NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWESTERN MEMORIAL HEALTHCARE (EIN 36-2338884)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-10
- IRS object ID
- 201731309349303358
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-10T15:12:35-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 191 West Nationwide Blvd Ste 500 | AddressLine1Txt |
| City | Columbus | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 432152568 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362338884 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Northern Illinois Medical Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DAVID TOMLINSON | InCareOfNm |
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 8157885800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4201 MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | MCHENRY | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60050 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID TOMLINSON | PersonNm |
| Person Title | EVP & CFO | PersonTitleTxt |
| Phone | 8157885800 | PhoneNum |
| Signature | 2017-05-08 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Mollie P Longhouse 51017 | PreparerPersonNm |
| PTIN | P00294881 | PTIN |
| Phone | 6142492300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL S EESLEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 385 MILLENNIUM DRIVE | AddressLine1Txt |
| City | CRYSTAL LAKE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60012 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $335,437,385 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CENTEGRA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1956 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTH CARE SERVICES WITH INNOVATIVE AND RESPONSIBLE USE OF RESOURCES AND PROMOTE WELLNESS FOR THE MCHENRY COUNTY AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 1642 | TotalEmployeeCnt |
| Total Volunteers | 330 | TotalVolunteersCnt |
| Total Gross UBI | $489,979 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$26,368 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,089 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,203,544 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $256,904,977 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $306,454,803 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12,272,162 | PYInvestmentIncomeAmt |
| CY Investment Income | $435,156 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,503,826 | PYOtherRevenueAmt |
| CY Other Revenue | $6,478,019 | CYOtherRevenueAmt |
| PY Total Revenue | $276,690,054 | PYTotalRevenueAmt |
| CY Total Revenue | $315,571,522 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $92,540,073 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $103,512,761 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $151,438,802 | PYOtherExpensesAmt |
| CY Other Expenses | $196,199,789 | CYOtherExpensesAmt |
| PY Total Expenses | $243,978,875 | PYTotalExpensesAmt |
| CY Total Expenses | $299,712,550 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $32,711,179 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $15,858,972 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $297,525,658 | TotalAssetsBOYAmt |
| Total Assets EOY | $467,395,773 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $124,325,097 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $288,241,982 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $173,200,561 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $179,153,791 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The primary mission of Northern Illinois Medical Center is to provide quality health care services with innovative and responsible use of resources and promote wellness for the greater McHenry County area. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $271,026,745 | ExpenseAmt |
| Revenue | $306,711,465 | RevenueAmt |
| Desc | See Schedule O | Desc |
| Total Program Service Expenses | $271,026,745 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 1642 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID TOMLINSON | PersonNm |
| Phone | 8157885800 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 385 MILLENNIUM DRIVE | AddressLine1Txt |
| City | CRYSTAL LAKE | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60012 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| MICHAEL S EESLEY | |||||||||
| CEO | 0.0 | 40.0 | Yes (X) | Yes (X) | $0 | $1,567,554 | $141,514 | ||
| CHARIE ZANCK | |||||||||
| DIRECTOR | 0.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| CHARLES RUTH | |||||||||
| DIRECTOR | 0.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| CHRIS NEWKIRK | |||||||||
| DIRECTOR | 0.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| JACK PORTER | |||||||||
| DIRECTOR | 0.0 | 1.0 | Yes (X) | $0 | $0 | $0 | |||
| KATHY POWELL | |||||||||
| DIRECTOR | 0.0 | 5.0 | Yes (X) | $0 | $0 | $0 | |||
| LUKE JOHNSOS | |||||||||
| DIRECTOR | 0.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL LUECHT | |||||||||
| TREASURER | 0.0 | 4.0 | Yes (X) | $0 | $0 | $0 | |||
| MIKE CURRAN | |||||||||
| CHAIRMAN | 0.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| PATRICK MOREHEAD | |||||||||
| DIRECTOR | 0.0 | 4.0 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD LIND MD | |||||||||
| DIRECTOR | 0.0 | 1.0 | Yes (X) | $0 | $293,680 | $14,812 | |||
| TERRENCE J BUGNO | |||||||||
| DIRECTOR | 0.0 | 4.0 | Yes (X) | $0 | $0 | $0 | |||
| TOM CAREY | |||||||||
| VICE CHAIRMAN | 0.0 | 3.0 | Yes (X) | $0 | $0 | $0 | |||
| LISA GLOSSON MD | |||||||||
| DIRECTOR | 0.0 | 40.0 | Yes (X) | $0 | $244,619 | $18,633 | |||
| WILLIAM BUSSE | |||||||||
| DIRECTOR | 0.0 | 2.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVE DOMEK | |||||||||
| DIRECTOR | 0.0 | 3.0 | Yes (X) | $0 | $0 | $0 | |||
| IRFAN HAFIZ MD | |||||||||
| SECRETARY | 0.0 | 40.0 | Yes (X) | $0 | $411,021 | $21,551 | |||
| DAVID TOMLINSON | |||||||||
| EVP/ CFO | 0.0 | 40.0 | Yes (X) | $0 | $603,938 | $60,723 | |||
| JASON R SCIARRO | |||||||||
| PRESIDENT / COO | 0.0 | 40.0 | Yes (X) | $0 | $978,327 | $91,729 | |||
| RACHEL SEBASTIAN | |||||||||
| VP SITE ADMINISTRATOR | 40.0 | 0.0 | $407,919 | $0 | $43,300 | Yes (X) | |||
| JOSEPH MCMAHON | |||||||||
| CHIEF MEDICAL PHYSICIST | 40.0 | 0.0 | $213,619 | $0 | $11,247 | Yes (X) | |||
| CONNIE K SECOR | |||||||||
| DIRECTOR SURGERY | 40.0 | 0.0 | $212,980 | $0 | $5,597 | Yes (X) | |||
| JOHN G GEINOPOLOS | |||||||||
| MEDICAL PHYSICIST | 40.0 | 0.0 | $181,494 | $0 | $23,998 | Yes (X) | |||
| PANG CHONG | |||||||||
| MANAGER PHARMACY | 40.0 | 0.0 | $149,255 | $0 | $20,018 | Yes (X) | |||
| JIGISHA DESAI | |||||||||
| CLINICAL STAFF PHARMACIST | 40.0 | 0.0 | $146,825 | $0 | $10,577 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,312,092 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,099,139 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $463,699 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 67 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDLINE INDUSTRIES | |||||
| ONE MEDLINE PLACE | MUNDELEIN | IL | 60060 | HOSPITAL SUPPLIES | $5,988,204 |
| SODEXO INC AFFILIATES | |||||
| 4880 PAYSHERE CIRCLE | CHICAGO | IL | 60674 | MANAGEMENT SERVICES | $3,401,950 |
| GE HEALTHCARE | |||||
| 101 CARNIEGIE CENTER | PRINCETON | NJ | 08540 | EQUIPMENT SERVICES | $2,607,400 |
| PRECYSE SOLUTIONS LLC | |||||
| 1275 DRUMMERS LANE STE 200 | WAYNE | PA | 19087 | CODING SERVICES | $1,721,988 |
| OBHG ILLINOIS SC | |||||
| 10 CENTIMETERS DRIVE | MAULDIN | SC | 29662 | OB/GYN SERVICES | $1,497,900 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 33 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $2,077,913 | RelatedOrganizationsAmt |
| Government Grants | $125,631 | GovernmentGrantsAmt |
| Total Contributions | $2,203,544 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ANCILLARY OUTPATIENT SERVICES | 621110 | $208,562,334 | $208,562,334 |
| ROUTINE PATIENT SERVICES | 621110 | $90,211,713 | $90,211,713 |
| ANCILLARY INPATIENT SERVICES | 621110 | $12,890,196 | $12,890,196 |
| IDPA PROVIDER TAX REVENUE | 621110 | $11,070,155 | $11,070,155 |
| CHARITY CARE/ADMIN ALLOWANCE | 621110 | -$16,279,595 | -$16,279,595 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $306,454,803 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,702,693 | TotalRevenueColumnAmt |
| Exclusion | $4,702,693 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55 | TotalRevenueColumnAmt |
| Exclusion | $55 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $15,598,271 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $19,865,863 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$4,267,592 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$4,267,592 | TotalRevenueColumnAmt |
| Exclusion | -$4,267,592 | ExclusionAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|---|---|
| CAFETERIA SERVICES/EDUCATION | 900099 | $1,046,610 | $1,046,610 | ||
| CHILD DAY CARE /RETAIL PHARMACY/LACTATION | 624410 | $3,163,757 | $2,673,778 | $489,979 | |
| RELATED COMPANY REVENUE | 900099 | $256,662 | $256,662 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,010,990 | TotalRevenueColumnAmt |
| Exclusion | $2,010,990 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,478,019 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $315,571,522 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $306,711,465 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $489,979 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,166,534 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $536,637 | TotalAmt |
| Management And General | $536,637 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,257,384 | TotalAmt |
| Program Services | $72,357,596 | ProgramServicesAmt |
| Management And General | $9,899,788 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,753,375 | TotalAmt |
| Program Services | $1,542,354 | ProgramServicesAmt |
| Management And General | $211,021 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,257,860 | TotalAmt |
| Program Services | $11,662,258 | ProgramServicesAmt |
| Management And General | $1,595,602 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,707,505 | TotalAmt |
| Program Services | $5,020,599 | ProgramServicesAmt |
| Management And General | $686,906 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $834,957 | TotalAmt |
| Management And General | $834,957 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,848 | TotalAmt |
| Management And General | $41,848 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,564,599 | TotalAmt |
| Program Services | $10,586,838 | ProgramServicesAmt |
| Management And General | $1,977,761 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $748,454 | TotalAmt |
| Program Services | $28,336 | ProgramServicesAmt |
| Management And General | $720,118 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,603,141 | TotalAmt |
| Program Services | $53,856,720 | ProgramServicesAmt |
| Management And General | $746,421 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,030 | TotalAmt |
| Program Services | $21,759 | ProgramServicesAmt |
| Management And General | $5,271 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,307,358 | TotalAmt |
| Program Services | $4,301,735 | ProgramServicesAmt |
| Management And General | $1,005,623 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,206 | TotalAmt |
| Program Services | $172,232 | ProgramServicesAmt |
| Management And General | $32,974 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,076 | TotalAmt |
| Program Services | $102,018 | ProgramServicesAmt |
| Management And General | $26,058 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,809,187 | TotalAmt |
| Program Services | $3,350,746 | ProgramServicesAmt |
| Management And General | $458,441 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,709,944 | TotalAmt |
| Program Services | $8,541,340 | ProgramServicesAmt |
| Management And General | $1,168,604 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,302,356 | TotalAmt |
| Program Services | $2,904,913 | ProgramServicesAmt |
| Management And General | $397,443 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| RELATED COMPANY - CHS | $55,408,369 | $48,739,896 | $6,668,473 |
| BAD DEBT | $10,958,038 | $10,958,038 | |
| IDPA PROVIDER TAX | $7,419,667 | $7,419,667 | |
| RELATED COMPANY - LAB | $3,703,151 | $3,703,151 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,428,408 | TotalAmt |
| Program Services | $25,756,549 | ProgramServicesAmt |
| Management And General | $1,671,859 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $299,712,550 | TotalAmt |
| Program Services | $271,026,745 | ProgramServicesAmt |
| Management And General | $28,685,805 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,682 | BOYAmt |
| EOY | $361,489 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,913,819 | BOYAmt |
| EOY | $54,487,610 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,334,050 | BOYAmt |
| EOY | $52,442,254 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,001,456 | BOYAmt |
| EOY | $5,814,528 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,071,362 | BOYAmt |
| EOY | $1,355,287 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $223,578,016 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $156,112,776 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,100,943 | BOYAmt |
| EOY | $67,465,240 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,840,363 | BOYAmt |
| EOY | $255,593,364 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,953,557 | BOYAmt |
| EOY | $7,343,646 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,013 | BOYAmt |
| EOY | $17 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,238,413 | BOYAmt |
| EOY | $22,532,338 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,525,658 | BOYAmt |
| EOY | $467,395,773 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,926,914 | BOYAmt |
| EOY | $183,985,481 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,880,611 | BOYAmt |
| EOY | $101,246,418 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,517,572 | BOYAmt |
| EOY | $3,010,083 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,325,097 | BOYAmt |
| EOY | $288,241,982 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,453,765 | BOYAmt |
| EOY | $174,870,526 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,746,796 | BOYAmt |
| EOY | $4,283,265 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,200,561 | BOYAmt |
| EOY | $179,153,791 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,525,658 | BOYAmt |
| EOY | $467,395,773 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $15,858,972 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,512,270 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$7,393,472 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $41,484 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $41,484 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Description of Lobbying Activities | FormAndLineReferenceDesc |
| Explanation | Form Sch C Part II-B Line 1i As part of our dues payments to the Illinois Hospital Association, American Hospital Association and Metropolitan Chicago Healthcare Council, approximately 37.3% of dues, on average, are allocable to lobbying activities. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $65,000 | OtherCostOrOtherBasisAmt |
| Book Value | $65,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $86,489,944 | OtherCostOrOtherBasisAmt |
| Depreciation | $45,536,537 | DepreciationAmt |
| Book Value | $40,953,407 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,309,414 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,789,939 | DepreciationAmt |
| Book Value | $519,475 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $128,827,779 | OtherCostOrOtherBasisAmt |
| Depreciation | $108,758,230 | DepreciationAmt |
| Book Value | $20,069,549 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,885,879 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,070 | DepreciationAmt |
| Book Value | $5,857,809 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $67,465,240 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROFESSIONAL LIABILITY | Desc |
| Amt | $3,010,083 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,010,083 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form Sch D Part X Line 2 | FormAndLineReferenceDesc |
| Explanation | ASC Topic 740, Income Taxes, addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded on the consolidated financial statements. Under ASC Topic 740, the Health System must recgonize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financials statements from such a position are measured based on the largest benefit that has the greater than fifty percent likelihood of being realized upon ultimate settlement. ASC Topic 740 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. As of June 30, 2016 and 2015 the Health System does not have a liability for unrecognized tax benefits. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,355,757 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $2,355,757 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00790 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $28,683,226 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,016,632 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $5,666,594 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.01900 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $31,038,983 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,016,632 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,022,351 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02690 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 24 | ActivitiesOrProgramsCnt |
| Persons Served | 2076 | PersonsServedCnt |
| Total Community Benefit Expns | $384,616 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $384,616 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 8 | ActivitiesOrProgramsCnt |
| Persons Served | 57 | PersonsServedCnt |
| Total Community Benefit Expns | $392,040 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $800 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $391,240 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00130 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 32 | ActivitiesOrProgramsCnt |
| Persons Served | 2133 | PersonsServedCnt |
| Total Community Benefit Expns | $776,656 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $800 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $775,856 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00260 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 32 | ActivitiesOrProgramsCnt |
| Persons Served | 2133 | PersonsServedCnt |
| Total Community Benefit Expns | $31,815,639 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $23,017,432 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $8,798,207 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.02950 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $10,958,037 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $4,074,694 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $98,072,293 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $113,245,441 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$15,173,148 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
Management Co And Jnt Ventures ManagementCoAndJntVenturesGrp (2 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Org Profit Or OwnershipOrgProfitOrOwnershipPct |
|---|---|
| ALGON RD SURGERT CTR | |
| OUTPATIENT SURGICAL SERVICES | 0.1275 |
| ARSC REAL ESTATE | |
| PROPERTY MANAGEMENT | 0.25 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN ILLINOIS MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4201 MEDICAL CENTER DRIVE | AddressLine1Txt |
| City | MCHENRY | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60050 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
| Other | CANCER CENTER | OtherDesc |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHERN ILLINOIS MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| CHNA Conducted | 14 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | WWW.CENTEGRA.ORG | OwnWebsiteURLTxt |
| Other Website | Yes (X) | OtherWebsiteInd |
| Other Website URL | WWW.CO.MCHENRY.IL.US | OtherWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 14 | ImplementationStrategyAdptYr |
| Strategy Posted Website | false | StrategyPostedWebsiteInd |
| Strategy Attached | Yes (true) | StrategyAttachedInd |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200. | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 600. | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Other Criteria | Yes (X) | OtherCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | WWW.CENTEGRA.ORG | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | WWW.CENTEGRA.ORG | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | WWW.CENTEGRA.ORG | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| FAP Notice Displayed | Yes (X) | FAPNoticeDisplayedInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| FAP Notified Upon Admission | Yes (X) | FAPNotifiedUponAdmissionInd |
| FAP Notified Before Discharge | Yes (X) | FAPNotifiedBeforeDischargeInd |
| FAP Notified All Patients | Yes (X) | FAPNotifiedAllPatientsInd |
| Documented Elig Determination | Yes (X) | DocumentedEligDeterminationInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Other Method Used | Yes (X) | OtherMethodUsedInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Account Input from Person who represent the community | Form Sch H Part V Line 5 The McHenry County CHNA was conducted in partnership with a variety of community organizations, including the McHenry Country Department of Health. These organizations have extensive knowledge of the community and its constituents, and shared that input during the CHNA process. Community Survey A description of community issues and problems based on a sample of McHenry County residents. The survey was conducted online with the link widely broadcast by partner organizations, and supplemented by a paper version disseminated at numerous events and locations. Survey respondents numbered 744 with a 60/40 split between online and paper respondents. Questions in the survey covered: *Community features *Financial issues *Health status - perception of health and prevalence of diseases and conditions (physical and mental) *Access to care *Health insurance status *Abuse, suicide, care of other persons Key Informants Interviews with 21 community leaders, agency directors, and other people considered experts in their field based on professional expertise, knowledge of local human services system or position of influence. As selected by the partners, many key informants or their predecessors at their organizations had been interviewed for the 2010 study. Interview questions focused on community assets, challenges, target groups in need of services, and perception of strengths and weaknesses of health and human services delivery. Key informants were interviewed by four volunteer interviewers, recorded, and transcribed by Health Systems Research staff. |
| CHNA conducted with other hosiptal facilities | Form Sch H Part V Line 6a THE CHNA WAS CONDUCTED WITH THE FOLLOWING HOSPITALS: Advocate Good Shepherd Hospital and Advocate Sherman Hospital |
| CHNA conducted with other facilities | Form Sch H Part V Line 6b THE CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS: McHenry County Department of Health, Family Alliance Inc., McHenry County College, McHenry County Community Foundation, McHenry County Mental Health Board, Pioneer Center for Human Services, Senior Services Associates, Inc., United Way of Greater McHenry County, Woodstock Consolidated Unit School District 200. |
| HOW THE HOSPITAL IS ADDRESSING NEEDS AND NEEDS NOT ADDRESSED | Form Sch H Part V Line 11 The ways in which Centegra Health System is addressing the significant needs identified in its most recently conducted CHNA are thoroughly described in the attached implementation strategy. There are certain needs identified in the CHNA that are not being addressed by Centegra Health System. These needs include areas of which Centegra Health System has no expertise, and fall outside the scope of care in which Centegra Health System provides to the community. Several of Centegra Health System's CHNA partner organizations are addressing these needs. |
| Income Level Other than FPG | Form Sch H Part V Line 13b In addition to the documented 200% of FPG, we also provide a sliding scale discount of 80% for those who have FPG up to 350%. In addition we have presumption charity which allows for charity discounts/financial assistance to those who currently meet Medicaid eligibility or other state programs based on FPG who may not have had insurance coverage at the time of the service we provided. |
| Other Factors used in determining amounts charged patients | Form Sch H Part V Line 13h All patients are charged the same for services rendered. Patients may qualify for free or discounted care as described in Part VI, Line 3. Eligibility for financial assistance depends on factors such as income level, asset level and medical indigency. |
| Other Billing determination of individuals without insurance | SCHEDULE H, PART V, LINE 22D SEE PART VI SUPPLEMENTAL INFORMATION FOR BILLING AND COLLECTION POLICIES REGARDING PERSONS ELIGIBLE FOR FINANCIAL ASSISTANCE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 21 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (21 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| Crystal Lake Medical Arts Imaging Center | ||||
| 360 Station Drive Suite 150 | Crystal Lake | IL | 60014 | Medical Imaging Center |
| Gavers Breast Center | ||||
| 360 N Terra Cotta Road | Crystal Lake | IL | 60012 | Medical Imaging and Breast Care Center |
| NIMC Rehab & Sports Medicine Clinic | ||||
| 200 Congress Parkway | Crystal Lake | IL | 60014 | Sports Medicine and Rehabilitation Clinic |
| NIMC Neuro-Rehabilitation Center | ||||
| 500 Coventry Lane | Crystal Lake | IL | 60014 | Neurotrauma Day Treatment Center |
| NIMC Rehab & Sports Medicine Clinic | ||||
| 2507 N Richmond Road | McHenry | IL | 60050 | Physical Rehabilitation Clinic |
| Centegra Health Center - Huntley | ||||
| 10350 Haligus Road | Huntley | IL | 60142 | Anticoagulation Clinic, Medical Imaging, and Bariatric Center |
| Centegra Home Health Care | ||||
| 213 North Front Street Suite 2 | McHenry | IL | 60050 | Home Health Care |
| Centegra Home Medical Equipment | ||||
| 213 Front Street Suite 2 | McHenry | IL | 60050 | Medical Equipment |
| Centegra Home Medical Equipment | ||||
| 1118 North Main Street | Algonquin | IL | 60102 | Medical Equipment |
| Centegra Milestone Therapy | ||||
| 394 Federal Drive | Crystal Lake | IL | 60014 | Therapy |
| Centegra Physician Care - Fox Lake | ||||
| 248 E Grand Avenue | Fox Lake | IL | 60020 | Physician Care |
| Centegra Physician Care - Fox Valley | ||||
| 650 Dakota Street Suite A | Crystal Lake | IL | 60012 | Physician Care |
| Centegra Physician Care - Fox Valley | ||||
| 1465 Commerce Drive | Algonquin | IL | 60102 | Physician Care |
| Centegra Physician Care - Neurology | ||||
| 750 E Terra Cotta Avenue | Crystal Lake | IL | 60014 | Physician Care |
| Centegra Physician Care - Spring Grove | ||||
| 1906 Holian Drive | Spring Grove | IL | 60081 | Physician Care |
| Centegra Physician Care - Surgical Assoc | ||||
| 690 E Terra Cotta Avenue Suite A | Crystal Lake | IL | 60014 | Physician Care |
| Centegra Physician Care - Gavers | ||||
| 360 N Terra Cotta Avenue Suite A | Crystal Lake | IL | 60014 | Physician Care |
| Centegra Physician Care - Woodstock | ||||
| 3707 Doty Road Suites C D E G | Woodstock | IL | 60098 | Physician Care |
| Centegra Rehab & Sports Med Cl - McHenry | ||||
| 333 Front Street | McHenry | IL | 60050 | Sports Rehabilitation Medicine |
| Centegra Rehab & Sport Md Cl - Woodstock | ||||
| 201 N Throop Street | Woodstock | IL | 60098 | Sports Rehabilitation Medicine |
| Centegra Rehab & Sports Med Cl - Huntley | ||||
| 10450 Algonquin Road | Huntley | IL | 60142 | Sports Rehabilitation Medicine |
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Financial Assistance and Community Benefits | Form Sch H Part I Line 7 Line 7a - 7c dollars are calculated using the Medicare cost to charge ratio. Line 7e-7i dollars are calculated from community benefit reports that are submitted by the Hospital departments for various activities and support groups that benefit the community. |
| Methodology Used to Estimate Bad Debt Expense | Form Sch H Part III Line 2 In estimating allowances for doubtful accounts, the Health System analyzes past history, existing trends, and payer sources to determine the reserves needed. |
| Methodology of Est Amount & Rational For Including in Community Benefit | Form Sch H Part III Line 3 The estimated amount of bad debt expense which could be reasonably attributable to patients who would likely qualify for financial assistance under the organization's charity care policy if sufficient information had been available to make a determination of their eligibility was based on the self pay patient accounts which were written off as bad debts. Any payments received during the fiscal year on these accounts were deducted from the expense. The amount of expense that exceeds reimbursement is actual expense to treat patients and is therefore treated as a community benefit. |
| Bad Debt Expense | Form Sch H Part III Line 4 In estimating allowances for doubtful accounts, the Health System analyzes past history, existing trends, and payer sources to determine the reserves needed. Please referenece pages 13-14 of the audited financial statements for notes on the allowances for doubtful accounts. |
| Explanation of Shortfall as Community Benefit | Form Sch H Part III Line 8 The amount of cost that exceeds reimbursement is actual cost to treat patients and is therefore treated as a community benefit. |
| Provisions on collection practices for qualified patients | FORM SCH H PART III LINE 9B Centegra provides patients with consistent information on payment expectations and assists them in meeting their financial obligations. A written explanation of the payment requirements categorized by type of payor is given prior to admission/registration or upon admission/registration of each Centegra Health System (CHS) patient. Centegra will bill the patient's insurance carrier. Procedures will be implemented over time and by area to collect as much as possible of the time of service unless payor contracts require billing (i.e., no assignments). 1. Admission reservation/outpatient appointment made by physician/patient. Walk-in and Emergency Department patients present for service. 2. Perform the patient pre-registration for applicable scheduled registrations. 3. Patient verbal consent obtained and annotated except where prohibited by law. ""On (date) at about (time), (patient or representative) orally authorized (Site Name) to release information concerning the patient's medical care, treatment and diagnosis to employers, insurance companies, government agencies or third-party payors and their agents, for verification of benefits and pre-certification. I (the Pre-Registrar) did not obtain a written consent signed by the patient, due to the patient not being physically present and limited time constraints."" This statement would be signed and dated by the Pre-Registrar. Patient refusal to provide oral consent requires patient notification of potential penalties and places the burden on the patient to complete payor requirements. 4. Complete insurance verification and initiate pre-certification. 5. Estimate the approximate cost of services and advise the responsible party. Explanation of the cost will fluctuate based on services ordered by the physicians. 6. Discuss the financial requirements, including payment expectations with the patient/guarantor prior to admission/registration when applicable. 7. Interview conducted by Financial Counselor of patients who express difficulty in meeting Centegra's payment requirements. 8. Admission/registration of patient is completed. Patient/guarantor signature for the Consent to Release Information obtained. 9. Collect the estimated patient share. The deductible and co-payments and any non-covered amounts quoted by the carrier are due from inpatients prior to discharge and where possible, for outpatients prior to or at the time of registration. 10. Self-Pay accounts are to be paid in full or screened by the Financial Counselor for potential State or Federal Program, Financial Assistance application or payment plan. 11. Policy regarding non-compliance with respect to payment arrangements or plans: Self-Pay: Patients who have not completed arrangements for one of the payment options within 120 days of the billing date will be automatically turned over to a collection agency. Broken Promise/Defaults: Patients with delinquent payments, 15 or more days late, will be turned over to a collection agency. After Insurance: Processing patients who have not made payments or enrolled in one of the payment options for co-insurance and deductible amounts within 120 days of insurance payment will be turned over to a collection agency. |
| Needs Assessment | Schedule H, Part VI, Line 2 CENTEGRA HEALTH SYSTEM IDENTIFIES COMMUNITY HEALTH CARE PRIORITIES AND DEVELOPS ACTIVITIES AND STRATEGIES TO MEET THE HEALTH CARE NEEDS OF AT RISK POPULATIONS WITHIN ITS SERVICE AREA. THESE COMMUNITY BENEFIT PROGRAMS PROMOTE COMMUNITY WELLNESS AND DISEASE PREVENTION, ENHANCE COMMUNITY HEALTH EDUCATION, AND IMPROVE THE QUALITY OF CLINICAL EDUCATION. IN 2013, CENTEGRA HEALTH SYSTEM PARTNERED WITH THE MCHENRY COUNTY HEALTH DEPARTMENT, UNITED WAY OF MCHENRY COUNTY AND OTHER HOSPITALS AND ORGANIZATIONS TO CONDUCT THE 2014 MCHENRY COUNTY HEALTHY COMMUNITY STUDY. THE INTENT OF THE NEEDS ASSESSMENT WAS TO UNDERSTAND AND ADDRESS THE COUNTY'S MOST PRESSING NEEDS, INVOLVING PARTNERS FROM DIVERSE ORGANIZATIONS, IN ORDER TO IMPROVE THE HEALTH OF COUNTY RESIDENTS. A THOROUGH UNDERSTANDING OF THE COUNTY'S HEALTH WAS MEASURED USING FOUR ASSESSMENTS, EACH FROM A DIFFERENT PERSPECTIVE INCLUDING RESIDENTS, POPULATIONS IN NEED OF SERVICES, COMMUNITY LEADERS, AND DESCRIPTORS USING SECONDARY DATA SOURCES. THROUGH THE ASSESSMENTS, KNOWLEDGE WAS GAINED ABOUT THE CURRENT HEALTH STATUS OF COUNTY RESIDENTS, DEMOGRAPHIC TRENDS, SOCIAL AND ECONOMIC INDICATORS, HEALTH BEHAVIORS, AND UTILIZATION OF HEALTH SERVICES. THE ASSESSMENTS ALSO ATTEMPTED TO UNDERSTAND THE PERCEPTIONS OF COMMUNITY STRENGTHS AND WEAKNESSES AS WELL AS ANSWER QUESTIONS ABOUT THE HEALTH AND HUMAN SERVICES DELIVERY SYSTEM, UNMET NEEDS, GAPS, AND BARRIERS TO CARE. |
| Patient Education of Eligibility of Assistance | Schedule H, Part VI, Line 3 Uninsured patients arriving at our emergency department and/or direct admits are screened at time of service by either an Emergency Department Financial Counselor or the Health System's In-Patient Financial Counseling Team, Public Aid Representatives, and a Medication Assistance Coordinator to identify eligibility guidelines for federal, state and local government programs, as well as charity care. CHS's Self Pay Process includes a screening which is completed by using hospital form C910050 03-09 prompting an interview offering payment options and eligibility guidelines. It is at this time that a patient becomes aware of the Hospital Uninsured Patient Discount Act, Medicaid, Medication Assistance Programs, Crime Victims, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of timeline for completing application processes at time of service in person. Appropriate scripting is followed by CHS Associates. Discounts were established following the 200%, 350% and 600% federal poverty guidelines to assist in determining charity adjustments. Applications were designed by CHS Self Pay Committee in accordance to our Financial Policy (Policy Number 9850-2) identifying qualifications for the medically needy/catastrophic aid. Uninsured patients opting for elective services are contacted by phone prior to their date of service by the CHS Outpatient Financial Counseling Team. CHS's Self Pay Process is followed and includes a screening for federal, state and local government programs as well as charity care. An interview offering payment options and eligibility guidelines using hospital form C910050 03/09 prompts a quick eligibility determination. It is at this time that a patient becomes aware of the Uninsured Patient Discount Act, Medicaid, Medication Assistance Programs, Crime Victims, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of time line for completing application processes prior to their elective services via phone. Appropriate scripting is followed by CHS Associates. Discounts were established following the 200%, 350% and 600% federal poverty guidelines to assist in determining charity adjustments. Applications were designed by CHS Self Pay Committee in accordance to our Financial Policy (Policy Number 9850-2) identifying qualifications for the medically needy/catastrophic aid. Our health system's website offers FAQ's and answers as well as encourages patients to contact our Customer Service Team when they are unable to pay for services. Our health system's statements also identify detailed account and billing information encouraging the patient to contact our Customer Service Team and inquire about Financial Assistance options. Documentation is essential in effective communication. Follow up teams will then move forward in a timely manner with the appropriate actions to insure all necessary documents (if applicable) are received for eligibility determinations. CHS advertises a Price Line encouraging patients to inquire about estimated costs for future services. The Price is manned by our outpatient financial counselors from 8:00am to 7:00pm. When calls are returned with estimated costs, a conversation ensues to identify a possible financial hardship. Our Self Pay Process is put into effect at this time. Site Registrars will notify the CHS Financial Counseling Team when a financial hardship is identified. Emergency Department Financial Counseling positions have been created to meet the needs of our ED patients. In addition to these new roles, a full time Financial Counselor position was created to meet the special needs of our cancer patients. A Financial Assistance Coordinator reviews all financial applications, gathers needed documents, determines financial assistance and prepares each patient file for leadership approval. |
| Community Information | Schedule H, Part VI, Line 4 Centegra Health System defines its primary service area as McHenry County, an area of approximately 603 square miles 418,721 residents (2015). McHenry County has been among the fastest growing counties in Illinois with an 18.7% population growth from 2000-2010, according to the U.S. Census conducted in 2010. The age groups with projected population growth within Centegra Health System's primary service area from 2015-2020 are 18-44 with 2.8% growth, and 65+ with 21.2% growth. Centegra Health System's primary service area's population is projected to increase 3.4% in the next five years (2015-2020). For 2015, the age distribution of the population was as follows: 25% for 0-17, 34% for 18-44, 28% for 45-64, and 13% for 65 and older. McHenry County has relatively high socioeconomic status compared to the rest of Illinois. Median household income for 2012 was $76,417, compared to the Illinois state average of $55,126. The April 2015 unemployment rate was 5.4%, which is lower than the state average of 6.0%. For 2012, the percentage of the county's population holding a high school diploma or higher was 92.2%, while the percentage holding a bachelor's degree or higher was 32.4%. The McHenry County uninsured in 2012 was 9.8% compared to the state uninsured rate of 12.8%. The most recent data available was used in this description. |
| Promotion of Community Health | Schedule H, Part VI, Line 5 Please see Schedule O for a detailed description of the Medical Center's program service accomplishments. |
| Affiliated Health Care System | Schedule H, Part VI, Line 6 Northern Illinois Medical Center of McHenry, IL is affiliated with Memorial Medical Center of Woodstock, IL. Both Hospitals are acute care facilities serving the greater McHenry County area. Centegra Health System is the parent of both Northern Illinois Medical Center and Memorial Medical Center. Northern Illinois Medical Center is affiliated with Health Bridge Fitness Centers in Crystal Lake, and the Medical Center provides outpatient physical rehabilitation services to the community from a clinic within that location. The Centegra Health System Foundation supports Hospital operations through fundraising activities. Please see schedule R for complete listing of all affiliated organizations. STATE FILING OF COMMUNITY BENEFIT REPORT SCHEDULE H, PART VI, LINE 7 IL |
| Facility Reporting Group(s) | Schedule H, Part VI Northern Illinois Medical Center is a 179 bed facility with a Level II nursery and a center for cancer care, Sage Cancer Center. In addition, NIMC operates four off-site physical rehabilitation centers offering therapy services, as noted in Part V. NIMC also operates two sites where medical imaging services are offered, as noted in Part V. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL S EESLEY | ||||||||||||||
| CEO | $0 | $923,531 | $0 | $319,403 | $0 | $324,620 | $0 | $123,889 | $0 | $17,625 | $0 | $1,709,068 | $0 | $0 |
| RICHARD LIND MD | ||||||||||||||
| DIRECTOR | $0 | $293,680 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $14,812 | $0 | $308,492 | $0 | $0 |
| LISA GLOSSON MD | ||||||||||||||
| DIRECTOR | $0 | $232,288 | $0 | $0 | $0 | $12,331 | $0 | $7,399 | $0 | $11,234 | $0 | $263,252 | $0 | $0 |
| IRFAN HAFIZ MD | ||||||||||||||
| SECRETARY | $0 | $341,063 | $0 | $69,958 | $0 | $0 | $0 | $21,525 | $0 | $26 | $0 | $432,572 | $0 | $0 |
| DAVID TOMLINSON | ||||||||||||||
| EVP/ CFO | $0 | $457,428 | $0 | $146,510 | $0 | $0 | $0 | $34,105 | $0 | $26,618 | $0 | $664,661 | $0 | $0 |
| JASON R SCIARRO | ||||||||||||||
| PRESIDENT / COO | $0 | $636,395 | $0 | $229,947 | $0 | $111,985 | $0 | $69,175 | $0 | $22,554 | $0 | $1,070,056 | $0 | $0 |
| RACHEL SEBASTIAN | ||||||||||||||
| VP SITE ADMINISTRATOR | $323,587 | $0 | $84,332 | $0 | $0 | $0 | $28,174 | $0 | $15,126 | $0 | $451,219 | $0 | $0 | $0 |
| JOSEPH MCMAHON | ||||||||||||||
| CHIEF MEDICAL PHYSICIST | $213,619 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $11,247 | $0 | $224,866 | $0 | $0 | $0 |
| CONNIE K SECOR | ||||||||||||||
| DIRECTOR SURGERY | $188,818 | $0 | $24,162 | $0 | $0 | $0 | $4,336 | $0 | $1,261 | $0 | $218,577 | $0 | $0 | $0 |
| JOHN G GEINOPOLOS | ||||||||||||||
| MEDICAL PHYSICIST | $181,494 | $0 | $0 | $0 | $0 | $0 | $1,849 | $0 | $22,149 | $0 | $205,492 | $0 | $0 | $0 |
| PANG CHONG | ||||||||||||||
| MANAGER PHARMACY | $142,428 | $0 | $6,827 | $0 | $0 | $0 | $0 | $0 | $20,018 | $0 | $169,273 | $0 | $0 | $0 |
| JIGISHA DESAI | ||||||||||||||
| CLINICAL STAFF PHARMACIST | $146,825 | $0 | $0 | $0 | $0 | $0 | $0 | $3,139 | $0 | $7,438 | $146,825 | $10,577 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Form Sch J Part I Line 4b | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING PEOPLE RECEIVED THE FOLLOWING AMOUNTS AS PART OF A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: Name Title Amount MICHAEL EESLEY CHIEF EXECUTIVE OFFICER $118,000 JASON SCIARRO PRESIDENT / COO $63,205 RACHEL SEBASTIAN VP SITE ADMINISTRATOR $22,068 DAVID TOMLINSON EVP / CFO $27,741 IRFAN HAFIZ SVP CHIEF MEDICAL OFFICER $21,525 | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RACHEL SEBASTIAN | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FAMILY MEMBER | RelationshipDescriptionTxt |
| Transaction | $451,219 | TransactionAmt |
| Transaction | EMPLOYEE | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Business Transactions Involving Interested Persons | FormAndLineReferenceDesc |
| Explanation | Schedule L, Part IV All business transactions are arms length transactions. See conflict of interest disclosures in Schedule O for Form 990, part VI, Line 2. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PROGRAM SERVICE ACCOMPLISHMENTS | Form 990 Part III Line 4a Executive Summary Centegra Health System (Centegra) coordinates the delivery of health care services by assisting in the management of Centegra Hospital- McHenry (Northern Illinois Medical Center) and Centegra Hospital- Woodstock (Memorial Medical Center), (The Medical Centers), and Centegra Health System Foundation, Health Bridge Corporation and NIMED Corporation (Affiliates). Centegra Hospital- Huntley is opening in August 2016. Centegra's mission is to inspire and engage our community in their health and wellness. We provide quality health care services with innovative and responsible use of resources and promote wellness for the communities in and around the greater McHenry County area in Illinois. During its fiscal year 2016, Centegra Health System sponsored more than 200 community events. These events touched more than 191,000 individuals. The Medical Centers provide optimum quality health care, delivered by competent hospital and medical center staff, to all whom seek its services regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The primary mission of the Medical Centers is to enhance the health of the community as the preferred health care organization providing outstanding service and value. It is the Medical Centers' objective to serve the community with respect to providing health care services and education. Although reimbursement for services rendered is critical to the operation and stability of the Medical Centers, it is recognized that not all individuals possess the ability to purchase essential medical services. Therefore, in keeping with the Medical Centers' commitment to serve all members of its community, free care and/or subsidized care will be considered where the need and/or an individual's inability to pay exist. Medical Services are provided in a dignified manner to Medicare, Medicaid and indigent patients. System-wide, community benefits included approximately $4.5 million of charity care, over $43.5 million of government sponsored indigent health care, approximately $5.4 million of other community benefits, and over 88,000 community benefit hours. *The Medical Centers' services include, but are not limited to: Centegra Hospital-McHenry is a 179-bed facility located about 50 miles outside of Chicago. The hospital is the region's leading provider of advanced cardiovascular treatments through the Centegra Cardiovascular & Thoracic Center. It is also home to the Centegra Hip & Knee Replacement Center, the Centegra Sage Cancer Center and the Centegra Family Birth Center. As part of Centegra Health System, Centegra Hospital-McHenry achieved Magnet designation for nursing excellence. Centegra Hospital-McHenry provides sophisticated treatments and advanced technology to address the most serious medical conditions. These include: *Open-heart surgery and heart catheterizations *Joint replacement surgeries *A Level II Trauma Center and on-site Flight for Life helicopter *Certified chest pain and stroke centers *Advanced cancer treatments including radiation oncology and infusion services *Labor and delivery and on-site 24/7 obstetrics hospitalists and neonatologists *Intensive care *Medical-Surgical care and 24/7 hospitalist care *Outpatient surgery Centegra Hospital-Woodstock is a 106-bed facility located about 60 miles outside of Chicago. The hospital provides exceptional inpatient and outpatient care and has won top awards for patient safety and satisfaction. As part of Centegra Health System, Centegra Hospital-Woodstock achieved Magnet designation for nursing excellence. Centegra Hospital - Woodstock provides sophisticated treatments and advanced technology to address the most serious medical conditions, including: *A Level II Trauma Center and on-site Flight for Life helicopter *Certified chest pain and stroke centers *Intensive care *Medical-Surgical care and 24/7 hospitalist care *Outpatient surgery *Inpatient behavioral health services *Weight-loss surgery through the Centegra Healthy Living Institute *State-of-the-art medical imaging Centegra Health System Foundation provides fund-raising services for Centegra Health System in conjunction with the Medical Centers. The proceeds of these activities are used to purchase medical equipment and supplies, therefore enabling the Medical Centers to better serve the community. Health Bridge Corporation provides various rehabilitation services for the Medical Centers in conjunction with Centegra Health System, by providing fitness centers and pools that serve the community in various capacities and sponsors and hosts assorted educational programs. NIMED Corporation aids in the management of the Medical Centers and several satellite locations within the Centegra Health System organization. The Medical Centersthe Affiliates' program accomplishments are summarized below. SUPPORT GROUPS Centegra Health System, in conjunction with the Medical Centers and Affiliates, sponsors or hosts many support groups for its patients as well as the community. The following ongoing support groups are held at the Medical Centers, Affiliates or in the community. By supporting these groups, the Medical Centers and Affiliates are able to provide one or all of the following: *Staff professionals who either act as facilitators of the group or function as "Guest Speakers," *Space offered free or at minimal charge, *Free marketing to educate the community about these services. Programs sponsored by the Medical Centers and or Affiliates in conjunction with Centegra Health System include: Oncology Support Groups *Cancer Transitions focuses on the needs of cancer survivors who have finished treatment within the last two years. *Caring for the Caregiver is a group for those offering care to anyone with a serious illness. The group provides an opportunity to connect with others who understand the unique experience of being a caregiver. Education and support are offered on relevant topics to assist successful management of the challenges of caregiving. *Creating Expressions links artistic experience with the emotional benefits of cancer management. *Growing Together Through Cancer Transitions is a monthly group for cancer survivors who have completed the Cancer Transitions program. Education and support is offered through the group experience to increase personal empowerment and wellness in body, mind and spirit toward the goal of long term cancer survivorship. *Centegra STAR Program Guided Patient Services (GPS) where participants receive valuable information and resources that aid them before, during and after diagnosis and treatment. Members of the Survivorship Training and Rehabilitation (STAR) certified team are available to address questions and concerns while patients participate in assessments to help create a personalized plan of care. *H.O.P.E.: High on Positive Energy is for women living with breast cancer. *Look Good Feel Better is a free program offered by the American Cancer Society and teaches beauty techniques to women who are currently undergoing cancer treatment. *Partners in Cancer Transitions, a monthly support group for cancer survivors and their care partners. *Pathfinders, a support group for men and women living with cancer and their care partners. *Wig Boutique: This American Cancer Society program helps women with cancer select a free wig. *Young Ribbons, a support group or those diagnosed with breast cancer younger than the age of 45. This support group helps participants connect with other breast cancer survivors to share, learn and support one another during and after treatment. Additional Support Groups and Services: *A.W.A.K.E. (Alert, Well and Keeping Energetic) Support Group is a sleep disorder support group for patients and family members affected by sleep disordered breathing. The A.W.A.K.E. Support Group is part of the American Sleep Apnea Association. *ADHD Parent Support Group a free support group for parents of children with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) this group provides opportunities for parents to share, collaborate and communicate about some of the challenges involved in raising children with ADD or ADHD. *Breastfeeding Support groups are held to support all breastfeeding moms. *Centegra Crisis Services in partnership with the McHenry County Mental Health Board offers 24-hour crisis line and 24-hour onsite response team. *Diabetes Support Group is for individuals with diabetes and their families. *Eating Disorder Support Group, a monthly eating disorder support group led by a mental health professional and a registered dietitian. *Free Freshstart/Tobacco Cessation: Centegra has partnered with the American Cancer Society to empower participants towards quitting a tobacco habit. Freshstart provides information about effective strategies and helps motivate and prepare participants to make a successful quit attempt. *Living with Grief, spo |
| Tax Exempt Bond | Form 990, Part IV, Line 24 NORTHERN ILLINOIS MEDICAL CENTER HOLDS A LIABILITY ON ITS BOOKS FOR TAX-EXEMPT BONDS, WHICH IS AN ALLOCATION FROM ITS SOLE CORPORATE MEMBER, CENTEGRA HEALTH SYSTEM. AS A RESULT, THIS QUESTION WAS ANSWERED NO, AND SCHEDULE K WILL BE COMPLETED ON CENTEGRA HEALTH SYSTEM'S FORM 990. |
| Business or Family Relationship of Officers, Directors, Etc. | Form 990 Part VI Line 2 Northern Illinois Medical Center, (NIMC), as part of Centegra Health System, has adopted specific conflict of interest policies for its governing and management staff. The policy includes, but is not limited to, when an individual, governor, committee member, officer, agent or employee believes that he or she, or a member of his or her immediate family might have or does have a real or apparent conflict, he or she should in addition to filing the disclosure notice required, abstain from making motions, voting, executing agreements, or taking any other similar direct action on behalf of the Medical Center. During fiscal year 2016, Northern Illinois Medical Center purchased certain goods and/or services from organizations with director's affiliation. All goods were competitively bid and conducted at arm's length. The fees paid were at fair market value. During Fiscal year 2016, Director Michael Curran is an officer/director of Curran Contracting Company, supplier of excavation and asphalt pavement services. Director Patrick Morehead, whose term on the Board of Governors expired in December 2015, is a 2% owner of Home State Bank. Director Charles Ruth is the Board Chairman of American Community Bank & Trust and Chief Executive Officer of Alliance Contractors. Director Tom Carey is Vice President and majority owner of Carey Electric Contacting, Inc., supplier of electrical contracting services. Senior Vice President, Chief Operating OFficer of Centegra Hospital- McHenry, is the daughter of Michael Esley, CEO. Rachel Sebastian reports directly to the President and Chief Operating Officer JAson Sciarro. |
| Explanation of Classes of Members or Shareholder | Form 990 Part VI Line 6 Centegra Health System is the sole member of NIMC. Centegra Health System has a single class of members. |
| How Members or shareholders elect governing body | Form 990 Part VI Line 7a The powers and duties of the Centegra Health System members in fulfilling the purposes and objectives of the Corporation shall include, but not be limited to, the taking of action with respect to the following matters: The election of governors and the filling of vacancies on the Board of Governors, which shall be in accordance with the procedures set forth in the Bylaws. The Nominating Committee shall select one candidate for each position on the Board having a term to be voted upon for the office of governor at the next annual meeting of members. The Nominating Committee shall consider and approve a list of candidates and submit such list to the Board of Governors not less than 10 days prior to the date of the last meeting of the Board of Governors prior to the date on which notice of the annual meeting of members is to be sent, and the candidates set forth on such list shall be subject to approval by the Board of Governors. The names of the candidates so selected by the Nominating Committee and approved by the Board of Governors shall be included in the notice of the annual meeting of the members of the Corporation and shall be presented to the members of the Corporation at the annual meeting. The voting members of the Corporation may nominate candidates for the positions on the Board of Governors. Nominations by such members may be effected by means of written nomination signed by not less than 20 voting members in good standing, accompanied by a written statement of such nominee indicating a willingness to serve as a governor of the Corporation if elected. Any such nomination must be received by the Nominating Committee of the Corporation not less than 60 days prior to the annual meeting of members in order to be considered at such annual meeting. All elections shall be by secret ballot if there are more nominees than vacancies to be filled on the Board. All voting members present in person or by proxy at a meeting at which an election occurs shall be entitled to vote for governors. To be valid a ballot must not have more votes than there are vacancies. If there are more nominees than vacancies to be filled on the Board, those nominees who receive the most votes shall be elected to the Board of Governors. Members shall not be entitled to cumulate their votes in the election of governors. |
| Review Process | Form 990 Part VI Line 11b The review process for the Form 990 includes compilation by internal staff, detailed review by an outside tax preparer and the Centegra Health System (CHS) Controller and Chief Financial Officer, prior to submission to the IRS. The tax return will be made available for the Board to review after submission to the IRS. |
| Explanation of monitoring and enforcement of conflicts | Form 990 Part VI Line 12c As stated in Centegra's Bylaws, the Bylaws recognize that both real and apparent conflicts of interest sometimes naturally occur in the course of conducting daily affairs. Conflicts occur because the many persons associated with Centegra should be expected to have and do, in fact, generally have multiple interests and affiliations and various positions of responsibility within the community. The long-range interests of Centegra do not require the termination of all association with persons who may have real or apparent conflicts if a prescribed and effective method can render such conflicts harmless to all concerned. Centegra Health System has a conflict of interest policy that is intended to address such matters. 1. Duty to Disclose: In connection with any actual or possible conflicts of interest, an interested person or other person subject to this policy must disclose the existence and nature of his or her financial interest in writing to the President of Centegra or the Chief Corporate Responsibility Officer or designee, who shall provide such written disclosure to the Governors Affairs Committee of Centegra, which shall consider all conflicts of interest issues and, if appropriate, to the directors and members of committees with board-delegated powers considering the proposed transaction or arrangement. The disclosure must occur, at minimum, annually, with a Conflict of Interest Disclosure Statement being submitted no later than January 31st of each year. Copies of disclosure statements filed by Board members shall be distributed to the Board annually at the February Board meeting. 2. Determining Whether a Conflict of Interest Exists: When a conflict of interest is disclosed at meeting of the board or committee thereof, after disclosure of the financial interest, the interested person shall leave the board or committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. The interested person's leaving such meeting shall not affect whether a quorum exists at such meeting. 3. Procedures for Addressing the Transaction or Arrangement from Which the Conflict Arose: A. The chairperson of the board or committee shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. B. After exercising due diligence, the board or committee shall determine whether Centegra can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or entity that would not give rise to a conflict of interest. C. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the board or committee shall determine by a majority vote of the disinterested directors whether the transaction or arrangement is in Centegra's best interest and for its own benefit and whether the transaction is fair and reasonable to Centegra and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. 4. Violations of the Conflicts of Interest Policy: A. If the administration, the board, or a committee has a reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose. B. If, after hearing the response of the member and making such further investigation as may be warranted in the circumstances, the board or committee determines that the member has, in fact, failed to disclose an actual or possible conflict of interest, it shall refer the matter to the Governors Affairs Committee for consideration, which shall subsequently recommend appropriate disciplinary and corrective action to such board or committee. 5. The minutes of the board and all committees with board-delegated powers shall contain the names of the persons who disclosed or otherwise were found to have a financial interest in connection with an actual or possible conflict of interest, the nature of the financial interest, any action taken to determine whether a conflict of interest was present, and the board's or committee's decision as to whether a conflict of interest, in fact, existed. The names of the persons who were present for discussion and votes relating to the transaction or arrangement, the content of the discussions, including any alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection therewith. 6. A voting member of any committee whose jurisdiction includes compensation matters and who receives compensation, directly or indirectly, from Centegra for services is precluded from voting on matters pertaining to that member's compensation, Physicians who receive compensation, directly or indirectly from Centegra, whether as employees or independent contractors, are precluded from membership on any committee whose jurisdiction includes compensation matters and in which such physician may have a direct or indirect interest. 7. Each director, principal officer, and member of a committee with board-delegated powers shall annually sign a statement which affirms that such person has received a copy of the conflicts of interest policy; has read and understands the policy; has agreed to comply with the policy; and understands that Centegra is a charitable organization and that in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish one or more of its tax exempt purposes. 8. To ensure that Centegra operates in a matter consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall, at a minimum, include the following subjects: Whether acquisition of physician practices and other provider services result in inurement or impermissible private benefit. Whether joint venture arrangements and arrangements with management service organizations and physician hospital organizations conform to written policies, are properly recorded, reflect reasonable payment for goods and services, further Centegra's charitable purposes and do not result in inurement or impermissible private benefit. Whether agreements to provide healthcare and agreements with other healthcare providers, employees, and third party payors further Centegra's charitable purposes and do not result in inurement or impermissible private benefit. Whether business transactions on behalf of Centegra or an entity controlled by it are the result of arms-length dealing and are no less advantageous than competitively available goods and services of like grade and quality. 9. In conducting the periodic reviews provided for in Article VII, Centegra may, but need not, use outside advisors. If outside experts are used, their use shall not relieve the board of its responsibility for ensuring that periodic reviews are conducted. |
| COMPENSATION REVIEW & APPROVAL PROCESS- OFFICERS & KEY EMPLOYEES | Form 990 Part VI Line 15a & 15b The Board of Directors of Centegra Health System, through the Compensation Committee comprised of independent members free of conflict, reviewed executive compensation levels and other features of the compensation plan in accordance with the organization's approved compensation philosophy and strategy: The Committee is comprised of members of the Board of Directors, who are independent of Centegra management, have no personal interest in the compensation arrangements, are not related to, or under the control of any individual whose compensation arrangement is being reviewed and have no material business relationship with Centegra. The C-Suites compensation is determined by the Compensation Committee in relation to compareable peers or 990 market data. Compensation for other members of the executive staff is recommended by the CEO, reviewed by the Committee and evaluated against market data based on comparable peers. The Committee approves all compensation decisions in advance of their implementation and documents its determinations and discussions. Its decisions and deliberations are thoroughly documented and meeting minutes are kept and distributed to the Committee members (for historical reference). The Compensation Committee uses a number of external sources and comparisons, and their review includes total compensation (cash compensation, plus benefits provided by Centegra) in relation to organizational performance and prevailing industry practices of comparably-sized organizations. They have engaged the services of a compensation consulting firm (Sullivan Cotter) specializing in the not-for-profit sector that has worked with Centegra and reports directly to the Compensation Committee. Reasonableness letters and documentation are provided to the organization after each review. |
| OTHER ORGANIZATION DOCUMENTS PUBLICLY AVAILABLE | Form 990 Part VI Line 19 The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. |
| RELATED COMPANY - CHS | Form 990 Part IX Line 24a It should be noted that the Related Company expenses in Form 990, Part IX, line 24a are allocated at 70% of total expense of the related company (Centegra Health System, FEIN 36-3196559). The allocation method is reviewed annually. Expense detail is as follows: Salaries $18,576,032; Benefits $3,662,675; Payroll Taxes $1,347,106; Purchased Services/Professional Fees $18,467,341; IT Expenses $5,310,607; Office Expenses $1,662,694; Advertising and Promotional $1,482,663; Other Expenses $4,899,251. |
| RECONCILIATION OF NET ASSETS | FORM 990, PART XI, LINE 9 AFFILIATE TRANSFERS ($9,000,000) INTEREST IN FOUNDATION $1,606,528 ------------- ($7,393,472) |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Centegra Health System | ||||||||||
| 385 Millenium Drive | Crystal Lake | IL | 60012 | 363196559 | Health System | IL | 501(c)(3) | 11c | NA | false |
| Centegra Health System Foundation | ||||||||||
| 385 Millenium Drive | Crystal Lake | IL | 60012 | 363726310 | Fundraising | IL | 501(c)(3) | 11a | Centegra HS | false |
| NIMED Corporation | ||||||||||
| 385 Millenium Drive | Crystal Lake | IL | 60012 | 363199111 | Property Mgmt | IL | 501(c)(3) | 11c | Centegra HS | false |
| Health Bridge Corporation | ||||||||||
| 385 Millenium Drive | Crystal Lake | IL | 60012 | 363196550 | Health FT CTR | IL | 501(c)(3) | 11c | Centegra HS | false |
| Oak Creek Lodge | ||||||||||
| 385 Millenium Drive | Crystal Lake | IL | 60012 | 363591359 | Hospital | IL | 501(c)(3) | 3 | Centegra HS | false |
| Centegra Hospital Huntley- Holdings | ||||||||||
| 385 Millennium Dr | Crystal Lake | IL | 60012 | 453449737 | Support Org | IL | 501(c)(3) | 11C | NIMC | false |
| Memorial Medical Center | ||||||||||
| 3701 Doty Road | Woodstock | IL | 60098 | 362179764 | Hospital | IL | 501(c)(3) | 3 | Centegra HS | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Centegra Management Services | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 385 Millenium Drive | AddressLine1Txt |
| City | Crystal Lake | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60012 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364028114 | EIN |
| Primary Activities | Management | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Centegra HS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C Corp | EntityTypeTxt |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (true) | TransferFromOtherOrgInd |