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NORTHWEST COMMUNITY HOSPITAL: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
NORTHWEST COMMUNITY HOSPITAL (EIN 36-2340313)
Tax period
2012-10-01 to 2013-09-30
Filed
2014-08-13
IRS object ID
201422259349300202
Schema version
2012v2.3
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-08-13T01:22:22-05:00Timestamp
Tax Period End Date2013-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1155 NORTH WACKER DRIVEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362340313EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northwest Community HospitalBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% SANDY SORIAInCareOfName
Name ControlNORTNameControl
Phone8476181000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 WEST CENTRAL ROADAddressLine1
Address Line2SuiteAddressLine2
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARSHA LIUName
TitleEVP/CFOTitle
Phone3128792000Phone
Date Signed2014-08-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
Phone3128792000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonStephen O ScognaNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1800 W CENTRAL ROADAddressLine1
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
Gross Receipts565780762GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.nch.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionNCH operates an acute care hospital in Arlington Heights, IL. The hospital exists to improve the health of the communities we serve and to meet individuals' healthcare needs.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees3825TotalNbrEmployees
Total Nbr Volunteers825TotalNbrVolunteers
Total Gross UBI1567788TotalGrossUBI
Contributions Grants Prior Year1466035ContributionsGrantsPriorYear
Contributions Grants Current Year1494187ContributionsGrantsCurrentYear
Program Service Revenue Prior Year472194812ProgramServiceRevenuePriorYear
Program Service Revenue CY432581609ProgramServiceRevenueCY
Investment Income Prior Year521265InvestmentIncomePriorYear
Investment Income Current Year1727907InvestmentIncomeCurrentYear
Other Revenue Prior Year6907544OtherRevenuePriorYear
Other Revenue Current Year5914233OtherRevenueCurrentYear
Total Revenue Prior Year481089656TotalRevenuePriorYear
Total Revenue Current Year441717936TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year187489GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY229307GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year240095074SalariesEtcPriorYear
Salaries Etc Current Year232064994SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year228410407OtherExpensePriorYear
Other Expenses Current Year195422176OtherExpensesCurrentYear
Total Expenses Prior Year468692970TotalExpensesPriorYear
Total Expenses Current Year427716477TotalExpensesCurrentYear
Revenues Less Expenses Prior Year12396686RevenuesLessExpensesPriorYear
Revenues Less Expenses CY14001459RevenuesLessExpensesCY
Total Assets BOY619249436TotalAssetsBOY
Total Assets EOY624911391TotalAssetsEOY
Total Liabilities BOY456809134TotalLiabilitiesBOY
Total Liabilities EOY432284393TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY162440302NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY192626998NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionNorthwest Community Hospital exists to improve the health of the communities it serves and to meet individuals' healthcare needs. It strives to be known for its singular focus on providing a comprehensive, patient-centered system of care that surpasses every expectation for excellence (in quality and service).MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense42031410Expense
Grants0Grants
Revenue43295792Revenue
DescriptionCardiac Northwest community hospital's (hospital) cardiac service line provided quality, patient centered, compassionate care, regardless of ability to pay, to approximately 30,300 inpatients and OUTPATIENTS DURING FY 2013. THE TREATMENT WAS PROVIDED IN hospital's state-of-the-art digital cardiac cath lab suites, inclusive of its high tech operating rooms and private family centered patient care rooms all at a cost of nearly $42,100,000. An on-call team of nurses, radiology techs, or techs, cardiologists and surgeons were readily available 24 hours a day, 7 days a week, to provide emergent care to those with cardiac disease. The cardiac team works with the emergency room and multiple neighboring community paramedics and emergency personnel To Consistently exceed the national benchmark of door to balloon time (or open artery) in less than 90 minutes for patients presenting in hospital's emergency room having an acute MI. NCH also prides itself on its comprehensive electrophysiology program that provides the most complex ablation procedures for patients with atrial fibrillation and other cardiac arrhythmias. In addition, the hospital has an outpatient device clinic that provides ongoing management and monitoring for patients with pacemakers and implantable defibrillators. The clinic currently services nearly 2,000 patients. Hospital has been repeatedly recognized for its commitment to quality outcomes and has twice been recognized as an accredited chest pain center by the society for chest pain centers. In addition, NCH has been recognized as an accredited echo lab by the intersocietal commission for the accreditation of echocardiography laboratories (icael) since 2000. In addition, hospital has also been recognized five times between 2000 and 2010 as a Thomson Reuters top 100 heart hospital for providing excellence in a cost effective manner to multiple cardiac patient populations. Hospital has also been the recipient of multiple healthgrades awards for excellence in cardiac services, most recently in 2010. The cardiac department also provides multiple screening and education programs, including free individual consultations with cardiac rehab personnel for community members considered to be at risk for developing heart disease based on their completion of hospital's on-line screening tool. Every year the hospital hosts community events where blood pressure, cholesterol and BMI screenings are used to calculate an individual's risk of developing heart disease for a minimal fee. In addition, physicians provided education on heart health and wellness.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense27605546Expense
Grants229307Grants
Revenue43134485Revenue
DescriptionGastroenterology Hospital's gastroenterology (gi) center provides quality, patient centered, compassionate care for patients, regardless of ability to pay, in need of diagnostic and therapeutic endoscopic procedures. The GI center has become a regional referral center for patients in need of interventional procedures including endoscopic retrograde cholangiopancreatography and endoscopic ultrasound. A state-of-the-art interventional suite offers patients access to superior quality care by providing digital imaging. Hospital's interventional team is led by an expert interventional physician. This team provides same-day care for patients in and beyond hospital's service area who are in need of interventional procedures. In FY 2013 the GI center provided service for 29,850 patients.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense35432564Expense
Grants0Grants
Revenue31504306Revenue
DescriptionGeneral Surgery Hospital's general surgery service line provided quality, patient centered, compassionate care, regardless of ability to pay, to 3,264 general surgical patients (inpatient and outpatient) in the main or during FY 2013. Procedures were performed in state-of-the-art operating rooms which include three dedicated minimally invasive surgery suites. the general surgery program provides care for both pediatric and adult populations. In FY 2011, hospital partnered with children's memorial hospital to plan for a neonatal surgery program to support its new level 3 NICU. The general surgery program also includes davinci robotic capabilities and a dedicated pancreatic surgery program. General Surgery services are provided 24 hours a day, 7 days a week, and the program is designated a level 2 trauma center. Hospital has been the recipient of multiple healthgrades awards which include GI services. General surgery mortality and surgical site infections observed-to-expected ratios are in the "low" range based on hospital's case mix index. a multidisciplinary team has worked to improve results in the surgical care improvement project's core measures. An advanced practice nurse was hired to oversee surgical outcomes and improve performance in all surgical specialties. Areas of concentration include: antibiotics administered within 60 minutes of incision, appropriate antibiotics administered, antibiotics discontinued within 24 hours, appropriate hair removal, urinary catheter removed post-op day 1 or 2, surgery temperature management, beta blocker prior to surgery and VTE prophylaxis. The majority of hospital's outcome measures were at or above benchmark levels. Form 990, Part III - Other Program Services, Line 4d Form 990, Part III, Line 4d includes revenue and expenses from all other program services not described on Form 990, part III, lines 4a-4c.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp232960811TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev314647026TotalOfOtherProgramServiceRev
Total Program Service Expense338030331TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096523NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3825NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSANDY SORIANamePerson
Telephone Number8476184636TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13060 SALT CREEK LANEAddressLine1
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (36 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Robert J Longo MD
Director/MED STAFF PRES10.01.0X4875000
Louis J Marsico
Director1.01.0X35000
Mary R Sheahen
Director1.01.0X35000
William D Soper MD
Director1.01.0X35000
Raymond Grady
Director1.01.0X35000
Cynthia M Valukas MD
Director1.01.0X35000
Max Brittain Jr
Chairperson10.01.0X35000X
Thomas P MacCarthy
Vice Chairperson10.01.0X35000X
Bruce K Crowther
PRES/CEO/SECRETARY THRU 4/1310.030.0X8992730273974X
Stephen O Scogna
CFO/TREAS '12;COO/PRES/CEO '1310.030.0X5566840141405X
Kirk Clark MD
Director1.01.0X000
Susan E Nelson MD
Director40.01.0X1851310102914
M Shan Atkins
Director1.01.0X000
James H Bishop
Director1.01.0X35000
Craig E Christell
Director1.01.0X35000
Daniel P DiCaro
Director1.01.0X35000
Dale J Garber
Director1.01.0X000
Louis A Gatta
Director1.01.0X35000
Marla F Glabe
Director1.01.0X35000
Charles A Hempfling
Director1.01.0X35000
Diane G Hill
Director1.01.0X35000
Francis J Lamberta MD
Director1.01.0X35000
MARSHA C LIU
EXEC VP/CFO/TREASURER 201310.030.0X87554020059X
MARK D LUSSON
Executive VP Human RESOURCES0.00.0364425078700X
DALE E BEATTY
Exec VP Patient Services & CNO0.00.0410873061774X
Michael C Hartke
EXECUTIVE VP/COO40.01.0289011089786X
ERIC BENINK MD
CHIEF MEDICAL OFFICER38.02.0000X
KIMBERLY NAGY
CHIEF NURSING OFFICER40.00.0000X
WILLIS G PARSONS MD
GASTROENTEROLOGY PHYSICIAN40.00.01658542016092X
MALCOLM BILIMORIA MD
GASTROENTEROLOGY Physician40.00.01546671030725X
SOTIRIOS MARKULY MD
Hospitalist40.00.0279647026328X
Mohammed Tahseen MD
Psychiatrist40.00.0295149037045X
ANDREA BENNET MD
Hospitalist40.00.0266080027297X
MICHAEL B ZENN
Executive VP/COO/TREASURER0.00.0312468018550X
Leighton B Smith MD
Exec VP Chief Medical Officer0.00.0747234013941X
RAMEEZ ALASADI MD
GASTROENTEROLOGY Physician0.00.0847924045X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8800666TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation938635TotalOtherCompensation
Number Individuals GT100 K175NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
NORTHWESTERN MEDICAL FACULTY FOUNDA
680 N LAKESHORE DR SUITE 1118CHICAGOIL60611NEURO-VASCULAR SVCS2822766
XTEND HEALTHCARE
500 W MAIN STREET SUITE 14HENDERSONVILLETX37075COLLECTION SERVICES2275216
SIEMENS MEDICAL SOLUTIONS
DEPT CH 14195PALATINEIL60055IT SUPPORT1851309
HLS WHEELING LLC
13028 COLLECTION CENTER DRCHICAGOIL60693LAUNDRY SERVICES1520923
GE HEALTHCARE
PO BOX 96483CHICAGOIL60693EQUIP. MAINTENANCE1502167
FieldValueIRS element (for citing)
Number Of Contractors GT100 K103NumberOfContractorsGT100K
Fundraising Events0FundraisingEvents
Related Organizations1246379RelatedOrganizations
Government Grants247808GovernmentGrants
Noncash Contributions0NoncashContributions
Total Contributions1494187TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Net patient services6211104081390354081390350$0
Lab services62150022262251206944631567788$0
MEANINGFUL USE REIMBURSEMENTS9000993238063238060$0
Classes and training900099102191410219140$0
Nursing services9000991651991651990$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column669404TotalRevenueColumn
Related Or Exempt Function Income669404RelatedOrExemptFunctionIncome
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue432581609TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1492626TotalRevenueColumn
Exclusion$1,492,626ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column75TotalRevenueColumn
Exclusion$75ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2697777Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1091161Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1606616Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1606616TotalRevenueColumn
Exclusion$1,606,616ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities122260762Securities
Other609890Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities122618012Securities
Other17434Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-357250Securities
Other592456Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column235206TotalRevenueColumn
Exclusion$235,206ExclusionAmount
FieldValueIRS element (for citing)
Fundraising Direct Expenses0FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Sales Of Inventory340777GrossSalesOfInventory
Cost Of Goods Sold336219CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column4558TotalRevenueColumn
Exclusion$4,558ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
INSURANCE SURPLUS DISTRIBUTION900099200844200$2,008,442
Cafeteria722514157453800$1,574,538
MEDICAL RECORDS RELEASE90009934529700$345,297

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column374782TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$374,782ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4303059TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column441717936TotalRevenueColumn
Related Or Exempt Function Income431013821RelatedOrExemptFunctionIncome
Unrelated Business Revenue1567788UnrelatedBusinessRevenue
Exclusion$7,642,140ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total229307Total
Program Services229307ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3481016Total
Program Services0ProgramServices
Management And General3481016ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total172984581Total
Program Services135377564ProgramServices
Management And General37607017ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total14232610Total
Program Services10849718ProgramServices
Management And General3382892ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total29190635Total
Program Services22189271ProgramServices
Management And General7001364ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total12176152Total
Program Services9494816ProgramServices
Management And General2681336ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total3137713Total
Program Services0ProgramServices
Management And General3137713ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total221404Total
Program Services0ProgramServices
Management And General221404ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total
Fundraising0Fundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total172860Total
Program Services0ProgramServices
Management And General172860ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total27822158Total
Program Services12828018ProgramServices
Management And General14994140ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total1713665Total
Program Services6844ProgramServices
Management And General1706821ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total17710335Total
Program Services13961001ProgramServices
Management And General3749334ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total8509165Total
Program Services5713821ProgramServices
Management And General2795344ManagementAndGeneral
Fundraising0Fundraising

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total8908938Total
Program Services7987192ProgramServices
Management And General921746ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total564894Total
Program Services319871ProgramServices
Management And General245023ManagementAndGeneral
Fundraising0Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total308734Total
Program Services178357ProgramServices
Management And General130377ManagementAndGeneral
Fundraising0Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total8706120Total
Program Services8706120ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total
Program Services0ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total29247883Total
Program Services22426368ProgramServices
Management And General6821515ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total5684238Total
Program Services5434511ProgramServices
Management And General249727ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Medical Supplies435466624354666200
Pharmaceuticals159504921595049200
Bad Debt - Patient Svcs110850991108509900
Illinois Provider Tax116761231167612300

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total455693Total
Program Services69176ProgramServices
Management And General386517ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total427716477Total
Program Services338030331ProgramServices
Management And General89686146ManagementAndGeneral
Fundraising0Fundraising

Total Joint Costs TotalJointCosts

FieldValueIRS element (for citing)
Total0Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY30946366BOY
EOY40336464EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY60733467BOY
EOY63199420EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY98476BOY
EOY18958EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY5315340BOY
EOY4803892EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY3627812BOY
EOY5046918EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis641130089LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec266878742LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY382232029BOY
EOY374251347EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY97484804BOY
EOY98835268EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY6698999BOY
EOY7231660EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY32112143BOY
EOY31187464EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY619249436BOY
EOY624911391EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY91828628BOY
EOY85970863EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY122193BOY
EOY480851EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY277615000BOY
EOY271665000EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY87243313BOY
EOY74167679EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY456809134BOY
EOY432284393EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY155741303BOY
EOY185395339EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY5587588BOY
EOY5995329EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1111411BOY
EOY1236330EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY162440302BOY
EOY192626998EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY619249436BOY
EOY624911391EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses14001459ReconcilationRevenueExpenses
Reconciliation Unrealized Invest240430ReconciliationUnrealizedInvest
Reconcilation Other Changes15944807ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Media Advertisements$0MediaAdvertisementsAmount
Mailings MembersfalseMailingsMembers
Mailings Members$0MailingsMembersAmount
Publications Or BroadcastfalsePublicationsOrBroadcast
Publications Or Broadcast$0PublicationsOrBroadcastAmount
Grants Other OrganizationsfalseGrantsOtherOrganizations
Grants Other Organizations$0GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Direct Contact Legislators$0DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Rallies Demonstrations$0RalliesDemonstrationsAmount
Other ActivitiestrueOtherActivities
Other Activities$58,602OtherActivitiesAmount
Total Lobbying Expenditures IIB58602TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLOBBYING ACTIVITIESIdentifier
Return ReferencePART II-B, LINE 11ReturnReference
ExplanationNORTHWEST COMMUNITY HOSPITAL PAYS DUES TO CERTAIN HOSPITAL ASSOCIATIONS WHICH USE A PORTION OF THESE DUES FOR LOBBYING.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2799106BeginningOfYearBalance
Contributions4039Contributions
Investment Earnings Or Losses411064InvestmentEarningsOrLosses
Other Expenditures56673OtherExpenditures
End Of Year Balance3157536EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2319650BeginningOfYearBalance
Contributions950Contributions
Investment Earnings Or Losses478506InvestmentEarningsOrLosses
End Of Year Balance2799106EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2248734BeginningOfYearBalance
Contributions169337Contributions
Investment Earnings Or Losses-10576InvestmentEarningsOrLosses
Other Expenditures87845OtherExpenditures
End Of Year Balance2319650EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2160499BeginningOfYearBalance
Contributions9266Contributions
Investment Earnings Or Losses78969InvestmentEarningsOrLosses
End Of Year Balance2248734EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2131037BeginningOfYearBalance
Contributions39825Contributions
Investment Earnings Or Losses-10363InvestmentEarningsOrLosses
End Of Year Balance2160499EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.51130BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.48870PermanentEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1789072OtherCostOrOtherBasis
Book Value1789072BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis298674187OtherCostOrOtherBasis
Depreciation107782545Depreciation
Book Value190891642BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis206573589OtherCostOrOtherBasis
Depreciation95989202Depreciation
Book Value110584387BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis109598226OtherCostOrOtherBasis
Depreciation53563746Depreciation
Book Value56034480BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis24495015OtherCostOrOtherBasis
Depreciation9543249Depreciation
Book Value14951766BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings374251347TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
Due to third-party payors$52,738,415
Pension obligation$18,926,277
Interest rate swap liability$1,010,804
Asset retirement obligation$833,218
Short term capital lease obligation$300,976
Long term capital lease obligation$301,738
Due to affiliates$56,251
FieldValueIRS element (for citing)
Total Of Amounts74167679TotalOfAmounts

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierIntended use of endowment fundsIdentifier
Return ReferenceSCHEDULE D, PART V, LINE 4ReturnReference
ExplanationENDOWMENT FUNDS ARE CREATED ACCORDING TO HOSPITAL NEEDS AND DESIGNATION OR PREFERENCES OF THE DONOR(S) SUPPORTING THE ENDOWMENT FUND. SCHOLARSHIP FUNDS, CONTINUED EDUCATION, OR FUNDS FOR PATIENT CARE IN A HOSPITAL DEPARTMENT DESIGNATED BY THE ENDOWMENT FUND ARE EXAMPLES OF FUND USES.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare

Other Percentage OtherPercentage

FieldValueIRS element (for citing)
OtherXOther
Free Other Percentage300.FreeOtherPercentage
FieldValueIRS element (for citing)
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage600.DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense14335940TotalCommunityBenefitExpense
Net Community Benefit Expense14335940NetCommunityBenefitExpense
Percent Of Total Expense0.03440PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense36395837TotalCommunityBenefitExpense
Direct Offsetting Revenue22614078DirectOffsettingRevenue
Net Community Benefit Expense13781759NetCommunityBenefitExpense
Percent Of Total Expense0.03310PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense50731777TotalCommunityBenefitExpense
Direct Offsetting Revenue22614078DirectOffsettingRevenue
Net Community Benefit Expense28117699NetCommunityBenefitExpense
Percent Of Total Expense0.06750PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1210426TotalCommunityBenefitExpense
Direct Offsetting Revenue1122DirectOffsettingRevenue
Net Community Benefit Expense1209304NetCommunityBenefitExpense
Percent Of Total Expense0.00290PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense3416065TotalCommunityBenefitExpense
Direct Offsetting Revenue2250DirectOffsettingRevenue
Net Community Benefit Expense3413815NetCommunityBenefitExpense
Percent Of Total Expense0.00820PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense358310TotalCommunityBenefitExpense
Net Community Benefit Expense358310NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense203173TotalCommunityBenefitExpense
Direct Offsetting Revenue2000DirectOffsettingRevenue
Net Community Benefit Expense201173NetCommunityBenefitExpense
Percent Of Total Expense0.00050PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense765729TotalCommunityBenefitExpense
Net Community Benefit Expense765729NetCommunityBenefitExpense
Percent Of Total Expense0.00180PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense5953703TotalCommunityBenefitExpense
Direct Offsetting Revenue5372DirectOffsettingRevenue
Net Community Benefit Expense5948331NetCommunityBenefitExpense
Percent Of Total Expense0.01430PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense56685480TotalCommunityBenefitExpense
Direct Offsetting Revenue22619450DirectOffsettingRevenue
Net Community Benefit Expense34066030NetCommunityBenefitExpense
Percent Of Total Expense0.08180PercentOfTotalExpense

Economic Development EconomicDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense3103TotalCommunityBuildingExpense
Net Community Building Expense3103NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Community Support CommunitySupport

FieldValueIRS element (for citing)
Total Community Building Expense6458TotalCommunityBuildingExpense
Direct Offsetting Revenue1512DirectOffsettingRevenue
Net Community Building Expense4946NetCommunityBuildingExpense

Coalition Building CoalitionBuilding

FieldValueIRS element (for citing)
Total Community Building Expense15094TotalCommunityBuildingExpense
Net Community Building Expense15094NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense34580TotalCommunityBuildingExpense
Net Community Building Expense34580NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense59235TotalCommunityBuildingExpense
Direct Offsetting Revenue1512DirectOffsettingRevenue
Net Community Building Expense57723NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$11,085,099BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare142557141AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare185856980CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-43299839MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST COMMUNITY HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1800 W CENTRAL ROADAddressLine1
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
CHNA ConductedtrueCHNAConducted
Community DefinitionXCommunityDefinition
Community DemographicsXCommunityDemographics
Existing ResourcesXExistingResources
How Data ObtainedXHowDataObtained
Community Health NeedsXCommunityHealthNeeds
Other Health IssuesXOtherHealthIssues
Identifying ProcessXIdentifyingProcess
Consulting ProcessXConsultingProcess
Information GapsXInformationGaps
Needs Assessment Conducted12NeedsAssessmentConducted
Take Into AccounttrueTakeIntoAccount
Other FacilitiesfalseOtherFacilities
CHNA Widely AvailabletrueCHNAWidelyAvailable
Own WebsiteXOwnWebsite
On RequestXOnRequest
Other MethodXOtherMethod
Adopt Implement StrategyXAdoptImplementStrategy
Execute Implement StrategyXExecuteImplementStrategy
Develop Community PlanXDevelopCommunityPlan
Participate Community PlanXParticipateCommunityPlan
Include Operational PlansXIncludeOperationalPlans
Adopt BudgetXAdoptBudget
Prioritize Health NeedsXPrioritizeHealthNeeds
Prioritize ServicesXPrioritizeServices
Other Needs AddressedXOtherNeedsAddressed
All Needs AddressedfalseAllNeedsAddressed
Organization Incur Excise TaxfalseOrganizationIncurExciseTax
Eligibility Criteria ExplainedtrueEligibilityCriteriaExplained
Uses FPG FreetrueUsesFPGFree
FPG Free Percent300.FPGFreePercent
Uses FPG DiscountedtrueUsesFPGDiscounted
FPG Discount Percent600.FPGDiscountPercent
Explains BasistrueExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application MethodtrueExplainsApplicationMethod
Includes Publicity MeasurestrueIncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On NonpaymenttrueActionsOnNonpayment
Collection ActivitiesfalseCollectionActivities
Notify Upon AdmissionXNotifyUponAdmission
Notify Before DischargeXNotifyBeforeDischarge
Notified All PatientsXNotifiedAllPatients
Documented DeterminationXDocumentedDetermination
Nondiscrim Emergency Care PolicytrueNondiscrimEmergencyCarePolicy
Used Other MethodXUsedOtherMethod
Amounts Generally BilledtrueAmountsGenerallyBilled
Gross ChargesfalseGrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities11NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
NCH MENTAL HEALTH & YOUTH CENTER
901 W KIRCHOFF ROADARLINGTON HEIGHTSIL60005IN & OUT MENTAL Health AND YOUTH SUBSTANCE ABUSE TREATMENT
NCH IMMEDIATE CARE & IMAGING CENTER
199 W RAND ROADMOUNT PROSPECTIL60056WALK IN URGENT CARE CENTER, IMAGING SERVICES & CARDIAC SERVICES
NCH IMMEDIATE CARE & IMAGING CENTER
519 S ROSELLE ROADSCHAUMBURGIL60193WALK IN URGENT CARE CENTER, IMAGING SERVICES & OUTPATIENT PHYSICAL MEDICINE SERVICES
NORTHWEST COMMUNITY HOSPITAL IMAGING
1450 BUSCH PARKWAYBUFFALO GROVEIL60089IMAGING SERVICES
NCH IMMEDIATE CARE & IMAGING CENTER
15 S MCHENRY ROADBUFFALO GROVEIL60089WALK IN URGENT CARE CENTER, IMAGING SERVICES & OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH CARDIAC & PHYSICAL MEDICINE REHAB
900 W CENTRAL ROADARLINGTON HEIGHTSIL60005OUTPATIENT CARDIAC REHAB PROGRAM AND PHYSICAL MEDICINE SERVICES
NCH HOME HEALTH
3060 SALT CREEK LANEARLINGTON HEIGHTSIL60005HOME HEALTHCARE SERVICES
NCH IMMEDIATE CARE CENTER
1201 S RAND ROADLAKE ZURICHIL60047WALK IN URGENT CARE CENTER & OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH OUTPATIENT CENTER
3300 KIRCHOFF ROADROLLING MEADOWSIL60008OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH PHYSICAL MEDICINE & REHAB
1590 N ARLINGTON HEIGHTS ROADARLINGTON HEIGHTSIL60005OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH OCCUPATIONAL WELLNESS & REHAB
455 S ROSELLE ROADSCHAUMBURGIL60193OCCUPATIONAL WELLNESS & REHAB

Form990 Schedule H Part VI Form990ScheduleHPartVI (22 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
PART I, LINE 3CCHARITY CARE POLICYHOSPITAL PROVIDES EMERGENT AND MEDICALLY NECESSARY SERVICES TO ALL PATIENTS WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. THE WRITTEN CHARITY CARE POLICY IS WIDELY DISTRIBUTED AND COMMUNICATED TO THE COMMUNITY UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE AMOUNT OF FREE CARE PROVIDED IS DETERMINED BY FINANCIAL NEED AND IS NOT LIMITED BY BUDGETED AMOUNTS. PATIENTS EARNING LESS THAN 300% OF THE FEDERAL POVERTY GUIDELINES RECEIVE FREE CARE AND THOSE BETWEEN 300% AND 600% OF THE GUIDELINES RECEIVE DISCOUNTED CARE ON A SLIDING SCALE. THE FINANCIAL ASSISTANCE PROGRAM LOOKS AT THE CURRENT INCOME AND THEN CALCULATES THE POTENTIAL BENEFIT. CONSISTENT WITH THE ILLINOIS UNINSURED PATIENT DISCOUNT ACT, PATIENTS WITHOUT INSURANCE COVERAGE ARE ELIGIBLE FOR A 64% DISCOUNT IF THEIR INCOME IS BETWEEN 300% AND 600% OF THE FEDERAL POVERTY GUIDELINES. OF THE REMAINING BALANCE, THE PATIENT'S LIABILITY IS CAPPED AT 25% OF THE FAMILY'S ANNUAL INCOME.
PART I, LINE 6ACOMMUNITY BENEFIT REPORThospital's community benefit activities are included in an annual report issued by northwest community healthcare, the sole corporate member of the hospital.
PART I, LINE 7COSTING METHODOLOGYthe following methodologies were used to determine the amounts reported in the table for line 7: part i, lines 7a - 7d, ratio of cost to charges as determined using worksheet 2 in the form 990, schedule h instructions. part i, lines 7e - 7i, costs were determined using the direct and indirect costs for specific programs or services. these costs were maintained / identified in hospital's "community benefit inventory for social accountability software" (cbisa). the indirect portion of these costs was calculated utilizing the indirect cost ratio from the hospitals latest available Medicare cost report. this "indirect" ratio was entered into cbisa for the calculation of indirect costs. part i, line 7g: subsidized health services hospital provides a mobile dental clinic program staffed by a hospital employed full time dentist, dental assistant and program manager. evidence based research demonstrates that gum disease and oral health problems are linked to other systemic medical problems such as cardiovascular disease, stroke, and bacterial pneumonia, as well as increased risk of delivering pre-term or low birth-weight babies. the hospital, with financial support from local townships, provides preventative and restorative care to uninsured and underinsured members of the community 4-5 days per week in a traveling dental clinic. PART I, LINE 7, COLUMN F: BAD DEBT EXPENSE THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN PART IX, LINE 25, COLUMN (A) THAT WAS EXCLUDED FROM THE CALCULATION OF THE NET COMMUNITY BENEFIT EXPENSE WAS $11,085,099.
PART IICOMMUNITY BUILDING ACTIVITIESeconomic development hospital's vice president of professional services is a member and active participant of the arlington heights economic alliance. the purpose of the alliance is to provide the business community a strong partnership with the village and to promote a healthy business climate. the alliance is the village board's economic advisory committee on business issues. community support HOSPITAL provided support per the request of the cook county department of public health to assist with a salmonella outbreak at a local food distribution company. the hospital provided assistance with lab testing for employees of the company. coalition building HOSPITAL'S director of corporate accounting represents HOSPITAL through participation in the palatine rotary club in the hospital's primary service area. rotary club members are predominately business and professional leaders who come together to support organizations that address need and disparity in the community. areas addressed include homelessness, mental health issues, cancer, troubled youth, developmentally disabled, domestic violence and many more. workforce development HOSPITAL'S executive director of patient care services participated on the leadership board of the Illinois organization of nurse leaders (ionl). the purpose of ionl is to develop nursing leaders in all healthcare settings. ionl provides direction for achievement of excellence in nursing leadership. it promotes professional development, research and innovation for the advancement of THE nursing practice. ionl encourages development of care delivery systems that are forthright and visionary. the ionl develops strategic initiatives in the area of executive management expertise in healthcare systems. HOSPITAL also has programs to encourage high school students to explore careers in healthcare. the first program provides local high school students the opportunity to spend 14 weeks in the hospital shadowing 16 different departments. as the students rotate through the various departments they are exposed to an array of clinical fields, providing them with an in-depth look at just some of the many career tracks they could pursue. hospital also sponsors an annual healthcare career fair for two local high school districts. at the fair, leaders from various clinical departments provide a brief overview of their specialties, again providing the students with a closer look at potential career tracks they might like to pursue.
PART III, LINE 1BAD DEBT EXPENSEhospital records bad debt expense in accordance with generally accepted accounting principles (gaap). hfma statement 15 is followed to the extent that it aligns with the guidelines per gaap.
PART III, LINES 2-4BAD DEBT EXPENSEHOSPITAL IS SENSITIVE TO THE FINANCIAL HEALTH OF ITS PATIENTS AND RECOGNIZES THAT FAMILY FINANCIAL CONCERNS MAY NOT ALWAYS BE SHARED. AT TIMES, A PATIENT MAY BE RELUCTANT TO COMPLETE A FINANCIAL ASSESSMENT TO DETERMINE THEIR ELIGIBILITY FOR CHARITY CARE. IT IS POSSIBLE THAT BECAUSE OF THESE CIRCUMSTANCES, A PORTION OF BAD DEBT EXPENSE COULD REPRESENT PATIENTS THAT ARE UNABLE TO PAY AND MIGHT QUALIFY FOR FINANCIAL ASSISTANCE, HOWEVER, ACCURATE DATA TO ESTIMATE THIS AMOUNT IS UNAVAILABLE. hospital is included in the audited financial statements of northwest community healthcare (nch) and subsidiaries. the text of the footnote referencing accounts receivable in the fy 2013 audit is as follows: "[nch] analyZes the allowance for uncollectible accounts quarterly using a hindsight calculation that utilizes write-off data for all payOr classes during the previous eighteen month period to estimate the allowance for uncollectible accounts at a point in time. the reserve percentages in the allowance for uncollectible accounts reserve change each month given changes in trends from these analyses or policy changes." accounts receivable are charged to the allowance for uncollectible accounts when they are deemed uncollectible. write-offs are shown net of contractuals and discounts. hospital's bad debt expense as reported on lines 2 and 3 was reported at remaining charges. for fy 2013, the hospital recorded provisions for bad debt expense of $11,085,099. in 2013, the hospital began using a financial tool to determine "presumptive eligibility" for charity care write-offs. this tool utilizes various criteria to help determine patients that would be eligible for financial assistance even if those patients have not completed a financial assistance application. it is believed that all patients who would qualify for charity have been identified and that little to none of the amounts written off as bad debt could be classified as charity as a result of the use of this new financial tool.
PART III, LINE 8MEDICARE SHORTFALLthe medicare shortfall reported in part iii, line 7 represents the excess cost of providing services to medicare beneficiaries over the payments received from the medicare program. access to quality healthcare is imperative for all medicare recipients, many of whom are living on a fixed income. as such, the costs absorbed by hospital in providing these services is a benefit to the members of the community we serve.
PART III, LINE 9BCOLLECTION PRACTICESit is the policy of hospital to offer patients a payment plan or financial assistance when it becomes known or suspected that a patient needs such assistance. financial counselors contact and work with the patient or their family to help determine if there are any third party payers which may be available to help the patient meet their obligations, such as medicaid, cobra, workers compensation, or specialized grant programs. if no third party programs are identified, the financial counselors work with the patient to help them apply for charity discounts or payment plans. forms are available in english and spanish, and translation services are provided in many languages. in addition, all patient bills and statements include information about how to apply for financial assistance and the information is also posted on hospital's website. collection activity will be suspended during the consideration of a completed financial assistance application or an application for other healthcare bracket (i.e, medicare, medicaid, etc.). the patient's account may be suspended from collection activity until financial assistance can be determined. accounts in the financial assistance process will be monitored and, upon the decision to approve or deny financial assistance, the patient's account will be updated. if the financial assistance application is approved with a percentage less than 100% or denied, the patient's account will be noted and the hospital will resume the self-pay collection activity in compliance with its self pay follow-up procedures.
PART V, SECTION B, LINE 3INPUT FROM REPRESENTATIVES FOR THE COMMUNITY HEALTH NEEDS ASSESSMENTthe hospital participated in a regional community health needs assessment (chna) offered by the metropolitan chicago healthcare council (mchc) in partnership with professional research consultants (prc). the chna gathered input from representatives of the community by conducting 30-minute telephone health surveys in english and spanish. 3,710 surveys were conducted in the region which consisted of cook, dupage and lake counties, with 325 in the hospitals immediate service area. careful consideration was taken to ensure that the demographics of those participating in the survey mirrored the demographics of the community. the survey instrument used for the study is based largely on the centers for disease control and prevention (cdc) behavioral risk factor surveillance system (brfss), as well as various other public health surveys and customized questions addressing gaps in indicator data relative to health promotion and disease prevention objectives and other recognized health issues. the final survey instrument was developed by prc, with input from hospital and the other community sponsors. issues addressed included self-reported health status, physical health status, mental health status, death and disability, infection and chronic disease, births, children's health status, modifiable health risks, access to healthcare, health education and outreach, and health information sources. in order to gather input from persons with special knowledge of or expertise in public health, focus groups were held by prc in north cook county. participants included representatives from public health, physicians, and other health professionals, social service providers and other community leaders. the participants were chosen because of their ability to identify primary concerns of the populations with who they work, as well as of the community overall. participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with person with chronic disease conditions.
PART V, SECTION B, LINE 5CCHNA REPORT AVAILABLE TO THE PUBLICin addition to posting the chna on hospital's website (www.nch.org) and having copies available upon request, hospital also sent several press releases to local newspapers to inform the community that the report was available.
PART V, SECTION B, LINE 6IDESCRIPTION OF NEEDS IDENTIFIED IN CHNA REPORThospital partners with many not for profit agencies, municipalities, and others to address community health needs identified in the chna. the hospital collaborates with a county health clinic and a federally qualified health center to address the need of improving access to primary and behavioral healthcare for uninsured and underinsured individuals. access to oral health care is addressed through a collaborative mobile dental clinic program that is operated by hospital with support of four local townships, university of chicago dental school, and professional volunteers. in addition, hospital works with local school districts, healthcare organizations, social service organizations and community organizations to address diabetes, nutrition, cancer and other healthcare needs. a complete list of partners is included in the hospitals implementation plan which is posted on the hospital's website (www.nch.org).
PART V, SECTION B, LINE 7DESCRIPTION OF NEEDS NOT IDENTIFIED IN CHNA REPORTin acknowledging the wide range of priority health issues that emerged from the chna process, hospital determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence. therefore, hospital selected the top five prioritized needs to focus its efforts and resources on. the only two needs not being addressed include chronic disease (such as arthritis, rheumatism, osteoporosis, and kidney disease) and adult substance abuse. hospital feels that efforts to improve access to primary health services will have a positive impact on early detection of chronic disease and that a separate set of disease specific initiatives is not necessary. for those diagnosed with chronic diseases, hospital provides treatment in its scopes of service regardless of a patient's ability to pay. hospital is recognized for its youth treatment center program for substance abuse and mental health, but refers adult patients to other resources in the community.
PART V, SECTION B, LINE 10FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR FREE CAREthe hospital provides free care for patients earning less than 300% of the federal poverty level.
PART V, SECTION B, LINE 11FEDERAL POVERTY GUIDELINES TO DETERMINE ELIGIBILITY FOR DISCOUNTED CAREthe hospital provides discounted care for patients earning between 301-600% of the federal poverty level.
PART V, SECTION B, LINE 20FAP-ELIGIBLE INDIVIDUALSamounts that can be charged to fap-eligible individuals was calculated using the average discount for all managed care contracts (excluding blue cross plans, and beech street, multiplan, and preferred access network plans).
PART V, SECTION B, LINES 20-21FAP-ELIGIBLE INDIVIDUALS WITH INSURANCE COVERAGEindividuals are qualified for financial assistance utilizing federal poverty guidelines, family income levels and family size. most individuals who qualify under our financial assistance policy would be billed an amount significantly lower than the amount that would be billed for an individual with insurance coverage. however, in rare instances it is possible that the amount billed to such an individual could be higher than that billed for individuals with insurance coverage.
PART VI, LINE 2NEEDS ASSESSMENTthe assessment conducted by prc, which was described in part v, line 3 was a data-driven approach to determining the health status of the community and included both quantitative (phone survey) and qualitative (focus group) components. the assessment also integrated the most recent secondary public health data to complement the research of the chna. the data collected for hospital's service area was benchmarked against the secondary data available for the region, state, u.s., healthy people 2020 as well as comparing the data collected against hospital's previous assessment. all quantitative and qualitative data was compiled and presented to hospital in a 213 page document which included a recommendation on areas of concern or opportunity. the chna is conducted every three years. hospital convened an internal, multi-disciplinary committee to review the results of the chna, affirm and prioritize needs, and develop an implementation plan. representatives from the following departments served on the committee: community services, strategic planning, patient access services, finance, clinical resource management, foundation, data governance, nursing, research, and marketing. committee members reviewed the findings and areas of opportunity that were presented by prc. in addition, feedback on community health needs from the community services department and other internal departments was also considered. the committee used the following criteria when prioritizing health issues: magnitude, impact, feasibility and consequences of inaction. the most predominant issue was the difficulty the community has in accessing healthcare services which includes primary, oral, and behavioral health services, as well as prescription medication. other concerns were adult and childhood obesity/obesity and cancer. hospital has identified these concerns as the five main "priority areas", and the majority of hospital's outreach efforts focus on addressing these needs. an implementation plan was developed and was presented for approval to the community health and outreach committee, a committee of the board of directors, as well as to the community benefit regulatory committee, a new committee formed to ensure hospital is meeting all regulatory requirements. both committees unanimously approved the plan which includes measurement indicators and the plan was posted to hospital's website (www.nch.org), which the community was made aware of through press releases. the implementation plan is assessed and updated on hospital's website on an annual basis. as mentioned previously, hospital maintains a full time community services department who is in constant collaboration with community organizations, local government, schools, churches and social service agencies to identify and address unmet needs. the director of the community services department is on the board of directors of the palatine opportunity center, a local not for profit that helps hospital run a community resource center in hospital's primary service area. the resource center houses eleven not-for-profit agencies including cook county health and hospital system and cook county department of public health. providers at this center meet with hospital regularly to review community needs and explore collaborative strategies to address them.
PART V, LINE 14 AND PART VI, LINE 3PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCEthe financial assistance program at northwest community hospital is communicated widely to patients and visitors in english and spanish using the following methods: (1) signage in english and spanish is posted throughout the organization at all access points, including the emergency department and outpatient registration areas. these areas also stock and make available a brochure, printed in english and spanish, describing hospital's policy. a full-time interpretation service department is available to assist those who need additional information in other languages. in fy 2013 hospital responded to 16,919 in-person requests and provided telephonic assistance on 64,122 phone calls in 42 different languages. (2) each page of hospital's website (www.nch.org) contains the following footnote: "northwest community hospital is a charitable organization and provides financial assistance to those who are eligible. for more information, click here." a link takes visitors to a subsequent page that describes financial assistance/charity care and provides a phone number to contact a northwest community hospital financial counselor. applications for financial assistance, in english and spanish, are available for download on the hospital website. (3) all external hospital publications include the following note: "northwest community hospital is a charitable organization and provides financial assistance to people who are eligible. for more information please call 847.618.4542 or visit our website at www.nch.org." (4) information on financial assistance is included with every patient bill. patients who have indicated that they have met presumptive eligibility criteria, at the point of registration, are provided with unique verbiage on their bill directing them to contact the financial counseling department to pursue assistance through a streamlined process. (5) financial counselors provide financial assistance information to patients during their registration and work with patients identified at registration or after admission to help them get the assistance they need, answer questions, set up payment plans and facilitate applications for government programs such as medicaid.
PART VI, LINE 4COMMUNITY INFORMATIONnorthwest community hospital is located in arlington heights, illinois; a suburb located approximately 25 miles northwest of chicago. its primary service area consists of arlington heights and the surrounding suburbs of mt. prospect, palatine, and rolling meadows. hospital's secondary service area is comprised of barrington, buffalo grove, des plaines, elk grove village, hoffman estates, lake zurich, prospect heights, schaumburg and wheeling. these areas have a combined population of approximately 676,000 people. this number has remained fairly stable and growth over the next 5 years is expected to be relatively flat. hospital's total service area is predominately caucasian (67.1%), followed by hispanic (15.5%), asian (13.1%) and all others (4.2%). the hispanic population is expected to grow by 14.6% and the asian population 7.2% over the next 5 years. of individuals living in hospital's total service area, 15.5% are on medicaid and 5% are uninsured. over the past 10 years, there has been a decided shift in the age of those living in hospital's service area. a portion of the 18-44 age group moved into the 45-64 age group. it is estimated that in the next 5 years, the area will see further migration into the 65+ age group resulting in a 18.1% increase. there are four other hospitals located in hospital's service area. the entire primary service area and a significant portion of the secondary service area have been designated as a medically-underserved area. hospital supports both a federally qualified health center located across the street from hospital, and a county run primary care clinic, also located in hospital's primary service area.
PART VI, LINE 5PROMOTION OF COMMUNITY HEALTHHospital furthers its exempt purpose by promoting the health of its community in many ways as follows: (1) a majority of hospital's board of directors is comprised of persons who live or work in hospital's primary service area and are not employees or contractors of hospital. (2) hospital extends medical staff privileges to all qualified physicians in its community. (3) a standing community health and outreach committee of the hospital board reviews the community health needs assessment and ensures the implementation plan addresses identified needs. the committee provides oversight in monitoring and evaluating the effectiveness of strategies and initiatives included in the implementation plan. the committee monitors the amount of dollars invested in community benefit including charity care, community health education, community medical/dental clinics, and community health improvement initiatives. (4) hospital maintains any surplus funds in hospital itself or at northwest community healthcare (a 501(c)(3) supporting organization and sole member of hospital) for funding capital improvements in technology, facilities or patient care equipment, and supporting hospital operations or community outreach initiatives. (5) hospital has dedicated staff that serve as members, chairpersons, officers, and board members of local and national organizations devoted to improving the health and wellbeing of community members. these organizations include: wings (women in need growing stronger), harper college nursing advisory committee, metropolitan chicago healthcare council health care workforce advisory institute, chicago dental society, hospice of northeastern illinois, healthworld, bridge youth and family services, little city foundation human rights committee, as well as local rotary clubs. (6) hospital has dedicated staff that assist with advocacy initiatives to promote community, state, and national efforts to improve the health of the population. this includes a cancer research and prevention project through the american cancer society. (7) collaborative partnerships are the foundation to many of hospital's community health initiatives aimed to improve the health and wellbeing of the community. these partnerships include a collaboration with access community health network (a local federally qualified health center), and cook county health and hospital system to bring primary care services for the uninsured and underinsured to the community. in fy 2013, 40,985 patient visits were provided at these clinics and hospital's financial and in-kind support was $149,000. hospital also partners with elk grove, palatine, schaumburg, and wheeling townships on a mobile dental clinic program which provided 2,570 patient visits in fy 2013 with hospital absorbing $130,000 of the total cost. northwest community healthcare, an affiliate of hospital, also partners with the palatine opportunity center (poc), a local 501(c)(3) organization, to operate and run a resource center which provides direct services, referrals, and other assistance to the under-resourced. hospital owns and maintains the building and provides free or low-cost rent to local not for profit agencies, including: preservation for human dignity (phd), the center-resources for teaching and learning (ecdec program), community economic development association (ceda), palatine township senior citizens council, palatine police department, harper college, the cook county department of public health, palatine public library, buehler ymca, path (palatine assisting through hope), as well as the cook county primary care clinic described previously. some of the many programs offered at the resource center include ged and citizenship classes, healthcare services, computer literacy, after-school youth program, bilingual counseling, parenting classes, job placement, career education and recreation. in fy 2013, the poc had 234,250 client visits and hospital's cost to operate the facility was $248,000. in addition to the resource center, hospital works with poc on many collaborative health initiatives including the promotoras de salud program which provides health education to the latino population. this program identifies latina women who demonstrate the potential to become leaders in the community. these women then receive leadership training and education on specific health topics and lead small group presentations and health discussions with members of the community. in fy 2013, more than 500 people participated in classes led by the promotora and sixty-nine percent of the participants had annual household incomes of $25,000 or less and 39 percent had no health insurance. poc and hospital also collaboratively provide the services of a bilingual community health nurse and bilingual behavioral health navigator who focus on helping under-resourced members of the community navigate healthcare resources, provide health education, and help patients obtain low-cost prescriptions. in fy 2013 the part-time community nurse had 1,964 client interactions and the part-time behavioral health navigator had 1296. individuals with intellectual and developmental disabilities are another population that has difficulty accessing primary and oral healthcare services. hospital partners with little city foundation, a local residential organization that serves such individuals, on providing primary healthcare by an advanced practice nurse and oral healthcare by the mobile dental clinic team. (8) hospital operates an emergency department that is open 24 hours a day, 7 days a week and serves all persons regardless of their ability to pay. (9) hospital participates in both the medicare and medicaid government-sponsored healthcare programs. hospital contracts with mira med assistance program to provide assistance to patients, free of charge, throughout the medicaid application process when applying for medical coverage through the illinois medicaid program. the assistance provided is inclusive of completing the application, gathering all of the appropriate additional documents that must be submitted, working with the state on the patient's behalf and, in some cases, working through an appeal process. the cost of providing this service was $94,000 in fy 2013. (10) hospital provides services free or at a reduced rate to individuals with limited financial resources who are unable to access entitlement programs. individuals are eligible for free or discounted medically necessary healthcare services based on established criteria and hospital's financial assistance policy is widely distributed and communicated to the community. (11) hospital is an independent community hospital, that provides acute care and is recognized for the following outstanding services: primary stroke center (designated by joint commission), gastroenterology center (directed by a nationally-renowned gastroenterologist with the only gi teaching gallery in illinois for instructing clinicians), level iii neonatal intensive care unit, specialized cancer services (accredited by the commission on cancer), illinois center for pancreatic and hepatobiliary disease, top hospital based on quality and safety criteria by the leapfrog group, and magnet award for nursing excellence recipient (awarded by the american nurses credentialing center). (12) one of hospital's most significant contributions to the region is the northwest community emergency medical services (ems) system. lAUNCHED in 1972, it was the first ems program in illinois and the first in the nation to serve multiple communities. today hospital continues to serve as the area's ems resource hospital, providing administrative, clinical practice, quality management, and fiscal oversight and education for emergency medical dispatchers (emd), emergency medical responders (emr), emergency medical technicians (emt), paramedics, and emergency communications registered nurses (ecrn) within a 375 square-mile area. the system is a coalition of 6 hospitals and 24 ems provider agencies that employ over 950 paramedics and 400 emts, who respond to more than 64,000 patients each year. on-line medical control is provided by over 250 ecrns. the net cost for ems resource hospital activities in fy 2013 was $1,668,600 and provided training for 1,492 individuals. (13) hospital's competent and committed professional nursing staff provides their time and expertise to serve as clinical preceptors for 430 undergraduate nursing students who come to the organization to complete their clinical practicum requirements. the nursing students come from various colleges and universities, including harper college, elmhurst college, university of illinois-chicago, north park university, chamberlain college, rush university, olivet nazarene university, and loyola university. as many nurses throughout the chicago area continue to pursue educational degrees (bsn and msn), many of these individuals seek hospital as a place to complete their requirements
PART VI, LINE 6AFFILIATED HEALTH CARE SYSTEMnorthwest community hospital (hospital) is one of several affiliates under the common control of northwest community healthcare (nch). nch is a supporting organization that also supports northwest community day surgery center, inc., and northwest community hospital foundation. these 4 entities are 501(c)(3) exempt organizations and together provide the resources and funding to deliver quality healthcare services to the people of the northwest suburban community of chicago. in addition to the charity care that the hospital provided, the day surgery center provided an additional $145,265 in charity care (at cost) in fy 2013. the northwest community hospital foundation's primary function is to stimulate philanthropic giving and obtain charitable gifts in order to meet the changing needs of the community as well as fund community benefit initiatives. northwest community health services, inc., a multi-specialty medical group, is another affiliate of nch. health services owns and operates the nch medical group, a multi-specialty physician practice with offices in arlington heights, buffalo grove, palatine and mt. prospect, illinois. health services also operates "fast care", a clinic that is located centrally in a local grocery store that provides affordable primary healthcare services during convenient hours.
PART VI, LINE 7STATE FILING COMMUNITY BENEFIT REPORTnorthwest community healthcare, the sole corporate member of hospital, files an annual nonprofit hospital community benefits plan report with the illinois attorney general's office in accordance with illinois law. the report is filed on behalf of northwest community healthcare, the hospital, and northwest community day surgery center, inc.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
AMERICAN CANCER SOCIETY
1114 N ARLINGTON HTS RDARLINGTON HTSIL60005131788491501(c)(3)15000RELAY FOR LIFE
AMERICAN HEART ASSOCIATION
208 S LASALLE STE 1500CHICAGOIL60604135613797501(c)(3)5300METRO CHICAGO HEART WALK
HEKTOEN INSTITUTE LLC
2240 W OGDEN AVENUECHICAGOIL60612366006541501(c)(3)100000VISTA CLINIC SUPPORT
LITTLE CITY FOUNDATION
1760 W ALGONQUIN RDPALATINEIL60067362434562501(c)(3)10000ANNUAL SPONSORSHIP
SOLIDARITY BRIDGE
1577 FLORENCE AVEEVANSTONIL60201364481213501(c)(3)23400MISSION TRIPS
SPECIAL LEISURE SERVICES FOUNDATION
3000 W CENTRAL RDROLLING MEADOWSIL60008363145710501(c)(3)15000ANNUAL SPONSORSHIP
WINGS
PO BOX 95615PALATINEIL60095363456061501(c)(3)5400ANNUAL SPONSORSHIP
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants7TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationGRANTS IN SUPPORT OF NORTHWEST COMMUNITY HOSPITAL'S (HOSPITAL) MISSION ARE MONITORED BY NORTHWEST COMMUNITY'S FINANCE COMMITTEE AND BOARD OF DIRECTORS AS PART OF THE MONTHLY REVIEW OF HOSPITAL'S FINANCIAL RESULTS. SIGNIFICANT GRANTS TO UNRELATED 501(C)(3) OR GOVERNMENTAL ORGANIZATIONS ARE APPROVED BY HOSPITAL'S COMMUNITY SERVICES DEPARTMENT AND ARE MONITORED THROUGH ONGOING INTERACTIONS WITH OFFICIALS OF THOSE RECIPIENTS REGARDING PROGRAM SERVICES PROVIDED IN HOSPITAL'S SERVICE AREA.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Bruce K Crowther
PRES/CEO/SECRETARY THRU 4/13620844025000025342902583910155830117324703026200
Stephen O Scogna
CFO/TREAS '12;COO/PRES/CEO '1339687601580000180801217090196960698089000
MARK D LUSSON
Executive VP Human RESOURCES25424802500008517706755401114604431250835690
DALE E BEATTY
Exec VP Patient Services & CNO33159402500005427904918001259404726470524710
Michael C Hartke
EXECUTIVE VP/COO23868802500002532307309001669603787970235150
MICHAEL B ZENN
Executive VP/COO/TREASURER0000312468000185500331018000
WILLIS G PARSONS MD
GASTROENTEROLOGY PHYSICIAN10149170643625000150000109201674634000
MALCOLM BILIMORIA MD
GASTROENTEROLOGY Physician1546671000001500001572501577396000
RAMEEZ ALASADI MD
GASTROENTEROLOGY Physician735847000112077000450847969000
SOTIRIOS MARKULY MD
Hospitalist279047060000020000063280305975000
Susan E Nelson MD
Director11054507318601400060450968690288045000
Leighton B Smith MD
Exec VP Chief Medical Officer19828400054895000013941076117502709990
Mohammed Tahseen MD
Psychiatrist273149022000000175000195450332194000
ANDREA BENNET MD
Hospitalist2658800200000106000166970293377000

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
COMPENSATION DETERMINATION PROCESS FOR TOP MANAGEMENT OFFICIALSCHEDULE J, PART I, LINE 3THE COMPENSATION AND GOVERNANCE COMMITTEE OF THE PARENT CORPORATION (HEALTHCARE) ANNUALLY REVIEWS AND MAKES RECOMMENDATIONS TO THE BOARD REGARDING THE COMPENSATION OF THE PRESIDENT AND THE GUIDELINES FOR COMPENSATION OF THE EXECUTIVE VICE PRESIDENTS, OTHER VICE PRESIDENTS AND OTHER KEY MANAGEMENT OFFICERS AS DETERMINED BY THE BOARD. AN INDEPENDENT REASONABLENESS OPINION IS OBTAINED ANNUALLY REGARDING THE CHIEF EXECUTIVE OFFICER'S COMPENSATION AND THAT OF OTHER EXECUTIVES AS DETERMINED BY THE COMMITTEE.
SEVERANCE PAYMENTSSchedule J, Part I, Line 4aIn 2012, the following individuals received severence payments as part of their compensation arrangement: Michael B. Zenn $312,468 Leighton B. Smith, MD $235,294 Rameez Alasadi, MD $112,077
Supplemental Nonqualified Retirement PlanSchedule J, Part I, Line 4bBruce Crowther participates in a SERP. This plan was frozen in 2010 and an amendment to the Plan eliminated all future benefit accruals including credited service final average earnings and final average amounts used to calculate plan benefits. Therefore no deferred compensation is recorded for the current year.
NON-FIXED COMP PAYMENTSSCHEDULE J, PART I LINE 7THE CEO AND VICE PRESIDENTS OF THE HOSPITAL ARE ELIGIBLE FOR AN ANNUAL INCENTIVE COMPENSATION PAYMENT THAT IS ALIGNED WITH THE STRATEGIC, FINANCIAL, AND OPERATIONAL GOALS OF THE ORGANIZATION. PERFORMANCE MEASURES ARE TRACKED AT THREE LEVELS: THRESHOLD MEASURES, WHICH CONSTITUTE THE MINIMUM REQUIREMENTS THAT MUST BE ACHIEVED IN ORDER TO HAVE AN INCENTIVE PAYOUT; ORGANIZATIONAL MEASURES, CONSISTING OF SPECIFIC BUDGET GOALS FOR OPERATING MARGIN, COST PER CASE, MARKET SHARE, QUALITY, ETC.; AND FUNCTIONAL MEASURES, INCLUDING PERSONAL GOALS THAT ARE QUANTIFIABLE AND TIME-SPECIFIC. WEIGHTING OF THE ORGANIZATIONAL AND FUNCTIONAL MEASURES VARIES BETWEEN EXECUTIVES DEPENDING ON THE RELATIVE IMPORTANCE OF VARIOUS PROJECTS ASSIGNED DURING THE YEAR. ACTUAL AMOUNTS AWARDED ARE BASED ON A COMBINATION OF DEFINED TARGETS (15 - 25% OF BASE PAY) AND DISCRETIONARY AMOUNTS (5 - 10% OF BASE PAY). MAXIMUM PAYABLE IS 150% OF THE TARGET. AMOUNTS TO BE PAID ARE RECOMMENDED BY THE CEO AND SUBJECT TO APPROVAL BY THE NORMINATION AND COMPENSATION COMMITTEE OF NORTHWEST COMMUNITY HEALTHCARE, THE SOLE MEMBER OF THE HOSPITAL.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Bond ReferenceBondReferenceCdIssuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
ILLINOIS FINANCE AUTHORITY
A8610919671111111112011-12-0153100000SEE PART VIfalsefalsefalse
ILLINOIS FINANCE AUTHORITY
B86109196745200FNR62008-09-19151075932SEE PART VIfalsefalsefalse
ILLINOIS FINANCE AUTHORITY
C86109196745200FNU92008-10-1786820000SEE PART VIfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Bond ReferenceBondReferenceCdAmount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
A00531000000004342790005266572102011truefalsetruetrue
B00151417356000143793400149979422002010falsefalsetruetrue
C008682000000059807593000086128925002008truefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Bond ReferenceBondReferenceCdPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersOwning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTestChange In Use Bond Financed PropChangeInUseBondFinancedPropRemedial Action TakenRemedialActionTakenNon Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs
A0
B0falsefalsefalsefalsefalsefalsefalsetrue
C0

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledRebate Not Due YetRebateNotDueYetException To RebateExceptionToRebateNo Rebate DueNoRebateDueVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICBusiness Name Line1NameOfGICProvider/BusinessNameLine1Gross Proceeds InvestedGrossProceedsInvestedWritten Proc To Monitor ReqsWrittenProcToMonitorReqs
0
Afalsetruefalsefalsetruefalsefalse0falsetrue
0
Bfalsefalsefalsetruefalsefalsefalse0falsetrue
0
Cfalsefalsetruefalsetruefalsefalse0falsetrue

Form990 Schedule K Part V Form990ScheduleKPartV (3 entries)

Bond ReferenceBondReferenceCdProc To Undertk Corrective ActionProcToUndertkCorrectiveAction
Atrue
Btrue
Ctrue

Form990 Schedule K Part VI Form990ScheduleKPartVI

FieldValueIRS element (for citing)
IdentifierSUPPLEMENTAL INFORMATIONIdentifier
Return Reference0ReturnReference
ExplanationSCHEDULE K, PART I, COLUMN (F) BOND A PROCEEDS WERE USED TO REFUND THE 2/13/2002 BOND ISSUANCE. SCHEDULE K, PART I, COLUMN (F) BOND B PROCEEDS WERE USED FOR: CONSTRUCTION OF A PATIENT TOWER AND PARKING GARAGE; EXPANSION AND RENOVATION OF THE HOSPITAL'S EMERGENCY DEPARTMENT AND SURGERY SUITES; RELOCATION OF CERTAIN DEPARTMENTS ON THE HOSPITAL'S CAMPUS; AND PURCHASE OF CERTAIN EQUIPMENT USED IN THE HOSPITAL'S BUSINESS. SCHEDULE K, PART I, COLUMN (F) BOND C PROCEEDS WERE USED TO REFUND THE 2/13/2002 BOND ISSUANCE. SCHEDULE K, PART IV, LINE 1C BOND B A REBATE CALCULATION WAS CONDUCTED ON APRIL 17, 2014.Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonJames J Smith MDNamePerson
Purpose Of LoanPhysician Prac SvcsPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$85,793OriginalPrincipalAmount
Balance Due18958BalanceDue
DefaultfalseDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due18958TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
SARAH BISHOP
SEE PART V60548SALARYfalse
SEE PART V

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierRELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATIONIdentifier
Return ReferenceSCHEDULE L, PART IVReturnReference
ExplanationSARAH BISHOP IS THE DAUGHTER OF JAMES H. BISHOP (DIRECTOR). By virtue of being elected as officers of the medical staff, two physicians were elected as directors of the board. The two directors owned more than 5% ownership in their respective practices (Suburban ENT and Advanced Surgical Associates). Unrelated to the directors' tenure on the board, these practices rented office space and purchased answering services from the hospital and provided services to the hospital which totaled $1,297,475.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (9 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF RELATIONSHIPSFORM 990, PART VI, QUESTION 2BRUCE K. CROWTHER, NORTHWEST COMMUNITY HOSPITAL (HOSPITAL) DIRECTOR AND CEO, AND JAMES H. BISHOP, HOSPITAL DIRECTOR, ARE DIRECTOR AND OFFICER RESPECTIVELY OF WINTRUST FINANCIAL CORPORATION AND BARRINGTON BANK AND TRUST COMPANY NA. MICHAEL B. ZENN, FORMER HOSPITAL OFFICER, AND JAMES H. BISHOP, HOSPITAL DIRECTOR, ARE DIRECTOR AND OFFICER RESPECTIVELY OF VILLAGE BANK & TRUST. HOSPITAL DOES NOT TRANSACT ANY BUSINESS WITH WINTRUST FINANCIAL, BARRINGTON BANK, OR VILLAGE BANK AND TRUST.
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, QUESTION 6NORTHWEST COMMUNITY HEALTHCARE (NCH) IS THE SOLE CORPORATE MEMBER OF NORTHWEST COMMUNITY HOSPITAL (HOSPITAL). AS SUCH, IT ELECTS OR APPOINTS THE MEMBERS OF HOSPITAL'S GOVERNING BODY AND APPROVES SIGNIFICANT DECISIONS.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTSFORM 990, PART VI, QUESTION 7ANCH IS THE SOLE CORPORATE MEMBER OF HOSPITAL. AS SUCH, IT ELECTS OR APPOINTS THE MEMBERS OF THE GOVERNING BODY OF HOSPITAL PERIODICALLY OR AS VACANCIES ARISE.
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTSFORM 990, PART VI, QUESTION 7BNCH IS THE SOLE CORPORATE MEMBER OF HOSPITAL. AS SUCH, IT MUST APPROVE CERTAIN ACTIONS OF HOSPITAL. ACTION IS TAKEN BY A MAJORITY VOTE OF THE NCH BOARD WITH A QUORUM PRESENT. NCH MUST APPROVE THE FOLLOWING TYPES OF DECISIONS BY HOSPITAL: VOLUNTARY DISSOLUTION, MERGER, CONSOLIDATION OR SALE OR TRANSFER OF 10% OR MORE OF HOSPITAL'S ASSETS; SALE OF REAL PROPERTY OR INTEREST THEREIN; CREATION OF A SUBSIDIARY OR AFFILIATE; ANNUAL AND LONG-TERM CAPITAL AND OPERATING BUDGETS; AMENDMENT, ALTERATION OR REPEAL OF HOSPITAL'S ARTICLES OF INCORPORATION OR BYLAWS; SELECTION OF AUDITORS; APPOINTMENT, REMOVAL AND EVALUATION OF HOSPITAL DIRECTORS; DEBT OR INDEBTEDNESS, GUARANTEES OR BORROWINGS; APPOINTMENT, COMPENSATION, BENEFITS AND EVALUATION OF OFFICERS; APPOINTMENT AND EMPLOYMENT OF THE PRESIDENT; AND ACTIONS TAKEN BY TRUSTEES OF THE NORTHWEST COMMUNITY HOSPITAL EMPLOYEES RETIREMENT PLAN.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990FORM 990, PART VI, QUESTION 11BA COPY OF FORM 990 WAS MADE AVAILABLE TO THE MEMBERS OF HOSPITAL'S BOARD PRIOR TO FILING. THE AUDIT AND COMPLIANCE COMMITTEE OF THE NCH BOARD REVIEWED FORM 990 FOR AFFILIATES OF NCH PRIOR TO DISTRIBUTION TO THE FULL BOARD.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTFORM 990, PART VI, QUESTION 12CEACH YEAR, THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS SENT TO DIRECTORS, OFFICERS AND KEY EMPLOYEES. EACH RESPONSE IS REVIEWED BY THE GENERAL COUNSEL AND THOSE IN WHICH ANY ACTUAL OR APPARENT CONFLICT WITH THE PRESENT ROLE IS DISCLOSED, ARE REVIEWED BY THE PRESIDENT/CEO AND BOARD CHAIRPERSON. IN THE CASE OF ANY CONFLICT INVOLVING AN ENTITY OR PARTY WITH WHICH HOSPITAL IS DEALING OR COMPETING, THE PERSON WITH THE CONFLICT MAY NOT PARTICIPATE IN ANY DECISIONS REGARDING THAT PARTY. INDIVIDUALS WHO ARE INDEPENDENT CONTRACTORS, OFFICERS, DIRECTORS, OR EMPLOYEES OF OTHER HEALTHCARE FACILITIES IN HOSPITAL'S SERVICE AREA MAY NOT SERVE ON NCH'S OR ANY RELATED ORGANIZATION'S BOARD OR BOARD COMMITTEE. IN ADDITION, THE POLICY INCLUDES A SAMPLE CONFLICT OF INTEREST DISCLOSURE LETTER TO BE USED IF A CONFLICT ARISES AFTER SUBMISSION OF THE ANNUAL QUESTIONNAIRE AND BEFORE SUBMISSION OF THE NEXT ANNUAL QUESTIONNAIRE. SUCH DISCLOSURE LETTERS WOULD BE REVIEWED AS NOTED ABOVE AT THE TIME THEY ARE RECEIVED.
COMPENSATION DETERMINATION PROCESS FOR TOP MANAGEMENT OFFICIALFORM 990, PART VI, LINE 15ATHE COMPENSATION AND GOVERNANCE COMMITTEE OF THE NCH BOARD IS RESPONSIBLE FOR SETTING THE COMPENSATION OF THE PRESIDENT/CEO WHO IS THE TOP MANAGEMENT OFFICIAL. COMPENSATION IS REVIEWED USING AN EXTERNAL COMPENSATION FIRM. THE REVIEW ALSO UTILIZES COMPARISONS TO SIMILAR ORGANIZATIONS THROUGH REVIEW OF FORMS 990, USE OF COMPARISON STUDIES FROM THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL AND OTHER SOURCES. THE PROCESS IS DOCUMENTED IN THE MINUTES OF THE COMPENSATION AND GOVERNANCE COMMITTEE. COMPENSATION DETERMINATION PROCESS FOR OFFICERS AND KEY EMPLOYEES FORM 990, PART VI, LINE 15B THE COMPENSATION AND GOVERNANCE COMMITTEE OF THE NCH BOARD IS RESPONSIBLE FOR APPROVING THE COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES (VICE PRESIDENTS) OF HOSPITAL BASED ON RECOMMENDATIONS FROM THE PRESIDENT/CEO. THE REVIEW UTILIZES COMPARISONS TO STUDIES FROM THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL AND OTHER SOURCES. THE PROCESS IS DOCUMENTED IN THE MINUTES OF THE COMPENSATION AND GOVERNANCE COMMITTEE.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLICFORM 990, PART VI, QUESTION 19GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE PUBLIC. HOSPITAL'S FINANCIAL STATEMENTS ARE INCLUDED IN THE ANNUAL CONSOLIDATED AUDIT REPORT OF NCH AND SUBSIDIARIES. THESE CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE MUNICIPAL SECURITIES RULEMAKING BOARD'S ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AT WWW.EMMA.MSRB.ORG.
RECONCILIATION OF NET ASSETS - OTHER CHANGES IN NET ASSETSFORM 990, PART XI, QUESTION 9BASIS SWAP GAIN 51,614 PENSION RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST 19,376,505 RESTRICTED FUNDS - SILVER LINING PROGRAM (15,973) CHANGE IN TEMPORARILY RESTRICTED FUNDS 407,742 CHANGE IN PERMANENTLY RESTRICTED FUNDS 124,919 NET ASSETS TRANSFER TO NORTHWEST COMMUNITY HEALTHCARE (4,000,000) =========== TOTAL 15,944,807

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
Northwest Community Physicians Assn LLC
3060 Salt Creek LaneArlington HtsIL60005510457240Patient CareIL2726957612700NA
NCH Service Company LLC
3060 Salt Creek LaneArlington HtsIL60005263791362Patient CareIL1764364621014NCPA LLC

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Northwest Community Healthcare
800 West Central RoadArlington HTSIL60005363125209Support OrgIL501(c)(3)11 TYPE IINAfalse
Northwest Community Day Surgery Center
675 West Kirchoff RoadArlington HTSIL60005363540436OutpatientIL501(c)(3)3NCHfalse
Northwest Community Hospital Foundation
3060 Salt Creek LaneArlington HTSIL60005363125193FundraisingIL501(c)(3)7NCHfalse

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1NPC-CYBERKNIFE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1800 W CENTRAL RDAddressLine1
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
EIN204462828EIN
Primary ActivityEQUIPMENT LEASINGPrimaryActivity
Legal Domicile StateDELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1naBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType

Form990 Schedule R Part IV Form990ScheduleRPartIV (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrgShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
Northwest Community Health Services Inc
800 West Central RoadArlington HeightsIL60005363312906healthcare svcsILhealthcare svcsC CORPfalse
Northwest Community Capco Inc
800 West Central RoadArlington HeightsIL60005364027717Managed CareILHospitalC Corpfalse58356210952151.00000
NCH Casualty Insurance SPC LTD
980442062InsurancehealthcareC Corpfalse68 West Bay Raod KY1-1102Grand CaymancAYMAN ISLANDSCJCJ
NCH Physicians Cooperative
800 West Central RoadArlington HeightsIL60005201830299Group PurchasingILHospitalC Corpfalse001.00000
CENTRAL INSURANCE COMPANY LTD
981109518INSURANCEHEALTHCAREC CORP171 ELGIN AVENUE KY1-1002GEORGE TOWNCJCJ
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Northwest Community Capco IncBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeqTransactionType
Amount Involved1282277AmountInvolved
Method Of Amt DeterminationCostMethodOfAmtDetermination