NORTHWEST COMMUNITY HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
NORTHWEST COMMUNITY HOSPITAL (EIN 36-2340313)
Tax period
2009-10-01 to 2010-09-30
Filed
2011-08-12
IRS object ID
201102289349301340
Schema version
2009v1.7
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-08-12T11:39:39-05:00Timestamp
Tax Period End Date2010-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code462042094ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362340313EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northwest Community HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone8476181000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 WEST CENTRAL ROADAddressLine1
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameBRUCE K CROWTHERName
TitlePRESIDENT & CEOTitle
Date Signed2011-08-10DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBruce K CrowtherNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1800 W Central RoadAddressLine1
CityArlington HeightsCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
Gross Receipts793545031GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.nch.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionNCH OPERATES AN ACUTE CARE HOSPITAL IN ARLINGTON HEIGHTS, IL. THE HOSPITAL EXISTS TO PROVIDE QUALITY COMPASSIONATE HEALTHCARE SERVICES TO THE PEOPLE OF THE NORTHWEST SUBURBAN COMMUNITY OF CHICAGO.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees3879TotalNbrEmployees
Total Nbr Volunteers800TotalNbrVolunteers
Total Gross UBI3069573TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year36803133ContributionsGrantsPriorYear
Contributions Grants Current Year58803610ContributionsGrantsCurrentYear
Program Service Revenue Prior Year434294611ProgramServiceRevenuePriorYear
Program Service Revenue CY429297770ProgramServiceRevenueCY
Investment Income Prior Year4872780InvestmentIncomePriorYear
Investment Income Current Year3115869InvestmentIncomeCurrentYear
Other Revenue Prior Year6467135OtherRevenuePriorYear
Other Revenue Current Year6127030OtherRevenueCurrentYear
Total Revenue Prior Year482437659TotalRevenuePriorYear
Total Revenue Current Year497344279TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY438997GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year241750900SalariesEtcPriorYear
Salaries Etc Current Year236671537SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year212448341OtherExpensePriorYear
Other Expenses Current Year216879648OtherExpensesCurrentYear
Total Expenses Prior Year454199241TotalExpensesPriorYear
Total Expenses Current Year453990182TotalExpensesCurrentYear
Revenues Less Expenses Prior Year28238418RevenuesLessExpensesPriorYear
Revenues Less Expenses CY43354097RevenuesLessExpensesCY
Total Assets BOY575280731TotalAssetsBOY
Total Assets EOY610945530TotalAssetsEOY
Total Liabilities BOY436136979TotalLiabilitiesBOY
Total Liabilities EOY440717241TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY139143752NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY170228289NetAssetsOrFundBalancesEOY
Mission DescriptionThe Hospital's Mission and Vision Statement is: We exist to improve the health of the communities we serve and to meet individuals' healthcare needs. We will be known for our singular focus on providing a comprehensive, patient-centered system of care that surpasses every expectation for excellence (in quality, convenience and service).MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense369319803Expense
Grants308303Grants
Revenue426228197Revenue
DescriptionNorthwest Community Hospital provides quality healthcare services to inpatients and outpatients regardless of race, sex, national origin, age or ability to pay. In serving all members of its community, Northwest Community Hospital provides free/subsidized care, care to persons covered by governmental programs at less than full charges, and community health/education/wellness programs. The Hospital treats patients in immediate need of medical services without regard to their ability to pay for such services. Pursuant to its written charity care policy which is widely distributed and communicated to the community, the cost of charity care provided during FY 2010 was $8,821,000. The Hospital also provides care to persons covered by governmental programs at below cost. The unreimbursed cost of providing this care to Medicare and Medicaid patients was $79,824,000 in FY2010. In addition, the Hospital provides community benefits in the form of health and wellness education ($275,000 cost in FY10), language translation services ($338,000), paramedic training ($368,000), and other social services, transportation services, emergency preparedness, and adult day care programs ($158,000). The Hospital contributed financial and in-kind support of $401,000 to a local FQHC and community center, and operated a mobile dental clinic ($82,000). During FY2010, the community contributed 109,600 hours towards our mission of serving the healthcare needs of the community. The value of these volunteer services was approximately $1,072,000, which benefits the community through lower costs of patient services. During FY2010, the Hospital provided care to 25,721 inpatients and 74,326 emergency department patients and treated 70,722 patients at its three immediate care centers. Outpatient care included 518,094 laboratory exams, 256,224 radiology procedures, and 43,952 home healthcare visits.Description
Total Program Service Expense369319803TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096480NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3879NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLAURENCE S APPEL CONTROLLERNamePerson
Telephone Number8476184610TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13060 SALT CREEK LNAddressLine1
CityARLINGTON HGHTSCity
StateILState
ZIP Code60005ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (40 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
M Shan Atkins
Director1.0X000
James H Bishop
Director1.0X35000
Beth A Brooks
Director1.0X35000
Craig E Christell
Director1.0X35000
Dale J Garber
Director1.0X000
Louis A Gatta
Director1.0X35000
Charles A Hempfling
Director1.0X35000
Diane G Hill
Director1.0X35000
Francis J Lamberta MD
Director1.0X000
Robert J Longo MD
Director1.0X000
Thomas P MacCarthy
Director1.0X35000
Allen S Malmed MD
Director/Med Staff Pres 201010.0X35000
Louis J Marsico
Director1.0X35000
Ari N Shariatzadeh MD
Director/Med Staff Pres 200910.0X4835000
Gilbert A Sita MD
Director1.0X35000
Donald D Torisky
Director1.0X35000
Cynthia Valukas MD
Director1.0X35000
Daniel P DiCaro
Chairperson1.0X35000X
Max Brittain Jr
Vice Chairperson1.0X35000X
Bruce K Crowther
President/CEO/Secretary26.0X10970390251709X
Michael B Zenn
Executive VP/COO/Treasurer31.04893610158945X
Gail A Finn
Vice President/CFO33.0266639030757X
Leighton Smith MD
Exec VP/Chief Medical Officer38.0716211068422X
Mark Lusson
Executive Vice President40.0286527064616X
Dale Beatty
Exec VP/Chief Nursing Officer38.0276184037206X
George Morris
VP/Chief Information Officer40.0272684049837X
Mary P Stack
Vice President40.0226626058581X
Dawn Walden
Vice President40.0221249040222X
Angela Stefaniu
Vice President40.0182375048610X
Robert Klasek
Vice President40.0203227042129X
Laura Pollack
Vice President40.0150190035972X
Gary Skiba
Vice President40.0185901037172X
Ann Sayvetz
General Counsel40.0243085021986X
Malcolm Bilimoria MD
Employed Physician40.019778890171401X
Willis Parsons MD
Employed Physician40.01870096013426X
Rameez Alasadi MD
Employed Physician40.0587460024747X
Sonia Mehta MD
Employed Physician40.0379102039593X
Tahseen Mohammed MD
Employed Physician40.0301929024818X
Richard Hinden
General Counsel (former)0.011775608948X
Theresa Hoban
General Counsel (former)0.010771100X
FieldValueIRS element (for citing)
Total Reportable Comp From Org10212491TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation1229097TotalOtherCompensation
Number Individuals GT100 K250NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
CSC Consulting Inc
PO Box 905145CHARLOTTENC28290Consulting services3239119
GE Healthcare
PO Box 96483CHICAGOIL60693Equip maint svcs2194915
Siemens Medical Solutions USA Inc
Dept CH 14195PALATINEIL60055IT services2086931
OWPP
111 W Washington St Suite 2100CHICAGOIL60602Architectural svcs1852144
Hospital Laundry Services
2689 Reliable ParkwayCHICAGOIL60686Laundry services1759705
FieldValueIRS element (for citing)
Number Of Contractors GT100 K96NumberOfContractorsGT100K
Related Organizations58667020RelatedOrganizations
Government Grants134630GovernmentGrants
All Other Contributions1960AllOtherContributions
Total Contributions58803610TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Net patient services622110425206126425206126
Lab services62150030695733069573
Classes and Training900099899632899632
NURSING SVCS - PALATINE OPPORTUNITY CTR900099122439122439
FieldValueIRS element (for citing)
Total Program Service Revenue429297770TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2513776TotalRevenueColumn
Exclusion$2,513,776ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column2405TotalRevenueColumn
Exclusion$2,405ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2473236Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real990358Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1482878Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1482878TotalRevenueColumn
Exclusion$1,482,878ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities295933888Securities
Other142258Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities295410115Securities
Other66343Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities523773Securities
Other75915Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column599688TotalRevenueColumn
Exclusion$599,688ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory223403GrossSalesOfInventory
Cost Of Goods Sold-266064CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-42661TotalRevenueColumn
Exclusion-$42,661ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Cafeteria7222101773862$1,773,862
Reinsurance Recovery9000991738107$1,738,107
Communications900099354855$354,855

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column819989TotalRevenueColumn
Exclusion$819,989ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4686813TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column497344279TotalRevenueColumn
Related Or Exempt Function Income426228197RelatedOrExemptFunctionIncome
Unrelated Business Revenue3069573UnrelatedBusinessRevenue
Exclusion$9,242,899ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total438997Total
Program Services438997ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total4871548Total
Management And General4871548ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total213188Total
Program Services213188ProgramServices

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total178098376Total
Program Services143232818ProgramServices
Management And General34865558ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total9484760Total
Program Services7384280ProgramServices
Management And General2100480ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total31258922Total
Program Services24230128ProgramServices
Management And General7028794ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12744743Total
Program Services10031396ProgramServices
Management And General2713347ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total870441Total
Program Services21133ProgramServices
Management And General849308ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total236971Total
Management And General236971ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total207859Total
Management And General207859ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total25914406Total
Program Services12638121ProgramServices
Management And General13276285ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total3736637Total
Program Services5853ProgramServices
Management And General3730784ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total81565862Total
Program Services77467508ProgramServices
Management And General4098354ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5938425Total
Program Services4596508ProgramServices
Management And General1341917ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total8787416Total
Program Services7887858ProgramServices
Management And General899558ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total508217Total
Program Services274455ProgramServices
Management And General233762ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total159419Total
Program Services131744ProgramServices
Management And General27675ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total5238076Total
Program Services5238076ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total33085352Total
Program Services25437425ProgramServices
Management And General7647927ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total9679296Total
Program Services9454946ProgramServices
Management And General224350ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROV. FOR UNCOLLECTIBLE ACCTS2889984928899849
Illinois hospital assessment1167666211676662
Dues33904058858280182
Basis swap settlement3572035720

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total453990182Total
Program Services369319803ProgramServices
Management And General84670379ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1209935BOY
EOY16891000EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY12628619BOY
EOY2397078EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY52563797BOY
EOY51457091EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY86707BOY
EOY90465EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY293377BOY
EOY283430EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY3839375BOY
EOY4483867EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY6152404BOY
EOY9536463EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis624603137LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec216697959LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY384194164BOY
EOY407905178EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY100895013BOY
EOY104611294EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY6703439BOY
EOY5433417EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY6713901BOY
EOY7856247EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY575280731BOY
EOY610945530EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY68033504BOY
EOY64574817EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY129163BOY
EOY6463988EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY294045000BOY
EOY288780000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY73929312BOY
EOY80898436EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY436136979BOY
EOY440717241EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY132440313BOY
EOY164794872EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5907086BOY
EOY4475858EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY796353BOY
EOY957559EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY139143752BOY
EOY170228289EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY575280731BOY
EOY610945530EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$41,981GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB41981TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLobbying ActivitiesIdentifier
Return ReferencePart II-B, Line 1FReturnReference
ExplanationNorthwest Community Hospital maintains memberships with certain hospital associations, of which certain dues paid were used for lobbying.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2160499BeginningOfYearBalance
Contributions9266Contributions
Investment Earnings Or Losses78969InvestmentEarningsOrLosses
End Of Year Balance2248734EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2131037BeginningOfYearBalance
Contributions39825Contributions
Investment Earnings Or Losses-10363InvestmentEarningsOrLosses
End Of Year Balance2160499EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.53000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.47000PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1789072OtherCostOrOtherBasis
Book Value1789072BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis294267378OtherCostOrOtherBasis
Depreciation86086671Depreciation
Book Value208180707BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis207002798OtherCostOrOtherBasis
Depreciation79655910Depreciation
Book Value127346888BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis97733375OtherCostOrOtherBasis
Depreciation43137804Depreciation
Book Value54595571BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis23810514OtherCostOrOtherBasis
Depreciation7817574Depreciation
Book Value15992940BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings407905178TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (5 entries)

DescriptionDescriptionAmountAmount
PENSION OBLIGATION$46,703,341
DUE TO THIRD-PARTY PAYORS$30,299,914
Interest rate swap liability$1,975,139
Asset retirement obligation$1,223,382
DUE TO AFFILIATES$696,660
FieldValueIRS element (for citing)
Total Of Amounts80898436TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of intended uses of endowment fundsIdentifier
Return ReferenceSchedule D, Part V, Line 4ReturnReference
ExplanationEndowment funds are created according to hospital needs and designation or preferences of the donor(s) supporting the endowment fund. Scholarship funds, continued education, or funds for patient care in a hospital department designated by the endowment fund are examples of fund uses.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense20748278TotalCommunityBenefitExpense
Net Community Benefit Expense20748278NetCommunityBenefitExpense
Percent Of Total Expense0.04880PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense37866759TotalCommunityBenefitExpense
Direct Offsetting Revenue25684850DirectOffsettingRevenue
Net Community Benefit Expense12181909NetCommunityBenefitExpense
Percent Of Total Expense0.02870PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense58615037TotalCommunityBenefitExpense
Direct Offsetting Revenue25684850DirectOffsettingRevenue
Net Community Benefit Expense32930187NetCommunityBenefitExpense
Percent Of Total Expense0.07750PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1290052TotalCommunityBenefitExpense
Direct Offsetting Revenue122694DirectOffsettingRevenue
Net Community Benefit Expense1167358NetCommunityBenefitExpense
Percent Of Total Expense0.00270PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense833613TotalCommunityBenefitExpense
Direct Offsetting Revenue465268DirectOffsettingRevenue
Net Community Benefit Expense368345NetCommunityBenefitExpense
Percent Of Total Expense0.00080PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense312682TotalCommunityBenefitExpense
Direct Offsetting Revenue230700DirectOffsettingRevenue
Net Community Benefit Expense81982NetCommunityBenefitExpense
Percent Of Total Expense0.00020PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense28000TotalCommunityBenefitExpense
Net Community Benefit Expense28000NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense438997TotalCommunityBenefitExpense
Net Community Benefit Expense438997NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2903344TotalCommunityBenefitExpense
Direct Offsetting Revenue818662DirectOffsettingRevenue
Net Community Benefit Expense2084682NetCommunityBenefitExpense
Percent Of Total Expense0.00480PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense61518381TotalCommunityBenefitExpense
Direct Offsetting Revenue26503512DirectOffsettingRevenue
Net Community Benefit Expense35014869NetCommunityBenefitExpense
Percent Of Total Expense0.08230PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense105614TotalCommunityBuildingExpense
Direct Offsetting Revenue49630DirectOffsettingRevenue
Net Community Building Expense55984NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense218643TotalCommunityBuildingExpense
Net Community Building Expense218643NetCommunityBuildingExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Other Other

FieldValueIRS element (for citing)
Total Community Building Expense21028TotalCommunityBuildingExpense
Net Community Building Expense21028NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense345285TotalCommunityBuildingExpense
Direct Offsetting Revenue49630DirectOffsettingRevenue
Net Community Building Expense295655NetCommunityBuildingExpense
Percent Of Total Expense0.00070PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$8,675,735BadDebtExpenseAmount
Amount Attributable To780816AmountAttributableTo
Amount Reimbursed By Medicare143117003AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare179853860CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-36736857MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV (12 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeLicensed HospitalLicensedHospitalGeneral Medical And SurgicalGeneralMedicalAndSurgicalEr24 HoursEr24HoursOtherOther
Northwest Community Hospital
800 W Central RoadArlington HeightsIL60005XXX
NCH Cardiac and Physical Medicine Rehab
900 W Central RoadArlington HeightsIL60005OUTPATIENT CARDIAC REHAB PROGRAM AND PHYSICAL MED SVCS
NCH Immediate Care Center
15 S McHenry RoadBuffalo GroveIL60089WALK IN URGENT CARE CENTER & OUTPATIENT PHYSICAL MED. SVCS
NCH Immediate Care Center
1201 S Rand RoadLake ZurichIL60047WALK IN URGENT CARE CENTER & OUTPATINET PHYSICAL MED. SVCS
NCH Immediate Care and Imaging Center
509 S Roselle RoadSchaumburgIL60193WALK IN URGENT CARE CENTER AND IMAGING SERVICES
NCH Mental Health & Youth Treatment Ctr
901 W Kirchoff RoadArlington HeightsIL60005IN & OUT MENTAL HEALTH AND YOUTH SUBSTANCE ABUSE TRMT
NCH Physical Medicine and Rehab
500 N Hicks RoadPalatineIL60067OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH Physical Medicine and Rehab
901 W Kirchoff RoadArlington HeightsIL60005OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH Physical Medicine and Rehab
601 W Deerfield ParkwayBuffalo GroveIL60089OUTPATIENT PHYSICAL MEDICINE SERVICES
Northwest Community Hospital Home Health
3060 Salt Creek LaneArlington HeightsIL60005Home Health Care SERVICES
NCH Outpatient Center
3300 Kirchoff RoadRolling MeadowsIL60008Outpatient Physical Medicine Services
NCH Occupational Medicine
455 S Roselle RoadSchaumburgIL60193Occupational Wellness and Rehab

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Income Based CriteriaCharity Care Policy The Hospital provides emergent and medically necessary services to all patients without regard to the patient's ability to pay. Under the Hospital's financial assistance policy, the amount of free care provided is determined by financial need and is not limited by budgeted amounts. Patients earning less than 200% of the Federal Poverty Guidelines receive free care and those between 200% and 400% of the Guidelines receive discounted care on a sliding scale. Consistent with the Illinois Uninsured Patient DIscount Act, patients without insurance coverage are eligible for a discount if their income is at or below 600% of the Federal Poverty Guidelines. Of the remaining balance, the patient's liabilty is capped at 25% of the family's annual income.IncomeBasedCriteria
Annual Community Benefit ExplnCommunity Benefit Report The Hospital's community benefit activities are included in an annual report issued by Northwest Community Healthcare, the sole corporate member of the Hospital.AnnualCommunityBenefitExpln
Costing Method UsedCosting Methodology The following methodologies were used to determine the amounts reported in the table for line 7: For lines 7a - 7d, ratio of cost to charges as determined using Worksheet 2 in the Form 990 Instructions; for lines 7e - 7i, costs were determined using the direct costs for the specific program or service from the Hospital's general ledger system. PART III, LINE 1 BAD DEBT EXPENSE The Hospital records bad debt expense in accordance with Generally Accepted Accounting Principles (GAAP). HFMA Statement 15 is followed to the extent that it aligns with the guidelines per GAAP.CostingMethodUsed
Subsidized Health Services ExplnSubsidized Heatlh Services The Hospital has not included any costs related to a physician clinic as part of subsidized health services.SubsidizedHealthServicesExpln
Percent Of Total Expense ExplnBad Debt Expense The amount of bad debt expense included in Part IX, line 25, column (A) that was excluded from the calculation of this percentage was $28,899,849.PercentOfTotalExpenseExpln
Bad Debt FootnoteBad Debt Expense Northwest Community Hospital is included in the audited financial statements of Northwest Community Healthcare and Subsidiaries. The text of the footnote referencing bad debt expense in the FY 2010 audit is as follows: Healthcare evaluates the collectibility of its accounts receivable based on the length of time the receivable is outstanding, payor class and the anticipated future collectible amounts based on historical experience. Accounts receivable are charged to the allowance for uncollectible accounts when they are deemed uncollectible." The Hospital's bad debt expense as reported on lines 2 and 3 was determined using the cost to charge ratio calculated using Worksheet 2 in the Form 990 instructions. For FY 2010, the Hospital recorded provisions for bad debt expense of $28,899,849 (at charges) of which it is estimated that 9% of this amount would have been reported as charity if the patient would have fully completed the charity application process.BadDebtFootnote
Shortfall As Community BenefitMedicare Shortfall The Medicare shortfall reported in line 7 should be treated as community benefit because: (a) without the Medicare program, it is likely that many of these individuals would qualify for charity care or Medicaid; (b) by the Hospital accepting payment below cost to treat these patients, the burdens of government are relieved with respect to these individuals; (c) there is a significant possibility that continued reductions in Medicare reimbursement may actually reduce access to care for these individuals; and (d) the amount spent by the Hospital to cover the Medicare shortfall is money not available to cover charity care and other community benefit needs.ShortfallAsCommunityBenefit
Debt Collection PolicyCollection Practices It is the policy of the Hospital to offer patients a payment plan or financial assistance when it becomes known or suspected that a patient needs such assistance. Financial counselors contact and work with the patient or their family to help determine if there are any third party payors which may be available to help the patient meet their obligations, such as Medicaid, COBRA, Workers Compensation, or specialized grant programs. If no third party programs are identified, the financial counselors work with the patient to help them apply for chartity discounts or payment plans. Forms are available in English and Spanish, and translation services are provided in many languages. In addition, all patient bills and statements include information about how to apply for financial assistance and the information is also posted on the Hospital's website.DebtCollectionPolicy
Number Of Facility Type ExplnIn Part V of Schedule H, Northwest Community Hospital reports: one acute care hospital, six physical medicine and rehab clinics, three immediate care centers, one radiology imaging center, one home health agency and one mental heatlh and youth alcohol and substance abuse treatment center.NumberOfFacilityTypeExpln
Needs AssessmentIn prior years, Northwest Community Hospital has conducted community needs assessments through direct contracting with third party consulting firms. The last such survey was done in 2007, and was used as the basis for addressing community health concerns for the succeeding three years. In 2010, the Hospital participated in a regional assessment offered by the Metropolitan Chicago Healthcare Council, which combined results from a community heatlh survey with other available data. Organizations participating in the assessment have access to a web portal where data can be drilled down by geographic area or by zip code. A team comprised of Hospital representatives from Community Services, Immediate Care/Wellness, Finance, Nursing and Marketing departments reviewed the results of the assessment and concluded that it should be used to drive community health improvement plans beginning in 2011.NeedsAssessment
Patient Education AssistanceThe financial assistance program at Northwest Community Hospital is communicated widely to patients and visitors in English and Spanish using the following methods: (1) signage in English and Spanish is posted throughout the organization at all access points, including the emergency department and outpatient registration areas. These areas also stock and make available a brochure, printed in English and Spanish, describing the Hospital's policy. Interpretation services are available for those who need additional information in other languages. (2) Each page of the Hospital's website (www. nch.org) contains the following footnote: "Northwest Community Hospital is a charitable organization and provides financial assistance to those who are eligible. For more information, click here." A link takes visitors to a subsequent page that describes financial assistance/charity care and provides the financial counselors' phone number. Applications for financial assistance, in English and Spanish, are available for download on the Hospital website. (3) All external Hospital publications include the following note: "Northwest Community Hospital is a charitable organization and provides financial assistance to people who are eligible. For more information please call 847.618.4542 or visit our website at www.nch.org." (4) information on financial assistance is included with every patient bill (5) Financial counselors work with patients identified upon registration or after admisssion to help them get assistance they need, answer questions, set up payment plans and facilitate applications for government programs such as Medicaid.PatientEducationAssistance
Community InformationNorthwest Community Hosptial is located in Arlington Heights, Illinois, a suburb located approximately 25 miles northwest of Chicago. Its primary and secondary service area consists of Arlington Heights and the surrounding suburbs of Mt. Prospect, Rolling Meadows, Palatine, Buffalo Grove, Barrington, Des Plaines, Elk Grove Village, Lake Zurich, Prospect Heights, Schaumburg and Wheeling. These areas have a combined population of approximately 650,000 people. This number has remained fairly stable since 2007, with the greatest growth in the over 65 age group. There are four other hospitals located in the Hospital's service area. Part of Arlington Heights has been designated as a medically-underserved area, with a Federally Qualified Health Center located across the street from the Hospital.CommunityInformation
Community Building ActivitiesIn 2010, the Hospital spent $56,000 preparing for any type of disaster in our service area. Current emergency preparedness training and equipment allows the Hospital to maintain its mission to provide healthcare during extreme conditions - either on the Hospital campus or out in the community. Each year, staff spends many hours conducting and participating in drills, including those that involve or are coordinated by outside agencies such as the Cook County Department of Public Health, State of Illinois and US Homeland Security. We also actively participate on state and local task forces including the Regional Catastrophic Planning Team medical subcommittee, that plan for and coordinate community-wide responses to disasters. In 2010, the Hospital provided funding of $21,000 to the Illinois Poison Center (IPC). The IPC serves Illlinois residents and is staffed by nurses, physicians and pharmacists, receiving over 90,000 poison-related calls from the public and healthcare providers per year. The toll-free hotline offers free, confidential poison prevention advice and treatment recommendations. The IPC serves as an early warning system for potential public threats through hazard identification, surveillance and situational awareness. The Hospital also provides opportunities in the form of clinical rotations for lab, pharmacy and radiological technology students, as well as internships and vocational information for area junior high and high school students. Costs related to these programs were $218,000 in 2010.CommunityBuildingActivities
Other InformationSchedule H, Part VI, Line 6 Northwest Community Hospital promotes the health of its community by: (1) extending medical staff privileges to all qualified physicians in its community for some or all of its departments; (2) maintaining any surplus funds either in the Hospital itself or at Northwest Community Healthcare, a 501(c)(3) support organization and sole member of the Hospital, for funding capital improvements in technology, facilities or patient care equipment, or to support Hosptial operations; (3) having a Board of Directors the majority of whom live or work in the Hospital's service area and who are not employees or contractors of the Hospital; (4) having a standing Community Health and Outreach Committee of the Hospital Board which is responsible for developing, implementing, monitoring and evaluating the effectiveness of the NCH community benefit plan, including charity care, community health education, community medical/dental clinics, corporate citizenship, community medical service gap analysis and community health improvement initiatives; (5) operating or funding community-based health care clinics, including a mobile dental clinic, a FQHC in Arlington Heights and a Cook County medical clinic in Palatine.(6) providing $315,000 in financial support to organizations and agencies that address issues such as domestic violence, child abuse and equal access to social services; (7) serving as the area's emergency medical services resource hospital, providing administrative, clinical practice, quality management and fiscal oversight and eduction for paramedics, EMT'S, emergency medical dispatchers and emergency communications registered nurses within a 375 square-mile area. The EMS system is a coalition of seven hospitals and 24 EMS provider agencies that employ over 900 paramedics and 400 EMT's who respond to over 52,000 patients per year; and (8) operating the Promotoras de Salud program which provides health education to the Latino population in the community through the identification of Hispanic women who have the potential to become leaders in the community. These leaders then receive leadership training and education on specific health topics and in turn lead small group presentations and health discussions with members of the community. State Community Benefit Report Schedule H, Part VI, Line 8 Northwest Community Healthcare, the sole corporate member of the Hospital, files an annual community benefit report with the Illinois Attroney General's office in accordance with Illinois law. The report is filed on behalf of Northwest Community Healthcare, the Hospital, and Northwest Community Day Surgery Center, Inc.OtherInformation
Affiliated Health Care SystemNorthwest Community Hospital (Hospital) is one of several affiliates under the common control of Northwest Community Healthcare (NCH). NCH is a support organization that also consists of Northwest Community Day Surgery Center, Inc. and Northwest Community Hospital Foundation. These four entities are 501(c)(3) exempt organizations and together provide the resources and funding to deliver quality healthcare services to the people of the northwest suburban community of Chicago. Other affiliates of NCH include Northwest Community Health Services, Inc., a multi-specialty medical group.AffiliatedHealthCareSystem
Reports Filed With StatesILReportsFiledWithStates

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (12 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
Access Community Health Network
1501 S CaliforniaChicagoIL60608363317058501(c)(3)105000ACCESS FQHC @ Northwest Community financial support
American Cancer Society
100 W Palatine RdPalatineIL60067131788491501(c)(3)10000Charitable Contribution - Relay for Life
American Heart Association
PO Box 06393ChicagoIL60606135613797501(c)(3)5300Charitable Contribution - Heart Walk
Cook CountyHektoen Institute
627 S Wood St Suite 221ChicagoIL60612366006541501(c)(3)87203Charitable Contribution - Vista Clinic Support
Hospice of Northeastern Illinois
410 S Hager StBarringtonIL60010363305643501(c)(3)5600Charitable Contribution
Little City Foundation
1760 W Algonquin RdPalatineIL60067362434562501(c)(3)6500Charitable Contribution
Mt Prospect Chamber of Commerce
107 S Main StMt ProspectIL60056362224579501(c)(3)6300Charitable Contribution
NWSRA
3000 W Central STE 205Rolling MeadowsIL60008363145710501(c)(3)15000Charitable Contribution - Annual sponsorship, Special Olympics
Palatine Opportunity Center
1585 N Rand RdPalatineIL60074363881109501(c)(3)11200Charitable Contribution - Community Diabetes Education
Revelation Golf
PO Box 91831Elk Grove VillageIL60009830439102501(c)(3)5200Charitable Contribution
Shelter Inc
120 Eastman StArlington HeightsIL60004237399596501(c)(3)25000Charitable Contribution - Healthy Families Sponsorship
WINGS
PO Box 95615PalatineIL60156363546061501(c)(3)6000Charitable Contribution
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants12TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations67TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationGrants in support of Northwest Community Hospital's mission are monitored by Northwest Community's Finance Committee and Board of Directors as part of the monthly review of the Hospital's financial results. Significant grants to unrelated 501(c)(3) or governmental organizations are approved by the Hospital's commmunity services department and are monitored through ongoing interactions with officials of those recipients regarding program services provided in Hospital's service area.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensesfalseWrittenPolicyReTAndEExpenses
Substantiation RequiredfalseSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptiontrueInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (21 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Bruce K Crowther
529006080000048803302158520358570134874804237630
Michael B Zenn
34248903948001073920135232023713064830601057220
Gail A Finn
23350800033131029870088702973960314610
Leighton Smith MD
4303820382750247554055823012599078463301739220
Mark Lusson
23410302071503170904976001485603511430300390
Dale Beatty
2225790113930422120280870911903133900405420
George Morris
21982301249604036503407401576303225210386950
Mary P Stack
17436801113704112104568201289902852070394510
Dawn Walden
1774370908303472902731001291202614710330590
Angela Stefaniu
1563330841601762602984701876302309850159560
Robert Klasek
1552660972003824103203001009902453560365710
Laura Pollack
14294205640016080210750148970186162000
Gary Skiba
172136012157016080260730110990223073000
Ann Sayvetz
2354050007680090520129340265071000
Malcolm Bilimoria MD
137788906000000004900016650102149290000
Willis Parsons MD
16514530218643000114850194101883522000
Rameez Alasadi MD
587076000384089270158200612207000
Sonia Mehta MD
347255022177096700123610272320418695000
Tahseen Mohammed MD
3019290000120060128120326747000
Richard Hinden
1355500010420100089480126704000
Theresa Hoban
000010771100000107711000

Form990 Schedule J Part III Form990ScheduleJPartIII (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Supplemental Compensation InformationSchedule J, Part I, Lines 1A and 1BThe Hospital's CEO receives a $10,000 stipend per year to be used for country club dues. This amount is included in taxable compensation on his W-2. The CEO also receives additional compensation as a tax gross-up to cover the income taxes on certain life insurance premiums. The provision of the CEO's stipend for country club dues is documented in his written contract, which is approved by the Board of Directors. Payments for tax-gross ups are also approved by the Nomination and Compensation Committee of the Northwest Community Healthcare Board of Directors. Healthcare is the sole corporate member of the Hospital.
Severance PaymentSchedule J, Part I, line 4ARichard Hinden, former General Counsel, received $90,867 of severance pay during calendar year 2009 pursuant to a written separation agreement with the Hospital.
Supplemental Nonqualified Retirement PlanSchedule J, Part I, Line 4bBruce Crowther, CEO, Michael Zenn, Executive Vice President, and Mark Lusson, Executive Vice President, participate in a non-qualified supplemental retirement plan (SERP) sponsored by Northwest Community Hospital. The reasonable estimate of the increase in actuarial value of the SERP was $13,376 for Mr. Crowther, $9,639 for Mr. Zenn and $3,261 for Mr. Lusson. These amounts are included in column (c) of Schedule J, Part II. Certain Officers and Key Employees of Northwest Community Hospital participate in a Section 457(f) deferred compensation plan. Current year deferred amounts are included in Part VII, Line 1A, Column F and Schedule J, Part II, Column C. Current year distributions, included in Part VII, Line 1A, Column D and Schedule J, Part II, Column B(iii) are: $423,763 for Mr. Crowther, $105,722 for Mr. Zenn, $31,461 for Ms. Finn, $173,922 for Dr. Smith, $30,039 for Mr. Lusson, $40,542 for Mr. Beatty, $38,696 for Mr. Morris, $39,452 for Ms. Stack, $33,059 for Ms. Walden, $15,956 for Ms. Stefaniu, $36,571 for Mr. Klasek, and $107,711 for Ms. Hoban.
Compensation Based on Revenues of the OrganizationSchedule J, Part I, Line 5ABonus payments of $218,643 were made to Willis Parsons, MD, an employed gastroenterologist, under the terms of his written employment contract. The amount was based on a percentage of professional collections (i.e. collections from the performance by physicians of professional medical services) exceeding a specified threshold until a cap specified in the contract is reached.
Non-Fixed Compensation PaymentsSchedule J, Part I, Line 7The CEO and Vice Presidents of the Hospital are eligible for an annual incentive compensation payment that is aligned with the strategic, financial and operational goals of the organization. Performance measures are tracked at three levels: Threshold Measures, which constitute the minimum requirements that must be achieved in order to have an incentive payout; Organizational Measures, consisting of specific budget goals for operating margin, cost per case, market share, quality, etc.; and Functional Measures, including personal goals that are quantifiable and time-specific. Weighting of the organizational and functional measures varies between executives depending on the relative importance of various projects assigned during the year. Actual amounts awarded are based on a combination of defined targets (15 - 25% of base pay) and discretionary amounts (5 - 10% of base pay). Maximum payable is 150% of the target. Amounts to be paid are recommended by the CEO and subject to approval by the Nomination and Compensation committee of Northwest Community Healthcare, the sole member of the Hospital. During calendar year 2009, $252,982 was paid under this program. Dr. Sonia Mehta, an employed physician, is eligible for an annual discretionary bonus based on a variety of measures related to the Hopital's immediate care centers. During calendar year 2009, $22,177 was paid under this program.
Initial Contract ExceptionSchedule J, Part I, Line 8In order to fulfill a community need, the Hospital entered into an employment contract with Dr. Malcolm Bilimoria, a pancreatic surgeon. The contract was negotiated on an arms-length basis and included a signing bonus.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuer
Illinois Finance Authority
86109196745200FNR62010-09-19151075932SEE SCHEDULE Ofalsefalse
Illinois Finance Authority
86109196745200FNU92008-10-1786820000SEE SCHEDULE Ofalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundAmount DefeasedAmountDefeasedAmount UnspentAmountUnspentIssuance Costs From ProceedsIssuanceCostsFromProceedsWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
154765000000143793401496379982010truetruefalsetrue
86820000000691076002008truefalsefalsetrue

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed PropertyfalseOwningBondFinancedProperty
Any Lease ArrangementsfalseAnyLeaseArrangements
Mngment Cntrct Bond Financd PrprtyfalseMngmentCntrctBondFinancdPrprty
Any Research AgreementsfalseAnyResearchAgreements
Bond Counsel Routinely EngagedfalseBondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance ProcdrstruePostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICRegulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfiedGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsetruefalsefalsefalse
falsetruefalsetruefalsetrue

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonJames J Smith MDNamePerson
Purpose Of LoanPhys Practice SupptPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$85,793OriginalPrincipalAmount
Balance Due90465BalanceDue
DefaulttrueDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due90465TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (3 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Adam Skiba
SEE SCHEDULE O76553Salaryfalse
Amy Skiba
SEE SCHEDULE O64880Salaryfalse
Megan Stack-Sweet
SEE SCHEDULE O71755Salaryfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Decription of relationshipsForm 990, Part VI, Question 2Bruce Crowther, Director and CEO, and James Bishop, Director, serve on the Northwest Community Hospital (Hospital) Board as well as on the boards of Wintrust Financial Corporation and Barrington Bank and Trust Company NA. Michael Zenn, Hospital Officer, and James Bishop, Hospital Director, serve on the board of Village Bank and Trust (a Wintrust Bank). Hospital does not transact any business with Wintrust Financial, Barrington Bank or Village Bank and Trust. Donald Torisky, Diane Hill and Thomas MacCarthy, all Hospital Directors, serve on the Board of Northwest Cultural Council, an unrelated organization.
Description of Classes of Members or StockholdersForm 990, Part VI, Question 6Northwest Community Healthcare is the sole corporate member of Northwest Community Hospital. As such, it elects or appoints the members of the Hospital's governing body and approves significant decisions.
Description of Classes of Persons and the Nature of Their RightsForm 990, Part VI, Question 7aNorthwest Community Healthcare is the sole corporate member of the Hospital. As such, it elects or appoints the members of the governing body of the Hospital periodically or as vacancies arise.
Descr Classes of Persons, Decisions Requiring Appr & Type of Voting RightsForm 990, Part VI, Question 7bNorthwest Community Healthcare is the sole corporate member of the Hospital. As such, it must approve certain actions of the Hospital. Action is taken by a majority vote of the Heatlhcare Board with a quorum present. The Member (Healthcare) must approve the following types of decisions by the Hospital: voluntary dissolution, merger, consolidation or sale or transfer of 10% or more of the Hospital's assets; sale of real property or interest therein; creation of a subsidiary or affiliate; annual and long-term capital and operating budgets; amendment, alteration or repeal of the Hospital's Articles of Incorporation or Bylaws; selection of auditors; appointment, removal and evaluation of Hospital Directors; debt or indebtedness, guarantees or borrowings; appointment, compensation, benefits and evaluation of officers; appointment and employment of the President; and actions taken by Trustees of the Northwest Community Hospital Employees Retirement Plan.
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Question 11AA COPY OF THE FORM 990 WAS MADE AVAILABLE TO THE MEMBERS OF THE BOARD OF NORTHWEST COMMUNITY HOSPITAL PRIOR TO FILING. THE AUDIT AND COMPLIANCE COMMITTEE OF THE NORTHWEST COMMUNITY HEALTHCARE BOARD HAS BEEN ASSIGNED THE RESPONSIBILITY OF REVIEWING FORMS 990 FOR ALL AFFILIATES OF NORTHWEST COMMUNITY HEALTHCARE. THIS COMMITTEE REVIEWED THE FORM 990 PRIOR TO DISTRIBUTION TO THE FULL BOARD.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cEach year, the conflict of interest policy and questionnaire is sent to present and past directors, officers and key employees. Each response is reviewed by the General Counsel and those in which any actual or apparent conflict with the present role is disclosed, is reviewed by the CEO and Board Chairperson. In the case of any conflict involving an entity or party with which the Hospital is dealing or competing, the person with the conflict may not participate in any decisions regarding that party. Individuals who are independent contractors, officers, directors, or employees of other health care faciliities in Northwest Community Hospital's service area may not serve on any Northwest Community Healthcare or related organization Board or Board committee. In addition, the policy includes a sample conflict of interest disclosure letter to be used if a conflict arises after submission of the annual quesionnaire and before the next. Such disclosure letters would be reviewed as noted above at the time they are received.
Offices & Positions for Which Process was usedForm 990, Part VI, Question 15AThe Nomination and Compensation Committee of the Northwest Community Healthcare (NCH) Board is responsible for setting the compensation of the CEO. Compensation is reviewed using an external compensation firm, PINP, Inc. The review also utilizes comparisons to similar organizations through review of Forms 990, use of comparison studies from the Metropolitan Chicago Healthcare Council and other sources. The process is documented in the minutes of the Nomination and Compensation Committee.
Offices and Positions for Which Process was UsedForm 990, Part VI, Question 15BThe Nomination and Compensation Committee of the Northwest Community Healthcare (NCH) Board is responsible for approving the compensation of the officers and key employees (Vice Presidents) of Northwest Community Hospital based on recommendations from the CEO. The review utilizes comparisons to studies from the Metropolitan Chicago Healthcare Council and other sources. The process is documented in the minutes of the Nomination and Compensation Committee.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19Governing documents and the conflict of interest policy are not made public. Hospital's financial statements are included in the annual consolidated audit report of Northwest Community Healthcare and Subsidiaries. These consolidated financial statements are available to the public via the Municipal Securities Rulemaking Board's Electronic Municipal Market Access (EMMA) website at www.msrb.emma.org. Average Hours Worked Part VII, Section A The following individuals are employees of Northwest Community Hospital and generally work 40 hours per week. A portion of their regular work week is spent providing services to Northwest Community Day Surgery Center, Inc, Northwest Community Healthcare and Northwest Community Hospital Foundation, which are 501(c)(3) affiliates of the Hospital: Bruce K. Crowther (14 hours), Michael B. Zenn (9 hours), Leighton Smith (2 hours), Dale Beatty (2 hours) and Gail Finn (7 hours).
Description of purpose of Bond Issues.Schedule K, Part IIssuer Name: Illinois Finance Authority Issuer EIN: 86-1091967 Cusip #: 45200FNR6 Issue Price: $151,075,932. Description of Purpose: Proceeds used for: construction of a patient tower and parking garage; expansion and renovation of the Hospital's emergency department and surgery suites; relocation of certain departments on the Hospital's campus; and purchase of certain equipment used in the Hospital's business. Issuer Name: Illinois Finance Authority Issuer EIN: 86-1091967 Cusip #: 45200FNU9 Issue Price: $86,820,000. Description of Purpose: Proceeds were used to repay a taxable loan, the proceeds of which were used, together with other funds, to redeem the Authority's Series 2002A Bonds (NW Community Hospital) in April 2008.
Business Transactions Involving Interested PersonsSchedule L, Part IVName of Interested Person: Adam Skiba Relationship between interested person and Hospital: son of Gary Skiba, Vice President (key employee) Name of Interested Person: Amy Skiba Relationship between interested person and Hospital: daughter of Gary Skiba, Vice President (key employee) Name of Interested Person: Megan Stack-Sweet Relationship between interested person and Hospital: daughter of Mary Stack, Vice President (key employee).

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1
NORTHWEST COMMUNITY PHYSICIANS ASSN LLC
3060 SALT CREEK LANEARLINGTON HghtsIL60005510457240PATIENT CAREIL3686490499178N/A
NCH SERVICE COMPANY LLC
3060 SALT CREEK LANEARLINGTON HGHTSIL60005263791362Patient careIL1554278832725NCPA LLC

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
NORTHWEST COMMUNITY HEALTHCARE
800 WEST CENTRAL ROADARLINGTON HGHTSIL60005363125209SUPPORTNG ORGIL501(C)(3)11 TYPE IINA
NORTHWEST COMMUNITY DAY SURGERY CTR INC
675 WEST KIRCHOFFARLINGTON HGHTSIL60005363540436OUTPTNT SUGRYIL501(c)(3)3NC HlthcarE
NORTHWEST COMMUNITY HOSPITAL FOUNDATION
3060 SALT CREEK LANEARLINGTON HGHTSIL60005363125193FUNDRAISINGIL501(c)(3)7NC Hlthcare

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1NPC-CYBERKNIFE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1800 WEST CENTRAL RAODAddressLine1
CityARLINGTON HTSCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
EIN204462828EIN
Primary ActivityEQUIPMENT LEASINGPrimaryActivity
Legal Domicile StateDELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
NORTHWEST COMMUNITY HEALTH SERVICES INC
800 WEST CENTRAL ROADARLINGTON HEIGHTSIL60005363312906HEALTHCARE SVCSILNAC CORP
NORTHWEST COMMUNITY CAPCO INC
800 W CENTRAL ROADARLINGTON HEIGHTSIL60005364027717MANAGED CAREILNAC CORP3000006804131.00000
NCH CASUALTY INSURANCE SPC LIMITED
980442062INSURANCENAC corp68 WEST BAY ROADGRAND CAYMANCAYMAN ISLANDSCJKY1-1102CJ
NCH Physicians Cooperative
800 W Central RoadArlington HEIGHTSIL60005201830299Group PurchasingILnac corp001.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (9 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
NORTHWEST COMMUNITY DAY SURGERY CENTER
q4104307
NORTHWEST COMMUNITY DAY SURGERY CENTER
p12349912
NORTHWEST COMMUNITY HOSPITAL FOUNDATION
q554479
NORTHWEST COMMUNITY HOSPITAL FOUNDATION
C7700664
NORTHWEST COMMUNITY HOSPITAL FOUNDATION
P1495216
NORTHWEST COMMUNITY HEALTH SERVICES
p1566044
NPC - CYBERKNIFE
j1152000
NPC - CYBERKNIFE
p385330
NORTHWEST COMMUNITY CAPCO
p230017

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