2011-10-25T16:27:03-00:00 2010-12-31 PriceWaterhouseCoopers LLP 2001 Market St Ste 1700 Philadelphia PA 19103 990 2010-01-01 363197918 Rockford Memorial Development Foundation ROCK 8159714141 2400 N Rockton Ave Rockford IL 61103 Henry M Seybold Jr 2011-10-20 true Matthew Petroski 2673303000 2010 2016-03-07 17:11:31Z Gary Kaatz President CEO 2400 N Rockton Ave Rockford IL 61103 112818240 false X www.rhsnet.org X 1982 IL To support the operations of all entities of Rockford Health System & provide assistance to these other 501(c)(3) non-profit organizations by receiving, maintaining, and administering funds received from the public and other available sources to further the exempt purposes of these organizations. To support the operations of all entities of Rockford Health System provide assistance to these other 501c3 non-profit organizations by receiving, maintaining, and administering funds received from the public and other available sources to further the exempt purposes of these organizations. 17 12 0 195 0 1295533 1427149 0 16378997 4151869 158354 152142 17832884 5731160 1990984 1064883 0 520137 528426 0 406940 723159 763524 3234280 2356833 14598604 3374327 99272833 108988211 916090 859071 98356743 108129140 The mission of Rockford Health System RHS is Superior Care. Everyday. For All Our Patients. Rockford Memorial Development Foundation RMDF assists this mission specifically by applying resources to the vision of RHS which is To fulfill this Committment through Performance Excellence, Lifelong Learning, and Innovation. false false 870771 98984 Restricted gifts and endowments at Rockford Health System help departments fund equipment, facilities projects and care and comfort items to benefit patients and their families. In 2010, endowment proceeds supported education and training opportunities for RHS employees to help them enhance the care they provide to patients. Additionally, the Foundation provided significant support for the renovation of the Emergency Department at Rockford Memorial Hospital. These expenditures are just a few examples of what was funded with restricted gifts and endowments in 2010. 202229 The Rockford Health System employee Family Giving Campaign raised funds in 2010 for three uses an Employee Crisis Fund, the Wishbook catalogue of care and comfort items, and the Employee Education Fund. The crisis fund provides assistance to employees who have experienced a crisis such as a fire or flood in their homes or the severe illness, traumatic injury or death of a spouse or child. The Wishbook provides small items for care-giving departments throughout Rockford Health System. The Employee Education Fund expands opportunities for employees to attend training and skills development seminars. RMDF donations were also used to assist Visiting Nurses Association to care for the elderly, the homebound, the recovering, and the dying. In 2010 some specific donations were also made for hospice care. 105853 Through charitable contributions, RMDF supports the Ronald McDonald Care Mobile, staffed and operated by RMH, which provides free medical and dental care to uninsured and underinsured children in five counties at 12 different sites in Northern Illinois. The Care Mobile visits included vaccinations, lead and/or blood screenings, medical diagnoses, preventative and restorative dental care and treatment/care to avoid an emergency room visit. RMDF donations from the Auxiliary provided some of the Care Mobile funding as well as funds for supplies and education materials for the pediatric and pediatric intensive care units, health and wellness resources for patients, nursing scholarships for minority students, the Healing Harp program that creates an atmosphere of care and comfort for hospitalized patients, a video program in both English and Spanish that helps parents provide care for their newborn babies, and other support for the system. 1178853 true true false false false false false true true true false false true true true false true false false false false false false true false false true false true false false false false false false false false false false false false false true true true false false true 17 0 true 0 false false false false false true true false false false false false false false X 17 12 false false false false true true true true true false false true true true true true true true true false IL X David E Vola Controller 8159715000 2400 N Rockton Ave Rockford IL 61103 X Carol Armstrong 001.00 X 0 0 0 Marc LBarbeau 001.00 X 0 0 0 John J Holevas 000.10 X 0 0 0 W Walter Boothe 001.00 X 0 0 0 Julie Bosma 002.00 X 0 0 0 John Van Landingham 000.10 X 0 0 0 Paul AGreen 001.00 X 0 0 0 Hollis AHanson 000.50 X 0 0 0 Linda Heckert 000.50 X 0 0 0 Phillip ADHiggins 001.00 X 0 441067 94389 Gary EKaatz 003.00 X X 0 969051 150705 Scott KLaue 002.00 X X 0 0 0 John JMorrissey 000.70 X 0 0 0 Jay Maddox 001.00 X 0 0 0 Jeffrey RSmith 001.00 X X 0 385943 98022 Dennis TUehara 000.40 X 0 412499 70487 Mark DZarnke 002.00 X 0 134810 0 Helen Brooks 040.00 X 188164 0 32601 Henry MSeybold 000.30 X 0 439582 59187 Vicki Woodhouse 040.00 X 41821 0 9261 229985 2782952 514652 1 false true false NA 1 48146 190000 1189003 1427149 1409585 1409585 109669904 106927620 2742284 2742284 2742284 311500 48146 159460 152040 152040 Miscellaneous 900099 102 102 102 5731160 4304011 1064883 1064883 0 0 0 271846 54369 54369 163108 0 170092 34018 34018 102056 30875 6175 6175 18525 45418 9084 9084 27250 10195 2039 2039 6117 60000 60000 0 6519 6519 0 552360 552360 6007 6007 7505 824 5445 1236 92380 4083 5973 82324 3084 771 1542 771 0 3297 3297 1990 398 1194 398 0 2900 2900 0 0 678 678 0 Food 14729 2209 7365 5155 Other Purchased Services 12075 12075 0 2356833 1178853 771040 406940 1595850 31933 4207760 1215235 768258 653864 72 4491 153405 149674 3748 3731 82446482 96946793 10250735 10132092 99272833 108988211 866844 797820 49246 61251 916090 859071 X 84920362 93493455 8625461 9269834 4810920 5365851 98356743 108129140 99272833 108988211 X 3374327 6398070 X false true X false X X X X false false false Rockford Memorial Hospital 362167847 3 true true true 0 Visiting Nurses Assn 362167945 9 true true true 0 Rockford Health Physicians 363907436 3 true true true 0 3 0.00000 0.00000 0.00000 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false 88668632 1738649 9948265 1064883 985990 552801 97751872 72939613 1572227 17349427 1990984 724771 476880 88668632 99000446 2008929 -25700856 1309396 491317 568193 72939613 0.03160 0.00360 0.96480 false false 60859 60859 83301 83301 9245 5514 3731 3731 Restricted Endowment Funds Interest in Beneficial Trust 10032586 Life Insurance and others 61251 Due from RMH/RHPH/RHS Employee Rec-Supplemental Survivor Premium 38255 10132092 Life Insurance Value 50445 Capital Accumulation Account 10304 CAA Fas 124 Valuation 502 61251 5731160 2356833 3374327 4683841 1714228 6398069 9772396 10022101 4683841 159460 4843301 5178800 552360 552360 5731160 1451228 159460 159460 1291768 552360 512705 1065065 2356833 V 4 - Funds were used to provide for a lecture series for continuing education for employees to improve their credentials or to focus on a new skill or technology not currently available in the Rockford community and for miscellaneous projects according to the wishes of RMDF. All funds were expended per the specific direction of each endowment. XI 8 -The change in Net Assets during the year include transfers from permanently restricted net assets 512,705 reduction in pledges receivables -75,000 chg in UPMIFA valuation 10,834 chg in unexpended restricted funds 159,897 mkt value chg in endowed funds 415,585 and mkt value change in externally managed restricted funds 690,207. XII 2d -159,460 is the amount of direct expenses for Special Events XII 4a -552,360 is the amount of investment fees included on Part VIII line 12 XIII 2d -159,460 is the amount of direct expenses for Special Events XIII 4a -552,360 is the amount of investment fees included on Part IX line 25 XIII 4b -512,705 is the amount of restricted funds transferrred and expended Gala 286707 48146 238561 120175 Golf 44179 44179 4272 18001 2366 1 28760 28760 14646 359646 48146 311500 4272 18001 137187 159460 152040 true Rockford Health Council 1601 Parkview Ave Rockford IL 61107 363229371 501c3 20000 Other Community Program MCHC Service Corporation PO Box 95468 Chicago IL 606945468 362167008 13500 Other Community Poison Control March of Dimes Foundation 5411 E State Rockford IL 61108 131846366 501c3 10000 Other Community Event St Elizabeth Center 1536 S Main St Rockford IL 61102 362171737 501c3 5000 Other Capital Project 3 1 X true true X X X X true true false false false false false true false false Phillip ADHiggins 308858 130435 1774 69786 24602 535455 25356 Gary EKaatz 552287 304971 111792 124719 25986 1119755 76766 Jeffrey RSmith 346680 38632 630 83157 14865 483964 27536 Dennis TUehara 387409 23543 1548 53266 17220 482986 Helen Brooks 151614 35929 621 16075 16526 220765 5870 Henry MSeybold 316687 115387 7509 47878 11310 498771 25145 I 1a - By policy Membership to the YWCA 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 is prorated for personal vs business use and that percentage is added to taxable wages. The organization also pays for half of a social club membership for the Executive Director. If personal use exceeds business use, the additional prorated cost is added to taxable wages. I 4a - A future increase in severance this year for Gary Kaatz was 7,971 by contract. I 7a - 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 Gary Kaatz 93,816 Henry Seybold 29,736 and Helen Brooks 6,200. I 7a - 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. I 3 - Compensation for executives is governed by the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for all executives from all related entities including RMDF. This Board has established a Compensation Committee to establish and review all executive compensation annually based on the established philosophy. An independent external executive compensation firm provides consulting on RHS including RMDF salary ranges and compensation philosophy. The appropriate peer group for compensation comparison purposes is other not-for-profit healthcare systems similar in size and complexity. RHS generally conducts an analysis of total compensation every three years but may choose to vary from this schedule as determined by the Compensation Committee. The RMDF board of directors concedes the authority to set compensation to RHS as the sole corporate member. Form 990 Part VI 6,7 a-b - Rockford Health System RHS is the sole corporate member of the Foundation and has the authority to elect members to the board and ultimately has the authority to approve or deny all RMDF board actions. Form 990 Part IV 11a - The data was gathered by the accounting staff with input from RMDF and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RHS 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 RMDF Board of Directors before filing. Form 990 Part VI 12 - RHS Compliance Department acting on behalf of RMDF 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 actions are taken as a result of the review. Employees are given the policy and a statement to complete at the beginning of the year or as a new party is hired or joins the RMDF board. Form 990 Part VI 15a - Compensation for executives is governed by the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for executives from related entities including RMDF. This Board has established a Compensation Committee to establish and review all executive compensation annually based on the established philosophy. An independent external executive compensation firm provides consulting on RHS including RMDF salary ranges and compensation philosophy. The appropriate peer group for compensation comparison purposes is other not-for-profit healthcare systems similar in size and complexity. RHS generally conducts an analysis of total compensation every three years but may vary from this schedule as directed by the Compensation Committee. The RMDF board concedes the authority to set compensation to RHS, 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 Board Secretary. Form 990 Part VII 1 - Some members of the board were compensated by related organizations for other duties as follows Mark Zarnke Independent surgeon who provides Emergency Trauma coverage and a Medical Staff director was compensated by RMH Phillip Higgins 60 hrs Medical Director OB-GYN and active physician, Jeffery Smith 56 hrs Medical Director-General Medicine and active physician, and Dennis Uehara 51.7 hrs Chair of Emergency Department and active physician were compensated by RHPH Rockford Health Physicians Gary Kaatz as President and CEO also worked an additional 40 hrs. and Henry Seybold an additional 45.6 hrs as CFO Sr VP of Finance they spent most of their time and received compensation for those duties in support of the other related entities RMH/RHPH/RHS/VNA. Form 990 Part XI 5 The change in fund balances for permanent and temporarily restricted net asset was 1,199,303 the transfer from Restricted Funds was 512,705 and the transfer to restricted net assets was 2,221 and the unrealized gains on investments was 4,683,841 Rockford Memorial Hospital 2400 N Rockton Ave Rockford IL 61103 362167847 Healthcare IL 501c3 3 Rockford Health System true 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 true Visiting Nurses Assn of the Rockford Area 2400 N Rockton Ave Rockford IL 61103 362167945 Healthcare IL 501c3 9 Rockford Health System true Van Matre Rehab Center LLC 3660 Grandview Birmingham AL 35243 364397130 Healthcare IL NA NA false false Rockford Health Insurance LTD Wellesley House So 2nd Flr 90 Pitts Pembrooke HM BD 08 Insurance BD NA C Corp false true true false false false false false false false false false false true true false true false Rockford Memorial Hospital b 745824 Financial Analysis Visiting Nurses Association b 108456 Financial Analysis Rockford Memorial Hospital c 190000 Payment Rockford Memorial Hospital n 381123 Financial Analysis Rockford Memorial Hospital o 247661 Financial Analysis