and subsequent implementation of its recommendations. RHS is continuing with development and implementation of a comprehensive multifaceted community benefit plan to improve the overall health and well-being of residents in the primary service area. Part VI Line 3 RMH posts signs in all general registration areas and the emergency department in both Spanish and English to indicate that financial assistance is available for those who qualify. The organizations web site states Patients throughout Rockford Health System are treated regardless of their ability to pay. Click on the entity above to learn more. The RMH link to Financial Assistance and Discount Programs explains the process in this manner Rockford Health System provides health Part VI Line 3 care regardless of the patients ability to pay for such care. These guidelines are intended to provide a framework to offer assistance to patients and families with legitimate financial hardship, who are unable to pay for all or a portion of their medical care. Covered services are those which are determined medically necessary by a physician. Our Financial Assistance Programs are based on whether you have insurance coverage of any kind or are uninsured. Part VI Line 4 RMH is located in Rockford, IL Winnebago County with a defined primary service area that includes Winnebago, Boone and Ogle counties. 2010 US Census Bureau data places the population for this service area at approximately 403,000 individuals with close to 3/4 living in Winnebago County approximately 295,000. This represents a drop in population of approximately 6000 individuals from 2009 Census information and 2011 US Census estimates project another decrease to 401,500 residents. Part VI Line 4 Located in northern Illinois, the primary service area is characterized as largely rural and populated with very small communities with the exception of the neighboring cities of Rockford, Loves Park, and Machesney Park which comprise more than 200,000 individuals. The hospital also serves the secondary service area which includes DeKalb, McHenry, Whiteside, Lee, LaSalle, Stephenson and Rock counties for select tertiary services. Part VI Line 4 The next largest community is Belvidere, located in Boone County, where the entire county has just over 54,000 residents. More than 86 of hospital inpatients are from the Primary Service Area. As a community that relies heavily on manufacturing companies and small businesses, the area continues to experience difficult economic times. Currently the largest employers include Chrysler Boone County, the Rockford school district, and the three Rockford health care providers. Part VI Line 4 Median household income in 2010 inflation adjusted dollars per the U.S. Census Bureau in Winnebago County was 43,792 representing a drop from 2009 median income levels of 47,600. In comparison, the states 2009 median household income was approximately 53,974. These disparities are also reflected in unemployment, education and poverty rates. Rockford April 2012 unemployment rate was 10.7 significantly higher than the overall state rate of 8.7. Part VI Line 4 Most recent census figures estimate 20 of Winnebago County residents attain a bachelors degree while in the state more than 29 attain one. Poverty levels continue to rise with approximately 18 of Winnebago County residents below the poverty level compared to state levels of 13. The 2010 Illinois Kids Count report stated 34 of children in Rockford live at or below the federal poverty rate, placing Rockford with the highest rate in the state of Illinois. Part VI Line 4 These conditions have resulted in increasing pressures on the community. RMH is located in the older, western portion of the city and serves a significant indigent and elderly population. This is evident when looking at income levels for households located in zip codes in western Rockford where the hospital resides. U.S. Census Bureau profile for individual zip codes lists median household income for west side zip codes as follows 61103 - 37,000 61102 - 34,000 61101 - 31,700. Bad debts from these zip codes accounted for more than7.6 million - 42 of the hospital total. Part VI Line 4 The geographic disparities are evident, compared to households on the east side of Rockford. The 3 largest east side zip codes have median household incomes of 61107 - 49,000 61108 - 44,700 61114 - 67,000. As the only northern Illinois hospital with Level III neonatal intensive care, comprehensive pediatric and pediatric intensive care, RMH is committed to children Part VI Line 4 as the main provider of childrens services in the immediate and greater tertiary service area. With 1 in 3 children currently at or below federal poverty levels in the county and the overall economic condition of the community, the hospital has seen increases in uninsured and public aid patients and this trend continues to grow. Part VI Line 5 Led by Community Boards of Directors, Rockford Memorial Hospital RMH and its affiliates are extremely involved in promoting a healthier community. As one of Rockfords largest employers, the organization takes a leading role in financially supporting not only health-related initiatives, but also community-building activities across the region. It includes providing financial support and talent for economic development and business-related activities, as well as quality of life and Part VI Line 5 and educational initiatives. Employees participate in community boards and are actively involved in promoting the region and its assets. Whether it was active participation in the Keep Northern Illinois Beautiful Medication Collection to protect the environment, donations for Gigis Playhouse supporting Down syndrome families, or providing an on-going educational program for seniors at a neighborhood independent living facility, the hospitals presence is broad in our community. Part VI Line 5 In 2011, RMH and its affiliates promoted community health in many ways. One way was to continue to raise the bar on clinical quality across services. In doing so, we also helped to boost the local economy working with over 200 local vendors and supported 76 full-time construction-related jobs in the region. An investment of 15.2 million went toward major improvements at its facilities. The largest construction projects were the 4.5 million development of the Part VI Line 5 Womens Center, and the 2.9-million MRI Addition at Rockford Memorial Hospital. Other significant projects include the renovations to Interventional Radiology, enhancements to A2 Mother Baby, development of an IV Infusion area within the hospitals Cancer Center, introduction of Advanced Tele-medicine in the ICU. Part VI Line 5 Our support, including both experienced staff and fiscal resources, led to the community health needs assessment for the Rockford region that was produced by the Rockford Health Council. The priorities include 1 improving access to care, 2 creating partnerships to improve basic needs for residents at the poverty level, 3 improving the health status of the chronically ill and promoting healthy lifestyles, 4 providing comprehensive prenatal and maternal services for excellent outcomes, 5 improving Part VI Line 5 the behavioral health status of the community, 6 ensuring equitable health services to all, 7 partnering with local law enforcement to reduce crime and violence, and 8 supporting community efforts to improve educational efforts and the labor force. Based upon that assessment, the Board of Directors approved community benefit plan aimed at improving the overall health and well-being of residents in the primary service area. The RMH plan outlines initiatives to address the key priorities identified in the study and was Part VI Line 5 developed to ensure that RHS along with RMH allocates resources, time and talent in strategies that will directly impact community health needs. Some significant examples of the ways the organization addressed health needs was to enhance access to medical and dental care for uninsured and underinsured adults and children with programs such as the Bridge Clinic a joint partnership with a local church that brought health care to almost 600 people in their neighborhood and through the Ronald McDonald Part VI Line 5 cont CareMobile that provided medical and dental care for over 500 needy children-representing over 181,000 in free care. In partnership with other community organizations, RMH sought to support families at poverty level in many ways, such as supporting a school breakfast program at Northwest Community Center, where many underpriviledged children are served, adopting a neighborhood school where nearly 90 of the children line in a family at or below the poverty level. Part VI Line 5 cont RMH and its employees donate both food and dollars to local food banks and support of the United Way as a Golden Campaign Leader. We provided external community grants for like purposes by partnering with A Silver Lining Foundation that provide free mammograms and breast diagnostic services for uninsured women supporting other non-profit, health-related organizations that also address the health needs of chronically-ill patients in our community. Coupled with internal clinical teams Part VI Line 5 working to manage of diseases such as diabetes and congestive heart failure, RHS professionals serve as educators, not only for patients and their families, but also for caregivers outside our walls. Our clinicians work with local nursing homes to establish appropriate monitoring and treatment once our patients are discharged to other settings. As the regions leading provider of Part VI Line 5 comprehensive prenatal and maternal services for mothers and infants, RMH caregivers help connect at-risk patients to appropriate services across the community. Besides having a premier maternity service and the only Level III Neonatal Intensive Care Unit in the region, our obstetricians and midwives provide comprehensive care to many low income mothers and help educate teens on pregnancy and on developing parenting skills. Part VI Line 5 Addressing another reagional health priority, the behavioral health status of the community, RMH has long been a lead provider of inpatient behavioral health services. Through primary care and specialty physician offices, the organization seeks to screen and identify at risk individuals at early stages where intervention and treatment are most successful. In all clinical programs, we seek to ensure that we are providing equitable care for all patients. Recognizing that there is a low Part VI Line 5 level of awareness of health disparities, RMH participates in community dialogue, supports community initiatives such as the Black Healthcare Coalition, promotes diversity and cultural educational programs internally and is working to identify internal disparities in relation to patient outcomes. To address crime and violence issues in the community, RMH hosts neighborhood meetings on violence in partnership with the Rockford Police Department and Rockford Neighborhood Network. Part VI Line 5 RMH also represents one of Rockfords largest employers. As such, the organization is committed to supporting community initiatives to prepare an excellent labor force to help in providing continuing health education opportunities for residents, as well as employees. Besides offering a medical science elective course for high school students, the organization participates in Part VI Line 5 the Northern Illinois Healthcare Collaborative, sends professionals into the schools to volunteer and share knowledge and each year grants nursing scholarships to minorities in our region. Rockford Memorial Hospital continues to use these identified community needs as the blueprint for its community benefit efforts. Part VI Line 6 All of Rockford Health System RHS entities work closely with the community and Rockford Memorial Hospital RMH to address important health needs of the community. In 2011, volunteers from the Visiting Nurses Association VNA, Rockford Health Physicians RHPH, Rockford Memorial Development Foundation RMDF and RMH donated their time and talents to volunteer on behalf of the community. The affiliates also continued or launched new and innovative programming to reach out into the community Part VI Line 6 with health education and support. The outreach addresses needs identified in the regional health assessment done by the Rockford Health Council. In 2011, RMH and RHPH began using a new video interpretation system to ensure that all residents receive quality care and understand their diagnosis and course of treatment. Video interpretation was introduced for the Deaf and Hard of Hearing, as well as Spanish-speaking patients. Part VI Line 6 Laptop computers, with video cameras, in both the hospital and physician offices, quickly link skilled interpreters with patients and caregivers. It enables an accurate exchange of information for purposes of diagnosis and treatment. The video system compliments a language line service. Here are just some examples of how specific entities served unique community health needs. In 2011, the VNAs Older Adult Care program reached the 25th anniversary Part VI Line 6 of operation with its Elder Abuse, Neglect and Exploitation Services. VNA was originally selected as one of the five demonstration sites for the program in 1986. Today, VNAs Elder Abuse program is a program of excellence, one that others in the state benchmark against. Over the course of 25 years, strong relationships have emerged between the elder abuse staff and those within our regional and local law enforcement offices and legal and judicial systems. Part VI Line 6 These ties lead to the recent development of the Winnebago/Boone County Elder Abuse Fatality Review Team. Purpose of the board is to review questionable deaths of seniors. And, if necessary, recommend a more intense investigation into the cause of death. In 2011, VNAs Older Adult Care also continued its Money Follows the Person Program. The program is designed to help older adults who have lived in the nursing home for more than three months, move out, and back into their communities. Part VI Line 6 Qualified care coordinators determine eligibility. Mental and physical health are assessed, finances reviewed and existing and potential support systems evaluated. The care coordinator helps develop a plan for living. RHPH, the employed physicians group participates in and supports numerous initiatives on behalf of the communities it serves. These physicians support the hospitals clinical programs, such as the hospitalist program in obstetrics and in pediatrics, Part VI Line 6 where the majority of patients are indigent as well as providing critical staff for the 24-hr. emergency department. Physicians also actively participate in community outreach efforts. The Bridge Clinic, which serves the immediate medical needs of underinsured adults is staffed by RHPH physicians, the Centering Pregnancy Program, a support group initiated by our midwives for primarily low income pregnant women and significant continuing financial and physician support for a Part VI Line 6 local child abuse program called MERIT. Throughout the region, the physician group helps to support initiatives with schools and village government services. Our physicians and employees also provided community education. CPR training, financial support and volunteers for a pediatric diabetes camp and an educational partnership with the Golden Apple Foundation are a few of the other initiatives by the medical group. Part VI Line 6 In 2011, the external grants program of the RMDF provided nearly 100,000 in support to other community not-for-profits. Among the organizations, programs and services supported by those grants were RAMP a non-profit, non-residential Center for Independent Living that partners and empowers people with disabilities Remedies, a non-profit organization assisting those fleeing violent relationships a parent academy at a local school serving low income children Part VI Line 6 perinatal bereavement services a summer camp for children with Muscular Dystrophy and an exercise program through the YMCA to name a few. The Foundation also supported the Ronald McDonald Care Mobile and provided automatic external defibrillators AED to organizations that serve a wide variety of citizens. Part VI Line 7 Part VI Line 7, IL true The Rosecrance Foundation 1021 N Mulford Road Rockford IL 611073877 364167891 501c3 5000 Community Program Univ of IL-College of Medicine 1601 Parkview Rockford IL 61107 376000511 501c3 90000 Support healthcare Rockford Symphony Orchestra 711 N Main St Rockford IL 61103 261180940 501c3 17500 Support Fine Arts Community Foundation of No IL 946 N Second St Rockford IL 61107 364402089 501c3 5000 General support Easter Seals Metropolitan Chicago 233 South Wacker Drive Suite 2400 Chicago IL 60616 362171729 501c3 11500 Support Handicapped Rock Valley College 3301 N Mulford Rd Rockford IL 61114 363037232 501c3 30000 Community Education The Haven Network for Perinatal Death and Bereavement 124 N WATER ST STE 303B Rockford IL 611073975 200620800 501c3 5000 Support healthcare Rock River Valley Pantry 1080 Short Elm St Rockford IL 611022217 363135643 501c3 5500 Community Program Growth Dimensions 200 S State St Belvidere IL 61008 363196645 501c6 7500 Community Development Epilepsy Found North Central IL 3815 Harrison Ave Rockford IL 61101 362741730 501c3 5000 Support healthcare Retreat & Refresh Stroke Camp 425 W Giles Ln Peoria IL 61614 640954851 501c3 5000 Support healthcare Coalition to Protect America's Health Care PO Box 30211 Bethesda MD 208240211 522253225 501c4 5000 General support Gigi's Playhouse 8801 N Second St Suite 2 Machesney Park IL 61115 272251844 501c3 25150 Support healthcare Crusaders Health Foundation 1200 West State Street Rockford IL 61102 363259761 501c3 5000 Support healthcare Boys and Girls Club 1275 Peachtree Street Atlanta GA 30309 135562976 501c3 5000 Community Program United Way of Rock River Valley 612 N Main St Rockford IL 61103 362167843 501c3 30000 Community Program March of Dimes 1275 Mammaroneck Ave White Plains NY 10605 131846366 501c3 5000 Support infant healthcare OSF St Anthony Medical Center PO Box 6087 Rockford IL 61125 370813229 501c3 13300 Support healthcare American Heart Association 7272 Greenville Ave Dallas TX 752315129 135613797 501c3 7500 Support healthcare Midwest Fdn for Orthopaedic Research & Education (MFORE) 324 Roxbury Road Rockford IL 61107 362691111 501c3 6000 Support healthcare 18 2 X true true 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 9104 377479 Jos LGonzalez 394428 1600 1134 36500 18399 452061 Dennis TUehara 455767 12215 1548 58500 13390 541420 Gary EKaatz 627315 369197 68499 84178 125919 1275108 89051 Henry MSeybold 357107 128327 8886 41536 63444 599300 24857 Gordon Langejans 229261 72918 10823 26954 26658 366614 22829 Kerry Hill 196865 44801 2259 51383 35880 331188 8353 Carolyn Bengtson 266774 63941 1134 34415 37063 403327 11742 Michael Tyrkus 202574 13926 10373 34966 19408 281247 Susan Schreier 197290 53498 1655 32654 34633 319730 5180 Curt Lesher 168255 11076 7237 20347 18581 225496 Lawrence Verfurth 291854 51600 1170 11708 58900 415232 Dan Parod 276968 120303 1170 44319 45833 488593 32720 I 1a - By policy Membership to the YMCA 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 are prorated for personal vs business use and that percentage is added to taxable wages. 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 Carolyn Bengtson 12,104 Gary Kaatz 97,196 Sue Schreier 8,369 Henry Seybold 37168 Kerry Hill, 9,932 Lawrence Verfurth 23,592. 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 Department. The department and committee reviews the results and make a recommendation to the board who then acts upon this information to set compensation for executives. Illinois Finance Authority 861091967 45000GFS5 2008-12-11 31008000 Refund 1994 Series Bonds, Issuance Costs, SWAP Payment false false false 31008000 483711 16125 30508164 2008 true false true true false true true JP Morgan Chase 0000000010.300000000000 false false false false false X Connie Vitale RMH Board member Partner, RMH Pathologists Ltd 290117 Contract for pathology services false Form 990 Part XI 5 Other changes in Net Assets Unrealized gain/loss on investments 6,694,029, pension-related changes other than net periodic pension cost 2,157,503, Postretirement medical benefit cost 283,252, Net assets released from restrictions used for capital 224,610, transfers to affiliates 53,819,357, change in FAS 124 valuation 23,573, change in termporarily restricted net assets 106,730, UPMIFA 156,175. Form 990 Part VI 12C The RHS conflict of interest policy says that all board members will be asked annually to fill out a document concerning any conflict of interest they might have. Due to an oversight, only the new board members were asked to do so in 2011, but all board members have been requested to do so in 2012. Form 990 Part VII 1a - These members of the board were compensated by related organizations for other duties as well as unpaid service as board members James Breckenridge 41 hrs Anesthesiologist with Rockford Health Physicians RHPH and service to RHPH and RHS boards, John Dorsey 61 hrs RHPH Internal Medicine physician and RHPH and RHS boards, Jose Gonzalez 51 RHPH Neonatologist and RHPH and RHS boards, Dennis Uehara 35 hrs RHPH Emergency Services physician, RHPH and RHS and Foundation RMDF boards. Gary Kaatz had 42 additional hrs as President and CEO, Julie Peterson had 41 hrs as executive secretary, and Henry Seybold had 42.5 hrs as CFO Sr VP of Finance these employees compensation includes duties within RMH organization and for supporting all of the related entities RHS/RHPH/RMDF/VNA. Form 990 Part VI 11a - The data was gathered by the accounting staff with input from RMH and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RMH tax analyst. During the process, there were ongoing meetings held with a group consisting of the RHS CFO, the VP of Finance, the Controller, and the 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 RMH Finance Committee and at a meeting of the Board of Directors prior to filing. Form 990 Part VI 15 a,b - RHS is the sole corporate member. Form 990 Part VI 19 - Financial statements are available through the Illinois Attorney Generals Office. Governing documents are available by request from the board secretary. Form 990 Part III Program Service Accomplishments Line 4d Other Activities Program Service Expenses 820,140, Grants and allocations 160,000, Revenue 388,931 Through Rockford Memorial Hospital Auxiliary, RMH is able to provide extra funds and services to support its mission. The Auxiliary has 368 volunteers who logged 35,381 hours while assisting with greeting visitors, transporting patients, floral or gift deliveries, thrift shop and gift shop activities, and other services as requested. The volunteers efforts provide extra funds and enhance the overall hospital experience for patients, visitors and staff. Form 990, Part III, Line 4d Program Service Expenses 820,140, Grants and allocations 160,000, Revenue 388,931 Through Rockford Memorial Hospital Auxiliary, RMH is able to provide extra funds and services to support its mission. The Auxiliary has 368 volunteers who logged 35,381 hours while assisting with greeting visitors, transporting patients, floral or gift deliveries, thrift shop and gift shop activities, and other services as requested. The volunteers efforts provide extra funds and enhance the overall hospital experience for patients, visitors and staff. Form 990 Part XI Line 5 Other changes in Net Assets Unrealized gain/loss on investments 6,694,029, pension-related changes other than net periodic pension cost 2,157,503, Postretirement medical benefit cost 283,252, Net assets released from restrictions used for capital 224,610, transfers to affiliates 53,819,357, change in FAS 124 valuation 23,573, change in termporarily restricted net assets 106,730, UPMIFA 156,175. Form 990 Part VI Section B Line 12C The RHS conflict of interest policy says that all board members will be asked annually to fill out a document concerning any conflict of interest they might have. Due to an oversight, only the new board members were asked to do so in 2011, but all board members have been requested to do so in 2012. Form 990 Part VII Section A Line 1a - These members of the board were compensated by related organizations for other duties as well as unpaid service as board members James Breckenridge 41 hrs Anesthesiologist with Rockford Health Physicians RHPH and service to RHPH and RHS boards, John Dorsey 61 hrs RHPH Internal Medicine physician and RHPH and RHS boards, Jose Gonzalez 51 RHPH Neonatologist and RHPH and RHS boards, Dennis Uehara 35 hrs RHPH Emergency Services physician, RHPH and RHS and Foundation RMDF boards. Gary Kaatz had 42 additional hrs as President and CEO, Julie Peterson had 41 hrs as executive secretary, and Henry Seybold had 42.5 hrs as CFO Sr VP of Finance these employees compensation includes duties within RMH organization and for supporting all of the related entities RHS/RHPH/RMDF/VNA. Form 990 Part VI Section A Line 11a - The data was gathered by the accounting staff with input from RMH and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RMH tax analyst. During the process, there were ongoing meetings held with a group consisting of the RHS CFO, the VP of Finance, the Controller, and the 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 RMH Finance Committee and at a meeting of the Board of Directors prior to filing. Form 990 Part VI Section B Line 15 a,b - RHS is the sole corporate member. Form 990 Part VI Section C Line 19 - Financial statements are available through the Illinois Attorney Generals Office. Governing documents are available by request from the board secretary. Rockford Health System Ventures LLC 2400 N Rockton Ave Rockford IL 61103 364366881 Healthcare IL NA Visiting Nurses Assn of the Rockford Area 2400 N Rockton Ave Rockford IL 61103 362167945 Healthcare IL 501c3 9 Rockford Health System true Rockford Health System 2400 N Rockton Ave Rockford IL 61103 363197915 Support of Healthcare IL 501c3 11c N/A false 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 362197918 Support of Healthcare IL 501c3 11a Rockford Health System true Van Matre Rehabilitation Center LLC 3660 Grandview Parkway Ste 200 Birmingham AL 35243 364397130 Healthcare IL NA Related 2524675 7608987 false true 0.50000 Rockford Health Insurance LTD Wellesley House So 2nd Flr 90 Pitts Pembrooke HM BD 08 Insurance BD NA C Corp 48256 533960 1.00000 false true true false false false false true true true true true true true false true false true VanMatre Rehabilitation Center LLC j 155959 VanMatre Rehabilitation Center LLC k 568055 VanMatre Rehabilitation Center LLC l 77710