NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: NORTHWESTERN MEMORIAL HEALTHCARE (EIN 23-7087041)
Tax period: 2011-05-01 to 2012-04-30
Filed: 2012-12-17
IRS object ID: 201243529349300614
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 K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-12-17T09:39:05-06:00	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	237087041	EIN

Name Name

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

Field	Value	IRS element (for citing)
Name Control	KISH	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	222419047	GrossReceipts
Group Return For Affiliates	0	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	WWW.KISHHOSPITAL.ORG	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1970	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 AREA OF DEKALB COUNTY.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	3	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	2	NbrIndependentVotingMembers
Total Nbr Employees	1213	TotalNbrEmployees
Total Nbr Volunteers	320	TotalNbrVolunteers
Total Gross UBI	111772	TotalGrossUBI
Net Unrelated Business Txbl Income	19743	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	1113923	ContributionsGrantsPriorYear
Contributions Grants Current Year	930478	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	163834645	ProgramServiceRevenuePriorYear
Program Service Revenue CY	174560488	ProgramServiceRevenueCY
Investment Income Prior Year	2966348	InvestmentIncomePriorYear
Investment Income Current Year	4533345	InvestmentIncomeCurrentYear
Other Revenue Prior Year	1803798	OtherRevenuePriorYear
Other Revenue Current Year	2395820	OtherRevenueCurrentYear
Total Revenue Prior Year	169718714	TotalRevenuePriorYear
Total Revenue Current Year	182420131	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	999268	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	317643	GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year	0	BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	56726719	SalariesEtcPriorYear
Salaries Etc Current Year	59347491	SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year	0	TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	6193	TotalFundrsngExpCurrentYear
Other Expense Prior Year	95690873	OtherExpensePriorYear
Other Expenses Current Year	103689576	OtherExpensesCurrentYear
Total Expenses Prior Year	153416860	TotalExpensesPriorYear
Total Expenses Current Year	163354710	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	16301854	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	19065421	RevenuesLessExpensesCY
Total Assets BOY	278068882	TotalAssetsBOY
Total Assets EOY	294914074	TotalAssetsEOY
Total Liabilities BOY	101229299	TotalLiabilitiesBOY
Total Liabilities EOY	104281500	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	176839583	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	190632574	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 AREA OF DEKALB COUNTY. KISHWAUKEE COMMUNITY HOSPITAL (KCH) SERVES ALL PEOPLE WITH SKILL AND COMPASSION WHILE RESPECTING THEIR DIGNITY, RIGHTS, AND CHOICES BY OFFERING ACCESS TO HIGH-QUALITY PREVENTIVE, CURATIVE, AND REHABILITATIVE CARE DELIVERED IN A COST EFFECTIVE MANNER. KISHWAUKEE COMMUNITY HOSPITAL RECOGNIZES THE NEED TO EFFECTIVELY MANAGE RESOURCES FOR PRESENT AND FUTURE GENERATIONS.	MissionDescription
Significant New Program Services	0	SignificantNewProgramServices
Significant Change	0	SignificantChange
Expense	137216484	Expense
Grants	317643	Grants
Revenue	176671127	Revenue
Description	KISHWAUKEE COMMUNITY HOSPITAL (KCH), LOCATED IN DEKALB, ILLINOIS, SERVES THE RESIDENTS OF DEKALB COUNTY AND THE SURROUNDING AREAS BY OFFERING A NUMBER OF PROGRAMS AND SERVICES FOR COMMUNITY BENEFIT, INCLUDING CHARITY CARE. KISHWAUKEE COMMUNITY HOSPITAL 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 OBJECTIVES OF HOSPITAL'S COMMUNITY BENEFIT PROGRAM ARE 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 POPULATIONSUSING ALL THESE RESOURCES, THE HEALTH SYSTEM FOCUSED ON THE FOLLOWING COMMUNITY HEALTH NEEDS IN FY12: * THE PREVALENCE OF OBESITY IN CHILDREN AND ADULTS* ACCESS TO AFFORDABLE PRIMARY HEALTH CARE IN THE DEKALB/SYCAMORE AREA AND OUTLYING RURAL AREA* OUTPATIENT MENTAL HEALTH SERVICES AT BOTH HOSPITALS* TYPE II DIABETES * 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 COLLABORATION/SCHOOL & WELLNESS PROGRAMS. THE HOSPITAL'S COMMUNITY HEALTH LIAISON SERVES ON THE DEKALB WELLNESS SCHOOLS COMMITTEE. THE HOSPITAL SPONSORED "FOOD PLAY", A PROFESSIONAL PLAY/ASSEMBLY FOR DEKALB SCHOOL CHILDREN FOCUSED ON NUTRITION, FITNESS AND REDUCING SCREEN TIME WITH PRE- AND POST-TESTS GIVEN AS WELL AS PROGRAMS FOR THE TEACHERS TO IMPLEMENT. THE HOSPITAL'S COMMUNITY HEALTH LIAISON ALSO MET WITH SYCAMORE SCHOOL DISTRICT LEADERS TO DISCUSS IMPLEMENTATION OF HEALTHY MINDS AND BODIES IN THE SCHOOLS. * OTHER COMMUNITY OUTREACH AND WELLNESS EFFORTS. FREE SAFE SITTER PROGRAM FOR 24 STUDENTS IN THE SYCAMORE SPARTAN REACH, A PROGRAM FOR CHILDREN WHO RECEIVE EITHER REDUCED OR FREE LUNCHES. COMMUNITY WELLNESS EDUCATORS TAUGHT HEALTH TOPICS IN AREA SCHOOLS, VISITING 473 CLASSROOMS WORKING WITH 14,713 STUDENTS. COMMUNITY WELLNESS EDUCATORS SERVED ON THE FOLLOWING COMMITTEES TO PROMOTE HEALTH AND WELLNESS: DEKALB LEADERSHIP ACADEMY, CO-COACH/PIONEERING HEALTHY COMMUNITIES/YMCA, SYCAMORE SCHOOL DISTRICT WELLNESS COMMITTEE, DEKALB SCHOOL DISTRICT WELLNESS COMMITTEE (SCHOOL LUNCH POLICIES AND COMMUNITY OUTREACH SUBCOMMITTEES), LATINO ACTION GROUP, GO RED LUNCHEON COMMITTEE, HOSPITAL'S CANCER COMMITTEE. ALSO, FREE AND LOW COST FITNESS AND INJURY PREVENTION CLASSES THROUGH UNLIMITED PERFORMANCE REHABILITATION AND SPORTS MEDICINE. SPONSORED ANNUAL FITFEST, A WALKING EVENT WITH THE KISHWAUKEE FAMILY YMCA TO PROMOTE EMPLOYEE HEALTH AND FITNESS DAY TO AREA EMPLOYERS. ATTENDED BY 400. ENTERED INTO AGREEMENTS WITH THE KISHWAUKEE FAMILY YMCA (DEKALB) TO HELP UNDERWRITE THE COST OF FITNESS AND RECREATIONAL ACTIVITIES FOR COMMUNITY MEMBERS.* 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, CASH AND IN-KIND DONATIONS, AND OTHER. - 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 US 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 & WORKFORCE DEVELOPMENT. A MEDICAL LIBRARY IS MAINTAINED FOR PHYSICIAN, STAFF AND PATIENT USE. 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 ACTIVITIES- CASH 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.- DONATION HIGHLIGHTS. FY 12, THE HOSPITAL PROVIDED SUBSTANTIAL CASH CONTRIBUTIONS TO: BEN GORDON CENTER TO SUPPORT MENTAL HEALTH SERVICES FOR THE LOW INCOME, KISHWAUKEE FAMILY YMCA TO SUPPORT STRONG KIDS SCHOLARSHIP PROGRAM AND SPONSOR HEALTH AND WELLNESS ACTIVITIES FOR FAMILIES, FAMILY SERVICE AGENCY TO SUPPORT BIG BROTHERS BIG SISTERS, COURT APPOINTED SPECIAL ADVOCATES, SENIOR SERVICES AND FAMILY COUNSELING, KISHWAUKEE COLLEGE FOUNDATION TO SUPPORT ITS NURSING AND RADIOLOGY TRAINING PROGRAMS , KISHWAUKEE UNITED WAY TO SUPPORT SOCIAL SERVICE AGENCIES THAT PROMOTE NUTRITION AND HEALTH ESPECIALLY AMONG THE LOW INCOME, VOLUNTARY ACTION CENTER TO SUPPORT MEALS ON WHEELS, TRANSPORTATION SERVICES AND DAY CARE LUNCH PROGRAMS, DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION, DEKALB, SYCAMORE, GENOA, SANDWICH AND PLANO CHAMBERS OF COMMERCE TO SUPPORT THE BUSINESS COMMUNITY AND ECONOMIC DEVELOPMENT FOR THE REGION, AND MANY OTHERS.- OTHER ACTIVITIES INCLUDE MEDICAL HELICOPTER SERVICES, UNLIMITED PERFORMANCE REHABILITATION AND SPORTS MEDICINE, FREE ACTIVITIES IN THE COMMUNITY RELATED TO EXERCISE AND FITNESS, PROPERTY TAXES, AND SALES TAXES PAID.	Description
Total Program Service Expense	137216484	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	1	GrantsToIndividuals
Schedule J Required	1	ScheduleJRequired
Tax Exempt Bonds	1	TaxExemptBonds
Invest Tax Exempt Bonds	0	InvestTaxExemptBonds
Escrow Account	0	EscrowAccount
On Behalf Of Issuer	0	OnBehalfOfIssuer
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	131	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	1	ComplianceWithBackupWitholding
Number Of Employees	1213	NumberOfEmployees
Employment Tax Returns Filed	1	EmploymentTaxReturnsFiled
Unrelated Business Income	1	UnrelatedBusinessIncome
Form990-T Filed	1	Form990-TFiled
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	1	InvestmentInJointVenture
Written Policy Or Procedure	1	WrittenPolicyOrProcedure
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 OF 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 (19 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
MICHAEL MOONEY
VICE CHAIR (THRU 11/30)	2.00	X	X	0	0	0
MICHAEL CULLEN
CHAIR	2.00	X	X	0	0	0
KEVIN POORTEN
PRESIDENT & CEO, KHS	30.00	X	X	0	698961	102663
THOMAS MATYA
VICE CHAIR	2.00	X	X	0	0	0
LOREN FOELSKE
VP FINANCE	10.00		X	0	316761	41819
BRAD COPPLE
PRESIDENT - KCH & VWCH	20.00			0	365900	42075	X
PAM DUFFY
VP PATIENT CARE	20.00			0	241412	27266	X
JOE DANT
VP DEVELOPMENT	20.00			0	263727	41741	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	20.00			0	197280	29354	X
CHERYL FISHER
ASST VP - PATIENT CARE	20.00			0	150191	32889	X
MICHAEL MUZZILLO
VP OPERATIONS - VWCH	40.00			0	179349	27579	X
THOMAS W TILTON DO
OPTHAMOLOGIST	40.00			464833	0	42105		X
THOMAS WARZECHA
DIRECTOR OF PHARMACY	40.00			145805	0	31872		X
KENYA M WILLIAMS MD
OPTHAMOLOGIST	40.00			233584	0	20875		X
JASMEET DHALIWAL
OPTHAMOLOGIST	40.00			574169	0	22746		X
KENNETH O'BRIEN
Y1 CHARGE RN	40.00			133538	0	30030		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1551929	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	3256825	TotalReportableCompFrmRltdOrgs
Total Other Compensation	579191	TotalOtherCompensation
Number Individuals GT100 K	38	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
KISHHEALTH SYSTEM
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	MANAGEMENT SERVICES	15272721
DOCTORS OF EMERGENCY MEDICINE
2807 BRITTANY COURT	ST CHARLES	IL	60175	EMERGENCY MEDICINE SERVICES	6697188
POWER CONSTRUCTION COMPANY LLC
2360 NORTH PALMER DRIVE	SCHAUMBURG	IL	60173	CONSTRUCTION SERVICES	4373874
SABET SIDDIQUI MDPC
6925 ERROL COURT	CHERRY VALLEY	IL	61016	PHYSICAN - CANCER CARE CENTER	1662237
SODEXO INC & AFFILIATES
4880 PAYSPHERE CIRCLE	CHICAGO	IL	60674	FOOD SERVICES	1416093

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	33	NumberOfContractorsGT100K
Membership Dues	1016	MembershipDues
Related Organizations	194102	RelatedOrganizations
Government Grants	727932	GovernmentGrants
All Other Contributions	7428	AllOtherContributions
Total Contributions	930478	TotalContributions

Program Service Revenue ProgramServiceRevenue

Field	Value	IRS element (for citing)
Description	NET PATIENT SERVICE RE	Description
Business Code	621110	BusinessCode
Total Revenue Column	174560488	TotalRevenueColumn
Related Or Exempt Function Income	174475466	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	85022	UnrelatedBusinessRevenue

Field	Value	IRS element (for citing)
Total Program Service Revenue	174560488	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	4827674	TotalRevenueColumn
Exclusion	$4,827,674	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	326421	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	213955	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	112466	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	112466	TotalRevenueColumn
Exclusion	$112,466	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	39375564	Securities
Other	46027	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	39715398	Securities
Other	522	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	-339834	Securities
Other	45505	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	-294329	TotalRevenueColumn
Exclusion	-$294,329	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Income Fundraising Events	14459	GrossIncomeFundraisingEvents
Fundraising Direct Expenses	0	FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	14459	TotalRevenueColumn
Exclusion	$14,459	ExclusionAmount

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	115525	GrossSalesOfInventory
Cost Of Goods Sold	69041	CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	46484	TotalRevenueColumn
Exclusion	$46,484	ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue
CAFETERIA SALES	621110	694127	689596	4531
OTHER SERVICES	621110	681183	658964	22219
INCOME PASSTHROUGH - K	621110	527223	527223

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	319878	TotalRevenueColumn
Related Or Exempt Function Income	319878	RelatedOrExemptFunctionIncome

Field	Value	IRS element (for citing)
Total Other Revenue	2222411	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	182420131	TotalRevenueColumn
Related Or Exempt Function Income	176671127	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	111772	UnrelatedBusinessRevenue
Exclusion	$4,706,754	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	292259	Total
Program Services	292259	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	25384	Total
Program Services	25384	ProgramServices

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	44114548	Total
Program Services	42196844	ProgramServices
Management And General	1917704	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	2388137	Total
Program Services	2284322	ProgramServices
Management And General	103815	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	9654392	Total
Program Services	9234706	ProgramServices
Management And General	419686	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	3190414	Total
Program Services	3051723	ProgramServices
Management And General	138691	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	12642156	Total
Management And General	12642156	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	272308	Total
Management And General	272308	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	4327	Total
Management And General	4327	ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	402633	Total
Management And General	402633	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	18328450	Total
Program Services	17245259	ProgramServices
Management And General	1083191	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	987722	Total
Program Services	77838	ProgramServices
Management And General	909884	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	24237983	Total
Program Services	23273485	ProgramServices
Management And General	960210	ManagementAndGeneral
Fundraising	4288	Fundraising

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	1907496	Total
Program Services	480682	ProgramServices
Management And General	1426814	ManagementAndGeneral

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	3684809	Total
Program Services	3621044	ProgramServices
Management And General	63765	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	207983	Total
Program Services	192534	ProgramServices
Management And General	15449	ManagementAndGeneral

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	10044	Total
Program Services	10044	ProgramServices

Interest Interest

Field	Value	IRS element (for citing)
Total	3712162	Total
Management And General	3712162	ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	11689526	Total
Program Services	11689526	ProgramServices

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2168039	Total
Program Services	995852	ProgramServices
Management And General	1172187	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Management And GeneralManagementAndGeneral	Program ServicesProgramServices
UNRELATED BUSINESS INCO	11583	11583
BAD DEBT EXPENSE	13678918		13678918
PHYSICAN FEES	4395969		4395969
FEDERAL AND STATE ASSES	2348718		2348718

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	2998750	Total
Program Services	2121377	ProgramServices
Management And General	875468	ManagementAndGeneral
Fundraising	1905	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	163354710	Total
Program Services	137216484	ProgramServices
Management And General	26132033	ManagementAndGeneral
Fundraising	6193	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	6499149	BOY
EOY	15302921	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	279934	BOY
EOY	251766	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	25341679	BOY
EOY	28815521	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	3529110	BOY
EOY	3725696	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2061173	BOY
EOY	2901412	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	173017997	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	66096416	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	104821380	BOY
EOY	106921581	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	104528505	BOY
EOY	118483018	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
BOY	22243230	BOY
EOY	8089823	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	8764722	BOY
EOY	10422336	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	278068882	BOY
EOY	294914074	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	13418274	BOY
EOY	13536946	EOY

Deferred Revenue DeferredRevenue

Field	Value	IRS element (for citing)
BOY	945417	BOY
EOY	743742	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	63685000	BOY
EOY	63685000	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1245941	BOY
EOY	1226938	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	21934667	BOY
EOY	25088874	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	101229299	BOY
EOY	104281500	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	172416577	BOY
EOY	186447120	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4423006	BOY
EOY	4185454	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	176839583	BOY
EOY	190632574	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	278068882	BOY
EOY	294914074	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	19065421	ReconcilationRevenueExpenses
Reconcilation Other Changes	-5272430	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	$24,583	OtherActivitiesAmount
Total Lobbying Expenditures IIB	24583	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	5255089	OtherCostOrOtherBasis
Book Value	5255089	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	109056324	OtherCostOrOtherBasis
Depreciation	27854971	Depreciation
Book Value	81201353	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	565362	OtherCostOrOtherBasis
Depreciation	137173	Depreciation
Book Value	428189	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	52696409	OtherCostOrOtherBasis
Depreciation	38104272	Depreciation
Book Value	14592137	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	5444813	OtherCostOrOtherBasis
Book Value	5444813	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	106921581	TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (4 entries)

DescriptionDescription	AmountAmount
THIRD PARTY PAYABLES	$17,173,388
DUE TO AFFILIATES	$1,430,949
ACCRUED INTEREST PAYABLE	$307,958
OTHER PAYABLES - LONG TERM	$6,176,579

Field	Value	IRS element (for citing)
Total Of Amounts	25088874	TotalOfAmounts
Total Revenue	182420131	TotalRevenue
Total Expenses	163354710	TotalExpenses
Excess Or Deficit For Year	19065421	ExcessOrDeficitForYear
Net Unrealized GL On Investments	-1139781	NetUnrealizedGLOnInvestments
Other	-$4,132,649	OtherAmount
Total Adjustments	-5272430	TotalAdjustments
Excess Or Deficit Per FS	13792991	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	181671811	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-1139781	NetUnrealizedGainsInvestments
Revenue Not Rptd F990	-1139781	RevenueNotRptdF990
Revenue Subtotal	182811592	RevenueSubtotal
Other Revenues Not Included	-391461	OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt	-391461	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	182420131	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	163628496	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	282996	OtherExpensesIncluded
Expenses Not Rptd F990	282996	ExpensesNotRptdF990
Expenses Subtotal	163345500	ExpensesSubtotal
Other Expenses Not Included	9210	OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt	9210	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	163354710	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifier	ExplanationExplanation
PART XI, LINE 8 - OTHER ADJUSTMENTS:	EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM -4,440,000. CHANGE OF INTEREST IN NET ASSETS OF KISHHEALTH FOUNDATION -65,942. BOOK/TAX DIFFERENCES IN K-1 PASSTHROUGH ENTITIES 333,417. GRANT REVENUE INCLUDED IN FIXED ASSETS FOR FINANCIAL STATEMENT PURPOSES -30,850. OTHER EQUITY ADJUSTMENT 70,726. TOTAL TO SCHEDULE D, PART XI, LINE 8: -4,132,649.
PART XII, LINE 4B - OTHER ADJUSTMENTS:	BOOK/TAX DIFFERENCE ON INCOME FROM PASSTHROUGH ENTITIES - KISH AREA PHO 3,600. CONTRIBUTION REVENUE FROM KISHHEALTH FOUNDATION 194,102. BOOK/TAX DIFFERENCE ON INCOME FROM PASSTHROUGH ENTITIES - MIDLAND SURGICAL -337,017. GRANT REVENUE INCLUDED IN FIXED ASSETS FOR FINANCIAL STATEMENT PURPOSES 30,850. RECLASSIFICATION OF COST OF GOODS SOLD -69,041. RECLASSIFICATION OF RENTAL EXPENSES -213,955.
PART XIII, LINE 2D - OTHER ADJUSTMENTS:	RECLASSIFICATION OF COST OF GOODS SOLD 69,041. RECLASSIFICATION OF RENTAL EXPENSES 213,955.
PART XIII, LINE 4B - OTHER ADJUSTMENTS:	CONTRIBUTION TO KISHHEALTH FOUNDATION 9,210.
	PART XI, LINE 10, EXCESS OR (DEFICIT) FOR THE YEAR PER FINANCIAL STATEMENTS: LINE 10 IDENTIFIES FINANCIAL STATEMENT INCOME AS EQUALING $13,792,991. FINANCIAL STATEMENT INCOME IS ACTUALLY $18,043,313. THE DIFFERENCE RELATES TO THE FOLLOWING ITEMS: 1. KISHWAUKEE COMMUNITY HOSPITAL MADE A NET CAPITAL DISTRIBUTION OF $4,440,000 TO ITS PARENT ORGANIZATION, KISHHEALTH SYSTEM. 2. KISHHEALTH FOUNDATION (KHF), AN AFFILIATED ENTITY, RECEIVES CONTRIBUTIONS DESIGNATED FOR USE BY KISHWAUKEE COMMUNITY HOSPITAL. THIS IS ALLOCATED TO KISHWAUKEE COMMUNITY HOSPITAL, VIA AN ENTRY TO INCREASE KISHWAUKEE COMMUNITY HOSPITAL'S INTEREST IN THE ASSETS OF KHF. A CORRESPONDING EQUITY ENTRY IS MADE ON KISHWAUKEE COMMUNITY HOSPITAL'S GENERAL LEDGER. THE CURRENT YEAR DECREASE WAS $65,942. 3. KCH RECEIVED CONTRIBUTIONS FROM AFFILIATES (KHF) IN THE AMOUNT OF $194,102 AND MADE CONTRIBUTIONS TO AFFILIATES IN THE AMOUNT OF $9,210. THESE CONTRIBUTIONS WERE REFLECTED AS EQUITY TRANSACTIONS FOR FINANCIAL STATEMENT PURPOSES. 4. THERE WERE OTHER ADJUSTMENTS OF $70,726.

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

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	600.000000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
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	5469441	TotalCommunityBenefitExpense
Direct Offsetting Revenue	2041416	DirectOffsettingRevenue
Net Community Benefit Expense	3428025	NetCommunityBenefitExpense
Percent Of Total Expense	0.02100	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17846231	TotalCommunityBenefitExpense
Direct Offsetting Revenue	9835333	DirectOffsettingRevenue
Net Community Benefit Expense	8010898	NetCommunityBenefitExpense
Percent Of Total Expense	0.04900	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	23315672	TotalCommunityBenefitExpense
Direct Offsetting Revenue	11876749	DirectOffsettingRevenue
Net Community Benefit Expense	11438923	NetCommunityBenefitExpense
Percent Of Total Expense	0.07000	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6111897	TotalCommunityBenefitExpense
Direct Offsetting Revenue	775500	DirectOffsettingRevenue
Net Community Benefit Expense	5336397	NetCommunityBenefitExpense
Percent Of Total Expense	0.03270	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1522784	TotalCommunityBenefitExpense
Direct Offsetting Revenue	17627	DirectOffsettingRevenue
Net Community Benefit Expense	1505157	NetCommunityBenefitExpense
Percent Of Total Expense	0.00920	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	930410	TotalCommunityBenefitExpense
Direct Offsetting Revenue	305212	DirectOffsettingRevenue
Net Community Benefit Expense	625198	NetCommunityBenefitExpense
Percent Of Total Expense	0.00380	PercentOfTotalExpense

Research Research

Field	Value	IRS element (for citing)
Total Community Benefit Expense	0	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	483955	TotalCommunityBenefitExpense
Direct Offsetting Revenue	0	DirectOffsettingRevenue
Net Community Benefit Expense	483955	NetCommunityBenefitExpense
Percent Of Total Expense	0.00300	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	9049046	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1098339	DirectOffsettingRevenue
Net Community Benefit Expense	7950707	NetCommunityBenefitExpense
Percent Of Total Expense	0.04870	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	32364718	TotalCommunityBenefitExpense
Direct Offsetting Revenue	12975088	DirectOffsettingRevenue
Net Community Benefit Expense	19389630	NetCommunityBenefitExpense
Percent Of Total Expense	0.11870	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	1	BadDebtExpenseReported
Bad Debt Expense	$13,678,918	BadDebtExpenseAmount
Amount Attributable To	2325416	AmountAttributableTo
Amount Reimbursed By Medicare	33911481	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	52259678	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-18348197	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

Field	Value	IRS element (for citing)
Written Debt Collection Policy	1	WrittenDebtCollectionPolicy
Provision For Charity Care	1	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

Field	Value	IRS element (for citing)
Business Name Line1	1 MIDLAND SURGICAL CENTER (MSC)	BusinessNameLine1

Field	Value	IRS element (for citing)
Description Ent Primary Activity	AMBULATORY SURGERY	DescriptionEntPrimaryActivity
Organization Profit Or Ownership	0.77500	OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership	0.00000	OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership	0.00000	PhysicansProfitOrOwnership

Field	Value	IRS element (for citing)
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	KISHWAUKEE COMMUNITY HOSPITAL	BusinessNameLine1

Address Address

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)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
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	KISHWAUKEE 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	600.000000000000	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: 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: FOR THE 4/30/12 FISCAL YEAR, KCH PROVIDED BILLED CHARGES TO MEDICARE PATIENTS TOTALING $161,000,000. HOWEVER, DUE TO THE MEDICARE INPATIENT AND OUTPATIENT PAYMENT METHODOLOGIES, THE ACTUAL CASH PAYMENTS RECEIVED FROM PROVIDING CARE TO THOSE PATIENTS WAS JUST $34,000,000, OR 21% OF BILLED CHARGES. THE COST OF PROVIDING THIS CARE, PER THE MEDICARE COST REPORT, WAS $52,500,000. THUS, THE PAYMENTS RECEIVED FROM MEDICARE WERE $18,500,000 LESS THAN COST, OR 65% OF COST. TRULY THIS $18,500,000 SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. AS APPROXIMATELY 46% OF ALL KISHWAUKEE COMMUNITY HOSPITAL CHARGES GENERATED ARE FROM MEDICARE PATIENTS, THIS SHORTFALL PLACES A TREMENDOUS FINANCIAL BURDEN ON OUR HOSPITAL.KISHWAUKEE COMMUNITY HOSPITAL, LIKE OTHER NOT-FOR-PROFIT HOSPITALS, MUST ACCEPT MEDICARE PAYMENTS AS PAYMENT IN FULL FOR SERVICES PROVIDED, WITH THE EXCEPTION OF COLLECTING ON DEDUCTIBLES AND CO-INSURANCE AMOUNTS. HOSPITALS CANNOT BILL MEDICARE PATIENTS FOR THE DIFFERENCE BETWEEN THE BILLED CHARGES AND MEDICARE PAYMENTS.KISHWAUKEE COMMUNITY HOSPITAL PROVIDES SERVICES TO ALL PATIENTS WHO NEED CARE, ABIDING BY THE FEDERAL EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA) REGULATION. IT REQUIRES HOSPITALS AND AMBULANCE SERVICES TO PROVIDE CARE TO ANYONE NEEDING EMERGENCY HEALTHCARE TREATMENT REGARDLESS OF CITIZENSHIP, LEGAL STATUS OR ABILITY TO PAY.KCH UTILIZED THE CALCULATION OF MEDICARE COST FROM THE ANNUAL MEDICARE COST REPORT. THIS APPROACH ALLOCATES COST FROM NON REVENUE PRODUCING DEPARTMENTS TO THE REVENUE GENERATING DEPARTMENTS, BASED ON STEP DOWN STATISTICAL COST FINDING. WHILE NOT AS COMPREHENSIVE AS A TRUE COST ACCOUNTING SYSTEM, THIS PROCESS RESULTS IN AN ACCEPTABLE BASIS OF THE DEPARTMENTAL COST FOR PROVIDING SERVICES. RECALL THAT PRIOR TO MEDICARE PROSPECTIVE PAYMENT SYSTEM (PPS), THIS METHODOLOGY WAS THE BASIS FOR THE REIMBURSEMENT TO HOSPITALS.
PART III, LINE 9B: COLLECTION ACTIONS INVOLVING UNINSURED PATIENTS. KHS (KISHHEALTH SYSTEM, PARENT ORGANIZATION OF KISHWAUKEE 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.	KISHWAUKEE COMMUNITY HOSPITAL
PART VI, LINE 2: KISHWAUKEE COMMUNITY HOSPITAL IDENTIFIES COMMUNITY HEALTH NEEDS IN SEVERAL WAYS:* DEKALB COUNTY HEALTH DEPARTMENT I-PLAN* COMMUNITY HEALTH NEEDS SURVEY* U.S. GOVERNMENT HEALTHY PEOPLE 2010 AND 2010 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.
PART VI, LINE 3: INFORMATION IS PROVIDED AT REGISTRATION, VIA THE HOSPITAL WEBSITE, THROUGH CONSULTATIONS WITH FINANCIAL COUNSELORS FOR SOME OUTPATIENTS AS WELL AS INPATIENTS, DURING THE BILLING PROCESS ON STATEMENTS AND VIA PHONE CONVERSATIONS.
PART VI, LINE 4: KISHWAUKEE COMMUNITY HOSPITAL SERVES ALL OF DEKALB COUNTY, IL, AND BORDER COMMUNITIES IN KANE AND OGLE COUNTIES. POPULATION OF THE HOSPITAL'S SERVICE AREA, BASED ON 2010 CENSUS, IS 130,000. THIS GEOGRAPHIC AREA INCLUDES A GROWING HISPANIC POPULATION. A UNIQUE POPULATION IN OUR SERVICE AREA IS NORTHERN ILLINOIS UNIVERSITY STUDENTS (22,900 ENROLLED IN 2012), INCLUDING FOREIGN STUDENTS AND VISITORS. THE HISPANIC POPULATION IS EXPECTED TO GROW BY 23.5% BY 2017. THE POVERTY LEVELS IN THE HOSPITAL'S PRIMARY MARKET ARE DEKALB, 26.3%; SYCAMORE, 6.7%; AND CORTLAND, 10.4%.
PART VI, LINE 5: KISHWAUKEE COMMUNITY HOSPITAL IN DEKALB, 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 HEALTH 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 MEDICAL STAFF BYLAWS. PHYSICIANS ARE GIVEN 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 FOR. 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. COMMUNITY HEALTH NEEDS ASSESSMENT: IN COLLABORATION WITH DEKALB COUNTY HEALTH DEPARTMENT, KISHWAUKEE COMMUNITY 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 ORGANIZATIONS, 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, COORDINATED APPROACH TO CHILD HEALTH (CATCH) IN THE SCHOOLS AND THE YMCA SUMMER CAMP; AND SERVING ON THE SYCAMORE WELLNESS SCHOOLS COMMITTEE. SCHOOL PROGRAMS TOUCHED 14,713 STUDENTS.KISH / YMCA "PHC PIONEERING HEALTHIER COMMUNITIES": PHC IS A GRANT SPONSORED BY THE NATIONAL YMCA AND AWARDED TO KISHWAUKEE FAMILY YMCA IN DEKALB. THE INITIATIVE FOCUSES ON COLLABORATIVE ENGAGEMENT WITH COMMUNITY LEADERS AND ENVIRONMENTAL CHANGE EFFORTS THAT SUPPORT AND PROMOTE HEALTHY LIFESTYLES. THE INITIATIVE EMPOWERS LOCAL COMMUNITIES WITH PROVEN STRATEGIES AND MODELS TO CREATE AND SUSTAIN POSITIVE, LASTING CHANGE FOR HEALTHY LIVING. THE KISH HOSPITAL COMMUNITY HEALTH LIAISON CO- FACILITATES THE PHC WITH A YMCA REPRESENTATIVE.FARMERS MARKET VOUCHERS: KISH HOSPITAL TRIALED A VOUCHER PROGRAM FOR THE DEKALB FARMERS MARKET. WORKING WITH THE DEKALB COUNTY HEALTH DEPARTMENT'S WIC PROGRAM AND THE FAMILY SERVICE AGENCY'S SENIOR CENTERS. MORE THAN $6,000 IN FRUITS AND VEGETABLES WERE PURCHASED.OTHER ACCESS INITIATIVES: 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: MADE $50,000 CONTRIBUTION TO BEN GORDON (MENTAL HEALTH) CENTER TO SUPPORT THE COST OF MENTAL HEALTH SERVICES FOR DEKALB COUNTY'S UNINSURED. 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 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 WERE; GO RED FOR WOMEN CAMPAIGN IN PARTNERSHIP WITH THE AMERICAN HEART ASSOCIATION LUNCHEON ATTENDED IN MAY ATTENDED BY 150 PEOPLE. WOMEN'S HEALTH EVENT AT KISH HOSPITAL IN FEBRUARY GREW FROM 750 ATTENDEES IN FY 11 TO 1,300 IN FY 12. KNOW YOUR NUMBERS EVENTS 2012 RESULTED IN 527 FREE SCREENINGS; NUMEROUS COMMUNITY WELLNESS PROGRAMS AND CLASSESHEALTHY U SUMMER CAMPAIGN: THE SUMMER CAMPAIGN FOR KISH HOSPITAL TOOK WELLNESS EDUCATION AND PREVENTION ON THE ROAD TO 69 EVENTS THROUGHOUT THE COMMUNITY AND FOR EMPLOYEES. BLOOD PRESSURE CLINICS: THE CAMPAIGN PROMOTION OF THE FREE BLOOD PRESSURE CLINICS SHOWED HUGE SUCCESS. THE AVERAGE MONTHLY PARTICIPANT COUNT FOR BLOOD PRESSURE CHECKS AT KISH WAS AN AVERAGE OF 184 PER MONTH, WITH INCREASES IN GENOA ON AVERAGE 7 MORE PER MONTH AND IN WATERMAN ON AVERAGE 12 PER MONTH. TOTAL BLOOD PRESSURE CHECKS WERE 3,158.CANCER CARE SERVICES, EDUCATION AND PREVENTION: A "WOMEN MATTER" EVENT AT KISH HOSPITAL PROVIDED FREE MAMMOGRAMS TO 26 UNINSURED WOMEN. MARROW REGISTRY DRIVE ADDED 125 PEOPLE TO THE NATIONAL REGISTRY. A COMMUNITY PROGRAM SPONSORED BY THE HOSPITAL, TITLED "THOSE WHO LAUGH, WILL LAST," FEATURED A NATIONALLY-RECOGNIZED SPEAKER ON THE IMPORTANCE OF LAUGHTER AND EXERCISE WHEN COPING WITH SERIOUS ILLNESS. WORKED WITH THE KISHWAUKEE FAMILY YMCA TO ESTABLISH THE LIVESTRONG FITNESS PROGRAM FOR CANCER PATIENTS. CO-SPONSORED 5K RUN IN PLANO/SANDWICH, OUR SOUTHERN MARKET, TO RAISE MONEY FOR A CANCER PATIENT RETREAT. STARTED THE FREE PROGRAM CLIMB-CHILDREN'S LIVES INCLUDE MOMENTS OF BRAVERY FOR AGES 6-12 WHO HAVE BEEN TOUCHED BY A LOVED ONES CANCER. CONTINUED THE FOLLOWING PROGRAMS AND SUPPORTS GROUPS: LOOK GOOD...FEEL BETTER, CARING THE CAREGIVER, CREATIVE CONNECTIONS, GREEN THUMB HEALING, WOMEN WITH CANCER SUPPORT GROUP, MEN WITH CANCER SUPPORT. HELD QUARTERLY EDUCATIONAL AND SOCIAL ACTIVITIES AT THE KISH CANCER CENTER FOR PATIENTS AND THE PUBLIC. PROVIDED SPACE TO AMERICAN CANCER SOCIETY FOR A RESOURCE LIBRARY AT THE CANCER CENTER, OPEN TO THE PUBLIC. PROVIDED FINANCIAL SUPPORT OF AMERICAN CANCER SOCIETY RELAYS FOR LIFE FOR DEKALB COUNTY, NORTHERN ILLINOIS UNIVERSITY AND LOWER FOX VALLEY (KENDALL COUNTY). PROVIDED FREE SKIN CANCER SCREENING AT KISH HOSPITAL WOMEN'S HEALTH EVENT. PROVIDED BREAST CANCER AWARENESS BOOTH AT SYCAMORE'S LADIES NIGHT OUT.AFFORDABLE ACCESS TO CHILDBIRTH EDUCATION AND OB HOSPITAL SERVICES: A BREASTFEEDING CENTER WAS OPENED AT KISHWAUKEE COMMUNITY HOSPITAL PROVIDING FREE LACTATION COUNSELING, SUPPORT GROUPS, IN PERSON, ONLINE AND OVER THE PHONE.
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, EMPLOYEES OF THE HEALTH SYSTEM AND BOTH HOSPITALS 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. HOW KISHWAUKEE COMMUNITY HOSPITAL SERVES THE HEALTH OF OUR COMMUNITES IS WELL DOCUMENTED IN THIS SECTION. OF NOTE ARE A $50,000 GRANT TO BEN GORDON CENTER FOR MENTAL HEALTH SERVICES FOR THE UNINSURED; $25,000 GRANT FOR A CONSTRUCTION PROJECT FOR THE HOPE HAVEN HOMELESS SHELTER; $25,000 TO HELP THE Y PROVIDE FITNESS AND HEALTH ACTIVITIES FOR 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 PROVIDE HEALTH RELATED EDUCATION.
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 (21 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant	Amount Of Non Cash AssistanceAmountOfNonCashAssistance	Method Of ValuationMethodOfValuation	Description Of Non Cash AssistanceDescriptionOfNonCashAssistance	Address Line2AddressUS/AddressLine2
AMERICAN CANCER SOCIETY
143 FIRST STREET	BATAVIA	IL	60510	131788491	501(C)(3)	16000	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO CANCER RESEARCH AND EDUCATION
AMERICAN HEART ASSOCIATION
PO BOX 4002902	DES MOINES	IA	50340	135613797	501(C)(3)	19000	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO HEART HEALTH RESEARCH AND EDUCATION
BEN GORDON CENTER
12 HEALTH SERVICES DRIVE	DEKALB	IL	60115	362771343	501(C)(3)	50000	TO PROVIDE FINANCIAL ASSISTANCE FOR MENTAL HEALTH SERVICES FOR UNDER OR UNINSURED
KISHHEALTH FOUNDATION
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	363649077	501(C)(3)		TO PROVIDE FINANCIAL SUPPORT OF HEALTH FOUNDATION ACTIVITIES	9210	FMV	SUPPLIES
COMMUNITY FOUNDATION FOR THE LAND OF LINCOLN
205 SOUTH FIFTH STREET SUITE 930	SPRINGFIELD	IL	62701	204191391	501(C)(3)	5000	TO PROVIDE FINANCIAL SUPPORT FOR PARTNERS IN NURSING INITIATIVE
DEKALB CHAMBER OF COMMERCE
164 E LINCOLN HWY	DEKALB	IL	60115	360981630	501(C)(6)	8275	TO PROVIDE FINANCIAL SUPPORT FOR COMMUNITY ECONOMIC VITALITY AND DEVELOPMENT AS WELL AS LEADERSHIP ACADEMY FOR ADULTS AND HIGH SCHOOL STUDENTS
DEKALB COUNTY EDC
421 NORTH CROSS STREET	SYCAMORE	IL	60178	363524353	501(C)(6)	11500	TO PROVIDE FINANCIAL ASSISTANCE FOR SUPPOR OF LOCAL ECONOMIC DEVELOPMENT
DEKALB COUNTY AMERICAN RED CROSS
2727 SYCAMORE ROAD SUITE 2A	DEKALB	IL	60115	530196605	501(C)(3)	5718	TO PROVIDE FINANCIAL ASSISTANCE FOR LOCAL DISASTER RELIEF
DEKALB COUNTY YOUR SERVICES BUREAU
330 GROVE STREET	DEKALB	IL	60115	363034427	501(C)(3)	5000	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO YOUTH SERVICES
DEKALB CORN FEST
1586 BARBER GREENE RD	DEKALB	IL	60115	364028426	501(C)(3)	7700	TO PROVIDE FINANCIAL ASSISTANCE FOR CORN FEST RACE
FAMILY SERVICE AGENCY
14 HEALTH SERVICES DRIVE	DEKALB	IL	60115	362360012	501(C)(3)	25000	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO CASA AND BIG BROTHERS/BIG SISTERS PROGRAMS
GENOA CHAMBER OF COMMERCE
327 W MAIN STREET	GENOA	IL	60135	362355846	501(C)(6)	5950	TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO PROMOTION OF GENOA AREA ECONOMIC VITALITY
HOPE HAVEN
1145 RUSHMOORE DRIVE	DEKALB	IL	60115	363537762	501(C)(3)	25000	TO PROVIDE FINANCIAL ASSISTANCE FOR LOCAL HOMELESS SHELTER
ILLINOIS POISON CONTROL CENTER
222 SOUTH RIVERSIDE PLAZA SUITE	CHICAGO	IL	60606	362167008	501(C)(3)	7480	TO PROVIDE FINANCIAL ASSISTANCE FOR POISON CONTROL HOTLINE				1900
KISHWAUKEE COLLEGE FOUNDATION
21193 MALTA ROAD	MALTA	IL	60150	237433949	501(C)(3)	17500	TO PROVIDE FINANCIAL ASSISTANCE FOR PROMOTION OF HEALTHCARE EDUCATION
KISHWAUKEE FAMILY YMCA
2500 BETHANY ROAD	SYCAMORE	IL	60178	362379643	501(C)(3)	21500	TO PROVIDE FINANCIAL ASSISTANCE RELATED TO HEALTH AND FITNESS ACTIVITES FOR LOW INCOME CHILDREN AND FAMILIES
KISHWAUKEE UNITED WAY
PO BOX 311 115 N FIRST STREET	DEKALB	IL	60115	366158489	501(C)(3)	14321	TO PROVIDE FINANCIAL ASSISTANCE IN SUPPORT OF COMMUNITY SOCIAL SERVICES
MARCH OF DIMES
5411 E STATE STREET STE 8	ROCKFORD	IL	61108	131846366	501(C)(3)	9677	TO PROVIDE FINANCIAL ASSISTANCE IN SUPPORT OF PRE-NATAL EDUCATION AND RESEARCH
NORTHERN PUBLIC RADIO
801 N FIRST STREET	DEKALB	IL	60115	366086819	501(C)(3)	13795	TO PROVIDE FINANCIAL ASSISTANCE TO UNDERWRITE LOCAL PUBLIC RADIO
SYCAMORE CHAMBER OF COMMERCE
407 W STATE STREET STE 10	SYCAMORE	IL	60178	361848940	501(C)(6)	6725	TO PROVIDE FINANCIAL ASSISTANCE TO PROMOTE SYCAMORE ECONOMIC VITALITY AND DEVELOPMENT
VOLUNTARY ACTION CENTER
1606 BETHANY ROAD	SYCAMORE	IL	60178	362798257	501(C)(3)	5000	TO PROVIDE FINANCIAL ASSISTANCE IN SUPPORT OF MEALS ON WHEELS AND TRANSPORTATION SERVICES FOR LOW INCOME AND ELDERLY

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	17	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	21	TotalNbrOfOtherOrganizations

Form990 Schedule I Part III Form990ScheduleIPartIII (2 entries)

Type Of GrantTypeOfGrant	Number Of RecipientsNumberOfRecipients	Amount Of Cash GrantAmountOfCashGrant
KISHWAUKEE COMMUNITY HOSPITAL AUXILIARY SCHOLARSHIP PROGRAM	13	23000
KISHWAUKEE COMMUNITY HOSPITAL BNA SCHOLARSHIP PROGRAM	2	2384

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 KISHWAUKEE 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 (16 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 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
MICHAEL MUZZILLO
0	145011	0	34338	0	0	0	12707	0	14872	0	206928	0	0
THOMAS W TILTON DO
355841	0	108992	0	0	0	19288	0	22817	0	506938	0	0	0
THOMAS WARZECHA
137854	0	7951	0	0	0	9769	0	22103	0	177677	0	0	0
KENYA M WILLIAMS MD
221233	0	12351	0	0	0	19288	0	1587	0	254459	0	0	0
JASMEET DHALIWAL
268795	0	305374	0	0	0	0	0	22746	0	596915	0	0	0
KENNETH O'BRIEN
133538	0	0	0	0	0	8102	0	21928	0	163568	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 K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	CITY OF SYCAMORE DEKALB COUNTY ILLINOIS HEALTH FACILITIES REVENUE BOND	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	861091967	IssuerEIN
CUSIP Number	452032AJ4	CUSIPNumber
Date Issued	2008-08-01	DateIssued
Issue Price	63685000	IssuePrice
Description Of Purpose	CONSTRUCTION OF NEW FACILITY FOR KISHWAUKEE COMMUNITY HOSPITAL	DescriptionOfPurpose
Defeased	1	Defeased
On Behalf Of Issuer	1	OnBehalfOfIssuer
Pool Financing	0	PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Total Proceeds	63371994	TotalProceeds
Issuance Costs From Proceeds	328434	IssuanceCostsFromProceeds
Year Of Subst Completion	2007	YearOfSubstCompletion
Current Refunding	0	CurrentRefunding
Advance Refunding	1	AdvanceRefunding
Final Allocation Made	1	FinalAllocationMade
Adequate Books And Recds Maintaind	1	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

Field	Value	IRS element (for citing)
Owning Bond Financed Property	0	OwningBondFinancedProperty
Any Lease Arrangements	0	AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty	0	MngmentCntrctBondFinancdPrprty
Any Research Agreements	0	AnyResearchAgreements
Post Issuance Compliance Procdrs	0	PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	0	Form8038TFiled
Variable Rate Issue	0	VariableRateIssue
Hedge Identified In Books And Recds	0	HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC	0	GrossProceedsInvestedInGIC
Gross Proceeds Invested	0	GrossProceedsInvested
Exception To Rebate	0	ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (9 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
KISHHEALTH SYSTEM
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, KHS IS PARENT ORGANIZATION OF KCH	12642156	KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF KISHWAUKEE 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
KISHHEALTH SYSTEM
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, KHS IS PARENT ORGANIZATION OF KCH	4440000	DURING THE CURRENT YEAR, KISHWAUKEE COMMUNITY HOSPITAL ALSO MADE A NET EQUITY DISTRIBUTION BACK TO ITS PARENT ORGANIZATION.	0
DEKALB COUNTY HOSPICE
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	117323	DEKALB COUNTY HOSPICE (DCH) IS AN AFFILIATE OF KISHWAUKEE COMMUNITY HOSPITAL (SAME PARENT CORPORATION). KCH IS UTILIZED BY DEKALB COUNTY HOSPICE FOR MEDICAL TREATMENTS AND SUPPLIES.	0
DEKALB COUNTY HOSPICE
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	53976	KISHWAUKEE COMMUNITY HOSPITAL (KCH) IS AN AFFILIATE OF DEKALB COUNTY HOSPICE (SAME PARENT CORPORATION). DEKALB COUNTY HOSPICE RENTS SPACE IN THE BUILDING OWNED BY KCH.	0
KISHHEALTH FOUNDATION
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	191062	KISHWHEALTH FOUNDATION UTILIZES EMPLOYEES OF KISHWAUKEE COMMUNITY HOSPITAL. EMPLOYEES ARE LEASED FROM KISHWAUKEE COMMUNITY HOSPTIAL.	0
HEALTH PROGRESS INC
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	9493	KISHWAUKEE COMMUNITY HOSPITAL PROVIDES FOR HOUSEKEEPING SERVICES UTILIZED BY HEALTH PROGRESS, INC.	0
VALLEY WEST COMMUNITY HOSPITAL
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	5031688	KISHWAUKEE COMMUNITY HOSPITAL ROUTINELY SELLS SUPPLIES AND SERVICES TO VALLEY WEST COMMUNITY HOSPITAL AS PART OF ITS DAY-TO-DAY BUSINESS.	0
COMMUNITY CARES CLINIC INC
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	347910	KISHWAUKEE COMMUNITY HOSPITAL PROVIDES MEDICAL SERVICES AND STAFF TO THE CLINIC. FEES PAID TO KCH ARE IN EXCHANGE FOR THESE SERVICES.	0
HEALTH PROGRESS INC
COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE	1011	KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. KHS LEASES LAND TO HEALTH PROGRESS, INC. THIS LAND IS THEN SUBLEASED TO A RELATED ENTITY WHICH PROVIDES CANCER TREATMENT SERVICES.	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 KISHWAUKEE COMMUNITY HOSPITAL. MR. POORTEN IS PRESIDENT AND CEO OF KISHWHEALTH 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. MICHAEL MOONEY AND MICHAEL CULLEN ARE MEMBERS OF THE KISHWAUKEE COMMUNITY HOSPITAL BOARD OF DIRECTORS. THEY ALSO SERVE ON THE BOARD OF DIRECTORS OF KISHHEALTH SYSTEM, THE PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL. THE FOLLOWING INDIVIDUALS ARE OFFICERS OR KEY EMPLOYEES OF KISHHEALTH SYSTEM AND ARE ALSO CONSIDERED OFFICERS OR KEY EMPLOYEES OF KISHWAUKEE 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 HEATH BELL, VP AND CHIEF INFORMATION OFFICER MARK THATE, VP HUMAN RESOURCES DR. MICHAEL KULISZ, CHIEF MEDICAL OFFICER
FORM 990, PART VI, SECTION A, LINE 6	KISHHEALTH SYSTEM IS THE SOLE MEMBER OF KISHWAUKEE COMMUNITY HOSPITAL.
FORM 990, PART VI, SECTION A, LINE 7A	AS THE SOLE MEMBER AND PARENT ORGANIZATION OF KISHWAUKEE 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. PER THE BYLAWS, WITH RESPECT TO THE GOVERNANCE OF KCH, THE FOLLOWING POWERS SHALL BE RESERVED TO THE SOLE CORPORATE MEMBER: A. ELECTING THE MEMBERS OF THE KCH 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 KCH; D. APPROVING THE DISPOSITION OF ANY ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS FOR KCH; E. APPROVING ANY CHANGE IN MEMBERSHIP OF KCH; F. APPROVING THE ADOPTION OF AND AMENDMENTS TO THE ORGANIZATIONAL DOCUMENTS, INCLUDING THE ARTICLES OF INCORPORATION AND BYLAWS OF KCH; G. APPROVING A PLAN OF MERGER OR A PLAN OF CONSOLIDATION OF KCH OR ESTABLISHING A NEW SUBSIDIARY OR SISTER ENTITY; H. APPROVING A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF KCH; 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 KCH OPERATIONAL QUALITY IMPROVEMENT POLICIES AND PROGRAMS; K. ACCEPTING GIFTS, GRANTS, BEQUESTS AND DONATIONS ON BEHALF OF KCH; L. APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGETS FOR KCH; M. EXERCISING ANY RIGHTS THAT KCH HAS AS A SHAREHOLDER OR MEMBER OF ANY SUBSIDIARY ENTITY; N. APPROVING ANY AFFILIATIONS OF KCH; 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 KCH; Q. AUTHORIZING THE VOLUNTARY DISSOLUTION OF KCH, 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 KCH; 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 KCH. 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 KCH, 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 KISHWAUKEE COMMUNITY HOSPITAL.	DESCRIPTION OF HOURS FOR RELATED ORGANIZATIONS
FORM 990, PART XI, LINE 5:	NET UNREALIZED LOSSES ON INVESTMENTS: -1,139,781. EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM -4,440,000. CHANGE OF INTEREST IN NET ASSETS OF KISHHEALTH FOUNDATION -65,942. BOOK/TAX DIFFERENCES IN K-1 PASSTHROUGH ENTITIES 333,417. GRANT REVENUE INCLUDED IN FIXED ASSETS FOR FINANCIAL STATEMENT PURPOSES -30,850. OTHER EQUITY ADJUSTMENT 70,726. TOTAL TO FORM 990, PART XI, LINE 5: -5,272,430.	CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XI, LINE 2C	NO CHANGES IN THIS PROCESS WERE MADE DURING THE TAX YEAR. 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.	RESPONSIBILITY 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 ORGANIZATION OF 501(C)(3) HEALTH SYSTEM	IL	501(C)(3)	11B	N/A	0
VALLEY WEST COMMUNITY HOSPITAL
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	364244337	HEALTHCARE SERVICES, PRIMARILY ACUTE CARE	IL	501(C)(3)	3	N/A	0
DEKALB COUNTY HOSPICE
2727 SYCAMORE ROAD 1B	DEKALB	IL	60115	363164329	HEALTHCARE SERVICES, HOSPICE SERVICES	IL	501(C)(3)	7	N/A	0
KISHHEALTH FOUNDATION
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	363649077	SUPPORT OF KISHWAUKEE HEALTH SYSTEM NOT FOR PROFIT ENTITIES	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		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 III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivityPrimaryActivity	Legal Domicile StateLegalDomicileState	Predominant Income TypePredominantIncomeType	Share Of Total IncomeShareOfTotalIncome	Share Of EOY AssetsShareOfEOYAssets	Disproportionate AllocationsDisproportionateAllocations	General Or Managing PartnerGeneralOrManagingPartner	Percentage OwnershipPercentageOwnership
KISHWAUKEE AREA PHO
ONE KISH HOSPITAL DRIVE	DEKALB	IL	60115	364205273	MEDICARE SERVICES	IL	RELATED	-27776	3022	0	0	0.50000
THE MIDLAND SURGICAL CENTER LLC
3085 WOLF COURT	DEKALB	IL	60115	352194610	SURGICAL SERVICES	IL	RELATED	527237	655734	0	0	0.77500

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 BUSINESS	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	1	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	1	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	0	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