2014-03-07T16:15:12-06:00 2013-04-30 420714325 MCGLADREY LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2012-05-01 363673380 Sherman Health Systems SHER 2247838718 1425 N Randall Road Elgin IL 60123 Eric Krueger 2247838718 2014-02-24 1 Zack Fortsch P00052725 3126343400 2012 2016-02-25 16:41:14Z Linda Deering 1425 N Randall Road Elgin IL 60123 13394091 0 X WWW.SHERMANHEALTH.ORG X 1989 IL Maintain health service institutions serving the surrounding community. 15 13 0 2 1579877 -421282 0 0 7246107 6434803 2189691 3301558 915689 729499 10351487 10465860 0 0 0 0 1630509 1499670 0 0 0 4618676 4128726 6249185 5628396 4102302 4837464 120541894 138764043 13433527 12888617 107108367 125875426 X Establish and maintain institutions which provide comprehensive health services to meet the health needs of the community surrounding Elgin, IL. 0 0 5628396 4854926 Sherman Health Systems (SHS) supports the efforts of its three supported organizations: Sherman Home Health Care Corporation (SHHCC), Sherman West Court (SWC), and Sherman Hospital (SH).SHHCC was organized in 1984 and continues to be operated exclusively to provide quality home health care to the members of the surrounding community. SHHCC's services are provided as a benefit to all patients by relieving disease and suffering in the comfortable and familiar surroundings of home. Availability of services is non-discriminate to all people and includes indigent and destitute patients. In fiscal year 2013, SHHCC provided 12,394 skilled nursing and therapy visits to Medicare patients in addition to 4,865 similar type visits to non-Medicare patients. Home Medical Equipment was provided to some of those patients in 1,786 encounters. SHHCC's patient service fees are used solely to provide or support the provision of health care.SWC is a not-for-profit organization which specializes in rehabilitation and long-term care in the Fox Valley area. SWC focuses on bringing people back to the community with their previous level of function. SWC treats people in the workforce as well as the elderly population, and its services are open to all members of the community. During fiscal year 2013, SWC provided 26,315 total patient days of care. This includes 12,221 patient days to Medicare patients, 10,959 days to skilled care patients, and 3,135 days to Medicaid patients. SWC also provided in excess of $23,468 in charity care to individuals who have no means of paying for healthcare services. SWC provides community services to educate the elderly population on well-being.SHF was established in 2004 as the official fundraising and gift receiving arm of SHS. The Foundation encourages and receives contributions that are used to enhance the delivery of high quality, comprehensive healthcare services for those who live and work in the communities served by SHS. The Foundation accomplishes this through fundraising events, such as Music by the Water, and programs, such as the Seeds of Healing and Hope, which was established by the Foundation as a way for patients and family to show their thanks and appreciation by making a donation for the care provided by SHS.SH was founded in 1887 as a community hospital. Today, the hospital is a recognized regional heart center for the far northwest suburbs of Chicago. In 1972, when the first open-heart surgery was performed at its facility, the hospital became one of the first community hospitals in the nation performing open-heart surgery. SH has received numerous awards and recognition for excellence in quality, including Magnet designation for nursing excellence as well as a silver Illinois Performance Excellence award, which is the State of Illinois' equivalent of the national Baldrige Performance Excellence award. SH also received certification and accreditation of its Chest Pain clinic, Breast Center, and for Stroke care. SH completed the implementation of the Computerized Physician Order Entry (CPOE) system and met the criteria for Meaningful Use requirements ahead of the prescribed timelines set forth by the federal government. 5628396 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 0 0 0 1 1 1 CJ 0 0 0 0 0 0 0 0 X 15 13 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 IL X Eric Krueger 2247838718 1425 N Randall Road Elgin IL 60123 Richard Floyd 6.00 34.00 X X 0 673976 154631 Richard Jakle 1.00 X X 0 8000 0 Terry Dunning 1.00 X X 0 6000 0 David Bear 1.00 X X 0 5500 0 William Hoffer 1.00 X X 0 6000 0 Robert Cormier 1.00 X 0 6000 0 Audrey Reed 1.00 6.00 X 0 6000 0 Roger Bielinski MD 1.00 X 0 6000 0 Nathaniel Edmond 1.00 X 0 6000 0 Lane B Hoffman 1.00 0.50 X 0 5000 0 Brian Ziegler 1.00 X 0 5000 0 Pamela Jensen 1.00 X 0 6000 0 Kenneth Koehler 1.00 X 0 6000 0 Solomon Secemsky MD 1.00 X 0 5525 0 Linda Wallace 1.00 X 0 6000 0 Lawrence Kosinski MD 1.00 X 0 5350 0 Michael Shales 1.00 X 0 500 0 Sharon Jakle 1.00 X 0 2750 0 Eric Krueger 6.00 34.00 X 0 342501 66531 Linda Deering 6.00 34.00 X 0 413807 74141 Katie Bata 6.00 34.00 X 0 260354 48454 Patricia Turner 40.00 X 0 118426 11595 0 1900689 355352 0 0 1 0 0 Admin. Cost Sharing 541900 4854926 4854926 Sherman Choice 561000 860501 860501 Patient Services 621500 719376 719376 6434803 3307003 3307003 3652285 2922786 729499 729499 729499 5445 -5445 -5445 -5445 10465860 4854926 1579877 4031057 X 72500 72500 1186001 1186001 241169 241169 22770 22770 196231 196231 798133 798133 39529 39529 761043 761043 300 300 660610 660610 1279733 1279733 23587 23587 Intercompany Mgmt Fees 341107 341107 5683 5683 5628396 5628396 0 0 44778 15387 369102 279313 346979 387091 65107518 20628219 45687190 44479299 71880281 88407903 2213564 5195050 120541894 138764043 1189632 1172311 12104853 11577264 139042 139042 13433527 12888617 X 107108367 125875426 107108367 125875426 120541894 138764043 X 4837464 4405952 9523643 X 0 1 X 1 0 X X X 0 0 0 Sherman Hospital 362167920 3 1 0 Sherman West Court 363725580 9 1 0 Sherman Home Health Care Corporation 363330085 9 1 0 3 0 29779950 29779950 31457910 17979357 13478553 3869658 2648862 1220796 44479299 Accrued Medical Malpractice & Liabilities 139042 139042 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Sherman is primarily comprised of not-for-profit corporations as described in section 501(c)(3) of the Internal Revenue Code (Code). Section 501(c)(3) organizations are exempt from federal income taxes on related income on those entities pursuant to section 501(a) of the Code. None of Sherman's not-for-profit organizations have significant unrelated business activities. Sherman uses an asset and liability approach for financial accounting and reporting purposes as it relates to income taxes. Deferred tax liabilities and assets are determined based upon the difference between the financial statement and tax basis of assets and liabilities using enacted tax rates in effect for the year in which the differences are expected to reverse. Sherman Health Systems and its not-for-profit affiliates file the applicable Forms 990 (Return of Organization Exempt from Income Tax) annually. When these returns are filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the following: the tax exempt status of each entity, the continued tax exempt status of bonds issued by the obligated group, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business taxable income (UBTI). UBTI is reported on Form 990-T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. At April 30, 2013 and 2012, there were no unrecognized tax benefits identified or recorded as liabilities. Central America and the Caribbean - 0 0 Program Services Self Insurance 7106993 0 0 0 0 0 0 7106993 0 7106993 1 0 1 0 0 0 0 1 0 0 0 0 0 0 0 Richard Floyd 0 497435 0 161987 0 14554 0 131867 0 22764 0 828607 0 0 Eric Krueger 0 281193 0 60573 0 735 0 44773 0 21758 0 409032 0 0 Linda Deering 0 314754 0 87997 0 11056 0 65794 0 8347 0 487948 0 0 Katie Bata 0 190232 0 48513 0 21609 0 31443 0 17011 0 308808 0 0 Part I, Line 3 See Form 990, Part VI, Section B, Line 15. Part I, Line 4b Supplemental Executive Retirement Plan Participants: Richard Floyd - $119,617 Eric Krueger - $33,881 Linda Deering - $54,438 Katie Bata - $23,007 Form 990, Part VI, Section A, line 2 Richard Jakle and Sharon Jakle have a family relationship. Form 990, Part VI, Section B, line 11 Sherman Health System's (Sherman) financial staff gathers the necessary information for the tax advisor to prepare the Form 990. The tax advisor and financial management review the Form 990 and submit the completed form to the Finance Committee for review and approval. A copy of Form 990 is distributed to the organization's governing body prior to filing. Form 990, Part VI, Section B, line 12c Each director, principal officer and member of a committee with board-delegated powers shall annually sign a statement, which affirms that such person: a) has received a copy of the conflict of interest policy, b) has read and understands the policy, c) has agreed to comply with the policy, and d) understands that Sherman Health Systems ("Sherman") is a charitable organization and that in order to maintain federal tax exemption it must engage primarily in activities which accomplish one or more of its tax-exempt purposes. All questionnaires are reviewed by the compliance officer and any conflicts are discussed with the Chairman of the Board of Directors or the Compliance Committee. To ensure that Sherman operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall be conducted. Sherman Hospital, the master payor for all Sherman entities, conducts market evaluations on a periodic basis for all positions within Sherman. The evaluation process consists of review of established salary benchmarks for market competitiveness, and evaluation of turnover and retention. The independent salary and executive compensation committee is responsible for evaluating the performance of and establishing the compensation and benefits for the senior management of the parent corporation and its affiliates. Contemporaneous documentation is maintained for all decisions and deliberations. Form 990, Part VI, Section C, line 19 All organization governing documents, the conflict of interest policy, and financial statements are made available to the public upon request. Other Fees Form 990, Part IX, line 11g Purchased Services: Program service expenses 148,235. Management and general expenses 0. Fundraising expenses 0. Total expenses 148,235. Bank Fees: Program service expenses 2,568. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,568. Reference Lab: Program service expenses 407,459. Management and general expenses 0. Fundraising expenses 0. Total expenses 407,459. Flashnet/Internet Access: Program service expenses 2,022. Management and general expenses 0. Fundraising expenses 0. Total expenses 2,022. Software Contracts: Program service expenses 25,198. Management and general expenses 0. Fundraising expenses 0. Total expenses 25,198. Security Services: Program service expenses 450. Management and general expenses 0. Fundraising expenses 0. Total expenses 450. Service Contracts: Program service expenses 20,021. Management and general expenses 0. Fundraising expenses 0. Total expenses 20,021. Housekeeping: Program service expenses 192,180. Management and general expenses 0. Fundraising expenses 0. Total expenses 192,180. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Gain from Health Visions 2,350,689. Intercompany Net Asset Transfers 7,172,954. Sherman Health Foundation 1425 N Randall Road Elgin IL 60123 320106211 Provide charitable support to healthcare organization IL 501(c)(3) Line 11a, I Sherman Health Systems 1 Sherman Home Health Care Corporation 901 Center Street Suite 2001A Elgin IL 60120 363330085 Services include skilled and unskilled general nursing IL 501(c)(3) Line 9 Sherman Health Systems 1 Sherman Hospital 1425 N Randall Road Elgin IL 60123 362167920 Serve the community's healthcare needs IL 501(c)(3) Line 3 Sherman Health Systems 1 Sherman West Court 1950 Larkin Avenue Elgin IL 60123 363725580 Provide long-term nursing care IL 501(c)(3) Line 9 Sherman Health Systems 1 Health Visions Inc 1425 N Randall Road Elgin IL 60123 363780082 Physician practice management IL Sherman Health Systems C -3895305 4661394 1.00000 1 The Delphi Group IV Inc 1425 N Randall Road Elgin IL 60123 364017279 Health cost management IL Sherman Health Systems C 0.83000 1 Sherman Group Practice Inc 1435 N Randall Road Elgin IL 60123 262891035 Physician group IL Health Visions Inc C 1.00000 1 Sherman Physician Group Inc 1435 N Randall Road Elgin IL 60123 264800497 Physician group IL Health Visions Inc C 1.00000 1 Sherman Health Insurance Company Ltd PO Box 1159 Grand Cayman CJ KY1-1102 980703036 Insurance Provider CJ Sherman Health Systems C 1.00000 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 1 1 Health Visions Inc J 536596 Fair Market Value Sherman Home Health Care Corporation J 75497 Fair Market Value Sherman Health Foundation J 55357 Fair Market Value Sherman Hospital J 2002960 Fair Market Value Health Visions Inc O 97267 Fair Market Value Sherman Home Health Care Corporation O 95806 Fair Market Value Sherman West Court O 54133 Fair Market Value Sherman Hospital O 2837997 Fair Market Value Sherman Hospital P 5337356 Fair Market Value Sherman Hospital R 1592334 Fair Market Value Sherman Hospital S 455162 Fair Market Value Sherman Hospital S 9000000 Fair Market Value Sherman Health Insurance Company P 199358 Fair Market Value