2011-11-11T23:51:21-00:00 2010-12-31 PriceWaterhouseCoopers LLP 2001 Market St Ste 1700 Philadelphia PA 19103 990 2010-01-01 362167847 Rockford Memorial Hospital ROCK 8159715000 2400 N Rockton Ave Rockford IL 61103 Henry M Seybold 8159715000 2011-10-18 true Matthew Petroski 2673303000 2011-11-01 2010 2016-02-24 21:20:13Z Gary Kaatz 2400 N Rockton Ave Rockford IL 61103 565594665 false X www.rhsnet.org X 1905 IL To improve and protect the health and welfare of the community in accordance with our mission: Superior Care, Every Day, For all our patients. A 396-bed hospital 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 15 8 2693 365 1205464 -185653 4329740 4003677 330016655 349978108 2121066 6026508 166422 164128 336633883 360172421 279570 845017 0 134796549 137556563 0 0 153805071 146852556 288881190 285254136 47752693 74918285 333648078 372867851 194947920 208340079 138700158 164527772 X The Mission of Rockford Health System and Rockford Memorial Hospital is Superior Care, Every Day, For All Our Patients. We will fulfill our commitment through performance excellence, innovation, and lifelong learning. false false 152432645 196168796 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. 76337558 147456558 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. 2763961 334960 493711 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. 647110 510057 394465 232181274 true true false false false false false false true true false false true true false false true false false false false false false false false true true true false true true false false false false false false false true true true false false false false true true true true false false true 365 0 true 2693 true true true true BD false false false false false false false false X 15 8 false false false false true true true true true false false true true true true true true true true true false IL X David Vola Controller 8159715000 2400 N Rockton Avenue Rockford IL 61103 Jack JBecherer 000.66 X 0 0 0 James WBreckenridge 001.00 X 0 478500 103356 Thomas DBudd 000.30 X 0 0 0 John WChadwick 000.30 X 0 0 0 Eleanor FDoar 001.00 X 0 0 0 John TDorsey 000.10 X 0 273716 69563 Pamela SFox 000.10 X 0 0 0 Jos LGonzalez 000.70 X 0 374511 68096 Alphonso NGoode 001.00 X 0 0 0 Jack WPackard 000.50 X 0 0 0 Dennis TUehara 020.50 X 0 412499 70487 Connie MVitali 002.00 X 0 0 0 Curtis DWorden 000.50 X 0 0 0 Paul AGreen 001.00 X X 0 0 0 Duane RBach 000.10 X X 0 0 0 Gary EKaatz 001.00 X X 0 969051 150705 Henry MSeybold 003.00 X 0 439582 59187 Julie APeterson 001.00 X 0 71646 27194 Gordon Langejans 031.30 X 314915 0 48460 Earl Tamar 000.00 X 48646 0 10893 Carolyn Bengtson 040.00 X 314032 0 56037 Michael Tyrkus 040.00 X 210305 0 39860 Susan Schreier 040.00 X 223385 0 43664 Curt Lesher 040.00 X 173549 0 28248 Jeffrey Campbell 040.00 X 147832 0 33213 Kerry Hill 040.00 X 0 221339 50166 1432664 3240844 859129 13 true true false 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 5 745824 3255078 2775 4003677 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 1765682 Medicare/Medicaid 900099 155584560 155584560 2656024 10251 2645773 349978108 1698928 1698928 499215 335087 164128 164128 116702 35639 11787 209308037 106700 204947478 139679 4360559 -32979 4327580 4327580 360172421 344513530 1205464 10449750 845017 845017 0 0 0 363375 363375 0 102983050 77568229 25414821 7786257 5883646 1902611 19536961 14748603 4788358 6886920 5190534 1696386 4178837 12942 4165895 436701 436701 223141 223141 0 659508 659508 811853 180406 631447 1042306 4865 1037441 10061371 6182983 3878388 7952986 7391582 561404 0 9710275 7070321 2639954 117372 93094 24278 0 535854 176351 359503 2855379 2855379 0 15511908 14296987 1214921 5122129 3273276 1848853 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 1717052 935113 781939 285254136 232181274 53072862 0 3500 3500 22717768 56353959 1446236 494476 41106559 44815243 15595 12713 5807024 6056539 2842703 6805891 266186116 186892440 89268023 79293676 149081455 158236077 21359215 20795777 333648078 372867851 93437415 108410765 73537769 70987769 1174595 685072 26798141 28256473 194947920 208340079 X 131376914 156330922 4698085 5571691 2625159 2625159 138700158 164527772 333648078 372867851 X 74918285 -49090671 X false true true X true true X 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false 4309770 748599 347198 190000 558599 26727 4630241 3472212 555556 938002 250000 381821 24179 4309770 4463526 800219 -1259075 200000 305881 26577 3472212 1.00000 false true true 468730 2111708 2580438 5455293 48166766 36634871 16987188 99060 84305 14755 201797181 145024814 56772367 8087378 5148450 2938928 79293676 Deferred Financing Costs 669533 Other 4961948 Land Held for Future Use 6422260 Partnerships 8742036 Deposits 20795777 Post Retirement 4616801 Basic Pension 23076820 Capital Lease 562852 28256473 360172421 285254136 74918285 6416488 -56380074 -49963586 24954699 366264489 6416488 335087 6751575 359512914 659507 659507 360172421 284929717 335087 335087 284594630 659507 659507 285254137 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. true true true X 0000000175.000000000000 true X 0000000600.000000000000 true true true false true true 8887880 8887880 0.03120 70008407 84770481 -14762074 78896287 84770481 -5874194 0.03120 1091969 273737 818232 0.00290 1531254 174373 1356881 0.00480 23283370 21442736 1840634 0.00650 841755 841755 0.00300 26748348 21890846 4857502 0.01720 105644635 106661327 -1016692 0.04840 true 4288620 76956364 70550020 6406344 X true true 1 1 Rockford Memorial Hospital

2400 N Rockton Avenue Rockford IL 61103

X X X X X X 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 true 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 22 3 X true true X X X X true true false false false false false true false 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 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. Illinois Finance Authority 861091967 45000GFS5 2008-12-11 31008000 Refund 1994 Series Bonds, Issuance Costs, SWAP Payment false false 31008000 483711 2008 true false true true false true true JP Morgan Chase 0000000009.600000000000 false false false Connie Vitali RMH Board Member Partner, RMH Pathologists Ltd. 271388 Contract for exclusive pathology false 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. Rockford Health System Ventures LLC 2400 N Rockton Ave Rockford IL 61103 364366881 Healthcare IL 2174322 NA 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 N/A false 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 Van Matre Rehabilitation Center LLC 3660 Grandview Parkway Ste 200 Birmingham AL 35243 364397130 Healthcare IL NA Related 2174322 9115116 false true 1.00000 Rockford Health Insurance LTD Wellesley House So 2nd Flr 90 Pitts Pembrooke HM BD 08 Insurance BD NA C Corp 26130 1927420 1.00000 false true true false false false false true true false true true true true true true true true 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