NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- NORTHWESTERN MEMORIAL HEALTHCARE (EIN 36-2338884)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201301359349306320
- Schema version
- 2011v1.5
- 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 | 2013-05-15T12:18:08-07:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | 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 | Robert T Green | Name |
| Title | Exec. V.P., C.F.O. | Title |
| Date Signed | 2013-05-15 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | 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 | 257883047 | 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 | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 6 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1599 | TotalNbrEmployees |
| Total Nbr Volunteers | 253 | TotalNbrVolunteers |
| Total Gross UBI | 512683 | TotalGrossUBI |
| Contributions Grants Prior Year | 941197 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 562350 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 229892070 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 231945346 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8959448 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4777410 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2656927 | OtherRevenuePriorYear |
| Other Revenue Current Year | 3966510 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 242449642 | TotalRevenuePriorYear |
| Total Revenue Current Year | 241251616 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 88055422 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 90331592 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 131320692 | OtherExpensePriorYear |
| Other Expenses Current Year | 136642183 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 219376114 | TotalExpensesPriorYear |
| Total Expenses Current Year | 226973775 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 23073528 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 14277841 | RevenuesLessExpensesCY |
| Total Assets BOY | 244559601 | TotalAssetsBOY |
| Total Assets EOY | 244008694 | TotalAssetsEOY |
| Total Liabilities BOY | 97844806 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 101298528 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 146714795 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 142710166 | NetAssetsOrFundBalancesEOY |
| Mission Description | See Schedule O. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 200770725 | Expense |
| Revenue | 233476500 | Revenue |
| Description | See Schedule O. | Description |
| Total Program Service Expense | 200770725 | 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 | 126 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 1599 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Form8886 T Filed | false | Form8886TFiled |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Non Deductible Disclosure | false | NonDeductibleDisclosure |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Quid Pro Quo Disclosure | false | QuidProQuoDisclosure |
| 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 |
| Form720 Filed | false | Form720Filed |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | 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 |
| Policies Reference Chapters | false | PoliciesReferenceChapters |
| 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 | Robert T Green | 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 (35 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|---|
| Robert M Rosenberger | |||||||||
| CFO & SR VP | 2.00 | X | X | 0 | 449550 | 88573 | |||
| Charie Zanck | |||||||||
| Chairman | 2.00 | X | X | 0 | 0 | 0 | |||
| Charles Ruth | |||||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||||
| Kathy Powell | |||||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||||
| Jack Porter | |||||||||
| Director | 0.00 | X | 0 | 0 | 0 | ||||
| Parmod Narang | |||||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||||
| Pat Morehead | |||||||||
| Treasurer | 2.00 | X | X | 0 | 0 | 0 | |||
| Angela McAuley | |||||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||||
| Michael Luecht | |||||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||||
| Luke Johnsos | |||||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||||
| Michael S Eesley | |||||||||
| CEO | 2.00 | X | X | 0 | 1139819 | 404262 | |||
| Mike Curran | |||||||||
| Vice Chairman | 2.00 | X | X | 0 | 0 | 0 | |||
| William Cox | |||||||||
| Secretary | 2.00 | X | X | 0 | 0 | 0 | |||
| Tom Carey | |||||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||||
| Terrence J Bugno | |||||||||
| Director | 1.00 | X | 0 | 0 | 0 | ||||
| Matthew C Towler | |||||||||
| Vice President | 1.00 | X | 0 | 127085 | 22366 | ||||
| David L Tomlinson | |||||||||
| SR VP & CIO | 1.00 | X | 0 | 272730 | 46622 | ||||
| Bernadette S Szczepanski | |||||||||
| Vice President | 1.00 | X | 0 | 186442 | 23778 | ||||
| Aaron T Shepley | |||||||||
| SR VP | 1.00 | X | 0 | 343200 | 66848 | ||||
| Rachel L Sebastian | |||||||||
| Vice President | 1.00 | X | 0 | 195768 | 35926 | ||||
| Jason R Sciarro | |||||||||
| President/COO | 1.00 | X | 0 | 609493 | 86546 | ||||
| Gail D Rudolph | |||||||||
| Vice President | 1.00 | X | 0 | 183760 | 32763 | ||||
| Neil W Murphy | |||||||||
| V.P. & C.N.O. | 1.00 | X | 0 | 129013 | 2638 | ||||
| Susan M Milford | |||||||||
| Sr. V.P. | 1.00 | X | 0 | 264569 | 84755 | ||||
| Zbigniew T Lorenc | |||||||||
| Vice President | 1.00 | X | 0 | 258468 | 35290 | ||||
| Barbara J Johnson | |||||||||
| Sr. V.P. | 1.00 | X | 0 | 330190 | 27447 | ||||
| Michael J Ford | |||||||||
| Vice President | 1.00 | X | 0 | 127829 | 20566 | ||||
| Pasquale G Bernardi | |||||||||
| Vice President | 1.00 | X | 0 | 259719 | 27018 | ||||
| Laura Walczak | |||||||||
| Director, ED | 0.00 | 0 | 88656 | 15193 | X | ||||
| Todd A Meyers | |||||||||
| Chief MedPhysicist | 40.00 | 164068 | 0 | 23456 | X | ||||
| John G Geinopolos | |||||||||
| Medical Physicist | 40.00 | 157950 | 0 | 30296 | X | ||||
| Amy L Moerschbaecher | |||||||||
| Exec Director SCC | 40.00 | 163213 | 0 | 31499 | X | ||||
| Ifeanyi F Onyibor | |||||||||
| RN II ICU | 24.00 | 137862 | 0 | 28197 | X | ||||
| Susan H Corcoran | |||||||||
| Pharmacist | 35.00 | 133930 | 0 | 29473 | X | ||||
| Angela C McAuley | |||||||||
| Senior Vice President | 0.00 | 0 | 45999 | 12198 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 757023 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 5012290 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1175710 | TotalOtherCompensation |
| Number Individuals GT100 K | 38 | NumberIndividualsGT100K |
| Formers Listed | true | 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 |
|---|---|---|---|---|---|
| Sunquest Information Systems | |||||
| PO Box 75214 | Charlotte | NC | 282750214 | Computer Support | 577696 |
| Sodexo Inc & Affiliates | |||||
| 4880 Paysphere Circle | Chicago | IL | 60674 | Management Services | 3399874 |
| Dell Marketing LP | |||||
| PO Box 677654 | Dallas | TX | 752676021 | Computer Support | 1262746 |
| Cardiac Surgery Associates | |||||
| PO Box 153 | Channahon | IL | 60410 | Physician Services | 866688 |
| Aon Risk Service Central Inc | |||||
| 75 Remittance Drive Ste 1926 | Chicago | IL | 606751926 | Insurance Services | 536905 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 21 | NumberOfContractorsGT100K |
| Related Organizations | 529701 | RelatedOrganizations |
| Government Grants | 32649 | GovernmentGrants |
| Total Contributions | 562350 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Routine Patient Services | 622110 | 77382381 | 77382381 |
| IDPA Provider Tax Revenue | 622110 | 5195526 | 5195526 |
| Charity Care/Admin Allowa | 622110 | -19254748 | -19254748 |
| Ancillary Outpatient Serv | 622110 | 141919517 | 141919517 |
| Ancillary Inpatient Servi | 622110 | 26702670 | 26702670 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 231945346 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 10499417 | TotalRevenueColumn |
| Exclusion | $10,499,417 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -2884702 | TotalRevenueColumn |
| Exclusion | -$2,884,702 | 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 | 13743123 | Securities |
| Other | 51003 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 16572625 | Securities |
| Other | 58806 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -2829502 | Securities |
| Other | -7803 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -2837305 | TotalRevenueColumn |
| Exclusion | -$2,837,305 | 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 | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Interco Lab/ER Trauma Rev | 621500 | 1531154 | 1531154 | ||
| Child Day Care Center | 624410 | 851715 | 512683 | $339,032 | |
| Cafeteria Services & Educ | 722210 | 984533 | $984,533 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 599108 | TotalRevenueColumn |
| Exclusion | $599,108 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 3966510 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 241251616 | TotalRevenueColumn |
| Related Or Exempt Function Income | 233476500 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 512683 | UnrelatedBusinessRevenue |
| Exclusion | $6,700,083 | ExclusionAmount |
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 | 0 | Total |
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 | 72987946 | Total |
| Program Services | 64708688 | ProgramServices |
| Management And General | 8279258 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1178903 | Total |
| Program Services | 1038504 | ProgramServices |
| Management And General | 140399 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11160695 | Total |
| Program Services | 9831536 | ProgramServices |
| Management And General | 1329159 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5004048 | Total |
| Program Services | 4408102 | ProgramServices |
| Management And General | 595946 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 903051 | Total |
| Management And General | 903051 | 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 | 31452 | Total |
| Management And General | 31452 | 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 | 9208783 | Total |
| Program Services | 8436527 | ProgramServices |
| Management And General | 772256 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32841 | Total |
| Program Services | 32684 | ProgramServices |
| Management And General | 157 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37546451 | Total |
| Program Services | 36900081 | ProgramServices |
| Management And General | 646370 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15923 | Total |
| Program Services | 12385 | ProgramServices |
| Management And General | 3538 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2497359 | Total |
| Program Services | 1012784 | ProgramServices |
| Management And General | 1484575 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 217828 | Total |
| Program Services | 190225 | ProgramServices |
| Management And General | 27603 | 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 | 85956 | Total |
| Program Services | 59493 | ProgramServices |
| Management And General | 26463 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3619743 | Total |
| Program Services | 3188657 | ProgramServices |
| Management And General | 431086 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10733370 | Total |
| Program Services | 9455102 | ProgramServices |
| Management And General | 1278268 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3408292 | Total |
| Program Services | 3002389 | ProgramServices |
| Management And General | 405903 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral | Program ServicesProgramServices |
|---|---|---|---|
| Extraordinary Loss on GE | 4655772 | 4655772 | |
| IDPA Provider Tax | 4950245 | 4950245 | |
| Bad Debt | 15088895 | 15088895 | |
| Related Company | 38372006 | 4569832 | 33802173 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5274216 | Total |
| Program Services | 4652255 | ProgramServices |
| Management And General | 621962 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 226973775 | Total |
| Program Services | 200770725 | ProgramServices |
| Management And General | 26203050 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55493 | BOY |
| EOY | 136346 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 19845914 | BOY |
| EOY | 19816348 | 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 | 25728617 | BOY |
| EOY | 31241332 | 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 | 3916508 | BOY |
| EOY | 4163547 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1895147 | BOY |
| EOY | 1884424 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 182159942 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 116288114 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72652122 | BOY |
| EOY | 65871828 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83741777 | BOY |
| EOY | 83657820 | 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 | 4303835 | BOY |
| EOY | 3692707 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32420188 | BOY |
| EOY | 33544342 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 244559601 | BOY |
| EOY | 244008694 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 26349508 | BOY |
| EOY | 26238964 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70579993 | BOY |
| EOY | 70781285 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 915305 | BOY |
| EOY | 4278279 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97844806 | BOY |
| EOY | 101298528 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 145453931 | BOY |
| EOY | 141591968 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1260864 | BOY |
| EOY | 1118198 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 146714795 | BOY |
| EOY | 142710166 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 244559601 | BOY |
| EOY | 244008694 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 14277841 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -18282470 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
| Federal Grant Audit Performed | false | FederalGrantAuditPerformed |
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 | $31,452 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 31452 | 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 | 77608204 | OtherCostOrOtherBasis |
| Depreciation | 32907805 | Depreciation |
| Book Value | 44700399 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1764249 | OtherCostOrOtherBasis |
| Depreciation | 1450273 | Depreciation |
| Book Value | 313976 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 99720416 | OtherCostOrOtherBasis |
| Depreciation | 81930036 | Depreciation |
| Book Value | 17790380 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3002073 | OtherCostOrOtherBasis |
| Book Value | 3002073 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 65871828 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Other Receivables | 3829247 |
| Intercompany Receivables | 29567094 |
| Intangible Asset | 148001 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 33544342 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Professional Liability | Description |
| Amount | $4,278,279 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 4278279 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Part X | Part X : FIN48 Footnote | 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. At the date of adoption, and as of June 30, 2012, the Health System does not have a liability for unrecognized tax benefits. The adoption of ASC Topic 740 had no impact on the consolidated financial statements of the Health System. |
| Part XI, Line 8 | Part XI, Line 8: Other Changes in Net Assets or Fund Balances | Increase in Temp Restricted-SCC Expansion $157180 Interest in Foundation (non-capital) $50000 Transfers to Affiliates $ -10816695 Interest in Foundation (non-capital, temp restricted) $ -299843 |
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 | 4933084 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 4933084 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02170 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 19507792 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8724700 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 10783092 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04750 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24440876 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8724700 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15716176 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06920 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 21 | NumberOfActivitiesOrPrograms |
| Persons Served | 5322 | PersonsServed |
| Total Community Benefit Expense | 459244 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9732 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 449512 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00200 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 8 | NumberOfActivitiesOrPrograms |
| Persons Served | 376 | PersonsServed |
| Total Community Benefit Expense | 348708 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 348708 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00150 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 29 | NumberOfActivitiesOrPrograms |
| Persons Served | 5698 | PersonsServed |
| Total Community Benefit Expense | 807952 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 9732 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 798220 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00350 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 29 | NumberOfActivitiesOrPrograms |
| Persons Served | 5698 | PersonsServed |
| Total Community Benefit Expense | 25248828 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 8734432 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 16514396 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07270 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $4,420,753 | BadDebtExpenseAmount |
| Amount Attributable To | 2881352 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 67953231 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 80239879 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -12286648 | 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 | 0 | 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 |
| 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 |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Provided On Admission | X | ProvidedOnAdmission |
| 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 (12 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 7.97%. | |
| 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, Section 1011, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of time lines 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 Out-Patient 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, Section 1011, IBCCP, Cash Pay Fee Schedules, and other hospital discount incentives. Patients are advised of time lines 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 Out-Patient 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 19d - Other Billing Determination of Individuals Without Insurance | Patients without insurance are given a 25% discount off of the standard charge for service. | Number of Hospital Faciltiy - 0 |
| 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 shortfall in Part III, line 7 was calculated using the Medicare cost-to-charge ratio. 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 | 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. |
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 | true | 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 (18 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | 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 | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|
| Zbigniew T Lorenc | ||||||||||
| 234253 | 24215 | 26510 | 8780 | 293758 | ||||||
| Todd A Meyers | ||||||||||
| 164068 | 3136 | 20320 | 187524 | |||||||
| Susan M Milford | ||||||||||
| 237787 | 26762 | 63200 | 21555 | 349324 | 20 | |||||
| Susan H Corcoran | ||||||||||
| 133930 | 8446 | 21027 | 163403 | |||||||
| Robert M Rosenberger | ||||||||||
| 384585 | 58195 | 66687 | 21886 | 538123 | 6770 | |||||
| Rachel L Sebastian | ||||||||||
| 177030 | 18738 | 20229 | 15697 | 231694 | ||||||
| Pasquale G Bernardi | ||||||||||
| 248718 | 11001 | 11102 | 15916 | 286737 | ||||||
| Michael S Eesley | ||||||||||
| 783098 | 352926 | 393378 | 10884 | 1544081 | 3795 | 256440 | ||||
| John G Geinopolos | ||||||||||
| 157950 | 10273 | 20023 | 188246 | |||||||
| Jason R Sciarro | ||||||||||
| 538495 | 68235 | 64549 | 21997 | 696039 | 2763 | |||||
| Ifeanyi F Onyibor | ||||||||||
| 137862 | 8638 | 19559 | 166059 | |||||||
| Gail D Rudolph | ||||||||||
| 166911 | 16829 | 11443 | 21320 | 216523 | 20 | |||||
| David L Tomlinson | ||||||||||
| 248581 | 24149 | 24907 | 21715 | 319352 | ||||||
| Bernadette S Szczepanski | ||||||||||
| 180119 | 6323 | 18708 | 5070 | 210220 | ||||||
| Barbara J Johnson | ||||||||||
| 263209 | 66981 | 16825 | 10622 | 357637 | 35419 | |||||
| Angela C McAuley | ||||||||||
| 45999 | 2809 | 9389 | 58197 | |||||||
| Amy L Moerschbaecher | ||||||||||
| 163213 | 10384 | 21115 | 194712 | |||||||
| Aaron T Shepley | ||||||||||
| 306968 | 36232 | 44996 | 21852 | 410048 | ||||||
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| American Community Bank | |||
| Board Director | 106815 | Investment Services | false |
| Home State Bank | |||
| Board Treasurer | 100000 | Investment Services | false |
| American Community Bank | |||
| Board Chairperson | 106815 | Investment Services | false |
| Home State Bank | |||
| Board Member | 100000 | 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 (16 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part V, Line 1c | Northern Illinois Medical Center did not issue any form W2-Gs. | |
| Form 990, Part V, Lines 7g and 7h | Northern Illinois Medical Center did not have any contributions of this kind. | |
| 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 60% 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 $14,469,403; Benefits $2,593,294; Payroll Taxes $1,025,230; Purchased Services/Professional Fees $10,402,327; IT Expenses $3,097,382; Office Expenses $2,422,730; Advertising and Promotional $1,627,828; Other Expenses $2,733,812. | |
| Form 990, Part IV, Ln 12 and Part XI, Ln 2b | The Hospital was audited on a consolidated basis. The consolidated audit is done with the oversight of the Finance and Audit Committee. | |
| 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 (95 students served by the Health System in the fiscal year ending June 30, 2012), 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, 2011, 910 persons received 2,266 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 (43,302 patient days in fiscal year ending June 30, 2012), Level Two Trauma Center, 24 hr Emergency Medicine Physicians, On-site Flight for Life Helicopter (484 flights in fiscal year ending June 30, 2012), Portable TDD (Telephone Device for the Deaf) on site, Center for New Life including Level Two Nursery (2,131 newborn patient days in fiscal year ending June 30, 2012), 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 (18,186 radiation oncology procedures and 2,570 medical oncology visits in fiscal year ending June 30, 2012), Cardiac Surveillance, Cardiac Catherization Suite, Three-level Cardiac Rehabilitation Program (25,857 visits in fiscal year ending June 30, 2012), Heart Failure Clinic, Full-body CT Scanner and Magnetic Resonance Imaging (MRI) (19,155 CT Scans and 4,312 MRI procedures performed in fiscal year ending June 30, 2012), PET/CT scans, Women's Diagnostic Services (In Medical Imaging), Center for Physical Rehabilitation (4,436 patient days in fiscal year ending June 30, 2012), Inpatient Unit, Independence Square, Occupational, Physical and Speech Therapies, Outpatient Therapies, Respiratory Therapy, Home Health Care (31,768 visits in fiscal year ending June 30, 2012), 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. | |
| 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 11: Form 990 Review Process | The review process for the 990 included review by the Director of Accounting and Chief Financial Officer. The 990 also was sent to an outside auditor for review before submission to the IRS. | Form 990, Part VI, Line 11 |
| Form 990, Part VI, Line 6: Explanation of Classes of Members or Shareholder | 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, and Environmental Services work. Perot (Dell) provided management and support services for the Information Systems area. Professional Business Consultants is used for the management of the Managed Care department. | 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 2012, 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. | Form 990, Part VI, Line 2 |
Schedule R IRS990ScheduleR
Form990 Schedule R Part I Form990ScheduleRPartI (4 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 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 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 Millennium 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 |
| 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 |
| 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 |