NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization: NORTHWESTERN MEMORIAL HEALTHCARE (EIN 36-2338884)
Tax period: 2012-07-01 to 2013-06-30
Filed: 2014-05-15
IRS object ID: 201441359349306934
Schema version: 2012v2.0
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2014-05-15T16:11:26-07:00	Timestamp
Tax Period End Date	2013-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	191 W Nationwide Blvd Suite 500	AddressLine1
City	Columbus	City
State	OH	State
ZIP Code	43215	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2012-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	362338884	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Northern Illinois Medical Center	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	NORT	NameControl
Phone	8157885800	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	4201 Medical Center Drive	AddressLine1
City	McHenry	City
State	IL	State
ZIP Code	60050	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	David Tomlinson	Name
Title	EVP, CFO, CIO	Title
Date Signed	2014-05-15	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	Mollie Longhouse	Name
PTIN	P20029488	PTIN
Phone	6142492300	Phone

Field	Value	IRS element (for citing)
Tax Year	2012	TaxYear
Build TS	2015-11-30 17:44:51Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	Michael S Eesley	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	385 Millennium Drive	AddressLine1
City	Crystal Lake	City
State	IL	State
ZIP Code	60012	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	252649202	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
All Affiliates Included	false	AllAffiliatesIncluded
Organization501c3	X	Organization501c3
Web Site	www.centegra.org	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1956	YearFormation
State Legal Domicile	IL	StateLegalDomicile
Activity Or Mission Description	See Schedule O supplemental information titled Form 990, Part I, Line 1 and Part III, Line 1 Mission.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	13	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	1329	TotalNbrEmployees
Total Nbr Volunteers	237	TotalNbrVolunteers
Total Gross UBI	474188	TotalGrossUBI
Net Unrelated Business Txbl Income	-18594	NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year	562350	ContributionsGrantsPriorYear
Contributions Grants Current Year	480699	ContributionsGrantsCurrentYear
Program Service Revenue Prior Year	231945346	ProgramServiceRevenuePriorYear
Program Service Revenue CY	219801434	ProgramServiceRevenueCY
Investment Income Prior Year	4777410	InvestmentIncomePriorYear
Investment Income Current Year	8915656	InvestmentIncomeCurrentYear
Other Revenue Prior Year	3966510	OtherRevenuePriorYear
Other Revenue Current Year	3240442	OtherRevenueCurrentYear
Total Revenue Prior Year	241251616	TotalRevenuePriorYear
Total Revenue Current Year	232438231	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	90331592	SalariesEtcPriorYear
Salaries Etc Current Year	85274672	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	136642183	OtherExpensePriorYear
Other Expenses Current Year	128767153	OtherExpensesCurrentYear
Total Expenses Prior Year	226973775	TotalExpensesPriorYear
Total Expenses Current Year	214041825	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	14277841	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	18396406	RevenuesLessExpensesCY
Total Assets BOY	244008694	TotalAssetsBOY
Total Assets EOY	260857048	TotalAssetsEOY
Total Liabilities BOY	101298528	TotalLiabilitiesBOY
Total Liabilities EOY	112210005	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	142710166	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	148647043	NetAssetsOrFundBalancesEOY
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Mission Description	See Schedule O supplemental information titled Form 990, Part I, Line 1 and Part III, Line 1 Mission.	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	193654903	Expense
Revenue	220395318	Revenue
Description	See Schedule O supplemental narrative titled Form 990, Part III, Line 4a.	Description
Total Program Service Expense	193654903	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	true	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	true	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	false	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	true	ReportFin48Footnote
Independent Audit Financial Stmt	false	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	true	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	true	Hospital
Financial Stmt Attached	true	FinancialStmtAttached
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	true	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Invest Tax Exempt Bonds	false	InvestTaxExemptBonds
Escrow Account	false	EscrowAccount
On Behalf Of Issuer	false	OnBehalfOfIssuer
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	true	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	true	DisregardedEntity
Related Entity	true	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org	false	TransfersToExemptNonChrtblOrg
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	134	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Compliance With Backup Witholding	true	ComplianceWithBackupWitholding
Number Of Employees	1329	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	true	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Number Of8282 Filed	0	NumberOf8282Filed
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Form8899 Filed	false	Form8899Filed
Form1098 C Filed	false	Form1098CFiled
Excess Business Holdings	false	ExcessBusinessHoldings
Taxable Distributions	false	TaxableDistributions
Distribution To Donor	false	DistributionToDonor
Filed Lieu1041	false	FiledLieu1041
Licensed More Than One State	false	LicensedMoreThanOneState
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	13	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	true	FamilyOrBusinessRelationship
Delegation Of Management Duties	true	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	true	MembersOrStockholders
Election Of Board Members	true	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	true	ConflictOfInterestPolicy
Annual Disclosure Covered Persons	true	AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement	true	RegularMonitoringEnforcement
Whistleblower Policy	true	WhistleblowerPolicy
Document Retention Policy	true	DocumentRetentionPolicy
Compensation Process CEO	true	CompensationProcessCEO
Compensation Process Other	true	CompensationProcessOther
Investment In Joint Venture	true	InvestmentInJointVenture
Written Policy Or Procedure	true	WrittenPolicyOrProcedure
States Where Copy Of Return Is Filed	IL	StatesWhereCopyOfReturnIsFiled
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	David Tomlinson	NamePerson
Telephone Number	8157885800	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	385 Millennium Drive	AddressLine1
City	Crystal Lake	City
State	IL	State
ZIP Code	60012	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (37 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	Average Hours Per Week RelatedAverageHoursPerWeekRelated	Individual Trustee Or DirectorIndividualTrusteeOrDirector	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Highest Compensated EmployeeHighestCompensatedEmployee
Robert M Rosenberger
CFO & SR VP	1.00	39.00	X	X	0	627306	39398
Parmod Narang
Director	1.00	1.00	X		0	0	0
Charie Zanck
Chairperson	0.66	1.34	X	X	0	0	0
Charles Ruth
Director	0.33	2.67	X		0	0	0
Kathy Powell
Director	0.33	3.67	X		0	0	0
Jack Porter
Director	0.33	0.67	X		0	0	0
Pat Morehead
Treasurer	0.33	1.67	X	X	0	0	0
Angela McAuley
Director	0.33	1.67	X		0	0	0
Michael Luecht
Director	0.33	1.67	X		0	0	0
Luke Johnsos
Director	0.33	1.67	X		0	0	0
Michael S Eesley
CEO	1.00	39.00	X	X	0	1277730	346911
Mike Curran
Vice Chairman	0.33	0.67	X	X	0	0	0
William Cox
Secretary	0.33	1.67	X	X	0	0	0
Tom Carey
Director	0.33	4.67	X		0	0	0
Terrence J Bugno
Director	0.33	0.67	X		0	0	0
Christopher Westerkamp
Vice President	1.00	39.00		X	0	177279	6284
Sheila Senn
Vice President	0.50	39.50		X	0	150138	32254
Matthew Towler
VP	19.50	20.50		X	0	229091	22461
David Tomlinson
SR VP & CIO	1.00	39.00		X	0	331725	38118
Bernadette S Szczepanski
Vice President	1.00	39.00		X	0	219911	18963
Aaron T Shepley
SR VP	1.00	39.00		X	0	428888	75450
Rachel L Sebastian
Vice President	39.00	1.00		X	280727	0	40770
Jason R Sciarro
President/COO	1.00	39.00		X	0	724714	96798
Robin K Purdy
CMI Officer	1.00	39.00		X	0	300194	30787
Kumar Nathan
VP Clinical Eff	1.00	39.00		X	0	224423	31838
Gail D Rudolph
Vice President	0.33	39.00		X	0	178816	21597
Neil W Murphy
V.P. & C.N.O.	1.00	39.00		X	0	284790	5394
Susan M Milford
Sr. V.P.	1.00	39.00		X	0	286937	89719
Zbigniew T Lorenc
Vice President	1.00	39.00		X	0	301170	24289
Barbara J Johnson
Sr. V.P.	1.00	39.00		X	0	369160	20728
Pasquale G Bernardi
Vice President	1.00	39.00		X	0	383404	23129
Mattias Carlen
VP Hlth & Welln	1.00	39.00		X	0	130801	25775
Todd A Meyers
Chief MedPhysicist	40.00	0.00			173649	0	32685	X
John G Geinopolos
Medical Physicist	40.00	0.00			163584	0	33119	X
Susan H Corcoran
Pharmacist	35.00	0.00			144745	0	31767	X
Sara M Sigrist
RN II ED	24.00	0.00			140735	0	8451	X
Jeannine C Nosko
Dir Pt Care Svs	40.00	0.00			137540	0	31293	X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	1040980	TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs	6626477	TotalReportableCompFrmRltdOrgs
Total Other Compensation	1127978	TotalOtherCompensation
Number Individuals GT100 K	33	NumberIndividualsGT100K
Formers Listed	false	FormersListed
Total Comp GT150 K	true	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1	CityAddressOfContractor/AddressUS/City	StateAddressOfContractor/AddressUS/State	ZIP CodeAddressOfContractor/AddressUS/ZIPCode	Description Of ServicesDescriptionOfServices	CompensationCompensation
Total Home Health
780 S Mclean Blvd	Elgin	IL	60123	Home Med Equipment	789047
Sodexo Inc & Affiliates
4880 Paysphere Circle	Chicago	IL	60674	Management Services	3348147
McKesson Technologies
PO Box 98347	Chicago	IL	606938347	Computer Support	2492949
Dell Marketing LP
PO Box 677654	Dallas	TX	752676021	Computer Support	1039138
Cardiac Surgery Associates
PO Box 153	Channahon	IL	60410	Physician Services	908681

Field	Value	IRS element (for citing)
Number Of Contractors GT100 K	18	NumberOfContractorsGT100K
Related Organizations	443330	RelatedOrganizations
Government Grants	37369	GovernmentGrants
Total Contributions	480699	TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Routine Patient Services	622110	75746615	75746615
IDPA Provider Tax Revenue	622110	5013680	5013680
Charity Care/Admin Allowa	622110	-23422116	-23422116
Ancillary Outpatient Serv	622110	138008391	138008391
Ancillary Inpatient Servi	622110	24454864	24454864

Field	Value	IRS element (for citing)
Total Program Service Revenue	219801434	TotalProgramServiceRevenue

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	7089263	TotalRevenueColumn
Exclusion	$7,089,263	ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

Field	Value	IRS element (for citing)
Total Revenue Column	7833	TotalRevenueColumn
Exclusion	$7,833	ExclusionAmount

Royalties Revenue RoyaltiesRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

Field	Value	IRS element (for citing)
Securities	22025913	Securities
Other	3618	Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

Field	Value	IRS element (for citing)
Securities	20210971	Securities

Gain Or Loss GainOrLoss

Field	Value	IRS element (for citing)
Securities	1814942	Securities
Other	3618	Other

Net Gain Or Loss Investments NetGainOrLossInvestments

Field	Value	IRS element (for citing)
Total Revenue Column	1818560	TotalRevenueColumn
Exclusion	$1,818,560	ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

Field	Value	IRS element (for citing)
Total Revenue Column	0	TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescription	Business CodeBusinessCode	Total Revenue ColumnTotalRevenueColumn	ExclusionExclusionAmount	Unrelated Business RevenueUnrelatedBusinessRevenue
Related Company Revenue	900099	687034	$687,034
Child Day Care Center	624410	815271	$341,083	474188
Cafeteria Services & Educ	722210	870724	$870,724

Miscellaneous Revenue MiscellaneousRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	867413	TotalRevenueColumn
Related Or Exempt Function Income	593884	RelatedOrExemptFunctionIncome
Exclusion	$273,529	ExclusionAmount

Field	Value	IRS element (for citing)
Total Other Revenue	3240442	TotalOtherRevenue

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	232438231	TotalRevenueColumn
Related Or Exempt Function Income	220395318	RelatedOrExemptFunctionIncome
Unrelated Business Revenue	474188	UnrelatedBusinessRevenue
Exclusion	$11,088,026	ExclusionAmount

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	X	InfoInScheduleOPartIX

Grants To Domestic Orgs GrantsToDomesticOrgs

Field	Value	IRS element (for citing)
Total	0	Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

Field	Value	IRS element (for citing)
Total	0	Total

Foreign Grants ForeignGrants

Field	Value	IRS element (for citing)
Total	0	Total

Benefits To Members BenefitsToMembers

Field	Value	IRS element (for citing)
Total	0	Total

Comp Current Officers Directors CompCurrentOfficersDirectors

Field	Value	IRS element (for citing)
Total	321497	Total
Management And General	321497	ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	0	Total

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	69462248	Total
Program Services	61950925	ProgramServices
Management And General	7511323	ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

Field	Value	IRS element (for citing)
Total	1135761	Total
Program Services	1008278	ProgramServices
Management And General	127483	ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	9443146	Total
Program Services	8383208	ProgramServices
Management And General	1059938	ManagementAndGeneral

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	4912020	Total
Program Services	4360674	ProgramServices
Management And General	551346	ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

Field	Value	IRS element (for citing)
Total	1045525	Total
Management And General	1045525	ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Lobbying FeesForServicesLobbying

Field	Value	IRS element (for citing)
Total	35967	Total
Management And General	35967	ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

Field	Value	IRS element (for citing)
Total	0	Total

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	7460129	Total
Program Services	6625675	ProgramServices
Management And General	834454	ManagementAndGeneral

Advertising Advertising

Field	Value	IRS element (for citing)
Total	34637	Total
Program Services	34637	ProgramServices

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	33502200	Total
Program Services	32955837	ProgramServices
Management And General	546363	ManagementAndGeneral

Information Technology InformationTechnology

Field	Value	IRS element (for citing)
Total	20175	Total
Program Services	16801	ProgramServices
Management And General	3374	ManagementAndGeneral

Royalties Royalties

Field	Value	IRS element (for citing)
Total	0	Total

Occupancy Occupancy

Field	Value	IRS element (for citing)
Total	2255981	Total
Program Services	914011	ProgramServices
Management And General	1341970	ManagementAndGeneral

Travel Travel

Field	Value	IRS element (for citing)
Total	194934	Total
Program Services	178426	ProgramServices
Management And General	16508	ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

Field	Value	IRS element (for citing)
Total	0	Total

Conferences Meetings ConferencesMeetings

Field	Value	IRS element (for citing)
Total	86888	Total
Program Services	71357	ProgramServices
Management And General	15531	ManagementAndGeneral

Interest Interest

Field	Value	IRS element (for citing)
Total	3367855	Total
Program Services	2989833	ProgramServices
Management And General	378022	ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

Field	Value	IRS element (for citing)
Total	0	Total

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	10467938	Total
Program Services	9292973	ProgramServices
Management And General	1174965	ManagementAndGeneral

Insurance Insurance

Field	Value	IRS element (for citing)
Total	2823157	Total
Program Services	2506274	ProgramServices
Management And General	316883	ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
IDPA Provider Tax	4950237	4950237
Related Company-Lab	6122630	6122630
Bad Debt	12089690	12089690
Related Company-CHS	39180395	34782624	4397772

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	5128815	Total
Program Services	4420813	ProgramServices
Management And General	708001	ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	214041825	Total
Program Services	193654903	ProgramServices
Management And General	20386922	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	136346	BOY
EOY	247838	EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

Field	Value	IRS element (for citing)
BOY	19816348	BOY
EOY	15083028	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
EOY	0	EOY

Accounts Receivable AccountsReceivable

Field	Value	IRS element (for citing)
BOY	31241332	BOY
EOY	29906359	EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

Field	Value	IRS element (for citing)
EOY	0	EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

Field	Value	IRS element (for citing)
EOY	0	EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

Field	Value	IRS element (for citing)
EOY	0	EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

Field	Value	IRS element (for citing)
BOY	4163547	BOY
EOY	3987439	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	1884424	BOY
EOY	1257686	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	193641329	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	126780173	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	65871828	BOY
EOY	66861156	EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

Field	Value	IRS element (for citing)
BOY	83657820	BOY
EOY	90855755	EOY

Investments Other Securities InvestmentsOtherSecurities

Field	Value	IRS element (for citing)
EOY	0	EOY

Investments Program Related InvestmentsProgramRelated

Field	Value	IRS element (for citing)
BOY	3692707	BOY
EOY	4533676	EOY

Intangible Assets IntangibleAssets

Field	Value	IRS element (for citing)
EOY	111005	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	33544342	BOY
EOY	48013106	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	244008694	BOY
EOY	260857048	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	26238964	BOY
EOY	20172535	EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

Field	Value	IRS element (for citing)
BOY	70781285	BOY
EOY	88835515	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	4278279	BOY
EOY	3201955	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	101298528	BOY
EOY	112210005	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	141591968	BOY
EOY	147237552	EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	1118198	BOY
EOY	1409491	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	142710166	BOY
EOY	148647043	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	244008694	BOY
EOY	260857048	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	18396406	ReconcilationRevenueExpenses
Reconciliation Unrealized Invest	-386127	ReconciliationUnrealizedInvest
Reconcilation Donated Services	2500	ReconcilationDonatedServices
Reconcilation Other Changes	-12075902	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited

FS Audited Basis FSAuditedBasis

Field	Value	IRS element (for citing)
Financial Statement Consolidated	X	FinancialStatementConsolidated

Field	Value	IRS element (for citing)
Audit Committee	true	AuditCommittee
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital170b1 Aiii	X	Hospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

Field	Value	IRS element (for citing)
Contributor Number	RESTRICTED	ContributorNumber

Contributor Name Business ContributorNameBusiness

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor Address US ContributorAddressUS

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Aggregate Contributions	RESTRICTED	AggregateContributions

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Form4720 Filed4955 Tax	false	Form4720Filed4955Tax
Correction Made	false	CorrectionMade
Volunteers	false	Volunteers
Paid Staff Or Management	false	PaidStaffOrManagement
Media Advertisements	false	MediaAdvertisements
Mailings Members	false	MailingsMembers
Publications Or Broadcast	false	PublicationsOrBroadcast
Grants Other Organizations	false	GrantsOtherOrganizations
Direct Contact Legislators	false	DirectContactLegislators
Rallies Demonstrations	false	RalliesDemonstrations
Other Activities	true	OtherActivities
Other Activities	$35,967	OtherActivitiesAmount
Total Lobbying Expenditures IIB	35967	TotalLobbyingExpendituresIIB
Not Described In501c3	false	NotDescribedIn501c3
Form4720 Filed4912 Tax	false	Form4720Filed4912Tax

Form990 Schedule C Part IV Form990ScheduleCPartIV

Field	Value	IRS element (for citing)
Identifier	Part II-B, Line 1i	Identifier
Return Reference	Part II-B, Line 1i - Other Activities Description	ReturnReference
Explanation	As a part of our dues payments to the Illinois Hospital Association, American Hospital Association, and Metropolitan Chicago Healthcare Council, approximately 30% of dues, on average, are allocable to lobbying activities.	Explanation

Schedule D IRS990ScheduleD

Land Land

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	65000	OtherCostOrOtherBasis
Book Value	65000	BookValue

Buildings Buildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	79177183	OtherCostOrOtherBasis
Depreciation	35999798	Depreciation
Book Value	43177385	BookValue

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	1764249	OtherCostOrOtherBasis
Depreciation	1517098	Depreciation
Book Value	247151	BookValue

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	112868727	OtherCostOrOtherBasis
Depreciation	89263277	Depreciation
Book Value	23605450	BookValue

Other Land Buildings OtherLandBuildings

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	-233830	OtherCostOrOtherBasis
Book Value	-233830	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	66861156	TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescription	Book ValueBookValue
Other Receivables	3346612
Intercompany Receivables	44666494

Field	Value	IRS element (for citing)
Total Book Value Other Assets	48013106	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	Professional Liability	Description
Amount	$3,201,955	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	3201955	TotalOfAmounts
Footnote In Part XIII	X	FootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

Field	Value	IRS element (for citing)
Identifier	Part X	Identifier
Return Reference	Part X : FIN48 Footnote	ReturnReference
Explanation	ASC Topic 740, Income Taxes, addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Topic 740, the Health System must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than fifty percent likelihood of being realized upon ultimate settlement. ASC Topic 740 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. As of June 30, 2013 and 2012, the Health System does not have a liability for unrecognized tax benefits.	Explanation

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Charity Care Policy	true	CharityCarePolicy
Written Policy	true	WrittenPolicy
FPG Reference Free Care	true	FPGReferenceFreeCare
Pcent200	X	Pcent200
FPG Reference Discounted Care	true	FPGReferenceDiscountedCare

Discounted Other DiscountedOther

Field	Value	IRS element (for citing)
Other	X	Other
Discounted Other Percentage	600.000000000	DiscountedOtherPercentage

Field	Value	IRS element (for citing)
Free Disc Care Medically Indigent	true	FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care	true	AmountsBudgetedForCharityCare
Expenses Exceeded Budget	true	ExpensesExceededBudget
Unable To Provide Care	false	UnableToProvideCare
Annual Community Benefit Report	true	AnnualCommunityBenefitReport
Report Publically Available	true	ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

Field	Value	IRS element (for citing)
Total Community Benefit Expense	6222978	TotalCommunityBenefitExpense
Net Community Benefit Expense	6222978	NetCommunityBenefitExpense
Percent Of Total Expense	0.02910	PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

Field	Value	IRS element (for citing)
Total Community Benefit Expense	17670267	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6677598	DirectOffsettingRevenue
Net Community Benefit Expense	10992669	NetCommunityBenefitExpense
Percent Of Total Expense	0.05140	PercentOfTotalExpense

Total Charity Care TotalCharityCare

Field	Value	IRS element (for citing)
Total Community Benefit Expense	23893245	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6677598	DirectOffsettingRevenue
Net Community Benefit Expense	17215647	NetCommunityBenefitExpense
Percent Of Total Expense	0.08050	PercentOfTotalExpense

Community Health Services CommunityHealthServices

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	13	NumberOfActivitiesOrPrograms
Persons Served	5522	PersonsServed
Total Community Benefit Expense	467958	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6715	DirectOffsettingRevenue
Net Community Benefit Expense	461243	NetCommunityBenefitExpense
Percent Of Total Expense	0.00220	PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	6	NumberOfActivitiesOrPrograms
Persons Served	1095	PersonsServed
Total Community Benefit Expense	400458	TotalCommunityBenefitExpense
Direct Offsetting Revenue	1500	DirectOffsettingRevenue
Net Community Benefit Expense	398958	NetCommunityBenefitExpense
Percent Of Total Expense	0.00190	PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	19	NumberOfActivitiesOrPrograms
Persons Served	6617	PersonsServed
Total Community Benefit Expense	868416	TotalCommunityBenefitExpense
Direct Offsetting Revenue	8215	DirectOffsettingRevenue
Net Community Benefit Expense	860201	NetCommunityBenefitExpense
Percent Of Total Expense	0.00410	PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

Field	Value	IRS element (for citing)
Number Of Activities Or Programs	19	NumberOfActivitiesOrPrograms
Persons Served	6617	PersonsServed
Total Community Benefit Expense	24761661	TotalCommunityBenefitExpense
Direct Offsetting Revenue	6685813	DirectOffsettingRevenue
Net Community Benefit Expense	18075848	NetCommunityBenefitExpense
Percent Of Total Expense	0.08460	PercentOfTotalExpense

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	true	BadDebtExpenseReported
Bad Debt Expense	$3,566,459	BadDebtExpenseAmount
Amount Attributable To	3239026	AmountAttributableTo
Amount Reimbursed By Medicare	66700715	AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare	79424667	CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall	-12723952	MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

Field	Value	IRS element (for citing)
Cost To Charge Ratio	X	CostToChargeRatio

Field	Value	IRS element (for citing)
Written Debt Collection Policy	true	WrittenDebtCollectionPolicy
Provision For Charity Care	true	ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV (2 entries)

Description Ent Primary ActivityDescriptionEntPrimaryActivity	Organization Profit Or OwnershipOrganizationProfitOrOwnership
ARSC Real Estate
Property Management	0.25000
Algonquin Road Surgery Ctr
Outpatient Surgical Service	0.12750

Field	Value	IRS element (for citing)
Number Of Hospital Facilities	1	NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

Field	Value	IRS element (for citing)
Facility Number	1	FacilityNumber

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	Northern Illinois Medical Ctr	BusinessNameLine1

Address Address

Field	Value	IRS element (for citing)
Address Line1	4201 Medical Center Drive	AddressLine1
City	McHenry	City
State	IL	State
ZIP Code	60050	ZIPCode

Field	Value	IRS element (for citing)
Licensed Hospital	X	LicensedHospital
General Medical And Surgical	X	GeneralMedicalAndSurgical
Critical Access Hospital	X	CriticalAccessHospital
Er24 Hours	X	Er24Hours
Other	Cancer Center	Other

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	Northern Illinois Medical Ctr	BusinessNameLine1

Field	Value	IRS element (for citing)
Hospital Facility Number	1	HospitalFacilityNumber
CHNA Conducted	true	CHNAConducted
Community Definition	X	CommunityDefinition
Community Demographics	X	CommunityDemographics
Existing Resources	X	ExistingResources
How Data Obtained	X	HowDataObtained
Community Health Needs	X	CommunityHealthNeeds
Other Health Issues	X	OtherHealthIssues
Consulting Process	X	ConsultingProcess
Needs Assessment Conducted	10	NeedsAssessmentConducted
Take Into Account	true	TakeIntoAccount
Other Facilities	true	OtherFacilities
CHNA Widely Available	true	CHNAWidelyAvailable
On Request	X	OnRequest
Adopt Implement Strategy	X	AdoptImplementStrategy
Execute Implement Strategy	X	ExecuteImplementStrategy
Develop Community Plan	X	DevelopCommunityPlan
Participate Community Plan	X	ParticipateCommunityPlan
Include Operational Plans	X	IncludeOperationalPlans
Adopt Budget	X	AdoptBudget
Prioritize Health Needs	X	PrioritizeHealthNeeds
Prioritize Services	X	PrioritizeServices
All Needs Addressed	true	AllNeedsAddressed
Organization Incur Excise Tax	false	OrganizationIncurExciseTax
File Form4720 Report Excise Tax	false	FileForm4720ReportExciseTax
Eligibility Criteria Explained	true	EligibilityCriteriaExplained
Uses FPG Free	true	UsesFPGFree
FPG Free Percent	200.0000	FPGFreePercent
Uses FPG Discounted	true	UsesFPGDiscounted
FPG Discount Percent	600.0000	FPGDiscountPercent
Explains Basis	true	ExplainsBasis
Income Level	X	IncomeLevel
Asset Level	X	AssetLevel
Medical Indigency	X	MedicalIndigency
Insurance Status	X	InsuranceStatus
Uninsured Discount	X	UninsuredDiscount
Medicaid Medicare	X	MedicaidMedicare
State Regulation	X	StateRegulation
Other Factors	X	OtherFactors
Explains Application Method	true	ExplainsApplicationMethod
Includes Publicity Measures	true	IncludesPublicityMeasures
Posted On Website	X	PostedOnWebsite
Posted In Emergency Room	X	PostedInEmergencyRoom
Posted In Admission Office	X	PostedInAdmissionOffice
Available On Request	X	AvailableOnRequest
Actions On Nonpayment	true	ActionsOnNonpayment
Collection Activities	false	CollectionActivities
Nondiscrim Emergency Care Policy	true	NondiscrimEmergencyCarePolicy
Used Other Method	X	UsedOtherMethod
Amounts Generally Billed	false	AmountsGenerallyBilled
Gross Charges	false	GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

Field	Value	IRS element (for citing)
Number Of Other Facilities	6	NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1	CityAddress/City	StateAddress/State	ZIP CodeAddress/ZIPCode	Facility TypeFacilityType
NIMC Back to Work Program
200 Congress Parkway	Crystal Lake	IL	60014	Physical Rehabilitation Clinic.
NIMC Rehab & Sports Medicine Clinic
2507 N Richmond Road	McHenry	IL	60050	Physical Rehabilitation Clinic
NIMC Neuro-Rehabilitation Center
500 Coventry Lane	Crystal Lake	IL	60014	Neurotrauma Day Treatment Center
NIMC Rehab & Sports Medicine Clinic
200 Congress Parkway	Crystal Lake	IL	60014	Sports Medicine and Rehabilitation Clinic
Gavers Breast Center
360 N Terra Cotta Road	Crystal Lake	IL	60012	Medical Imaging and Breast Care Center
Crystal Lake Medical Arts Imaging Center
360 Station Drive Suite 150	Crystal Lake	IL	60014	Medical Imaging Center

Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Part VI - Additional Information	Schedule H, Part I, Line 7a-7c dollars are calculated using the Medicare cost to charge ratio. Line 7e-7i dollars are calculated from community benefit reports that are submitted by the Hospital departments for various activities and support groups that benefit the community. Schedule H, Line 7, column f percentages are automatically calculated by the software based on total functional expenses. If bad debt expense were removed from the functional expense total, then the percent of total expense would be 8.95%.
Part V - Explanation of Number of Facility Type	Northern Illinois Medical Center is a 177 bed facility with a Level II nursery and a center for cancer care, Sage Cancer Center. In addition, NIMC operates four off-site physical rehabilitation centers offering therapy services, as noted in Part V. NIMC also operates two sites where medical imaging services are offered, as noted in Part V.
Part VI - States Where Community Benefit Report Filed	IL
Part VI - Affilated Health Care System Roles and Promotion	Northern Illinois Medical Center of McHenry, IL is affliated with Memorial Medical Center of Woodstock, IL. Both Hospitals are acute care facilities serving the greater McHenry County area. Centegra Health System is the parent of both Northern Illinois Medical Center and Memorial Medical Center. Northern Illinois Medical Center is affiliated with Health Bridge Fitness Centers in Crystal Lake, and the Medical Center provides outpatient physical rehabilitation services to the community from a clinic within that location. The Centegra Health System Foundation supports Hospital operations through fundraising activities.Please see schedule R for complete listing of all affiliated organizations.
Part VI - Explanation Of How Organization Furthers Its Exempt Purpose	Please see Schedule O for a detailed description of the Medical Center's program service accomplishments.
Part VI - Community Information	Centegra Health System defines its primary service area as McHenry County, an area of approximately 603 square miles and 308,760 residents. This county is among the fastest growing counties in Illinois with an 18.7% population growth from 2000-2010. The age groups with projected population growth from 2012 to 2017 are the 0-19 with 0.6% and the 65+ age group with 15.3% growth. The county's overall population is projected to increase by 1.4% in the next five years (2012 to 2017). For 2010, the age distribution of the population was as follows: 30% 0-19, 32% 20-44, 28% 45-64, and 10% 65+. McHenry County has relatively high socioeconomic status compared to the rest of Illinois. Median household income for 2011 was $76,909 compared to the IL state median income of $56,576. The 2013 unemployment rate was 9.3% which is lower than the state average of 9.4%. For 2011, the percentage of the county's population holding a high school diploma was 27.4%, while the percentage holding a bachelor's degree was 21.7%. 5.4% of families fell below the poverty level.
Part VI - Patient Education of Eligibility for Assistance	Uninsured patients arriving at our emergency department and/or direct admits are screened at time of service by either an Emergency Department Financial Counselor or the Health Systems In-Patient Financial Counseling Team, Public Aid Representatives, and a Medication Assistance Coordinator to identify eligibility guidelines for federal, state and local government programs, as well as charity care. CHSs Self Pay Process includes a screening which is completed by using hospital form C910050 03-09 prompting an interview offering payment options and eligibility guidelines. It is at this time that a patient becomes aware of the Hospital Uninsured Patient Discount Act, Medicaid, Medication Assistance Programs, Crime Victims, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of time line for completing application processes at time of service in person. Appropriate scripting is followed by CHS Associates. Discounts were established following the 200%, 350% and 600% federal poverty guidelines to assist in determining charity adjustments. Applications were designed by CHS Self Pay Committee in accordance to our Financial Policy (Policy Number 9850-2)identifying qualifications for the medically needy/catastrophic aid. Uninsured patients opting for elective services are contacted by phone prior to their date of service by the CHS Outpatient Financial Counseling Team. CHSs Self Pay Process is followed and includes a screening for federal, state and local government programs as well as charity care. An interview offering payment options and eligibility guidelines using hospital form C910050 03/09 prompts a quick eligibility determination. It is at this time that a patient becomes aware of the Uninsured Patient Discount Act, Medicaid, Medication Assistance Programs, Crime Victims, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of time line for completing application processes prior to their elective services via phone. Appropriate scripting is followed by CHS Associates. Discounts were established following the 200%, 350% and 600% federal poverty guidelines to assist in determining charity adjustments. Applications were designed by CHS Self Pay Committee in accordance to our Financial Policy (Policy Number 9850-2) identifying qualifications for the medically needy/catastrophic aid. Our health systems website offers FAQs and answers as well as encourages patients to contact our Customer Service Team when they are unable to pay for services. Our health systems statements also identify detailed account and billing information encouraging the patient to contact our Customer Service Team and inquire about Financial Assistance options. Documentation is essential in effective communication. Follow up teams will then move forward in a timely manner with the appropriate actions to insure all necessary documents (if applicable) are received for eligibility determinations. CHS advertises a Price Line encouraging patients to inquire about estimated costs for future services. The Price is manned by our outpatient financial counselors from 8:00am 7:00pm. When calls are returned with estimated costs, a conversation ensues to identify a possible financial hardship. Our Self Pay Process is put into effect at this time. Site Registrars will notify the CHS Financial Counseling Team when a financial hardship is identified. Emergency Department Financial Counseling positions have been created to meet the needs of our ED patients. In addition to these new roles, a full time Financial Counselor position was created to meet the special needs of our cancer patients. A Financial Assistance Coordinator reviews all financial applications, gathers needed documents, determines financial assistance and prepares each patient file for leadership approval.
Part VI - Needs Assessment	Centegra Health System is an active participant in the McHenry County Health Departments on-going MAPP (Mobilizing for Action through Planning & Partnerships) process. MAPP priorities include the following:1) Increase Access to Medical, Dental and Mental Health care * Provide increased access to follow up care (medical, dental, mental) for the under/uninsured residents of McHenry County. * Increase access to (medical, dental, mental) prevention, education, and screening programs available for all residents of McHenry County.2) Information & Referral * Centralize and update Information and Referral located on Crisis Services website * Market Crisis Line #/Website (future 2-1-1) to community to increase visibility * 2-1-1 Information and Referral System3) Cardiovascular Care * By 2017, reduce the death rate from cardiovascular disease by 20%Cemtegra Health System identifies community health care priorities and develops activities and strategies to meet the health care needs of at risk populations within its service area. These community benefit programs promote community wellness and disease prevention, enhance community health education, and improve the quality of clinical education.
Part V, Line 20d - Other Billing Determination of Individuals Without Insurance	See Part VI Supplemental Information for billing and collection policies regarding persons eligible for financial assistance.	Number of Hospital Faciltiy - 1
Part V, Line 12h - Other Factors Used in Determing Amounts Charged Patients	All patients are charged the same for services rendered. Patients may qualify for free or discounted care as described in Part VI, Line 3. Eligibility for financial assistance depends on factors such as income level, asset level,& medical indigency.	Number of Hospital Faciltiy - 1
Part V, Line 4 - List Other Hospital Facilities that Jointly Conducted Needs Assessment	Department of Public Health and other area Health Care Facilities	Number of Hospital Faciltiy - 1
Part V, Line 3 - Account Input from Person Who Represent the Community	The Health Systems works with the Department of Public Health and other area Hospitals to conduct the assessment.	Number of Hospital Faciltiy - 1
Part III, Line 9b - Provisions On Collection Practices For Qualified Patients	Centegra provides patients with consistent information on payment expectations and assists them in meeting their financial obligations. A written explanation of the payment requirements categorized by type of payor is given prior to admission/registration or upon admission/registration of each Centegra Health System (CHS) patient.Centegra will bill the patient's insurance carrier. Procedures will be implemented over time and by area to collect as much as possible of the time of service unless payor contracts require billing (i.e., no assignments).1. Admission reservation/outpatient appointment made by physician/patient. Walk-in and Emergency Department patients present for service.2. Perform the patient pre-registration for applicable scheduled registrations.3. Patient verbal consent obtained and annotated except where prohibited by law."On (date) at about (time), (patient or representative) orally authorized (Site Name) to release information concerning the patient's medical care, treatment and diagnosis to employers, insurance companies, government agencies or third-party payors and their agents, for verification of benefits and pre-certification. I (the Pre-Registrar) did not obtain a written consent signed by the patient, due to the patient not being physically present and limited time constraints."This statement would be signed and dated by the Pre-Registrar. Patient refusal to provide oral consent requires patient notification of potential penalties and places the burden on the patient to complete payor requirements.4. Complete insurance verification and initiate pre-certification.5. Estimate the approximate cost of services and advise the responsible party. Explanation of the cost will fluctuate based on services ordered by the physicians.6. Discuss the financial requirements, including payment expectations with the patient/guarantor prior to admission/registration when applicable.7. Interview conducted by Financial Counselor of patients who express difficulty in meeting Centegra's payment requirements.8. Admission/registration of patient is completed. Patient/guarantor signature for the Consent to Release Information obtained.9. Collect the estimated patient share. The deductible and co-payments and any non-covered amounts quoted by the carrier are due from inpatients prior to discharge and where possible, for outpatients prior to or at the time of registration.10. Self-Pay accounts are to be paid in full or screened by the Financial Counselor for potential State or Federal Program, Financial Assistance application or payment plan.11. Policy regarding non-compliance with respect to payment arrangements or plans:Self-Pay: Patients who have not completed arrangements for one of the payment options within 120 days of the billing date will be automatically turned over to a collection agency.Broken Promise/Defaults: Patients with delinquent payments, 15 or more days late, will be turned over to a collection agency.After Insurance: Processing patients who have not made payments or enrolled in one of the payment options for co-insurance and deductible amounts within 120 days of insurance payment will be turned over to a collection agency.
Part III, Line 8 - Explanation Of Shortfall As Community Benefit	The amount of cost that exceeds reimbursement is actual cost to treat patients and is therefore treated as a community benefit.
Part III, Line 4 - Bad Debt Expense	In estimating allowances for doubtful accounts, the Health System analyzes past history, existing trends, and payer sources to determine the reserves needed. Please reference pages 2, 13, and 16-17 of the audited financial statements for notes on the allowances for doubtful accounts.
Part III, Line 3 - Methodology of Estimated Amount & Rationale for Including in Community Benefit	The estimated amount of bad debt expense (at cost) which could be reasonably attributable to patients who would likely qualify for financial assistance under the organization's charity care policy if sufficient information had been available to make a determination of their eligibility was based on the self pay patient accounts which were written off as bad debts. These amounts were then multiplied by the cost to charge ratio. Any payments received during the fiscal year on these accounts were deducted from the cost. The amount of cost that exceeds reimbursement is actual cost to treat patients and is therefore treated as a community benefit.
Part III, Line 2 - Methodology Used To Estimate Bad Debt Expense	The actual gross bad debt write offs of $12,089,690 were multiplied by the cost to charge ratio of .295 to estimate the cost of bad debt.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	X	CompensationCommittee
Independent Consultant	X	IndependentConsultant
Written Employment Contract	X	WrittenEmploymentContract
Compensation Survey	X	CompensationSurvey
Board Or Committee Approval	X	BoardOrCommitteeApproval
Severance Payment	false	SeverancePayment
Supplemental Nonqual Retire Plan	true	SupplementalNonqualRetirePlan
Equity Based Comp Arrangement	false	EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org	false	CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs	false	CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org	false	CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs	false	CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments	false	AnyNonFixedPayments
Initial Contract Exception	false	InitialContractException
Rebuttable Presumption Procedure	false	RebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (23 entries)

TitleTitle	Comp Based On Related OrgsCompBasedOnRelatedOrgs	Bonus Related OrgsBonusRelatedOrgs	Other Compensation Related OrgsOtherCompensationRelatedOrgs	Deferred Comp Related OrgsDeferredCompRelatedOrgs	Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs	Total Compensation Related OrgsTotalCompensationRelatedOrgs	Base Compensation Filing OrgBaseCompensationFilingOrg	Deferred Comp Filing OrgDeferredCompFilingOrg	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg	Total Compensation Filing OrgTotalCompensationFilingOrg	Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs	Bonus Filing OrgBonusFilingOrg
Zbigniew T Lorenc
Vice President	249763	48001	3406	14700	9589	325459
Todd A Meyers
Chief MedPhysicist							173649	10852	21833	206334
Susan M Milford
Sr. V.P.	223295	63642		66549	23170	376656					5506
Susan H Corcoran
Pharmacist							144745	9125	22642	176512
Sheila Senn
Vice President	133314	16824		9492	22762	182392
Robin K Purdy
CMI Officer	271332	28862		14700	16087	330981
Robert M Rosenberger
CFO & SR VP	469516	122154	35636	15893	23505	666704					19889
Rachel L Sebastian
Vice President							243577	17520	23250	321497		37150
Pasquale G Bernardi
Vice President	322584	60820			23129	406533
Neil W Murphy
V.P. & C.N.O.	225156	59634			5394	290184
Michael S Eesley
CEO	822323	451843	3564	335234	11677	1624641					261678
Mattias Carlen
VP Hlth & Welln	124601	6200			25775	156576
Matthew Towler
VP	193313	35778			22461	251552
Kumar Nathan
VP Clinical Eff	213992	10431		13925	17913	256261
John G Geinopolos
Medical Physicist							163584	10404	22715	196703
Jeannine C Nosko
Dir Pt Care Svs							137540	8611	22682	168833
Jason R Sciarro
President/COO	564364	156422	3928	73224	23574	821512					19515
Gail D Rudolph
Vice President	178816			5056	16541	200413
David Tomlinson
SR VP & CIO	276560	55165		14700	23418	369843
Christopher Westerkamp
Vice President	162609	14670		4786	1498	183563
Bernadette S Szczepanski
Vice President	194954	24957		13327	5636	238874
Barbara J Johnson
Sr. V.P.	312899	56261		9966	10762	389888					56261
Aaron T Shepley
SR VP	333458	95430		52000	23450	504338					14724

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (6 entries)

RelationshipRelationship	Amount Of TransactionAmountOfTransaction	Description Of TransactionDescriptionOfTransaction	Sharing Of RevenuesSharingOfRevenues
Tom Carey
Board Member	488932	Electrical Services	false
Rachel Sebastian
Family membe	321497	Employee	false
American Community Bank
Board Director	107217	Investment Services	false
Home State Bank
Board Treasurer	103027	Investment Services	false
American Community Bank
Board Chairperson	107217	Investment Services	false
Home State Bank
Board Member	103027	Investment Services	false

Form990 Schedule L Part V Form990ScheduleLPartV

Field	Value	IRS element (for citing)
Explanation	All business transactions are arms length transactions. See conflict of interst discloures in Schedule O for Form 990, part VI, Line 2.	Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (18 entries)

Return ReferenceReturnReference	ExplanationExplanation	IdentifierIdentifier
Form 990, Part IX, Line 24a	It should be noted that the Related Company expenses in Form 990, Part IX, line 24a are allocated at 65% of total expense of a related company (Centegra Health System, FEIN 36-3196559). The allocation method is reviewed annually. Expense detail is as follows: Salaries $14,387,044; Benefits $2,527,839; Payroll Taxes $1,107,512; Purchased Services/Professional Fees $10,990,128; IT Expenses $3,647,130; Office Expenses $2,544,095; Advertising and Promotional $1,426,301; Other Expenses $2,550,347.
Form 990, Part IV, Line 24	Northern Illinois Medical Center holds a liability on its books for tax-exempt bonds, which is an allocation from its sole corporate member, Centegra Health System. As a result, this question was answered no, and Schedule K will be completed on Centegra Health Systems Form 990.
Form 990, Part III, Line 4 Program Service Accomplishments Cont'd	Northern Illinois Medical Center, in conjunction with Centegra Health System and Memorial Medical Center, works in cooperation with McHenry County College and Health Bridge Fitness Center to provide a complete series of specialized training for those interested in developing their knowledge of emergency basics, or in pursuing a career in the emergency health care field. These programs are used extensively by local fire, EMS, and police departments. Northern Illinois Medical Center offers a variety of classes that can help people save lives. By sponsoring these classes, Northern Illinois Medical Center is helping the community in two ways; first, by building skills and confidence levels of the class participants; and second, by making trained help available for the community in case of emergencies. There are three levels of training available. The First Responder is designed to instruct laymen in the following skills: identifying the emergency situation, stabilizing the victim, and providing basic emergency care until emergency medical personnel arrive. The Emergency Medical Technician - Basic course provides a more in-depth study of the recognition and management of victims of traumatic injuries or medical emergencies, and it includes hospital clinical experience. This course enables the participant to become a State of Illinois licensed EMT-Basic. The Emergency Medical Technician - Paramedic program provides an intensive learning experience in the use of advanced life support procedures for the management of traumatic injuries and medical emergencies prior to arrival at the hospital. This course enables the participant to become a State of Illinois licensed Paramedic. An Emergency Medical Dispatcher Course designed to prepare individuals for employment as dispatchers for a public service agency providing dispatch to law enforcement, fire service, and/or Emergency Medical Service is also offered. Continuing education for licensing renewal is also provided. Northern Illinois Medical Center is a designated resource hospital for 16 rescue squads. The Medical Center also provided International Trauma Life Support training, Advanced Cardiac Life Support training, and Pediatric Advanced Life Support training. Centegra Health System is a learning center (clinical site) for students from a multitude of colleges and universities. Students have completed internships in programs such as nurse practitioner, nursing, nurse aide, physician assistant, social work, speech therapy, phlebotomy, diagnostic medical sonography, medical imaging, medical records, pharmacy, medical physics, surgical technology, professional counselor, substance abuse counselor, and medical assistant. Centegra Health System is also a learning site for 3rd and 4th year medical students from the University of Illinois at Rockford. Northern Illinois Medical Center was the first hospital in the state of Illinois to adopt the E.N.C.A.R.E. (Emergency Nurses Cancel Alcohol Related Emergencies) program which lets nurses tell teenagers exactly what they have learned on the job -- that alcohol causes death, disability, and pain to thousands of teenagers throughout the country every year.
Form 990, Part III, Line 4 - Program Service Accomplishments Cont'd	Northern Illinois Medical Center's Sage Cancer Center, together with the American Cancer Society and Gavers Community Cancer Foundation, sponsor various Cancer Awareness Programs. Each fall, a community cancer symposium is offered in partnership with McHenry County College. National physician experts are invited to speak to area residents. The Center offers colorectal cancer screenings, skin cancer screenings, and reduced fee PSA screenings. Cancer awareness also includes programs on reduction of risk for cancer through good nutrition and healthy lifestyle habits. Northern Illinois Medical Center also sponsors celebrations of cancer survivorship. The Sage Cancer Center participates in McHenry County Tobacco-Free Community Coalition, a community partnership developed to address the hazards of tobacco and develop a county wide smoking cessation campaign. The Sage Cancer Center participates in the McHenry County Breast Cancer Task Force, the Fox Valley Regional Health Initiatives Council of the American Cancer Society. The Cancer Center also provides a resource library for patients to learn more about their conditions through the use of computer research and book loans. Get Checked! is a cancer screening and education program designed to educate all residents about prevention and early detection for breast/colon/prostate/testicular cancers and to motivate all McHenry County residents to have their age appropriate cancer screenings completed. The Cancer Center delivers the message of cancer awareness and the importance of appropriate screenings through a variety of community outreach activities that include appearances at local schools, community groups, church groups, health fairs, business expos, the McHenry County Fair, and the McHenry Township Senior Resource Expo. Northern Illinois Medical Center, in conjunction with Centegra Health System and Memorial Medical Center, offers specialized exercise programs which help participants get moving and stay active for a healthier lifestyle. These include: Arthritis Water Exercise Program; Senior Citizen's Exercise Group; The Get Off Your Rocker Program designed for individuals at least 55 years of age to improve flexibility, strength, and endurance; and the Stroke Exercise Program which is a general physical conditioning exercise program for stroke patients to improve coordination and increase range of motion. Yoga, Tai-Chi, weight management, and a variety of other programs are offered through Health Bridge Fitness Center. The Rehabilitation and Sports Medicine Clinic at Health Bridge Fitness Center provides sports medicine, aquatics, and outpatient physical and occupational therapy programs. The Back to Work Program, an industrial injury prevention and rehabilitation program, provides physical therapy, ergonomic consultation, and back safety programs. The program also uses the aquatic pool located at the Rehabilitation and Sports Medicine Clinic at Health Bridge Fitness Center. Additional education programs are offered to assist community members in taking charge of their own special needs and their changing lifestyles. Programs inform the community about Advance Medical Directives including living wills, durable power of attorney issues, and organ donations. Education programs include Understanding Medicare, Critical Care Class, Healthy Heart Nutrition, Stroke: Are You Doing All You Can?, Food and Feelings, and Weight Management Programs. Integrative programs include mindful eating, understanding the healing potential of food, and journaling. The Medical Center sponsors programs focusing on women's health issues. The Center also provides reduced fee mammograms, programs on osteoporosis, and programs on menopause. Depression and anxiety screenings are also offered. Relaxation Training teaches techniques to bring the body and mind in balance. Improving Your Blood Pressure is a program which promotes understanding of the factors that affect blood pressure, the early warning signs of heart attack, how to better control risk factors.
Form 990, Part III, Line 4 - Program Service Accomplishments cont'd	In addition to the programs described above, Northern Illinois Medical Center, in conjunction with Centegra Health System and Memorial Medical Center, participates in various community projects such as Meals on Wheels, free Flu Vaccination Clinics, National Depression/Anxiety Screening Day, and health fairs/county fairs. The Medical Center offers career shadowing opportunities for area high school students, Flight for Life Helicopter appearances, poison awareness programs, blood drives to support local banks, mammograms, colorectal cancer screenings and lipid profiles. Glaucoma, hearing, and other screenings are offered in order to promote health and awareness in the community. The Referral Line offers toll-free, computerized service to callers who require information or physician referrals. The line is staffed by a trained counselor. Several medical specialties are represented, and physicians are on staff for referrals. The line also gives information regarding physicians' office hours, locations, insurance, and languages spoken. Additionally, counselors give information on Self-help and Support Groups. Centegra S.H.I.P. (Senior Health Insurance Program) provides trained volunteers to answer questions on a weekly basis regarding insurance coverage. Together We Can Immunization Partnership Clinics were instituted at Northern Illinois Medical Center, Memorial Medical Center, and other medical office buildings in Cary, Huntley, and Woodstock, Illinois to provide immunizations for the unvaccinated children of McHenry County. Clinics are held once per month at the medical centers and office buildings providing Hepatitis B, DPt, Hib, OPV, MMR, and Td immunizations. Fees are based upon ability to pay with a maximum charge of $15.00 per immunization. Centegra Health System absorbs 87% of the cost of this program. During fiscal year ending June 30, 2013, 267 persons received 577 vaccines at Centegra Health System sites.
Form 990, Part III, Line 4 - Program Service Accomplishments	Northern Illinois Medical Center, in conjunction with Centegra Health System and Memorial Medical Center, sponsors or hosts many support groups for its patients, as well as the community. Each of the following ongoing support groups is held at the Medical Center or in the community and is free of charge. By supporting these groups, the Medical Center is able to provide one or all of the following three benefits: Staff professionals who act either as group facilitators or guest speakers, free education about the programs available, space offered free of charge. Programs include: Alcoholics' Anonymous, a twelve-step program for individuals recovering from alcohol dependence, Alcoholics' Anonymous, Women's Group, a special group for women, Al-Anon, a twelve-step program group for co dependent individuals, Arthritis Support group, Bariatric Support Group for those individuals who have had weight loss surgery, Better Breathers Club for those with pulmonary disease and their families, Caregiver's Support Group for those who care for someone with a chronic or life-threatening illness, Diabetes Support Group for individuals with diabetes and their families, Families' Anonymous for families with chemically dependent members, Fibromyalgia Support Group for those suffering from Fibromyalgia, Get Help Live Longer, a smoking cessation education and support group, Hat's Off for women with any type of cancer, and Headwinds for survivors of traumatic brain injury and their family members/care givers. This group hosts speakers including medical professionals who specialize in traumatic brain injuries. Northern Illinois Medical Center participates in conjunction with the Pioneer Center. Participants receive information on topics such as dealing with behavioral problems and the financial issues of long-term care. Living with Grief, sponsored by Centegra pastoral care, offers support for adults grieving the loss of a loved one. Make Today Count is a group for anyone with a life-threatening illness as well as their family and friends. The purpose of the program is to help members cope and gain emotional strength. The Group also puts participants in touch with professional resources available to help them. The McHenry County Crisis Line is available for 24 hour mental health information, referral service, and crisis assistance. Multiple Sclerosis (MS) Support Group is under the greater Illinois Chapter of the National Multiple Sclerosis Society. The group is open to persons with MS, their family members and others interested in treatment and management of the disease. Specialists are often invited to speak to the group regarding the symptoms of the disease. NAMI addresses mental illness. Narcotics Anonymous is a twelve-step support program for those recovering from narcotic dependence. Nuts and Bolts is a unique support group for stroke survivors who are 55 years of age or younger. The emphasis of this group is on assisting the families as they adapt to the special lifestyle changes of the young stroke survivor. The group has earned attention from the National Stroke Conference leaders as it is one of the first support groups of its type. Perinatal Grief Support Group is for anyone who has experienced the loss of a newborn or an infant through miscarriage, ectopic pregnancy, or Sudden Infant Death Syndrome (SIDS). St. Peregrine's Cancer Support Group is a non-denominational support group for patients and their families and friends. What's Aphasia? is a group for stroke survivors and family members who have an impairment of their ability to speak or comprehend words. Wingspan is a group that provides the opportunity of open discussions, question and answer sessions, lectures, and social events for people recovering from strokes as well as their families. Y-Me Breast Cancer Support Program is a national program designed to let participants listen to physicians, survivors, social workers, and nurses who have been invited to speak on topics such as handling anger, considered prostheses, and recent concerns about breast implant risks.
Form 990, Part III, Line 1 - Mission	The primary mission of Northern Illinois Medical Center is to provide quality health care services with innovative and responsible use of resources and promote wellness for the greater McHenry County area. Northern Illinois Medical Center's services include, but are not limited to: 177 licensed-bed Comprehensive Medical Center (40,050 patient days in fiscal year ending June 30, 2013), Level Two Trauma Center, 24 hr Emergency Medicine Physicians, On-site Flight for Life Helicopter (417 flights in fiscal year ending June 30, 2013), Portable TDD (Telephone Device for the Deaf) on site, Center for New Life including Level Two Nursery (2,051 newborn patient days in fiscal year ending June 30, 2013), Antenatal Testing Center, Prenatal Classes, Hello Daddy and Dial-A-Dad pagers, Very Important Sibling Classes, Lamaze Classes, Breastfeeding Classes, Intensive and Intermediate Care Units, Sage Cancer Center (17,775 radiation oncology procedures and 2,651 medical oncology visits in fiscal year ending June 30, 2013), Cardiac Surveillance, Cardiac Catherization Suite, Three-level Cardiac Rehabilitation Program (24,359 visits in fiscal year ending June 30, 2013), Heart Failure Clinic, Full-body CT Scanner and Magnetic Resonance Imaging (MRI) (18,364 CT Scans and 4,141 MRI procedures performed in fiscal year ending June 30, 2013), PET/CT scans, Women's Diagnostic Services (In Medical Imaging), Center for Physical Rehabilitation (4,369 patient days in fiscal year ending June 30, 2013), Inpatient Unit, Independence Square, Occupational, Physical and Speech Therapies, Outpatient Therapies, Respiratory Therapy, Home Health Care (30,159 visits in fiscal year ending June 30, 2013), Back to Work Program for Industrial Injury Prevention and Rehabilitation, Neurotrauma Day Treatment Program, Sports Medicine Clinic, Occupational Health, Patient Express! Transportation, Extra Touch Program, Pastoral Care, Social Service, Community Education Programs, Support Programs/Groups, and Nutritional Therapy Services.
Other Changes In Net Assets Or Fund Balances - Other Decreases	LOSS ON DEFEASANCE OF DEBT = -$789406	Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other Increases	INCOME ON '02 BONDS = $78616	Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other Increases	FOUNDATION = $445973	Form 990, Part XI, Line 9
Other Changes In Net Assets Or Fund Balances - Other Decreases	AFFILIATE TRANSFERS = -$11811085	Form 990, Part XI, Line 9
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	All governing documents, policies, and financial statements are available upon request.	Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	The Board of Directors of Centegra Health System, through the Compensation Committee comprised of independent members free of conflict, reviewed executive compensation levels and other features of the compensation plan in accordance with the organization's approved compensation philosophy and strategy: The Committee is comprised of members of the Board of Directors, who are independent of Centegra management, have no personal interest in the compensation arrangements, are not related to, or under the control of any individual whose compensation arrangement is being reviewed and have no material business relationship with Centegra.The Chief Executive Officer's compensation is determined by the Compensation Committee in relation to appropriate comparability data. Compensation for other members of the executive staff are developed by the CEO, reviewed by the Committee, evaluated against market data, and approved by the Committee. The Committee approves all compensation decisions in advance of their implementation and documents its determinations and discussions. Its decisions and deliberations are thoroughly documented and meeting minutes are kept and distributed to the Committee members (for historical reference). The Compensation Committee uses a number of external resources and comparisons, and their review includes total compensation (cash compensation, plus benefits provided by Centegra) in relation to organizational performance and prevailing industry practices of comparably-sized organizations. They have engaged the services of a compensation consulting firm (Sullivan Cotter) specializing in the not-for-profit sector that has worked with Centegra and reports directly to the Compensation Committee.	Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	As stated in Centegra's Bylaws, the Bylaws recognize that both real and apparent conflicts of interest sometimes naturally occur in the course of conducting daily affairs. Conflicts occur because the many persons associated with Centegra should be expected to have and do, in fact, generally have multiple interests and affiliations and various positions of responsibility within the community. The long-range interests of Centegra do not require the termination of all association with persons who may have real or apparent conflicts if a prescribed and effective method can render such conflicts harmless to all concerned. Centegra Health System has a conflict of interest policy that is intended to address such matters. 1. Duty to Disclose: In connection with any actual or possible conflicts of interest, an interested person or other person subject to this policy must disclose the existence and nature of his or her financial interest in writing to the President of Centegra or the Chief Corporate Responsibility Officer or designee, who shall provide such written disclosure to the Governors Affairs Committee of Centegra, which shall consider all conflicts of interest issues and, if appropriate, to the directors and members of committees with board-delegated powers considering the proposed transaction or arrangement. The disclosure must occur, at minimum, annually, with a Conflict of Interest Disclosure Statement being submitted no later than January 31st of each year. Copies of disclosure statements filed by Board members shall be distributed to the Board annually at the February Board meeting.2. Determining Whether a Conflict of Interest Exists: When a conflict of interest is disclosed at meeting of the board or committee thereof, after disclosure of the financial interest, the interested person shall leave the board or committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. The interested person's leaving such meeting shall not affect whether a quorum exists at such meeting.3. Procedures for Addressing the Transaction or Arrangement From Which the Conflict Arose: A. The chairperson of the board or committee shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement.B. After exercising due diligence, the board or committee shall determine whether Centegra can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or entity that would not give rise to a conflict of interest.C. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the board or committee shall determine by a majority vote of the disinterested directors whether the transaction or arrangement is in Centegra's best interest and for its own benefit and whether the transaction is fair and reasonable to Centegra and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination.4. Violations of the Conflicts of Interest Policy: A. If the administration, the board, or a committee has a reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose.B. If, after hearing the response of the member and making such further investigation as may be warranted in the circumstances, the board or committee determines that the member has, in fact, failed to disclose an actual or possible conflict of interest, it shall refer the matter to the Governors Affairs Committee for consideration, which shall subsequently recommend appropriate disciplinary and corrective action to such board or committee.	Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11b: Form 990 Review Process	The Form 990 and related schedules are compiled by CHS staff. The review process for the 990 includes detailed review by an outside auditor, bond counsel, Controller, and Chief Financial Officer, prior to submission to the IRS. The tax return will be made available for the Board to review after submission to the IRS.	Form 990, Part VI, Line 11b
Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder	Centegra Health System is the sole member of NIMC. Centegra Health System has a single class of members.	Form 990, Part VI, Line 6
Form 990, Part VI, Line 3: Description of Delegated Duties to Management Company	Management companies were used for the daily operations and management of the following services for the health system: Sodexho Inc. & Affiliates was used to manage Food & Nutrition, Plant Operations and Maintenance (during the first quarter of FY13 only), and Environmental Services work. Perot (Dell) provided management and support services for the Information Systems area. None of the outsourced managers or directors are executive level staff, and none of them need to be named in Part VII.	Form 990, Part VI, Line 3
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et	Northern Illinois Medical Center, (NIMC), adopted specific conflict of interest policies for its governing and management staff. The policy includes, but is not limited to, when an individual, governor, committee member, officer, agent or employee believes that he or she, or a member of his or her immediate family might have or does have a real or apparent conflict, he or she should in addition to filing the disclosure notice required, abstain from making motions, voting, executing agreements, or taking any other similar direct action on behalf of the Medical Center.During fiscal year 2013, Northern Illinois Medical Center purchased certain goods and/or services from organizations with director affiliation. All transactions were competitively bid and were conducted at arms length. The fees paid were at fair market value. Director Kathy Powell is an employee and Vice President of Home State Bank. Treasurer Patrick Morehead is on the Board of Directors and a 1% owner of Home State Bank. Chairman Charie Zanck is a Director of American Community Bank & Trust. Director Charles Ruth is the Board Chairman of American Community Bank & Trust. Tom Carey is Vice President of Carey Electric. Vice President Rachel Sebastian is the daughter of CEO Michael Eesley.	Form 990, Part VI, Line 2

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (5 entries)

Address Line1AddressForeign/AddressLine1	CityAddressForeign/City	Province Or StateAddressForeign/ProvinceOrState	CountryAddressForeign/Country	Postal CodeAddressForeign/PostalCode	Primary ActivitiesPrimaryActivities	Legal Domicile Foreign CountryLegalDomicileForeignCountry	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Legal Domicile StateLegalDomicileState
Centegra Insurance Services Ltd
PO Box 1051	George Town	Grand Cayman	CJ	KY1-1102	Provide Malpractice Insurance	CJ	Centegra Health System
Centegra Health and Wellness Network
					Contracting and care management organization		Centegra Health System	385 Millennium Drive	Crystal Lake	IL	60012	364740459	DE
Centegra Clinical Laboratories LLC
					Laboratory and Pathology Services		Centegra Health System	385 Millennium Drive	Crystal Lake	IL	60012	364706465	DE
Centegra Health Bridge Fitness Center
					Health & Fitness Center		Health Bridge Corporation	10450 Algonquin Road	Huntley	IL	60142	261277524	DE
Centegra Primary Care LLC
					Physician Practice		Centegra Health System	385 Millennium Drive	Crystal Lake	IL	60012	364085398	DE

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	EINEIN	Primary ActivitiesPrimaryActivities	Legal Domicile StateLegalDomicileState	Exempt Code SectionExemptCodeSection	Public Charity StatusPublicCharityStatus	Business Name Line1DirectControllingEntityName/BusinessNameLine1	Controlled OrgControlledOrg	Direct Controlling Entity NADirectControllingEntityNA
Centegra Hospital Huntley
10400 Haligus Road	Huntley	IL	60142	453449737	Hospital	IL	501(C)3	3	Centegra Health System	false
Oak Creek Lodge
385 Millenium Drive	Crystal Lake	IL	60012	363591359	Hospital Operations	IL	501(c)3	3	Centegra Health System	false
NIMED Corporation
385 Millenium Drive	Crystal Lake	IL	60012	363199111	Property Management Services	IL	501(c)(3)	11c	Centegra Health System	false
Memorial Medical Center
3701 Doty Road	Woodstock	IL	60098	362179764	Hospital Operations	IL	501(c)(3)	3	Centegra Health System	false
Health Bridge Corporation
200 Congress Parkway	Crystal Lake	IL	60014	363196550	Health & Fitness Center	IL	501(c)(3)	11c	Centegra Health System	false
Centegra Health System Foundation
385 Millenium Drive	Crystal Lake	IL	60012	363726310	Charitable Foundation	IL	501(c)(3)	11a	Centegra Health System	false
Centegra Health System
385 Millenium Drive	Crystal Lake	IL	60012	363196559	Support for Hospital Operations	IL	501(c)(3)	11c		false	N/A

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

Field	Value	IRS element (for citing)
Business Name Line1	Centegra Management Services	BusinessNameLine1

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	385 Millenium Drive	AddressLine1
City	Crystal Lake	City
State	IL	State
ZIP Code	60012	ZIPCode

Field	Value	IRS element (for citing)
EIN	364028114	EIN
Primary Activity	Management services for physician practice	PrimaryActivity
Legal Domicile State	IL	LegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	Centegra Health System	BusinessNameLine1

Field	Value	IRS element (for citing)
Type Of Entity	C Corp	TypeOfEntity
Controlled Org	false	ControlledOrg

Field	Value	IRS element (for citing)
Receipt Of Int Ann Rents Royalties	false	ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org	false	GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org	true	GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org	false	LoansOrGuaranteesFromOtherOrg
Dividends Related Organization	false	DividendsRelatedOrganization
Sale Of Assets To Other Org	false	SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org	false	PurchaseOfAssetsFromOtherOrg
Exchange Of Assets	false	ExchangeOfAssets
Rental Of Facilities To Other Orgs	false	RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs	false	RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs	false	PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs	true	PerformOfServicesByOtherOrgs
Sharing Of Facilities	false	SharingOfFacilities
Sharing Of Paid Employees	true	SharingOfPaidEmployees
Reimbursement Paid To Other Org	true	ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org	true	ReimbursementPaidByOtherOrg
Other Transfer To Other Org	true	OtherTransferToOtherOrg
Other Transfer From Other Org	true	OtherTransferFromOtherOrg