SWEDISHAMERICAN HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SWEDISHAMERICAN HOSPITAL (EIN 36-2222696)
- Tax period
- 2012-06-01 to 2013-05-31
- Filed
- 2014-04-14
- IRS object ID
- 201421049349301367
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-04-14T17:39:32-05:00 | Timestamp |
| Tax Period End Date | 2013-05-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE SOUTH WACKER DR SUITE 800 | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-06-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362222696 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SWEDISHAMERICAN HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SWED | NameControl |
| Phone | 8159662087 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1401 E STATE STREET | AddressLine1 |
| City | ROCKFORD | City |
| State | IL | State |
| ZIP Code | 611042298 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WILLIAM GORSKI MD | Name |
| Title | CEO | Title |
| Phone | 8159662087 | Phone |
| Date Signed | 2014-04-10 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ZACK FORTSCH | Name |
| PTIN | P00052725 | PTIN |
| Phone | 3126343400 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | WILLIAM GORSKI MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1313 EAST STATE ST | AddressLine1 |
| City | ROCKFORD | City |
| State | IL | State |
| ZIP Code | 61104 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 616006852 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.SWEDISHAMERICAN.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1911 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | THROUGH EXCELLENCE IN HEALTHCARE AND COMPASSIONATE SERVICE, WE CARE FOR OUR COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 26 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 17 | NbrIndependentVotingMembers |
| Total Nbr Employees | 3368 | TotalNbrEmployees |
| Total Nbr Volunteers | 612 | TotalNbrVolunteers |
| Total Gross UBI | 536673 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 243101 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1813920 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4815838 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 434827414 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 445165745 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8093553 | InvestmentIncomePriorYear |
| Investment Income Current Year | 10708821 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 4971442 | OtherRevenuePriorYear |
| Other Revenue Current Year | 4610509 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 449706329 | TotalRevenuePriorYear |
| Total Revenue Current Year | 465300913 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 561606 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 561606 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 215843433 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 213603436 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 223383007 | OtherExpensePriorYear |
| Other Expenses Current Year | 229894226 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 439788046 | TotalExpensesPriorYear |
| Total Expenses Current Year | 444059268 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 9918283 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 21241645 | RevenuesLessExpensesCY |
| Total Assets BOY | 454467569 | TotalAssetsBOY |
| Total Assets EOY | 521850360 | TotalAssetsEOY |
| Total Liabilities BOY | 207594843 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 250968297 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 246872726 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 270882063 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THROUGH EXCELLENCE IN HEALTHCARE AND COMPASSIONATE SERVICE, WE CARE FOR OUR COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 252460685 | Expense |
| Grants | 561606 | Grants |
| Revenue | 354607718 | Revenue |
| Description | SWEDISHAMERICAN HOSPITAL OPERATES 2 FULL SERVICE ACUTE CARE HOSPITALS WITH 386 LICENSED BEDS, AND SERVES A 12 COUNTY AREA. ITS VISION IS TO DEVELOP A FULLY INTEGRATED HEALTHCARE DELIVERY NETWORK THAT WILL CONTINUOUSLY SET THE STANDARD FOR QUALITY CARE AND SERVICE, ACCEPT RESPONSIBILITY FOR BUILDING A HEALTHIER POPULATION, PROVIDE REGIONAL ACCESS, IMPROVE RESOURCE UTILIZATION THROUGH COLLABORATION WITH KEY STAKEHOLDERS, AND MANAGE PATIENT CARE AND THE HOSPITAL'S RESOURCES IN SUCH A WAY THAT WE CREATE VALUE FOR OUR PATIENTS AND BENEFIT FOR OUR COMMUNITY. DURING 2013 WE CARED FOR 18,246 INPATIENTS AND PERFORMED 789,129 OUTPATIENT PROCEDURES, INCLUDING 73,428 EMERGENCY ROOM VISITS AND 2,620 DELIVERIES. WE SPONSOR THE UNIVERSITY OF ILLINOIS - COLLEGE OF MEDICINE PROGRAM AND PROVIDED $4.8 MILLION IN EDUCATION FOR PRIMARY CARE RESIDENTS. WE PARTICIPATE IN THE ILLINOIS EXCELLENCE IN ACADEMIC MEDICINE PROGRAM AND THE NATIONAL SURGICAL ADJUVANT BREAST AND BOWEL PROJECT, WHICH ARE GOVERNMENT SPONSORED RESEARCH AND PROGRAMS. OUR EMPLOYEES AND VOLUNTEERS PROVIDED OVER 30,000 HOURS IN UNPAID COMMUNITY SERVICES. SWEDISHAMERICAN RECOGNIZES ITS RESPONSIBILITY TO ALL THE PEOPLE OF OUR COMMUNITY, REGARDLESS OF THEIR ABILITY TO PAY FOR CARE. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 94248472 | Expense |
| Grants | 0 | Grants |
| Revenue | 88391917 | Revenue |
| Description | SWEDISHAMERICAN HOSPITAL EMPLOYS PRIMARY CARE AND SPECIALTY PHYSICIANS WHO PRACTICE AT 20 LOCATIONS THROUGHOUT OUR SERVICE AREA. WE EMPLOY SPECIALISTS IN ORTHOPEDICS, CARDIOLOGY, CARDIOTHORACIC SURGERY, ENDOCRINOLOGY, ALLERGY, NEUROLOGY, NEUROSURGERY, PULMONOLOGY/CRITICAL CARE, HEMATOLOGY/ONCOLOGY, OBSTETRICS AND GYNECOLOGY, MATERNAL FETAL MEDICINE, RHEUMATOLOGY, PSYCHIATRY, PODIATRY, OTOLARYNGOLOGY, AS WELL AS INTERNAL MEDICINE, FAMILY PRACTICE, IMMEDIATE CARE AND PEDIATRIC PHYSICIANS. DURING 2013 OUR PHYSICIAN ENCOUNTERS WERE 347,035. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6715097 | Expense |
| Grants | 0 | Grants |
| Revenue | 6259441 | Revenue |
| Description | SWEDISHAMERICAN DELIVERS HOME HEALTH CARE SERVICES TO PATIENTS IN OUR SERVICE AREA. MAJOR AREAS OF HOME HEALTH CARE INCLUDE: RN NURSING SERVICES PROVIDING ASSESSMENTS, TREATMENTS AND MEDICATION ADMINISTRATION; INTRAVENOUS INFUSION THERAPY; PHYSICAL, SPEECH AND OCCUPATIONAL THERAPY SERVICES AND IN-HOME PERSONAL CARE ASSISTANTS. DURING 2013 WE PERFORMED 25,857 EPISODES OF CARE. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 353424254 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 1 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 1 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 1 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 398 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 3368 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 26 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 17 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DONALD HARING CFO | NamePerson |
| Telephone Number | 8159662087 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1313 EAST STATE ST | AddressLine1 |
| City | ROCKFORD | City |
| State | IL | State |
| ZIP Code | 61104 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (33 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| PETER CHRISTMAN | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| DANNY L COPELAND MD | |||||||||
| TRUSTEE | 40.00 | 4.00 | X | 205662 | 0 | 35410 | |||
| MICHAEL DALLMAN | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| PATRICK DERRY | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| JAMES L GINGRICH | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| WILLIAM R GORSKI MD | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | 4.00 | X | 580553 | 0 | 224226 | X | ||
| ROBERT L HEAD PHD | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| HELEN CHUNG HILL | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| MICHAEL HOUSELOG | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| DENNIS W JOHNSON | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 600 | 0 | 0 | |||
| GREGORY JURY | |||||||||
| TRUSTEE | 2.00 | 6.00 | X | 100 | 0 | 0 | |||
| MARCO T LENIS | |||||||||
| TRUSTEE | 2.00 | 6.00 | X | 100 | 0 | 0 | |||
| DAN LOESCHER | |||||||||
| 1ST/VICE CHAIRMAN/SECR. | 2.00 | 4.00 | X | 100 | 0 | 0 | X | ||
| FRAN MORRISSEY | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| JOHN C MYERS MD | |||||||||
| TRUSTEE | 40.00 | 6.00 | X | 571182 | 0 | 44783 | |||
| WILLIAM ROOP | |||||||||
| CHAIRMAN | 2.00 | 4.00 | X | 100 | 0 | 0 | X | ||
| DANIEL T ROSS | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| DAVID R RYDELL | |||||||||
| TRUSTEE | 2.00 | 6.00 | X | 100 | 0 | 0 | |||
| JOHN SCHEUB MD | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| STEVEN C SJOGREN | |||||||||
| TRUSTEE | 2.00 | 8.00 | X | 100 | 0 | 0 | |||
| JAMES WADDELL | |||||||||
| TRUSTEE | 2.00 | 6.00 | X | 100 | 0 | 0 | |||
| RICHARD WALSH | |||||||||
| CHIEF OPERATING OFFICER | 40.00 | 6.00 | X | 380115 | 0 | 128089 | X | ||
| THOMAS R WALSH | |||||||||
| 2ND VICE CHAIRMAN/ASSIST SECR. | 2.00 | 4.00 | X | 100 | 0 | 0 | X | ||
| FRANK WALTER | |||||||||
| IMMEDIATE PAST CHAIRMAN | 2.00 | 6.00 | X | 100 | 0 | 0 | |||
| AMY WILCOX | |||||||||
| TRUSTEE | 2.00 | 4.00 | X | 100 | 0 | 0 | |||
| ALLEN WILLIAMS MD | |||||||||
| TRUSTEE | 40.00 | 4.00 | X | 234723 | 0 | 42405 | |||
| DONALD HARING | |||||||||
| VP FINANCE/TREASURER | 40.00 | 8.00 | 337218 | 0 | 77750 | X | |||
| KATHLEEN KELLY MD | |||||||||
| VP MEDICAL AFFAIRS | 40.00 | 493706 | 0 | 46646 | X | ||||
| MERAT ESFAHANI MD | |||||||||
| PHYSICIAN | 40.00 | 700723 | 0 | 51304 | X | ||||
| STEVEN MILOS MD | |||||||||
| PHYSICIAN | 40.00 | 672807 | 0 | 34611 | X | ||||
| HARVEY EINHORN MD | |||||||||
| PHYSICIAN | 40.00 | 581050 | 0 | 76883 | X | ||||
| PRAKASH PEDAPATI | |||||||||
| PHYSICIAN | 40.00 | 494342 | 0 | 35799 | X | ||||
| HOWARD KAUFMAN DO | |||||||||
| PHYSICIAN | 40.00 | 509992 | 0 | 51304 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 5764673 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 849210 | TotalOtherCompensation |
| Number Individuals GT100 K | 165 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| RINGLAND-JOHNSON CONSTRUCTION | |||||
| PO BOX 5165 | ROCKFORD | IL | 61125 | CONSTRUCTION SERVICES | 10276522 |
| MIDWEST HEART SPECIALISTS LTD | |||||
| 1901 S MEYERS ROAD SUITE 350 | OAKBROOK TERRACE | IL | 60181 | PHYSICIANS | 3992134 |
| UNIVERSAL HOSPITAL SERVICES INC | |||||
| 2601 CROSSROADS DR SUITE 105 | MADISON | WI | 53704 | EQUIPMENT SERVICES | 2427288 |
| ARAMARK HEALTHCARE | |||||
| THE ARA TOWER 1101 MARKET ST | PHILADELPHIA | PA | 19107 | CAFETERIA AND DIETARY | 2391232 |
| ARUP LABORATORIES INC | |||||
| PO BOX 27964 | SALT LAKE CITY | UT | 84127 | LAB TESTING | 2097699 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 147 | NumberOfContractorsGT100K |
| Related Organizations | 178667 | RelatedOrganizations |
| Government Grants | 4578570 | GovernmentGrants |
| All Other Contributions | 58601 | AllOtherContributions |
| Total Contributions | 4815838 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICARE/MEDICAID | 621990 | 272584240 | 272584240 |
| PATIENT SERVICES | 621990 | 170980472 | 170980472 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1601033 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1601033 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 445165745 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5848111 | TotalRevenueColumn |
| Exclusion | $5,848,111 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 23626 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 43121 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -19495 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -19495 | TotalRevenueColumn |
| Exclusion | -$19,495 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 152745767 | Securities |
| Other | 2771504 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 147957938 | Securities |
| Other | 2698623 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 4787829 | Securities |
| Other | 72881 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4860710 | TotalRevenueColumn |
| Exclusion | $4,860,710 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | 10006 | GrossSalesOfInventory |
| Cost Of Goods Sold | 6257 | CostOfGoodsSold |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3749 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3749 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| DAY CARE CENTER | 624410 | 1423465 | 1423465 | |
| CAFETERIA & VENDING | 561000 | 1376440 | 1360441 | 15999 |
| INTERDEPT BILLING | 561000 | 1370457 | 1305676 | 64781 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 455893 | TotalRevenueColumn |
| Unrelated Business Revenue | 455893 | UnrelatedBusinessRevenue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 4626255 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 465300913 | TotalRevenueColumn |
| Related Or Exempt Function Income | 449259076 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 536673 | UnrelatedBusinessRevenue |
| Exclusion | $10,689,326 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 531606 | Total |
| Program Services | 531606 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30000 | Total |
| Program Services | 30000 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4230290 | Total |
| Program Services | 1146250 | ProgramServices |
| Management And General | 3084040 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 158782583 | Total |
| Program Services | 123209302 | ProgramServices |
| Management And General | 35573281 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9515980 | Total |
| Program Services | 7863076 | ProgramServices |
| Management And General | 1652904 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30280834 | Total |
| Program Services | 24004289 | ProgramServices |
| Management And General | 6276545 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10793749 | Total |
| Program Services | 8166842 | ProgramServices |
| Management And General | 2626907 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 934736 | Total |
| Management And General | 934736 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135007 | Total |
| Management And General | 135007 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 128808 | Total |
| Management And General | 128808 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 603677 | Total |
| Management And General | 603677 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38263461 | Total |
| Program Services | 30097689 | ProgramServices |
| Management And General | 8165772 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2198887 | Total |
| Program Services | 78678 | ProgramServices |
| Management And General | 2120209 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9901942 | Total |
| Program Services | 5211253 | ProgramServices |
| Management And General | 4690689 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4804995 | Total |
| Program Services | 4323733 | ProgramServices |
| Management And General | 481262 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12662528 | Total |
| Program Services | 7122544 | ProgramServices |
| Management And General | 5539984 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 224225 | Total |
| Program Services | 163614 | ProgramServices |
| Management And General | 60611 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 400335 | Total |
| Program Services | 163869 | ProgramServices |
| Management And General | 236466 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4555558 | Total |
| Program Services | 3395111 | ProgramServices |
| Management And General | 1160447 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19992889 | Total |
| Program Services | 15601460 | ProgramServices |
| Management And General | 4391429 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10282607 | Total |
| Program Services | 9796857 | ProgramServices |
| Management And General | 485750 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| INCOME TAX EXPENSE | 151000 | 151000 | |
| PATIENT SUPPLIES | 69139001 | 490268 | 68648733 |
| BAD DEBTS | 30745393 | 30745393 | |
| IPA PROVIDER TAX | 7650073 | 7650073 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17119104 | Total |
| Program Services | 5473882 | ProgramServices |
| Management And General | 11645222 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 444059268 | Total |
| Program Services | 353424254 | ProgramServices |
| Management And General | 90635014 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15151325 | BOY |
| EOY | 26458098 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 78384996 | BOY |
| EOY | 61625064 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 294828 | BOY |
| EOY | 250214 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6380256 | BOY |
| EOY | 6529568 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6126896 | BOY |
| EOY | 8554210 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 419772808 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 240212031 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 163568140 | BOY |
| EOY | 179560777 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 155892313 | BOY |
| EOY | 208115148 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1834079 | BOY |
| EOY | 1771351 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26834736 | BOY |
| EOY | 28985930 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 454467569 | BOY |
| EOY | 521850360 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48095146 | BOY |
| EOY | 43502558 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 106708525 | BOY |
| EOY | 143878109 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52791172 | BOY |
| EOY | 63587630 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 207594843 | BOY |
| EOY | 250968297 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 239487137 | BOY |
| EOY | 261739936 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1896459 | BOY |
| EOY | 3321200 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5489130 | BOY |
| EOY | 5820927 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 246872726 | BOY |
| EOY | 270882063 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 454467569 | BOY |
| EOY | 521850360 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 21241645 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 3129421 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | -361729 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $128,808 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 128808 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | EXPLANATION OF LOBBYING ACTIVITIES: | Identifier |
| Return Reference | PART II-B, LINE 1: | ReturnReference |
| Explanation | PORTIONS OF THE 2012/2013 ILLINOIS HOSPITAL AND AMERICAN HOSPITAL ASSOCIATION DUES USED FOR LOBBYING: $38,808. A LAW FIRM WAS ENGAGED TO REVIEW LEGISLATION AFFECTING HOSPITALS: $90,000. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 6007307 | BeginningOfYearBalance |
| Contributions | 11537 | Contributions |
| Investment Earnings Or Losses | 668467 | InvestmentEarningsOrLosses |
| Other Expenditures | 115555 | OtherExpenditures |
| End Of Year Balance | 6571756 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 6377718 | BeginningOfYearBalance |
| Contributions | 43659 | Contributions |
| Investment Earnings Or Losses | -269495 | InvestmentEarningsOrLosses |
| Other Expenditures | 144575 | OtherExpenditures |
| End Of Year Balance | 6007307 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5553681 | BeginningOfYearBalance |
| Contributions | 98184 | Contributions |
| Investment Earnings Or Losses | 763174 | InvestmentEarningsOrLosses |
| Other Expenditures | 37321 | OtherExpenditures |
| End Of Year Balance | 6377718 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 5098504 | BeginningOfYearBalance |
| Contributions | 13425 | Contributions |
| Investment Earnings Or Losses | 457937 | InvestmentEarningsOrLosses |
| Other Expenditures | 16185 | OtherExpenditures |
| End Of Year Balance | 5553681 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 6059940 | BeginningOfYearBalance |
| Contributions | 14405 | Contributions |
| Investment Earnings Or Losses | -958754 | InvestmentEarningsOrLosses |
| Other Expenditures | 17087 | OtherExpenditures |
| End Of Year Balance | 5098504 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.00000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.89000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.11000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2459970 | OtherCostOrOtherBasis |
| Book Value | 2459970 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 199231376 | OtherCostOrOtherBasis |
| Depreciation | 99067041 | Depreciation |
| Book Value | 100164335 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 10437795 | OtherCostOrOtherBasis |
| Depreciation | 5154204 | Depreciation |
| Book Value | 5283591 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 200838795 | OtherCostOrOtherBasis |
| Depreciation | 130986156 | Depreciation |
| Book Value | 69852639 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6804872 | OtherCostOrOtherBasis |
| Depreciation | 5004630 | Depreciation |
| Book Value | 1800242 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 179560777 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (4 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DEFERRED BOND ISSUANCE COSTS | 3405588 |
| ADVANCE TO AMERICAN RESTAURANT ASSOC. (ARA) | 189268 |
| INTEREST IN NET ASSETS OF RECIPIENT ORGANIZATION | 8589733 |
| GOODWILL | 16801341 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 28985930 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (6 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ESTIMATED DUE-3RD PARTY PAYORS | $30,023,208 |
| RESERVE FOR SELF INSURANCE | $16,509,051 |
| DEFERRED COMPENSATION | $10,405,138 |
| ASBESTOS RETIREMENT OBLIGATION | $266,744 |
| DUE TO AFFILIATED ORGANIZATION | $1,729,510 |
| CURRENT MATURITIES OF LONG TERM DEBT | $4,653,979 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 63587630 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH THE TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AT MAY 31, 2013 AND 2012, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED OR RECORDED AS LIABILITIES. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 600.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 12465670 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 12465670 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03020 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 85317417 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 70086960 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15230457 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03680 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 1962444 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1247440 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 715004 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00170 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 99745531 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 71334400 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 28411131 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06870 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6464568 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 2042782 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 4421786 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01070 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 17196364 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1517879 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15678485 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03790 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2060787 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 277776 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1783011 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 962411 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 293467 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 668944 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00160 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 26684130 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 4131904 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 22552226 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05450 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 126429661 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 75466304 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 50963357 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.12320 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 0 | BadDebtExpenseReported |
| Bad Debt Expense | $30,745,393 | BadDebtExpenseAmount |
| Amount Attributable To | 4611750 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 72661597 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 85940016 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -13278419 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)
| Description Ent Primary ActivityDescriptionEntPrimaryActivity | Organization Profit Or OwnershipOrganizationProfitOrOwnership | Officers Etc Profit Or OwnershipOfficersEtcProfitOrOwnership | Physicans Profit Or OwnershipPhysicansProfitOrOwnership |
|---|---|---|---|
| 1 FEATHERSTONE PARTNERSHIP LLC | |||
| AMBULATORY SURGERY CENTER | 0.28570 | 0.00000 | 0.71430 |
| 2 NORTHERN ILLINOIS VEIN CLINIC LLC | |||
| OUTPATIENT PHYSICIAN CLINIC | 0.50000 | 0.00000 | 0.50000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Hospital Facilities | 2 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA (2 entries)
| Facility NumberFacilityNumber | Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Licensed HospitalLicensedHospital | General Medical And SurgicalGeneralMedicalAndSurgical | Teaching HospitalTeachingHospital | Research FacilityResearchFacility | Er24 HoursEr24Hours | Facility Reporting GroupFacilityReportingGroup |
|---|---|---|---|---|---|---|---|---|---|---|
| SWEDISHAMERICAN HOSPITAL | ||||||||||
| 1 | 1401 E STATE STREET | ROCKFORD | IL | 61104 | X | X | X | X | X | A |
| SWEDISHAMERICAN MEDICAL CTR BELVIDERE | ||||||||||
| 2 | 1625 S STATE STREET | BELVIDERE | IL | 61008 | X | X | X | A | ||
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FACILITY REPORTING GROUP - A | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 999 | HospitalFacilityNumber |
| CHNA Conducted | 1 | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | 1 | TakeIntoAccount |
| Other Facilities | 1 | OtherFacilities |
| CHNA Widely Available | 1 | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| All Needs Addressed | 0 | AllNeedsAddressed |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 600.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 26 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (26 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| ONCOLOGY | ||||
| 209 9TH STREET | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| ACT | ||||
| 2473 MCFARLAND ROAD | ROCKFORD | IL | 61107 | OUTPATIENT CLINIC |
| ROCKFORD AMBULATORY SURGERY CENTER | ||||
| 1016 FEATHERSTONE ROAD | ROCKFORD | IL | 61107 | AMBULATORY SURGERY CENTER |
| BROOKSIDE SPECIALTY CENTER | ||||
| 1253 N ALPINE ROAD | ROCKFORD | IL | 61107 | OUTPATIENT CLINIC |
| WOODSIDE | ||||
| 3775 N MULFORD ROAD | ROCKFORD | IL | 61114 | OUTPATIENT CLINIC |
| MIDWEST HEART SPECIALISTS | ||||
| 1340 CHARLES STREET SUITE 300 | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| LUNDHOLM ORTHOPEDICS | ||||
| 1340 CHARLES STREET | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| BROOKSIDE OCCUPATIONAL & IMMED CARE | ||||
| 1215 N ALPINE ROAD | ROCKFORD | IL | 61107 | OUTPATIENT CLINIC |
| HOME HEALTH CARE | ||||
| 2550 CHARLES STREET | ROCKFORD | IL | 61108 | HOME HEALTH |
| 5 POINTS CLINIC | ||||
| 2404 CHARLES STREET | ROCKFORD | IL | 61108 | OUTPATIENT CLINIC |
| VALLEY CLINIC | ||||
| 6824 NEWBURG ROAD | ROCKFORD | IL | 61108 | OUTPATIENT CLINIC |
| CAMELOT OBGYN | ||||
| 1415 E STATE STREET | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| ROCK VALLEY WOMEN'S HEALTH CENTER | ||||
| 6861 VILLAGE GREEN VIEW | ROCKFORD | IL | 61107 | OUTPATIENT CLINIC |
| BELVIDERE CLINIC | ||||
| 1700 HENRY LUCKOW LANE | BELVIDERE | IL | 61008 | OUTPATIENT CLINIC |
| WOUND CARE & HYPERBARIC CLINICS | ||||
| 1415 E STATE STREET SUITE 408 609 | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| MIDTOWN CLINIC | ||||
| 1340 CHARLES STREET SUITE 405 | ROCKFORD | IL | 61103 | OUTPATIENT CLINIC |
| DAVIS JUNCTION CLINIC | ||||
| 5665 NORTH JUNCTION WAY | DAVIS JUNCTION | IL | 61020 | OUTPATIENT CLINIC |
| ROSCOE CLINIC & IMMEDIATE CARE | ||||
| 5005 HONONEGAH ROAD | ROSCOE | IL | 61073 | OUTPATIENT CLINIC |
| NEURO AND HEADACHE CENTER | ||||
| 1340 CHARLES STREET SUITE 400 | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| BYRON CLINIC | ||||
| 220 W BLACKHAWK DRIVE | BYRON | IL | 61010 | OUTPATIENT CLINIC |
| NORTHERN ILLINOIS VEIN CLINIC | ||||
| 1340 CHARLES STREET SUITE 404 | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| MATERNAL FETAL MEDICINE | ||||
| 1401 EAST STATE ST | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| CENTER FOR WOMEN | ||||
| 1340 CHARLES STREET SUITE 301 | ROCKFORD | IL | 61104 | OUTPATIENT CLINIC |
| MARENGO CLINIC & IMMEDIATE CARE | ||||
| 204 E PRAIRIE STREET | MARENGO | IL | 60152 | OUTPATIENT CLINIC |
| ROCHELLE CLINIC | ||||
| 380 ILLINOIS ROUTE 38 EAST | ROCHELLE | IL | 61068 | OUTPATIENT CLINIC |
| DIXON ONCOLOGY | ||||
| 101 W 2ND STREET | DIXON | IL | 61021 | OUTPATIENT CLINIC |
Form990 Schedule H Part VI Form990ScheduleHPartVI (26 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 7G: THE FOLLOWING SUBSIDIZED HEALTH SERVICES ARE FOR PHYSICIANS. THESE PHYSICIANS ARE NECESSARY TO SERVE THE COMMUNITY, ARE DIFFICULT TO RECRUIT, AND THE REIMBURSEMENT DOES NOT COVER THE COST OF THE SERVICES.HOSPITAL BASED PHYSICIANS' SPECIALTY CLINICS AND COVERAGE PAYMENTS $12,506,379EMERGENCY DEPARTMENT PHYSICIANS $1,301,269TOTAL $11,204,810 | ||
| PART I, L7 COL(F): THE BAD DEBT EXPENSE IN PART IX COLUMN A WAS SUBTRACTED FOR THE PURPOSE OF CALCULATING THE PERCENTAGE OF EXPENSE IS $30,745,393PART I, LINES 7: 7A AND 7F COSTS WERE CALCULATED USING THE 2013 MEDICARE COST REPORT COST TO CHARGE RATIO. LINES 7B AND 7C COSTS WERE CALCULATED USING THE COST ACCOUNTING SYSTEM. THE COST ACCOUNTING SYSTEM ADDRESSES ALL PATIENT SEGMENTS. ALL OTHER AMOUNTS IN LINE 7 WERE CALCULATED USING DIRECT COSTS.PART III, LINE 2: METHODOLOGY FOR DETERMINING BAD DEBT EXPENSE: IT IS OUR PRACTICE TO IDENTIFY, TO THE EXTENT POSSIBLE, CHARITY CASES AT THE TIME OF SERVICE. IF A PATIENT PROVIDES DOCUMENTATION THEY MEET OUR CHARITY CARE POLICY, THEY ARE NOT SENT TO COLLECTION. THOSE PATIENTS WHO DO NOT MEET PRESUMPTIVE ELIGIBILITY AND FAIL TO APPLY OR PROVIDE DOCUMENTATION ARE SENT TO COLLECTION AFTER 90 DAYS. THE ORGANIZATION AND ITS AGENTS FOLLOW THE FAIR PATIENT BILLING ACT. IF DURING THE COLLECTION PROCESS WE OR OUR AGENTS BECOME AWARE OF A PATIENT QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND THE PATIENT COOPERATES WITH THE REQUIREMENTS OF THE CHARITY CARE POLICY, COLLECTION EFFORTS ARE CEASED AND THE ACCOUNT IS WRITTEN OFF TO CHARITY. BAD DEBT EXPENSE REPORTED ON LINE 2 REPRESENTS THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IT IS DETERMINED BASED ON HISTORICAL EXPERIENCE OF UNCOLLECTIBLE AMOUNTS, AFTER CONTRACTUAL DISCOUNTS, PATIENT PAYMENTS AND AMOUNTS QUALIFYING UNDER CHARITY ASSISTANCE POLICY.PART III, LINE 3: SWEDISHAMERICAN HOSPITAL'S CHARITY POLICY ALLOWS A 100% CHARITY WRITE-OFF FOR THOSE WITH HOUSEHOLD INCOME OF 200% OR LESS OF THE FEDERAL POVERTY LEVEL AND PARTIAL CHARITY WRITE-OFF FOR THOSE UP TO 600% OF THE POVERTY LEVEL. THE LATEST DATA FROM THE U.S. CENSUS BUREAU FOR WINNEBAGO, BOONE AND OGLE COUNTIES, WHICH ARE THE COUNTIES SERVED BY THE HEALTHCARE FACILITIES, INDICATES THE FOLLOWING: WINNEBAGO COUNTY -17% OF THE POPULATION IS BELOW THE POVERTY LEVEL, THE MEDIAN HOUSEHOLD INCOME WAS $47,543 AND A HOUSEHOLD SIZE OF 2.56, BOONE COUNTY - 10% OF THE POPULATION IS BELOW THE POVERTY LEVEL, THE MEDIAN HOUSEHOLD INCOME WAS $63,670 AND A HOUSEHOLD SIZE OF 3.01, OGLE - 10% OF THE POPULATION IS BELOW THE POVERTY LEVEL, THE MEDIAN HOUSEHOLD INCOME WAS $55,590 AND A HOUSEHOLD SIZE OF 2.54. THE 2012 POVERTY GUIDELINES PER THE OFFICE OF ASSISTANT SECRETARY FOR PLANNING AND EVALUATION, (HTTP://ASPE.HHS.GOV) INDICATE FOR A HOUSEHOLD OF 3, AN INCOME $38,180 IS 200% OF THE POVERTY LEVEL AND $114,540 IS 600% OF THE POVERTY LEVEL. APPROXIMATELY 92% OF OUR CHARITY WRITE-OFFS ARE FOR PATIENTS WITHOUT INSURANCE, WHILE 71% OF OUR BAD DEBT WRITE-OFFS ARE FOR PATIENTS WITHOUT INSURANCE. IN 2013, ONLY 8% OF ALL ACCOUNTS WRITTEN OFF TO BAD DEBT WERE RECOVERED. BASED ON THIS DEMOGRAPHIC AND INTERNAL DATA, WE BELIEVE THAT A MINIMUM OF 15% OF THE AMOUNTS WRITTEN OFF AS BAD DEBT WOULD QUALIFY FOR CHARITY, AND AS SUCH, 15% OF THE BAD DEBT EXPENSE FROM LINE 2 IS REPORTED ON LINE 3. | ||
| PART III, LINE 4: PATIENT RECEIVABLES ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF ACCOUNTS RECEIVABLE, THE HOSPITAL IDENTIFIES TROUBLED ACCOUNTS, REVIEWS HISTORICAL EXPERIENCE AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR BAD DEBTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE HOSPITAL ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR BAD DEBTS, IF NECESSARY (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS A SIGNIFICANT PROVISION FOR BAD DEBTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES (OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. | ||
| PART III, LINE 8: SWEDISHAMERICAN HOSPITAL MUST TREAT PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE GOVERNMENT SETS NON-NEGOTIALBE MEDICARE RATES AND THE REIMBURSEMENT FROM MEDICARE HAS NOT KEPT PACE WITH THE RISING COST OF PROVIDING THOSE SERVICES. THE COST OF CARE HAS INCREASED DUE TO: WAGES AND BENEFITS NECESSARY TO KEEP HIGH DEMAND SKILLED PRACTITIONERS, MEDICAL SUPPLIES IN PARTICULAR CARDIOVASCULAR AND ORTHOPEDIC IMPLANTS AND PHARMACEUTICALS, MALPRACTICE INSURANCE COSTS, AND CAPITAL EQUIPMENT. SWEDISHAMERICAN HOSPITAL'S TREATMENT OF MEDICARE BENEFICIARIES RELIEVES THE FEDERAL GOVERNMENT BURDEN OF DIRECTLY PROVIDING MEDICAL CARE WHICH BY LAW THEY ARE REQUIRED TO PROVIDE TO ELIGIBLE BENEFICIARIES. DUE TO THE REQUIREMENT TO PROVIDE CARE AND THE INABILITY OF MEDICARE REIMBURSEMENT TO KEEP PACE WITH THE COST OF PROVIDING SERVICES, WE FEEL THE LOSS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES IS A PART OF OUR MISSION AND IS A BENEFIT TO OUR COMMUNITY. THE FOLLOWING IS A RECONCILIATION OF THE SHORTFALL FROM MEDICARE REPORTED ON THE COST REPORT ON LINE 7 TO THE MEDICARE SHORTFALL FROM ALL THE MEDICARE PROGRAMS AT SWEDISHAMERICAN HOSPITAL. THESE SHORTFALLS WERE CALCULATED USING THE COST TO CHARGE RATIO. MEDICARE SHORTFALL HOSPITAL PROGRAMS PART III, LINE 7: ($13,278,419)MEDICARE SHORTFALL PHYSICIAN PROGRAMS: ($29,524,589)TOTAL MEDICARE SHORTFALL: ($42,703,008) | ||
| PART III, LINE 9B: THE ORGANIZATION AND ITS AGENTS FOLLOW THE FAIR PATIENT BILLING ACT. IF DURING THE COLLECTION PROCESS WE OR OUR AGENTS BECOME AWARE OF A PATIENT QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND THE PATIENT COOPERATES WITH THE REQUIREMENTS OF THE CHARITY CARE POLICY, COLLECTION EFFORTS ARE CEASED. | ||
| PART III, LINE 2: METHODOLOGY FOR DETERMINING BAD DEBT EXPENSE: IT IS OUR PRACTICE TO IDENTIFY, TO THE EXTENT POSSIBLE, CHARITY CASES AT THE TIME OF SERVICE. IF A PATIENT PROVIDES DOCUMENTATION THEY MEET OUR CHARITY CARE POLICY, THEY ARE NOT SENT TO COLLECTION. THOSE PATIENTS WHO DO NOT MEET PRESUMPTIVE ELIGIBILITY AND FAIL TO APPLY OR PROVIDE DOCUMENTATION ARE SENT TO COLLECTION AFTER 90 DAYS. THE ORGANIZATION AND ITS AGENTS FOLLOW THE FAIR PATIENT BILLING ACT. IF DURING THE COLLECTION PROCESS WE OR OUR AGENTS BECOME AWARE OF A PATIENT QUALIFYING FOR CHARITY CARE OR FINANCIAL ASSISTANCE AND THE PATIENT COOPERATES WITH THE REQUIREMENTS OF THE CHARITY CARE POLICY, COLLECTION EFFORTS ARE CEASED AND THE ACCOUNT IS WRITTEN OFF TO CHARITY. BAD DEBT EXPENSE REPORTED ON LINE 2 REPRESENTS THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. IT IS DETERMINED BASED ON HISTORICAL EXPERIENCE OF UNCOLLECTIBLE AMOUNTS, AFTER CONTRACTUAL DISCOUNTS, PATIENT PAYMENTS AND AMOUNTS QUALIFYING UNDER CHARITY ASSISTANCE POLICY. | ||
| PART III, LINE 3: SWEDISHAMERICAN HOSPITAL'S CHARITY POLICY ALLOWS A 100% CHARITY WRITE-OFF FOR THOSE WITH HOUSEHOLD INCOME OF 200% OR LESS OF THE FEDERAL POVERTY LEVEL AND PARTIAL CHARITY WRITE-OFF FOR THOSE UP TO 600% OF THE POVERTY LEVEL. THE LATEST DATA FROM THE U.S. CENSUS BUREAU FOR WINNEBAGO, BOONE AND OGLE COUNTIES, WHICH ARE THE COUNTIES SERVED BY THE HEALTHCARE FACILITIES, INDICATES THE FOLLOWING: WINNEBAGO COUNTY -17% OF THE POPULATION IS BELOW THE POVERTY LEVEL, THE MEDIAN HOUSEHOLD INCOME WAS $47,543 AND A HOUSEHOLD SIZE OF 2.56, BOONE COUNTY - 10% OF THE POPULATION IS BELOW THE POVERTY LEVEL, THE MEDIAN HOUSEHOLD INCOME WAS $63,670 AND A HOUSEHOLD SIZE OF 3.01, OGLE - 10% OF THE POPULATION IS BELOW THE POVERTY LEVEL, THE MEDIAN HOUSEHOLD INCOME WAS $55,590 AND A HOUSEHOLD SIZE OF 2.54. THE 2012 POVERTY GUIDELINES PER THE OFFICE OF ASSISTANT SECRETARY FOR PLANNING AND EVALUATION, (HTTP://ASPE.HHS.GOV) INDICATE FOR A HOUSEHOLD OF 3, AN INCOME $38,180 IS 200% OF THE POVERTY LEVEL AND $114,540 IS 600% OF THE POVERTY LEVEL. APPROXIMATELY 92% OF OUR CHARITY WRITE-OFFS ARE FOR PATIENTS WITHOUT INSURANCE WHILE 71% OF OUR BAD DEBT WRITE-OFFS ARE FOR PATIENTS WITHOUT INSURANCE. IN 2013 ONLY 8% OF ALL ACCOUNTS WRITTEN OFF TO BAD DEBT WERE RECOVERED. BASED ON THIS DEMOGRAPHIC AND INTERNAL DATA WE BELIEVE THAT A MINIMUM OF 15% OF THE AMOUNTS WRITTEN OFF AS BAD DEBT WOULD QUALIFY FOR CHARITY, AND AS SUCH 15% OF THE BAD DEBT EXPENSE FROM LINE 2 IS REPORTED ON LINE 3. | ||
| PART VI, LINE 2: SWEDISHAMERICAN HOSPITAL HAS PROVIDED A THIRD OF THE MONETARY SUPPORT FOR THE 2010 HEALTHY COMMUNITY STUDY, CONDUCTED BY THE ROCKFORD HEALTH COUNCIL. THE COUNCIL CONSISTS OF THE MAJOR HEALTH CARE PROVIDERS IN OUR METROPOLITAN AREA SUCH AS THE THREE HOSPITALS, CRUSADER CLINIC (A FEDERALLY QUALIFIED HEALTHCARE CLINIC), THE UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE, JANET WATTLES MENTAL HEALTH CENTER, ROSECRANCE SUBSTANCE ABUSE CENTER AS WELL AS SEVERAL REPRESENTATIVES OF NOT-FOR-PROFIT AGENCIES, AND MEMBERS OF THE CORPORATE COMMUNITY. SINCE 2001, AN ASSESSMENT HAS BEEN COMPLETED EVERY THREE YEARS TO IDENTIFY AND TRACK TRENDS AS WELL AS AREAS TO ADDRESS. THESE STAKEHOLDERS UNDERSTAND THE NEED FOR A COMPREHENSIVE COMMUNITY STUDY THAT IS FOCUSED ON THE OVERALL NEEDS OF THE COMMUNITY. SWEDISHAMERICAN HAS USED THIS DATA TO LAUNCH INNOVATIVE PROGRAMS AND COLLABORATIVE PARTNERSHIPS SUCH AS CARDIAC SCREENINGS WITHIN MINORITY COMMUNITIES. | ||
| PART VI, LINE 3: FOR SERVICES PROVIDED IN THE HOSPITAL, OUR EMPLOYEES AND OUR AGENTS FOLLOW THE FAIR PATIENT BILLING ACT AND PROVIDE INFORMATION REGARDING THE AVAILABILITY OF CHARITY AND FINANCIAL ASSISTANCE AT ALL POINTS DURING THE COLLECTION PROCESS. WE HAVE POSTED SIGNAGE DISCLOSING THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE IN EMERGENCY ROOMS AND ON OUR WEBSITE. INPATIENTS ARE PROVIDED VARIOUS WRITTEN COMMUNICATIONS REGARDING THE AVAILABILITY OF CHARITY CARE AND FINANCIAL ASSISTANCE, AND ANY UNINSURED PATIENTS ARE SCREENED FOR MEDICAID AND ILLINOIS UNINSURED DISCOUNT ELIGIBILITY. FOR SERVICES PROVIDED IN PHYSICIAN OFFICES, FINANCIAL COUNSELORS ARE INSTRUCTED TO MAKE THE PATIENTS AWARE OF THE CHARITY CARE AND FINANCIAL ASSISTANCE POLICY DURING THE COLLECTION PROCESS AND EDUCATE THEM ON THE PROCESS OF APPLYING FOR MEDICAID. FOR SERVICES PROVIDED BY HOME HEALTH, SOCIAL WORKERS ASSIST PATIENTS BY SCREENING FOR MEDICAID ELIGIBILITY AND COMPLETING THE APPLICATION, COMPLETING CHARITY CARE APPLICATION, ASSISTING IN APPLYING FOR MEDICARE AND SOCIAL SECURITY DISABILITY BENEFITS, AND ASSISTING WITH APPLICATIONS FOR FOOD STAMP, LOW INCOME ENERGY ASSISTANCE, AND CIRCUIT BREAKER/ILLINOIS CARES PRESCRIPTION PROGRAMS. | ||
| PART VI, LINE 4: FOR MORE THAN 100 YEARS, ROCKFORD, ILLINOIS HAS BEEN KNOWN AS A MAJOR INDUSTRIAL MANUFACTURING CENTER OF MACHINE TOOLS, INDUSTRIAL FASTENERS, AUTOMOTIVE PARTS AND AEROSPACE COMPONENTS. THE ROCKFORD METROPOLITAN POPULATION HAS GROWN TO MORE THAN 250,000 PEOPLE AND IT SERVES AS THE REGIONAL TRADE CENTER FOR MORE THAN 400,000 PEOPLE IN NORTHERN ILLINOIS. MAJOR EMPLOYERS IN OUR SERVICE AREA INCLUDE CHRYSLER, HAMILTON SUNDSTRAND, TEXTRON, CITY OF ROCKFORD, ROCKFORD PUBLIC SCHOOLS, AND THREE AREA HOSPITALS. ROCKFORD BOASTS MANY GREAT PARKS, SHOPPING, DINING, CULTURAL ACTIVITIES, ENTERTAINMENT AND EDUCATIONAL OPPORTUNITIES. BUT LIKE MANY CITIES IN THE UPPER MIDWEST, IT ALSO CONTINUES TO STRUGGLE TO COMPETE IN WHAT IS NOW A GLOBAL MANUFACTURING ECONOMY. IN THE 1980S, ROCKFORD'S UNEMPLOYMENT RATE REACHED 25 PERCENT, THE HIGHEST IN THE NATION, AND IT BECAME A SYMBOL FOR THE PLIGHT OF A "RUST BELT" CITY. ALTHOUGH THE ECONOMY IS MORE DIVERSIFIED NOW, ROCKFORD REMAINS HEAVILY DEPENDENT ON MANUFACTURING. ALSO IN THE 1980S, CHARGES OF DISCRIMINATION WERE LEVELED AT THE PUBLIC SCHOOL DISTRICT, CULMINATING IN A FEDERAL LAWSUIT AND 12 YEARS OF FEDERAL SUPERVISION. THESE TWO MAJOR DEVELOPMENTS HAVE HAD THEIR EFFECT ON THE LOCAL ECONOMY, THE STABILITY OF GOOD PAYING JOBS AND THE PSYCHE AND SELF-ESTEEM OF THE COMMUNITY. THEY ALSO HAVE AFFECTED ROCKFORD'S CHANGING ROLE AND IMPORTANCE TO THE REGION, STATE, AND TO SOME DEGREE THE NATION. UNQUESTIONABLY, THESE DYNAMICS HAVE IMPACTED HEALTHCARE IN THE COMMUNITY. TODAY, ROCKFORD'S UNEMPLOYMENT RATE OF 13.4% IS 15TH HIGHEST IN THE NATION. LOSS OF MANUFACTURING JOBS AND HEALTH INSURANCE COVERAGE HAS CONTRIBUTED TO STRESS AND STRAIN ON EMPLOYERS, EMPLOYEES AND HEALTHCARE PROVIDERS. TWO COMMUNITY SURVEYS HAVE IDENTIFIED HEART DISEASE, DIABETES, CANCER, PRE-NATAL CARE AND DEPRESSION AS MAJOR HEALTHCARE ISSUES IN OUR MARKET.SWEDISHAMERICAN HELPED FUND THE 2010 ROCKFORD HEALTHY COMMUNITY STUDY IN PARTNERSHIP WITH THE UNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE AT ROCKFORD AND THE ROCKFORD HEALTH COUNCIL. THE STUDY REVEALED THAT MORE THAN 20 PERCENT OF THE RESIDENTS IN OUR HOSPITAL'S ZIP CODE LIVE BELOW THE POVERTY LEVEL, AND THAT THE MEDIAN HOUSEHOLD INCOME OF $25,527 IS THE LOWEST OF ALL ROCKFORD-AREA ZIP CODES. OUT-OF-POCKET HEALTHCARE COSTS ARE A PROBLEM FOR MORE THAN 45 PERCENT OF THIS AREA'S RESIDENTS, WHICH IS THE HIGHEST RATE IN THE CITY OF ROCKFORD. ADDITIONALLY, MANY RESIDENTS IN THIS VICINITY-WHICH IS AMONG THE STATE'S MOST DEPRESSED AREAS-ARE NOT ABLE TO RECEIVE NEEDED PHYSICAL OR MENTAL HEALTHCARE. THE UNITED WAY OF ROCK RIVER VALLEY' COMMUNITY ASSESSMENT FURTHER REVEALED THAT MANY LOCAL RESIDENTS LACK HEALTH INSURANCE AND ACCESS TO PRIMARY HEALTHCARE, LEADING TO PREMATURE MORBIDITY. THE ROCKFORD HEALTHY COMMUNITY STUDY IDENTIFIED EXTREMELY LOW LEVELS OF HOME OWNERSHIP IN SWEDISHAMERICAN HOSPITAL'S IMMEDIATE VICINITY. ACCORDING TO THE STUDY, MORE THAN 60 PERCENT OF RESIDENTS RENTED, WHICH WAS MUCH HIGHER THAN THE OVERALL SAMPLE (APPROXIMATELY 17 PERCENT). THE STUDY ALSO INDICATED THAT MORE THAN 12 PERCENT OF AREA RESIDENTS COULD NOT AFFORD TO MAKE BASIC HOME REPAIRS. THE UNITED WAY'S ASSESSMENT FURTHER IDENTIFIED THE NEED FOR MORE AFFORDABLE PERMANENT HOUSING UNITS, STATING: "EVEN THOUGH HOUSING IN ROCKFORD IS AMONG THE MOST AFFORDABLE IN THE COUNTRY, MANY FAMILIES, ESPECIALLY RENTERS, CANNOT AFFORD SHELTER." BY VIRTUE OF ITS MISSION, LOCATION IN THE CENTRAL CITY AND RELATIONSHIPS WITH OTHER PROVIDERS, SWEDISHAMERICAN SERVES THE NEEDS OF MANY OF THE COMMUNITY'S UNDERSERVED. FINDING WAYS TO IMPROVE THE HEALTH OF ALL AND TO MAKE ROCKFORD A MODEL COMMUNITY IN WHICH TO LIVE, WORK AND WORSHIP ARE SIGNIFICANT AND STRATEGIC INITIATIVES FOR SWEDISHAMERICAN. | ||
| PART VI, LINE 5: ALTHOUGH SWEDISHAMERICAN HOSPITAL'S COMMUNITY SERVICE EFFORTS REACH A BROAD SEGMENT OF THE POPULATION THROUGHOUT NORTHERN ILLINOIS, THE HOSPITAL DEVOTES A GREAT DEAL OF ITS ENERGY AND RESOURCES TO SERVING THE CITY'S NEEDIEST PEOPLE, MANY OF WHOM LIVE IN THE URBAN CORE WHERE SWEDISHAMERICAN IS LOCATED. OUR ORGANIZATION CONTRIBUTES MILLIONS OF DOLLARS TO CHARITY AND MEDICAID CARE EACH YEAR. RECOGNIZING THAT HEALTHY COMMUNITIES ARE CHARACTERIZED BY STRONG INTERCONNECTIONS BETWEEN RESIDENTS, INFRASTRUCTURE, ORGANIZATIONS AND SERVICES, WE HAVE WORKED IN PARTNERSHIP WITH OTHER COMMUNITY-BASED ORGANIZATIONS AS PART OF THE NON-PROFIT ROCKFORD HEALTH COUNCIL INC. THE COUNCIL SEEKS TO BUILD AND IMPROVE COMMUNITY HEALTH THROUGH EDUCATION, ACTION, DIALOGUE AND LEGISLATIVE ACTIVITY AND SERVE AS A CATALYST AND COORDINATOR FOR AGENCY AND INDIVIDUAL ACTION TO ENSURE ACCESS, COST EFFECTIVENESS AND QUALITY. BEYOND OUR WORK WITH THE COUNCIL, SOME OF OUR INITIATIVES TAKE PLACE IN CONCERT WITH OTHER INDIVIDUAL COMMUNITY ORGANIZATIONS AND HEALTHCARE PROVIDERS, WHILE OTHERS ARE CARRIED OUT BY SWEDISHAMERICAN HOSPITAL TEAMS. SWEDISHAMERICAN HAS SOUGHT TO IMPROVE THE COMMUNITY'S HEALTH BY TAKING EFFECTIVE LIFESTYLE MODIFICATION PROGRAMS TO THE PEOPLE WHO NEED THEM MOST. ALTHOUGH THIS APPLIES TO THE COMMUNITY AT LARGE, WE HAVE TAKEN SPECIAL EFFORTS TO BRING THESE STRATEGIES TO THE CITY'S ELDERLY AND UNDERSERVED RESIDENTS. THIS IS DEMONSTRATED BY OUR SUCCESSFUL PROGRAM TO IMPROVE THE HEALTH OF RESIDENTS AT LONGWOOD PLAZA, A SENIOR HOUSING FACILITY LOCATED TWO BLOCKS FROM OUR HOSPITAL'S CAMPUS. FINALLY, BEYOND LIFESTYLE MODIFICATION OUR ONGOING COMMUNITY HEALTH INITIATIVES INVOLVE RESEARCH-BASED HEALTH SCREENING PROGRAMS, AS WELL AS UNIQUE HEALTH EDUCATION EVENTS THAT TARGET BOTH AT-RISK MEMBERS OF THE COMMUNITY AND HEALTHCARE PROVIDERS. OUR MISSION IS "THROUGH EXCELLENCE IN HEALTHCARE AND COMPASSIONATE SERVICE WE CARE FOR OUR COMMUNITY." IN FURTHERANCE OF ITS EXEMPT PURPOSE SWEDISHAMERICAN HOSPITAL CONTINUALLY INVESTS IN THE SURROUNDING COMMUNITY WITH PHYSICIAN ACQUISITIONS AND REGIONAL EXPANSION TO ASSURE ACCESS TO HEALTH CARE. SWEDISHAMERICAN HOSPITAL ALSO ESTABLISHED CENTERS OF EXCELLENCE AND ALLIANCES WITH OTHER HEALTH CARE PROVIDERS, INCLUDING CRUSADER CLINIC, A FEDERALLY QUALIFIED HEALTH CENTER, AND UNIVERSITY OF WISCONSIN. THIS ASSURES THE COMMUNITY WE SERVE RECEIVES THE HIGHEST QUALITY CARE. WE ALSO INVEST IN TECHNOLOGY TO ASSURE COST EFFECTIVE CARE IS DELIVERED FOR WHICH SWEDISHAMERICAN HOSPITAL HAS WON NUMEROUS AWARDS FOR ITS QUALITY OF CARE. IN ADDITION, SWEDISHAMERICAN HOSPITAL MAINTAINS AN OPEN MEDICAL STAFF AND COMMUNITY BOARD AS PART OF ITS EXEMPT PURPOSE. | ||
| PART VI, LINE 6: SWEDISHAMERICAN HOSPITAL IS A STAND ALONE HEALTH CARE PROVIDER THAT INCLUDES TWO ACUTE CARE HOSPITALS, PHYSICIAN CLINICS, PHYSICIAN EMERGENCY SERVICES, AND HOME HEALTH CARE. SWEDISHAMERICAN FOUNDATION IS A SUBSIDIARY OF SWEDISHAMERICAN HOSPITAL AND IS ORGANIZED FOR TAX PURPOSES AS A SUPPORTING ORGANIZATION. IN ORDER TO IMPROVE THE LOW RATE OF HOME OWNERSHIP IDENTIFIED IN THE ROCKFORD HEALTHY COMMUNITY STUDY, SWEDISHAMERICAN FOUNDATION (SAF) INITIATED A NEIGHBORHOOD REVITALIZATION PROGRAM IN A SIX-BLOCK AREA DIRECTLY SOUTH OF OUR HOSPITAL CAMPUS. SAF'S NEIGHBORHOOD REVITALIZATION EFFORT INCLUDES:HABITAT FOR HUMANITY HOMES: SAF ENTERED INTO A FORMAL AGREEMENT WITH THE ROCKFORD HABITAT FOR HUMANITY CHAPTER IN 2002 TO CONSTRUCT NEW AREA HOMES. BY THE END OF 2012, A TOTAL OF 29 HABITAT FOR HUMANITY HOMES HAVE NOW BEEN COMPLETED AND SOLD TO LOW-INCOME HOME OWNERS.NEW CITY-BUILT HOMES: SAF PURCHASED AND RAZED THREE, ADDITIONAL SUBSTANDARD HOMES IN THE NEIGHBORHOOD AND PROVIDED THE LOTS TO THE CITY OF ROCKFORD. THE CITY SUBSEQUENTLY BUILT THREE NEW HOMES ON THESE SITES FOR SALE TO MODERATE INCOME FAMILIES WITH PURCHASE ASSISTANCE.CRUISE FUNDRAISER: OVER THE PAST 17 YEARS, SAF'S ANNUAL FUNDRAISING GALA HAS RAISED MORE THAN $1,000,000, WHICH HAS BEEN REINVESTED INTO COMMUNITY IMPACT INITIATIVES, SUCH AS SCHOOL PHYSICALS AND IMMUNIZATIONS FOR AREA CHILDREN AND CANCER SCREENINGS FOR NEIGHBORHOOD RESIDENTS.NEIGHBORHOOD PLAYGROUND AND PARKS: BECAUSE AREA CHILDREN DID NOT HAVE A SAFE PLACE TO PLAY, SAF PURCHASED THREE CONTIGUOUS PIECES OF PROPERTY, REMOVED EXISTING COMMERCIAL AND RESIDENTIAL STRUCTURES AND PARTNERED WITH TWO LOCAL CHARITIES TO CONSTRUCT A NEW NEIGHBORHOOD PLAYGROUND. DRIVEWAY/GARAGE RENOVATION PROJECT: FOLLOWING A NEIGHBORHOOD-WIDE SURVEY, SAF COORDINATED AND IMPLEMENTED A GARAGE CONSTRUCTION AND DRIVEWAY REPLACEMENT PROGRAM. IN ADDITION TO INCREASING EXISTING HOME VALUES, THIS PROGRAM WILL HELP REDUCE ON-STREET PARKING, THEREBY INCREASING TRAFFIC FLOW AND MAKING PARKED CARS LESS VISIBLE/ACCESSIBLE TO POTENTIAL THIEVES AND VANDALS. REVERSE HOME GIFT ANNUITY PROGRAM: TO HELP STRUGGLING ELDERLY RESIDENTS REMAIN IN THEIR HOMES, SAF DEVELOPED A PROGRAM WHEREBY HOMEOWNERS DEED PHYSICAL OWNERSHIP OF THEIR PROPERTY TO THE FOUNDATION IN EXCHANGE FOR THE RIGHT TO LIVE IN THEIR HOME UNTIL DEATH OR INCAPACITY. SAF ASSUMES RESPONSIBILITIES FOR TAXES, REPAIRS, UPKEEP, LAWN MAINTENANCE AND SNOW REMOVAL. UPON TAKING ULTIMATE POSSESSION OF A HOUSE, IT WILL BE SOLD TO AN EMPLOYEE OR OTHER OWNER OCCUPANT, TO HELP INCREASE [OR AT LEAST MAINTAIN] A SIGNIFICANT PERCENTAGE OF OWNER OCCUPIED HOMES.HOMEOWNER GRANTS TO EMPLOYEES: SINCE 2004, SWEDISHAMERICAN HOSPITAL HAS OFFERED $5,000 DOWN PAYMENT ASSISTANCE TO EMPLOYEES TO HELP ENCOURAGE HOME OWNERSHIP IN THE SIX-BLOCK AREA SURROUNDING THE HOSPITAL. THIS INITIATIVE INCLUDES A FIVE-YEAR FORGIVABLE GRANT TO EMPLOYEES IN GOOD STANDING WITH NO INCOME RESTRICTIONS, AND A SECOND POSSIBLE $5,000 GRANT FOR LOW-INCOME EMPLOYEES. SINCE INCEPTION, THIS PROGRAM HAS ASSISTED 17 EMPLOYEES PURCHASE HOMES IN THE SWEDISHAMERICAN NEIGHBORHOOD.HOME RESTORATION: SINCE 2004, SAF HAS PURCHASED A TOTAL OF 27 HOMES IN THE NEIGHBORHOOD TARGET AREA, REHABBED THEM AND MADE THEM AVAILABLE TO EMPLOYEES, FIREFIGHTERS, POLICE OFFICERS AND PUBLIC SCHOOL TEACHERS, AT DISCOUNT (LESS THAN THE COST OF PURCHASE AND REPAIRS). TO DATE, 20 HOMES HAVE BEEN SOLD TO EMPLOYEES AND OTHER ELIGIBLE OWNER OCCUPANTS. IN ORDER TO ALLEVIATE FIRST-TIME HOME BUYERS' CONCERNS ABOUT THE RISING COSTS OF OWNERSHIP, THESE HOMES HAVE A SOLID ROOF, SIDING, PLUMBING, ELECTRICAL, AND A GOOD WORKING FURNACE. THIS PROGRAM WILL CONTINUE FOR AT LEAST FOUR ADDITIONAL YEARS. IN COOPERATION WITH ROCKFORD EAST HIGH SCHOOL AND DE LA GARDIE HIGH SCHOOL/GYMNASIET (LIDKOPINGS, SWEDEN), THE SWEDISHAMERICAN FOUNDATION CONSTRUCTED TWO NEW NEIGHBORHOOD HOUSES AVAILABLE FOR SALE TO EMPLOYEES OR OTHER ELIGIBLE OWNER-OCCUPANTS.IN ADDITION, THE FOUNDATION HAS PURCHASED TWO, 12-UNIT APARTMENT BUILDINGS ADJACENT TO THE HOSPITAL CAMPUS WHICH WERE IN A STATE OF DISREPAIR. APPROXIMATELY THREE-QUARTERS OF A MILLION DOLLARS WERE INVESTED IN THESE TWO BUILDINGS TO BRING THEM TO "MARKET RATE" STATUS. ENCOURAGED BY OUR COMMITMENT TO RENOVATE OUR CAMPUS AND REVITALIZE THE SURROUNDING AREA, A NUMBER OF COMMERCIAL DEVELOPMENTS HAVE OCCURRED. AMONG THEM IS A NEW WALGREEN'S DRUG STORE, WHICH RETURNED RETAIL PHARMACY SERVICES TO THE AREA FOR THE FIRST TIME IN YEARS. A THREE-STORY OFFICE BUILDING SOUTH OF THE NEW WALGREEN'S WAS COMPLETED FOLLOWED BY A 60,000-SQUARE-FOOT MEDICAL OFFICE BUILDING SOUTH OF THE HOSPITAL. | ||
| PART I LINE 6A AND PART VI LINE 7 - SWEDISHAMERICAN HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE ILLINOIS ATTORNEY GENERAL. | ||
| SEE BELOW | PART V, LINE 8 FACILITY REPORTING GROUP A | |
| PART V, SECTION B, LINE 3: PRIMARY DATA WAS COLLECTED FROM INTERVIEWS WITH COMMUNITY LEADERS AND STAKEHOLDERS. THE HOSPITALS COMMISSIONED IN-DEPTH INTERVIEWS WITH COMMUNITY MEMBERS WHO REPRESENT THE BROAD INTERESTS AS WELL AS THE SPECIFIC POPULATIONS IN THE ROCKFORD AREA. THE INTERVIEWS MEASURED PERSPECTIVES ON A RANGE OF ISSUES THAT AFFECT THE POPULATION'S HEALTH AND WELL-BEING, E.G., COMMUNITY RESOURCES, BARRIERS TO HEALTH CARE PROVIDERS, AND REASONS FOR HIGH RATES OF DISEASE AND MORTALITY. INTERVIEWS WERE COMPLETED WITH THE INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS:LIFESCAPE COMMUNITY SERVICESSHELTER CARE MINISTRIESEMPLOYERS'S COALITION ON HEALTHROCKFORD AREA ECONOMIC DEVELOPMENT COUNCILCITY OF BELVIDEREROCKFORD CHAMBER OF COMMERCEOGLE COUNTY PUBLIC HEALTH DEPARTMENTSTATE SENATE REPRESENTATIVE OF ROCKFORD/BELVIDEREROSECRANCE HEALTH NETWORKWINNEBAGO COUNTY PUBLIC HEALTH DEPARTMENTBELVIDERE COMMUNITY UNIT SCHOOL DISTRICT 100CRUSADER COMMUNITY HEATHROCK VALLEY COLLEGEWINNEGAGO COUNTY STATE'S ATTORNEY'S OFFICEYWCA ROCKFORDLA VOZ LATINAUNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE, ROCKFORDCITY OF ROCKFORD | FACILITY 1 -- SWEDISHAMERICAN HOSPITAL | PART V, SECTION B, LINE 3: |
| PART V, SECTION B, LINE 4: SWEDISHAMERICAN HOSPITAL HAS TWO HOSPITAL FACILITIES, SWEDISHAMERICAN HOSPITAL LOCATED IN ROCKFORD, ILLINOIS, AND SWEDISHAMERICAN MEDICAL CENTER BELVIDERE LOCATED IN BELVIDERE, ILLINOIS. THE DEFINITION OF THE COMMUNITY FOR PURPOSES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS BASED ON THE PATIENT ORIGIN INFORMATION BY ZIP CODE FOR COMBINED EMERGENCY ROOM AND INPATIENT DISCHARGES AT BOTH FACILITIES. THE COUNTIES OF BOONE, OGLE AND WINNEBAGO REPRESENTED 86% OF EMERGENCY ROOM AND 85% OF INPATIENTS. COUNTIES AND THEREFORE WAS THE DEFINITION OF THE COMMUNITY FOR THE CHNA. THE CHNA CONDUCTED TOGETHER FOR BOTH FACILITIES. | FACILITY 1 -- SWEDISHAMERICAN HOSPITAL | PART V, SECTION B, LINE 4: |
| THE CHNA FOR BOTH HOSPITAL FACILITES CAN BE ACCESSED AT HTTP://WWW.SWEDISHAMERICAN.ORG/ABOUT/CHNA/ | FACILITY 1 -- SWEDISHAMERICAN HOSPITAL | PART V, SECTION B, LINE 5C: |
| PART V, SECTION B, LINE 7: THE CHNA WAS COMPLETED APRIL 25, 2013 AND THE CHNA AND IMPLEMENTATION STRATEGY WERE PUBLISHED BY MAY 31, 2013. MANY OF THE ACTION PLANS WERE IN PROCESS, BUT DUE TO TIMING, WERE NOT ABLE TO BE COMPLETED BY THE END OF THE TAX YEAR. | FACILITY 1 -- SWEDISHAMERICAN HOSPITAL | PART V, SECTION B, LINE 7: |
| THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS TRANSPARENT AND AVAILABLE TO ALL, AT ALL POINTS IN THE CONTINUUM, IN LANGUAGES APPROPRIATE FOR HOSPITAL'S SERVICE AREA. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, SIGNAGE, AND FINANCIAL COUNSELOR CONTACT INFORMATION ARE AVAILABLE IN ENGLISH AND SPANISH. SIGNAGE IS POSTED PROMINENTLY AT ALL POINTS OF ADMISSION AND REGISTRATION (INCLUDING THE EMERGENCY DEPARTMENT). WRITTEN INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND COPIES OF THE FINANCIAL ASSISTANCE FORM ARE AVAILABLE IN ADMISSION AND REGISTRATION AREAS. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION FORM AND FINANCIAL COUNSELOR CONTACT INFORMATION ARE ALSO POSTED ON THE HOSPITAL'S WEBSITE. THE HOSPITAL WILL MAKE EFFORTS TO PUBLICIZE ITS POLICY IN PRINT AND TELEVISION MEDIA, WHEREVER PRACTICABLE.PATIENT BILLING COMMUNICATIONS ALSO INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. EACH BILL, INVOICE, OR OTHER SUMMARY OF CHARGES TO AN UNINSURED PATIENT INCLUDES WITH IT, OR ON IT, A PROMINENT STATEMENT THAT AN UNINSURED PATIENT WHO MEETS CERTAIN INCOME REQUIREMENTS MAY QUALIFY FOR FINANCIAL ASSISTANCE AND INFORMATION ON HOW TO APPLY FOR CONSIDERATION UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ALL THIRD-PARTY AGENTS WHO SUBMIT OR COLLECT BILLS ON BEHALF OF HOSPITAL ARE REQUIRED TO FOLLOW THIS POLICY. | FACILITY 1 -- SWEDISHAMERICAN HOSPITAL | PART V, SECTION B, LINE 14G: |
| THE MAXIMUM AMOUNT THAT MAY BE COLLECTED IN A 12-MONTH PERIOD FROM AN UNINSURED PATIENT WITH FAMILY INCOME OF LESS THAN OR EQUAL TO 600% OF THE FEDERAL POVERTY GUIDELINES FOR MEDICALLY NECESSARY SERVICES IS 25% OF THAT PATIENT'S FAMILY INCOME. THE HOSPITAL WILL DETERMINE, ON A CASE-BY-CASE BASIS, WHETHER TO EXTEND THE SAME OR SIMILAR 12-MONTH MAXIMUM COLLECTIBLE AMOUNT TO ANY OTHER QUALIFYING SELF-PAY PATIENT WITH FAMILY INCOME OF LESS THAN OR EQUAL TO 600% OF THE FEDERAL POVERTY GUIDELINES FOR QUALIFYING SERVICES. THE HOSPITAL RESERVES THE RIGHT TO EXCLUDE PATIENTS HAVING ASSETS WITH A VALUE IN EXCESS OF 600% OF THE FEDERAL POVERTY GUIDELINES FROM THE APPLICATION OF THE 12-MONTH MAXIMUM COLLECTIBLE AMOUNT. FOR PURPOSES OF DETERMINING THE APPLICABILITY OF THE 12-MONTH MAXIMUM COLLECTIBLE AMOUNT, THE FOLLOWING ASSETS SHALL NOT BE COUNTED:A. THE UNINSURED PATIENT'S PRIMARY RESIDENCE.B. PERSONAL PROPERTY EXEMPT FROM JUDGMENT UNDER SECTION 12-1001 OF THE CODE OF CIVIL PROCEDURE.C. ANY AMOUNTS HELD IN A PENSION OR RETIREMENT PLAN, PROVIDED, HOWEVER, THAT DISTRIBUTIONS AND PAYMENTS FROM PENSION OR RETIREMENT PLAN MAY BE INCLUDED AS INCOME.TO BE ELIGIBLE TO HAVE THIS MAXIMUM AMOUNT APPLIED TO SUBSEQUENT CHARGES, A PATIENT SHALL INFORM THE HOSPITAL, IN SUBSEQUENT HOSPITAL IN-PATIENT ADMISSIONS OR OUTPATIENT ENCOUNTERS, THAT THE PATIENT HAS PREVIOUSLY RECEIVED MEDICALLY NECESSARY SERVICES FROM THE HOSPITAL AND WAS DETERMINED TO BE ENTITLED TO DISCOUNTED CARE UNDER THIS POLICY.IN NO EVENT SHALL A PATIENT WHO RECEIVES FINANCIAL ASSISTANCE UNDER THIS POLICY BE CHARGED "GROSS CHARGES" IN VIOLATION OF THE INTERNAL REVENUE CODE SECTION 501(R)(5)(B). FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO PATIENTS WHO RECEIVE FINANCIAL ASSISTANCE UNDER THIS POLICY, HOSPITAL SHALL NOT CHARGE AMOUNTS IN EXCESS OF CHARGES ALLOWED UNDER INTERNAL REVENUE CODE 501(R)(5)(A). ASSETS ARE NOT CONSIDERED IN DETERMINING A SELF-PAY PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THIS POLICY, EXCEPT FOR PURPOSES OF:A. DETERMINING THE APPLICABILITY OF THE 12-MONTH MAXIMUM COLLECTIBLE AMOUNT DESCRIBED ABOVE; ANDB. IN THE CASE OF A MEDICARE BENEFICIARY, APPLYING THE MANDATORY ASSET TEST FOR MEDICARE BENEFICIARIES DESCRIBED ABOVE. | FACILITY 1 -- SWEDISHAMERICAN HOSPITAL | PART V, SECTION B, LINE 20D: |
| PRIMARY DATA WAS COLLECTED FROM INTERVIEWS WITH COMMUNITY LEADERS AND STAKEHOLDERS. THE HOSPITALS COMMISSIONED IN-DEPTH INTERVIEWS WITH COMMUNITY MEMBERS WHO REPRESENT THE BROAD INTERESTS AS WELL AS THE SPECIFIC POPUATIONS IN THE ROCKFORD AREA. THE INTERVIEWS MEASURED PERSPECTIVES ON A RANGE OF ISSUES THAT AFFECT THE POPULATION'S HEALTH AND WELL-BEING, E.G., COMMUNITY RESOURCES, BARRIERS TO HEALTH CARE PROVIDERS, AND REASONS FOR HIGH RATES OF DISEASE AND MORTALITY. INTERVIEWS WERE COMPLETED WITH THE INDIVIDUALS FROM THE FOLLOWING ORGANIZATIONS:LIFESCAPE COMMUNITY SERVICESSHELTER CARE MINISTRIESEMPLOYER'S COALITION ON HEALTHROCKFORD AREA ECONOMIC DEVELOPMENT COUNCILCITY OF BELVIDEREROCKFORD CHAMBER OF COMMERCEOGLE COUNTY PUBLIC HEALTH DEPARTMENTSTATE SENATE REPRESENTATIVE OF ROCKFORD/BELVIDEREROSECRANCE HEALTH NETWORKWINNEBAGO COUNTY PUBLIC HEALTH DEPARTMENT BELVIDERE COMMUNITY UNIT SCHOOL DISTRICT 100CRUSADER COMMUNITY HEALTHROCK VALLEY COLLEGEWINNEBAGO COUNTY STATE'S ATTORNEY'S OFFICEYWCA ROCKFORDLA VOZ LATINAUNIVERSITY OF ILLINOIS COLLEGE OF MEDICINE, ROCKFORDCITY OF ROCKFORD | FACILITY 2 -- SWEDISHAMERICAN MEDICAL CTR. BELVIDERE | PART V, SECTION B, LINE 3: |
| SWEDISHAMERICAN HOSPITAL HAS TWO HOSPITAL FACILITIES, SWEDISHAMERICAN HOSPITAL LOCATED IN ROCKFORD, ILLINOIS, AND SWEDISHAMERICAN MEDICAL CENTER BELVIDERE LOCATED IN BELVIDERE, ILLINOIS. THE DEFINITION OF THE COMMUNITY FOR PURPOSES OF THE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA) WAS BASED ON THE PATIENT ORIGIN INFORMATION BY ZIP CODE FOR COMBINED EMERGENCY ROOM AND INPATIENT DISCHARGES AT BOTH FACILITES. THE COUNTIES OF BOONE, OGLE AND WINNEBAGO REPRESENTED 86% OF EMERGENCY ROOM AND 85% OF INPATIENTS AND THEY WERE DETERMINED TO BE THE DEFINITION OF THE COMMUNITY FOR THE CHNA. THE CHNA WAS CONDUCTED TOGETHER FOR BOTH FACILITIES. | FACILITY 2 -- SWEDISHAMERICAN MEDICAL CTR. BELVIDERE | PART V, SECTION B, LINE 4: |
| THE CHNA FOR BOTH HOSPITAL FACILITIES CAN BE ACCESSED AT HTTP://WWW.SWEDISHAMERICAN.ORG/ABOUT/CHNA/ | FACILITY 2 -- SWEDISHAMERICAN MEDICAL CTR. BELVIDERE | PART V, SECTION B, LINE 5C: |
| THE CHNA WAS COMPLETED APRIL 25, 2013 AND THE CHNA AND IMPLEMENTATION STRATEGY WERE PUBLISHED BY MAY 31, 2013. MANY OF THE ACTION PLANS WERE IN PROCESS, BUT DUE TO TIME, WERE NOT ABLE TO BE COMPLETED BY THE END OF THE TAX YEAR. | FACILITY 2 -- SWEDISHAMERICAN MEDICAL CTR. BELVIDERE | PART V, SECTION B, LINE 7: |
| THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY IS TRANSPARENT AND AVAILABLE TO ALL, AT ALL POINTS IN THE CONTINUUM, IN LANGUAGES APPROPRIATE FOR HOSPITAL'S SERVICE AREA. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION FORM, SIGNAGE, AND FINANCIAL COUNSELOR CONTACT INFORMATION ARE AVAILABLE IN ENGLISH AND SPANISH. SIGNAGE IS POSTED PROMINENTLY AT ALL POINTS OF ADMISSION AND REGISTRATION (INCLUDING THE EMERGENCY DEPARTMENT). WRITTEN INFORMATION ABOUT THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY AND COPIES OF THE FINANCIAL ASSISTANCE FORM ARE AVAILABLE IN ADMISSION AND REGISTRATION AREAS. THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, APPLICATION FORM AND FINANCIAL COUNSELOR CONTACT INFORMATION ARE ALSO POSTED ON THE HOSPITAL'S WEBSITE. THE HOSPITAL WILL MAKE EFFORTS TO PUBLICIZE ITS POLICY IN PRINT AND TELEVISION MEDIA, WHEREVER PRACTICABLE.PATIENT BILLING COMMUNICATIONS ALSO INFORM PATIENTS OF THE AVAILABILITY OF FINANCIAL ASSISTANCE. EACH BILL, INVOICE, OR OTHER SUMMARY OF CHARGES TO AN UNINSURED PATIENT INCLUDES WITH IT, OR ON IT, A PROMINENT STATEMENT THAT AN UNINSURED PATIENT WHO MEETS CERTAIN INCOME REQUIREMENTS MAY QUALIFY FOR FINANCIAL ASSISTANCE AND INFORMATION ON HOW TO APPLY FOR CONSIDERATION UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. ALL THIRD-PARTY AGENTS WHO SUBMIT OR COLLECT BILLS ON BEHALF OF HOSPITAL ARE REQUIRED TO FOLLOW THIS POLICY. | FACILITY 2 -- SWEDISHAMERICAN MEDICAL CTR. BELVIDERE | PART V, SECTION B, LINE 14G: |
| THE MAXIMUM AMOUNT THAT MAY BE COLLECTED IN A 12-MONTH PERIOD FROM AN UNINSURED PATIENT WITH FAMILY INCOME OF LESS THAN OR EQUAL TO 600% OF THE FEDERAL POVERTY GUIDELINES FOR MEDICALLY NECESSARY SERVICES IS 25% OF THAT PATIENT'S FAMILY INCOME. THE HOSPITAL WILL DETERMINE, ON A CASE-BY-CASE BASIS, WHETHER TO EXTEND THE SAME OR SIMILAR 12-MONTH MAXIMUM COLLECTIBLE AMOUNT TO ANY OTHER QUALIFYING SELF-PAY PATIENT WITH FAMILY INCOME OF LESS THAN OR EQUAL TO 600% OF THE FEDERAL POVERTY GUIDELINES FOR QUALIFYING SERVICES. THE HOSPITAL RESERVES THE RIGHT TO EXCLUDE PATIENTS HAVING ASSETS WITH A VALUE IN EXCESS OF 600% OF THE FEDERAL POVERTY GUIDELINES FROM THE APPLICATION OF THE 12-MONTH MAXIMUM COLLECTIBLE AMOUNT. FOR PURPOSES OF DETERMINING THE APPLICABILITY OF THE 12-MONTH MAXIMUM COLLECTIBLE AMOUNT, THE FOLLOWING ASSETS SHALL NOT BE COUNTED:A. THE UNINSURED PATIENT'S PRIMARY RESIDENCE.B. PERSONAL PROPERTY EXEMPT FROM JUDGMENT UNDER SECTION 12-1001 OF THE CODE OF CIVIL PROCEDURE.C. ANY AMOUNTS HELD IN A PENSION OR RETIREMENT PLAN, PROVIDED, HOWEVER, THAT DISTRIBUTIONS AND PAYMENTS FROM PENSION OR RETIREMENT PLAN MAY BE INCLUDED AS INCOME.TO BE ELIGIBLE TO HAVE THIS MAXIMUM AMOUNT APPLIED TO SUBSEQUENT CHARGES, A PATIENT SHALL INFORM THE HOSPITAL, IN SUBSEQUENT HOSPITAL INPATIENT ADMISSIONS OR OUTPATIENT ENCOUNTERS, THAT THE PATIENT HAS PREVIOUSLY RECEIVED MEDICALLY NECESSARY SERVICES FROM THE HOSPITAL AND WAS DETERMINED TO BE ENTITLED TO DISCOUNTED CARE UNDER THIS POLICY.IN NO EVENT SHALL A PATIENT WHO RECEIVES FINANCIAL ASSISTANCE UNDER THIS POLICY BE CHARGED "GROSS CHARGES" IN VIOLATION OF THE INTERNAL REVENUE CODE SECTION 501(R)(5)(B). FOR EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO PATIENTS WHO RECEIVE FINANCIAL ASSISTANCE UNDER THIS POLICY, HOSPITAL SHALL NOT CHARGE AMOUNTS IN EXCESS OF CHARGES ALLOWED UNDER INTERNAL REVENUE CODE 501(R)(5)(A). ASSETS ARE NOT CONSIDERED IN DETERMINING A SELF-PAY PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER THIS POLICY, EXCEPT FOR PURPOSES OF:A. DETERMINING THE APPLICABILITY OF THE 12-MONTH MAXIMUM COLLECTIBLE AMOUNT DESCRIBED ABOVE; ANDB. IN THE CASE OF A MEDICARE BENEFICIARY, APPLYING THE MANDATORY ASSET TEST FOR MEDICARE BENEFICIARIES DESCRIBED ABOVE. | FACILITY 2 -- SWEDISHAMERICAN MEDICAL CTR. BELVIDERE | PART V, SECTION B, LINE 20D: |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| ILLINOIS HOSPITAL RESEARCH & EDUCATION FOUNDATION | |||||||
| 1151 W WARRENVILLE RD | NAPERVILLE | IL | 60566 | 237421930 | 501(C)(3) | 193356 | QUALITY HEALTHCARE FOR ILLINOIS |
| THE BOARD OF TRUSTEES OF UNIVERSITY OF ILLINOIS | |||||||
| 560 S WRIGHT 209 HAB MCV-339 | URBANA | IL | 61801 | 376000511 | 501(C)(3) | 338250 | ACADEMIC RESEARCH |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 2 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part III Form990ScheduleIPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Grant | EDUCATIONAL SCHOLARSHIP FOR CHILDREN OF NON-MANAGEMENT EMPLOYEES | TypeOfGrant |
| Number Of Recipients | 30 | NumberOfRecipients |
| Amount Of Cash Grant | 30000 | AmountOfCashGrant |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | SWEDISHAMERICAN HOSPITAL ONLY MAKES DONATIONS TO OTHER TAX EXEMPT ORGANIZATIONS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DANNY L COPELAND MD | ||||||||||||||
| TRUSTEE | 205662 | 0 | 0 | 0 | 0 | 0 | 15189 | 0 | 20221 | 0 | 241072 | 0 | 0 | 0 |
| WILLIAM R GORSKI MD | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | 580553 | 0 | 0 | 0 | 0 | 0 | 208824 | 0 | 15401 | 0 | 804778 | 0 | 0 | 0 |
| JOHN C MYERS MD | ||||||||||||||
| TRUSTEE | 571182 | 0 | 0 | 0 | 0 | 0 | 11500 | 0 | 33283 | 0 | 615965 | 0 | 0 | 0 |
| RICHARD WALSH | ||||||||||||||
| CHIEF OPERATING OFFICER | 380115 | 0 | 0 | 0 | 0 | 0 | 104152 | 0 | 23937 | 0 | 508204 | 0 | 0 | 0 |
| ALLEN WILLIAMS MD | ||||||||||||||
| TRUSTEE | 234723 | 0 | 0 | 0 | 0 | 0 | 16351 | 0 | 26054 | 0 | 277128 | 0 | 0 | 0 |
| DONALD HARING | ||||||||||||||
| VP FINANCE/TREASURER | 337218 | 0 | 0 | 0 | 0 | 0 | 55979 | 0 | 21771 | 0 | 414968 | 0 | 0 | 0 |
| KATHLEEN KELLY MD | ||||||||||||||
| VP MEDICAL AFFAIRS | 359908 | 0 | 0 | 0 | 133798 | 0 | 46262 | 0 | 769 | 0 | 540737 | 0 | 106200 | 0 |
| MERAT ESFAHANI MD | ||||||||||||||
| PHYSICIAN | 700723 | 0 | 0 | 0 | 0 | 0 | 14433 | 0 | 36871 | 0 | 752027 | 0 | 0 | 0 |
| STEVEN MILOS MD | ||||||||||||||
| PHYSICIAN | 672807 | 0 | 0 | 0 | 0 | 0 | 14389 | 0 | 20222 | 0 | 707418 | 0 | 0 | 0 |
| HARVEY EINHORN MD | ||||||||||||||
| PHYSICIAN | 581050 | 0 | 0 | 0 | 0 | 0 | 37000 | 0 | 39883 | 0 | 657933 | 0 | 0 | 0 |
| PRAKASH PEDAPATI | ||||||||||||||
| PHYSICIAN | 494342 | 0 | 0 | 0 | 0 | 0 | 20000 | 0 | 15799 | 0 | 530141 | 0 | 0 | 0 |
| HOWARD KAUFMAN DO | ||||||||||||||
| PHYSICIAN | 509992 | 0 | 0 | 0 | 0 | 0 | 11500 | 0 | 24306 | 0 | 545798 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | WILLIAM GORSKI M.D.-457(F)-$190,699; RICHARD WALSH-457(F)-$86,027; DONALD HARING-457(F)-$35,979; KATHLEEN KELLY M.D.-457(F)-$28,136;. | Explanation |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| ILLINOIS FINANCE AUTHORITY - 2004 | ||||||||
| A | 861091967 | 45200BKQ0 | 2004-12-21 | 105360720 | CONSTRUCTION & EQUIPMENT CARDIAC PAVILION, RENOVATE OPERATING RM & CATH LAB | 0 | 0 | 0 |
| ILLINOIS FINANCE AUTHORITY - 2010 | ||||||||
| B | 861091967 | NONEAVAIL | 2010-04-19 | 25000000 | CONSTRUCTION & EQUIPMENT CARDIAC PAVILION, RENOVATE OPERATING RM & CATH LAB | 0 | 0 | 0 |
| ILLINOIS FINANCE AUTHORITY - 2012 | ||||||||
| C | 861091967 | 45203HLW0 | 2012-09-27 | 41833485 | CONSTRUCTION & EQUIPMENT REGIONAL CANCER CENTER | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Bond ReferenceBondReferenceCd | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Capital ExpendituresCapitalExpenditures | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Amount UnspentAmountUnspent |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 106458982 | 12819 | 74126290 | 991204 | 3672433 | 27656236 | 2007 | 1 | 1 | 1 | 1 | |
| B | 25000000 | 25000000 | 2010 | 1 | 1 | 1 | 1 | |||||
| C | 41887087 | 635680 | 22574947 | 0 | 0 | 0 | 1 | 18676459 |
Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs | Engage Bond Counsel ContractsEngageBondCounselContracts |
|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 1 | |
| B | 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 0 | 0 | 1 | |
| C | 0 | 0 | 1 | 0 | 0.00000 | 0.02000 | 0.02000 | 0 | 0 | 1 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 1 |
| B | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
| C | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | 1 |
| B | 1 |
| C | 1 |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SCHEDULE K SUPPLENTAL INFORMATION | Identifier |
| Explanation | SCHEDULE K, PART II, LINE 7 : BOND INSURANCE OF $3,672,397 WAS PURCHASED FROM BOND PROCEEDS AND IS INCLUDED AS A COST OF ISSUANCE. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| SHERYL HEAD | |||
| ROBERT L. HEAD PH.D TRUSTEE, SPOUSE | 89055 | EMPLOYEE COMPENSATION | 0 |
| BEVERLY DERRY | |||
| PATRICK DERRY TRUSTEE, SISTER-IN-LAW | 83925 | EMPLOYEE COMPENSATION | 0 |
| RIVERSIDE COMMUNITY BANK | |||
| DAN LOESCHER TRUSTEE AND OFFICER, CHAIRMAN OF RIVERSIDE COMMUNITY BANK | 116581 | BANKS FEES, CERTIFICATE OF DEPOSIT, DEMAND DEPOSIT ACCOUNTS | 0 |
| MICHELLE ROOP | |||
| WILLIAM ROOP TRUSTEE, DAUGHTER | 49787 | EMPLOYEE COMPENSATION | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | SWEDISHAMERICAN HEALTH SYSTEM (PARENT CORPORATION) IS THE SOLE CORPORATE MEMBER OF SWEDISHAMERICAN HOSPITAL (HOSPITAL) AND AS SUCH APPOINTS ALL TRUSTEES. | |
| FORM 990, PART VI, SECTION A, LINE 2 | DIRECTORS WILLIAM ROOP AND JAMES GINGRICH ARE BOARD MEMBERS OF SWEDISHAMERICAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. DIRECTORS DAVE RYDELL AND JAMES GINGRICH ARE BOARD MEMBERS OF SWEDISHAMERICAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. DIRECTORS DAN LOESCHER AND FRANK WALTER ARE BOARD MEMBERS OF SWEDISHAMERICAN HOSPITAL AND HAVE A BUSINESS RELATIONSHIP. | |
| FORM 990, PART VI, SECTION A, LINE 6 | SWEDISHAMERICAN HEALTH SYSTEM (PARENT CORPORATION) IS THE SOLE CORPORATE MEMBER OF SWEDISHAMERICAN HOSPITAL (HOSPITAL). | |
| FORM 990, PART VI, SECTION A, LINE 7A | SWEDISHAMERICAN HEALTH SYSTEM (PARENT CORPORATION) IS THE SOLE CORPORATE MEMBER OF SWEDISHAMERICAN HOSPITAL (HOSPITAL) AND AS SUCH APPOINTS ALL TRUSTEES. | |
| FORM 990, PART VI, SECTION A, LINE 7B | SWEDISHAMERICAN HEALTH SYSTEM (PARENT CORPORATION) IS THE SOLE CORPORATE MEMBER OF SWEDISHAMERICAN HOSPITAL (HOSPITAL) AND AS SUCH HAS THE AUTHORITY TO APPROVE CERTAIN DECISIONS OF THE HOSPITAL. SWEDISHAMERICAN HEALTH SYSTEM APPOINTS ALL TRUSTEES, NOMINATES CANDIDATES FOR PRESIDENT OF THE HOSPITAL, APPROVE AMENDMENTS TO THE ARTICLES OF INCORPORATION AND BYLAWS, APPROVE ANNUAL BUDGETS, AND STRATEGIC, LONG-RANGE AND HEALTH MANPOWER DEVELOPMENTAL PLANS, APPROVE ALL CONTRACTS OF INDEBTEDNESS OF $1,000,000 IN PRINCIPAL OR THAT ARE 60 MONTHS OR LONGER, APPROVE ALL PLANS OF MERGER OR CONSOLIDATION, OR THE SALE, LEASE, EXCHANGE, MORTGAGE OR PLEDGE OR OTHER DISPOSITION OF ALL OR SUBSTANTIALLY ALL, THE PROPERTY AND ASSETS OF THE HOSPITAL, OR VOLUNTARY DISSOLUTION OF THE HOSPITAL. | |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT VERSION OF FORM 990 WAS REVIEWED BY LEGAL COUNSEL AND THE CHIEF FINANCIAL OFFICER. SUBSEQUENTLY, THE AUDIT/COMPLIANCE COMMITTEE OF THE BOARD OF DIRECTORS OF SWEDISHAMERICAN HEALTH SYSTEM (PARENT CORPORATION) REVIEWED A FINAL DRAFT OF FORM 990 AND WAS PROVIDED WITH THE OPPORTUNITY TO COMMENT AND ASK QUESTIONS. THE ENTIRE SWEDISHAMERICAN HOSPITAL BOARD OF DIRECTORS WAS PROVIDED WITH A COPY OF FORM 990 BEFORE IT WAS FILED. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICIES, WHICH APPLY TO ALL MEMBERS OF THE BOARD OF DIRECTORS AND TO ALL EMPLOYEES. PROCEDURES ARE IN PLACE TO IDENTIFY CONFLICTS OF BOTH DIRECTORS AND EMPLOYEES. DIRECTOR CONFLICTS ARE HANDLED BY BOARD DELIBERATION AND BOARD VOTE FROM WHICH THE INTERESTED DIRECTOR IS EXCLUDED. EMPLOYEE CONFLICTS ARE HANDLED BY THE COMPLIANCE DEPARTMENT AND IN CERTAIN INSTANCES MAY REQUIRE SEPARATE BOARD ACTION. THE BOARD IS PROVIDED WITH PERIODIC COMPLIANCE REPORTS REGARDING CONFLICTS OF INTEREST. | |
| FORM 990, PART VI, SECTION B, LINE 15 | ALL COMPENSATION IS DETERMINED AND PAID BY SWEDISHAMERICAN HOSPITAL. ALL COMPENSATION DECISIONS ARE MADE BY INDEPENDENT PERSONS. WITH RESPECT TO THE PRESIDENT, CEO, OFFICERS, AND KEY EMPLOYEES, THE ORGANIZATION FOLLOWS A COMPENSATION APPROVAL PROCEDURE ANNUALLY THAT INVOLVES APPROVAL OF PROPOSED AND FINAL COMPENSATION ARRANGEMENTS BY THE ORGANIZATION'S EXECUTIVE COMPENSATION COMMITTEE USING COMPARABILITY DATA, AS WELL AS CONTEMPORANEOUS DOCUMENTATION OF COMPENSATION DECISIONS IN THE MINUTES. ALL PHYSICIAN COMPENSATION ARRANGEMENTS ARE APPROVED BY THE FINANCE COMMITTEE AND FULL BOARD OF DIRECTORS USING COMPARABILITY DATA, AS WELL AS CONTEMPORANEOUS DOCUMENTATION OF COMPENSATION DECISION IN THE MINUTES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC AND AUDITED FINANCIAL STATEMENTS OF SWEDISHAMERICAN HOSPITAL ARE AVAILABLE FROM PUBLICLY DISCLOSED FORM 990, THE ILLINOIS ATTORNEY GENERAL WEBSITE AND FROM THE U.S. SECURITIES AND EXCHANGE COMMISSION ELECTRONIC MUNICIPAL MARKET ACCESS SYSTEM. | |
| FORM 990, PART XI, LINE 9: | INTEREST IN RECIPIENT ORGANIZATION -67,671. SURGI CENTER BOOK/TAX DIFFERENCE -116,158. OTHER 767. SWEDISHAMERICAN FOUNDATION -178,667. | CHANGES IN NET ASSETS OR FUND BALANCES: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SWEDISHAMERICAN HEALTH SYSTEM CORPORATION | |||||||||||
| 1401 E STATE STREET | ROCKFORD | IL | 61104 | 363241458 | PARENT CORP. TO MANAGE & DIRECT ACTIVITIES OF ENTITITES | IL | 501(C)(3) | LINE 11B | N/A | 0 | |
| SWEDISHAMERICAN FOUNDATION | |||||||||||
| 1415 E STATE STREET | ROCKFORD | IL | 61104 | 363097493 | SUPPORTING ORG. FOR SWEDISHAMERICAN HOSPITAL FUND RAISING | IL | 501(C)(3) | LINE 7 | 1 | SWEDISHAMERICAN HOSPITAL | |
| SWEDISHAMERICAN REALTY CORPORATION | |||||||||||
| 1313 E STATE STREET | ROCKFORD | IL | 611042298 | 363248013 | TITLE HOLDING COMPANY | IL | 501(C)(2) | 1 | SWEDISHAMERICAN HEALTH SYSTEM CORPORATION | ||
| SWEDISHAMERICAN HOSPITAL SELF INSURANCE TRUST | |||||||||||
| 1401 E STATE STREET | ROCKFORD | IL | 611042333 | 366652702 | HOSPITAL MALPRACTICE TRUST | IL | 501(C)(3) | LINE 11A | 1 | SWEDISHAMERICAN HOSPITAL | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Predominant Income TypePredominantIncomeType | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THREE RIVERS PARTNERS LLC | ||||||||||||
| 1313 E STATE ST | ROCKFORD | IL | 61104 | 262231757 | INFORMATION TECHNOLOGY SERVICES | IL | N/A | N/A | 0 | 0 | ||
| NORTHERN ILLINOIS VEIN CLINIC | ||||||||||||
| 2550 CHARLES ST | ROCKFORD | IL | 61108 | 201642329 | OUTPATIENT HEALTH SERVICES | IL | N/A | RELATED | 0 | 1 | 210590 | 132167 |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| SARI INSURANCE COMPANY | |||||||||
| 76 ST PAUL ST SUITE 500 | BURLINGTON | VT | 05401 | 030308753 | CAPTIVE INSURANCE COMPANY | VT | SAHS CORP | C | 1 |
| LSG BUILDING CORPORATION | |||||||||
| 1313 EAST STATE ST | ROCKFORD | IL | 61104 | 363033985 | REAL ESTATE | IL | SAHS CORP | S | 1 |
| STATE & CHARLES INC | |||||||||
| 1313 EAST STATE ST | ROCKFORD | IL | 61104 | 363321193 | HOLDING COMPANY | IL | SAHS CORP | C | 1 |
| SWEDISHAERICAN HEALTH MANAGEMENT CORP | |||||||||
| 1401 EAST STATE ST | ROCKFORD | IL | 61104 | 363246511 | SERVICE | IL | STATE & CHARLES INC | C | 1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 1 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| SWEDISHAMERICAN FOUNDATION | ||
| C | 178667 | COST |
| SWEDISHAMERICAN HOSPITAL SELF INSURANCE TRUST | ||
| P | 1058974 | COST |
| SWEDISHAMERICAN HOSPITAL SELF INSURANCE TRUST | ||
| Q | 2939600 | COST |