2015-11-12T16:38:38-06:00 2014-12-31 350921680 CROWE HORWATH LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2014-01-01 363197918 ROCKFORD MEMORIAL DEVELOPMENT FOUNDATION ROCK 8159714141 2400 N ROCKTON AVE ROCKFORD IL 61103 Henry M Seybold CFO & Treasurer 2015-11-11 true Nicole Bencik P00756195 3128997000 2014 2016-02-25 16:41:14Z JAVON BEA 2400 N ROCKTON AVE ROCKFORD IL 61103 138308683 false X WWW.RHSNET.ORG X 1982 IL To support the operations of all entities of Rockford Health System & provide assistance to these other 501(c)(3) non-profit organizations by receiving, maintaining, and administering funds received from the public and other available sources to further the exempt purposes of these organizations. 19 15 6 228 0 0 2333954 1407464 0 0 6706283 8615403 -1722 75 9038515 10022942 1051060 8293498 0 0 367048 354806 0 0 123859 644121 587779 2062229 9236083 6976286 786859 132002135 128901028 696307 875047 131305828 128025981 The mission of Rockford Health System (RHS) is "Superior Care. Everyday. For All Our Patients." Rockford Memorial Development Foundation (RMDF) assists this mission specifically by applying resources to the vision of RHS which is "To fulfill this Commitment through Performance Excellence, Lifelong Learning, and Innovation." false false 7818363 7599960 Restricted gifts and endowments to Rockford Health System help fund equipment, facilities, projects and care and comfort items for patients. RHS patients now have access to the most advanced cancer fighting treatment in the region due to the addition of a new linear accelerator during 2014. RMDF provided $7 million for the project, the largest investment RMDF has ever made in a single project. Endowments provided staff training to use the new equipment to the fullest of its capabilities. Additional education and training was also provided for employees throughout the health system - including rapid response training for intensive care areas in order to bring critically needed care to patients in trouble more quickly. The Foundation supported the purchase of computers and printers for the Children's Learning Center on the RHS campus, a new CPACs license for Mindray Ultrasound System in the Cardiac Catheterization Lab, a SimMan patient simulator to provide state-of-the-art education and training to our nursing and care staff, a glide scope for adult critical care and a cardiac chair for our adult oncology unit. 388374 388374 The Family Giving Campaign raised funds in 2014 for three uses: an employee crisis fund, the Wishbook catalog of care and comfort items and the employee education fund. The crisis fund provides assistance to employees who have experienced a crisis such as a flood or fire in their home or a severe illness, injury or death of a spouse or child. The Wishbook provides small items for caregiving departments throughout Rockford Health System. The employee education fund expands opportunities for employees to attend training and skills development seminars. RMDF donations were also used to assist Visiting Nurses Association, a related organization, in caring for the elderly, the homebound, the recovering and those facing end of life. In 2014, 20 new Telehealth Monitors were purchased for our Visiting Nurses Association to help keep congestive heart failure patients in touch with their health care providers while at home instead of seeking more expensive and inconvenient care in the hospital. 305164 305164 Through charitable contributions, RMDF supports the Ronald McDonald Care Mobile staffed and operated by Rockford Memorial Hospital, which provides free medical and dental care to uninsured and underinsured children in five counties at 12 different sites in northern Illinois. The Care Mobile visits included vaccinations, lead or blood screenings, medical diagnoses, preventative and restorative dental care and treatment/care to avoid an emergency room visit. In addition, RMDF used donated Auxiliary funds to purchase "You and Your Baby" DVDs in both English and Spanish. Donations from the Auxiliary also provided upgrades to the Discovery Center Body Shop and assisted with care on the Care Mobile, nursing scholarships for minority students, and the healing harp program that creates an atmosphere of care and comfort for hospitalized patients as well as a new pager system for the Surgical Family Waiting Area to keep loved ones informed of their family members' progress in surgery and recovery. 8511901 true true false false false false false false true true false false true true false false true false false false false false false true false false true false true false false false false false false false false false false false false false true false false false true 25 0 true 6 true false false false false false true true false false false false X 19 15 false false false false true true true true true false false false true true true true true false false false IL X DAVID VOLA CONTROLLER 8159715000 2400 N ROCKTON AVE ROCKFORD IL 61103 GARY E KAATZ PRESIDENT & CEO 1.00 59.00 X X 0 1046965 63100 JOHN J MORRISSEY CHAIRMAN 3.00 0 X X 0 0 0 JULIE BOSMA VICE-CHAIR 2.00 0 X X 0 0 0 MARC L BARBEAU DIRECTOR 1.00 0 X 0 0 0 W WALTER BOOTHE DIRECTOR 1.50 0 X 0 0 0 LIBBY CLARK DIRECTOR 1.00 0 X 0 0 0 ELEANOR F DOAR DIRECTOR (Partial Year) 1.00 3.90 X 0 0 0 Scott Ferry DIRECTOR 1.00 0 X 0 0 0 LINDA HECKERT DIRECTOR 1.00 0 X 0 0 0 PHILLIP AD HIGGINS DIRECTOR 1.00 40.00 X 0 423887 45819 JOHN J HOLEVAS DIRECTOR 0.10 0 X 0 0 0 SCOTT K LAUE DIRECTOR 2.00 0 X 0 0 0 JAY MADDOX DIRECTOR 1.00 0 X 0 0 0 Patrick O'Keefe DIRECTOR 1.00 0 X 0 0 0 MILTON G SCHMITT DIRECTOR 1.00 0 X 0 0 0 JEFF R SMITH MD Director 1.00 42.00 X 0 372057 27970 DENNIS T UEHARA Director 1.00 54.50 X 0 534513 44010 Bruce D Vandegrift DIRECTOR 1.00 0.40 X 0 0 0 Connie Vitali DIRECTOR 1.00 0 X 0 0 0 KATHY WEBER DIRECTOR 1.00 0 X 0 0 0 Helen Brooks Executive Director 4.00 36.00 X 22771 204935 31752 HENRY M SEYBOLD CFO & Treasurer 0.30 45.00 X 0 474282 33136 Sharon Mattis SECRETARY (9/17/14-12/31/14) 40.00 0 X 12550 0 272 VICKI WOODHOUSE SECRETARY (1/1/14-5/29/14) 40.00 0.00 X 22361 0 1960 57681 3056639 248019 0 false true false 0 207357 335426 864681 0 1407464 0 0 0 0 0 2337985 2337985 0 0 134418122 128140704 6277418 0 6277418 6277418 135193 207357 145037 -9844 -9844 9840 9840 9840 MISCELLANEOUS 900099 79 79 0 0 0 0 79 10022942 0 0 8615478 8293498 8293498 63088 25235 25235 12618 207800 83120 72501 52179 7851 3510 2155 2186 59658 25681 19016 14961 16409 6564 5907 3938 12110 12110 280772 280772 140337 0 140337 0 4375 1085 3290 119070 63954 21385 33731 1326 1326 2107 2107 886 354 319 213 1893 757 682 454 Food 11414 6848 2283 2283 13489 1295 10898 1296 9236083 8511901 600323 123859 1333674 1518233 14840000 14840000 73197 179829 0 0 11232 9887 86080 86080 0 0 104079329 100540398 0 0 11664703 11812681 132002135 128901028 586906 764919 0 109401 110128 696307 875047 X 114867551 111489406 10420934 10385562 6017343 6151013 131305828 128025981 132002135 128901028 786859 -4066706 0 X false true X true false X X 3 ROCKFORD MEMORIAL HOSPITAL 362167847 3 true 8059943 0 VISITING NURSES ASSN OF THE ROCKFORD AREA 362167945 9 true 144205 0 ROCKFORD HEALTH PHYSICIANS 363907436 3 true 19753 0 3 8223901 true false false false false false false false false false false false false false false false false Schedule A, Part IV, Section B, Line 1 Power to elect or appoint The Bylaws of Rockford Memorial Development Foundation (Foundation) provide that Rockford Health System (RHS) is the sole corporate member of the Foundation. RHS is also the sole corporate member of each of the supported organizations-Rockford Memorial Hospital, Rockford Health Physicians, and Visiting Nurses Association of the Rockford Area-and has the power to appoint each member of the respective Boards of Directors. Pursuant to a written determination from the Internal Revenue Service, the Foundation is operated, supervised, or controlled by the supported organizations, and thus the Foundation is a Type I supporting organization. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2280090 56884 206118 149952 6342 2386798 1859405 148494 368484 91187 5106 2280090 1635655 69541 273774 112660 6905 1859405 1571000 95812 23498 45097 9558 1635655 1091439 320215 225711 57724 8641 1571000 0.156 0.46 0.384 false false 2779 2779 0 83301 83301 0 0 LIFE INSURANCE 81790 EMPLOYEE REC-SUPPLEMENTAL SURVIVOR PREMIUM 40348 INTEREST IN BENEFICIAL TRUST 11646956 DUE FROM RELATED ORGANIZATIONS 37798 CAPITAL ACCUMULATION ACCOUNTS 5789 11812681 LIFE INSURANCE VALUE 81790 CAPITAL ACCUMULATION ACCOUNTS 5789 DUE TO RELATED ORGANIZATIONS 22549 110128 Schedule D, Part X, Line 2 FIN48 (ASC 740) DISCLOSURE THERE IS NO FIN 48 LIABILITY AND AS SUCH, THE ORGANIZATION'S CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE A FIN 48 DISCLOSURE. Schedule D, Part V, Line 4 Intended uses of endowment funds Funds were used to provide a lecture series, for continuing education for employees wanting to improve their credentials or to focus on a new skill or some technology not currently available in the Rockford community. There were also miscellaneous projects designated by the foundation board in accordance with the specific endowment. All funds were expended per the specific direction of each endowment. Gala 280295 174186 106109 58684 16762 42332 Golf 54038 25150 28888 2807 18861 2817 1 8217 8021 196 88 642 750 1294 342550 207357 135193 2895 78187 17512 46443 145037 -9844 true Rockford Memorial Hospital 2400 N Rockton Ave Rockford IL 61103 362167847 501(c)(3) 8059943 SUPPORT FOR PROGRAM SERVICES Rockford Health Physicians 2300 N Rockton Ave Rockford IL 61103 363907436 501(c)(3) 19753 SUPPORT FOR PROGRAM SERVICES Visiting Nurses Association of the Rockford Area 4223 E State Street Rockford IL 61108 362167945 501(c)(3) 144205 SUPPORT FOR PROGRAM SERVICES 3 0 Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds Applications are submitted to the Foundation verifying a need for funds or products (i.e. Automatic Electronic Defibrilators-AED). Determination is made through a predetermined scoring method as to what organizations will be recipients of the funds or products. Cash contributions are made only for the amount of the appeal and for a specified need. The Foundation requests a grant feedback form from grant recipients as a way to monitor grant funds after they have been paid. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. Applications are submitted to the Foundation verifying a need for funds or products (i.e. Automatic Electronic Defibrilators-AED). Determination is made through a predetermined scoring method as to what organizations will be recipients of the funds or products. Cash contributions are made only for the amount of the appeal and for a specified need. The Foundation requests a grant feedback form from grant recipients as a way to monitor grant funds after they have been paid. false false false false false false false false false GARY E KAATZ PRESIDENT & CEO 0 686868 0 242722 0 117374 0 56476 0 6624 0 1110065 0 0 PHILLIP AD HIGGINS DIRECTOR 0 422753 0 0 0 1134 0 37500 0 8319 0 469706 0 0 JEFF R SMITH MD Director 0 371283 0 0 0 774 0 20000 0 7970 0 400027 0 0 DENNIS T UEHARA Director 0 531867 0 0 0 2646 0 37500 0 6510 0 578524 0 0 Helen Brooks Executive Director 22771 194204 0 9549 0 1183 3023 27204 153 1373 25946 233511 0 0 HENRY M SEYBOLD CFO & Treasurer 0 385657 0 58079 0 30547 0 22793 0 10343 0 507418 0 0 Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation THE PRESIDENT & CEO OF ROCKFORD HEALTH SYSTEM (RHS), THE SOLE CORPORATE MEMBER, IS CONSIDERED THE TOP MANAGEMENT OFFICIAL OF ROCKFORD MEMORIAL DEVELOPMENT FOUNDATION. THE RHS BOARD OF DIRECTORS HAS A COMPENSATION COMMITTEE THAT REVIEWS EXECUTIVE COMPENSATION. THEY ALSO AUTHORIZE AN INDEPENDENT FIRM TO PROVIDE DATA FOR ANALYSIS OF THE INDUSTRY AND THE MARKET TO OUR COMPENSATION DEPARTMENT. THE DEPARTMENT AND COMMITTEE REVIEWS THE RESULTS AND MAKE A RECOMMENDATION TO THE BOARD WHO THEN ACTS UPON THIS INFORMATION TO SET COMPENSATION FOR EXECUTIVES. Form 990, Part VI, Line 15a PROCESS USED TO ESTABLISH COMPENSATION FOR TOP MANAGEMENT OFFICIAL COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL IS GOVERNED BY THE ROCKFORD HEALTH SYSTEM (RHS) BOARD OF DIRECTORS. THE RHS BOARD HAS ESTABLISHED A TOTAL COMPENSATION PHILOSOPHY THAT DIRECTS THE COMPENSATION PRACTICES FOR EXECUTIVES FROM RELATED ENTITIES (INCLUDING RMDF). THIS BOARD HAS ESTABLISHED A COMPENSATION COMMITTEE TO ESTABLISH AND REVIEW ALL EXECUTIVE COMPENSATION ANNUALLY BASED ON THE ESTABLISHED PHILOSOPHY. AN INDEPENDENT EXTERNAL EXECUTIVE COMPENSATION FIRM PROVIDES CONSULTING ON RHS (INCLUDING RMDF) SALARY RANGES AND COMPENSATION PHILOSOPHY. THE APPROPRIATE PEER GROUP FOR COMPENSATION COMPARISON PURPOSES IS OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS SIMILAR IN SIZE AND COMPLEXITY. RHS GENERALLY CONDUCTS AN ANALYSIS OF TOTAL COMPENSATION EVERY THREE YEARS BUT MAY VARY FROM THIS SCHEDULE AS DIRECTED BY THE COMPENSATION COMMITTEE. THE RMDF BOARD CONCEDES THE AUTHORITY TO SET COMPENSATION TO RHS, THE SOLE CORPORATE MEMBER. Form 990, Part VI, Line 15b PROCESS TO ESTABLISH COMPENSATION FOR OTHER OFFICERS COMPENSATION FOR EXECUTIVES, INCLUDING OTHER OFFICERS, IS GOVERNED BY THE ROCKFORD HEALTH SYSTEM (RHS) BOARD OF DIRECTORS. THE RHS BOARD HAS ESTABLISHED A TOTAL COMPENSATION PHILOSOPHY THAT DIRECTS THE COMPENSATION PRACTICES FOR EXECUTIVES FROM RELATED ENTITIES (INCLUDING RMDF). THIS BOARD HAS ESTABLISHED A COMPENSATION COMMITTEE TO ESTABLISH AND REVIEW ALL EXECUTIVE COMPENSATION ANNUALLY BASED ON THE ESTABLISHED PHILOSOPHY. AN INDEPENDENT EXTERNAL EXECUTIVE COMPENSATION FIRM PROVIDES CONSULTING ON RHS (INCLUDING RMDF) SALARY RANGES AND COMPENSATION PHILOSOPHY. THE APPROPRIATE PEER GROUP FOR COMPENSATION COMPARISON PURPOSES IS OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS SIMILAR IN SIZE AND COMPLEXITY. RHS GENERALLY CONDUCTS AN ANALYSIS OF TOTAL COMPENSATION EVERY THREE YEARS BUT MAY VARY FROM THIS SCHEDULE AS DIRECTED BY THE COMPENSATION COMMITTEE. THE RMDF BOARD CONCEDES THE AUTHORITY TO SET COMPENSATION TO RHS, THE SOLE CORPORATE MEMBER. Form 990, Part VI, Line 1a Delegate broad authority to a committee THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIR AND VICE-CHAIR AND AT LEAST ONE ADDITIONAL DIRECTOR. IT SHALL MEET AS NEEDED. THE EXECUTIVE COMMITTEE SHALL MONITOR THE PERFORMANCE OF THE PRESIDENT AND EXECUTIVE DIRECTOR AGAINST ANNUAL OBJECTIVES AND REPORT THE RESULTS TO THE CHAIR OF THE ROCKFORD HEALTH SYSTEM BOARD. IN ADDITION, WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE EXECUTIVE COMMITTEE SHALL HAVE ALL THE POWERS, DUTIES, RESPONSIBILITIES AND AUTHORITY OF THE BOARD, EXCEPT AS PROHIBITED BY LAW. THE STAFF OF THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE PRESIDENT AND EXECUTIVE DIRECTOR, AS WELL AS OTHER SENIOR EXECUTIVES OF THE FOUNDATION AND ITS AFFILIATED CORPORATIONS SO DESIGNATED BY THE PRESIDENT WITH INPUT FROM THE CHAIR OF THE FOUNDATION. Form 990, Part VI, Line 6 Classes of members or stockholders The Foundation shall have one member, which shall be RHS. The sole member shall have powers and voting rights to do the following: (a) Appoint all the directors of the Foundation. (b) Nominate to the Foundation's board of directors all candidates for selection as the Foundation's president. (c) Approve expressly all amendments to the Foundation's articles of incorporation and by-laws. (d) Approve annual budgets and long-range plans of the Foundation. (e) Approve all contracts (including contracts of indebtedness) effective for longer than eighteen months. (f) Approve capital or operating expenditures in excess of amounts specified in the expenditure authorization policy as approved by the RHS Board of Directors. (g) Approve expenditures (including grants) from restricted and unrestricted donated funds in excess of $1,000,000. (h) Approve all plans of merger or consolidation. (i) Approve the sale, lease, exchange, mortgage, pledge or other disposition of all or substantially all, the property and assets of the Foundation. (j) Approve a voluntary dissolution of the Foundation. (k) Require the Foundation to take any action (including amending that Foundation's articles of incorporation or by-laws), or to modify or rescind an action already taken, if RHS determines that failure to take the action, or to modify or rescind an action already taken, may result in the member's or the Foundation's failure to obtain or maintain its exemption as an organization described in Section 501(c)(3) of the Code. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body See narrative for Part VI, line 6. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders See narrative for Part VI, line 6. Form 990, Part VI, Line 11b Review of form 990 by governing body The data was gathered by the accounting staff with input from the executive staff. The data was reviewed and the Form 990 prepared by the RHS staff. Once the Form 990 was completed, it was reviewed by an independent accounting firm and the organization's CFO. Form 990, Part VI, Line 12c Conflict of interest policy RHS Compliance Department (acting on behalf of RMDF and following guidelines set forth in the policy) generally sends out a copy of the policy with the Conflict of Interest form included. Employees and each board member complete the Financial Interest Disclosure Statement which is a part of the policy. The RHS Compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed, potential conflicts reviewed and appropriate actions are taken as a result of the review. Employees are usually given the policy and a statement to complete annually at the beginning of the year or as a new party is hired or joins the RMDF board. This process was last completed in 2015, when the questionnaires were sent to address any 2014 conflicts identified. The RHS Conflict of Interest Policy is available upon request. Form 990, Part VI, Line 19 Required documents available to the public Financial statements are available through the Illinois Attorney General's Office. Governing documents are available by request from Board Secretary. The conflict of interest policy is not published but is available upon request. ROCKFORD MEMORIAL HOSPITAL 2400 N ROCKTON AVE ROCKFORD IL 61103 362167847 HEALTHCARE IL 501(c)(3 3 ROCKFORD HEALTH SYSTEM true ROCKFORD HEALTH SYSTEM 2400 N ROCKTON AVE ROCKFORD IL 61103 363197915 SUPPORT OF HEALTHCARE IL 501(c)(3 Type III-FI NA false VISITING NURSES ASSN OF THE ROCKFORD AREA 4223 E STATE STREET ROCKFORD IL 61108 362167945 HEALTHCARE IL 501(c)(3 9 ROCKFORD HEALTH SYSTEM true ROCKFORD HEALTH PHYSICIANS 2300 N ROCKTON AVE ROCKFORD IL 61103 363097436 HEALTHCARE IL 501(c)(3 3 ROCKFORD HEALTH SYSTEM true ROCKFORD HEALTH INSURANCE LTD WELLESLEY HOUSE SO 2ND FLOOR PEMBROOKE BD HM INSURANCE BD NA C Corporation false CHARITABLE REMAINDER TRUST C/O 2400 ROCKTON AVE ROCKFORD IL 61103 TRUST IL NA Trust false false true true false false false false false false false false false false false true true false false false