2011-12-14T14:42:06-06:00 2011-04-30 CLIFTON GUNDERSON LLP 114 E EVERETT DIXON IL 61021 990 2010-05-01 237087041 KISHWAUKEE COMMUNITY HOSPITAL KISH 8157561521 ONE KISH HOSPITAL DRIVE DEKALB IL 60115 LOREN FOELSKE 8157561521 2011-12-13 1 KELLY JACKSON HARDY 8152842285 2010 2016-02-24 21:20:13Z KEVIN P POORTEN ONE KISH HOSPITAL DRIVE DEKALB IL 60115 193633562 0 X WWW.KISHHOSPITAL.ORG X 1970 IL TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING INPATIENT ACUTE AND NONACUTE CARE, AND VARIOUS OUTPATIENT SERVICES IN THE AREA OF DEKALB COUNTY. 3 2 1136 282 141780 43953 439308 1113923 154699731 163834645 2817426 2966348 1341487 1803798 159297952 169718714 581784 999268 0 0 52062278 56726719 0 0 5578 93398918 95690873 146042980 153416860 13254972 16301854 248596359 278068882 93032057 101229299 155564302 176839583 X TO PROVIDE COMPREHENSIVE HEALTH CARE SERVICES, INCLUDING INPATIENT ACUTE AND NONACUTE CARE, AND VARIOUS OUTPATIENT SERVICES IN THE AREA OF DEKALB COUNTY. KISHWAUKEE COMMUNITY HOSPITAL (KCH) SERVES ALL PEOPLE WITH SKILL AND COMPASSION WHILE RESPECTING THEIR DIGNITY, RIGHTS, AND CHOICES BY OFFERING ACCESS TO HIGH-QUALITY PREVENTIVE, CURATIVE, AND REHABILITATIVE CARE DELIVERED IN A COST EFFECTIVE MANNER. KISHWAUKEE COMMUNITY HOSPITAL RECOGNIZES THE NEED TO EFFECTIVELY MANAGE RESOURCES FOR PRESENT AND FUTURE GENERATIONS. 0 0 128532470 999268 165465868 KISHWAUKEE COMMUNITY HOSPITAL (KCH), LOCATED IN DEKALB, ILLINOIS, SERVES THE RESIDENTS OF DEKALB COUNTY AND THE SURROUNDING AREAS BY OFFERING A NUMBER OF PROGRAMS AND SERVICES FOR COMMUNITY BENEFIT, INCLUDING CHARITY CARE. KISHWAUKEE COMMUNITY HOSPITAL BELIEVES THAT IN ORDER TO BE A TRUE "COMMUNITY" HOSPITAL, WE MUST BE A RESOURCE FOR PREVENTATIVE AND CURATIVE HEALTH INFORMATION, EDUCATION AND SERVICES AND THAT WE MUST SUPPORT THE EFFORTS OF OTHERS WHO ALSO ARE DOING WORK FOR THE COMMUNITY GOOD. DOING SO HELPS BUILD TRUST, RESPECT AND LOYALTY FOR OUR HOSPITAL AND STRENGTHENS OUR ROLE AS A PARTNER IN IMPROVING THE HEALTH OF OUR CITIZENS AND THE QUALITY OF LIFE IN THE COMMUNITIES WE SERVE.THE COMMUNITY BENEFIT OBJECTIVES OF KCH INCLUDE PROGRAMS TO REDUCE GEOGRAPHIC, FINANCIAL, LANGUAGE AND CULTURAL BARRIERS; IMPROVE AND ENHANCE PUBLIC HEALTH; ADVANCE GENERALIZEABLE KNOWLEDGE, AND RELIEVE THE GOVERNMENT BURDEN OF PROVIDING HEALTH SERVICES FOR THE COMMUNITY, UNINSURED AND UNDERINSURED. THIS SECTION ELABORATES ON SEVERAL AREAS: COMMUNITY BENEFIT PATIENT SERVICES, EMERGENCY/DISASTER RESPONSE, CLINICAL EDUCATION, COMMUNITY WELLNESS ACTIVITIES, OTHER COMMUNITY EDUCATION AND OUTREACH, CASH CONTRIBUTIONS AND IN-KIND CONTRIBUTIONS.KISHWAUKEE COMMUNITY HOSPITAL SERVES ALL OF DEKALB COUNTY, IL, AND BORDER COMMUNITIES IN KANE AND OGLE COUNTIES. POPULATION OF THE HOSPITAL'S SERVICE AREA, BASED ON 2010 CENSUS, IS 131,782. THIS GEOGRAPHIC AREA INCLUDES A GROWING HISPANIC POPULATION. A UNIQUE POPULATION IN OUR SERVICE AREA IS NORTHERN ILLINOIS UNIVERSITY STUDENTS (23,850 FALL 2010 ENROLLMENT), INCLUDING FOREIGN STUDENTS AND VISITORS. THE HISPANIC POPULATION IS EXPECTED TO GROW BY 22.62% BY 2016. ACCORDING TO THE AMERICAN COMMUNITY SURVEY, 29.5% OF FAMILIES AND 42.7% OF INDIVIDUALS ARE BELOW THE POVERY LEVEL BASED ON POPULATION ADN HOUSING DATA FROM 2005-2009.COMMUNITY BENEFIT PATIENT SERVICESTHE HOSPITAL OPERATES A NUMBER OF HEALTH SERVICES AT A LOSS FOR THE GOOD OF THE HEALTH, SAFETY AND WELFARE OF OUR PATIENTS AND COMMUNITY. KCH FOCUSED ON THE FOLLOWING COMMUNITY HEALTH NEEDS FOR THE FISCAL YEAR ENDED APRIL 30, 2011:* THE PREVALENCE OF OBESITY IN CHILDREN AND ADULTS* ACCESS TO AFFORDABLE PRIMARY HELTH CARE IN THE DEKALB/SYCAMORE AREA AND OUTLYING RURAL AREA* OUTPATIENT BEHAVIORLA HEALTH SERVICES AT BOTH HOSPITALS* TYPE II DIABETES * CARDIOVASCULAR DISEASE AND ADEQUATE HOSPITAL-BASED AND COMMUNITY OUTREACH SERVICES * CANCER CARE SERVICES, EDUCATION AND PREVENTION * AFFORDABLE ACCESS TO CHILDBIRTH EDUCATION AND OB HOSPITAL SERVICES* OTHER COMMUNITY OUTREACH AND WELLNESS SERVICES.EACH OF THESE INITIATIVES IS SUMMARIZED BELOW:FY 2011 COMMUNITY WELLNESS OBESITY INITIATIVECOMMUNITY WELLNESS INITIATIVE IS TO DECREASE OBESITY AND THE CHRONIC DISEASES ASSOCIATED WITH IT BY OFFERING TARGETED WELLNESS PROGRAMS AND PREVENTATIVE SCREENINGS TO HELP OUR COMMUNITY GET WELL AND STAY WELL. CURRENT PROGRAMS INCLUDE:* KNOW YOUR NUMBERS EVENTS * ONGOING WELLNESS PROGRAMS: MANAGING YOUR CHOLESTEROL WITH TLC. FREE BLOOD PRESSURE CLINICS. TIME TO QUIT TOBACCO.* WELLNESS FOR KIDS PROGRAMS* "WE CAN" PROGRAM: DEVELOPED BY THE NATIONAL INSTITUTES OF HEALTH TO HELP PARENTS / FAMILIES ADDRESS THE ISSUE OF OVERWEIGHT CHILDREN (AGES 8 - 13) THROUGH NUTRITION, FITNESS AND REDUCED SCREEN TIME* CATCH (COORDINATED APPROACH TO CHILD HEALTH): TO CREATE BEHAVIORAL AND ENVIRONMENTAL CHANGE TO IMPROVE NUTRITION, PHYSICAL ACTIVITY AND REDUCE SCREEN TIME TO DECREASE OBESITY RATES; DEVELOPED BY THE CENTERS FOR DISEASE CONTROL.* WEIGHT NO MORE WITH THE YMCA: WELLNESS PRESENTATIONS AND FITNESS CLASSES OFFERED TWICE A YEARACCESS TO AFFORDABLE PRIMARY CARE. NEW PHYSICIANS WHO RECEIVE RECRUITMENT ASSISTANCE ARE REQUIRED TO ACCEPT MEDICAID PATIENTS. OUTPATIENT BEHAVIORAL HEALTHDURING FY 11, OUTPATIENT BEHAVIORAL HEALTH SERVICES WERE EXPANDED TO SISTER HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL IN SANDWICH. FOR KISH HOSPITAL PRIMARY MARKET, A LARGER OFFICE SUITE OPENED IN SYCAMORE. THERE WERE MORE THAN 3,700 BEHAVIORAL HEALTH PATIENT VISITS, A 44% INCREASE OVER THE PREVIOUS YEAR. AT THE SYCAMORE LOCATION, ONE OF THE CENTER'S TWO PSYCHIATRISTS EXPANDED OFFICE HOURS, BILINGUAL EMPLOYEE ASSISTANCE PROGRAM SERVICES WERE ADDED, AND SPECIALIZED SERVICES FOR CHILDREN WERE EXPANDED. THE MOVE TO NEW OFFICE SPACE ALSO FACILITATED A COLLABORATIVE RELATIONSHIP WITH ANOTHER TENANT, ALEXIAN BROTHERS BEHAVIORAL HEALTH FROM HOFFMAN ESTATES, WHICH IS PROVIDING INTENSIVE OUTPATIENT TREATMENT FOR ADULTS IN THE AREA OF EATING DISORDERS AND OBSESSIVE COMPULSIVE DISORDER.TYPE II DIABETESTO ADDRESS THE PREVALENCE OF DIABETES IN THE ADULT POPULATION, THE HOSPITAL CONTINUED TO OPERATE A DIABETES EDUCATION CENTERS AND RURAL SATELLITE SERVICES AT KISHHEALTH FAMILY & SPECIALTY CARE IN GENOA AND WATERMAN. THE KISH DIABETES EDUCATION CENTER HAD 6,777 CONSULTATIONS, A 5.3% DECREASE FROM THE PREVIOUS YEAR.CARDIOVASCULAR DISEASE AND HOSPITAL-BASED AND COMMUNITY OUTREACH SERVICES ACCORDING TO THE SYSTEM'S 2009 COMMUNITY HEALTH STATUS TELEPHONE SURVEY, MORE THAN 80% OF THE ADULT POPULATION IN THE KCH MARKET AND HAVE ONE OR MORE CARDIOVASCULAR RISK FACTORS OR BEHAVIORS, SUCH AS HIGH BLOOD PRESSURE, HIGH CHOLESTEROL OR SMOKE. COMMUNITY BENEFIT ACTIVITIES IN FY 11 THAT PROMOTED CARDIOVASCULAR HEALTH WERE: * GO RED FOR WOMEN CAMPAIGN IN PARTNERSHIP WITH THE AMERICAN HEART ASSOCIATION: LUNCHEON IN MAY ATTENDED BY 150 PEOPLE. BUSINESS LEADER BREAKFAST IN APRIL, ATTENDED BY 50.* WOMEN'S HEALTH EVENT IN FEBRUARY ATTENDED BY 750* KNOW YOUR NUMBERS CAMPAIGN DURING THE SUMMER/FALL OF 2010* NUMEROUS COMMUNITY WELLNESS PROGRAMS AND CLASSESCANCER CARE SERVICES, EDUCATION AND PREVENTION * OPEN HOUSE FOR THE NEW CANCER CENTER AT KISHWAUKEE COMMUNITY HOSPITAL ATTENDED BY SEVERAL HUNDRED* SPACE PROVIDED FOR AMERICAN CANCER SOCIETY RESOURCE LIBRARY AT THE NEW CANCER CENTER OPEN TO THE PUBLIC* FINANCIAL SUPPORT OF AMERICAN CANCER SOCIETY RELAYS FOR LIFE FOR DEKALB COUNTY AND LOWER FOX VALLEY (KENDALL COUNTY)* FREE SUPPORT GROUPS INCLUDING GARDEN THERAPY, MEN AND WOMEN NETWORKING, CAREGIVER SUPPORT* PROVIDED FREE SKIN CANCER SCREENING AT WOMEN'S HEALTH EVENT* PROVIDED BREAST CANCER AWARENESS BOOTH AT SYCAMORE'S LADIES NIGHT OUTAFFORDABLE ACCESS TO CHILDBIRTH EDUCATION AND OB HOSPITAL SERVICES* 672 TUITION WAIVERS FOR INFANT AND CHILDBIRTH CLASSES FOR CLIENTS OF THE DEKALB COUNTY HEALTH DEPARTMENT IN THE WIC PROGRAM AND HEALTHY MOMS/HEALTHY KIDS PROGRAM.* FREE PREPARED CHILDBIRTH CLASSES FOR YOUNG MOMS* MONTHLY MOMS BREASTFEEDING SUPPORT GROUP LED BY A LACTATION COUNSELOR * FREE POST PARTUM VISITS FOR NEW MOMS* BEGAN PLANNING FOR LACTATION CENTEROTHER COMMUNITY OUTREACH AND WELLNESS EFFORTS* FREE SAFE SITTER PROGRAM FOR 24 STUDENTS IN THE SYCAMORE SPARTAN REACH, A PROGRAM FOR CHILDREN WHO RECEIVE EITHER REDUCED OR FREE LUNCHES.* COMMUNITY WELLNESS EDUCATORS TAUGHT HEALTH TOPICS IN AREA SCHOOLS: 477 CLASSROOMS TOUCHING 12,048 STUDENTS.* COMMUNITY WELLNESS EDUCATORS SERVED ON THE FOLLOWING COMMITTEES TO PROMOTE HEALTH AND WELLNESS: DEKALB LEADERSHIP ACADEMY, CO-COACH / PIONEERING HEALTHY COMMUNITIES, SYCAMORE SCHOOL DISTRICT WELLNESS COMMITTEE, DEKALB SCHOOL DISTRICT WELLNESS COMMITTEE AND SCHOOL LUNCH AND COMMUNITY OUTREACH SUB-COMMITTEES, LATINO ACTION GROUP, GO RED LUNCHEON COMMITTEE,CANCER COMMITTEE, * FREE AND LOW COST FITNESS AND INJURY PREVENTION CLASSES THROUGH UNLIMITED PERFORMANCE REHABILITATION AND SPORTS MEDICINE.* SPONSORED ANNUAL FITFEST, A WALKING EVENT WITH THE KISHWAUKEE FAMILY YMCA TO PROMOTE EMPLOYEE HEALTH AND FITNESS DAY TO AREA EMPLOYERS. ATTENDED BY 400.* PUBLISHED A COMMUNITY WELLNESS MAGAZINE THREE TIMES A YEAR PROVIDING INFORMATION ABOUT PROGRAMS, FREE SCREENINGS, AND GENERAL HEALTH TIPS.OPERATIONAL COMMUNITY BENEFITCHARITY CARE* AS PART OF ITS CHARITABLE MISSION, FREE AND DISCOUNTED CARE PROVIDED, INCLUDING ACCESS TO PHARMACEUTICAL ASSISTANCE FOR PATIENTS WHO MET THE ELIGIBILITY CRITERIA ESTABLISHED IN ITS FINANCIAL ASSISTANCE POLICY. THE POLICY IS REVIEWED BY THE BOARD OF DIRECTORS ANNUALLY. THE LAST REVIEW WAS APRIL 2011.* ADHERED TO THE REQUIREMENTS OF THE HOSPITAL UNINSURED PATIENT DISCOUNT ACT OF 2009, PROVIDING UNINSURED PATIENTS DISCOUNTS WHEN FAMILY INCOME IS AT OR BELOW 600% OF THE FEDERAL POVERTY LEVEL FOR KISHWAUKEE COMMUNITY HOSPITAL, 300% OF THE FEDERAL POVERTY LEVEL FOR VALLEY WEST COMMUNITY HOSPITAL.* COORDINATED WITH THE ILLINOIS BREAST AND CERVICAL CANCER PROGRAM FOR ASSISTANCE WITH BREAST AND CERVICAL CANCER SCREENINGS AND TREATMENT.SUBSIDIZED HEALTH SERVICESA NUMBER OF PROGRAMS AND SERVICES WERE OPERATED AT A LOSS, BUT WERE SUBSIDIZED BECAUSE THEY IMPROVE THE HEALTH AND SAFETY OF THE COMMUNITY. MANY ORGANIZATIONS ALSO RECEIVED CASH AND IN KIND DONATIONS. 128532470 1 1 0 1 0 0 0 0 0 1 1 0 0 1 0 0 1 0 0 0 0 0 0 1 0 1 1 1 1 1 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 0 0 0 1 136 0 1 1136 1 1 1 0 0 0 0 1 0 0 0 0 0 X 3 2 1 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL X PHILLIP JOHNSON DIR OF ACCTG 8157561521 ONE KISH HOSPITAL DRIVE DEKALB IL 60115 X MICHAEL MOONEY 2.00 X X 0 0 0 MICHAEL CULLEN 2.00 X X 0 0 0 KEVIN POORTEN 30.00 X X 0 918469 100377 LOREN FOELSKE 10.00 X 0 303588 39563 BRAD COPPLE 20.00 X 0 341357 39811 PAM DUFFY 20.00 X 0 234689 26496 JOE DANT 20.00 X 0 258586 39499 MIKE KOKOTT 10.00 X 0 193903 22972 ROGER HEATH BELL 15.00 X 0 216841 37445 DR MICHAEL KULISZ 20.00 X 0 204758 20414 MARK THATE 20.00 X 0 179403 27847 CHERYL FISHER 20.00 X 0 136108 30631 THOMAS W TILTON DO 45.00 X 457022 0 39793 RON C LUBCKE 40.00 X 134714 0 18342 KENYA M WILLIAMS MD 40.00 X 242011 0 23954 JASMEET DHALIWAL 40.00 X 477103 0 20326 ANJU VOHRA 40.00 X 158138 0 20053 1468988 2851594 476892 29 0 1 0 POWER CONSTRUCTION COMPANY LLC 2360 NORTH PALMER DRIVE SCHAUMBURG IL 60173 CONSTRUCTION SERVICES 11652165 KISHHEALTH SYSTEM ONE KISH HOSPITAL DRIVE DEKALB IL 60115 MANAGEMENT SERVICES 11135722 DOCTORS OF EMERGENCY MEDICINE 2807 BRITTANY COURT ST CHARLES IL 60175 ER 6557328 SABET SIDDIQUI MDPC 6925 ERROL COURT CHERRY VALLEY IL 61016 PHYSICAN - CANCER CARE CENTER 1700000 SODEXO INC & AFFILIATES 4880 PAYSPHERE CIRCLE CHICAGO IL 60674 FOOD SERVICES 1370122 30 950 40771 1030699 34267 7236 15758 1113923 NET PATIENT SERVICE RE 621110 163782199 163678774 103425 AFFILIATED RENTAL INCO 621610 52446 52446 163834645 4563748 4563748 179278 207570 -28292 -28292 -28292 21996108 20283 23596108 17683 -1600000 2600 -1597400 -1597400 40727 40771 22871 17856 17856 111847 70616 41231 41231 CAFETERIA SALES 621110 671700 657365 14335 INCOME PASSTHROUGH - K 621110 618461 618461 DISCOUNTS AND REBATES 621110 260678 260678 222164 198144 24020 1773003 169718714 165465868 141780 2997143 975868 975868 23400 23400 40758604 39183853 1574751 2324647 2234832 89815 10668658 10256757 411901 2974810 2859875 114935 11135722 11135722 202275 202275 4512 4512 431158 431158 17727299 16211821 1515478 902557 82150 820407 22672615 21891120 777338 4157 1747972 481037 1266935 3356192 3316678 39514 171777 152827 18950 7490 7490 3591700 3591700 9934236 9934236 3028235 1073019 1955216 UNRELATED BUSINESS INCO 7045 7045 BAD DEBT EXPENSE 11210035 11210035 PHYSICAN FEES 3347646 3347646 PHYSICIAN RECRUITMENT 3127261 3127261 FEDERAL AND STATE ASSES 2063616 2063616 1021530 98949 921160 1421 153416860 128532470 24878812 5578 7816993 6499149 653378 279934 22393791 25341679 3088963 3529110 2271599 2061173 159479787 54658407 95545088 104821380 85746795 104528505 22067417 22243230 9012335 8764722 248596359 278068882 11813777 13418274 156389 945417 63685000 63685000 230016 1245941 17146875 21934667 93032057 101229299 X 150907951 172416577 4656351 4423006 155564302 176839583 248596359 278068882 X 16301854 4973427 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 0 0 1 22624 22624 0 EXPLANATION OF OTHER LOBBYING ACTIVITIES: PART II-B, LINE 1I: LOBBYING EXPENSES ARE ALLOCATED THROUGH MEMBERSHIP DUES WITH ILLINOIS HOSPITAL ASSOCIATION AND AMERICAN HOSPITAL ASSOCIATION. NO OTHER LOBBYING ACTIVITIES WERE CONDUCTED. 4110685 4110685 93721369 18945921 74775448 554682 85302 469380 46120556 33167524 12953032 14972495 2459660 12512835 104821380 2107306 C CASH EQUIVALENTS 7471986 F ACCRUED INTEREST 413670 F CERTIFICATES OF DEPOSIT 12250268 F 22243230 THIRD PARTY PAYABLES 14538082 DUE TO AFFILIATES 1695903 ACCRUED INTEREST PAYABLE 310133 OTHER PAYABLES - LONG TERM 5390549 21934667 169718714 153416860 16301854 7085798 -2112371 4973427 21275281 179400022 7085798 3758067 10843865 168556157 1162557 1162557 169718714 156319098 3758077 3758077 152561021 855839 855839 153416860 PART XI, LINE 8 - OTHER ADJUSTMENTS: EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM -1,880,000. CHANGE OF INTEREST IN NET ASSETS OF KISHHEALTH FOUNDATION -100,514. BOOK/TAX DIFFERENCES IN K-1 PASSTHROUGH ENTITIES -101,198. GRANT REVENUE INCLUDED IN FIXED ASSETS FOR FINANCIAL STATEMENT PURPOSES -30,659. PART XII, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFICATION TO EXPENSES 3,758,067. PART XII, LINE 4B - OTHER ADJUSTMENTS: BOOK/TAX DIFFERENCE ON INCOME FROM PASSTHROUGH ENTITIES - KISH AREA PHO 67. CONTRIBUTION REVENUE FROM KISHHEALTH FOUNDATION 1,030,699. BOOK/TAX DIFFERENCE ON INCOME FROM PASSTHROUGH ENTITIES - MIDLAND SURGICAL 101,132. GRANT REVENUE INCLUDED IN FIXED ASSETS FOR FINANCIAL STATEMENT PURPOSES 30,659. PART XIII, LINE 2D - OTHER ADJUSTMENTS: RECLASSIFICATION FROM REVENUE 3,758,067. ROUNDING 10. PART XIII, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTION TO KISHHEALTH FOUNDATION 855,839. PART XI, LINE 10, EXCESS OR (DEFICIT) FOR THE YEAR PER FINANCIAL STATEMENTS: LINE 10 IDENTIFIES FINANCIAL STATEMENT INCOME AS EQUALING $21,275,281. FINANCIAL STATEMENT INCOME IS ACTUALLY $23,080,924. THE DIFFERENCE RELATES TO THE FOLLOWING ITEMS: 1. KISHWAUKEE COMMUNITY HOSPITAL MADE A CAPITAL DISTRIBUTION OF $1,880,000 TO ITS PARENT ORGANIZATION, KISHHEALTH SYSTEM. 2. KISHHEALTH FOUNDATION (KHF), AN AFFILIATED ENTITY, RECEIVES CONTRIBUTIONS DESIGNATED FOR USE BY KISHWAUKEE COMMUNITY HOSPITAL. THIS IS ALLOCATED TO KISHWAUKEE COMMUNITY HOSPITAL, VIA AN ENTRY TO INCREASE KISHWAUKEE COMMUNITY HOSPITAL'S INTEREST IN THE ASSETS OF KHF. A CORRESPONDING EQUITY ENTRY IS MADE ON KISHWAUKEE COMMUNITY HOSPITAL'S GENERAL LEDGER. THE CURRENT YEAR DECREASE WAS $96,459. 3. KCH RECEIVED CONTRIBUTIONS FROM AFFILIATES (KHF) IN THE AMOUNT OF $1,026,644 AND MADE CONTRIBUTIONS TO AFFILIATES IN THE AMOUNT OF $855,839. THESE ADJUSTMENTS WERE REFLECTED AS EQUITY TRANSACTIONS FOR FINANCIAL STATEMENT PURPOSES. 6. THERE IS A ROUNDING ADJUSTMENT OF $11 ANNUAL SCHOLARSHIP BALL 81498 40771 40727 15963 2500 4408 81498 40771 40727 15963 2500 4408 22871 17856 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 4930972 2041416 2889556 0.02030 15454005 9931068 5522937 0.03880 20384977 11972484 8412493 0.05910 6665130 540568 6124562 0.04310 1376232 20348 1355884 0.00950 875853 218863 656990 0.00460 376091 376091 0.00260 9293306 779779 8513527 0.05980 29678283 12752263 16926020 0.11890 1 4016221 682758 33036390 51759695 -18723305 X 1 1 1 MIDLAND SURGICAL CENTER (MSC) AMBULATORY SURGERY 0.77500 0.00000 0.00000 1 1 KISHWAUKEE COMMUNITY HOSPITAL

ONE KISH HOSPITAL DRIVE DEKALB IL 60115

X X X NOT REQUIRED 1 PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 11210035. PART II: NO COMMUNITY BUILDING ACTIVITIES ARE REPORTED IN PART II. PART III, LINE 4: NET PATIENT SERVICE REVENUETHE HOSPITAL HAS AGREEMENTS WITH THIRD-PARTY PAYORS WHICH PROVIDE FOR REIMBURSEMENT TO THE HOSPITAL AT AMOUNTS DIFFERENT FROM ITS ESTABLISHED RATES. CONTRACTUAL ADJUSTMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS REPRESENT THE DIFFERENCE BETWEEN THE HOSPITAL'S BILLINGS AT LIST PRICE AND THE AMOUNTS REIMBURSED BY MEDICARE, MEDICAID, BLUE CROSS, AND CERTAIN OTHER THIRD-PARTY PAYORS; AND ANY DIFFERENCES BETWEEN ESTIMATED THIRD-PARTY REIMBURSEMENT SETTLEMENTS FOR PRIOR YEARS AND SUBSEQUENT FINAL SETTLEMENTS. CONTRACTUAL ADJUSTMENTS UNDER THIRD-PARTY REIMBURSEMENT PROGRAMS ARE ACCRUED ON AN ESTIMATED BASIS IN THE PERIOD THE RELATED SERVICES ARE RENDERED AND ARE ADJUSTED IN FUTURE PERIODS AS FINAL SETTLEMENTS ARE DETERMINED. A SUMMARY OF THE BASIS OF REIMBURSEMENT WITH MAJOR THIRD-PARTY PAYORS FOLLOWS:MEDICARE: KISHWAUKEE COMMUNITY HOSPITAL (KCH) IS PAID FOR INPATIENT ACUTE CARE AND OUTPATIENT CARE SERVICES RENDERED TO MEDICARE PROGRAM BENEFICIARY UNDER PROSPECTIVELY DETERMINED RATES PER DISCHARGE (PROSPECTIVE PAYMENT SYSTEMS). THESE RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. THE HOSPITAL'S CLASSIFICATION OF PATIENTS UNDER PROSPECTIVE PAYMENT SYSTEMS AND THE APPROPRIATENESS OF THE PATIENT'S ADMISSIONS ARE SUBJECT TO VALIDATION REVIEWS. THE HOSPITAL IS REIMBURSED FOR COST REIMBURSABLE ITEMS AT TENTATIVE RATES WITH FINAL SETTLEMENT DETERMINED AFTER SUBMISSION OF ANNUAL REIMBURSEMENT REPORTS BY THE HOSPITAL AND AUDITS BY THE MEDICARE FISCAL INTERMEDIARY. THE HOSPITAL'S CLASSIFICATION OF PATIENTS UNDER THE MEDICARE PROGRAM AND THE APPROPRIATENESS OF THEIR ADMISSION ARE SUBJECT TO AN INDEPENDENT REVIEW BY A PEER REVIEW ORGANIZATION. CHANGES AS A RESULT OF THE CENTERS FOR MEDICARE AND MEDICAID SERVICES IMPLEMENTATION OF THE PROVISIONS OF THE FUTURE MEDICARE LEGISLATION MAY HAVE AN ADVERSE EFFECT ON THE HOSPITAL'S NET PATIENT SERVICE REVENUE.LAWS AND REGULATIONS GOVERNING THE MEDICARE PROGRAM ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION. AS A RESULT,THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR-TERM.MEDICAID: THE HOSPITAL IS REIMBURSED AT PROSPECTIVELY DETERMINED RATES FOR EACH MEDICAID INPATIENT DISCHARGE. OUTPATIENT SERVICES ARE REIMBURSED BASED ON ESTABLISHED FEE SCREENS. FOR INPATIENT ACUTE CARE SERVICES, PAYMENT RATES VARY ACCORDING TO A PATIENT CLASSIFICATION SYSTEM THAT IS BASED ON CLINICAL, DIAGNOSTIC, AND OTHER FACTORS. THE PROSPECTIVELY DETERMINED RATES ARE NOT SUBJECT TO RETROACTIVE ADJUSTMENT. THE HOSPITAL ALSO RECEIVES INCREMENTAL MEDICAID REIMBURSEMENT FOR SPECIFIC PROGRAMS AND SERVICES AT THE DISCRETION OF THE STATE OF ILLINOIS MEDICAID PROGRAM. MEDICAID REIMBURSEMENT MAY BE SUBJECT TO PERIODIC ADJUSTMENT, AS WELL AS TO CHANGES IN EXISTING PAYMENT LEVELS AND RATES, BASED ON THE AMOUNT OF FUNDING AVAILABLE TO THE MEDICAID PROGRAM.LAWS AND REGULATIONS GOVERNING THE MEDICAID PROGRAM ARE EXTREMELY COMPLEX AND SUBJECT TO INTERPRETATION. AS A RESULT, THERE IS AT LEAST A REASONABLE POSSIBILITY THAT RECORDED ESTIMATES WILL CHANGE BY A MATERIAL AMOUNT IN THE NEAR-TERM.IN DECEMBER 2004, THE FEDERAL CENTERS FOR MEDICARE & MEDICAID SERVICES (CMS) APPROVED STATEOF ILLINOIS (STATE) LEGISLATION FOR A MEDICAID HOSPITAL ASSESSMENT PROGRAM (PROGRAM). UNDER THE PROGRAM, THE HOSPITAL RECEIVES ADDITIONAL MEDICAID REIMBURSEMENT FROM THE STATE AND PAYS ARELATED ASSESSMENT TAX. THE PROGRAM HAS BEEN EXTENDED THROUGH JUNE 30, 2013. BLUE CROSS: THE HOSPITAL ALSO PARTICIPATES AS A PROVIDER OF HEALTH CARE SERVICES UNDER A REIMBURSEMENT AGREEMENT WITH BLUE CROSS. THE PROVISIONS OF THIS AGREEMENT STIPULATE THAT INPATIENT SERVICES WILL BE REIMBURSED AT A TENTATIVE REIMBURSEMENT RATE AND THAT FINAL REIMBURSEMENT FOR THESE SERVICES IS DETERMINED AFTER THE SUBMISSION OF AN ANNUAL COST REPORT BY THE HOSPITAL AND A REVIEW BY BLUE CROSS. MANAGED CARE ORGANIZATIONS: THE HOSPITAL HAS ALSO ENTERED INTO REIMBURSEMENT AGREEMENTS WITH CERTAIN COMMERCIAL INSURANCE CARRIERS, HEALTH MAINTENANCE ORGANIZATIONS, AND PREFERRED PROVIDER ORGANIZATIONS. THE BASIS FOR PAYMENT UNDER THESE AGREEMENTS INCLUDES DISCOUNTS FROMESTABLISHED CHARGES AND PROSPECTIVELY DETERMINED PER DIEM RATES.INTERNAL REVENUE SERVICE WORKSHEET 2 (PER SCHEDULE H INSTRUCTIONS) WAS UTILIZED TO DETERMINE THE COST OF BAD DEBTS ATTRIBUTABLE TO PATIENT ACCOUNTS. 20% OF THE ORGANIZATION'S BAD DEBT EXPENSE WAS ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S CHARITY CARE POLICY. PART III, LINE 8: FOR THE 4/30/11 FISCAL YEAR, KCH PROVIDED BILLED CHARGES TO MEDICARE PATIENTS TOTALING $150,000,000. HOWEVER, DUE TO THE MEDICARE INPATIENT AND OUTPATIENT PAYMENT METHODOLOGIES, THE ACTUAL CASH PAYMENTS RECEIVED FROM PROVIDING CARE TO THOSE PATIENTS WAS JUST $33,036,390, OR 22% OF BILLED CHARGES. THE COST OF PROVIDING THIS CARE, PER THE MEDICARE COST REPORT, WAS $51,759,695. THUS, THE PAYMENTS RECEIVED FROM MEDICARE WERE $18,723,305 LESS THAN COST, OR 64% OF COST. TRULY THIS $18,723,305 SHORTFALL SHOULD BE INCLUDED AS A COMMUNITY BENEFIT. AS APPROXIMATELY 46% OF ALL KISHWAUKEE COMMUNITY HOSPITAL CHARGES GENERATED ARE FROM MEDICARE PATIENTS, THIS SHORTFALL PLACES A TREMENDOUS FINANCIAL BURDEN ON OUR HOSPITAL.KISHWAUKEE COMMUNITY HOSPITAL, LIKE OTHER NOT-FOR-PROFIT HOSPITALS, MUST ACCEPT MEDICARE PAYMENTS AS PAYMENT IN FULL FOR SERVICES PROVIDED, WITH THE EXCEPTION OF COLLECTING ON DEDUCTIBLES AND CO-INSURANCE AMOUNTS. HOSPITALS CANNOT BILL MEDICARE PATIENTS FOR THE DIFFERENCE BETWEEN THE BILLED CHARGES AND MEDICARE PAYMENTS.KISHWAUKEE COMMUNITY HOSPITAL PROVIDES SERVICES TO ALL PATIENTS WHO NEED CARE, ABIDING BY THE FEDERAL EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA) REGULATION. IT REQUIRES HOSPITALS AND AMBULANCE SERVICES TO PROVIDE CARE TO ANYONE NEEDING EMERGENCY HEALTHCARE TREATMENT REGARDLESS OF CITIZENSHIP, LEGAL STATUS OR ABILITY TO PAY.KCH UTILIZED THE CALCULATION OF MEDICARE COST FROM THE ANNUAL MEDICARE COST REPORT. THIS APPROACH ALLOCATES COST FROM NON REVENUE PRODUCING DEPARTMENTS TO THE REVENUE GENERATING DEPARTMENTS, BASED ON STEP DOWN STATISTICAL COST FINDING. WHILE NOT AS COMPREHENSIVE AS A TRUE COST ACCOUNTING SYSTEM, THIS PROCESS RESULTS IN AN ACCEPTABLE BASIS OF THE DEPARTMENTAL COST FOR PROVIDING SERVICES. RECALL THAT PRIOR TO MEDICARE PROSPECTIVE PAYMENT SYSTEM (PPS), THIS METHODOLOGY WAS THE BASIS FOR THE REIMBURSEMENT TO HOSPITALS. PART III, LINE 9B: COLLECTION ACTIONS INVOLVING UNINSURED PATIENTS. KHS (KISHHEALTH SYSTEM, PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL) SHALL NOT PURSUE A COLLECTION ACTION AGAINST AN UNINSURED PATIENT, UNLESS THE PATIENT HAS BEEN GIVEN THE OPPORTUNITY TO ASSESS THE ACCURACY OF THE BILL; APPLY FOR FINANCIAL ASSISTANCE UNDER THE KHS FINANCIAL ASSISTANCE POLICY AND PROCEDURE; AND AVAIL HIMSELF OR HERSELF OF A REASONABLE PAYMENT PLAN. NOTWITHSTANDING THIS, KHS MAY NOT PURSUE THE COLLECTION ACTION UNDER THE FOLLOWING CIRCUMSTANCES: (A) IF THE PATIENT HAS INDICATED AN INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT, UNTIL KHS HAS OFFERED THE PATIENT A PAYMENT PLAN. KHS MAY REQUIRE THE PATIENT TO PROVIDE REASONABLE VERIFICATION OF HIS OR HER INABILITY TO PAY THE FULL AMOUNT OF THE DEBT IN ONE PAYMENT.(B) IF KHS HAS REASON TO BELIEVE THE PATIENT MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE, UNTIL KHS HAS GIVEN THE PATIENT AT LEAST 60 DAYS FOLLOWING THE DATE OF DISCHARGE OR RECEIPT OF OUTPATIENT CARE TO SUBMIT AN APPLICATION FOR FINANCIAL ASSISTANCE. (C) IF THE PATIENT HAS AGREED TO A PAYMENT PLAN, UNTIL THE PATIENT HAS FAILED TO MAKE PAYMENTS IN ACCORDANCE WITH THAT PAYMENT PLAN. (D) IF THE PATIENT INFORMS KHS THAT HE OR SHE HAS APPLIED FOR HEALTH CARE COVERAGE UNDER MEDICAID, KIDCARE, OR OTHER GOVERNMENT-SPONSORED HEALTH CARE PROGRAM (AND THERE IS A REASONABLE BASIS TO BELIEVE THAT THE PATIENT WILL QUALIFY FOR SUCH PROGRAM), BUT THE PATIENT'S APPLICATION IS DENIED. PART VI, LINE 2: KISHWAUKEE COMMUNITY HOSPITAL IDENTIFIES COMMUNITY HEALTH NEEDS IN SEVERAL WAYS:* DEKALB COUNTY HEALTH DEPARTMENT I-PLAN* COMMUNITY HEALTH NEEDS SURVEY* U.S. GOVERNMENT HEALTHY PEOPLE 2010 AND 2010 GUIDELINES* INTERNAL REVIEW OF OUTPATIENT AND INPATIENT TRENDS, ESPECIALLY EMERGENCY DEPARTMENT USAGE * INPUT FROM OTHER COMMUNITY PROVIDERS. THIS INCLUDES PROVIDING HOSPITAL LEADERS TO SERVE ON BOARDS AND COMMITTEES THAT DIRECTLY OR INDIRECTLY IMPACT COMMUNITY HEALTH OR HELP THE HOSPITAL CONNECT TO UNDERSERVED OR VULNERABLE POPULATIONS. PART VI, LINE 3: INFORMATION IS PROVIDED AT REGISTRATION, VIA THE HOSPITAL WEBSITE, THROUGH CONSULTATIONS WITH FINANCIAL COUNSELORS FOR SOME ED AND OUTPATIENTS AS WELL AS INPATIENTS, DURING THE BILLING PROCESS ON STATEMENTS AND VIA PHONE CONVERSATIONS. PART VI, LINE 4: KISHWAUKEE COMMUNITY HOSPITAL SERVES ALL OF DEKALB COUNTY, IL, AND BORDER COMMUNITIES IN KANE AND OGLE COUNTIES. POPULATION OF THE HOSPITAL'S SERVICE AREA, BASED ON 2010 CENSUS, IS 131,782. THIS GEOGRAPHIC AREA INCLUDES A GROWING HISPANIC POPULATION. A UNIQUE POPULATION IN OUR SERVICE AREA IS NORTHERN ILLINOIS UNIVERSITY STUDENTS (23,850 FALL 2010 ENROLLMENT), INCLUDING FOREIGN STUDENTS AND VISITORS. THE HISPANIC POPULATION IS EXPECTED TO GROW BY 22.62% BY 2016. ACCORDING TO THE AMERICAN COMMUNITY SURVEY, 29.5% OF FAMILIES AND 42.7% OF INDIVIDUALS ARE BELOW THE POVERTY LEVEL BASED ON POPULATION AND HOUSING DATA FROM 2005-2009. PART VI, LINE 6: KISHWAUKEE COMMUNITY HOSPITAL IN DEKALB, IL, IS PART OF KISHHEALTH SYSTEM. THE HEALTH SYSTEM IS GOVERNED BY AN APPOINTED VOLUNTEER BOARD OF DIRECTORS, INDEPENDENT COMMUNITY LEADERS WHO RESIDE IN THE PRIMARY MARKETS SERVED BY THE HEALTH SYSTEM'S TWO HOSPITALS. THESE INDIVIDUALS ARE SELECTED FOR THE BOARD BECAUSE OF THEIR INTEREST AND EXPERTISE IN VARIOUS AREAS THAT CAN HELP MANAGEMENT CARRY OUT THE HEALTH SYSTEM'S MISSION. MEMBERS OF THE BOARD ARE NOT COMPENSATED FOR THEIR TIME. THE MEDICAL STAFF IS OPEN TO PHYSICIANS WHO MEET CRITERIA ESTABLISHED BY THE MEDICAL STAFF BYLAWS. PHYSICIANS ARE GIVEN AND TAKE THE OPPORTUNITY TO VOLUNTEER TO DO FREE COMMUNITY WELLNESS PROGRAMS ON HEALTH TOPICS. SURPLUS FUNDS GO BACK INTO THE ORGANIZATION TO SUPPORT OPERATIONS, CAPITAL IMPROVEMENTS, THE HEALTH SYSTEM'S COMMITMENT TO EXCELLENCE, EDUCATION AND INNOVATION, AND TO PROVIDE MEDICAL CARE TO ALL REGARDLESS OF ABILITY TO PAY. A COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED IN THE FALL OF 2009, VIA A RANDOM TELEPHONE SURVEY. OUR COMMUNITY WELLNESS DEPARTMENT USED THE FINDINGS AS ONE COMPONENT OF ITS DECISION TO EMBARK ON A MULTI-YEAR INITIATIVE TO ADDRESS THE PREVALENCE OF OBESITY AMONG CHILDREN AND ADULTS IN OUR COMMUNITIES. (SEE SCHEDULE O OF THIS REPORT FOR DETAILS ABOUT COMMUNITY WELLNESS ACTIVITIES FOR FY 11). DURING FY 11, KISHHEALTH SYSTEM'S OUTPATIENT BEHAVIORAL HEALTH SERVICES WERE EXPANDED BY ADDING SERVICES AT VALLEY WEST COMMUNITY HOSPITAL IN SANDWICH AND MOVING TO A LARGER OFFICE SUITE IN SYCAMORE. THERE WERE MORE THAN 3,700 BEHAVIORAL HEALTH PATIENT VISITS, A 44% INCREASE OVER THE PREVIOUS YEAR. AT THE SYCAMORE LOCATION, ONE OF THE CENTERS TWO PSYCHIATRISTS EXPANDED OFFICE HOURS, BILINGUAL EMPLOYEE ASSISTANCE PROGRAM SERVICES WERE ADDED, AND SPECIALIZED SERVICES FOR CHILDREN WERE EXPANDED.FOR THE SECOND YEAR, THE HOSPITAL ALSO MADE A $25,000 GRANT TO THE COMMUNITY MENTAL HEALTH CENTER (BEN GORDON CENTER) TO HELP THE AGENCY BETTER MEET THE NEEDS OF THE MEDICAID AND UNINSURED POPULATION.THE HEALTH SYSTEM PLAYS A CRITICAL ROLE IN FINANCING AND MANAGING THE COMMUNITY CARES CLINIC, WHICH PROVIDES PRIMARY CARE TO THE UNINSURED AND UNDERINSURED, BOTH CHILDREN AND ADULTS. IN 2009, THE HEALTH SYSTEM PLEDGED $650,000 OVER THREE YEARS FOR THE OPERATION AND MANAGEMENT OF THE CLINIC. THE CLINIC IS A PARTNERSHIP AMONG KISHHEALTH SYSTEM, NORTHERN ILLINOIS UNIVERSITY AND PRIVATE DONORS, OVER THE PAST TWO YEARS, THE CLINIC HAS SEEN 4,136 PATIENTS AND HAD 11,658 VISITS. IT HAS PROVIDED HEALTHCARE FOR 804 PATIENTS WITHOUT INSURANCE AND FOR 1,866 CHILDREN ON PUBLIC AID FOR WHOM ACCESS TO CARE WAS PREVIOUSLY VERY LIMITED. DUE TO STATE FUNDING CUTS, THE CLINIC TOOK OVER THE RESPONSIBILITY OF PUBLIC AID WELL-CHILD VISITS PREVIOUSLY HANDLED BY THE DEKALB COUNTY HEALTH DEPARTMENT. PART VI, LINE 7: KISHHEALTH SYSTEM MADE $120,000 IN CONTRIBUTIONS TO SEVERAL ORGANIZATIONS IN FY11, NOTABLY A $50,000 GRANT TO DEKALB COUNTY GOVERNMENT FOR A FIBER OPTIC PROJECT THAT IS ESTABLISHING BROADBAND CONNECTIVITY THROUGHOUT DEKALB COUNTY. THIS PROJECT IS ENABLING HIGH SPEED ELECTRONIC COMMUNICATION TO RURAL AREAS AND TO COMMUNITY INSTITUTIONS SUCH AS SCHOOLS, LOCAL GOVERNMENT, LIBRARIES AND THE TWO KISHHEALTH SYSTEM HOSPITALS IN THE COUNTY. OTHER GRANTS WERE MADE TO THE KISHWAUKEE (COMMUNITY COLLEGE) COLLEGE FOUNDATION TO SUPPORT AN ENDOWMENT FOR SCHOLARSHIPS IN HEALTH-RELATED FIELDS. OTHER MONETARY GIFTS SUPPORTED THE ECONOMIC HEALTH OF COMMUNITIES SERVED, SUCH AS DOWNTOWN DEKALB RENEWAL AND OTHER DEKALB COUNTY ECONOMIC DEVELOPMENT EFFORTS. HEALTH SYSTEM LEADERS SERVED ON NUMEROUS COMMUNITY BOARDS AND COMMITTEES, MOST NOTABLY THE COMMUNITY CARES CLINIC, VOLUNTARY ACTION CENTER, FAMILY SERVICE AGENCY, FOX VALLEY OLDER ADULT SERVICES, KISHWAUKEE UNITED WAY, AND KISHWAUKEE FAMILY YMCA, DEKALB COUNTY ECONOMIC DEVELOPMENT CORPORATION AND THE PLANO ECONOMIC DEVELOPMENT. IN ADDITION, HEALTH SYSTEM EMPLOYEES CONTRIBUTED MORE THAN 1,300 HOURS OF IN-KIND SERVICE TO COMMUNITY ORGANIZATIONS, EDUCATIONAL INSTITUTIONS AND OTHER ACTIVITIES THAT PROMOTE HEALTH, EDUCATION AND QUALITY OF LIFE. OTHER NON-PROFIT HEALTH SYSTEM ENTITIES THAT PROMOTE THE HEALTH OF THE COMMUNITY ARE VALLEY WEST COMMUNITY HOSPITAL, A CRITICAL ACCESS HOSPITAL IN SANDWICH, IL; COMMUNITY CARES CLINIC, DEKALB, IL, A PRIMARY CARE CLINIC FOR MEDICAID AND UNINSURED; DEKALB COUNTY HOSPICE, DEKALB, IL, WHICH PROVIDES FREE CARE AND SUPPORT FOR THE TERMINALLY ILL AS WELL AS GRIEF SUPPORT TO THE PUBLIC; AND KISHHEALTH FOUNDATION IN DEKALB, IL, WHICH RAISES MONEY FOR KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE AND THE COMMUNITY CARES CLINIC. REPORTS FILED WITH STATES PART VI, LINE 7 IL 1 AMERICAN CANCER SOCIETY - FOX VALLEY REGION 143 FIRST STREET BATAVIA IL 60510 131788491 501(C)(3) 10000 TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO CANCER RESEARCH AND TREATMENT AMERICAN HEART ASSOCIATION MIDWEST AFFILIATE PO BOX 4002902 DES MOINES IA 50340 135613797 501(C)(3) 20000 TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO HEART HEALTH RESEARCH AND TREATMENT KISHWAUKEE COLLEGE FOUNDATION 21193 MALTA ROAD MALTA IL 60150 237433949 501(C)(3) 18200 TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO HEALTH EDUCATION NORTHERN PUBLIC RADIO 801 N FIRST STREET DEKALB IL 60115 366086819 501(C)(3) 8517 TO PROVIDE CORPORATE SUPPORT OF PUBLIC RADIO FAMILY SERVICE AGENCY 14 HEALTH SERVICES DRIVE DEKALB IL 60115 362360012 501(C)(3) 24000 TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO FAMILY HEALTH SERVICES DEKALB CHAMBER OF COMMERCE 164 E LINCOLN HWY DEKALB IL 60115 360981630 501(C)(3) 7000 TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO COMMUNITY SERVICES DEKALB COUNTY YOUTH SERVICE BUREAU 330 GROVE STREET DEKALB IL 60115 363034427 501(C)(3) 5000 TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO YOUTH SERVICES KISHWAUKEE UNITED WAY PO BOX 311 115 N FIRST ST DEKALB IL 60115 366158489 501(C)(3) 11976 TO PROVIDE FINANCIAL ASSISTANCE FOR ACTIVITIES RELATED TO COMMUNITY SERVICES KISHHEALTH FOUNDATION ONE KISH HOSPITAL DRIVE DEKALB IL 60115 363649077 501(C)(3) 855839 TO PROVIDE FOR HEALTH SYSTEM ENDOWMENT KISHWAUKEE COMMUNITY HOSPITAL AUXILIARY SCHOLARSHIP PROGRAM 11 23400 PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: THE ORGANIZATION MAINTAINS SPECIFIC POLICIES AND QUALIFICATIONS FOR ALL GRANTS AVAILABLE. APPLICANTS MUST APPLY FOR THE RESPECTIVE GRANT AND BE APPROVED BY THE FUNDS GOVERNING BOARD. THE USE OF THE FUNDS IS MONITORED BY THE GOVERNING BOARD OF KISHWAUKEE COMMUNITY HOSPITAL. REQUESTS FOR FINANCIAL ASSISTANCE FROM OTHER CHARITABLE ORGANIZATIONS ARE REVIEWED AND APPROVED BY THE VP - FINANCE OF KISHHEALTH SYSTEM. IF NECESSARY DUE TO THE DOLLAR AMOUNT OF THE REQUEST, THESE ITEMS MAY ALSO BE PRESENTED TO THE BOARD OF DIRECTORS. A BUDGET IS SET ANNUALLY FOR CHARITABLE ASSISTANCE TO OTHER ORGANIZATIONS 1 X X X X 0 1 0 0 0 0 0 0 0 KEVIN POORTEN 0 493308 0 175161 0 250000 0 79288 0 21089 0 1018846 0 250000 LOREN FOELSKE 0 248671 0 54917 0 0 0 19288 0 20275 0 343151 0 0 BRAD COPPLE 0 267332 0 74025 0 0 0 19288 0 20523 0 381168 0 0 PAM DUFFY 0 190811 0 43878 0 0 0 18566 0 7930 0 261185 0 0 JOE DANT 0 210725 0 47861 0 0 0 19288 0 20211 0 298085 0 0 MIKE KOKOTT 0 165989 0 27914 0 0 0 15303 0 7669 0 216875 0 0 ROGER HEATH BELL 0 168475 0 48366 0 0 0 17393 0 20052 0 254286 0 0 DR MICHAEL KULISZ 0 204758 0 0 0 0 0 0 0 20414 0 225172 0 0 MARK THATE 0 145067 0 34336 0 0 0 14318 0 13529 0 207250 0 0 THOMAS W TILTON DO 366224 0 90798 0 0 0 19288 0 20505 0 496815 0 0 0 RON C LUBCKE 124569 0 10145 0 0 0 10790 0 7552 0 153056 0 0 0 KENYA M WILLIAMS MD 214490 0 27521 0 0 0 19288 0 4666 0 265965 0 0 0 JASMEET DHALIWAL 253957 0 223146 0 0 0 0 0 20326 0 497429 0 0 0 ANJU VOHRA 158138 0 0 0 0 0 12452 0 7601 0 178191 0 0 0 PART I, LINE 4B THE ORGANIZATION'S CEO PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. CONTRIBUTIONS FOR CALENDAR YEAR 2010 WERE $60,000. DURING 2010, THE CEO TOOK A DISTRIBUTION FROM THE DEFERRED COMPENSATION PLAN IN THE AMOUNT OF $250,000. THIS DISTRIBUTION IS INCLUDED IN W-2 WAGES, HOWEVER THE ACCRUAL OF THE DEFERRED COMPENSATION PAYMENTS HAS ALSO BEEN INCLUDED AS "OTHER COMPENSATION" ON PRIOR YEAR FORM 990S. CITY OF SYCAMORE DEKALB COUNTY ILLINOIS HEALTH FACILITIES REVENUE BOND 861091967 452032AJ4 2008-08-01 63685000 CONSTRUCTION OF NEW FACILITY FOR KISHWAUKEE COMMUNITY HOSPITAL 1 1 0 63371994 328434 2007 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 KISHHEALTH FOUNDATION BROTHER/SISTER ORGANIZATIONS 855839 CASH ASSISTANCE TO SUPPORT HEALTH SERVICES AND BUILD ENDOWMENT KISHHEALTH SYSTEM COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, KHS IS PARENT ORGANIZATION OF KCH 11135722 KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL. THE PURPOSE OF KHS IS TO PROVIDE MANAGEMENT AND SUPPORT SERVICES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH PROVIDE HEALTHCARE SERVICES. FEES PAID TO KHS ARE IN EXCHANGE FOR THESE SERVICES, INCLUDING THE ORGANIZATIONS SHARE OF COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. 0 KISHHEALTH SYSTEM COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, KHS IS PARENT ORGANIZATION OF KCH 1880000 DURING THE CURRENT YEAR, KISHWAUKEE COMMUNITY HOSPITAL ALSO MADE A AN EQUITY DISTRIBUTION BACK TO ITS PARENT ORGANIZATION. 0 KISHHEALTH FOUNDATION COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE 1026644 KISHHEALTH FOUNDATION WAS ORGANIZED TO SUPPORT CHARITABLE HEALTHCARE ORGANIZATIONS. THE FOUNDATION ANNUALLY MAKES CONTRIBUTIONS TO KISHWAUKEE COMMUNITY HOSPITAL. 0 DEKALB COUNTY HOSPICE COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE 302107 DEKALB COUNTY HOSPICE (DCH) IS AN AFFILIATE OF KISHWAUKEE COMMUNITY HOSPITAL (SAME PARENT CORPORATION). KCH IS UTILIZED BY DEKALB COUNTY HOSPICE FOR MEDICAL TREATMENTS AND SUPPLIES. 0 DEKALB COUNTY HOSPICE COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE 47736 KISHWAUKEE COMMUNITY HOSPITAL (KCH) IS AN AFFILIATE OF DEKALB COUNTY HOSPICE (SAME PARENT CORPORATION). DEKALB COUNTY HOSPICE RENTS SPACE IN THE BUILDING OWNED BY KCH. 0 KISHHEALTH FOUNDATION COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE 262472 KISHWHEALTH FOUNDATION UTILIZES EMPLOYEES OF KISHWAUKEE COMMUNITY HOSPITAL. EMPLOYEES ARE LEASED FROM KISHWAUKEE COMMUNITY HOSPTIAL. 0 HEALTH PROGRESS INC COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE 8576 KISHWAUKEE COMMUNITY HOSPITAL PROVIDES FOR HOUSEKEEPING SERVICES UTILIZED BY HEALTH PROGRESS, INC. 0 VALLEY WEST COMMUNITY HOSPITAL COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE 3917755 KISHWAUKEE COMMUNITY HOSPITAL ROUTINELY SELLS SUPPLIES AND SERVICES TO VALLEY WEST COMMUNITY HOSPITAL AS PART OF ITS DAY-TO-DAY BUSINESS. 0 COMMUNITY CARES CLINIC INC COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, BROTHER/SISTER AFFILIATE 276491 KISHWAUKEE COMMUNITY HOSPITAL PROVIDES MEDICAL SERVICES AND STAFF TO THE CLINIC. FEES PAID TO KCH ARE IN EXCHANGE FOR THESE SERVICES. 0 FORM 990, PART VI, SECTION A, LINE 2 KEVIN POORTEN AND LOREN FOELSKE ARE BOTH EMPLOYEES OF KISHHEALTH SYSTEM, THE PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL. MR. POORTEN IS PRESIDENT AND CEO OF KISHWHEALTH SYSTEM AND SERVES AS AN EX-OFFICIO DIRECTOR FOR ALL ORGANIZATIONS RELATED TO KISHHEALTH SYSTEM. MR. FOELSKE SERVES AS THE VICE-PRESIDENT - FINANCE OF KISHHEALTH SYSTEM, WHICH IS THE PARENT ORGANIZATION FOR ALL RELATED ENTITIES. MICHAEL MOONEY AND MICHAEL CULLEN ARE MEMBERS OF THE KISHWAUKEE COMMUNITY HOSPITAL BOARD OF DIRECTORS. THEY ALSO SERVE ON THE BOARD OF DIRECTORS OF KISHHEALTH SYSTEM, THE PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL. THE FOLLOWING INDIVIDUALS ARE OFFICERS OR KEY EMPLOYEES OF KISHHEALTH SYSTEM AND ARE ALSO CONSIDERED OFFICERS OR KEY EMPLOYEES OF KISHWAUKEE COMMUNITY HOSPITAL. THEY ARE ALL COMPENSATED BY KISHHEALTH SYSTEM: BRAD COPPLE, PRESIDENT KCH & VWCH PAM DUFFY, VP PATIENT CARE JOE DANT, VP DEVELOPMENT MIKE KOKOTT, ASST. VP MARKETING HEATH BELL, VP AND CHIEF INFORMATION OFFICER MARK THATE, VP HUMAN RESOURCES DR. MICHAEL KULISZ, CHIEF MEDICAL OFFICER FORM 990, PART VI, SECTION A, LINE 6 KISHHEALTH SYSTEM IS THE SOLE MEMBER OF KISHWAUKEE COMMUNITY HOSPITAL. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER AND PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL, KISHHEALTH SYSTEM HAS THE RIGHT TO APPROVE THE ELECTION OF MEMBERS OF THE HOSPITAL'S GOVERNING BOARD, PER THE HOSPITAL'S BYLAWS. FORM 990, PART VI, SECTION A, LINE 7B KISHHEALTH SYSTEM (KHS) SERVES AS THE SOLE MEMBER AND PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL (VWCH). PER THE BYLAWS, WITH RESPECT TO THE GOVERNANCE OF VWCH, THE FOLLOWING POWERS SHALL BE RESERVED TO THE SOLE CORPORATE MEMBER. PER THE BYLAWS, WITH RESPECT TO THE GOVERNANCE OF KCH, THE FOLLOWING POWERS SHALL BE RESERVED TO THE SOLE CORPORATE MEMBER: A. ELECTING THE MEMBERS OF THE KCH BOARD; B. APPROVING, EVALUATING AND/OR REMOVING THE PRESIDENT AND CEO AND REVIEWING AND APPROVING THE EMPLOYMENT CONTRACT OF THE PRESIDENT AND CEO AND ESTABLISHING COMPENSATION FOR SUCH OFFICE; C. APPROVING THE STRATEGIC PLAN FOR KCH; D. APPROVING THE DISPOSITION OF ANY ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS FOR KCH; E. APPROVING ANY CHANGE IN MEMBERSHIP OF KCH; F. APPROVING THE ADOPTION OF AND AMENDMENTS TO THE ORGANIZATIONAL DOCUMENTS, INCLUDING THE ARTICLES OF INCORPORATION AND BYLAWS OF KCH; G. APPROVING A PLAN OF MERGER OR A PLAN OF CONSOLIDATION OF KCH OR ESTABLISHING A NEW SUBSIDIARY OR SISTER ENTITY; H. APPROVING A PLAN FOR THE DISTRIBUTION OF THE ASSETS OF KCH; I. INITIATING, TAKING ANY AND ALL ACTIONS, AND EXERCISING ALL APPROVAL RIGHTS OF THE DIRECTORS PURSUANT TO THE APPLICABLE MEDICAL STAFF BYLAWS; J. IMPLEMENTING AND MONITORING KCH OPERATIONAL QUALITY IMPROVEMENT POLICIES AND PROGRAMS; K. ACCEPTING GIFTS, GRANTS, BEQUESTS AND DONATIONS ON BEHALF OF KCH; L. APPROVAL OF THE ANNUAL OPERATING AND CAPITAL BUDGETS FOR KCH; M. EXERCISING ANY RIGHTS THAT KCH HAS AS A SHAREHOLDER OR MEMBER OF ANY SUBSIDIARY ENTITY; N. APPROVING ANY AFFILIATIONS OF KCH; O. APPROVING AND/OR DETERMINING (I) THE CREATION OF NEW HEALTH SERVICES TO BE PROVIDED AND THE LOCATION OF SUCH HEALTH SERVICES AND (II) THE DISCONTINUANCE OF ANY HEALTH SERVICE; P. AUTHORIZING THE SALE, LEASE, EXCHANGE OR MORTGAGE OF ALL OR SUBSTANTIALLY ALL OF THE PROPERTY OR ASSETS OF KCH; Q. AUTHORIZING THE VOLUNTARY DISSOLUTION OF KCH, OR REVOKING THE PROCEEDINGS THEREOF; R. REQUIRING MINUTES OF MEETINGS, FINANCIAL RECORDS, AND SUCH OTHER INFORMATION AS MAY BE NECESSARY TO PROPERLY EVALUATE THE PERFORMANCE OF KCH; S. INITIATING ACTION TO REMOVE OR REINSTATE A DIRECTOR WHEN, IN THE OPINION OF THE KHS BOARD, IT IS IN THE BEST INTERESTS OF KHS OR KCH. ANY ACTION TO REMOVE OR REINSTATE SHALL REQUIRE A MAJORITY VOTE OF THOSE KHS DIRECTORS THEN IN OFFICE PRESENT AND VOTING AT A MEETING OF THE KHS BOARD AT WHICH A QUORUM IS PRESENT. IN ANY ACTION(S) TO REMOVE TAKEN BY THE KHS BOARD, THE DIRECTOR IN QUESTION SHALL BE ADVISED AT LEAST TWENTY (20) DAYS PRIOR TO THE MEETING THAT THE ACTION WILL BE CONSIDERED AND SHALL BE GIVEN THE OPPORTUNITY TO MAKE A STATEMENT, PRESENT WITNESSES ON HIS/HER BEHALF AND QUESTION THOSE PRESENTING REASONS FOR HIS/HER REMOVAL. ALL ACTIONS TO REMOVE SHALL BE TAKEN IN CLOSED SESSIONS OF THE KHS BOARD; AND T. TRANSFERRING MONEY OR PROPERTY AMONG KCH, KHS AND/OR ONE OR MORE SUBSIDIARY CORPORATIONS AND TRANSFERRING MONEY OR PROPERTY FROM A SUBSIDIARY CORPORATION, INCLUDING REQUIRING THE DIRECTORS, OFFICERS, OR TRUSTEES OF ANY SUBSIDIARY CORPORATION TO TRANSFER MONEY OR OTHER PROPERTY TO KHS. SUBJECT TO THE POWERS OF THE BOARD OF DIRECTORS OF EACH SUBSIDIARY CORPORATION, THE KHS BOARD MAY INITIATE AND TAKE THE FOREGOING ACTIONS ON BEHALF OF KHS AND THE SUBSIDIARY CORPORATIONS. FORM 990, PART VI, SECTION B, LINE 11 A DRAFT COPY OF FORM 990 IS PROVIDED TO THE GOVERNING BODY (BOARD OF DIRECTORS) AND THE GOVERANCE COMMITTEE FOR REVIEW BY THE RETURN PREPARER PRIOR TO FILING. THE ORGANIZATION'S CEO, CFO, AND OTHER MEMBERS OF THE ACCOUNTING DEPARTMENT ARE ALSO PROVIDED A COPY OF THE RETURN FOR THEIR REVIEW. THE CHAIR OF THE AUDIT COMMITTEE AND THE AUDIT COMMITTEE MEMBERS ARE ALSO PROVIDED DRAFT COPIES AND REVIEW. IF CHANGES ARE NECESSARY, THEY ARE REPORTED TO THE RETURN PREPARER AND INCORPORATED INTO THE FINAL RETURN. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST ARE INVESTIGATED BY APPOINTED MEMBERS OF THE GOVERANCE COMMITTEE ON AN ONGOING BASIS. IF IT IS DETERMINED THAT AN INDIVIDUAL FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE INDIVIDUAL OF SUCH A BELIEF AND AFFORD HIM AN OPPORTUNITY TO EXPLAIN. AFTER SAID EXPLANATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION AS DEEMED NECESSARY. THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD ANNUALLY AND UPDATED AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15 THROUGH THE OVERSIGHT OF THE BOARD OF DIRECTORS EXECUTIVE COMPENSATION COMMITTEE, THE KISHHEALTH SYSTEM EXECUTIVE TOTAL COMPENSATION PROGRAM WILL BE COMPETITIVELY POSITIONED IN THE MARKET PLACE OF RELEVANT ORGANIZATIONS AND FALL WITHIN THE SAFE HARBOR GUIDELINES ESTABLISHED BY THE INTERMEDIATE SANCTIONS RULES. THE EXECUTIVE COMPENSATION COMMITTEE IS MADE UP OF THREE MEMBERS OF THE BOARD OF DIRECTORS WHO MEET THE BOARD APPROVED DEFINITION OF "INDEPENDENT DIRECTORS". ANNUALLY THE EXECUTIVE COMPENSATION COMMITTEE CONTRACTS WITH SULLIVAN, COTTER AND ASSOCIATES, AN INDEPENDENT HUMAN RESOURCES CONSULTING FIRM TO PROVIDE THE COMMITTEE ANALYSIS AND COMPARABILITY DATA. USING THE SUPPLIED DATA THE COMPENSATION COMMITTEE APPROVES EACH EXECUTIVE'S TOTAL CASH COMPENSATION AND PROVIDES CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. TOTAL CASH COMPENSATION IS DEFINED AS THE SUM OF BASE SALARIES PLUS INCENTIVE AWARDS. BASED ON THE COMPARABILITY DATA AND THE PERFORMANCE OF EACH EXECUTIVE IN MEETING GOALS AND STRATEGIC OBJECTIVES, THE EXECUTIVE COMPENSATION COMMITTEE APPROVES INCREASES AND INCENTIVE AWARDS FOR EACH EXECUTIVE WITHIN THE GUIDELINES ESTABLISHED. THE EXECUTIVE COMPENSATION COMMITTEE REPORTS ON ALL COMPENSATION MATTERS TO THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN WRITING TO ADMINISTRATION. DESCRIPTION OF HOURS FOR RELATED ORGANIZATIONS FORM 990, PART VII, COLUMN (B) AVERAGE HOURS PER WEEK FOR THE INDIVIDUALS IDENTIFIED AS OFFICER'S ARE ESTIMATES OF THE INDIVIDUALS TOTAL TIME PER WEEK UTILIZED FOR WORK RELATED TO KISHWAUKEE COMMUNITY HOSPITAL. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED GAINS ON INVESTMENTS: 7,085,798. EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM -1,880,000. CHANGE OF INTEREST IN NET ASSETS OF KISHHEALTH FOUNDATION -100,514. BOOK/TAX DIFFERENCES IN K-1 PASSTHROUGH ENTITIES -101,198. GRANT REVENUE INCLUDED IN FIXED ASSETS FOR FINANCIAL STATEMENT PURPOSES -30,659. TOTAL TO FORM 990, PART XI, LINE 5: 4,973,427. RESPONSIBILITY FOR OVERSIGHT OF FINANCIAL STATEMENTS FORM 990, PART XI, LINE 2C NO CHANGES IN THIS PROCESS WERE MADE DURING THE TAX YEAR. THE ORGANIZATION MAINTAINS AN INDEPENDENT AUDIT COMMITTEE WHICH IS RESPONSIBLE FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS. THIS COMMITTEE IS ALSO RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT AUDITOR. MEMBERS OF THE AUDIT COMMITTEE ARE ALSO MEMBERS OF THE KISHHEALTH SYSTEM BOARD OF DIRECTORS. KISHHEALTH SYSTEM ONE KISH HOSPITAL DRIVE DEKALB IL 60115 363649080 PARENT ORGANIZATION OF 501(C)(3) HEALTH SYSTEM IL 501(C)(3) 11B N/A 0 VALLEY WEST COMMUNITY HOSPITAL ONE KISH HOSPITAL DRIVE DEKALB IL 60115 364244337 HEALTHCARE SERVICES, PRIMARILY ACUTE CARE IL 501(C)(3) 3 N/A 0 DEKALB COUNTY HOSPICE 2727 SYCAMORE ROAD 1B DEKALB IL 60115 363164329 HEALTHCARE SERVICES, HOSPICE SERVICES IL 501(C)(3) 7 N/A 0 KISHHEALTH FOUNDATION ONE KISH HOSPITAL DRIVE DEKALB IL 60115 363649077 SUPPORT OF KISHWAUKEE HEALTH SYSTEM NOT FOR PROFIT ENTITIES IL 501(C)(3) 7 N/A 0 COMMUNITY CARES CLINIC 3100 SYCAMORE ROAD DEKALB IL 60115 800424001 HEALTHCARE SERVICES, PRIMARY CARE IL 501(C)(3) 3 0 H-R EYE INSTITUTE 2240 GATEWAY DRIVE SYCAMORE IL 60178 HEALTHCARE SERVICES IL 501(C)(3) 3 N/A 0 KISHWAUKEE AREA PHO ONE KISH HOSPITAL DRIVE DEKALB IL 60115 364205273 MEDICARE SERVICES IL RELATED -24246 15399 0 0 0.50000 THE MIDLAND SURGICAL CENTER LLC 3085 WOLF COURT DEKALB IL 60115 352194610 SURGICAL SERVICES IL RELATED 618461 1242703 0 0 0.77500 HEALTH PROGRESS INC ONE KISH HOSPITAL DRIVE DEKALB IL 60115 363824138 INVESTMENT IN HEALTHCARE RELATED SMALL BUSINESS IL N/A C 0 1 1 0 0 0 0 0 1 0 0 0 0 1 1 1 1 1