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GENESIS HEALTH SYSTEM: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
GENESIS HEALTH SYSTEM (EIN 36-3616314)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-02-28
IRS object ID
201310599349300221
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2013-02-28T13:31:36-06:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN420714325EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCGLADREY LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1201 N HARRISON STREET SUITE 300AddressLine1
CityDAVENPORTCity
StateIAState
ZIP Code528011999ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN363616314EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1GENESIS HEALTH SYSTEMBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlGENENameControl
Phone5634216508Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1801 ILLINI DRIVEAddressLine1
CitySILVISCity
StateILState
ZIP Code61282ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARK G ROGERSName
TitleVICE PRESIDENT, FINANCE/CFOTitle
Phone5634216508Phone
Date Signed2013-02-26DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJOHN J ROMANOName
PTINP00227323PTIN
Phone5638884000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK G ROGERSNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1801 ILLINI DRIVEAddressLine1
CitySILVISCity
StateILState
ZIP Code61282ZIPCode
FieldValueIRS element (for citing)
Gross Receipts93424327GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteGENESISHEALTH.COMWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionGENESIS HEALTH SYSTEM EXISTS TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees950TotalNbrEmployees
Total Nbr Volunteers236TotalNbrVolunteers
Total Gross UBI213355TotalGrossUBI
Net Unrelated Business Txbl Income54942NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year481284ContributionsGrantsPriorYear
Contributions Grants Current Year1714995ContributionsGrantsCurrentYear
Program Service Revenue Prior Year89584278ProgramServiceRevenuePriorYear
Program Service Revenue CY88021750ProgramServiceRevenueCY
Investment Income Prior Year432239InvestmentIncomePriorYear
Investment Income Current Year481458InvestmentIncomeCurrentYear
Other Revenue Prior Year2442666OtherRevenuePriorYear
Other Revenue Current Year2385001OtherRevenueCurrentYear
Total Revenue Prior Year92940467TotalRevenuePriorYear
Total Revenue Current Year92603204TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year358481GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY169854GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year34828113SalariesEtcPriorYear
Salaries Etc Current Year35615517SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year51473355OtherExpensePriorYear
Other Expenses Current Year52439096OtherExpensesCurrentYear
Total Expenses Prior Year86659949TotalExpensesPriorYear
Total Expenses Current Year88224467TotalExpensesCurrentYear
Revenues Less Expenses Prior Year6280518RevenuesLessExpensesPriorYear
Revenues Less Expenses CY4378737RevenuesLessExpensesCY
Total Assets BOY75846041TotalAssetsBOY
Total Assets EOY79704790TotalAssetsEOY
Total Liabilities BOY19154268TotalLiabilitiesBOY
Total Liabilities EOY18733242TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY56691773NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY60971548NetAssetsOrFundBalancesEOY
Mission DescriptionGENESIS HEALTH SYSTEM EXISTS TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense65339697Expense
Grants169854Grants
Revenue83842574Revenue
DescriptionILLINI HOSPITAL-HEALTH CARE DELIVERY AND MANAGEMENT, GENERAL/OTHER: ILLINI HOSPITAL, A NOT-FOR-PROFIT ORGANIZATION, IS LICENSED AS A 149-BED ACUTE CARE HOSPITAL AND PROVIDES RELATED HEALTHCARE INPATIENT, EMERGENCY, AND OUTPATIENT ANCILLARY SERVICES. (15,799 PATIENT DAYS; 108,227 OUTPATIENT VISITS)Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense7146721Expense
Revenue8137834Revenue
DescriptionILLINI HOSPITAL NURSING HOME: HEALTH CARE FOR A 75-BED LICENSED NURSING FACILITY AND REHABILITATIVE AND PERSONAL CARE FOR A 45-BED FACILITY (34,422 PATIENT DAYS) WITH ASSISTED LIVING SERVICES CONSISTING OF 76 APARTMENTS AND 2 GUESTROOMS FOR THE ELDERLY (578 RESIDENT MONTHS).Description
FieldValueIRS element (for citing)
Total Program Service Expense72486418TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity1TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109674NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees950NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MARK G ROGERSBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5634216508TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11227 EAST RUSHOLME STREETAddressLine1
CityDAVENPORTCity
StateIAState
ZIP Code52803ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (30 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
STEVEN C BAHLS
DIRECTOR4.00X000
MARK D BAWDEN
CHAIRMAN4.00X000X
GREGORY J BUSH
TREASURER4.00X000X
CHRISTOPHER J COX
DIRECTOR4.00X000
EDMUND P COYNE JR MD
DIRECTOR4.00X000
DOUGLAS P CROPPER
PRESIDENT/CEO GHS44.00X0600993246461X
THOMAS A GILDEHAUS
DIRECTOR4.00X000
ROGER J HILL
SECRETARY4.00X000X
MARK C KILMER
DIRECTOR4.00X000
JAMES W KOEHLER
DIRECTOR4.00X000
GEORGE J KONTOS JR MD
DIRECTOR40.00X053547128016
CHARLENE E MAASKE
DIRECTOR4.00X000
EDWIN V MOTTO MD
DIRECTOR4.00X000
EDWARD J ROGALSKI PHD
PAST CHAIRMAN10.00X000X
G CHRISTOPHER WAHLIG
VICE CHAIRMAN4.00X000X
C DANA WATERMAN III
DIRECTOR4.00X000
CAROL A WATSON PHD RN CENP FAAN
DIRECTOR4.00X000
DALE D ZUDE
DIRECTOR4.00X000
MARK G ROGERS
V.P. FINANCE/CFO40.000307527114567X
ROBERT W FRIEDEN
V.P. INFORMATION SERVICES40.00032509436395X
FLORENCE L SPYROW
PRESIDENT, GMC ILLINI40.00141233165795103547X
KENNETH R CROKEN
V.P. CORPORATE COMMUNICATI40.00025819463998X
JAMES A LEHMAN MD
V.P. QUALITY40.00034475785558X
JULIE MANAS
PRESIDENT, GMC DAVENPORT40.00037873617946X
JUDITH MONDELLO
V.P. LEGAL AFFAIRS40.00035394850268X
ROBERT C TRAVIS
V.P. STRATEGIC DEVELOPMENT40.000321056115027X
HEIDI S KAHLY-MCMAHON
V.P. HUMAN RESOURCES40.00017957673626X
ROBERT M NELSON MD
V.P. CLINICAL SERVICES40.00024663154548X
JUDITH K PRANGER
V.P. PATIENT SERVICES40.00035204970044X
MIKE L SHARP
V.P. SUPPORT SERVICES40.00022567972307X
FieldValueIRS element (for citing)
Total Reportable Comp From Org141233TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs4595506TotalReportableCompFrmRltdOrgs
Total Other Compensation1132308TotalOtherCompensation
Number Individuals GT100 K26NumberIndividualsGT100K
Formers Listed1FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
EMERGENCY CARE AND HEALTH ORGANIZATION
15443 SUMMIT AVE SUITE 302OAKBROOKEIL60181PHYSICIAN FEES- MED SERVICES2670883
CHG MEDICAL STAFFING INC
PO BOX 972670DALLASTX75397PHYSICIAN FEES- MED SERVICES793665
COGENT HEALTHCARE INC
PO BOX 974451DALLASTX75397PHYSICIAN FEES- MED SERVICES670886
QUEST DIAGNOSTICS
PO BOX 740709ATLANTAGA30374OUTSIDE SERVICES403439
CASSLING
13808 F STREETOMAHANE68137OUTSIDE MAINTENANCE CONTRACTS - FA299469
FieldValueIRS element (for citing)
Number Of Contractors GT100 K16NumberOfContractorsGT100K
Related Organizations27757RelatedOrganizations
Government Grants1687238GovernmentGrants
Total Contributions1714995TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
PROFESSIONAL SERVICES900099164402609164402609
I/P ANCILLARY SERVICES6215002625902826045673213355
NURSING SERVICES9000992398316023983160
RESIDENT REVENUE623000994618994618
PHYSICAL THERAPY9000992622426224

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column-127643889TotalRevenueColumn
Related Or Exempt Function Income-127643889RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue88021750TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column383073TotalRevenueColumn
Exclusion$383,073ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real626359Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real581521Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real44838Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column44838TotalRevenueColumn
Exclusion$44,838ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other191905Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other93520Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other98385Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column98385TotalRevenueColumn
Exclusion$98,385ExclusionAmount
FieldValueIRS element (for citing)
Gross Sales Of Inventory185064GrossSalesOfInventory
Cost Of Goods Sold146082CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column38982TotalRevenueColumn
Exclusion$38,982ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
AMBULANCE62191010491551049155
OTHER SERVICES900099712423712423
NON OPERATING IH, INV900099399974399974

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column139629TotalRevenueColumn
Related Or Exempt Function Income139629RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue2301181TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column92603204TotalRevenueColumn
Related Or Exempt Function Income90109576RelatedOrExemptFunctionIncome
Unrelated Business Revenue213355UnrelatedBusinessRevenue
Exclusion$565,278ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total169854Total
Program Services169854ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total198287Total
Management And General198287ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total28733115Total
Program Services28524547ProgramServices
Management And General208568ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1040935Total
Program Services1033379ProgramServices
Management And General7556ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total3554368Total
Program Services3528283ProgramServices
Management And General26085ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2088812Total
Program Services2073132ProgramServices
Management And General15680ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total5604952Total
Program Services5364407ProgramServices
Management And General240545ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total27105Total
Management And General27105ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1592260Total
Program Services1397284ProgramServices
Management And General194976ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total12543Total
Program Services7301ProgramServices
Management And General5242ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8355784Total
Program Services8278184ProgramServices
Management And General77600ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total3710805Total
Program Services108374ProgramServices
Management And General3602431ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3497124Total
Program Services3376734ProgramServices
Management And General120390ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total338453Total
Program Services331641ProgramServices
Management And General6812ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total47796Total
Program Services46666ProgramServices
Management And General1130ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total245142Total
Program Services245142ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3946293Total
Program Services3946293ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total811147Total
Program Services244047ProgramServices
Management And General567100ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
CORPORATE OVERHEAD ALLO81453348145334
PROVISION FOR BAD DEBT68102546810254
PATIENT CHARGEABLE SUPP54995505499550
MISCELLANEOUS EXPENSE379455422932081501346

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total88224467Total
Program Services72486418ProgramServices
Management And General15738049ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4620BOY
EOY4141EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY18659621BOY
EOY17868586EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15899596BOY
EOY17555234EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY2261478BOY
EOY2258554EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY388788BOY
EOY659801EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis102828049LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec63736352LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY35809581BOY
EOY39091697EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY663832BOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1962113BOY
EOY2070420EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY196412BOY
EOY196357EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY75846041BOY
EOY79704790EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY5297435BOY
EOY6402493EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY8477977BOY
EOY7750000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5378856BOY
EOY4580749EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY19154268BOY
EOY18733242EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY56288451BOY
EOY60668171EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY359030BOY
EOY303377EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY44292BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY56691773BOY
EOY60971548EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY75846041BOY
EOY79704790EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses4378737ReconcilationRevenueExpenses
Reconcilation Other Changes-98962ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members1MailingsMembers
Mailings Members$0MailingsMembersAmount
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations1GrantsOtherOrganizations
Grants Other Organizations$2,000GrantsOtherOrganizationsAmount
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$2,008DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$25,105OtherActivitiesAmount
Total Lobbying Expenditures IIB29113TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPART II-B, LINE 1B, PAID STAFF OR MANAGEMENT: GENESIS HEALTH SYSTEM - ILLINOIS HAD TWO STAFF MEMBERS INVOLVED IN LOBBYING ACTIVITIES ON A PART TIME BASIS. THEIR LOBBYING ACTIVITIES ARE FOCUSED ON SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS AND MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS ON HEALTHCARE RELATED MATTERS. PART II-B, LINE 1D, MAILINGS TO MEMBERS, LEGISLATORS, OR THE PUBLIC: EMPLOYEES OF GENESIS HEALTH SYSTEM - ILLINOIS ARE ENCOURAGED TO PARTICIPATE IN THE ILLINOIS HOSPITAL ASSOCIATION'S "IHA ACTION ALERTS." THE EMPLOYEES PARTICIPATE BY RESPONDING TO E-MAIL ALERTS WHICH ALLOWS THEM TO VOICE THEIR OPINIONS TO THEIR STATE REPRESENTATIVES ON HEALTHCARE RELATED MATTERS (NOT CANDIDATE-SPECIFIC). THERE IS NO DIRECT COST TO GENESIS HEALTH SYSTEM - ILLINOIS REGARDING THIS ACTIVITY. PART II-B, LINE 1F, GRANTS TO OTHER ORGANIZATIONS FOR LOBBYING PURPOSES: GENESIS HEALTH SYSTEM - ILLINOIS CONTRIBUTED TO ONE ORGANIZATION: 1.) QUAD CITIES CHAMBER - ILLINOIS LEGISLATIVE FORUM, 2012, $2,000. PART II-B, LINE 1G, DIRECT CONTACT WITH LEGISLATORS, THEIR STAFFS, GOVERNMENT OFFICIALS, OR A LEGISLATIVE BODY: GENESIS HEALTH SYSTEM - ILLINOIS HAD TWO STAFF MEMBERS INVOLVED IN LOBBYING ACTIVITIES ON A PART TIME BASIS. THEIR LOBBYING ACTIVITIES ARE FOCUSED ON SENDING LETTERS OR PUBLICATIONS TO GOVERNMENT OFFICIALS OR LEGISLATORS AND MEETING WITH OR CALLING GOVERNMENT OFFICIALS OR LEGISLATORS ON HEALTHCARE RELATED MATTERS. THE DIRECT COSTS INCLUDED: SALARIES - $1,957, AND MILEAGE/TRAVEL EXPENSES - $51. PART II-B, LINE 1I, OTHER LOBBYING ACTIVITIES: LOBBYING EXPENDITURES RELATED TO MEMBERSHIP DUES INCLUDED: 27% OF MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION, OR $19,285, AND 25% OF MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION, OR $5,820.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance5519844BeginningOfYearBalance
Contributions2014051Contributions
Investment Earnings Or Losses99448InvestmentEarningsOrLosses
Administrative Expenses100AdministrativeExpenses
End Of Year Balance7633243EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance5040857BeginningOfYearBalance
Contributions16614Contributions
Investment Earnings Or Losses465988InvestmentEarningsOrLosses
Administrative Expenses3616AdministrativeExpenses
End Of Year Balance5519844EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5010740BeginningOfYearBalance
Contributions28352Contributions
Investment Earnings Or Losses297861InvestmentEarningsOrLosses
Grants Or Scholarships296096GrantsOrScholarships
End Of Year Balance5040857EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance5224450BeginningOfYearBalance
Contributions30636Contributions
Investment Earnings Or Losses-243446InvestmentEarningsOrLosses
Grants Or Scholarships900GrantsOrScholarships
End Of Year Balance5010740EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.49980BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.50020PermanentEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs1EndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule R1AreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2355591OtherCostOrOtherBasis
Book Value2355591BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis55054368OtherCostOrOtherBasis
Depreciation30445328Depreciation
Book Value24609040BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis16771OtherCostOrOtherBasis
Depreciation9052Depreciation
Book Value7719BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis41493730OtherCostOrOtherBasis
Depreciation31725462Depreciation
Book Value9768268BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3907589OtherCostOrOtherBasis
Depreciation1556510Depreciation
Book Value2351079BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings39091697TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
DUE TO AFFILIATES$2,339,227
THIRD PARTY PAYOR SETTLEMENTS$1,834,713
ACCRUED INS TRUST LOSSES$406,809
FieldValueIRS element (for citing)
Total Of Amounts4580749TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:GENESIS HEALTH SERVICES FOUNDATION, A RELATED ORGANIZATION, HOLDS THE ENDOWMENT FUNDS. THE INTENDED USE OF THE FOUNDATION'S ENDOWMENT FUNDS ARE AS FOLLOWS: SCHOLARSHIPS FOR EDUCATION IN THE MEDICAL FIELD, CHARITY CARE FOR THE INDIGENT AND VISITING NURSE, HOSPICE HOUSE, DIABETIC CARE, EMPLOYEE ASSISTANCE, AND PEDIATRIC HOSPICE SERVICES.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:GHS IOWA, GHS ILLINOIS, THE GENESIS HEALTH SERVICES FOUNDATION, THE ILLINI HOSPITAL FOUNDATION AND THE GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST ALL FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THESE RETURNS ARE FILED, IT IS HIGHLY CERTAIN THAT SOME POSITIONS TAKEN WOULD BE SUSTAINED UPON EXAMINATION BY THE TAXING AUTHORITIES, WHILE OTHERS ARE SUBJECT TO UNCERTAINTY ABOUT THE MERITS OF THE POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO HEALTH SYSTEMS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF EACH ENTITY, THE NATURE, CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME. UNRELATED BUSINESS TAXABLE INCOME IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF A TAX POSITION IS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS IN THE PERIOD DURING WHICH, BASED ON ALL AVAILABLE EVIDENCE, MANAGEMENT BELIEVES THAT IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED UPON EXAMINATION, INCLUDING THE RESOLUTION OF APPEALS OR LITIGATION PROCESSES, IF ANY. TAX POSITIONS ARE NOT OFFSET OR AGGREGATED WITH OTHER POSITIONS. TAX POSITIONS THAT MEET THE "MORE LIKELY THAN NOT" RECOGNITION THRESHOLD ARE MEASURED AS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS MORE THAN 50% LIKELY TO BE REALIZED ON SETTLEMENT WITH THE APPLICABLE TAXING AUTHORITY. THE PORTION OF THE BENEFITS ASSOCIATED WITH TAX POSITIONS TAKEN THAT EXCEEDS THE AMOUNT MEASURED AS DESCRIBED ABOVE IS REFLECTED AS A LIABILITY FOR UNCERTAIN TAX BENEFITS IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEETS ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. FORMS 990 AND 990T FILED BY GHS IOWA, GHS ILLINOIS, THE GENESIS HEALTH SERVICES FOUNDATION, THE ILLINI HOSPITAL FOUNDATION AND THE GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN & TRUST ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 AND 990T FILED BY GHS IOWA, GHS ILLINOIS, THE GENESIS HEALTH SERVICES FOUNDATION, THE ILLINI HOSPITAL FOUNDATION AND THE GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST ARE NO LONGER SUBJECT TO EXAMINATION FOR THE FISCAL YEARS ENDED JUNE 30, 2008 AND PRIOR. GENVENTURES, INC. IS A TAXABLE ORGANIZATION AND CURRENTLY FILES INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION AND VARIOUS STATE JURISDICTIONS. GENVENTURES, INC. IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS JUNE 30, 2008 AND PRIOR. FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, UNCERTAIN TAX POSITIONS HAVE REDUCED INCOME TAX EXPENSE AND HAVE INCREASED EXCESS OF REVENUE OVER EXPENSES BY NONE AND $45,000, RESPECTIVELY. FOR THE YEARS ENDED JUNE 30, 2012 AND 2011, THERE WAS NO INTEREST EXPENSE ASSOCIATED WITH UNCERTAIN TAX POSITIONS. NO AMOUNT HAS BEEN ACCRUED FOR PENALTIES.

Schedule F IRS990ScheduleF

Accts Actvs Out US Table AcctsActvsOutUSTable

FieldValueIRS element (for citing)
RegionCENTRAL AMERICA AND THE CARIBBEANRegion
Number Of Offices0NumberOfOffices
Number Of Employees0NumberOfEmployees
Type Of Activities ConductedINVESTMENTSINVESTMENTSTypeOfActivitiesConducted
FieldValueIRS element (for citing)
Subtotal Number Of Offices0SubtotalNumberOfOffices
Subtotal Number Of Employees0SubtotalNumberOfEmployees
Cont Number Of Offices0ContNumberOfOffices
Cont Number Of Employees0ContNumberOfEmployees
Total Number Of Offices0TotalNumberOfOffices
Total Number Of Employees0TotalNumberOfEmployees
Subtotal Amount Spent0SubtotalAmountSpent
Cont Amount Spent0ContAmountSpent
Total Amount Spent0TotalAmountSpent
Transfer To Foreign Corp0TransferToForeignCorp
Interest In Foreign Trust0InterestInForeignTrust
Own Foreign Corp0OwnForeignCorp
Passive Foreign Invest Co0PassiveForeignInvestCo
Foreign Partnership0ForeignPartnership
Boycott Countries0BoycottCountries

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent200 DXPcent200D
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense2162729TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense2162729NetCommunityBenefitExpense
Percent Of Total Expense0.02660PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense15301114TotalCommunityBenefitExpense
Direct Offsetting Revenue11957802DirectOffsettingRevenue
Net Community Benefit Expense3343312NetCommunityBenefitExpense
Percent Of Total Expense0.04110PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense17463843TotalCommunityBenefitExpense
Direct Offsetting Revenue11957802DirectOffsettingRevenue
Net Community Benefit Expense5506041NetCommunityBenefitExpense
Percent Of Total Expense0.06770PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense11749TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense11749NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense71743TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense71743NetCommunityBenefitExpense
Percent Of Total Expense0.00090PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense83492TotalCommunityBenefitExpense
Net Community Benefit Expense83492NetCommunityBenefitExpense
Percent Of Total Expense0.00100PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17547335TotalCommunityBenefitExpense
Direct Offsetting Revenue11957802DirectOffsettingRevenue
Net Community Benefit Expense5589533NetCommunityBenefitExpense
Percent Of Total Expense0.06870PercentOfTotalExpense

Health Improvement Advocacy HealthImprovementAdvocacy

FieldValueIRS element (for citing)
Total Community Building Expense109TotalCommunityBuildingExpense
Net Community Building Expense109NetCommunityBuildingExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Workforce Development WorkforceDevelopment

FieldValueIRS element (for citing)
Total Community Building Expense8937TotalCommunityBuildingExpense
Net Community Building Expense8937NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Total

FieldValueIRS element (for citing)
Total Community Building Expense9046TotalCommunityBuildingExpense
Net Community Building Expense9046NetCommunityBuildingExpense
Percent Of Total Expense0.00010PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,452,435BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare24761081AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare25777187CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-1016106MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 LARSON CENTER PARTNERSHIP LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityPROPERTY MANAGEMENTDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.75600OrganizationProfitOrOwnership
Officers Etc Profit Or Ownership0.00000OfficersEtcProfitOrOwnership
Physicans Profit Or Ownership0.22730PhysicansProfitOrOwnership
FieldValueIRS element (for citing)
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1GENESIS MEDICAL CENTER - ILLINIBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1801 ILLINI DRIVEAddressLine1
CitySILVISCity
StateILState
ZIP Code61282ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1GENESIS MEDICAL CENTER - ILLINIBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent200.000000000000FPGDiscountPercent
Explains Basis1ExplainsBasis
Income LevelXIncomeLevel
Asset LevelXAssetLevel
Medical IndigencyXMedicalIndigency
Insurance StatusXInsuranceStatus
Uninsured DiscountXUninsuredDiscount
Medicaid MedicareXMedicaidMedicare
State RegulationXStateRegulation
Explains Application Method1ExplainsApplicationMethod
Includes Publicity Measures1IncludesPublicityMeasures
Posted On WebsiteXPostedOnWebsite
Attached To InvoicesXAttachedToInvoices
Posted In Emergency RoomXPostedInEmergencyRoom
Posted In Admission OfficeXPostedInAdmissionOffice
Provided On AdmissionXProvidedOnAdmission
Available On RequestXAvailableOnRequest
Actions On Nonpayment1ActionsOnNonpayment
Collection Activities0CollectionActivities
Nondiscrim Emergency Care Policy1NondiscrimEmergencyCarePolicy
Lowest Negotiated RatesXLowestNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities6NumberOfOtherFacilities

Other Facilities OtherFacilities (6 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
ILLINI RESTORATIVE CARE
1455 ILLINI DRIVESILVISIL61282L-T INTERMEDIATE, NSG, & SHELTERED CARE
ILLINI LARSON CENTER
855 ILLINI DRIVESILVISIL61284I/P PHARMACY & O/P LAB
CROSSTOWN SQUARE
900 CROSSTOWN SQUARESILVISIL61282INDEPENDENT LIVING FACILITY
ILLINI AMBULANCE SERVICE
730 AVENUE OF THE CITIESEAST MOLINEIL61244AMBULANCE SERVICES
ILLINI - BUILDING #3
1414 10TH STREETSILVISIL61282OUTPATIENT DIAGNOSTIC CLINIC
PHYSICAL THERAPY CLINIC KING PLAZA
3650 AVENUE OF THE CITIESMOLINEIL61265OUTPATIENT PHYSICAL THERAPY CLINIC

Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
PART I, LINE 3C: NOT APPLICABLE
PART I, LINE 6A: NOT APPLICABLE
PART I, LINE 7: GENESIS HEALTH SYSTEM UTILIZED WORKSHEET 2 TO CALCULATE ITS COST-TO-CHARGE RATIO. THE CALCULATED COST-TO-CHARGE RATIO WAS USED TO CALCULATE THE COST OF CHARITY CARE AND UNREIMBURSED MEDICAID. THE COST OF SUBSIDIZED HEALTH SERVICES WAS OBTAINED FROM GENESIS HEALTH SYSTEM'S COST ACCOUNTING SYSTEM (I.E., DECISION SUPPORT SYSTEM) THAT CALCULATES THE PER UNIT REIMBURSEMENT AND COST FOR EACH TYPE OF SERVICE AND SUPPLY THAT THE NON-MEDICARE AND NON-MEDICAID PATIENTS CONSUMED IN THE DEPARTMENTS REPORTED. COSTS OF THE "OTHER BENEFITS" (EXCLUDING SUBSIDIZED HEALTH SERVICES) REPORTED IN 7E -7I WERE COMPILED THROUGHOUT THE YEAR IN THE COMMUNITY BENEFIT DATABASE (I.E., CBISA) THAT GENESIS HEALTH SYSTEM UTILIZES.
PART I, LINE 7G: NO COSTS ASSOCIATED WITH A PHYSICIAN CLINIC WERE REPORTED IN SUBSIDIZED HEALTH SERVICES.
PART I, L7 COL(F): $6,810,255 OF BAD DEBT EXPENSE IS SUBTRACTED FOR PURPOSES OF COMPUTING THE PERCENTAGE IN PART I, LINE 7K, COLUMN F. THE ORGANIZATION'S TOTAL COMMUNITY BENEFIT EXPENSE AS A PERCENTAGE OF TOTAL EXPENSES, LESS BAD DEBT, IS 21.55%, AND THE PERCENTAGE INCREASES TO 53.21% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE.
PART II: COMMUNITY HEALTH IMPROVEMENT ADVOCACY: GENESIS HEALTH SYSTEM LIVES ITS MISSION BY CONTINUALLY ADVOCATING AT LOCAL-LEVEL EVENTS, PROGRAMS AND FUNCTIONS, FOR THE IMPROVEMENT OF COMMUNITY HEALTH AND POLICY CHANGES TO IMPROVE HEALTHCARE PROGRAMS' EFFECTIVENESS. WORKFORCE DEVELOPMENT: GENESIS HEALTH SYSTEM AND UNITED TOWNSHIP HIGH SCHOOL CO-OPERATE A PROGRAM THAT TEACHES LIFE AND JOB SKILLS TO THE MENTALLY DISABLED.
PART III, LINE 4: PATIENT RECEIVABLES DUE DIRECTLY FROM THE PATIENTS ARE CARRIED AT THE ORIGINAL CHARGE FOR THE SERVICE PROVIDED LESS AMOUNTS COVERED BY THIRD-PARTY PAYORS AND LESS AN ESTIMATED ALLOWANCE FOR DOUBTFUL RECEIVABLES BASED ON A REVIEW OF ALL OUTSTANDING AMOUNTS ON A MONTHLY BASIS. RECEIVABLES DUE FROM MEDICAL OFFICE BUILDING TENANTS AND FROM COMMERCIAL LAUNDRY CUSTOMERS ARE CARRIED AT THE ORIGINAL INVOICE AMOUNT LESS AN ESTIMATE MADE FOR DOUBTFUL ACCOUNTS. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS, BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS, AND BY CONSIDERING THE PATIENT'S FINANCIAL HISTORY, CREDIT HISTORY AND CURRENT ECONOMIC CONDITIONS. THE SYSTEM DOES NOT CHARGE INTEREST ON PATIENT RECEIVABLES. RECEIVABLES ARE WRITTEN OFF AS BAD DEBTS WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED.THE RATIONALE AND COSTING METHODOLOGY USED TO CALCULATE BAD DEBT EXPENSE AT COST (LINE 2) CONSISTED OF MULTIPLYING THE TOTAL BAD DEBT EXPENSE PER THE INCOME STATEMENT BY THE RATIO OF PATIENT CARE COST TO CHARGES TO ARRIVE AT ESTIMATED COST OF BAD DEBT. PAYMENTS RECEIVED AFTER AN ACCOUNT HAD BEEN WRITTEN OFF TO BAD DEBT WERE CREDITED TO A BAD DEBT RECOVERY ACCOUNT. DISCOUNTS ON PATIENT ACCOUNTS PROVIDED BY THIRD-PARTY PAYERS WERE WRITTEN OFF TO A CONTRACTUAL ALLOWANCE ACCOUNT. GENESIS HEALTH SYSTEM CONTRACTS WITH AVADYNE HEALTH TO PROCESS AGING PATIENT ACCOUNTS. AVADYNE HEALTH'S COLLECTION PROCESS UTILIZES PUBLICLY AVAILABLE INFORMATION TO ENSURE ALL AGING PATIENT ACCOUNTS RECEIVE FINANCIAL ASSISTANCE IN ACCORDANCE TO GENESIS HEALTH SYSTEMS' POLICY BEFORE BEING DEEMED BAD DEBT. GENESIS HEALTH SYSTEM REPORTED ZERO DOLLARS FOR THE ESTIMATED AMOUNT OF THE ORGANIZATION'S BAD DEBT ATTRIBUTABLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
PART III, LINE 8: THE MEDICARE COST REPORT WAS USED TO DETERMINE THE AMOUNT REPORTED IN PART III, LINES 5, 6, AND 7 FOR THE HOSPITAL. IN ADDITION, GENESIS HEALTH SYSTEM - ILLINOIS CALCULATED ITS MEDICARE SHORTFALL TWO WAYS FOR SUPPLEMENTAL INFORMATIONAL PURPOSES. THESE CALCULATIONS WERE COMPUTED USING THE GROSS PATIENT REVENUE BY PAYOR MIX AND CONVERTED TO COST USING THE COST TO CHARGE RATIO FROM PART I, WORKSHEET 2. THE PAYMENT RATE WAS CALCULATED BY DIVIDING THE MEDICARE PAYMENTS BY MEDICARE CHARGES USING A 12-MONTH ZERO BALANCE REPORT. THE SHORTFALL IS THE DIFFERENCE BETWEEN THE PAYMENTS AND THE COSTS. A. UTILIZING THE PAYOR MIX AND ZERO BALANCE REPORT FOR GENESIS MEDICAL CENTER (GMC) - ILLINI CAMPUS, COMBINED WITH ITS COST TO CHARGE RATIO OF 36.01%, CALCULATED USING WORKSHEET 2, GMC - ILLINI HOSPITAL'S MEDICARE SHORTFALL IS $4,143,126. -SECTION B. MEDICARE - ILLINI HOSPITAL USING COST TO CHARGE RATIO5. TOTAL REVENUE RECEIVED FROM MEDICARE $30,315,052 6. ALLOWABLE COSTS OF CARE $34,458,1787. SURPLUS (SHORTFALL) ($4,143,126)B. UTILIZING THE PAYOR MIX AND ZERO BALANCE REPORT FOR GMC - ILLINI CAMPUS AND GMC - ILLINI NURSING HOME, ALONG WITH EACH BUSINESS UNIT'S RESPECTIVE COST TO CHARGE RATIO OF 36.01% AND 81.27%, CALCULATED USING WORKSHEET 2, THE GHS-ILLINOIS MEDICARE SHORTFALL IS $5,486,795. -SECTION B. MEDICARE - INDIVIDUAL ADDED - ILLINI HOSPITAL & INH5. TOTAL REVENUE RECEIVED FROM MEDICARE $32,912,926 6. ALLOWABLE COSTS OF CARE $38,399,7217. SURPLUS (SHORTFALL) ($5,486,795)NO MEDICARE SHORTFALLS WERE INCLUDED IN COMMUNITY BENEFIT. THE MEDICARE SHORTFALL REPRESENTS THE DIFFERENCE BETWEEN THE TOTAL REVENUE RECEIVED FROM MEDICARE BASED ON MEDICARE REIMBURSEMENT RATES AND THE COSTS INCURRED BY GENESIS HEALTH SYSTEM IN PROVIDING HEALTHCARE SERVICES TO THE ELDERLY. IN 2012, THE PERCENT OF PERSONS 65 YEARS AND OVER IN ROCK ISLAND AND SCOTT COUNTIES WAS 18.6%. IN ACCORDANCE WITH GENESIS HEALTH SYSTEM'S MISSION STATEMENT, "TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED," THE ELDERLY WERE SERVED DESPITE THE MEDICARE LOSS OF $1,016,106. GENESIS HEALTH SYSTEM HAS A CLEAR MISSION TO SERVE ALL THOSE IN NEED AND TO IMPROVE THE HEALTH OF THE COMMUNITY INCLUDING THE ELDERLY. FURTHERMORE, THERE ARE NO FOR-PROFIT HOSPITALS IN THE COMMUNITY, AND THEREFORE GENESIS HEALTH SYSTEM IS ONE OF TWO TAX-EXEMPT HEALTHCARE ORGANIZATIONS IN THE COMMUNITY WHO PROVIDE ACCESS TO HEALTHCARE FOR MEDICARE PATIENTS. ACCORDINGLY, IT IS GENESIS HEALTH SYSTEM'S POSITION FOR THE REASONS STATED ABOVE THAT THE MEDICARE SHORTFALL OF $1,016,106 REPRESENTS A COMMUNITY BENEFIT. PURSUANT TO THE INSTRUCTIONS TO THE FORM 990, SCHEDULE H, THE MEDICARE SHORTFALL IS NOT INCLUDED IN PART I, LINE 7. IF THE MEDICARE SHORTFALL WAS INCLUDED IN PART I, LINE 7, THEN PART I, LINE 7K, COLUMN F WOULD BE 8.11%.
PART III, LINE 9B: EVERY EFFORT IS MADE TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. IF ELIGIBLE, PAYMENT PLANS ARE MADE AVAILABLE BASED ON THEIR RESOURCES AND INCOME. ALL BALANCES OWING AFTER FINANCIAL ASSISTANCE ALLOWANCES HAVE BEEN TAKEN ARE PAYABLE IN MONTHLY PAYMENTS IN ACCORDANCE WITH THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY.
PART VI, LINE 2: GENESIS HEALTH SYSTEM UTILIZES THE COMMUNITY HEALTH ASSESSMENTS CREATED BY THE QUAD CITY HEALTH INITIATIVE (QCHI) AND THE COMMUNITY VITALITY TASK FORCE OF UNITED WAY. QCHI WAS FORMED BY GENESIS HEALTH SYSTEM, WHICH IS HEADQUARTERED IN SCOTT COUNTY, IOWA, AND TRINITY REGIONAL HEALTH SYSTEM, WHICH IS HEADQUARTERED IN ROCK ISLAND COUNTY, ILLINOIS. QCHI IS NOW A COMMUNITY PARTNERSHIP OF OVER 100 ORGANIZATIONS CONSISTING OF 500 ACTIVE INDIVIDUALS PURSUING INITIATIVES TO CREATE A HEALTHIER COMMUNITY, SERVING AS A CATALYST FOR IMPROVING THE HEALTH AND OVERALL QUALITY OF LIFE WITHIN THE QUAD CITIES. A COMMUNITY HEALTH ASSESSMENT WAS CONDUCTED BY PROFESSIONAL RESEARCH CONSULTANTS, INC., IN 2012.
PART VI, LINE 3: INFORMATION ON THE AVAILABILITY OF FINANCIAL ASSISTANCE IS POSTED IN VISIBLE LOCATIONS IN THE ADMISSION DEPARTMENTS OF THE HOSPITALS. IN ADDITION, THE HOSPITAL REGISTRATION STAFF MAKE AVAILABLE INFORMATIVE BROCHURES FOR PATIENTS IN THE EMERGENCY ROOM REGISTRATION AREA EXPLAINING THEIR ELIGIBILITY FOR ASSISTANCE. GENESIS HEALTH SYSTEM PROVIDES PATIENT FINANCIAL COUNSELORS ON EACH HOSPITAL CAMPUS TO DISCUSS OPTIONS WITH THE PATIENTS. SHARED BUSINESS SERVICES PREPARES AND PROVIDES A LETTER TO EACH PATIENT, EXPLAINING THEIR CURRENT BALANCE AND ADVISING THEM OF THEIR OPTIONS. A PHONE NUMBER IS PROVIDED WITH THE LETTER ENCOURAGING THE PATIENT TO CALL IF NEEDED. IN ADDITION, THE GENESIS HEALTH SYSTEM WEBSITE ALSO LISTS THE OPTIONS FOR PAYMENT, AND ON A MONTHLY BASIS A POWER POINT PRESENTATION IS GIVEN TO INCOMING CANCER PATIENTS INFORMING THEM OF THEIR PAYMENT OPTIONS. THE OUTPATIENT PHYSICIAN CLINICS AND THE HOME HEALTH DIVISION MAKE AVAILABLE THEIR FINANCIAL POLICY BROCHURES ALONG WITH DIRECTING PATIENTS TO GOVERNMENT PROGRAMS SUCH AS SCHIP.
PART VI, LINE 4: GENESIS HEALTH SYSTEM'S MISSION IS TO PROVIDE COMPASSIONATE, QUALITY HEALTH SERVICES TO ALL THOSE IN NEED. GENESIS LIVES ITS MISSION EACH AND EVERY DAY BY SERVING A 10-COUNTY REGION OF EASTERN IOWA AND WESTERN ILLINOIS, INCLUDING BOTH URBAN AND RURAL AREAS. THE REGION SERVED BY GENESIS HEALTH SYSTEM HAS A POPULATION OF 379,690. ACCORDING TO THE 2010 CENSUS, WHITES MADE UP 88.4% OF THE POPULATION WITH 8.3% BLACK OR AFRICAN-AMERICAN AND 7.6% HISPANIC OR LATINO ORIGIN.MEDIAN AGE OF THE POPULATION OF THE REGION IS 40.6 YEARS. MORE THAN 30% OF THE POPULATION OF THE REGION IS GREATER THAN 50 YEARS OLD, WHICH WILL CREATE A CONTINUED AND EXPANDED NEED FOR HEALTH CARE SERVICES IN THE NEXT 20 YEARS. THE PERCENT OF PERSONS 65 YEARS AND OVER WAS 18.6% IN ROCK ISLAND AND SCOTT COUNTIES.ACCORDING TO ESTIMATES FROM THE AMERICAN COMMUNITY SURVEY (ACS), 11.9% OF QUAD CITIES AREA RESIDENTS (SCOTT AND ROCK ISLAND COUNTIES) LIVE BELOW THE FEDERAL POVERTY. IN 2012, 2.0% OF QUAD CITIES AREA ADULTS REPORTED THAT THERE WAS A TIME IN THE PAST TWO YEARS WHEN THEY WERE LIVING ON THE STREET, IN A CAR, OR IN A TEMPORARY SHELTER. THE AVERAGE UNEMPLOYMENT RATE IN 2009 WAS 9.2% FOR ROCK ISLAND COUNTY, ILLINOIS AND 6.6% IN SCOTT COUNTY, IOWA.THE PERCENTAGE OF PEOPLE AGES 18-64 WHO DID NOT HAVE ANY HEALTH INSURANCE IN 2012 WAS 9.3% IN ROCK ISLAND COUNTY, ILLINOIS AND 11.4% IN SCOTT COUNTY, IOWA. THE QUAD CITIES AREA PERCENTAGE OF ADULTS WHO CURRENTLY SMOKED IN 2012 WAS 19.4%. THE PERCENTAGE OF ADULTS WHO WERE OBESE IN 2012 WAS 33.4% IN ROCK ISLAND COUNTY, ILLINOIS AND 33.6% IN SCOTT COUNTY, IOWA.
PART VI, LINE 5: GENESIS HEALTH SYSTEM'S BOARD OF DIRECTORS IS A DIVERSE REPRESENTATION OF PERSONS WHO RESIDE IN THE PRIMARY SERVICE AREA THAT GENESIS HEALTH SYSTEM SERVES. GENESIS EXECUTIVES AND EMPLOYEES SERVE ON DOZENS OF VOLUNTEER BOARDS THROUGHOUT THE REGION ON IMPORTANT PROJECTS AND INITIATIVES, SUCH AS NEW LIBRARY CONSTRUCTION, HOMELESS SHELTERS, MENTAL HEALTH, DOWNTOWN REDEVELOPMENT AND EVENTS AND FESTIVALS. GENESIS EMPLOYEES SERVE THE COMMUNITIES WHERE THEY LIVE BY SERVING IN ELECTED OFFICES IN CITY AND COUNTY GOVERNMENT.GENESIS HEALTH SYSTEM EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITIES. GENESIS HEALTH SYSTEM HAS ENDEAVORED TO IMPROVE ACCESS TO HEALTH CARE FOR THE COMMUNITIES IT SERVES BY PARTICIPATING IN APPROPRIATE JOINT VENTURES THAT OFFER NEEDED HEALTH CARE SERVICES TO UNDER-SERVED AREAS. GENESIS HEALTH SYSTEM SCHEDULES DOZENS OF HEALTH SCREENINGS AND IMMUNIZATIONS THROUGHOUT THE YEAR AT A REDUCED COST. THESE INCLUDE SCREENINGS FOR DIABETES, STROKE AND HEART DISEASE AND PUBLIC FLU IMMUNIZATION CLINICS.GENESIS HAS DONATED FUNDING FOR OUTDOOR EXERCISE COURSES CALLED GENESIS HEALTHBEAT IN DAVENPORT, IA., MOLINE, IL., AND DEWITT, IA. GENESIS SPONSORS GENESIS ADVENTURES IN NURSING (GAIN), A CAMP FOR CHILDREN INTERESTED IN HEALTH CARE CAREERS. GENESIS EMPLOYEES SERVE AS MENTORS AND INSTRUCTORS DURING CAMP WEEK.GENESIS EMPLOYEES MAKE MEDICAL MISSION TRIPS EACH YEAR TO AREAS OF NEED ALL OVER THE WORLD. GENESIS EMPLOYEES, WITH THE SUPPORT OF THE HEALTH SYSTEM, HAVE PROVIDED RELIEF TO HAITI AFTER THE EARTHQUAKE AND DURING THE CHOLERA OUTBREAK AND TO TRADITIONALLY IMPOVERISHED COUNTRIES, INCLUDING PERU, ECUADOR, THE DOMINICAN REPUBLIC, HAITI AND TO AFRICAN NATIONS.GENESIS EMPLOYEES SUPPORT COMMUNITY OUTREACH PROGRAMS THROUGH A PROGRAM CALLED "TAKIN IT TO THE STREETS." PROJECTS HAVE INCLUDED PRIMARY SPONSORSHIP OF A HABITAT FOR HUMANITY HOUSE (280 VOLUNTEERS); COLLECTION OF 18,000 ITEMS FOR DOMESTIC VIOLENCE SHELTERS AND HUMILITY OF MARY HOMELESS SHELTER; X-STREAM CLEANUP (85 VOLUNTEERS), A CLEANUP PROJECT OF RIVERS AND STREAMS. EMPLOYEES HAVE USED THEIR COLLECTIVE IMPACT TO SECURE DONATIONS FOR FOOD PANTRIES. GENESIS HAS REDUCED ITS ENVIRONMENTAL FOOTPRINT ON THE COMMUNITIES IT SERVES BY IMPLEMENTING BULK WASTE RECYCLING, POLYSTYRENE RECYCLING, REDUCING SHARPS DISPOSAL, AND IMPLEMENTING WATER RUNOFF MEASURES. IN 2012, GENESIS WILL BEGIN BUILDING A MEDICAL OFFICE PARK IN MOLINE, IL ON LAND THAT WAS REMEDIATED BY GENESIS FROM A LANDFILL SITE. GREEN FEATURES WILL BE INTEGRATED INTO THE SITE AND THE DESIGN OF THE BUILDING.GENESIS SPONSORS AND HOSTS A VERY POPULAR ANNUAL BOY SCOUT MERIT BADGE DAY TO ASSIST SCOUTS IN WORKING TOWARD FIRST AID AND MEDICINE MERIT BADGES. PROFESSIONAL HEALTH CARE STAFF VOLUNTEER TO INSTRUCT THE SCOUTS FOR THE DAY.GENESIS MAINTAINS AN ACTIVE EFFORT TO ADVOCATE FOR ACCESS TO HEALTH CARE IN IOWA AND ILLINOIS STATE GOVERNMENT AND IN WASHINGTON D.C. GENESIS EMPLOYEES PARTICIPATE IN A VOTER VOICE INITIATIVE TO ALSO ADVOCATE ON IMPORTANT HEALTH ISSUES WITH CITY, COUNTY, STATE AND NATIONAL ELECTED OFFICIALS. SURPLUS FUNDS RESULTING FROM EFFICIENT OPERATIONS AND COST-CONTAINMENT MEASURES ARE RE-INVESTED IN THE HEALTHCARE OPERATIONS OF GENESIS HEALTH SYSTEM TO IMPROVE THE HEALTHCARE SERVICES THAT GENESIS PROVIDES. ADVANCES IN MEDICAL EQUIPMENT AND TECHNOLOGY, STAFF EDUCATION, AND NEW MEDICAL SERVICES ARE EXAMPLES OF OPERATIONAL INVESTMENTS THAT ULTIMATELY IMPROVE THE HEALTH OF THE COMMUNITIES THAT GENESIS SERVES.
PART VI, LINE 6: GENESIS HEALTH SYSTEM (TAX ID #42-1418847), AN IOWA NONPROFIT CORPORATION, AND GENESIS HEALTH SYSTEM (TAX ID #36-3616314), AN ILLINOIS NOT-FOR-PROFIT CORPORATION, HAVE IDENTICAL GOVERNING BOARDS, MANAGEMENT AND BYLAWS AND CAN ACT JOINTLY.GENESIS HEALTH SYSTEM (TAX ID #42-1418847) IS ALSO THE SOLE MEMBER OF GENESIS HEALTH SERVICES FOUNDATION AND GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST, THE SOLE STOCKHOLDER OF GENVENTURES, INC., A MEMBER OF MISERICORDIA ASSURANCE COMPANY, LTD. AND A PARTNER IN GENGASTRO, LLC. GENESIS HEALTH SYSTEM (TAX ID #36-3616314) IS A PARTNER IN THE LARSON CENTER PARTNERSHIP.GENESIS HEALTH SYSTEM (TAX ID #42-1418847) OPERATES THE FOLLOWING BUSINESS UNITS TO PROMOTE THE HEALTH OF THE COMMUNITIES IT SERVES:GENESIS HEALTH SYSTEM PROVIDES ADMINISTRATIVE, MANAGEMENT, INFORMATION TECHNOLOGY AND OTHER SUPPORT SERVICES TO ITS AFFILIATES. GENESIS CLINICAL SERVICES: GHS OWNS AND OPERATES PHYSICIAN MEDICAL PRACTICES, CONVENIENT CARE PRACTICES, OPERATES AN OCCUPATIONAL MEDICINE CLINIC AND PROVIDES BEHAVIORAL HEALTH SERVICES TO THE RESIDENTS OF EASTERN IOWA AND WESTERN ILLINOIS. GENESIS MEDICAL CENTER - DAVENPORT (GMC - DAVENPORT) IS LICENSED AS A 502-BED ACUTE CARE HOSPITAL WHICH PROVIDES SERVICES FROM TWO HOSPITAL FACILITIES LOCATED IN DAVENPORT, IOWA. GENESIS FAMILY MEDICAL CENTER (GFMC) IS A FAMILY PRACTICE RESIDENCY TRAINING PROGRAM THAT OPERATES CLINICS IN DAVENPORT AND BLUE GRASS, IOWA TO PROVIDE A CLINICAL SETTING FOR THE RESIDENTS TO TREAT PATIENTS. GENESIS MEDICAL CENTER - DEWITT (GMC - DEWITT) IS CERTIFIED AS A CRITICAL ACCESS HOSPITAL, WHICH HAS 13-ACUTE CARE AND SWING BEDS, AND HAS A 77-BED LONG-TERM CARE FACILITY, WHICH PROVIDES SERVICES FROM ITS FACILITY IN DEWITT, IOWA. GENESIS ILLINOIS PROPERTIES (GIP) OWNS LAND LOCATED IN MOLINE, ILLINOIS. DURING THE YEAR ENDED JUNE 30, 2012, GIP SOLD ITS LAND TO GENESIS MEDICAL CENTER - ILLINI AND GIP WAS DISCONTINUED AS A BUSINESS UNIT. GENESIS VISITING NURSE ASSOCIATION AND HOSPICE (VNA) PROVIDES HOME HEALTH CARE, COMMUNITY NURSING SERVICES AND HOSPICE SERVICES TO PATIENTS IN EASTERN IOWA AND WESTERN ILLINOIS. GENESIS MEDICAL CENTER - ILLINI (GMC - ILLINI) IS LICENSED AS A 149-BED ACUTE CARE HOSPITAL WHICH PROVIDES SERVICES FROM ITS FACILITY IN SILVIS, ILLINOIS.ILLINI HOSPITAL NURSING HOME (INH) OPERATES ILLINI RESTORATIVE CARE CENTER AND CROSSTOWN SQUARE. ILLINI RESTORATIVE CARE CENTER IS A 120-BED LICENSED NURSING FACILITY, CONSISTING OF 75 SKILLED CARE BEDS AND 45 SHELTERED CARE BEDS. TWENTY-TWO OF THE SKILLED CARE BEDS ARE DESIGNATED AS HOSPITAL-BASED MEDICARE CERTIFIED BEDS. THE SHELTERED CARE UNIT PROVIDES REHABILITATIVE AND PERSONAL CARE IN A FAMILY-ORIENTED SETTING. CROSSTOWN SQUARE IS AN INDEPENDENT LIVING FACILITY CONTAINING 76 RENTABLE APARTMENTS AND TWO GUEST ROOMS THAT OFFERS SERVICES DESIGNED TO MEET THE NEEDS OF SENIOR ADULTS. GHS IOWA AND GHS ILLINOIS HAVE A CONTROLLING OWNERSHIP INTEREST OR MEMBERSHIP IN THE FOLLOWING ORGANIZATIONS: GENESIS HEALTH SERVICES FOUNDATION (GENESIS FOUNDATION) IS AN ORGANIZATION WHOSE MISSION IS TO DEVELOP, MANAGE AND GRANT CHARITABLE SUPPORT TO MEET THE HEALTH-RELATED NEEDS OF THE COMMUNITIES SERVED BY GENESIS HEALTH SYSTEM. THE GENESIS FOUNDATION IS REFERRED TO AS THE FOUNDATION. ILLINI HOSPITAL FOUNDATION (ILLINI FOUNDATION) SUPPORTS GMC - ILLINI BY PROVIDING FINANCIAL AND FUNDRAISING ASSISTANCE. THE MISSION OF THE ILLINI FOUNDATION IS TO ASSIST GMC - ILLINI IN PROVIDING QUALITY, COMPASSIONATE CARE FOR ALL THOSE IN NEED BY RAISING, MANAGING AND GRANTING CHARITABLE FUNDS. DURING THE YEAR ENDED JUNE 30, 2012, ILLINI FOUNDATION MERGED WITH GENESIS FOUNDATION AND ILLINI FOUNDATION WAS DISSOLVED. THE LARSON CENTER PARTNERSHIP (LCP) IS A FOR-PROFIT REAL ESTATE PARTNERSHIP WHICH OWNS A MEDICAL OFFICE BUILDING ADJACENT TO GMC - ILLINI AND LEASES SPACE FOR CLINICS, LABORATORY, PHARMACY AND OFFICES TO GMC - ILLINI AND OTHER THIRD-PARTY ORGANIZATIONS. GHS ILLINOIS IS A GENERAL PARTNER AND OWNS APPROXIMATELY 75.6% OF LCP.GENVENTURES, INC. (GENVENTURES) IS A WHOLLY-OWNED FOR-PROFIT CORPORATION WHICH OPERATES THE FOLLOWING DIVISIONS, PRIMARILY IN THE QUAD CITIES:GENESIS AT HOME, CONTINUING CARE SELLS AND LEASES HOME MEDICAL EQUIPMENT; PROVIDES INTRAVENOUS THERAPY SERVICES, INCLUDING SALES OF RELATED SOLUTIONS AND SUPPLIES TO PATIENTS; AND PROVIDES RETAIL PHARMACEUTICAL AND OVER-THE-COUNTER PRODUCTS TO PATIENTS AND EMPLOYEES OF THE SYSTEM.GENPROPERTIES OWNS, LEASES AND/OR MANAGES OFFICE SPACE IN 14 MEDICAL OFFICE BUILDINGS LOCATED IN DAVENPORT, ELDRIDGE, LECLAIRE, MUSCATINE AND BETTENDORF, IOWA.CRESCENT LAUNDRY PROVIDES COMMERCIAL LAUNDRY SERVICES TO HEALTH CARE FACILITIES IN EASTERN IOWA AND IN NORTH-CENTRAL ILLINOIS.GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN AND TRUST (WORKERS' COMPENSATION TRUST) PROVIDES A FUND WHICH CAN BE USED TO PAY WORKERS' COMPENSATION CLAIMS AND COSTS FOR THE BENEFIT OF GENESIS HEALTH SYSTEM.MISERICORDIA ASSURANCE COMPANY, LTD. (MISERICORDIA) IS A WHOLLY-OWNED CAYMAN BASED CAPTIVE INSURANCE COMPANY WHICH UNDERWRITES THE GENERAL AND PROFESSIONAL LIABILITY RISKS OF GENESIS HEALTH SYSTEM AND AFFILIATES.GENGASTRO, LLC (D/B/A THE CENTER FOR DIGESTIVE HEALTH) IS A LIMITED LIABILITY COMPANY, WHICH WAS FORMED IN 2003, A SINGLE-SPECIALTY GASTROENTEROLOGY AMBULATORY SURGERY CENTER LOCATED IN BETTENDORF, IOWA. IN DECEMBER 2010, GENESIS HEALTH SYSTEM ACQUIRED AN ADDITIONAL 16.67% INTEREST IN GENGASTRO AND MAINTAINED A 66.67% OWNERSHIP INTEREST AS OF JUNE 30, 2011. UPON OBTAINING A CONTROLLING INTEREST, THE SYSTEM CONSOLIDATED THE ACCOUNTS OF GENGASTRO, LLC IN ITS CONSOLIDATED FINANCIAL STATEMENTS IN JANUARY 2011. DURING THE YEAR ENDED JUNE 30, 2012, GENESIS HEALTH SYSTEM ACQUIRED AN ADDITIONAL 8.33% INTEREST IN GENGASTRO, LLC FROM NONCONTROLLING INTERESTS AND MAINTAINS A 75% OWNERSHIP INTEREST AS OF JUNE 30, 2012.DAVENPORT SRS LEASING, LLC (SRS) IS A LIMITED LIABILITY COMPANY, WHICH WAS FORMED IN 2008, WHICH LEASES MEDICAL EQUIPMENT. GENESIS HEALTH SYSTEM MAINTAINED A 93.75% OWNERSHIP INTEREST AS OF JUNE 30, 2011. DURING THE YEAR ENDED JUNE 30, 2012, GMC - DAVENPORT ACQUIRED THE REMAINING INTEREST OF SRS, TO OBTAIN 100% OWNERSHIP. UPON OBTAINING 100% OWNERSHIP, THE ASSETS, LIABILITIES AND OPERATIONS OF SRS WERE TRANSFERRED TO GMC - DAVENPORT AND SRS WAS DISSOLVED.GENESIS ACCOUNTABLE CARE ORGANIZATION, LLC (GENESIS ACO): THE GENESIS ACO IS AN IOWA LIMITED LIABILITY COMPANY FORMED IN DECEMBER 2011. ITS PURPOSE IS TO ENGAGE IN ANY LAWFUL BUSINESS AND ANY BUSINESS RELATED TO CREATION AND ORGANIZATION OF A "PHYSICIAN-DRIVEN" NETWORK TO ACT AS, AND/OR PARTICIPATE IN, AN ACCOUNTABLE CARE ORGANIZATION WITHIN THE MEANING OF THE FEDERAL PATIENT PROTECTION AND AFFORDABLE CARE ACT. THE COMPANY IS ALSO ORGANIZED TO DEVELOP A CLINICALLY INTEGRATED NETWORK OF PROVIDERS INCLUDING PHYSICIANS, HEALTH PROFESSIONALS, HOSPITALS AND ANCILLARY PROVIDERS WORKING TOGETHER TO PROMOTE HIGH QUALITY, COORDINATED AND EFFICIENT CARE TO PATIENTS INCLUDING MEMBERS OF VARIOUS MANAGED CARE PAYORS AND THE COMMUNITY AT LARGE. THE GENESIS ACO HAD NO FINANCIAL ACTIVITY DURING THE YEAR ENDED JUNE 30, 2012.
IL,IAREPORTS FILED WITH STATESPART VI, LINE 7

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrant
GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN & TRUST
1227 EAST RUSHOLME STREETDAVENPORTIA52803391905171501(C)(3)155549CLAIM PAYMENTS
GENESIS HEALTH SYSTEM - IOWA
1227 EAST RUSHOLME STREETDAVENPORTIA52803421418847501(C)(3)7860DEDUCTIONS BY MEDICAL STAFF, DIRECTED TOWARDS MEDICAL EDUCATION PURPOSES AND THE PERLMUTTER LIBRARY AT THE GMC, ILLINOIS CAMPUS.
GENESIS HEALTH SERVICES FOUNDATION
1227 EAST RUSHOLME STREETDAVENPORTIA52803421421670501(C)(3)5100UNRESTRICTED DONATIONS BY THE MEDICAL STAFF TO SUPPORT THE MISSION OF THE GENESIS HEALTH SERVICES FOUNDATION.
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants3TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: THE GENESIS HEALTH SYSTEM - ILLINOIS STAFF REQUIRES RECEIPTS AND OTHER DOCUMENTATION PRIOR TO RELEASING FUNDS FOR PROJECTS AND SERVICES WITHIN THE SCOPE OF THE ORGANIZATION'S MISSION. PROPER AUTHORIZATION OF GRANT REQUESTS IS ALSO REQUIRED. STAFF FOLLOWS THE ORGANIZATION'S FUNDING ADMINISTRATIVE POLICY TO ENSURE THAT GRANTS ARE BEING APPROVED AND UTILIZED CORRECTLY.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DOUGLAS P CROPPER
0560169000408240222056024405084745400
GEORGE J KONTOS JR MD
04946990004077209800018216056348700
MARK G ROGERS
0254279000532480101521013046042209400
ROBERT W FRIEDEN
023021900094875015894020501036148900
FLORENCE L SPYROW
13014615278000110871301546588546901044122518886522171000
KENNETH R CROKEN
019720000060994045123018875032219200
JAMES A LEHMAN MD
025425300090504071404014154043031500
JULIE MANAS
019005300018868307157010789039668200
JUDITH MONDELLO
021344800014050004156508703040421600
ROBERT C TRAVIS
0215755000105301098911016116043608300
HEIDI S KAHLY-MCMAHON
016196000017616055206018420025320200
ROBERT M NELSON MD
017877500067856038686015862030117900
JUDITH K PRANGER
01835850001684640576890123550422093089919
MIKE L SHARP
0143246000824330573900149170297986039942

Form990 Schedule J Part III Form990ScheduleJPartIII (3 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
PART I, LINE 1AGENESIS HEALTH SYSTEM PROVIDES THE FOLLOWING TO INDIVIDUALS REPORTED IN PART VII, SECTION A, LINE 1A: TRAVEL FOR COMPANIONS: THIS BENEFIT IS OFFERED TO ALL EMPLOYEES. THE ORGANIZATION REQUIRES REIMBURSEMENT OF THESE EXPENSES DIRECTLY TO THE ORGANIZATION. GROSS-UP PAYMENTS: THIS BENEFIT IS OFFERED TO QUALIFYING EXECUTIVES WHO HAD CONTRIBUTIONS MADE ON THEIR BEHALF IN THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. CONTRIBUTIONS TO THE PLAN ARE INCLUDED WITH REPORTABLE COMPENSATION FOR INDIVIDUALS WITH VESTED CONTRIBUTIONS.
PART I, LINE 4BTHE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN IN 2011 SPONSORED BY GENESIS HEALTH SYSTEM - IOWA, A RELATED ORGANIZATION: ROBERT C. TRAVIS - $64,692, AND JAMES A. LEHMAN, M.D. - $50,324. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY GENESIS HEALTH SYSTEM - IOWA ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2011 AND THE GROSS-UP PAYMENT TO COVER TAX. THIS INFORMATION IS INCLUDED IN REPORTABLE COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. THE FOLLOWING INDIVIDUALS PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT SAVING BENEFIT PLAN IN 2011 SPONSORED BY GENESIS HEALTH SYSTEM - IOWA, A RELATED ORGANIZATION: KENNETH R. CROKEN - $28,908, ROBERT W. FRIEDEN - $80,498, JUDITH MONDELLO - $100,291, ROBERT M. NELSON, M.D. - $26,086, JUDITH K. PRANGER - $142,899, MIKE L. SHARP - $60,684. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY GENESIS HEALTH SYSTEM - IOWA ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2011. THIS INFORMATION IS INCLUDED IN REPORTABLE COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J, PART II. THE FOLLOWING INDIVIDUALS ALSO PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT SAVINGS BENEFIT PLAN IN 2011 SPONSORED BY GENESIS HEALTH SYSTEM - IOWA: KENNETH R. CROKEN - $28,908, DOUGLAS P. CROPPER - $212,256, HEIDI S. KAHLY-MCMAHON - $44,290, JUDITH MONDELLO - $31,765, ROBERT M. NELSON, M.D. - $26,086, MARK G. ROGERS - $88,100, MIKE L. SHARP - $19,093, AND FLORENCE L. SPYROW - $91,478. THE DOLLAR AMOUNT REPRESENTS THE CURRENT YEAR CONTRIBUTION MADE BY GENESIS HEALTH SYSTEM - IOWA ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2011. THIS INFORMATION IS INCLUDED IN DEFERRED COMPENSATION ON THE FORM 990, PART VII AND SCHEDULE J PART II.
PART IIIPART I, LINE 3: GENESIS HEALTH SYSTEM - ILLINOIS RELIES ON GENESIS HEALTH SYSTEM - IOWA TO DETERMINE THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS, OFFICERS, DIRECTORS, AND KEY EMPLOYEES. GENESIS HEALTH SYSTEM - IOWA UTILIZES A COMPENSATION COMMITTEE, AN INDEPENDENT COMPENSATION CONSULTANT, A WRITTEN EMPLOYMENT CONTRACT, A COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE COMPENSATION COMMITTEE TO DETERMINE SUCH COMPENSATION. PART II, COLUMN F: THE FOLLOWING INDIVIDUAL ALSO PARTICIPATED IN A SUPPLEMENTAL EXECUTIVE RETIREMENT SAVINGS BENEFIT PLAN IN 2009, 2010, AND 2011 SPONSORED BY GENESIS HEALTH SYSTEM - IOWA, A RELATED ENTITY: JUDITH K. PRANGER - $89,919 AND MIKE L. SHARP - $39,942. THE DOLLAR AMOUNT REPRESENTS PRIOR YEAR CONTRIBUTIONS MADE BY GENESIS HEALTH SYSTEM - IOWA ON BEHALF OF THE INDIVIDUALS TO THE PLAN IN 2009 AND 2010. THIS INFORMATION WAS INCLUDED IN DEFERRED COMPENSATION ON THE PRIOR YEARS' FORM 990, PART VII AND SCHEDULE J, PART II. THESE INDIVIDUALS REACHED A SPECIFIED LEVEL OF VESTING IN 2011, SO THE DOLLAR AMOUNT IS NOW INCLUDED IN REPORTABLE COMPENSATION ON THE CURRENT YEAR FORM 990, PART VII AND SCHEDULE J, PART II. THE DOLLAR AMOUNT IS ALSO LISTED AS COMPENSATION REPORTED IN A PRIOR FORM 990 ON THE CURRENT YEAR FORM 990, SCHEDULE J, PART II.SUPPLEMENTAL INFORMATION

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (5 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
WELLMARK HEALTH PLAN OF IOWA INC
SEE BELOW IN PART V3920719GENESIS HEALTH SYSTEM (GHS) OBTAINS EMPLOYEE HEALTH INSURANCE COVERAGE AND ISSUES REFUNDS FOR OVERPAYMENTS TO WELLMARK HEALTH PLAN OF IOWA, INC.0
WELLMARK HEALTH PLAN OF IOWA INC
SEE BELOW IN PART V1599258GHS HAS A PROVIDER SERVICE AGREEMENT FOR PATIENT MEDICAL SERVICES WITH WELLMARK HEALTH PLAN OF IOWA, INC.0
LARSON CENTER PARTNERSHIP
SEE BELOW IN PART V702514FACILITY LEASE PAYMENTS0
GENVENTURES INC
SEE BELOW IN PART V617602GHS PAID GENVENTURES, INC. FOR MEDICAL SUPPLIES AND LAUNDRY SERVICES.0
GENVENTURES INC
SEE BELOW IN PART V20530PAYMENT FROM GENVENTURES, INC. FOR MEDICAL SUPPLIES0

Form990 Schedule L Part V Form990ScheduleLPartV (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
FORM 990, SCHEDULE L, PART IV, COLUMN BDESCRIPTION OF RELATIONSHIP - WELLMARK HEALTH PLAN OF IOWA, INC.DOUGLAS P. CROPPER IS THE BOARD PRESIDENT/CEO OF GHS AND A DIRECTOR ON THE BOARD OF WELLMARK HEALTH PLAN OF IOWA, INC.
FORM 990, SCHEDULE L, PART IV, COLUMN BDESCRIPTION OF RELATIONSHIP - LARSON CENTER PARTNERSHIPFLORENCE L. SPYROW IS A KEY EMPLOYEE OF GHS-IL AND THE VOTING REPRESENTATIVE IN THE LARSON CENTER PARTNERSHIP, OF WHICH GHS-IL IS A PARTNER.
FORM 990, SCHEDULE L, PART IV, COLUMN BDESCRIPTION OF RELATIONSHIP - GENVENTURES, INC.MARK G. ROGERS AND ROGER A. HILL ARE OFFICERS, FLORENCE L. SPYROW IS A KEY EMPLOYEE, JAMES W. KOEHLER IS A DIRECTOR, AND MIKE L. SHARP IS A FORMER KEY EMPLOYEE OF GHS AND ARE REPORTED ON THE FORM 990, PART VII. DURING THE TAX YEAR, MARK G. ROGERS, ROGER A. HILL, JAMES W. KOEHLER, AND MIKE L. SHARP WERE OFFICERS OF GENVENTURES, INC., AND FLORENCE L. SPYROW WAS A DIRECTOR OF GENVENTURES, INC.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11INTERNAL MANAGEMENT REVIEW IS COMPLETED OF THE COMPILED INFORMATION PRIOR TO PREPARATION AND REVIEW BY MCGLADREY LLP. FOLLOWING MCGLADREY LLP'S PREPARATION AND REVIEW OF THE FORM 990, IT IS REVIEWED WITH THE ORGANIZATION'S VICE PRESIDENT, FINANCE/CFO; VICE PRESIDENT, LEGAL AFFAIRS; AND VICE PRESIDENT, HUMAN RESOURCES. THE FORM 990 IS THEN REVIEWED AT A JOINT MEETING OF THE ORGANIZATION'S FINANCE COMMITTEE AND AUDIT & COMPLIANCE COMMITTEE. PRIOR TO SUBMITTING THE FORM 990 TO THE IRS, IT IS E-MAILED TO THE ORGANIZATION'S BOARD OF DIRECTORS ONE WEEK IN ADVANCE OF A SCHEDULED MEETING. AT THE BOARD OF DIRECTORS MEETING, INTERNAL MANAGEMENT REVIEWS THE FORM 990 WITH THE BOARD OF DIRECTORS. SUGGESTED CHANGES FROM ALL OF THESE REVIEWS ARE CONSIDERED FOR INCLUSION IN THE FINAL FORM 990 SUBMITTED TO THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CANY COVERED PERSON, DEFINED AS ANY DIRECTOR, OFFICER, OR MEMBER OF A BOARD OR BOARD COMMITTEE OF GENESIS HEALTH SYSTEM (GHS) OR AN AFFILIATE, SHOULD DISCLOSE AN INTEREST OR POTENTIAL INTEREST AS SOON AS THEY BECOME AWARE OF A POTENTIAL TRANSACTION THAT WILL BE CONSIDERED BY MANAGEMENT, THE BOARD, OR A COMMITTEE OF THE BOARD. COVERED PERSONS ARE REQUIRED ANNUALLY TO DISCLOSE ANY POSSIBLE PERSONAL, FAMILY, OR BUSINESS RELATIONSHIPS THAT REASONABLY COULD GIVE RISE TO AN INTEREST OR CONFLICT INVOLVING GHS, OR AN AFFILIATE, OR WITH RESPECT TO DESIGNATED FACILITIES AND ACTIVITIES, AND ACKNOWLEDGE BY HIS OR HER SIGNATURE THAT HE OR SHE IS FAMILIAR WITH AND IS IN COMPLIANCE WITH THE LETTER AND SPIRIT OF THIS POLICY. ANY COVERED PERSON FOUND TO HAVE A CONFLICT OF INTEREST MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING TO PRESENT INFORMATION AND ADDRESS ANY QUESTIONS RAISED BY OTHER DIRECTORS OR COMMITTEE MEMBERS. SAID PERSON SHALL NOT BE ALLOWED TO ACTIVELY AND AGGRESSIVELY ADVOCATE IN HIS OR HER OWN BEHALF NOR SHALL SUCH PERSON ADVOCATE HIS OR HER POSITION INFORMALLY THROUGH PRIVATE CONTACT, COMMUNICATION AND DISCUSSION WITH ANOTHER DIRECTOR. AFTER SUCH PRESENTATION, THE PERSON SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE APPLICABLE TRANSACTION OR ARRANGEMENT.
FORM 990, PART VI, SECTION B, LINE 15EACH EXECUTIVE POSITION IS EVALUATED USING A FORMAL EVALUATION PLAN THAT IS ESTABLISHED BY AN OUTSIDE CONSULTANT. AT THE PRESENT TIME, THE CONSULTANT USES A POINT SYSTEM FOR JOB EVALUATION. THE POINT VALUES ARE BASED ON "KNOW HOW", "PROBLEM SOLVING", "ACCOUNTABILITY", AND OTHER JOB ATTRIBUTES SPECIFIC TO THE POSITION. ONCE THE POINT VALUE IS SET FOR A POSITION, MARKET COMPARISONS FOR JOBS WITH THE SAME ORGANIZATIONAL IMPACT CAN BE COMPARED FOR SALARY PURPOSES AND ESTABLISH PAY RANGES. THE DESIGN OF THE PAY RANGES FOR EXECUTIVES IS BASED ON MARKET DATA. THE MIDPOINT OF EACH PAY RANGE IS ESTABLISHED AT THE 50TH PERCENTILE OF THE MARKET COMPARISONS. A MINIMUM GUIDELINE IS ESTABLISHED AT THE 25TH PERCENTILE, AND A MAXIMUM GUIDELINE IS SET AT THE 75TH PERCENTILE. SPECIFIC PAY RATES FOR EXECUTIVES ARE SUBJECT TO CEO AND COMPENSATION COMMITTEE AND THE GHS BOARD OF DIRECTORS APPROVAL. PAY RANGES ARE REVIEWED EACH YEAR TO DETERMINE THE NEED FOR REVISION. WHEN MARKET CONDITIONS SUGGEST AN ADJUSTMENT TO PAY RANGES, DATA WILL BE PRESENTED TO THE COMPENSATION COMMITTEE FOR ITS REVIEW. THE SPECIFIC PAY RANGES ARE SUBJECT TO CEO, COMPENSATION COMMITTEE, AND GENESIS HEALTH SYSTEM (GHS) BOARD OF DIRECTOR APPROVAL. THE PRESIDENT AND CEO HAS THE AUTHORITY AND RESPONSIBILITY TO ESTABLISH AND ADJUST, WITHIN THE RANGE APPROVED BY THE COMPENSATION COMMITTEE AND THE GHS BOARD OF DIRECTORS, THE BASE COMPENSATION OF EACH EXECUTIVE EMPLOYED BY GHS, AT APPROPRIATE TIMES. THE GHS BOARD OF DIRECTORS SHALL ESTABLISH AND ADJUST, WITHIN THE RANGE APPROVED BY THE COMPENSATION COMMITTEE, THE BASE COMPENSATION FOR THE CEO OF GHS, AT APPROPRIATE TIMES. THE LAST TIME THIS PROCESS WAS FORMALLY UNDERTAKEN WAS NOVEMBER 2012.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART XI, LINE 5:NET UNREALIZED GAINS ON INVESTMENTS: 983. CHANGE IN NET ASSETS OF THE FOUNDATION -99,945. TOTAL TO FORM 990, PART XI, LINE 5: -98,962.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2CTHE OVERSIGHT AND SELECTION PROCESS HAS NOT CHANGED FROM THE PRIOR TAX YEAR.
FORM 990, PART VII, LINE 1AGENESIS HEALTH SYSTEM, EIN 42-1418847, AND GENESIS HEALTH SYSTEM, EIN 36-3616314 HAVE IDENTICAL GOVERNING BOARDS AND AN IDENTICAL EXECUTIVE MANAGEMENT TEAM. THE HOURS REPORTED ON FORM 990, PART VII, SECTION A, COLUMN (B) REPRESENTS THE NUMBER OF HOURS THESE INDIVIDUALS DEVOTE TO BOTH ORGANIZATIONS. FURTHERMORE, THE AMOUNTS REPORTED AS REPORTABLE COMPENSATION FOR THE OFFICERS, KEY EMPLOYEES, AND HIGHLY COMPENSATED EMPLOYEES, UNLESS OTHERWISE NOTED ELSEWHERE IN PART VII, ARE FOR SERVICES RENDERED ON BEHALF OF BOTH ORGANIZATIONS. IT WOULD BE ADMINISTRATIVELY IMPRACTICABLE FOR MEMBERS OF THE GOVERNING BOARD AND THE EXECUTIVE TEAM TO BREAKOUT THEIR HOURS DEVOTED AS WELL AS THEIR REPORTABLE COMPENSATION BETWEEN EACH ORGANIZATION. ALL REPORTABLE COMPENSATION, UNLESS OTHERWISE NOTED IN PART VII, IS PAID BY GENESIS HEALTH SYSTEM, EIN 42-1418847.

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
GENESIS OUTPATIENT PHYSICAL THERAPY LLC
1227 EAST RUSHOLME STREETDAVENPORTIA52803208389282OUTPATIENT PHYSICAL THERAPY SERVICESIA00GENESIS HEALTH SYSTEM - 42-1418847
GENESIS ACCOUNTABLE CARE ORGANIZATION LLC
1227 EAST RUSHOLME STREETDAVENPORTIA52803454168932ACCOUNTABLE CARE SERVICESIA00GENESIS HEALTH SYSTEM - 42-1418847
SPIN ECHO LLC
1227 EAST RUSHOLME STREETDAVENPORTIA52803421491373PROPERTY MANAGEMENTIA838621614570GENVENTURES INC

Form990 Schedule R Part II Form990ScheduleRPartII (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
GENESIS HEALTH SYSTEM - IOWA
1227 EAST RUSHOLME STREETDAVENPORTIA52803421418847HEALTHCAREIA501(C)(3)LINE 3GENESIS HEALTH SYSTEM 36-36163141
GENESIS HEALTH SERVICES FOUNDATION
1227 EAST RUSHOLME STREETDAVENPORTIA52803421421670CHARITYIA501(C)(3)LINE 7GENESIS HEALTH SYSTEM 42-14188471
ILLINI HOSPITAL FOUNDATION
801 ILLINI DRIVESILVISIL61282366208583CHARITYIL501(C)(3)LINE 11A, IGENESIS HEALTH SYSTEM 36-36163141
GENESIS HEALTH SYSTEM WORKERS' COMPENSATION PLAN & TRUST
1227 EAST RUSHOLME STREETDAVENPORTIA52803391905171EMPLOYEE/BENEFIT/TRUSTIA501(C)(3)LINE 11A, IGENESIS HEALTH SYSTEM 42-14188471
DAVENPORT HOSPITAL AMBULANCE CORP
1204 EAST HIGH STREETDAVENPORTIA52803421186903AMBULANCE TRANSFERSIA501(C)(3)LINE 11A, IGENESIS HEALTH SYSTEM 42-14188471
GENESIS SENIOR LIVING ALEDO
309 NW NINTH AVENUEALEDOIL61231454475803SENIOR LIVING SERVICESIL501(C)(3)LINE 3GENESIS HEALTH SYSTEM 36-36163141
GENESIS MEDICAL CENTER ALEDO
409 NW NINTH AVENUEALEDOIL61231454475683HEALTHCAREIL501(C)(3)LINE 3GENESIS HEALTH SYSTEM 36-36163141

Form990 Schedule R Part III Form990ScheduleRPartIII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
GENGASTRO LLC
2222 53RD AVENUEBETTENDORFIA52722562315623AMBULATORY SURGERY CENTERIAN/A
SPRING PARK SURGERY CENTER LLC
3319 SPRING STREET STE 202ADAVENPORTIA52807421483989OUTPATIENT SURGICAL CENTERIAN/A
LARSON CENTER PARTNERSHIP
801 ILLINI DRIVESILVISIL61282363738454PROPERTY MANAGEMENTILGENESIS HEALTH SYSTEM 36-3616314RELATED4501332039797010.75600
DAVENPORT SRS LEASING LLC
1227 EAST RUSHOLME STREETDAVENPORTIA52803261655144LEASINGIAN/A
GENORTHO LLC
2300 53RD AVENUEBETTENDORFIA52722203406994ORTHOPAEDIC SURGERY CENTERIAN/A
GENRAD IMAGING LLC
1970 E 53RD STDAVENPORTIA52807453571628OUTPATIENT RADIOLOGY SERVICESIAN/A

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNAType Of EntityTypeOfEntityAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
GENVENTURES INC
1227 EAST RUSHOLME STREETDAVENPORTIA52803421269171SUPPORT SERVICES/PROPERTY MANAGEMENTIAN/AC
GENESIS HEART INSTITUTE
1236 EAST RUSHOLME STREETDAVENPORTIA52803421504979HEALTHCARE MANAGEMENTIAN/AC
MISERICORDIA ASSURANCE COMPANY LTD
980457943OTHER FINANCIAL VEHICLEN/ACPO BOX 1051GRAND CAYMANCJCJ
MOB 1 OWNERS' ASSOCIATION
1227 EAST RUSHOLME STREETDAVENPORTIA52803270865075PROPERTY MANAGEMENTIAN/AC
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties1ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org1GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org1PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs1RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs1RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs1PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs1PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org1ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org1ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org1OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (30 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
GENESIS HEALTH SYSTEM - IOWA
A229443FAIR MARKET VALUE
GENESIS HEALTH SYSTEM WORKERS COMPENSATION PLAN & TRUST
B155549FAIR MARKET VALUE
GENESIS HEALTH SYSTEM - IOWA
G1860599FAIR MARKET VALUE
GENESIS HEALTH SYSTEM - IOWA
I229443FAIR MARKET VALUE
LARSON CENTER PARTNERSHIP
J345799FAIR MARKET VALUE
LARSON CENTER PARTNERSHIP
J356715FAIR MARKET VALUE
GENESIS HEALTH SYSTEM- IOWA
K8190651FAIR MARKET VALUE
GENVENTURES INC
L545253FAIR MARKET VALUE
DAVENPORT HOSPITAL AMBULANCE CORPORATION
L248625FAIR MARKET VALUE
MISERICORDIA ASSURANCE COMPANY LTD
L139504FAIR MARKET VALUE
GENESIS HEALTH SYSTEM - IOWA
O89420979FAIR MARKET VALUE
GENESIS HEALTH SERVICES FOUNDATION
O108783FAIR MARKET VALUE
GENESIS HEALTH SERVICES FOUNDATION
P324915FAIR MARKET VALUE
GENESIS HEALTH SYSTEM - IOWA
P6037468FAIR MARKET VALUE
ILLINI HOSPITAL FOUNDATION
P145884FAIR MARKET VALUE
LARSON CENTER PARTNERSHIP
Q345799FAIR MARKET VALUE
DAVENPORT HOSPITAL AMBULANCE CORPORATION
Q248625FAIR MARKET VALUE
MISERICORDIA ASSURANCE COMPANY LTD
Q139504FAIR MARKET VALUE
LARSON CENTER PARTNERSHIP
Q356715FAIR MARKET VALUE
GENESIS HEALTH SERVICES FOUNDATION
Q324915FAIR MARKET VALUE
GENVENTURES INC
Q72349FAIR MARKET VALUE
GENVENTURES INC
Q545253FAIR MARKET VALUE
GENESIS HEALTH SYSTEM - IOWA
Q6037468FAIR MARKET VALUE
ILLINI HOSPITAL FOUNDATION
Q145884FAIR MARKET VALUE
GENESIS HEALTH SYSTEM WORKERS COMPENSATION PLAN & TRUST
Q105570FAIR MARKET VALUE
GENESIS HEALTH SYSTEM - IOWA
R89420979FAIR MARKET VALUE
GENESIS HEALTH SYSTEM - IOWA
R8190651FAIR MARKET VALUE
GENVENTURES INC
R72349FAIR MARKET VALUE
LARSON CENTER PARTNERSHIP
R189062FAIR MARKET VALUE
GENESIS HEALTH SERVICES FOUNDATION
R108783FAIR MARKET VALUE