JAVON BEA HOSPITAL: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization: JAVON BEA HOSPITAL (EIN 36-2167847)
Tax period: 2014-01-01 to 2014-12-31
Filed: 2015-11-12
IRS object ID: 201543169349305074
Schema version: 2014v5.0
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 I
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2015-11-12T17:00:34-06:00	ReturnTs
Tax Period End	2014-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	350921680	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CROWE HORWATH LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	225 West Wacker Drive	AddressLine1Txt
Address Line2	Suite 2600	AddressLine2Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	606061224	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2014-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	362167847	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ROCKFORD MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	ROCK	BusinessNameControlTxt
Phone	8159715000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2400 N ROCKTON AVE	AddressLine1Txt
City	ROCKFORD	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61103	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Henry M Seybold	PersonNm
Person Title	CFO	PersonTitleTxt
Signature	2015-11-11	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	NICOLE BENCIK	PreparerPersonNm
PTIN	P00756195	PTIN
Phone	3128997000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2014	TaxYr
Build TS	2016-04-25 22:37:26Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	JAVON BEA	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2400 N ROCKTON AVE	AddressLine1Txt
City	ROCKFORD	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61103	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$476,319,225	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.RHSNET.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1883	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	To improve and protect the health and welfare of the community in accordance with our mission: Superior Care, Every Day, For all our patients. A 396-bed hospital with a Level 1 Trauma Center, Level III Neonatal Intensive Care Unit, the region's only Pediatric Intensive Care Unit & designated Disaster POD hospital.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	2375	TotalEmployeeCnt
Total Volunteers	311	TotalVolunteersCnt
Total Gross UBI	$52,402	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$1,816	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$7,717,024	PYContributionsGrantsAmt
CY Contributions Grants	$12,588,560	CYContributionsGrantsAmt
PY Program Service Revenue	$326,155,534	PYProgramServiceRevenueAmt
CY Program Service Revenue	$353,344,658	CYProgramServiceRevenueAmt
PY Investment Income	$10,344,420	PYInvestmentIncomeAmt
CY Investment Income	$9,404,200	CYInvestmentIncomeAmt
PY Other Revenue	$2,010,494	PYOtherRevenueAmt
CY Other Revenue	$1,949,518	CYOtherRevenueAmt
PY Total Revenue	$346,227,472	PYTotalRevenueAmt
CY Total Revenue	$377,286,936	CYTotalRevenueAmt
PY Grants And Similar Paid	$657,863	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$770,756	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$145,187,551	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$145,668,209	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$151,222,443	PYOtherExpensesAmt
CY Other Expenses	$185,681,108	CYOtherExpensesAmt
PY Total Expenses	$297,067,857	PYTotalExpensesAmt
CY Total Expenses	$332,120,073	CYTotalExpensesAmt
PY Revenues Less Expenses	$49,159,615	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$45,166,863	CYRevenuesLessExpensesAmt
Total Assets BOY	$338,477,988	TotalAssetsBOYAmt
Total Assets EOY	$351,371,483	TotalAssetsEOYAmt
Total Liabilities BOY	$156,022,822	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$170,546,679	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$182,455,166	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$180,824,804	NetAssetsOrFundBalancesEOYAmt
Mission	The Mission of Rockford Health System and Rockford Memorial Hospital is "Superior Care, Every Day, For All Our Patients". We will fulfill our commitment through performance excellence, innovation, and lifelong learning.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$189,901,511	ExpenseAmt
Revenue	$230,704,182	RevenueAmt
Desc	ROCKFORD MEMORIAL HOSPITAL IS A NOT-FOR-PROFIT CHARITABLE HEALTHCARE INSTITUTION THAT FUNCTIONS IN ACCORDANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. IN THE COURSE OF OPERATIONS, RMH IS COMMITTED TO PROVIDE SUPERIOR CARE EVERY DAY FOR ALL ITS PATIENTS. RMH IS A 396-BED REGIONAL REFERRAL HOSPITAL WHICH INCLUDES A LEVEL I TRAUMA CENTER, LEVEL III NEONATAL INTENSIVE CARE UNIT AND THE REGION'S ONLY PEDIATRIC INTENSIVE CARE UNIT. IN 2014 PATIENT CARE WAS RENDERED TO 12,100 INDIVIDUALS WHO PRESENTED THEMSELVES FOR SERVICE INCLUDING 1,508 DELIVERIES AND 3,411 INPATIENT SURGERIES ALONG WITH SUPPORTING 54,338 EMERGENCY VISITS. CHARITY CARE PROVIDED IN 2014 AMOUNTED TO $33,565,000.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$77,736,119	ExpenseAmt
Revenue	$119,478,564	RevenueAmt
Desc	RMH IS DESIGNATED BY THE IL DEPT OF PUBLIC HEALTH AS THE DISASTER POD HOSPITAL FOR THE NORTHERN IL EMS REGION. AS A LEVEL I TRAUMA CENTER, RMH PROVIDES PATIENT CARE, DIAGNOSTIC AND THERAPEUTIC SERVICES 24/7 TO ALL WHO PRESENT THEMSELVES FOR SERVICE. IN 2014, THAT INCLUDED 1,610 VISITS TO THE SLEEP LAB; 87,339 DIAGNOSTIC RADIOLOGY PROCEDURES OR TESTS; 7,244 RADIATION ONCOLOGY TREATMENTS; 32,763 CARDIAC PROCEDURES OR TESTS; 3,589 VISITS TO THE PAIN CLINIC; AND 175,753 RESPIRATORY THERAPY TREATMENTS. THROUGH THE OUTREACH SERVICES OF ROCKFORD HEALTH MEDICAL LABORATORIES (RHML), RMH HAS PROVIDED TIMELY AND RESPONSIVE LAB SERVICES TO OTHER HOSPITALS, PHYSICIANS' OFFICES, AND GOVERNMENT AGENCIES, WHILE THE IN-HOUSE LABORATORY PROVIDES TESTING FOR ALL WHO PRESENT THEMSELVES AT THE HOSPITAL FOR TREATMENT. IN 2014, RHML PERFORMED 1,592,636 TESTS.	Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

Field	Value	IRS element (for citing)
Expense	$9,513,330	ExpenseAmt
Grant	$620,756	GrantAmt
Revenue	$2,759,841	RevenueAmt
Desc	RMH HAS PROVIDED HEALTH EDUCATION AND OUTREACH IN A VARIETY OF FORMS WITHIN THE ELEVEN COUNTY AREA THAT INCLUDES SEVERAL SCHOOL PARTNERSHIPS, MENTORING, HEALTH PROGRAMS, TEACHING, JOB SHADOWING AND VOLUNTEERING. RMH HOSTS SUPPORT GROUPS, TRAINING CLASSES, AND LECTURES SERIES FOR HEALTH AND SAFETY RELATED TOPICS. EMPLOYEES STAFF COMMUNITY HEALTH FAIRS AND OPEN HEALTH SCREENINGS. IN A PROGRAM JOINTLY SPONSORED WITH RONALD MCDONALD CHARITIES, RMH STAFFS THE CAREMOBILE WHICH PROVIDED 593 HEALTH AND DENTAL CHECKUPS AND BASIC HEALTH SERVICES TO 535 UNDERINSURED AND UNINSURED CHILDREN. RMH ALSO PROVIDES BOTH FOREIGN LANGUAGE AND HEARING IMPAIRED ASSISTANCE TO PATIENTS AND THEIR FAMILIES TO HELP THEM COMMUNICATE WITH MEDICAL PERSONNEL FOR TREATMENT. FUNDS WERE ALSO USED TO IMPROVE GENERAL HEALTHCARE CONDITIONS THROUGHOUT THE STATE. REVENUE USED TO HELP SUPPORT THESE ACTIVITIES IS PROVIDED BY INVESTMENT INCOME.	Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

Field	Value	IRS element (for citing)
Expense	$957,253	ExpenseAmt
Grant	$150,000	GrantAmt
Revenue	$350,746	RevenueAmt
Desc	THROUGH ROCKFORD MEMORIAL HOSPITAL AUXILIARY, RMH IS ABLE TO PROVIDE EXTRA FUNDS AND SERVICES TO SUPPORT ITS MISSION. THE AUXILIARY HAS 304 VOLUNTEERS WHO LOGGED 28,676 HOURS WHILE ASSISTING WITH GREETING VISITORS, TRANSPORTING PATIENTS, FLORAL OR GIFT DELIVERIES, THRIFT SHOP AND GIFT SHOP ACTIVITIES, AND OTHER SERVICES AS REQUESTED. THE VOLUNTEERS' EFFORTS PROVIDE EXTRA FUNDS AND ENHANCE THE OVERALL HOSPITAL EXPERIENCE FOR PATIENTS, VISITORS AND STAFF.	Desc

Field	Value	IRS element (for citing)
Total Other Prog Srvc Expense	$957,253	TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant	$150,000	TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue	$350,746	TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses	$278,108,213	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	Yes (true)	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	false	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	Yes (true)	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
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	Yes (true)	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	Yes (true)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	Yes (true)	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	Yes (true)	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	247	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	2375	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	Yes (true)	ForeignFinancialAccountInd
Foreign Country	BD	ForeignCountryCd
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	12	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	false	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	Yes (true)	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	false	CompensationProcessCEOInd
Compensation Process Other	false	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

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	DAVID VOLA CONTROLLER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	8159715000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2400 N ROCKTON AVE	AddressLine1Txt
City	ROCKFORD	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61103	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 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	Highest Compensated EmployeeHighestCompensatedEmployeeInd
GARY E KAATZ
PRESIDENT & CEO	1.00	59.00	Yes (X)	Yes (X)	$0	$1,046,965	$63,100
CONNIE M VITALI
CHAIR	2.00	0.90	Yes (X)	Yes (X)	$0	$0	$0
DENNIS T UEHARA
VICE-CHAIR	20.50	35.00	Yes (X)	Yes (X)	$0	$534,513	$44,010
THOMAS D BUDD
TREASUER	0.30	1.00	Yes (X)	Yes (X)	$0	$0	$0
DUANE R BACH
TREASURER (Partial Year)	0.10	1.10	Yes (X)	Yes (X)	$0	$0	$0
JACK J BECHERER
DIRECTOR	1.00	0.60	Yes (X)		$0	$0	$0
JOHN W CHADWICK
DIRECTOR	0.30	0.40	Yes (X)		$0	$0	$0
ELEANOR F DOAR
DIRECTOR	1.00	3.90	Yes (X)		$0	$0	$0
PAMELA S FOX
DIRECTOR	0.10	0.20	Yes (X)		$0	$0	$0
JOSE L GONZALEZ
DIRECTOR	0.70	53.20	Yes (X)		$0	$373,660	$27,255
PAUL A GREEN
DIRECTOR	1.00	1.10	Yes (X)		$0	$0	$0
JEFF R SMITH MD
Director	1.00	42.00	Yes (X)		$0	$372,057	$27,970
CURTIS D WORDEN
DIRECTOR	0.50	1.90	Yes (X)		$0	$1,429	$0
JULIE PETERSON
SECRETARY	1.00	40.30		Yes (X)	$0	$79,211	$4,320
HENRY M SEYBOLD
CFO	3.00	42.30		Yes (X)	$0	$474,282	$33,136
Carolyn Bengtson
VP UTILIZATION MANAGEMENT	40.00	0			$363,166	$0	$26,100	Yes (X)
JOHN T DORSEY
DIRECTOR	39.00	1.00			$388,306	$0	$25,372	Yes (X)
Daniel Parod
SR VP HOSPITAL & ADMIN AFFAIRS	40.00	0			$355,061	$0	$39,686	Yes (X)
Susan Schreier
CHIEF NURSING OFFICER	40.00	0			$244,484	$0	$18,618	Yes (X)
Michael Tyrkus
DIRECTOR OF CYTOGENETICS	40.00	0			$224,309	$0	$19,573	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,575,326	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$2,882,117	TotReportableCompRltdOrgAmt
Total Other Compensation	$329,140	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	52	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	Yes (true)	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
ROCKFORD HEALTH SYSTEM
2400 N ROCKTON AVE	ROCKFORD	IL	61103	ADMINISTRATIVE SERVICES	$11,273,719
SCHMELING CONSTRUCTION
315 HARRISON AVE	ROCKFORD	IL	61104	CONSTRUCTION	$4,654,475
PHILIPS MEDICAL SYSTEM
PO BOX 100355	ATLANTA	GA	30384	CONTRACT MAINTENANCE	$2,557,001
WILSON ELECTRIC
113 S MADISON ST	ROCKFORD	IL	611041195	ELECTRICAL CONTRACTOR	$2,063,450
SOLIC CAPITAL ADVISORS
1603 ORRINGTON AVE STE 1600	EVANSTON	IL	60201	CONSULTING	$1,843,563

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	53	CntrctRcvdGreaterThan100KCnt
Related Organizations	$7,970,126	RelatedOrganizationsAmt
Government Grants	$4,611,399	GovernmentGrantsAmt
All Other Contributions	$7,035	AllOtherContributionsAmt
Total Contributions	$12,588,560	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt	Unrelated Business RevenueUnrelatedBusinessRevenueAmt
INPATIENT ROUTINE & ANCILLARY	900099	$34,995,391	$34,995,391
OUTPATIENT & EMERGENCY	621400	$39,596,396	$39,596,396
DIAGNOSTIC & MEDICAL LABORATORY	621500	$14,881,802	$14,838,948	$42,854
MEDICARE/MEDICAID	900099	$260,931,834	$260,931,834
OTHER	900099	$2,939,235	$2,930,764	$8,471

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$353,344,658	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$2,005,135	TotalRevenueColumnAmt
Exclusion	$2,005,135	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$520,155	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$370,361	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$149,794	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$149,794	TotalRevenueColumnAmt
Exclusion	$149,794	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$104,921,640	SecuritiesAmt
Other	$1,139,353	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$98,264,535	SecuritiesAmt
Other	$397,393	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$6,657,105	SecuritiesAmt
Other	$741,960	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,399,065	TotalRevenueColumnAmt
Exclusion	$7,399,065	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	CAFETERIA/FOOD SERVICE/CATERING	Desc
Business	722320	BusinessCd
Total Revenue Column	$1,799,724	TotalRevenueColumnAmt
Unrelated Business Revenue	$1,077	UnrelatedBusinessRevenueAmt
Exclusion	$1,798,647	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$1,799,724	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$377,286,936	TotalRevenueColumnAmt
Related Or Exempt Func Income	$353,293,333	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$52,402	UnrelatedBusinessRevenueAmt
Exclusion	$11,352,641	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$770,756	TotalAmt
Program Services	$770,756	ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$108,495,336	TotalAmt
Program Services	$89,294,310	ProgramServicesAmt
Management And General	$19,201,026	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$5,123,199	TotalAmt
Program Services	$4,562,259	ProgramServicesAmt
Management And General	$560,940	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$25,248,516	TotalAmt
Program Services	$23,347,171	ProgramServicesAmt
Management And General	$1,901,345	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$6,801,158	TotalAmt
Program Services	$6,099,151	ProgramServicesAmt
Management And General	$702,007	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$217,250	TotalAmt
Management And General	$217,250	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$376,276	TotalAmt
Management And General	$376,276	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$290,413	TotalAmt
Management And General	$290,413	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,094,698	TotalAmt
Program Services	$1,089,756	ProgramServicesAmt
Management And General	$1,004,942	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$941,926	TotalAmt
Program Services	$3,114	ProgramServicesAmt
Management And General	$938,812	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$8,869,476	TotalAmt
Program Services	$6,491,606	ProgramServicesAmt
Management And General	$2,377,870	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$8,398,009	TotalAmt
Program Services	$4,522,027	ProgramServicesAmt
Management And General	$3,875,982	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$9,565,068	TotalAmt
Program Services	$6,830,963	ProgramServicesAmt
Management And General	$2,734,105	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$109,830	TotalAmt
Program Services	$82,161	ProgramServicesAmt
Management And General	$27,669	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$683,028	TotalAmt
Program Services	$204,940	ProgramServicesAmt
Management And General	$478,088	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$1,358,546	TotalAmt
Program Services	$1,358,546	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$17,032,102	TotalAmt
Program Services	$12,676,119	ProgramServicesAmt
Management And General	$4,355,983	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$8,511,245	TotalAmt
Program Services	$7,364,338	ProgramServicesAmt
Management And General	$1,146,907	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
Supplies/Drugs	$49,657,616	$49,572,652	$84,964
Healthcare Services	$40,943,460	$40,943,460
Medicaid Assessment Tax	$12,095,707	$12,095,707
Equipment rental/lease	$1,485,046	$752,422	$732,624

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$23,051,412	TotalAmt
Program Services	$10,046,755	ProgramServicesAmt
Management And General	$13,004,657	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$332,120,073	TotalAmt
Program Services	$278,108,213	ProgramServicesAmt
Management And General	$54,011,860	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$37,268,913	BOYAmt
EOY	$39,298,575	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$5,967,442	BOYAmt
EOY	$5,939,279	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$665,327	BOYAmt
EOY	$529,025	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$58,570,326	BOYAmt
EOY	$57,939,768	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$2,373	BOYAmt
EOY	$2,348	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$7,324,270	BOYAmt
EOY	$7,844,471	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$1,498,711	BOYAmt
EOY	$1,461,338	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$308,998,819	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$205,094,982	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$96,298,322	BOYAmt
EOY	$103,903,837	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$108,088,445	BOYAmt
EOY	$110,751,877	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$8,969,096	BOYAmt
EOY	$9,697,774	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$13,824,763	BOYAmt
EOY	$14,003,191	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$338,477,988	BOYAmt
EOY	$351,371,483	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$84,226,729	BOYAmt
EOY	$87,126,737	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$63,307,216	BOYAmt
EOY	$60,110,325	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
EOY	$973,275	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$8,488,877	BOYAmt
EOY	$22,336,342	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$156,022,822	BOYAmt
EOY	$170,546,679	EOYAmt

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$172,790,119	BOYAmt
EOY	$170,814,135	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,039,887	BOYAmt
EOY	$7,385,509	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,625,160	BOYAmt
EOY	$2,625,160	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$182,455,166	BOYAmt
EOY	$180,824,804	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$338,477,988	BOYAmt
EOY	$351,371,483	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$45,166,863	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$3,069,086	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	-$43,728,139	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	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

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)
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	$36,511	OtherActivitiesAmt
Total Lobbying Expenditures	$36,511	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 Description of the activities reported on lines 1A through 1L	FormAndLineReferenceDesc
Explanation	A percentage of the 2014 Illinois Hospital Association, American Hospital Association and Metropolitan Chicago Healthcare Council dues were used for lobbying.	ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$7,866,965	BeginningYearBalanceAmt
Contributions	$56,884	ContributionsAmt
Investment Earnings Or Losses	$749,923	InvestmentEarningsOrLossesAmt
Other Expenditures	$266,529	OtherExpendituresAmt
Administrative Expenses	$13,623	AdministrativeExpensesAmt
End Year Balance	$8,393,620	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,847,928	BeginningYearBalanceAmt
Contributions	$148,494	ContributionsAmt
Investment Earnings Or Losses	$1,068,646	InvestmentEarningsOrLossesAmt
Other Expenditures	$186,672	OtherExpendituresAmt
Administrative Expenses	$11,431	AdministrativeExpensesAmt
End Year Balance	$7,866,965	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$6,085,799	BeginningYearBalanceAmt
Contributions	$69,541	ContributionsAmt
Investment Earnings Or Losses	$933,066	InvestmentEarningsOrLossesAmt
Other Expenditures	$224,548	OtherExpendituresAmt
Administrative Expenses	$15,930	AdministrativeExpensesAmt
End Year Balance	$6,847,928	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$5,926,437	BeginningYearBalanceAmt
Contributions	$95,812	ContributionsAmt
Investment Earnings Or Losses	$130,832	InvestmentEarningsOrLossesAmt
Other Expenditures	$44,441	OtherExpendituresAmt
Administrative Expenses	$22,841	AdministrativeExpensesAmt
End Year Balance	$6,085,799	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$4,988,438	BeginningYearBalanceAmt
Contributions	$320,215	ContributionsAmt
Investment Earnings Or Losses	$756,626	InvestmentEarningsOrLossesAmt
Other Expenditures	$117,358	OtherExpendituresAmt
Administrative Expenses	$21,484	AdministrativeExpensesAmt
End Year Balance	$5,926,437	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	0.044	BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY	0.437	PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY	0.519	TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org	false	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	Yes (true)	EndowmentsHeldRelatedOrgInd
Related Org List Sch R	Yes (true)	RelatedOrgListSchRInd

Land LandGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$65,484	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$2,535,488	OtherCostOrOtherBasisAmt
Book Value	$2,600,972	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$559,677	InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis	$61,486,316	OtherCostOrOtherBasisAmt
Depreciation	$46,598,709	DepreciationAmt
Book Value	$15,447,284	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$99,060	OtherCostOrOtherBasisAmt
Depreciation	$98,917	DepreciationAmt
Book Value	$143	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$236,415,805	OtherCostOrOtherBasisAmt
Depreciation	$158,397,356	DepreciationAmt
Book Value	$78,018,449	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$7,836,989	OtherCostOrOtherBasisAmt
Book Value	$7,836,989	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$103,903,837	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDesc	AmtAmt
Accrued PENSION	$16,471,444
Accrued POST RETIREMENT Medical Benefits	$5,864,898

Field	Value	IRS element (for citing)
Total Liability	$22,336,342	TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

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.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
Indiv Hospital Tailored Policy	Yes (X)	IndivHospitalTailoredPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

Field	Value	IRS element (for citing)
Other	Yes (X)	OtherInd
Free Care Other	175	FreeCareOtherPct

Field	Value	IRS element (for citing)
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent300	Yes (X)	Percent300Ind
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	$5,484,259	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$5,484,259	NetCommunityBenefitExpnsAmt
Total Expense	0.0169	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$113,386,845	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$100,224,466	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$13,162,379	NetCommunityBenefitExpnsAmt
Total Expense	0.0407	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$118,871,104	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$100,224,466	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$18,646,638	NetCommunityBenefitExpnsAmt
Total Expense	0.0576	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,324,110	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$151,852	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,172,258	NetCommunityBenefitExpnsAmt
Total Expense	0.0036	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,883,950	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$443,977	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,439,973	NetCommunityBenefitExpnsAmt
Total Expense	0.0044	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$47,057,989	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$45,712,052	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,345,937	NetCommunityBenefitExpnsAmt
Total Expense	0.0042	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$6,276,721	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$6,276,721	NetCommunityBenefitExpnsAmt
Total Expense	0.0194	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$56,542,770	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$46,307,881	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$10,234,889	NetCommunityBenefitExpnsAmt
Total Expense	0.0316	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$175,413,874	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$146,532,347	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$28,881,527	NetCommunityBenefitExpnsAmt
Total Expense	0.0892	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$8,340,839	BadDebtExpenseAmt
Bad Debt Expense Attributable	$0	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$83,614,691	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$96,042,240	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$12,427,549	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
Hospital Facilities	2	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp (2 entries)

FacilityFacilityNum	Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Website AddressWebsiteAddressTxt	State LicenseStateLicenseNum	Licensed HospitalLicensedHospitalInd	General Medical And SurgicalGeneralMedicalAndSurgicalInd	Childrens HospitalChildrensHospitalInd	Teaching HospitalTeachingHospitalInd	Critical Access HospitalCriticalAccessHospitalInd	Emergency Room24 HrsEmergencyRoom24HrsInd	OtherOtherDesc
ROCKFORD MEMORIAL HOSPITAL
1	2400 N ROCKTON AVE	ROCKFORD	IL	61103	HTTP://WWW.ROCKFORDHEALTHSYSTEM.ORG/ROCKFORD-MEMORIAL-HOSPITAL	0002048	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)
VANMATRE HEALTH SOUTH
2	950 S MULFORD RD	ROCKFORD	IL	61108	HTTP://WWW.ROCKFORDHEALTHSYSTEM.ORG/VAN-MATRE-HEALTHSOUTH-REHABILITATION-HOSPITAL	0005215	Yes (X)						REHABILITATION

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp (2 entries)

FacilityFacilityNum	First Licensed CY Or PYFirstLicensedCYOrPYInd	Tax Exempt Hospital CY Or PYTaxExemptHospitalCYOrPYInd	CHNA ConductedCHNAConductedInd	Community DefinitionCommunityDefinitionInd	Community DemographicsCommunityDemographicsInd	Existing ResourcesExistingResourcesInd	How Data ObtainedHowDataObtainedInd	Community Health NeedsCommunityHealthNeedsInd	Other Health IssuesOtherHealthIssuesInd	Community Hlth Needs Id ProcessCommunityHlthNeedsIdProcessInd	Consulting ProcessConsultingProcessInd	CHNA ConductedCHNAConductedYr	Take Into Account Others InputTakeIntoAccountOthersInputInd	CHNA Conducted With Other FcltsCHNAConductedWithOtherFcltsInd	CHNA Conducted With Non FcltsCHNAConductedWithNonFcltsInd	CHNA Report Widely AvailableCHNAReportWidelyAvailableInd	Other WebsiteOtherWebsiteInd	Other Website URLOtherWebsiteURLTxt	Paper Copy Public InspectionPaperCopyPublicInspectionInd	Implementation Strategy AdoptImplementationStrategyAdoptInd	Implementation Strategy AdptImplementationStrategyAdptYr	Strategy Posted WebsiteStrategyPostedWebsiteInd	Strategy Website URLStrategyWebsiteURLTxt	Strategy AttachedStrategyAttachedInd	Organization Incur Excise TaxOrganizationIncurExciseTaxInd	Elig Criteria ExplainedEligCriteriaExplainedInd	FPG Family Incm Lmt Free DscntFPGFamilyIncmLmtFreeDscntInd	FPG Family Incm Lmt Free CareFPGFamilyIncmLmtFreeCarePct	FPG Family Incm Lmt Dscnt CareFPGFamilyIncmLmtDscntCarePct	Income Level CriteriaIncomeLevelCriteriaInd	Asset Level CriteriaAssetLevelCriteriaInd	Medical Indigency CriteriaMedicalIndigencyCriteriaInd	Insurance Status CriteriaInsuranceStatusCriteriaInd	Underinsurance Stat CriteriaUnderinsuranceStatCriteriaInd	Residency CriteriaResidencyCriteriaInd	Explained BasisExplainedBasisInd	App Financial Asst ExplnAppFinancialAsstExplnInd	Described InfoDescribedInfoInd	Described Suprt DocDescribedSuprtDocInd	Provided Hospital ContactProvidedHospitalContactInd	Provided Nonprofit ContactProvidedNonprofitContactInd	Includes Publicity MeasuresIncludesPublicityMeasuresInd	FAP Available On WebsiteFAPAvailableOnWebsiteInd	FAP App Available On WebsiteFAPAppAvailableOnWebsiteInd	FAP Avlbl On Request No ChargeFAPAvlblOnRequestNoChargeInd	FAP App Avlbl On Request No ChrgFAPAppAvlblOnRequestNoChrgInd	FAP Sum Avlbl On Request No ChrgFAPSumAvlblOnRequestNoChrgInd	FAP Actions On NonpaymentFAPActionsOnNonpaymentInd	Collection ActivitiesCollectionActivitiesInd	FAP Notified Upon AdmissionFAPNotifiedUponAdmissionInd	FAP Notified Before DischargeFAPNotifiedBeforeDischargeInd	FAP Notified All PatientsFAPNotifiedAllPatientsInd	Documented Elig DeterminationDocumentedEligDeterminationInd	Nondis Emergency Care PolicyNondisEmergencyCarePolicyInd	Other Method UsedOtherMethodUsedInd	Amounts Generally BilledAmountsGenerallyBilledInd	Gross ChargesGrossChargesInd	Rpt Available On Own WebsiteRptAvailableOnOwnWebsiteInd	Own Website URLOwnWebsiteURLTxt	No Emergency CareNoEmergencyCareInd	Medicare RatesMedicareRatesInd
ROCKFORD MEMORIAL HOSPITAL
1	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	14	Yes (true)	Yes (true)	false	Yes (true)	Yes (X)	http://www.rockfordhealthcouncil.org/RHorg2013/?page_id=2879	Yes (X)	Yes (true)	14	Yes (true)	http://www.rockfordhealthsystem.org/about-us/community-benefit	false	false	Yes (true)	Yes (X)	1.75	3.0	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	false	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)	Yes (X)	false	false
VANMATRE HEALTH SOUTH
2	false	false	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (X)		14	Yes (true)	Yes (true)	false	Yes (true)				false				false	false	Yes (true)	Yes (X)	2.0	4.0	Yes (X)						Yes (true)	Yes (true)	Yes (X)	Yes (X)	Yes (X)	Yes (X)	Yes (true)			Yes (X)	Yes (X)		false	false			Yes (X)	Yes (X)	false		false	false	Yes (X)	http://www.rockfordhealthsystem.org/about-us/community-benefit	Yes (X)	Yes (X)

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - ROCKFORD MEMORIAL HOSPITAL. In 2014, The Rockford Health Council produced a regional health needs assessment with extensive interviews and surveys taken during 2014. Contacts included Focus groups, health care providers, Community analysis, Household surveys all of which included local and state government organizations, local businesses, and local educators (pre-school through college). The survey was done with funding, cooperation, participation and assistance from all three Rockford hospitals - RMH, SwedishAmerican Hospital and St. Anthony's Medical Center. Survey is available and was promulgated within the community by the Rockford Health Council, survey participants and was made available on Rockford Health Council's website.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - ROCKFORD MEMORIAL HOSPITAL. SwedishAmerican Hospital and St. Anthony's Medical Center.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - Rockford Memorial Hospital. The 2014 Healthy Community Study included analysis of various extant data related to demographics, social and economic factors, physical environment, clinical care, healthy behaviors, and health outcomes. In addition, the survey tool that was used targeted the following health related areas: general health, chronic disease/obesity, behavioral health, and maternal/prenatal and early childhood. The latter three areas had been identified in previous studies as priority areas. By focusing on these health related areas, more focused, timely, and longitudinal information will be available to evaluate effects of targeted efforts. In the analysis, some demographic and social and economic deficits were revealed. Specifically, the local community showed deficits around poverty percentages as compared to the state and to the US. In addition, the data revealed deficits in educational attainment rates around high school and college diploma rates as compared to the state. While these are crucial areas that need to be addressed by the community, many other organizations are more knowledgeable and better equipped to develop strategies to improve these areas. Programs and strategies have been and are being developed by a multitude of community organizations to begin to affect the educational attainment and poverty deficits. Some of these organizations include The Rockford Public School System, Rock Valley College, Alignment Rockford, Transform Rockford, Rockford Literacy Council, etc. While Rockford Health System does play a role in supporting these organizations and efforts, our community benefit plan focuses on affecting the health needs/deficits of the local community.
Schedule H, Part V, Section B, Line 22 Facility , 1	Facility , 1 - FACILITY A-ROCKFORD MEMORIAL HOSPITAL. ROCKFORD MEMORIAL HOSPITAL (RMH) PROVIDES CARE, WITHOUT DISCRIMINATION, FOR EMERGENCY MEDICAL CONDITIONS TO INDIVIDUALS REGARDLESS OF WHETHER THEY ARE FAP-ELIGIBLE. RMH DOES NOT DISCOURAGE INDIVIDUALS FROM SEEKING EMERGENCY MEDICAL CARE BY DEMANDING PAYMENT PRIOR TO SERVICE. FAP-ELIGIBLE PATIENTS ARE NOT CHARGED MORE THAN AMOUNTS GENERALLY BILLED. IF THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, THE PATIENT WILL BE LIMITED IN LIABILITY TO 135% OF COST DETERMINED BY APPLYING RATIO OF COST TO CHARGES FROM MOST RECENTLY FILED MEDICARE COST REPORT TO UNINSURED PATIENT'S BILL. . THE MAXIMUM AMOUNT RMH MAY COLLECT IN A 12-MONTH PERIOD FROM A PATIENT IS 25% OF THE FAMILY'S GROSS ANNUAL INCOME. THIS POLICY DEFINES THE ILLINOIS HOSPITAL UNINSURED PATIENT DISCOUNT ACT. RMH ALSO PROVIDES TWO OTHER FINANCIAL ASSISTANCE PROGRAMS, TRADITIONAL AND CATASTROPHIC, ALONG WITH HUPDA AND WE APPLY THE HIGHEST DISCOUNT AMONG THE THREE PROGRAMS. THE AGB DISCOUNT PERCENTAGE IS TO BE DETERMINED UNDER A LOOK-BACK METHOD OF VARIOUS COMBINATIONS OF MEDICARE, COMMERCIAL INSURERS AND MEDICAID OR A PROSPECTIVE METHOD OF WHAT MEDICARE OR MEDICAID WOULD PAY.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - Van Matre HealthSouth Rehabilitation Hospital. SwedishAmerican Hospital and St. Anthony's Medical Center.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - VAN MATRE HEALTHSOUTH REHABILITATION HOSPITAL. AS THE PREMIER REHABILITATION FACILITY IN NORTHERN ILLINOIS, VAN MATRE, A 61-BED INPATIENT REHABILITATION HOPSITAL HAS BEEN FOCUSING ON PATIENT REHABILITATION BOTH IN INPATIENT REHABILITATION AS WELL AS OUTPATIENT THERAPY. THE NEED FOR REHABILITATION DUE TO STROKE AND NEUROLOGICAL DISORDERS IN NORTHERN ILLINOIS PROMPTED AN EXPANSION OF THE FACILITIES IN 2014. NEEDS OF THE COMMUNITY ARE CONTINUALLY REEVALUATED SO THAT VAN MATRE PATIENTS CAN QUICKLY RETURN TO LEADING ACTIVE AND INDEPENDENT LIVES.

Field	Value	IRS element (for citing)
Facility	0	FacilityNum

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 7 Bad Debt Expense excluded from financial assistance calculation	8340839
Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance	THE HOSPITAL UTILIZED BOTH THE MEDICARE COST REPORT CCR (COST-TO-CHARGE RATIO) AND OUR COST ACCOUNTING SYSTEM TO DETERMINE THE COST OF CHARGES, BAD DEBT AND CHARITY CARE EXPENSE INCLUDED IN LINE 7. THE SUBSIDIZED PROGRAMS ALSO INCLUDE THE COSTS (BASED ON A CALCULATED CCR) FROM THE RELATED COMPANY ROCKFORD HEALTH PHYSICIANS (RHPH) BECAUSE THERE ARE NO PHYSICIANS COSTS INCLUDED IN THE HOSPITAL COST ACCOUNTING ANALYSIS. BAD DEBT AND CHARITY AT COST HAVE BEEN REMOVED FROM LINES 7E/7F/7G SINCE THOSE COSTS WERE PREVIOUSLY INCLUDED.
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	All charges for any service provided by Rockford Memorial Hospital are the very same for every individual, regardless of whether it is for emergency or standard care and regardless of the patient's ability to pay. Each patient is then assessed for eligibility for financial assistance based on predefined criteria of financial status and income level. If the patient qualifies for financial assistance, the expected reimbursement is based on charity care policy guidelines. If the patient has no insurance and doesn't qualify for financial assistance, the expected reimbursement is 75% of billed charges. The organization maintains a bad debt reserve on the Balance Sheet. Any bad debt write-offs of patient accounts will go against the bad debt reserve. At each month end based on the accounts receivable by financial class and aging bucket, the reserve amount is re-evaluated. The amount needed to maintain the appropriate reserve level is the bad debt expense. Any payments received on patient accounts previously written off to bad debt will offset the bad debt expense.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	Rockford Health System Consolidated Audit reports: Net patient service revenue is reported at estimated net realizable amounts from patients, third-party payors, and others for services rendered. Contractual adjustments represent the difference between established rates for services and amounts paid by third-party payors. Payments under these agreements and programs are based on either a specific amount per case; costs, as defined, of rendering services to program beneficiaries; or contracted price. Amounts for uncollectible accounts are also included as reductions to net patient service revenue. Contractual adjustments and bad debts are accrued on an estimated basis in the period the related services are rendered, and are adjusted in future periods as final settlements are determined.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	The data reported for Medicare charges and payments is from the final Management Report produced by the firm that prepared the 2014 Cost Report as submitted to the Fiscal Intermediary in 2015 in compliance with all current regulations. Reported on Line 6 are allowable Medicare Costs provided by the Cost Report. Medicare costs are eliminated from the Subsidized Programs on Part 1 Ln 7g as calculated by our cost accounting analysis. A combination of cost accounting and the Medicare CCR was used for the computation of subsidized programs. This Section B-Medicare also includes 50% of the Medicare activity from Van Matre Health South (VMHS) and the corresponding cost based entirely on their Medicare CCR.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	Rockford Memorial Hospital has a strong commitment to provide quality patient care for all individuals. Our mission is to provide health care to everyone who comes to our door, regardless of their ability to pay. We will submit a claim to all 3rd party payors on behalf of the patient. We help patients apply for all possible insurance or assistance such as crime victims, an automobile accident, workers' compensation, Medicaid, COBRA, local assistance and/or hospital financial assistance. If they do not qualify for any of these, we can extend payment options such as monthly payments, credit card payments or financial assistance. This is offered to patients who are experiencing legitimate financial hardships and are unable to pay for all or part of the patient's medical care. Forgiveness may apply to an amount after applying all payments such as any insurance company, health plan or personal payments, any negotiated discounts or any uninsured discounts. If a patient eligible for charity care or partial financial assistance still has a portion of the outstanding balance due, other arrangements are made. RMH accepts a variety of payments and alternative payment plans. Monthly statements are sent as payment reminders for contracted arrangements. In case of default, additional letters and calls are made to bring it to a current status. An account is turned over to a collection agency only after non-payment or no contact in 120 days although RMH will suspend collection efforts once a completed application has been received and is pending approval or denial.
Schedule H, Part V, Section B, Line 16a FAP website	- ROCKFORD MEMORIAL HOSPITAL: Line 16a URL: http://www.rockfordhealthsystem.org/rmh-financial-assistance;
Schedule H, Part V, Section B, Line 16b FAP Application website	- ROCKFORD MEMORIAL HOSPITAL: Line 16b URL: http://www.rockfordhealthsystem.org/rmh-financial-assistance;
Schedule H, Part VI, Line 2 Needs assessment	In 2014, Rockford Health System partnered with other local health care providers and educational, government, and business leaders to support the efforts of the Rockford Health Council in developing a tool and completing a study that identified various areas affecting the quality of life for our residents. Formed in 1995 as a not-for-profit community membership collaborative, Rockford Health Council is comprised of various community leaders and is committed to promoting health and improving access for the residents of northern Illinois. The 2014 Healthy Community Study included a comprehensive community analysis that reviewed demographic, socioeconomic, general health behavior, and disease incidence and mortality information for the residents of Winnebago and Boone Counties and provided comparisons to state and national data. A household survey which focused on demographic, general health conditions, behavioral health, maternal, prenatal, and early childhood health, and chronic disease and obesity was also distributed to residents throughout the community. In addition, a key informant questionnaire was conducted with various individuals throughout the community to identify health and human service needs. The completed study is available on the Rockford Health System and Rockford Health Council respective websites. In addition to the 2014 Healthy Community Study, Rockford Health System completed a community needs assessment in order to plan for and anticipate future clinical program needs and related physician requirements specific to our local and regional community. This study analyzed physicians by specialty within the community including review of suggested physician manpower requirements as determined by population forecasts, physician age, and physician accessibility of the local area and forms the basis for physician recruitment and succession planning. Out-migration analysis was also completed. Understanding why residents of the local community leave the area for various inpatient services is used to plan for future clinical programs and services that may not be readily available in our local community. The study looks at pediatric versus adult patients, actual patient diagnosis and hospital services received. All of these tools were used to develop the Rockford Health System Community Benefit Implementation Plan which was approved by the Board of Directors in 2014. An oversight committee meets routinely to ensure plan implementation of the various strategies and tactics with a progress report provided to the Board on an annual basis.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	RMH posts signs in both Spanish and English in all general registration areas and the Emergency Department to indicate that financial assistance is available for those who qualify. The organization's website states "Patients throughout Rockford Health System are treated regardless of their ability to pay. Click on the entity above to learn more." The RMH link to financial assistance and discount programs explains the process in this manner "Rockford Health System provides health care regardless of the patient's ability to pay for such care. These guidelines are intended to provide a framework to offer assistance to patients and families with legitimate financial hardship, who are unable to pay for all or a portion of their medical care. Covered services are those which are determined medically necessary by a physician. Our financial assistance programs are based on whether you have insurance coverage of any kind or are uninsured."
Schedule H, Part VI, Line 4 Community information	Rockford Memorial Hospital is located in Rockford, IL (Winnebago County) with a defined primary service area that includes Winnebago, Boone, and Ogle Counties. 2013 US Census Bureau estimates project the population for the entire area at slightly more than 400,500 individuals with a little more than 73% living in Winnebago County (approximately 293,000). Located in northern Illinois, the primary service area is characterized as largely rural and populated with very small communities with the exception of the neighboring cities of Rockford, Loves Park, and Machesney Park which comprise more than 197,000 individuals. The next largest community is Belvidere, located in Boone County where the entire county has a population of approximately 54,000 people. In calendar year 2014, approximately 84% of hospital inpatients were from the Primary Service Area. As a community that relies heavily on manufacturing companies and small businesses, the area was particularly hard hit in recent years. Currently, the largest employers include Chrysler (Boone County), the Rockford Public Schools, and the three Rockford health care providers. The most recent median household income figures (U.S. Census Bureau) in Winnebago County were $47,000 compared to the state's median household income of $54,000. These disparities are also reflected in unemployment, education and poverty rates. Unemployment rates have improved with most recent figures for Rockford at 7.2%. Only 21% of Winnebago County residents attain a bachelor's degree or higher while in the state 31% do. More than 17% of the residents in Winnebago County live below the poverty line and children in the community have been particularly hit with more than 27% considered at or below poverty levels. The hospital also serves the secondary service area which includes DeKalb, McHenry, Whiteside, Lee, LaSalle, Stephenson and Rock counties for select tertiary services.
Schedule H, Part VI, Line 5 Promotion of community health	Led by a community board of directors, Rockford Memorial Hospital (RMH) and its affiliates are very involved in promoting a healthier community. As one of Rockford's largest employers, the organization takes a leading role in financially supporting not only health-related initiatives, but also community-building activities across the region. This includes providing financial support and talent for economic development and business related activities, as well as quality of life and educational initiatives. Employees participate on community boards and are actively involved in promoting the region and its assets. Based on the results of the Rockford Health Council 2013 Healthy Community Study, the 2014 - 2017 Community Benefit Implementation Plan identified several key areas to focus efforts. For example, as the predominate provider of pediatric services, Rockford Memorial maintains its commitment to the children of our community. This is evident in our support of the Ronald McDonald Care Mobile which provides free dental and medical care to uninsured and underinsured children in five northern Illinois counties. The 40-foot, 26,000 pound mobile unit houses two patient exam rooms, a central waiting room, and a sterilization area and has provided care to more than 6,500 children since the inception of the program in 2003. This totals more than $1.85 million in free care over the life of the program. The Care Mobile is completely funded by philanthropy from the Rockford Memorial Development foundation, Rockford Memorial Hospital Auxiliary, and the Ronald McDonald House Charities of Madison. The Bridge Clinic is yet another venue for un- and under-insured adults to receive free medical treatment for chronic medical issues. Since its opening in 2008, hundreds of people from our community have received care. Many physicians and other health care providers give freely of their time to provide these services to less fortunate individuals in our community to better manage their chronic conditions. Since 2012, Rockford Memorial continues to partner with A Silver Lining Foundation to provide free breast health services to un- and under-insured women in the community. Approximately 500 women have received free screening mammograms and other breast related services and procedures since the program's inception. These are only some of the many contributions that Rockford Memorial makes to promote and improve the health of the community. Rockford Memorial remains committed to educating the public about various health care issues and initiatives and improving the lives of our citizens. RMH does not restrict admission of providers and provides an open medical staff.
Schedule H, Part VI, Line 7 State filing of community benefit report	IL

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (true)	GrantRecordsMaintainedInd

Recipient Table RecipientTable (18 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	Recipient EINRecipientEIN	IRC SectionIRCSectionDesc	Cash GrantCashGrantAmt	Purpose Of GrantPurposeOfGrantTxt	Address Line2USAddress/AddressLine2Txt
ROCKFORD MEMORIAL DEVELOPMENT FOUNDATION
2400 N ROCKTON AVE	ROCKFORD	IL	61103	363197918	501(C)(3)	$150,000	Program Support
GIGI'S PLAYHOUSE ROCKFORD
8801 N Second St Suite 2	MACHESNEY PARK	IL	61115	462014837	501(C)(3)	$25,000	Program Support
EASTER SEALS OF METROPOLITAN CHICAGO
1939 WEST 13TH ST	CHICAGO	IL	60608	362169153	501(C)(3)	$11,950	Program Support	STE 300
AMERICAN CANCER SOCIETY
225 N MICHIGAN AVE	CHICAGO	IL	60601	362167721	501(C)(3)	$11,000	PROGRAM SUPPORT	STE 1200
HEALING PATHWAYS - CANCER RESOURCE CENTER
3921 E STATE ST	ROCKFORD	IL	611082053	262173633	501(C)(3)	$8,500	PROGRAM SUPPORT	STE D
AMERICAN HEART ASSOCIATION
7272 GREENVILLE AVE	DALLAS	TX	752315129	135613797	501(C)(3)	$9,543	PROGRAM SUPPORT
MARCH OF DIMES
1275 MAMARONECK AVE	WHITE PLAINS	NY	106055201	131846366	501(C)(3)	$22,500	Program Support
ALZHEIMER'S ASSOCIATION
225 N MICHIGAN AVE	CHICAGO	IL	606017633	133039601	501(C)(3)	$5,500	PROGRAM SUPPORT	SUITE 17TH FLR
CARRIE LYNN CHILDRENS CENTER
826 S Main	Rockford	ID	61103	364057184	501(c)(3)	$17,024	PROGRAM SUPPORT
CRUSADERS HEALTH FOUNDATION
1200 W State St	Rockford	ID	611022112	363259761	501(c)(3)	$12,000	PROGRAM SUPPORT
Growth Dimensions For Belvidere-Boone County Inc
401 WHITNEY BLVD	BELVIDERE	IL	61008	363196645	501(c)(6)	$7,500	PROGRAM SUPPORT
MCHC Chicago Hospital Council
222 S RIVERSIDE PLAZA 19TH FLOOR	Chicago	ID	606065808	362167008	501(c)(3)	$15,874	PROGRAM SUPPORT
MILESTONE INC
4060 McFarland Rd	Loves Park	ID	611114402	362769801	501(c)(3)	$8,000	PROGRAM SUPPORT
ROCK VALLEY COLLEGE
3301 N MULFORD RD	Rockford	ID	611145640	363037232	501(c)(3)	$30,000	PROGRAM SUPPORT
ROCKFORD AREA ECONOMIC COUNCIL
100 Park Ave	Rockford	ID	61101	363055858	501(c)(6)	$60,000	PROGRAM SUPPORT	Suite 100
ROCKFORD HEALTH COUNCIL
1601 PARKVIEW AVE	Rockford	ID	611071822	363229371	501(c)(3)	$20,000	PROGRAM SUPPORT
SALVATION ARMY
416 S MADISON ST	ROCKFORD	IL	61104	362167910	501(c)(3)	$9,640	PROGRAM SUPPORT
SHELTER CARE MINISTRIES
412 N CHURCH ST	Rockford	ID	611036811	363374370	501(c)(3)	$7,220	PROGRAM SUPPORT

Field	Value	IRS element (for citing)
Total501c3 Org	16	Total501c3OrgCnt
Total Other Org	2	TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds

APPLICATIONS ARE SUBMITTED TO THE HOSPITAL VERIFYING A NEED FOR FUNDS OR PRODUCTS (I.E. AUTOMATIC ELECTRONIC DEFIBRILATORS-AED). A 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 TO RECOGNIZED CHARITIES FOR WHICH GOOD FAITH REGARDING FUND USE HAS BEEN ESTABLISHED. THE CONTRIBUTION IS ONLY FOR THE AMOUNT OF THE APPEAL AND FOR A SPECIFIED NEED.

Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	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	Yes (true)	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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
GARY E KAATZ
PRESIDENT & CEO	$0	$686,868	$0	$242,722	$0	$117,374	$0	$56,476	$0	$6,624	$0	$1,110,065	$0	$0
DENNIS T UEHARA
VICE-CHAIR	$0	$531,867	$0	$0	$0	$2,646	$0	$37,500	$0	$6,510	$0	$578,524	$0	$0
JOSE L GONZALEZ
DIRECTOR	$0	$372,112	$0	$0	$0	$1,548	$0	$20,000	$0	$7,255	$0	$400,914	$0	$0
JEFF R SMITH MD
Director	$0	$371,283	$0	$0	$0	$774	$0	$20,000	$0	$7,970	$0	$400,027	$0	$0
HENRY M SEYBOLD
CFO	$0	$385,657	$0	$58,079	$0	$30,547	$0	$22,793	$0	$10,343	$0	$507,418	$0	$0
Carolyn Bengtson
VP UTILIZATION MANAGEMENT	$323,731	$0	$18,682	$0	$20,753	$0	$17,704	$0	$8,396	$0	$389,266	$0	$0	$0
JOHN T DORSEY
DIRECTOR	$340,752	$0	$17,043	$0	$30,511	$0	$19,897	$0	$5,475	$0	$413,678	$0	$0	$0
Daniel Parod
SR VP HOSPITAL & ADMIN AFFAIRS	$291,562	$0	$43,815	$0	$19,683	$0	$31,939	$0	$7,747	$0	$394,746	$0	$0	$0
Susan Schreier
CHIEF NURSING OFFICER	$219,922	$0	$13,375	$0	$11,188	$0	$12,156	$0	$6,462	$0	$263,102	$0	$0	$0
Michael Tyrkus
DIRECTOR OF CYTOGENETICS	$214,174	$0	$165	$0	$9,970	$0	$13,921	$0	$5,653	$0	$243,882	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation

THE ROCKFORD HEALTH SYSTEM BOARD OF DIRECTORS HAS A COMPENSATION COMMITTEE THAT REVIEWS EXECUTIVE COMPENSATION FOR THE SYSTEM. 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 MAKES A RECOMMENDATION TO THE BOARD WHO THEN ACTS UPON THIS INFORMATION TO SET COMPENSATION FOR RMH EXECUTIVES.

Schedule J, Part I, Line 7 Non-fixed payments

MANAGEMENT AND EMPLOYEES ARE PERIODICALLY FINANCIALLY REWARDED FOR EXCEEDING COMPANY AND DEPARTMENT PERFORMANCE GOALS. THE AMOUNTS ARE DISCRETIONARY AND ARE NOT RELATED TO NET EARNINGS OF THE ORGANIZATION AND ARE APPROVED BY THE CEO PRIOR TO PAYMENT WITH BOARD OVERSIGHT OF SUCH PAYMENTS. THE CEO'S FINANCIAL INCENTIVES ARE APPROVED BY THE BOARD OF DIRECTORS.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCd	Bond Issuer EINBondIssuerEIN	Bond IssuedBondIssuedDt	Issue PriceIssuePriceAmt	PurposePurposeDesc	DefeasedDefeasedInd	On Behalf Of IssuerOnBehalfOfIssuerInd	Pool FinancingPoolFinancingInd	CUSIPCUSIPNum
ILLINOIS FINANCE AUTHORITY
A	861091967	2012-05-02	$35,075,000	REFUND 1997 SERIES BONDS	false	false	false
ILLINOIS FINANCE AUTHORITY
B	861091967	2008-12-11	$32,782,769	REFUND 1994 SERIES BONDS	false	false	false	45200FSG5

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCd	RetiredRetiredAmt	Bond DefeasedBondDefeasedAmt	Total ProceedsTotalProceedsAmt	In Reserve FundInReserveFundAmt	Capitalized InterestCapitalizedInterestAmt	Refunding EscrowRefundingEscrowAmt	Issuance Costs From ProceedsIssuanceCostsFromProceedsAmt	Credit EnhancementCreditEnhancementAmt	Working Capital ExpendituresWorkingCapitalExpendituresAmt	Capital ExpendituresCapitalExpendituresAmt	Other Spent ProceedsOtherSpentProceedsAmt	UnspentUnspentAmt	Substantial CompletionSubstantialCompletionYr	Current RefundingCurrentRefundingInd	Advance RefundingAdvanceRefundingInd	Final Allocation MadeFinalAllocationMadeInd	Adequate Books And Rec MaintAdequateBooksAndRecMaintInd
A	$7,695,000	$0	$35,075,000	$0	$0	$0	$536,807	$0	$0	$0	$34,538,193	$0	2012	Yes (true)	false	Yes (true)	Yes (true)
B	$0	$0	$32,782,769	$0	$0	$0	$511,397	$17,524	$0	$0	$32,253,849	$0	2008	Yes (true)	false	Yes (true)	Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCd	Total Private Business UseTotalPrivateBusinessUsePct
A	0.0
B	0.0

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCd	Form8038 T FiledForm8038TFiledInd	Rebate Not Due YetRebateNotDueYetInd	Variable Rate IssueVariableRateIssueInd	Hedge Identified In Bks And RecHedgeIdentifiedInBksAndRecInd	Term Of HedgeTermOfHedgePct	Gross Proceeds Invested In GICGrossProceedsInvestedInGICInd	Gross Proceeds InvestedGrossProceedsInvestedInd	Written Proc To Monitor ReqsWrittenProcToMonitorReqsInd	No Rebate DueNoRebateDueInd	Superintegrated HedgeSuperintegratedHedgeInd	Hedge TerminatedHedgeTerminatedInd
(no name)
A	false	Yes (true)	false	false	0.0	false	false	Yes (true)
JP MORGAN CHASE
B	false		Yes (true)	Yes (true)	10.3	false	false	Yes (true)	Yes (true)	false	false

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCd	Procedures Corrective ActionProceduresCorrectiveActionInd
A	Yes (true)
B	Yes (true)

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule K, Part I, Column (e) Issue Price Not Identical to Form 8038	FormAndLineReferenceDesc
Explanation	The total issuance of the 2008 bonds issued from Illinois Finance Authority were issued to RMH and a related organization, Rockford Health Physicians (RHPH). RMH has reported its share of the issuance on Form 990, Part X, line 20, and accordingly has reported consistently for purposes of Schedule K. The total issue price per the Form 8038 is $60,800,000, and RHPH reports the difference on its Form 990.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RMH PATHOLOGISTS LTD	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Relationship Description	PARTNERSHIP OWNED 25% BY CONNIE VITALI, CURRENT DIRECTOR	RelationshipDescriptionTxt
Transaction	$297,127	TransactionAmt
Transaction	CONTRACT FOR PATHOLOGY SERVICES	TransactionDesc
Sharing Of Revenues	false	SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (12 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
CoreFormPartIII_PartIIILine4d Description of other program services	(Expenses $ 957,253 including grants of $ 150,000)(Revenue $ 350,746) THROUGH ROCKFORD MEMORIAL HOSPITAL AUXILIARY, RMH IS ABLE TO PROVIDE EXTRA FUNDS AND SERVICES TO SUPPORT ITS MISSION. THE AUXILIARY HAS 304 VOLUNTEERS WHO LOGGED 28,676 HOURS WHILE ASSISTING WITH GREETING VISITORS, TRANSPORTING PATIENTS, FLORAL OR GIFT DELIVERIES, THRIFT SHOP AND GIFT SHOP ACTIVITIES, AND OTHER SERVICES AS REQUESTED. THE VOLUNTEERS' EFFORTS PROVIDE EXTRA FUNDS AND ENHANCE THE OVERALL HOSPITAL EXPERIENCE FOR PATIENTS, VISITORS AND STAFF.
Form 990, Part VI, Line 15a PROCESS USED TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL	COMPENSATION FOR EXECUTIVES, INCLUDING THE TOP MANAGEMENT OFFICIAL, IS GOVERNED BY THE RHS BOARD OF DIRECTORS. THE RHS BOARD HAS ESTABLISHED A TOTAL COMPENSATION PHILOSOPHY THAT DIRECTS THE COMPENSATION PRACTICES FOR ALL EXECUTIVES. THIS BOARD HAS ESTABLISHED A COMPENSATION COMMITTEE TO ESTABLISH AND REVIEW ALL EXECUTIVE COMPENSATION ANNUALLY BASED ON THE ESTABLISHED PHILOSOPHY. AN EXTERNAL EXECUTIVE COMPENSATION FIRM PROVIDES CONSULTING ON RHS SALARY RANGES AND COMPENSATION PHILOSOPHY. THE APPROPRIATE PEER GROUP FOR COMPENSATION COMPARISON PURPOSES IS OTHER NOT-FOR-PROFIT HEALTHCARE SYSTEMS SIMILAR IN SIZE AND COMPLEXITY. RHS GENERALLY CONDUCTS AN ANALYSIS OF TOTAL COMPENSATION EVERY THREE YEARS BUT MAY CHOOSE TO VARY FROM THIS SCHEDULE AS DETERMINED BY THE COMPENSATION COMMITTEE.
Form 990, Part VI, Line 15b PROCESS USED TO ESTABALISH COMPENSATION FOR OTHER OFFICERS	COMPENSATION FOR EXECUTIVES, INCLUDING OTHER OFFICERS AND KEY EMPLOYEES, IS GOVERNED BY THE RHS BOARD OF DIRECTORS. THE RHS BOARD HAS ESTABLISHED A TOTAL COMPENSATION PHILOSOPHY THAT DIRECTS THE COMPENSATION PRACTICES FOR ALL EXECUTIVES. THIS BOARD HAS ESTABLISHED A COMPENSATION COMMITTEE TO ESTABLISH AND REVIEW ALL EXECUTIVE COMPENSATION ANNUALLY BASED ON THE ESTABLISHED PHILOSOPHY. AN EXTERNAL EXECUTIVE COMPENSATION FIRM PROVIDES CONSULTING ON RHS 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.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	The voting members of the RHS Executive Committee consists of seven individuals, each of whom shall have a vote, including: the RHS CEO, the chairman, vice-chairman, immediate past chairman, treasurer, and 2 additional directors of the board. At least one member of the Executive Committee shall be a physician. The Executive Committee shall in all instances be comprised of at least 51% community members. In the event that one or more of the aforementioned voting members of the Executive Committee is unable to serve in such capacity, then the chairman of the corporation shall designate a replacement from among the board members. The Executive Committee Shall meet as needed. The executive committee shall review reports from the RHS CEO regarding the performance of executives of the corporation and affiliated corporations, monitor the performance of the RHS CEO of the corporation against annual objectives, and determine the compensation level of the RHS CEO. 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.
Form 990, Part VI, Line 6 Classes of members or stockholders	Rockford Health System (RHS) is the sole member. RHS's rights are as follows: (a) Appoint all the directors of the corporation. (b) Nominate to the corporation's board of directors all candidates for selection as the corporation's president. (c) Approve expressly all amendments to the corporation's articles of incorporation and by-laws. (d) Approve annual budgets, and strategic, long-range and health manpower development plans of the corporation. (e) Require the corporation's board of directors to take any action (including authorizing the pledge or transfer of assets to RHS or as directed by RHS, or the execution of contracts) which would improve the credit worthiness or otherwise result in financial benefit to RHS and its tax-exempt Affiliated Corporations (provided that under no circumstances may RHS require transfer of assets in violation of law or the terms of any charitable trust or donation). (f) Approve all contracts of indebtedness effective for longer than eighteen months. (g) Approve all plans of merger or consolidation. (h) Approve the sale, lease, exchange, mortgage, pledge or other disposition of all or substantially all, the property and assets of the corporation. (i) Approve a voluntary dissolution of the corporation. (j) Approve material amendments to the corporation's standard form of physician employment agreement, provided, the corporation shall have the authority to negotiate the terms and conditions of individual physician employment agreements so long as the negotiated terms and conditions are consistent with the requirements of applicable law and the strategic, long-range and health manpower development plans approved by RHS. (k) Approve material amendments to the standard compensation system used by the corporation to establish individual physician compensation; and (l) Require the corporation's board of directors to take any action (including amending the corporation's articles of incorporation or by-laws), or to modify or rescind an action already taken, if the member determines that failure to take the action, or to modify or rescind an action already taken, may result in the corporation'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 FORM 990, PART VI, LINE 6.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	SEE NARRATIVE FOR FORM 990, 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	By written policy, RHS sends out, on an annual basis, the corporate Conflict and Duality of Interest policy to all Board members, corporate officers and other key individuals (those having responsibility and authority to make final decisions regarding the acquisition of products or services). Each recipient is required to complete a Financial Interest Disclosure Statement, which is submitted to the Vice President, Legal Services/General Counsel for review. With respect to physicians and managers who are key individuals, any potential conflict of interest is reviewed with the appropriate executive staff member for follow up with the disclosing party in order to review the matter in more detail. This includes emphasizing that the disclosing party is not permitted to participate in any negotiations for the purchase of any products or services where the conflict is deemed material, or authorize the subsequent purchase of related goods and services. The disclosing party is also required to identify each and every instance of a potential conflict as they may arise in the ordinary course of business. A similar process is followed for the Board of Directors, except that any potential conflict is reviewed by the Board's Governance Committee. Board members may comment on transactions where there is a potential conflict, but cannot vote on the related matter and may be required to leave any meeting where the potential conflict is reviewed by the Board or where the Board takes action to either approve or not approve the proposed transaction. A board member also has a continuing duty to report any conflicts as they may arise in the ordinary course of business. In the event that a potential conflict of interest is reported or discovered outside the established process, appropriate review and action would be taken. 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 the board secretary. The conflict of interest policy is not published but is available upon request.
Form 990, Part VII, Section A NONEMPLOYEE COMPENSATION	CURTIS WORDEN IS NOT COMPENSATED AS A BOARD MEMBER; HE RECEIVED TAXABLE NONEMPLOYEE COMPENSATION FROM RHS, A RELATED ORGANIZATION, ON A FORM 1099 FOR 2014 LEGAL SERVICES PROVIDED TO THE SYSTEM.
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	Pension-Related changes other than net periodic pension cost - -16457892; Post-retirement medical benefit-related changes other than net periodic post-retirement cost - 467315; Net assets released from restrictions used for capital - 89817; Transfer to/from affiliates - -28173001; Net change in beneficial interest in trust - -11587; UPMIFA - 357209;

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	ROCKFORD HEALTH SYSTEM VENTURES LLC	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2400 N ROCKTON AVE	AddressLine1Txt
City	ROCKFORD	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	61103	ZIPCd

Field	Value	IRS element (for citing)
EIN	364366881	EIN
Primary Activities	HEALTHCARE	PrimaryActivitiesTxt
Legal Domicile State	IL	LegalDomicileStateCd
Total Income	$3,234,248	TotalIncomeAmt
End Of Year Assets	$9,697,774	EndOfYearAssetsAmt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 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
VISITING NURSES ASSN OF THE ROCKFORD AREA
4223 E STATE STREET	ROCKFORD	IL	61108	362167945	HEALTHCARE	IL	501(c)(3	9	ROCKFORD HEALTH SYSTEM	Yes (true)
ROCKFORD HEALTH SYSTEM
2400 N ROCKTON AVE	ROCKFORD	IL	61103	363197915	SUPPORT OF HEALTHCARE	IL	501(c)(3	Type III-FI	NA	false
ROCKFORD MEMORIAL DEVELOPMENT FOUNDATION
2400 N ROCKTON AVE	ROCKFORD	IL	61103	362197918	SUPPORT OF HEALTHCARE	IL	501(c)(3	Type I	ROCKFORD HEALTH SYSTEM	Yes (true)
ROCKFORD HEALTH PHYSICIANS
2300 N ROCKTON AVE	ROCKFORD	IL	61103	363097436	HEALTHCARE	IL	501(c)(3	3	ROCKFORD HEALTH SYSTEM	Yes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	ROCKFORD HEALTH INSURANCE LTD	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Primary Activities	INSURANCE	PrimaryActivitiesTxt
Legal Domicile Foreign Country	BD	LegalDomicileForeignCountryCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	NA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C Corporation	EntityTypeTxt
Share Of Total Income	$13,764	ShareOfTotalIncomeAmt
Share Of EOY Assets	$593,215	ShareOfEOYAssetsAmt
Ownership	1	OwnershipPct
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	Yes (true)	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	Yes (true)	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	Yes (true)	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	Yes (true)	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