JAVON BEA HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization: JAVON BEA HOSPITAL (EIN 36-2167847)
Tax period: 2010-01-01 to 2010-12-31
Filed: 2011-11-11
IRS object ID: 201113169349300001
Schema version: 2010v3.4
Note: A later return for the same period supersedes this one.
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 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	2011-11-11T23:51:21-00:00	Timestamp
Tax Period End Date	2010-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

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

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	2001 Market St Ste 1700	AddressLine1
City	Philadelphia	City
State	PA	State
ZIP Code	19103	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2010-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	362167847	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Rockford Memorial Hospital	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	ROCK	NameControl
Phone	8159715000	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2400 N Rockton Ave	AddressLine1
City	Rockford	City
State	IL	State
ZIP Code	61103	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	Henry M Seybold	Name
Title	Senior VP of Finance CFO	Title
Phone	8159715000	Phone
Date Signed	2011-10-18	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Matthew Petroski	Name
Phone	2673303000	Phone
Date Prepared	2011-11-01	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2010	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Name Of Principal Officer Business NameOfPrincipalOfficerBusiness

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

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	2400 N Rockton Ave	AddressLine1
City	Rockford	City
State	IL	State
ZIP Code	61103	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	565594665	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	www.rhsnet.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1905	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	To improve and protect the health and welfare of the community in accordance with our mission: Superior Care, Every Day, For all our patients. A 396-bed hospital includes a Level 1 Trauma Center, Level III Neonatal Intensive Care Unit, region's only Pediatric Intensive Care Unit and the designated Disaster POD hospital To improve and protect the health and welfare of the community in accordance with our mission Superior Care, Every Day, For all our patients. A 396-bed hospital includes a Level 1 Trauma Center, Level III Neonatal Intensive Care Unit, regions only Pediatric Intensive Care Unit and the designated Disaster POD hospital	ActivityOrMissionDescription
Nbr Voting Members Governing Body	15	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	8	NbrIndependentVotingMembers
Total Nbr Employees	2693	TotalNbrEmployees
Total Nbr Volunteers	365	TotalNbrVolunteers
Total Gross UBI	1205464	TotalGrossUBI
Net Unrelated Business Txbl Income	-185653	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	4329740	ContributionsGrantsPriorYear
Contributions Grants Current Year	4003677	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	330016655	ProgramServiceRevenuePriorYear
Program Service Revenue CY	349978108	ProgramServiceRevenueCY
Investment Income Prior Year	2121066	InvestmentIncomePriorYear
Investment Income Current Year	6026508	InvestmentIncomeCurrentYear
Other Revenue Prior Year	166422	OtherRevenuePriorYear
Other Revenue Current Year	164128	OtherRevenueCurrentYear
Total Revenue Prior Year	336633883	TotalRevenuePriorYear
Total Revenue Current Year	360172421	TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year	279570	GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY	845017	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	134796549	SalariesEtcPriorYear
Salaries Etc Current Year	137556563	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	153805071	OtherExpensePriorYear
Other Expenses Current Year	146852556	OtherExpensesCurrentYear
Total Expenses Prior Year	288881190	TotalExpensesPriorYear
Total Expenses Current Year	285254136	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	47752693	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	74918285	RevenuesLessExpensesCY
Total Assets BOY	333648078	TotalAssetsBOY
Total Assets EOY	372867851	TotalAssetsEOY
Total Liabilities BOY	194947920	TotalLiabilitiesBOY
Total Liabilities EOY	208340079	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	138700158	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	164527772	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	The Mission of Rockford Health System and Rockford Memorial Hospital is Superior Care, Every Day, For All Our Patients. We will fulfill our commitment through performance excellence, innovation, and lifelong learning.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	152432645	Expense
Revenue	196168796	Revenue
Description	Rockford Memorial Hospital is a not-for-profit charitable healthcare institution that functions in accordance with all applicable laws and regulations. In the course of operations, RMH is committed to provide superior care every day for all its patients. RMH is a 396-bed regional referral hospital which includes a Level I Trauma Center, Level III Neonatal Intensive Care Unit and the regions only Pediatric Intensive Care Unit. In 2010 inpatient care and diagnostic services were rendered to 15,520 individuals who presented themselves for service including 1,667 deliveries and 4,006 inpatient surgeries.	Description

Activity2 Activity2

Field	Value	IRS element (for citing)
Expense	76337558	Expense
Revenue	147456558	Revenue
Description	RMH is designated by the IL Dept of Health as the Disaster POD hospital for the Northern IL EMS region. As a Level I Trauma Center, RMH provides patient care, diagnostic and therapeutic services 24/7 to all who present themselves for service. In 2010 that included 47,507 persons in the Emergency room 1,254 visits to the Sleep Lab 96,700 diagnostic radiology procedures 9,614 Radiation Oncology treatments 36,948 cardiac procedures or tests 7,999 visits to the Pain Clinic 212,920 respiratory therapy treatments and 8,090 outpatient surgeries. RMH provides the only medical genetics services in the area with 1,774 visits in 2010. RMH also has the only regional cytogenetics medical laboratory, and processed 7,451 tests in 2010. Through the outreach services of Rockford Health Medical Laboratories RHML , RMH has provides timely and responsive lab services to other hospitals, physicians offices, and government agencies, while the in-house laboratory provides testing for all who present themselves at the hospital for treatment. In 2010 RHML performed 1,510,156 tests.	Description

Activity3 Activity3

Field	Value	IRS element (for citing)
Expense	2763961	Expense
Grants	334960	Grants
Revenue	493711	Revenue
Description	RMH has provided health education and outreach in a variety of forms within the eleven county area that includes several school partnerships, mentoring, health programs, teaching, job shadowing and volunteering. RMH hosts support groups, training classes and lectures series for health and safety related topics. Employees staff community health fairs and open health screenings. In a program jointly sponsored with Ronald McDonald Charities, RMH staffs the Caremobile which provided 711 health and dental checkups and basic health services to 496 underinsured and uninsured children. RMH also provides language assistance to patients and their families who need to communicate with medical personnel for treatment, and meeting space for various medical and social service support groups. Funds were also used to support healthcare conditions throughout the state of Illinois.	Description

Field	Value	IRS element (for citing)
Total Of Other Program Service Exp	647110	TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt	510057	TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev	394465	TotalOfOtherProgramServiceRev
Total Program Service Expense	232181274	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	true	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	true	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	true	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	true	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	true	RelatedOrgControlledEntity
Transaction Related Entity	true	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	365	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	2693	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Form990-T Filed	true	Form990-TFiled
Foreign Financial Account	true	ForeignFinancialAccount
Name Of Foreign Country	BD	NameOfForeignCountry
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	15	NbrVotingGoverningBodyMembers
Number Independent Voting Members	8	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	true	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	true	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	true	InvestmentInJointVenture
Written Policy Or Procedure	false	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	IL	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	David Vola Controller	NamePerson
Telephone Number	8159715000	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2400 N Rockton Avenue	AddressLine1
City	Rockford	City
State	IL	State
ZIP Code	61103	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (26 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	OfficerOfficer	FormerFormer	Highest Compensated EmployeeHighestCompensatedEmployee
Jack JBecherer
Director	000.66	X	0	0	0
James WBreckenridge
Director	001.00	X	0	478500	103356
Thomas DBudd
Director	000.30	X	0	0	0
John WChadwick
Director	000.30	X	0	0	0
Eleanor FDoar
Director	001.00	X	0	0	0
John TDorsey
Director	000.10	X	0	273716	69563
Pamela SFox
Director	000.10	X	0	0	0
Jos LGonzalez
Director	000.70	X	0	374511	68096
Alphonso NGoode
Director	001.00	X	0	0	0
Jack WPackard
Director	000.50	X	0	0	0
Dennis TUehara
Director	020.50	X	0	412499	70487
Connie MVitali
Director	002.00	X	0	0	0
Curtis DWorden
Director	000.50	X	0	0	0
Paul AGreen
Chairman	001.00	X	0	0	0	X
Duane RBach
Treas/Vice-Chair	000.10	X	0	0	0	X
Gary EKaatz
President	001.00	X	0	969051	150705	X
Henry MSeybold
Treasurer	003.00		0	439582	59187	X
Julie APeterson
Secretary	001.00		0	71646	27194	X
Gordon Langejans
VP Med Affairs	031.30		314915	0	48460	X
Earl Tamar
COO	000.00		48646	0	10893		X
Carolyn Bengtson
VP Utilization Management	040.00		314032	0	56037			X
Michael Tyrkus
Director of Cytogentics	040.00		210305	0	39860			X
Susan Schreier
Chief Nursing Officer	040.00		223385	0	43664			X
Curt Lesher
Pharmacy Manager	040.00		173549	0	28248			X
Jeffrey Campbell
Pharmacy Clinical Coordinator	040.00		147832	0	33213			X
Kerry Hill
VP Finance	040.00		0	221339	50166		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1432664	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	3240844	TotalReportableCompFrmRltdOrgs
Total Other Compensation	859129	TotalOtherCompensation
Number Individuals GT100 K	13	NumberIndividualsGT100K
Formers Listed	true	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Philips Medical System
PO Box 100355	Atlanta	GA	30384	Contract Maintenance	1965286
Cardiac Surgery Associates
PO Box 1285	Joliet	IL	604341285	Healthcare Provider	1175010
Schmeling Construction Co
315 Harrison Ave	Rockford	IL	61104	General Contractors	1632604
Mayo Collaborative Services dba Mayo Med Laboratories
PO Box 9146	Minneapolis	MN	554809146	Healthcare Services	1001970
Air Methods Corp
PO Box 676592	Dallas	TX	752676592	Helicopter Pilot/Services	1242546

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	5	NumberOfContractorsGT100K
Related Organizations	745824	RelatedOrganizations
Government Grants	3255078	GovernmentGrants
All Other Contributions	2775	AllOtherContributions
Total Contributions	4003677	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome	Unrelated Business RevenueUnrelatedBusinessRevenue	ExclusionExclusionAmount
Inpatient Routine Ancillary	900099	101765210	101765210
Outpatient Emergency	621400	76916744	76916744
Diagnostic Medical Laboratory	621500	11286307	10130314	1155993
Cafeteria/Food Service/Catering	722320	1769263		3581	$1,765,682
Medicare/Medicaid	900099	155584560	155584560

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	2656024	TotalRevenueColumn
Unrelated Business Revenue	10251	UnrelatedBusinessRevenue
Exclusion	$2,645,773	ExclusionAmount

Field	Value	IRS element (for citing)
Total Program Service Revenue	349978108	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	1698928	TotalRevenueColumn
Exclusion	$1,698,928	ExclusionAmount

Gross Rents GrossRents

Field	Value	IRS element (for citing)
Real	499215	Real

Less Rental Expenses LessRentalExpenses

Field	Value	IRS element (for citing)
Real	335087	Real

Rental Income Or Loss RentalIncomeOrLoss

Field	Value	IRS element (for citing)
Real	164128	Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	164128	TotalRevenueColumn
Related Or Exempt Function Income	116702	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	35639	UnrelatedBusinessRevenue
Exclusion	$11,787	ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	209308037	Securities
Other	106700	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	204947478	Securities
Other	139679	Other

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	4360559	Securities
Other	-32979	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	4327580	TotalRevenueColumn
Exclusion	$4,327,580	ExclusionAmount

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	360172421	TotalRevenueColumn
Related Or Exempt Function Income	344513530	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	1205464	UnrelatedBusinessRevenue
Exclusion	$10,449,750	ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	845017	Total
Program Services	845017	ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	363375	Total
Management And General	363375	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	102983050	Total
Program Services	77568229	ProgramServices
Management And General	25414821	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	7786257	Total
Program Services	5883646	ProgramServices
Management And General	1902611	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	19536961	Total
Program Services	14748603	ProgramServices
Management And General	4788358	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	6886920	Total
Program Services	5190534	ProgramServices
Management And General	1696386	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	4178837	Total
Program Services	12942	ProgramServices
Management And General	4165895	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	436701	Total
Management And General	436701	ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	223141	Total
Management And General	223141	ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	0	Total

Field	Value	IRS element (for citing)
Fees For Services Prof Fundraising		FeesForServicesProfFundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	659508	Total
Management And General	659508	ManagementAndGeneral

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	811853	Total
Program Services	180406	ProgramServices
Management And General	631447	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	1042306	Total
Program Services	4865	ProgramServices
Management And General	1037441	ManagementAndGeneral

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	10061371	Total
Program Services	6182983	ProgramServices
Management And General	3878388	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	7952986	Total
Program Services	7391582	ProgramServices
Management And General	561404	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	9710275	Total
Program Services	7070321	ProgramServices
Management And General	2639954	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	117372	Total
Program Services	93094	ProgramServices
Management And General	24278	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	535854	Total
Program Services	176351	ProgramServices
Management And General	359503	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	2855379	Total
Program Services	2855379	ProgramServices

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	15511908	Total
Program Services	14296987	ProgramServices
Management And General	1214921	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	5122129	Total
Program Services	3273276	ProgramServices
Management And General	1848853	ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
Medicaid Assessment Tax	9983148	9983148
Supplies/Drugs	47447818	47228358	219460
Healthcare Services	9752387	9752387
Bad Debt Expense	13528770	13528770
Other purchased services	5203761	4979283	224478

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	1717052	Total
Program Services	935113	ProgramServices
Management And General	781939	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	285254136	Total
Program Services	232181274	ProgramServices
Management And General	53072862	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	3500	BOY
EOY	3500	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	22717768	BOY
EOY	56353959	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	1446236	BOY
EOY	494476	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	41106559	BOY
EOY	44815243	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
BOY	15595	BOY
EOY	12713	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	5807024	BOY
EOY	6056539	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2842703	BOY
EOY	6805891	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	266186116	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	186892440	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	89268023	BOY
EOY	79293676	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	149081455	BOY
EOY	158236077	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	21359215	BOY
EOY	20795777	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	333648078	BOY
EOY	372867851	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	93437415	BOY
EOY	108410765	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	73537769	BOY
EOY	70987769	EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

Field	Value	IRS element (for citing)
BOY	1174595	BOY
EOY	685072	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	26798141	BOY
EOY	28256473	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	194947920	BOY
EOY	208340079	EOY

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

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	131376914	BOY
EOY	156330922	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	4698085	BOY
EOY	5571691	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	2625159	BOY
EOY	2625159	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	138700158	BOY
EOY	164527772	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	333648078	BOY
EOY	372867851	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	74918285	ReconcilationRevenueExpenses
Reconcilation Other Changes	-49090671	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Consolidated	X	FinancialStatementConsolidated
Federal Grant Audit Required	true	FederalGrantAuditRequired
Federal Grant Audit Performed	true	FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii
Public Support Pertcentage170	0.00000	PublicSupportPertcentage170
Public Support Percentage509	0.00000	PublicSupportPercentage509
Investment Income Percentage	0.00000	InvestmentIncomePercentage

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 D IRS990ScheduleD

Field	Value	IRS element (for citing)
Included On FS	false	IncludedOnFS

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4309770	BeginningOfYearBalance
Contributions	748599	Contributions
Investment Earnings Or Losses	347198	InvestmentEarningsOrLosses
Grants Or Scholarships	190000	GrantsOrScholarships
Other Expenditures	558599	OtherExpenditures
Administrative Expenses	26727	AdministrativeExpenses
End Of Year Balance	4630241	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	3472212	BeginningOfYearBalance
Contributions	555556	Contributions
Investment Earnings Or Losses	938002	InvestmentEarningsOrLosses
Grants Or Scholarships	250000	GrantsOrScholarships
Other Expenditures	381821	OtherExpenditures
Administrative Expenses	24179	AdministrativeExpenses
End Of Year Balance	4309770	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	4463526	BeginningOfYearBalance
Contributions	800219	Contributions
Investment Earnings Or Losses	-1259075	InvestmentEarningsOrLosses
Grants Or Scholarships	200000	GrantsOrScholarships
Other Expenditures	305881	OtherExpenditures
Administrative Expenses	26577	AdministrativeExpenses
End Of Year Balance	3472212	EndOfYearBalance

Field	Value	IRS element (for citing)
Permanent Endowment EOY Balance	1.00000	PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs	false	EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs	true	EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R	true	AreRelatedOrgsListedScheduleR

Land Land

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	468730	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	2111708	OtherCostOrOtherBasis
Book Value	2580438	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	5455293	InvestmentCostOrOtherBasis
Other Cost Or Other Basis	48166766	OtherCostOrOtherBasis
Depreciation	36634871	Depreciation
Book Value	16987188	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	99060	OtherCostOrOtherBasis
Depreciation	84305	Depreciation
Book Value	14755	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	201797181	OtherCostOrOtherBasis
Depreciation	145024814	Depreciation
Book Value	56772367	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	8087378	OtherCostOrOtherBasis
Depreciation	5148450	Depreciation
Book Value	2938928	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	79293676	TotalOfBookValueLandBuildings

Other Assets OtherAssets (5 entries)

DescriptionDescription	Book ValueBookValue
Deferred Financing Costs	669533
Other	4961948
Land Held for Future Use	6422260
Partnerships	8742036
Deposits

Field	Value	IRS element (for citing)
Total Book Value Other Assets	20795777	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescription	AmountAmount
Post Retirement	$4,616,801
Basic Pension	$23,076,820
Capital Lease	$562,852

Field	Value	IRS element (for citing)
Total Of Amounts	28256473	TotalOfAmounts
Total Revenue	360172421	TotalRevenue
Total Expenses	285254136	TotalExpenses
Excess Or Deficit For Year	74918285	ExcessOrDeficitForYear
Net Unrealized GL On Investments	6416488	NetUnrealizedGLOnInvestments
Other	-$56,380,074	OtherAmount
Total Adjustments	-49963586	TotalAdjustments
Excess Or Deficit Per FS	24954699	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	366264489	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	6416488	NetUnrealizedGainsInvestments
Other Revenues	335087	OtherRevenues
Revenue Not Rptd F990	6751575	RevenueNotRptdF990
Revenue Subtotal	359512914	RevenueSubtotal
Investment Expenses Not Included	659507	InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt	659507	RevenueNotRptdOnFinStmt
Total Revenue Per Form990	360172421	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	284929717	TotExpensesEtcAuditedFinclStmt
Other Expenses Included	335087	OtherExpensesIncluded
Expenses Not Rptd F990	335087	ExpensesNotRptdF990
Expenses Subtotal	284594630	ExpensesSubtotal
Investment Expenses Not Included2	659507	InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt	659507	ExpensesNotRptdOnFinStmt
Total Expenses Per Form990	285254137	TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
X	2	- Rockford Memorial Hospital as a part of RHS Rockford Health System adopted FIN 48 in 2007 and the impact was not material. The System did not record any additional liabilities due to the implementation of FIN 48 for the years ended December 31, 2008 or 2009 or 2010
XI	8	- The following were adjusting items in the Audited Income Statement Pension related changes other than net periodic pension cost 588,711. Post-retirement medical benefit-related charges other than net post retirement medical benefit cost 328,785. Net assets released from restr used for capital 61,000. Transfer to/from affiliates 56,660,000. Change in FAS124 Valuation 41,000.
XII	2d	- Rental expenses recorded in expenses section for the financial statements, shown net on tax return.
XIII	2d	- Rental expenses recorded in expenses section for the financial statements, shown net on tax return.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare

Other Percentage OtherPercentage

Field	Value	IRS element (for citing)
Other	X	Other
Free Other Percentage	0000000175.000000000000	FreeOtherPercentage

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	0000000600.000000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	8887880	TotalCommunityBenefitExpense
Net Community Benefit Expense	8887880	NetCommunityBenefitExpense
Percent Of Total Expense	0.03120	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	70008407	TotalCommunityBenefitExpense
Direct Offsetting Revenue	84770481	DirectOffsettingRevenue
Net Community Benefit Expense	-14762074	NetCommunityBenefitExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	78896287	TotalCommunityBenefitExpense
Direct Offsetting Revenue	84770481	DirectOffsettingRevenue
Net Community Benefit Expense	-5874194	NetCommunityBenefitExpense
Percent Of Total Expense	0.03120	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1091969	TotalCommunityBenefitExpense
Direct Offsetting Revenue	273737	DirectOffsettingRevenue
Net Community Benefit Expense	818232	NetCommunityBenefitExpense
Percent Of Total Expense	0.00290	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Total Community Benefit Expense	1531254	TotalCommunityBenefitExpense
Direct Offsetting Revenue	174373	DirectOffsettingRevenue
Net Community Benefit Expense	1356881	NetCommunityBenefitExpense
Percent Of Total Expense	0.00480	PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

Field	Value	IRS element (for citing)
Total Community Benefit Expense	23283370	TotalCommunityBenefitExpense
Direct Offsetting Revenue	21442736	DirectOffsettingRevenue
Net Community Benefit Expense	1840634	NetCommunityBenefitExpense
Percent Of Total Expense	0.00650	PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

Field	Value	IRS element (for citing)
Total Community Benefit Expense	841755	TotalCommunityBenefitExpense
Net Community Benefit Expense	841755	NetCommunityBenefitExpense
Percent Of Total Expense	0.00300	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	26748348	TotalCommunityBenefitExpense
Direct Offsetting Revenue	21890846	DirectOffsettingRevenue
Net Community Benefit Expense	4857502	NetCommunityBenefitExpense
Percent Of Total Expense	0.01720	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Total Community Benefit Expense	105644635	TotalCommunityBenefitExpense
Direct Offsetting Revenue	106661327	DirectOffsettingRevenue
Net Community Benefit Expense	-1016692	NetCommunityBenefitExpense
Percent Of Total Expense	0.04840	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$4,288,620	BadDebtExpenseAmount
Amount Reimbursed By Medicare	76956364	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	70550020	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	6406344	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Other	X	Other

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

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

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Rockford Memorial Hospital	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	2400 N Rockton Avenue	AddressLine1
City	Rockford	City
State	IL	State
ZIP Code	61103	ZIPCode

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

Form990 Schedule H Part VI Form990ScheduleHPartVI (59 entries)

IdentifierIdentifier	ExplanationExplanation
Part I line 3c	- Rockford Memorial Hospital RMH offers two charity care programs - HUPDA and our traditional charity care program. We will process charity care for whichever provides the highest percentage of discount. These criteria are determined as early as possible, preferably before or at the time of service. HUPDA is the Illinois Hospital Uninsured Patient Discount Act for all uninsured patients. Eligibility consists of being an Illinois resident, income less than 600 of FPG, and medically
Part I line 3c	continued necessary, limited to 25 of annual income. Patients submit proof of income including tax returns/pay stubs within 60 days of discharge. Traditional discounts follow our internal traditional charity care program for those who are uninsured or are insured with a patient liability. This income limit is 300 of FPG. Patient must submit proof of income that includes tax returns. Underinsured patients may be eligible for other discounts for the patient liability - and
Part I line 3c	continued there are potential discounts for Catastrophic Financial Assistance and/or Prompt Pay. Extenuating circumstances may also be taken into account.
Part I line 6a	- Rockford Health System prepares an annual Hospital Community Benefit Report as required by the State of Illinois. The report includes data for Rockford Memorial Hospital RMH as well as the other four related tax-exempt organizations. The report is distributed within the health system and is also available upon request.
Part I line 7g	- The subsidized health services included are our psychiatric care, pulmonology, endocrinology and neurosurgery. These programs are operated with a subsidy from the hospital using the cost accounting system to define direct and variable expense and the cost-to charge ratio to evaluate the cost of both bad debts and charity write off. Physicians costs from affiliated organization are included in these programs
Part I line 7	- Overall explanation of inclusion of RHPH - The hospital used the 990 worksheet to determine the cost-to-charge that was used for the bad debt and charity care expense included in all parts of Line 7. The subsidized programs also include the costs from our physician clinic because there are no physicians costs included in the hospital cost accounting analysis. Bad debt and charity expenses have been removed. Medicaid has also been removed from the charges except for the provider tax expense included with the cost to charge ratio. This is due to the fact that RMH has NO unreimbursed Medicaid and therefore did not include any part of the dollars from Line 7b.
Part III line 4	- The Systems policy is to provide medically necesary health care services regardless of the patients ability to pay for such care. RHS maintains records to identify and monitor the charity, uncompensated care and community benefit it provides. These records include the cost for services and supplies furnished under its policies as well as the estimated difference between the cost of the services provided to Medicaid patients and the reimbursement received from the state for this care.
Part III line 4	cont During the years ended December 31, 2010 and 2009, the following levels of charity care and community service, including serviced for which the System received no reimbursement or was reimbursed below cost, were provided. Estimated costs and expenses incurred for charity care in 000s 2009 - 8,146 2010 - 10,772. Estimated cost over reimbursement for Medicaid patients care 2009 - 11,421 2010 - 4,299. Cost of other Charity Care and Community Benefits 2009 - 22,962 2010 - 21,668.
Part III line 4	cont In addition to the above, the System received no reimbursement or is reimbursed below cost for these services, for the years ended December 31, 2010 and 2009 Estimated cost over reimbursement for Medicare patients care 2009 - 35,795 2010 - 26,273. Estimated costs for bad debt 2009 - 10,787 2010 - 7,847.
Part III line 4	cont Total cost of Charity, Uncompensated Care Other Community Services 2009 - 69,544 2010 - 55,788 community service, research and education 2009 - 3,395 2010 - 6,597. The System actively sponsors community benefits that respond to community needs. These programs focus on the underserved with the intention of improving the overall health of the entire community. Examples of this outreach include mobile clinics, partnering with local schools and employers to provide health
Part III line 4	cont screenings, support and health education providing social services, such as multi-faith ministry, intepreters and support groups providing emergency medical training to other providers across the region and serving as the regions emergency disaster response center. Our 24 hour emergency room, mental health services, and multiple convenient care locations provide for various
Part III line 4	cont and timely health care needs throughout the region. The costing methodology used for determining the cost of bad debt is the Medicare CCR. Since bad debt is often difficult to distinguish from charity care due to insufficient data provided by the patient, RMH continues to provide the care as a part of its mission and considers it a substantial benefit to the community.
Part III line 8	- The data reported for Medicare charges and payments is from the final Management Report produced by the firm that prepared the 2010 Cost Report as submitted to the Fiscal Intermediary in 2011 in compliance with all current regulations. Reported are allowable Medicare Costs provided by the Cost Report less Medicare costs included in Subsidized Programs on Line 1,7g as calculated by our cost accounting analysis.
Part III line 9b	- Rockford Memorial Hospital has a strong commitment to provide quality patient care for all individuals. Our mission is to provide health care to everyone who comes to our door, regardless of their ability to pay. We will submit a claim to all 3rd party payors on behalf of the patient. We help patients apply for all possible insurance or assistance such as crime victims, an automobile accident, workers compensation, Medicaid, COBRA, local assistance and/or hospital financial assistance.
Part III line 9b	cont If they do not qualify for any of these, we can extend payment options such as monthly payments, credit card payments or financial assistance. This is offered to patients who are experiencing legitimate financial hardships and are unable to pay for all or part of the patients medical care. Forgiveness may apply to an amount after applying all payments such as any insurance company, health plan or personal payments, any negotiated discounts or any uninsured discounts.
Part III line 9b	cont If a patient eligible for charity care or partial financial assistance still has a portion of the outstanding balance due, other arrangements are made. RMH accepts a variety of payments and alternative payment plans. Monthly statements are sent as payment reminders for contracted arrangements. In case of default, additional letters and calls are made to bring it to a current status. An account is turned over to a collection agency only after non-payment or no contact in 120 days.
Part VI Line 2	- Rockford Memorial Hospital through RHS - Rockford Health System was one of the local hospitals that helped to fund and produce the 2010 Healthy Community Survey. The study addresses quality of life issues in Winnebago and Boone Counties, identifying trends and changes in the demographics and the health care environments.
Part VI Line 2	cont It includes four components 1 Community Analysis - a comprehensive analysis of data from many sources, providing an overview of community health, demographic and socioeconomic characteristics, with comparisons to state and U.S. measures using these Data Sources - U.S. Census Bureau, Vital Statistics, Education, Employment, Income, Social Indicators, Crime, Abuse.
Part VI Line 2	cont 2 Household Survey - Gathered data on health conditions experienced, health behaviors, other problems/needs experienced, perceptions of community problems related to health and human services and other community needs. A total of 13,775 surveys were distributed, with a return rate of 16.8. There was a three tiered Distribution, with mailings to 8000 homes 13 response, online surveys-the Chamber of Commerce 14, and distribution in Rockford School District 205 24.
Part VI Line 2	cont 3 Key Informants Interviews - In-depth interviews with 60 key individuals in the community investigated community health and human services needs, both met and unmet and local experts in education, government, human services, or business which was direct to these topics Best aspects of living in Winnebago and Boone Counties Target populations in need of services Health and human services systems Changes for the future in the counties.
Part VI Line 2	cont4 Focus Groups - 22 focus groups were held approx. 160 participants to gain knowledge about their views and experiences with health and human services, particularly within the specific population group they represent. The Prioritization Process identified issues for collaborative action Access to CareBasic Needs, Behavioral Health, Crime and Violence/Public Safety, Chronic Disease, Dental Care, Education/Employment, Health Equity, Infectious Disease, Maternal/Prenatal/Early Childhood.
Part VI Line 2	cont The results were rolled out to the public by Rockford Health Council to the public and interested providers within the Winnebago/Boone County region in July 2011. RHS not only collaborated with RHC but provided expertise from personnel to produce the Survey.
Part VI Line 2	cont Dr Norem is a Rockford Health Physicians employee and RHC Chairman of the Board. Gary Kaatz, CEO of RHS is Vice Chair and Evelyn Pagan, Vice President Quality Performance Measurement for RHS serves on the board and chaired the Health Equity study. John Rudzinski and Ray Davis, employed RHPH physicians and Dena Hobbs, an employee with RHS also contributed their time and talent to the process.
Part VI Line 3	-The process of informing patients varies due to individual circumstances. If they indicate they have no insurance, they are considered to be self-pay. With routine admission to the hospital, a patient representative visits the patient to determine if they may be eligible for third party assistance . The patient or his representative must provide enough information to determine eligibility and if any assistance may be available to the patient from the IL Dept of Healthcare
Part VI Line 3	cont and Family Services, the United States Social Security Office or other available funding sources. These must be pursued in good faith before the RHS application will be considered. Financial Assistance will not be considered by RHS until all available third party payors have been billed and payments from such payors have been received or denied. This requirement includes the submission and processing of a state Medicaid application and/or a federal Social Security application.
Part VI Line 3	cont RMH follows the Illinois Hospital Uninsured Patient Discount Act for all uninsured patients. Eligibility consists of being an Illinois resident, with income less than 600 of FPG, and medically necessary treatment. Payment is limited to 25 of annual income from eligible patients. Patients must submit required documentation when requested. The patient is then considered self-pay/uninsured and is eligible for discounts/financial assistance under either HUDPA regulations or RHS policy.
Part VI Line 3	cont For traditional assistance the uninsured patients who do not qualify under HUDPA use the FPG to determine the amount of discount to be applied. A patient who is underinsured and may have some personal liability for their medical expenses may also apply for financial assistance. A financial aid counselor will provide the application and assist them with the process.
Part VI Line 3	cont If a patient that presents himself/herself for treatment in the emergency room, a review will be done to determine what insurance or eligibility for other aid may be available. Admissions will provide them with a financial aid assistance packet for charity care if they are uninsured or underinsured. If any other circumstances apply, they would be directed to other available third party financial aid, for example, a crime victim may be eligible to apply through a victim assistance program.
Part VI Line 4	- RMH is located in Rockford, IL Winnebago County with a defined primary service area that includes Winnebago, Boone and Ogle counties. 2010 US Census Bureau estimates project the population for the entire primary service area at approximately 403,000 individuals with close to three-quarters living in Winnebago County approximately 295,000. This represents a drop in population of approximately 6000 individuals from 2009 US Census projections.
Part VI Line 4	continued The hospital also serves the secondary service area which includes DeKalb, McHenry, Whiteside, Lee, LaSalle, Stephenson and Rock counties for select tertiary services. Located in northern Illinois, the primary service area is characterized as largely rural and populated with very small communities with the exception of the neighboring cities of Rockford, Loves Park, and Machesney Park which comprise more than 200,000 individuals.
Part VI Line 4	cont The next largest is Belvidere, in Boone County, where the entire county has a population of just over 54,000 individuals. More than 86 of hospital inpatients are from the Primary Service Area. As a community that relies heavily on manufacturing companies and small businesses, the area continues to experience difficult economic times. Currently the largest employers include Chrysler Boone County, the Rockford school district, and the three Rockford healthcare providers.
Part VI Line 4	cont Median household income in 2010 inflation-adjusted dollars U.S. Census Bureau in Winnebago County was 43,792 representing a drop from 2009 median income levels of 47,600.In comparison, the states 2009 median household income was 53,974.These disparities are also reflected in unemployment, education and poverty rates. While unemployment has dropped in Rockford from nearly 18 in March, 2010 to 15.1 in August, 2010, the community is still significantly
Part VI Line 4	cont higher than the overall State rate of slightly more than 10. Most recent census figures estimate 20 of Winnebago County residents attain a bachelors degree while in the state more than 29 do. Poverty levels continue to rise with approximately 18 of Winnebago County residents below the poverty level compared to state levels of 13. In February, the 2010 Illinois Kids Count report stated 34 and one in three children in Rockford live at or below the federal poverty rate
Part VI Line 4	cont placing Rockford with the highest rate in the entire state of Illinois. All of these conditions have resulted in increasing pressures on the community. RMH is located in the older, western portion of the community and serves a significant indigent and elderly population. This is evident when looking at income levels for households located in zip codes in western Rockford where the hospital resides. For example, the U.S. Census Bureau 2000 profile for individual zip codes
Part VI Line 4	cont lists median household income for west side zip codes as follows 61103-approximately 37,000 61102-34,000 61101-31,700. Bad debts from these zip codes accounted for more than 7.6 million and 42 of the hospital total. The geographic disparities are evident, comparing these numbers to households in the eastern portion of Rockford. In comparison, the 3 largest eastside zip codes have the following median household incomes 61107-49,000 61108-44,700 61114-67,000.
Part VI Line 4	contAs the only northern Illinois hospital with Level III neonatal intensive care, comprehensive pediatric and pediatric intensive care, RMH is committed to children as the main provider of childrens services in the immediate and greater tertiary service area. With 1 in 3 children currently at or below federal poverty levels in the county and with the overall economic condition, the hospital has seen increases in uninsured and public aid patients. This trend continues to grow.
Part VI Line 5	- In 2010, RMH, integral part of Rockford Health System RHS, continued to invest thousands of dollars and hours in promoting a stronger, healthier community. As one of Rockfords largest employers, the organization takes a leading role in financially supporting not only health-related initiatives, but also community-building activities across the region. It includes providing financial support and talent for economic development and business-related activities, as well as quality of
Part VI Line 5	continued life and educational initiatives, to name just a few. RHS professionals participate on many community boards and are actively involved in promoting and protecting the Rockford region and its assets. Two of the more significant community projects funded by RMH in 2010 include the Sharefest project, which helped to renovate an aging middle school in the hospitals neighborhood and the support of a new Science and Math Center at our local community college.
Part VI Line 5	cont RHS is a leading funder of nonprofit organizations and their missions in the region. And, the need for support has grown significantly in 2010, as the community continues to be hard hit by difficult economic times. Whether it is helping to fund Gigis Playhouse for children and adults with Down syndrome, stocking the local food bank or supporting the survival of the arts by funding the Rockford Symphony Orchestra and the Rockford Ballet, the reach of the organization is wide and deep.
Part VI Line 5	cont Donations to local causes amounted to hundreds of thousands of dollars in 2010. To promote a healthier community, RHS supported the Rockford Health Council in completing its 2010 Healthy Community Study for Winnebago and Boone Counties. The support was financial, as well as technical, with RHS represented on the Rockford Health Council Board of Directors. This collaborative effort, partnering healthcare and education, gathered, analyzed and reported on the health needs of the community.
Part VI Line 5	cont It revealed trends, changes and unmet needs. This assessment serves as a blueprint for future health care initiatives and growth in our region. While RHS professionals take a role locally in community-building activities related to healthcare, it also takes a similar role in Illinois. The RHS President and CEO is a member of the Illinois Hospital Associations Board and in 2011 became its chair. RHS professionals are leading advocates for the healthcare needs of the Rockford region.
Part VI Line 5	cont With local unemployment rates among the highest in Illinois, health care providers continue to see a rise in underinsured and uninsured individuals in our community. Besides a proactive charity care program, RHS invests in safety net programs to assist residents in accessing health care and other needed services. That support includes Ronald McDonald Care Mobile, which provides free medical and dental services and our Bridge Clinic partnership provides free care for underinsured adults.
Part VI Line 5	cont The RMH Auxiliary presented six minority women scholarships to attend nursing school. Each of the students received 2,000 for pursuing their careers at local colleges. Two were given to Hispanic students who speak Spanish. The goal is to help remove financial barriers for minority students and thus create a more diverse workforce. It is also hoped that additional Spanish-speaking nurses in local health care facilities will help remove barriers for patients who do not speak English.
Part VI Line 5	cont The organization makes additional significant financial and manpower commitments to organizations such as local chambers of commerce, Boone County Growth Dimensions, area colleges, the United Way, Black Healthcare Coalition, La Voz Latina, local public schools and quality of life initiatives which are intended to maintain Rockfords strengths in difficult times.
Part VI Line 5	cont As the largest employer in Rockford, the health system is a major economic force in the region, providing a positive impact on the local economy. The workforce provides not only a broad range of employment opportunities, but also makes other spending and financial contributions possible. During 2010, RHS worked with over 200 local vendors and supported 46 full-time construction-related jobs in the region. An investment of 9.2- million went toward major improvements at its facilities.
Part VI Line 5	cont The largest construction project was the 4.4-million renovation of the Emergency Department at Rockford Memorial Hospital. Rockford Health Physicians-Mulford location received renovations for implementation of digital mammography and the expansion of the Obstetrics and Gynecology program. We also developed a Dermatology program at Rockford Health Physicians-Perryville.
Part VI Line 5	cont Playing a key role in keeping the community safe and prepared in the event of a disaster, Rockford Memorial Hospital has been designated by the Illinois Department of Public Health as the Disaster POD hospital for the northern Illinois EMS region. In that role, the hospital, which is a Level 1 Trauma Center, serves as the designated resource hospital for regional disaster planning and response maintains an established disaster plan
Part VI Line 6	-Each of Rockford Health Systems entities work closely with the community and Rockford Memorial Hospital RMH to address health needs. In 2010, volunteers from the Visiting Nurses Association VNA gave 5,000 hours of their time to help care for, educate and serve residents of the Rock River Valley. The VNA provides support services for end of life patients, protecting the elderly from abuse and helping them stay in their own homes as long as possible.
Part VI Line 6	continued In 2010, VNA Hospice teamed up with Northern Illinois Hospice to host the 8th Annual Talking Hospice Conference, Cultural Diversity Difference in the Delivery of End-of-Life Care. To date, more than 1700 individuals have attended the conferences. Also this year, VNAs Older Adult Care was one of six sites selected to receive grant funding to pilot the Money Follows the Person Program. The program is designed to help older adults who have lived in the nursing home for more than
Part VI Line 6	continued three months, move out, and back into their communities. Many elderly residing in nursing facilities are unaware of the community resources available to support a choice of community living. Ten former nursing home residents including a married couple have benefitted from this program. Also in 2010, VNA Elder Abuse Neglect and Exploitation staff was instrumental in forming the Winnebago and Boone Counties Elder Fatality Review Board, a multidisciplinary team comprised of
Part VI Line 6	continued coroners, lawyers, police officials, and elder abuse staff. The purpose of the board is to review questionable deaths of area seniors that may potentially be attributed to abuse. Input from individuals who intervene in elder abuse can actually close the door on a questionable death or open it to further investigation. Review boards such as this have helped with the prosecution of those who abuse senior citizens. VNA is also very involved in providing community outreach
Part VI Line 6	continued at area health and wellness fairs. Home care professionals participated in a number of these events in 2010. VNA introduced Pet Therapy as a complement to their more medically traditional services. All dogs and owners are certified as Pet Therapists and receive specialized training prior to being accepted into the program. Therapy dogs help patients physically, socially and emotionally and have become a welcome addition to VNA Hospice Program.
Part VI Line 6	continued Rockford Health Physicians RHPH, the employed physicians group that is part of RHS, participates in numerous initiatives on behalf of the communities it serves. These physicians support the hospitals clinical programs, such as the hospitalist program in obstetrics and in pediatrics, where the majority of patients are indigent as well as providing critical staff for the 24 hr. emergency department.
Part VI Line 6	continued The doctors also actively participate in community outreach efforts. The Bridge Clinic, which serves the immediate medical needs of underinsured adults is staffed by RHPH physicians, the Centering Pregnancy Program, a support group initiated by our midwives for primarily low income pregnant women and significant continuing financial support for a local child abuse program called MERIT, were among many initiatives at RHPH.
Part VI Line 6	continued Throughout the region, the physician group helps to support initiatives with local schools and village government services. Our physicians and employees also provided community education on heart, neck and back pain, cosmetic surgery and hearing loss issues. CPR training, financial support and volunteers for a pediatric diabetes camp and an educational partnership with the Golden Apple Foundation are other 2010 initiatives by the medical group.
Part VI Line 6	continued In 2010, the external grants program of the Rockford Memorial Development Foundation RMDF provided 100,000 in support to community not-for-profits that serve as an extension of Rockford Health Systems healthcare mission. RMDF also provides support for the Ronald McDonald Care Mobile, which provides free medical and dental services to children in the region. In addition, the Foundation provided automatic external defibrillators AED to organizations that serve a wide variety of citizens. They included Roscoe Police Dept., Milestone, Inc., Remedies formerly PHASE/WAVE, Village of Machesney Park, IL and Rockford Park District. The Foundations AED grant program has provided nearly 109 of the lifesaving devices to community organizations since 1999.
Part VI Line 6	continued RHS also proactively responds to diverse community need. Whether it is, support for an open heart program in neighboring Wisconsin, a VIP Program that assists local employers with wellness initiatives, comprehensive pediatric support services for children and parents, or nursing scholarships for minorities, the organization invests money, time and talents in supporting community health initiatives that provide immediate needs and long lasting benefits to the community. RHS is a leading funder of nonprofit organizations and their missions in the region. Whether it is helping to fund Gigis Playhouse for children and adults with Down syndrome, stocking the local food bank or supporting the survival of the arts through funding the Rockford Symphony Orchestra and the Rockford Ballet, the organization reaches wide and deep. Donations to local causes amounted to hundreds of thousands of dollars in 2010.
Part VI Line 6	continued To promote a healthier community, RHS supported the Rockford Health Council in completing its 2010 Healthy Community Study for Winnebago and Boone Counties. The support was both financial, as well as technical, with RHS represented on the Rockford Health Council Board of Directors. This collaborative effort, partnering health care and education, gathered, analyzed and reported on the health needs of the community. This can serve as a blueprint for future health care initiatives. RHS professionals are leading advocates for the health care needs of the Rockford region. The system through RMH Auxiliary presented six minority women scholarships to attend nursing school. Each of the students received 2,000 for pursuing their careers at local colleges. Two were given to Hispanic students who speak Spanish. The goal is to help remove financial barriers for minority students and thus create a more diverse workforce. It is also hoped that more Spanish-speaking nurses in local health care facilities will remove barriers for patients who do not speak English.
Part VI Line 7	Part VI Line 7, IL

Schedule I IRS990ScheduleI

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

Recipient Table RecipientTable (25 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EIN Of RecipientEINOfRecipient	IRC SectionIRCSection	Amount Of Cash GrantAmountOfCashGrant	Purpose Of GrantPurposeOfGrant
Rkfd Area Economic Council
100 Park Ave	Rockford	IL	61101	363055858	501c6	120000	Community building
Univ of IL-College of Medicine
1601 Parkview	Rockford	IL	61107	376000511	501c3	80000	Support healthcare
Rockford Symphony Orchestra
711 N Main St	Rockford	IL	61103	261180940	501c3	11000	Support Fine Arts
Community Foundation of No IL
946 N Second St	Rockford	IL	61107	364402089	501c3	30000	General support
Easter Seals Metropolitan Chicago
233 South Wacker Drive Suite 2400	Chicago	IL	60616	362171729	501c3	5940	Support Handicapped
Rock Valley College
3301 N Mulford Rd	Rockford	IL	61114	363037232	501c3	34520	Community Education
Janet Wattles
526 W State St	Rockford	IL	61101	363636657	501c3	31050	Support healthcare
American Cancer Society
4312 E State St	Rockford	IL	61108	237040934	501c3	10000	Support healthcare
Growth Dimensions
200 S State St	Belvidere	IL	61008	363196645	501c6	7420	Community Development
Epilepsy Found North Central IL
3815 Harrison Ave	Rockford	IL	61101	362741730	501c3	4800	Support healthcare
Retreat & Refresh Stroke Camp
425 W Giles Ln	Peoria	IL	61614	640954851	501c3	7000	Support healthcare
YMCA
200 Y Blvd	Rockford	IL	611073019	362174838	501c3	5094	Youth Services
Golden Apple Foundation
5050 E State Street	Rockford	IL	61108	363890062	501c3	9920	Community Education
Crusaders Health Foundation
1200 West State Street	Rockford	IL	61102	363259761	501c3	4500	Support healthcare
Boys and Girls Club
1275 Peachtree Street	Atlanta	GA	30309	135562976	501c3	5000	Community Program
United Way of Rock River Valley
612 N Main St	Rockford	IL	61103	362167843	501c3	15000	Community Program
Boy Scouts
PO Box 4085	Rockford	IL	61110	362169127	501c3	5000	Community Program
Girl Scouts
2101 Auburn St	Rockford	IL	61103	362358083	501c3	6000	Community Program
Regional Access & Mobilization Project (RAMP)
202 Market Street	Rockford	IL	61107	363149827	501c3	15750	Support Handicapped
Rockford Sharefest
1280 S Alpine Rd	Rockford	IL	61108	262931796	501c3	25000	Community Coalition
March of Dimes
1275 Mammaroneck Ave	White Plains	NY	10605	131846366	501c3	10000	Support infant healthcare
Rockford Chamber of Commerce
308 W State St Ste 190	Rockford	IL	61101	361695170	501c6	10000	Community Development
Midwest Fdn for Orthopaedic Research & Education (MFORE)
324 Roxbury Road	Rockford	IL	61107	362691111	501c3	6000	Support healthcare
Kantorei
415 N Church St	Rockford	IL	61103	362603214	501c3	5000	Community Program
OSF St Anthony Medical Center
PO Box 6087	Rockford	IL	61125	370813229	501c3	9220	Support healthcare

Field	Value	IRS element (for citing)
Total Nbr Of501 C3 And Govt Grants	22	TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations	3	TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Club Dues Or Fees	X	ClubDuesOrFees
Written Policy Re T And E Expenses	true	WrittenPolicyReTAndEExpenses
Substantiation Required	true	SubstantiationRequired
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	true	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	true	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs	Base Compensation Filing OrgBaseCompensationFilingOrg	Bonus Filing OrgBonusFilingOrg	Other Compensation Filing OrgOtherCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg
James WBreckenridge
290192	187174	1134	86160	17196	581856	79750
John TDorsey
261149	11434	1134	41396	8469	323582	31409
Jos LGonzalez
351014	22364	1134	52356	15740	442608	25212
Dennis TUehara
387409	23543	1548	53266	17220	482986
Gary EKaatz
552287	304971	111792	124719	25986	1119755	76766
Henry MSeybold
316687	115387	7509	47878	11310	498771	25145
Gordon Langejans
							230232	72542	12140	22932	25528	363374
Earl Tamar
								42397	6249	10200	692	59538	4100
Carolyn Bengtson
							253556	59372	1104	33269	22768	370069	18417
Michael Tyrkus
							194477	5847	9981	19344	20516	250165
Susan Schreier
							180583	41274	1528	23323	20341	267049	6208
Curt Lesher
							153433	14650	5466	10940	17308	201797
Jeffrey Campbell
							137228	10350	254	9644	23569	181045
Kerry Hill
171328	43421	6589	25972	24194	271504	8333

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
I	1a	- By policy Membership to the YMCA is paid for the CEO. Two social club memberships are paid for by the organization for the CEO and any personal use of these facilities is reimbursed in full. The actual cost of these memberships are prorated for personal vs business use and that percentage is added to taxable wages.
1	4b	- The executive team receives annual additions to a non-qualified retirement plan. These amounts, accrued for 2010, are included in compensation and listed in detail in Part II for Carolyn Bengtson 13,123 Gary Kaatz 93,816 Gordon Langejans 4,756.00 Sue Schreier 9,198 Henry Seybold 38,800 Kerry Hill, 8,774.
1	7	- Short term incentive opportunities, designating threshold, target and maximum annual awards are established for all executives, driven by the strategic initiatives and priorities of RHS. If incentive thresholds are not met, CEO may grant discretionary bonuses for outstanding performance within certain parameters.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	Illinois Finance Authority	BusinessNameLine1

Field	Value	IRS element (for citing)
Issuer EIN	861091967	IssuerEIN
CUSIP Number	45000GFS5	CUSIPNumber
Date Issued	2008-12-11	DateIssued
Issue Price	31008000	IssuePrice
Description Of Purpose	Refund 1994 Series Bonds, Issuance Costs, SWAP Payment	DescriptionOfPurpose
Defeased	false	Defeased
On Behalf Of Issuer	false	OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

Field	Value	IRS element (for citing)
Total Proceeds	31008000	TotalProceeds
Issuance Costs From Proceeds	483711	IssuanceCostsFromProceeds
Year Of Subst Completion	2008	YearOfSubstCompletion
Current Refunding	true	CurrentRefunding
Advance Refunding	false	AdvanceRefunding
Final Allocation Made	true	FinalAllocationMade
Adequate Books And Recds Maintaind	true	AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part IV Form990ScheduleKPartIV

Field	Value	IRS element (for citing)
Form8038 T Filed	false	Form8038TFiled
Variable Rate Issue	true	VariableRateIssue
Hedge Identified In Books And Recds	true	HedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

Field	Value	IRS element (for citing)
Business Name Line1	JP Morgan Chase	BusinessNameLine1

Field	Value	IRS element (for citing)
Term Of Hedge	0000000009.600000000000	TermOfHedge
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGIC
Gross Proceeds Invested	false	GrossProceedsInvested
Exception To Rebate	false	ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Field	Value	IRS element (for citing)
Name Person	Connie Vitali RMH Board Member	NamePerson

Field	Value	IRS element (for citing)
Relationship	Partner, RMH Pathologists Ltd.	Relationship
Amount Of Transaction	271388	AmountOfTransaction
Description Of Transaction	Contract for exclusive pathology	DescriptionOfTransaction
Sharing Of Revenues	false	SharingOfRevenues

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
Form 990 Part XI	5	-Other Changes in Net Assets Unrealized gain/loss on investments 6,416,488, Pension related changes other than net periodic pension cost 588,711, Postretirement medical benefit cost 328,785, Net assets released from restrictions used for capital 60,987, transfers to affiliates 56,660,704, change in FAS124 valuation 40,972, UPMIFA 248,743, change in temporarily restricted net assets 624,863
Form 990 Part VI	1a	- These members of the board were compensated by related organizations for other duties as well as unpaid service as board members James Breckenridge 48 hrs Anesthesiologist with Rockford Health Physicians RHPH and service to RHPH and RHS boards, John Dorsey 61 hrs RHPH Internal Medicine physician and RHPH and RHS boards, Jose Gonzalez 52.3 RHPH Neonatologist and RHPH and RHS boards, Dennis Uehara 31.6 hrs RHPH Emergency Services physician, RHPH and RHS and Foundation RMDF boards. Gary Kaatz had 42 additional hrs as President and CEO, Julie Peterson had 44 hrs as executive secretary, and Henry Seybold had 42.9 hrs as CFO Sr VP of Finance these employees compensation includes duties within RMH organization and for supporting all of the related entities RHS/RHPH/RMDF/VNA.
Form 990 Part VI	11a	- The data was gathered by the accounting staff with input from RMH and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RMH tax analyst. During the process, there were ongoing meetings held with a group consisting of the RHS CFO, the VP of Finance, the Controller, and the tax analyst. Once the Form 990 was completed, it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intracompany website. A presentation of the return was made to the RMH Finance Committee and at a meeting of the Board of Directors prior to filing.
Form 990 Part VI	12	- RHS Compliance Department acting on behalf of RMH annually sends out a copy of the policy with the Conflict of Interest form included. Each member completes the Financial Interest Disclosure Statement which is a part of the policy. The RHS Compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed, potential conflicts reviewed and appropriate actinsare taken as a result fo the review. Employees are given the policy and a statement to complete at teh beginning of the year or as a new party is hired or joins the RMH board.
Form 990 Part VI	15a,b	- RHS is the sole corporate member.
Form 990 Part VI	19	- Financial statements are available through the Illinois Attorney Generals Office. Governing documents are available by request from the board secretary.
Form 990 Part III Program Service Accomplishments	Line 4d Other Activities	Program Service Expenses 647,110, Grants and allocations 510,057, Revenue 394,465 Through Rockford Memorial Hospital Auxiliary, RMH is able to provide extra funds and services to support its mission. The Auxiliary has 354 volunteers who logged 35,847 hours while assisting with greeting visitors, transporting patients, floral or gift deliveries, thrift shop and gift shop activities, and other services as requested. The volunteers efforts provide extra funds and enhance the overall hospital experience for patients, visitors and staff.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI

Name Of Disregarded Entity NameOfDisregardedEntity

Field	Value	IRS element (for citing)
Business Name Line1	Rockford Health System Ventures LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	2400 N Rockton Ave	AddressLine1
City	Rockford	City
State	IL	State
ZIP Code	61103	ZIPCode

Field	Value	IRS element (for citing)
EIN	364366881	EIN
Primary Activities	Healthcare	PrimaryActivities
Legal Domicile State	IL	LegalDomicileState
Total Income	2174322	TotalIncome

Direct Controlling Entity Name DirectControllingEntityName

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

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
Visiting Nurses Assn of the Rockford Area
2400 N Rockton Ave	Rockford	IL	61103	362167945	Healthcare	IL	501c3	9	Rockford Health System	false
Rockford Health System
2400 N Rockton Ave	Rockford	IL	61103	363197915	Support of Healthcare	IL	501c3	11		false	N/A
Rockford Health Physicians
2300 N Rockton Ave	Rockford	IL	61103	363097436	Healthcare	IL	501c3	3	Rockford Health System	false
Rockford Memorial Development Foundation
2400 N Rockton Ave	Rockford	IL	61103	362197918	Support of Healthcare	IL	501c3	11	Rockford Health System	false

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	Van Matre Rehabilitation Center LLC	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	3660 Grandview Parkway Ste 200	AddressLine1
City	Birmingham	City
State	AL	State
ZIP Code	35243	ZIPCode

Field	Value	IRS element (for citing)
EIN	364397130	EIN
Primary Activity	Healthcare	PrimaryActivity
Legal Domicile State	IL	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Predominant Income Type	Related	PredominantIncomeType
Share Of Total Income	2174322	ShareOfTotalIncome
Share Of EOY Assets	9115116	ShareOfEOYAssets
Disproportionate Allocations	false	DisproportionateAllocations
General Or Managing Partner	true	GeneralOrManagingPartner
Percentage Ownership	1.00000	PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	Rockford Health Insurance LTD	BusinessNameLine1

Address Foreign AddressForeign

Field	Value	IRS element (for citing)
Address Line1	Wellesley House So 2nd Flr 90 Pitts	AddressLine1
City	Pembrooke	City
Province Or State	HM	ProvinceOrState
Country	BD	Country
Postal Code	08	PostalCode

Field	Value	IRS element (for citing)
Primary Activity	Insurance	PrimaryActivity
Legal Domicile Foreign Country	BD	LegalDomicileForeignCountry

Direct Controlling Entity Name DirectControllingEntityName

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

Field	Value	IRS element (for citing)
Type Of Entity	C Corp	TypeOfEntity
Share Of Total Income	26130	ShareOfTotalIncome
Share Of EOY Assets	1927420	ShareOfEOYAssets
Percentage Ownership	1.00000	PercentageOwnership

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

Transactions Related Orgs Table TransactionsRelatedOrgsTable (15 entries)

Transaction TypeTransactionType	Amount InvolvedAmountInvolved	Method Of Amt DeterminationMethodOfAmtDetermination
Rockford Memorial Development Foundation
b	190000	Payment
Rockford Memorial Development Foundation
c	745824	Financial Analysis
Rockford Health System
h	8214446	Asset listing review
VanMatre Rehabilitation Center LLC
j	149129	Per contract
Rockford Health Physicians
k	226659	Financial Analysis
VanMatre Rehabilitation Center LLC
k	549797	Financial Analysis
Rockford Health Physicians
l	4868113	Financial Analysis
VanMatre Rehabilitation Center LLC
l	860837	Financial Analysis
Rockford Health Physicians
m	406730	Financial Analysis
Rockford Health Physicians
n	5685246	Financial Analysis
Visiting Nurses Association
n	926434	Financial Analysis
Rockford Memorial Development Foundation
n	381123	Financial Analysis
Visiting Nurses Association
p	788728	Payment
Rockford Health Physicians
p	2504191	Financial Analysis
Rockford Memorial Development Foundation
p	247661	Financial Analysis