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OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER (EIN 36-2604009)
Tax period
2011-05-01 to 2012-04-30
Filed
2013-02-26
IRS object ID
201330579349300773
Schema version
2011v1.2
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)
Timestamp2013-02-26T16:57:36-06:00Timestamp
Tax Period End Date2012-04-30TaxPeriodEndDate

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 Date2011-05-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362604009EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlOTTANameControl
Phone8154315479Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 EAST NORRIS DRIVEAddressLine1
CityOTTAWACity
StateILState
ZIP Code61350ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameROBERT CHAFFINName
TitlePRESIDENT/CEOTitle
Phone8154315479Phone
Date Signed2013-02-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJOHN J ROMANOName
PTINP00227323PTIN
Phone5638884000Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonROBERT CHAFFINNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11100 EAST NORRIS DRIVEAddressLine1
CityOTTAWACity
StateILState
ZIP Code61350ZIPCode
FieldValueIRS element (for citing)
Gross Receipts105047955GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.OTTAWAREGIONAL.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1964YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTHE MISSION OF OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER IS TO MAINTAIN A LEADERSHIP POSITION IN THE PROVISION OF EFFICIENT AND QUALITY HEALTHCARE SERVICES CONSISTENT WITH THE NEEDS OF THE COMMUNITY AND THE RESOURCES OF THE HOSPITAL. OUR HEALTHCARE ORGANIZATION WILL PROVIDE SERVICES FOR ALL MEMBERS OF THE COMMUNITY, REGARDLESS OF ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body10NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees798TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year634979ContributionsGrantsPriorYear
Contributions Grants Current Year563598ContributionsGrantsCurrentYear
Program Service Revenue Prior Year75080901ProgramServiceRevenuePriorYear
Program Service Revenue CY78492614ProgramServiceRevenueCY
Investment Income Prior Year1828028InvestmentIncomePriorYear
Investment Income Current Year3944872InvestmentIncomeCurrentYear
Other Revenue Prior Year-2525219OtherRevenuePriorYear
Other Revenue Current Year-2278439OtherRevenueCurrentYear
Total Revenue Prior Year75018689TotalRevenuePriorYear
Total Revenue Current Year80722645TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year40784252SalariesEtcPriorYear
Salaries Etc Current Year41176886SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year38319438OtherExpensePriorYear
Other Expenses Current Year40843479OtherExpensesCurrentYear
Total Expenses Prior Year79103690TotalExpensesPriorYear
Total Expenses Current Year82020365TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-4085001RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-1297720RevenuesLessExpensesCY
Total Assets BOY112820521TotalAssetsBOY
Total Assets EOY107614791TotalAssetsEOY
Total Liabilities BOY25978005TotalLiabilitiesBOY
Total Liabilities EOY25910634TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY86842516NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY81704157NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE MISSION OF OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER IS TO MAINTAIN A LEADERSHIP POSITION IN THE PROVISION OF EFFICIENT AND QUALITY HEALTHCARE SERVICES CONSISTENT WITH THE NEEDS OF THE COMMUNITY AND THE RESOURCES OF THE HOSPITAL. OUR HEALTHCARE ORGANIZATION WILL PROVIDE SERVICES FOR ALL MEMBERS OF THE COMMUNITY, REGARDLESS OF ABILITY TO PAY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense61623447Expense
Revenue78492614Revenue
DescriptionNON-PROFIT 99-BED, ACUTE CARE HOSPITAL, INCLUDING A 26-BED PSYCHIATRIC CARE UNIT. $7,831,733 CHARITY CARE PROVIDED.Description
Total Program Service Expense61623447TotalProgramServiceExpense
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 Assets1ReportOtherAssets
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 Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Financial Stmt Attached1FinancialStmtAttached
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
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 With109676NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees798NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members10NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
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 Line1MICHELE KONIEWICZBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8154315479TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11100 E NORRIS DRIVEAddressLine1
CityOTTAWACity
StateILState
ZIP Code61350ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (18 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
STEVEN M GONZALO
CHAIRMAN1.00XX000
CHRISTINA CANTLIN
FIRST CHAIR1.00X000
GEORGE SHANLEY
SECOND CHAIR1.00X000
MARK PALMER
TREASURER1.00XX000
MARY MORGAN
SECRETARY1.00XX000
JULIE POLANCIC
TRUSTEE1.00X000
WILLIAM KUMMER
TRUSTEE1.00X000
ERIC ORTINEAU MD
TRUSTEE1.00X000
STEVE CHUNG MD
TRUSTEE1.00X000
RENEE KRANOV RN
TRUSTEE1.00X000
ROBERT CHAFFIN
PRESIDENT/CEO40.00X278959038971
JUDY CHRISTIANSEN
CHIEF OPERATING OFFICER40.00X195776017760
DAWN TROMPETER
CHIEF FINANCIAL OFFICER40.00X137384032407
CHIN SWONG MD
PHYSICIAN40.00434533028211X
DAVID BAYLEY MD
PHYSICIAN40.00378689027623X
MICHAEL M GLAVIN MD
PHYSICIAN40.00363932027211X
ANTHONY FOULEN MD
PHYSICIAN40.00359106010962X
JOSEPH W CHUPREVICH MD
PHYSICIAN40.00294214026521X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2442593TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation209666TotalOtherCompensation
Number Individuals GT100 K24NumberIndividualsGT100K
Formers Listed0FormersListed
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
DRINKER BIDDLE & REATH LLP
ONE LOGAN SQUARE SUITE 2000PHILADELPHIAPA191036996LEGAL424096
WOMEN'S HEALTHCARE PARTNERS OF ILL
1050 E NORRIS DROTTAWAIL61350MEDICAL415498
HINSHAW & CULBERTSON LLP
8142 SOLUTIONS CENTER DRCHICAGOIL606778001LEGAL293879
ST MARY'S ANESTHESIOLOGY PC
1005 4TH STLACONIL61540ANESTHESIA278619
DOWNSTATE SHOCKWAVE THERAPIES
403 BRONCO DR STE 2BLOOMINGTONIL61704MEDICAL277894
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Fundraising Events30044FundraisingEvents
Related Organizations17730RelatedOrganizations
Government Grants496660GovernmentGrants
All Other Contributions19164AllOtherContributions
Noncash Contributions16371NoncashContributions
Total Contributions563598TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NURSING SERVICES6230006326941763269417
RADIOLOGY9000994114270441142704
ROUTINE CARE6211102669846726698467
LABORATORY6215002202635322026353
PHYSICIAN SERVICES9000991098221110982211

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column-85626538TotalRevenueColumn
Related Or Exempt Function Income-85626538RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue78492614TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column770137TotalRevenueColumn
Exclusion$770,137ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real815459Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1371120Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-555661Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-555661TotalRevenueColumn
Exclusion-$555,661ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities26027961Securities
Other59877Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities22857680Securities
Other55423Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3170281Securities
Other4454Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3174735TotalRevenueColumn
Exclusion$3,174,735ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events35153GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events30044CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses41087FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-5934TotalRevenueColumn
Exclusion-$5,934ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA722210422366$422,366
MISCELLANEOUS900099122928$122,928
COMMUNITY CLASSES90009938275$38,275

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column-2300413TotalRevenueColumn
Exclusion-$2,300,413ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue-1716844TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column80722645TotalRevenueColumn
Related Or Exempt Function Income78492614RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$1,666,433ExclusionAmount

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total643663Total
Program Services200112ProgramServices
Management And General443551ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total29666761Total
Program Services22271683ProgramServices
Management And General7395078ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total810562Total
Program Services597372ProgramServices
Management And General213190ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7981133Total
Program Services5160816ProgramServices
Management And General2820317ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2074767Total
Program Services1516953ProgramServices
Management And General557814ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total866093Total
Management And General866093ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total193020Total
Management And General193020ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total23797Total
Management And General23797ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total234492Total
Program Services832ProgramServices
Management And General233660ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8910009Total
Program Services7724672ProgramServices
Management And General1185337ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total962480Total
Program Services223534ProgramServices
Management And General738946ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1231017Total
Program Services500813ProgramServices
Management And General730204ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total204496Total
Program Services164074ProgramServices
Management And General40422ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total358995Total
Program Services358995ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5994176Total
Program Services5021203ProgramServices
Management And General972973ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total902471Total
Program Services387744ProgramServices
Management And General514727ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CHARITY CARE78317337831733
PURCHASED SERVICES417967627613561418320
BAD DEBT38801343880134
OTHER EXPENSES336621613167472049469

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1704674Total
Program Services1704674ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total82020365Total
Program Services61623447ProgramServices
Management And General20396918ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2700BOY
EOY2800EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1046324BOY
EOY2754486EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY8313015BOY
EOY13123099EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1658739BOY
EOY1629513EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY752296BOY
EOY736467EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis116669524LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec62766187LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY54967037BOY
EOY53903337EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY34623068BOY
EOY25095359EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY9915BOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY11447427BOY
EOY10369730EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY112820521BOY
EOY107614791EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10607515BOY
EOY10232477EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY12984302BOY
EOY12319976EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY2386188BOY
EOY3358181EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY25978005BOY
EOY25910634EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY86832668BOY
EOY81694275EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY9848BOY
EOY9882EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY86842516BOY
EOY81704157EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY112820521BOY
EOY107614791EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-1297720ReconcilationRevenueExpenses
Reconcilation Other Changes-3840639ReconcilationOtherChanges
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 Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators0DirectContactLegislators
Rallies Demonstrations0RalliesDemonstrations
Other Activities1OtherActivities
Other Activities$23,797OtherActivitiesAmount
Total Lobbying Expenditures IIB23797TotalLobbyingExpendituresIIB
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
Explanation27%, OR $19,109 OF MEMBERSHIP DUES TO THE ILLINOIS HOSPITAL ASSOCIATION IS ATTRIBUTABLE TO LOBBYING ACTIVITIES. 24.6%, OR $4,688 OF MEMBERSHIP DUES TO THE AMERICAN HOSPITAL ASSOCIATION IS ATTRIBUTABLE TO LOBBYING ACTIVITIES.Explanation

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance4725BeginningOfYearBalance
End Of Year Balance4725EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance4725BeginningOfYearBalance
End Of Year Balance4725EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4725BeginningOfYearBalance
End Of Year Balance4725EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance4725BeginningOfYearBalance
End Of Year Balance4725EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance1.00000PermanentEndowmentEOYBalance
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 Basis4149486OtherCostOrOtherBasis
Book Value4149486BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis71156930OtherCostOrOtherBasis
Depreciation34728820Depreciation
Book Value36428110BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis34804644OtherCostOrOtherBasis
Depreciation24597790Depreciation
Book Value10206854BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis6558464OtherCostOrOtherBasis
Depreciation3439577Depreciation
Book Value3118887BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings53903337TotalOfBookValueLandBuildings

Other Assets OtherAssets (11 entries)

DescriptionDescriptionBook ValueBookValue
SELF INSURANCE TRUST3733376
LOAN ORIGINATION COST455041
DEBT SERVICE RESERVE FUND1293134
BOND INTEREST FUND176
457B FUNDS490586
RADIATION ONCOLOGY JOINT VENTURE863154
FOX RIVER CANCER CENTER JOINT VENTURE1598828
PHYSICIAN LOANS336000
OTTAWA REGIONAL HEALTHCARE AFFILIATES1294886
CHOICES BLDG FUNDS20436
ASSESSMENT284113
FieldValueIRS element (for citing)
Total Book Value Other Assets10369730TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionTHIRD-PARTY PAYOR SETTLEMENTSDescription
Amount$3,358,181Amount
FieldValueIRS element (for citing)
Total Of Amounts3358181TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:THE ENDOWMENT FUND IS HELD BY THE OTTAWA REGIONAL HOSPITAL FOUNDATION, A RELATED ORGANIZATION. THE EARNINGS FROM THE FUND ARE USED FOR GENERAL SUPPORT PURPOSES.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X:THE OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER (HOSPITAL), OTTAWA REGIONAL HOSPITAL AUXILIARY (AUXILIARY) AND OTTAWA REGIONAL HOSPITAL FOUNDATION (FOUNDATION) HAVE BEEN RECOGNIZED AS TAX EXEMPT PURSUANT TO SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND A SIMILAR PROVISION OF STATE LAW. IN LIEU OF CORPORATION INCOME TAXES, THE MEMBERS OF RADIATION ONCOLOGY OF NORTHERN ILLINOIS, LLC (RONI) ARE TAXED ON THEIR SHARE OF THE LLC'S INCOME, DEDUCTIONS, LOSSES AND CREDITS. THEREFORE, THESE CONSOLIDATED FINANCIAL STATEMENTS DO NOT INCLUDE ANY PROVISION FOR INCOME TAXES FOR THESE ENTITIES. OTTAWA REGIONAL HEALTHCARE AFFILIATES, INC (ORHA) IS A FOR-PROFIT CORPORATION SUBJECT TO APPLICABLE FEDERAL AND STATE INCOME TAXES. DEFERRED TAXES FOR ORHA ARE PROVIDED ON A LIABILITY METHOD WHEREBY DEFERRED TAX ASSETS ARE RECOGNIZED FOR DEDUCTIBLE TEMPORARY DIFFERENCES AND OPERATING LOSSES AND TAX CREDIT CARRYFORWARDS AND DEFERRED TAX LIABILITIES ARE RECOGNIZED FOR TAXABLE TEMPORARY DIFFERENCES. TEMPORARY DIFFERENCES ARE THE DIFFERENCES BETWEEN THE REPORTED AMOUNTS OF ASSETS AND LIABILITIES AND THEIR TAX BASIS. DEFERRED TAX ASSETS ARE REDUCED BY A VALUATION ALLOWANCE WHEN, IN THE OPINION OF MANAGEMENT, IT IS MORE LIKELY THAN NOT THAT SOME PORTION OR ALL OF THE DEFERRED TAX ASSETS WILL NOT BE REALIZED. DEFERRED TAX ASSETS AND LIABILITIES ARE ADJUSTED FOR THE EFFECTS OF CHANGES IN THE TAX LAWS AND RATES ON THE DATE OF ENACTMENT. THE HOSPITAL, AUXILIARY, AND FOUNDATION FILE A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. WHEN THIS RETURN IS 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 TAX POSITION TAKEN OR THE AMOUNT OF THE POSITION THAT WOULD ULTIMATELY BE SUSTAINED. EXAMPLES OF TAX POSITIONS COMMON TO TAX EXEMPT ORGANIZATIONS INCLUDE SUCH MATTERS AS THE FOLLOWING: THE TAX EXEMPT STATUS OF THE ENTITY, THE CONTINUED TAX EXEMPT STATUS OF BONDS ISSUED, THE NATURE, THE CHARACTERIZATION AND TAXABILITY OF JOINT VENTURE INCOME AND VARIOUS POSITIONS RELATIVE TO POTENTIAL SOURCES OF UNRELATED BUSINESS TAXABLE INCOME (UBIT). UBIT IS REPORTED ON FORM 990T, AS APPROPRIATE. THE BENEFIT OF 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 UNRECOGNIZED TAX BENEFITS IN THE ACCOMPANYING CONSOLIDATED BALANCE SHEET ALONG WITH ANY ASSOCIATED INTEREST AND PENALTIES THAT WOULD BE PAYABLE TO THE TAXING AUTHORITIES UPON EXAMINATION. AS OF APRIL 30, 2012 AND 2011, THERE WERE NO UNRECOGNIZED TAX BENEFITS IDENTIFIED AND RECORDED AS A LIABILITY. FORMS 990 AND 990T FILED BY THE ORGANIZATION ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN. FORMS 990 FILED BY THE ORGANIZATION ARE NO LONGER SUBJECT TO EXAMINATION FOR THE YEAR ENDED APRIL 30, 2008 AND PRIOR. FORM 1120 FILED BY ORHA IS SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) UP TO THREE YEARS FROM THE EXTENDED DUE DATE OF EACH RETURN.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1AUTUMN LEAVES GALANameOfEvent1
Gross Receipts Event165197GrossReceiptsEvent1
Charitable Contributions Event130044CharitableContributionsEvent1
Gross Revenue Event135153GrossRevenueEvent1
Other Direct Expenses Event141087OtherDirectExpensesEvent1
Gross Receipts Total65197GrossReceiptsTotal
Charitable Contributions Total30044CharitableContributionsTotal
Gross Revenue Total Events35153GrossRevenueTotalEvents
Other Direct Expenses Total Events41087OtherDirectExpensesTotalEvents
Direct Expense Summary Events41087DirectExpenseSummaryEvents
Net Income Summary-5934NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense3344168TotalCommunityBenefitExpense
Net Community Benefit Expense3344168NetCommunityBenefitExpense
Percent Of Total Expense0.04280PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense11904297TotalCommunityBenefitExpense
Direct Offsetting Revenue2939804DirectOffsettingRevenue
Net Community Benefit Expense8964493NetCommunityBenefitExpense
Percent Of Total Expense0.11470PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense271562TotalCommunityBenefitExpense
Direct Offsetting Revenue171526DirectOffsettingRevenue
Net Community Benefit Expense100036NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense15520027TotalCommunityBenefitExpense
Direct Offsetting Revenue3111330DirectOffsettingRevenue
Net Community Benefit Expense12408697NetCommunityBenefitExpense
Percent Of Total Expense0.15880PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense82257TotalCommunityBenefitExpense
Net Community Benefit Expense82257NetCommunityBenefitExpense
Percent Of Total Expense0.00110PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense2001550TotalCommunityBenefitExpense
Net Community Benefit Expense2001550NetCommunityBenefitExpense
Percent Of Total Expense0.02560PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense161216TotalCommunityBenefitExpense
Direct Offsetting Revenue36051DirectOffsettingRevenue
Net Community Benefit Expense125165NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2245023TotalCommunityBenefitExpense
Direct Offsetting Revenue36051DirectOffsettingRevenue
Net Community Benefit Expense2208972NetCommunityBenefitExpense
Percent Of Total Expense0.02830PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense17765050TotalCommunityBenefitExpense
Direct Offsetting Revenue3147381DirectOffsettingRevenue
Net Community Benefit Expense14617669NetCommunityBenefitExpense
Percent Of Total Expense0.18710PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported0BadDebtExpenseReported
Bad Debt Expense$1,425,323BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare25206042AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare30278252CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5072210MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care0ProvisionForCharityCare

Form990 Schedule H Part IV Form990ScheduleHPartIV

Name Of Entity NameOfEntity

FieldValueIRS element (for citing)
Business Name Line11 RADIATION ONCOLOGY OF NORTHERN ILLINOIS LLCBusinessNameLine1
FieldValueIRS element (for citing)
Description Ent Primary ActivityRADIATION ONCOLOGYDescriptionEntPrimaryActivity
Organization Profit Or Ownership0.57000OrganizationProfitOrOwnership
Physicans Profit Or Ownership0.43000PhysicansProfitOrOwnership
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 Line1OTTAWA REGIONAL HOSPITAL & HEALTHCAREBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line11100 EAST NORRIS DRIVEAddressLine1
CityOTTAWACity
StateILState
ZIP Code61350ZIPCode
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 Line1OTTAWA REGIONAL HOSPITAL & HEALTHCARE CEBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber
Eligibility Criteria Explained1EligibilityCriteriaExplained
Uses FPG Free1UsesFPGFree
FPG Free Percent200.000000000000FPGFreePercent
Uses FPG Discounted1UsesFPGDiscounted
FPG Discount Percent400.000000000000FPGDiscountPercent
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
Average Negotiated RatesXAverageNegotiatedRates
Amounts Generally Billed0AmountsGenerallyBilled
Gross Charges0GrossCharges

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities2NumberOfOtherFacilities

Other Facilities OtherFacilities (2 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
OTTAWA REGIONAL MEDICAL CENTER INC
1614 EAST NORRIS DRIVEOTTAWAIL61350OUTPATIENT MEDICAL AND DIAGNOSTIC SERVICES
RADIATION ONCOLOGY OF NORTHERN ILLINOIS
1200 STARFIRE DRIVEOTTAWAIL61350RADIATION ONCOLOGY CENTER

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: THE COST TO CHARGE RATIO (OBTAINED FROM THE MEDICARE COST REPORT) WAS USED TO DETERMINE THE AMOUNTS REPORTED ON LINE 7.
PART I, LINE 7G: A FREESTANDING FACILITY, THE HEALTH CENTER OF EASTERN LASALLE COUNTY (HEALTH CENTER), PROVIDES FREE HEALTH CARE SERVICES TO INDIVIDUALS AND FAMILIES WHO DO NOT HAVE ACCESS TO HEALTH INSURANCE, DO NOT QUALIFY FOR STATE OR FEDERAL PROGRAMS, AND DO NOT HAVE THE FINANCIAL RESOURCES TO SECURE THE HEALTH CARE THEY NEED. NINE OF OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER'S (ORHHC) PHYSICIANS VOLUNTEER THEIR SERVICES TO PROVIDE PRIMARY HEALTH CARE, AND THE HEALTH CENTER DOES NOT RECEIVE ANY FEDERAL OR STATE FUNDS. ANCILLARY SERVICES, SUCH AS LAB AND X-RAY, THAT ARE UNAVAILABLE AT THE HEALTH CENTER, ARE PROVIDED BY THE HOSPITAL AT NO CHARGE.ORHHC HAS THE ONLY HOSPITAL PROVIDING MENTAL HEALTH SERVICES BETWEEN NAPERVILLE, JOLIET, PEORIA AND THE QUAD CITIES. ALTHOUGH SEVERAL LOCAL AND REGIONAL HOSPITALS CEASED TO PROVIDE BEHAVIORAL HEALTH CARE DUE TO A LACK OF PROFITABILITY, ORHHC EXPANDED ITS PROGRAMS AND SERVICES TO MEET COMMUNITY NEEDS. WHILE THE PROGRAM CONTINUES TO OPERATE AT A LOSS (ALMOST $2 MILLION IN FY2012), ORHHC REMAINS COMMITTED TO PROVIDING THIS VITAL SERVICE.
PART I, L7 COL(F): $3,880,134 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 22.73%, AND THE PERCENTAGE INCREASES TO 61.48% IF MEDICARE ALLOWABLE COSTS ARE INCLUDED IN TOTAL COMMUNITY BENEFIT EXPENSE.
PART II: NOT APPLICABLE.
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. MANAGEMENT DETERMINES THE ALLOWANCE FOR DOUBTFUL ACCOUNTS BY IDENTIFYING TROUBLED ACCOUNTS AND BY HISTORICAL EXPERIENCE APPLIED TO AN AGING OF ACCOUNTS. THE ORGANIZATION DOES NOT CHARGE INTEREST ON RECEIVABLES. PATIENT ACCOUNTS RECEIVABLE ARE DUE IN FULL WHEN BILLED. ACCOUNTS ARE CONSIDERED PAST DUE WHEN AN AMOUNT IS PAST DUE ACCORDING TO THE PAYOR'S AGREED-UPON TERMS. PATIENT RECEIVABLES ARE WRITTEN OFF AS BAD DEBT EXPENSE WHEN DEEMED UNCOLLECTIBLE. RECOVERIES OF RECEIVABLES PREVIOUSLY WRITTEN OFF ARE RECORDED AS A REDUCTION OF BAD DEBT EXPENSE WHEN RECEIVED. AS A SERVICE TO THE PATIENT, THE ORGANIZATION BILLS THIRD-PARTY PAYORS DIRECTLY AND THE PATIENT WHEN THE PATIENT'S LIABILITY IS DETERMINED.THE AMOUNT INCLUDED ON LINE 2 WAS CALCULATED USING THE COST OF CHARGE RATIO OBTAINED FROM THE MEDICARE COST REPORT. THE AMOUNT ON LINE 3 IS ZERO DUE TO THE FACT THAT PATIENT ELIGIBILITY FOR CHARITY CARE OR FINANCIAL ASSISTANCE IS DETERMINED PRIOR TO PATIENT BILLING, THEREFORE THESE PATIENT AMOUNTS WOULD NOT BE INCLUDED IN BAD DEBT.
PART III, LINE 8: THE COST TO CHARGE RATIO (OBTAINED FROM THE MEDICARE COST REPORT) WAS USED TO DETERMINE THE AMOUNT REPORTED ON LINE 7.
PART III, LINE 9B: PATIENT ELIGIBILITY FOR CHARITY CARE OR FINANCIAL ASSISTANCE IS DETERMINED PRIOR TO PATIENT BILLING, THEREFORE THESE PATIENTS WOULD NOT BE INCLUDED IN THE DEBT COLLECTION POLICY.
PART VI, LINE 2: THE ORGANIZATION DOES NOT CURRENTLY CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT AS IT IS NOT YET REQUIRED UNTIL TAX YEARS BEGINNING AFTER MARCH 23, 2012.
PART VI, LINE 3: THERE IS SIGNAGE IN REGISTRATION, ADMITTING, AND THE CREDIT AND BILLING DEPARTMENTS COMMUNICATING THAT FINANCIAL ASSISTANCE IS AVAILABLE. SOME PATIENTS ARE UNAWARE THAT THEY MAY BE ELIGIBLE FOR MEDICAID BENEFITS, THEREFORE OUR FINANCIAL ASSISTANCE INCLUDES HELPING THE PATIENT COMPLETE A MEDICAID APPLICATION. WE ALSO PROVIDE THEM WITH ASSISTANCE IN COMPLETING OUR CHARITY APPLICATION.
PART VI, LINE 4: THE ORGANIZATION'S PRIMARY SERVICE AREA IS DEFINED AS OTTAWA, MARSEILLES, SERENA, AND GRAND RIDGE (APPROXIMATELY 36,315 RESIDENTS). THE SECONDARY SERVICE AREA IS DEFINED AS (EAST) SENECA AND MORRIS; (WEST) UTICA, OGLESBY, LASALLE, PERU, MENDOTA, AND PRINCETON; (SOUTH) STREATOR; (NORTH) WEDRON, SHERIDAN, NEWARK, EARLVILLE, LELAND, SOMONAUK, SANDWICH, PLANO, AND YORKVILLE (APPROXIMATELY 135,019 RESIDENTS). ACCORDING TO THE U.S. CENSUS BUREAU IN 2000, THE PRIMARY SERVICE AREA INCLUDED AN AVERAGE OF 5.65% OF FAMILIES BELOW POVERTY LEVEL AND AN AVERAGE OF 7.5% OF INDIVIDUALS BELOW POVERTY LEVEL. THE MEDIAN AGE WAS 38.6 AND THE MEDIAN HOUSEHOLD INCOME WAS $44,675.
PART VI, LINE 5: IN ADDITION TO CHARITY CARE, THE HOSPITAL PROVIDES COMMUNITY BENEFITS, INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING: OPERATION OF FULL-TIME EMERGENCY ROOM PROVIDING MEDICAL SERVICES TO ALL MEMBERS OF THE PUBLIC REQUIRING SUCH CARE; MAINTENANCE OF PROVIDER AGREEMENTS WITH MEDICARE AND MEDICAID PROGRAMS; FINANCIAL SUPPORT OF AN INDIGENT CLINIC IN THE COMMUNITY; EXTERNSHIPS FOR MEDICAL STUDENTS; NURSING SCHOLARSHIPS OR TUITION PAYMENTS FOR PROFESSIONAL EDUCATION TO NON-EMPLOYEES AND VOLUNTEERS; PROVISION OF A CLINICAL SETTING FOR UNDERGRADUATE/VOCATIONAL TRAINING TO STUDENTS ENROLLED IN AN OUTSIDE ORGANIZATION; NEGATIVE CONTRIBUTIONS IN SEVERAL DEPARTMENTS INCLUDING BEHAVIORAL HEALTH; CONTRIBUTIONS TO OTHER NOT-FOR-PROFIT ORGANIZATIONS; MEETING ROOM OVERHEAD/SPACE FOR NOT-FOR-PROFIT ORGANIZATIONS; RECRUITMENT OF PHYSICIANS AND OTHER HEALTH PROFESSIONALS FOR FEDERALLY MEDICAL UNDERSERVED AREAS; PARTNERSHIP WITH COMMUNITY COLLEGE TO ADDRESS THE HEALTH CARE WORK FORCE SHORTAGE; HEALTH SCREENINGS, BLOOD PRESSURE CHECKS, ENROLLMENT ASSISTANCE IN PUBLIC PROGRAMS, INFORMATION AND REFERRALS TO COMMUNITY SERVICES AND PREVENTION PROGRAMS OFFERED FREE OR AT LOW COST TO THE COMMUNITY.
PART VI, LINE 6: OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER (HOSPITAL) IS LICENSED AS A 99-BED, NOT-FOR-PROFIT, ACUTE CARE HOSPITAL, INCLUDING A 26-BED PHSYCHIATRIC CARE UNIT. THE HOSPITAL ALSO PROVIDES RELATED ANCILLARY AND OUTPATIENT SERVICES. THE HOSPITAL'S AFFILIATES INCLUDE OTTAWA REGIONAL HEALTHCARE AFFILIATES, INC. (INCLUDING ITS WHOLLY OWNED SUBSIDIARY, OTTAWA REGIONAL MEDICAL CENTER, INC.), RADIATION ONCOLOGY OF NORTHERN ILLINOIS, LLC, THE OTTAWA REGIONAL HOSPITAL AUXILIARY, AND THE OTTAWA REGIONAL HOSPITAL FOUNDATION.OTTAWA REGIONAL HEALTHCARE AFFILIATES, INC. (ORHA) IS AN ILLINOIS BUSINESS CORPORATION AND IS THE SOLE STOCKHOLDER OF OTTAWA REGIONAL MEDICAL CENTER, INC. (ORMC) AND OTTAWA REGIONAL CARDINAL SLEEP CENTER, LLC (ORCSC) AND 50% OWNER OF OTTAWA REGIONAL DME, LLC (DME). THE HOSPITAL IS THE SOLE STOCKHOLDER OF ORHA. OTTAWA REGIONAL MEDICAL CENTER, INC. WAS INCORPORATED AS AN ILLINOIS BUSINESS CORPORATION IN SEPTEMBER 2009 AND PURCHASED CERTAIN ASSETS OF A THIRD-PARTY IN DECEMBER 2009. ORMC PROVIDES OUTPATIENT MEDICAL AND DIAGNOSTIC SERVICES AND IS CONSOLIDATED WITH ORHA.OTTAWA REGIONAL CARDINAL SLEEP CENTER, LLC AND OTTAWA REGIONAL DME, LLC ARE LIMITED LIABILITY COMPANIES FORMED IN JULY 2010. ORHA HAS NOT MADE ANY INITIAL CAPITAL CONTRIBUTIONS TO THESE ENTITIES, AND THERE HAVE BEEN NO OPERATIONS WITHIN THESE ENTITIES AS OF APRIL 30, 2012.RADIATION ONCOLOGY OF NORTHERN ILLINOIS, LLC (RONI) IS A LIMITED LIABILITY COMPANY ESTABLISHED TO OWN AND OPERATE A RADIATION ONCOLOGY CENTER. THE HOSPITAL HAS A 57% OWNERSHIP INTEREST IN RONI. RONI IS CONSOLIDATED WITH THE HOSPITAL. OTTAWA REGIONAL HOSPITAL AUXILIARY (AUXILIARY) IS A NOT-FOR-PROFIT FUND RAISING ORGANIZATION WHOSE PURPOSE IS TO PROMOTE AND ADVANCE THE WELFARE OF THE HOSPITAL.OTTAWA REGIONAL HOSPITAL FOUNDATION (FOUNDATION) IS A NOT-FOR-PROFIT FUND RAISING ORGANIZATION WHOSE PURPOSE IS TO SUPPORT AND ENCOURAGE HEALTH CARE SERVICES IN FURTHERANCE OF THE PURPOSE OF AND IN ASSITANCE TO THE HOSPITAL, THROUGH PROVIDING FINANCIAL AND FUND RAISING ASSISTANCE AND IN ALL OTHER RELEVANT WAYS AIDING IN SUPPORTING HEALTH CARE ORGANIZATIONS AND INDIVIDUALS INTERESTED IN CAREERS IN HEALTH CARE.
ILREPORTS FILED WITH STATESPART VI, LINE 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
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 (8 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
ROBERT CHAFFIN
26113701650001322076000313710317930000
JUDY CHRISTIANSEN
194808000968060180117420213536000
DAWN TROMPETER
136729000655047840276230169791000
CHIN SWONG MD
4328880001645000282110462744000
DAVID BAYLEY MD
35697802000001711000276230406312000
MICHAEL M GLAVIN MD
147292021561601024000272110391143000
ANTHONY FOULEN MD
3591060000000109620370068000
JOSEPH W CHUPREVICH MD
147705014650900000265210320735000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 3ReturnReference
ExplanationTHE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE CHIEF EXECUTIVE OFFICER (CEO) IS NOT A MEMBER OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS, AND THIS PERFORMANCE REVIEW IS PROVIDED TO THE COMMITTEE. THE COMMITTEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS THE BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO "EXCESS BENEFIT" AMOUNT IS PAID OR FURNISHED.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1CITY OF OTTAWABusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN366006037IssuerEIN
CUSIP Number689419AW9CUSIPNumber
Date Issued2004-08-15DateIssued
Issue Price16630000IssuePrice
Description Of PurposeREFUND SERIES 1994 BONDS; CAPITAL PROJECTSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer
Pool Financing0PoolFinancing

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Amount Retired3725000AmountRetired
Total Proceeds16630000TotalProceeds
Amount In Reserve Fund1293134AmountInReserveFund
Refunding Escrow12510024RefundingEscrow
Issuance Costs From Proceeds8441IssuanceCostsFromProceeds
Credit Enhancement278700CreditEnhancement
Capital Expenditures2645000CapitalExpenditures
Year Of Subst Completion2006YearOfSubstCompletion
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made1FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Post Issuance Compliance Procdrs0PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
OTTAWA REGIONAL MEDICAL CENTER INC (ORMC)
CHAFFIN, CHRISTIANSEN, TROMPETER ARE OFFICERS OF THE ORGANIZATION AND ORMC404921OTTAWA REGIONAL MEDICAL CENTER, INC. PAID RENT TO OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER.0
OTTAWA REGIONAL MEDICAL CENTER INC (ORMC)
CHAFFIN, CHRISTIANSEN, TROMPETER ARE OFFICERS OF THE ORGANIZATION AND ORMC3392673OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER PROVIDED CAPITAL CONTRIBUTIONS TO OTTAWA REGIONAL MEDICAL CENTER, INC.0
(no name)
0
DOWNSTATE SHOCKWAVE THERAPIES (DOWNSTATE)
CHUNG IS DIRECTOR OF THE ORGANIZATION AND OWNS 16% OF DOWNSTATE251722OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER PAID MEDICAL SERVICE EXPENSES TO DOWNSTATE SHOCKWAVE THERAPIES0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION A, LINE 6OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER HAS LIFE MEMBERS WHICH ARE PERSONS WHO HAVE PAID THE HOSPITAL FIVE HUNDRED DOLLARS ($500) FOR SUCH MEMBERSHIP. THE ORGANIZATION ALSO HAS ORGANIZATIONAL MEMBERS WHICH ARE CORPORATIONS, INSTITUTIONS, ORGANIZATIONS, ASSOCIATIONS, ETC. WHICH HAVE MET THE REQUIREMENTS OF LIFE OR ANNUAL MEMBERSHIP AND HAVE SPECIFIED THAT THE SUMS DONATED BE RECOGNIZED IN THE ORGANIZATIONAL NAME. EACH MEMBER OF THE HOSPITAL SHALL HAVE ONE VOTE ON ALL PROPOSITIONS PRESENTED AND ACTED UPON AT ANY MEETING OF THE MEMBERS AT WHICH THE MEMBERS ARE PERSONALLY PRESENT OR REPRESENTED BY PROXY.
FORM 990, PART VI, SECTION A, LINE 7ATHE OFFICERS OF THE ORGANIZATION ARE ELECTED BY THE CORPORATE MEMBERSHIP. THESE POSITIONS INCLUDE THE CHAIRMAN OF THE BOARD, TWO VICE-CHAIRMAN, DESIGNATED FIRST VICE-CHAIRMAN AND SECOND VICE-CHAIRMAN, THE SECRETARY, AND THE TREASURER.
FORM 990, PART VI, SECTION B, LINE 11THE ORGANIZATION'S GOVERNING BODY WILL MEET WITH THE ORGANIZATION'S ASSISTANT CONTROLLER AT A BOARD MEETING TO REVIEW THE FINAL FORM 990 AFTER ITS FILING.
FORM 990, PART VI, SECTION B, LINE 12CIT SHALL BE THE POLICY OF THE GOVERNING BOARD OF OTTAWA REGIONAL HOSPITAL AND HEALTHCARE CENTER TO REQUIRE THAT EACH BOARD MEMBER, PRIOR TO MAKING HIS/HER POSITION ON THE BOARD, AND ALL PRESENT BOARD MEMBERS AS SOON AS PRACTICABLE AFTER THE ADOPTION OF THIS POLICY, BUT NO LATER THAN FORTY-FIVE DAYS, SUBMIT IN WRITING TO THE CHIEF EXECUTIVE OFFICER OF THE HOSPITAL A LIST OF ALL BUSINESS OR OTHER ORGANIZATIONS OF WHICH HE/SHE IS AN OFFICER, MEMBER, OWNER OR EMPLOYEE OR WHICH HE/SHE ACTS AS AN AGENT, WITH WHICH THE HOSPITAL HAS, OR MIGHT REASONABLY IN THE FUTURE ENTER INTO, A RELATIONSHIP OR A TRANSACTION IN WHICH THE BOARD MEMBER WOULD HAVE CONFLICTING INTERESTS. EACH WRITTEN STATEMENT WILL BE RESUBMITTED WITH ANY NECESSARY CHANGES, EACH YEAR. AT SUCH TIME AS ANY MATTER COMES BEFORE THE BOARD IN SUCH A WAY AS TO GIVE RISE TO A CONFLICT OF INTEREST, THE AFFECTED BOARD MEMBER SHALL MAKE KNOWN THE POTENTIAL CONFLICT, WHETHER DISCLOSED BY HIS/HER WRITTEN STATEMENT OR NOT, AND AFTER ANSWERING ANY QUESTIONS THAT MIGHT BE ASKED HIM/HER, EITHER AS TO THE CONFLICT OR AS TO ANY SPECIAL EXPERTISE POSSESSED BY THAT BOARD MEMBER, SHALL WITHDRAW FROM THE MEETING FOR SO LONG AS THE MATTER SHALL CONTINUE UNDER DISCUSSION. SHOULD THE MATTER BE BROUGHT TO A VOTE, THE AFFECTED BOARD MEMBER SHALL NOT VOTE ON IT. IN THE EVENT THAT HE/SHE FAILS TO WITHDRAW VOLUNTARILY, THE CHAIRMAN OF THE BOARD IS EMPOWERED AND SHALL REQUIRE THAT HE/SHE REMOVE HIMSELF/HERSELF FROM THE ROOM DURING BOTH THE DISCUSSION AND VOTE ON THE MATTER.
FORM 990, PART VI, SECTION B, LINE 15LINE 15A: THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE CHIEF EXECUTIVE OFFICER (CEO) IS NOT A MEMBER OF THE COMMITTEE. THE PERFORMANCE OF THE CEO AND HIS ACHIEVEMENT OF ANNUAL GOALS IS EVALUATED EACH YEAR BY THE FULL BOARD OF DIRECTORS, AND THIS PERFORMANCE REVIEW IS PROVIDED TO THE COMMITTEE. THE COMMITTEE ALSO OBTAINS COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT. BASED ON ALL OF THESE FACTORS, THE COMMITTEE SETS THE BASE SALARY AND BENEFITS OF THE CEO AND APPROVES THE EXECUTIVE COMPENSATION PLAN APPLICABLE TO THE CEO. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR THE CEO, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO "EXCESS BENEFIT" AMOUNT IS PAID OR FURNISHED. LINE 15B: THE BOARD OF DIRECTORS HAS ESTABLISHED A BOARD COMMITTEE KNOWN AS THE HUMAN RESOURCES COMMITTEE WHOSE MEMBERS ARE ALL PROFESSED MEMBERS OF THE RELIGIOUS CONGREGATION KNOWN AS THE SISTERS OF THE THIRD ORDER OF ST. FRANCIS WHO HAVE TAKEN A VOW OF POVERTY. HENCE, THEY DO NOT PERSONALLY BENEFIT FROM DECISIONS OF THE COMMITTEE. THE COMMITTEE DETERMINES WHICH OFFICERS, KEY EMPLOYEES AND OTHER EMPLOYEES ARE ELIGIBLE TO PARTICIPATE IN THE EXECUTIVE COMPENSATION PLAN. BASED ON PERFORMANCE REVIEWS BY THE SUPERVISORS OF SUCH PERSONS AND COMPENSATION SURVEY DATA AND RECOMMENDATIONS FROM A NATIONALLY KNOWN INDEPENDENT COMPENSATION CONSULTANT, THE COMMITTEE APPROVES ANY EXECUTIVE COMPENSATION PLAN APPLICABLE TO KEY EMPLOYEES AND ESTABLISHES THE BASE SALARY AND BENEFITS FOR PLAN PARTICIPANTS. PRIOR TO PAYMENT OF ANY BONUS OR INCENTIVE COMPENSATION, THE TOTAL COMPENSATION FOR EACH KEY EMPLOYEE, INCLUDING BASE SALARY, BENEFITS, AND PROPOSED BONUS OR INCENTIVE COMPENSATION, IS AGAIN REVIEWED BY A NATIONALLY RECOGNIZED COMPENSATION CONSULTANT TO ENSURE THAT NO "EXCESS BENEFIT" AMOUNT IS PAID OR FURNISHED. SOME KEY EMPLOYEES LISTED IN PART VII ARE PRACTICING PHYSICIANS WHO ARE LISTED AS KEY EMPLOYEES AS A RESULT OF THE COMPENSATION THEY RECEIVE AND NOT DUE TO ANY EXECUTIVE OR MANAGEMENT POSITION WHICH THEY HOLD. SUCH PHYSICIANS GENERALLY ARE NOT PARTICIPANTS IN THE EXECUTIVE COMPENSATION PLAN, AND THEIR COMPENSATION, INCLUDING BASE SALARY, BENEFITS, AND ANY APPLICABLE BONUS OR INCENTIVE COMPENSATION, IS ESTABLISHED IN ACCORDANCE WITH NATIONALLY RECOGNIZED PHYSICIAN COMPENSATION SURVEYS AND IS SET FORTH IN WRITTEN EMPLOYMENT AGREEMENTS WHICH ARE APPROVED BY THE BOARD OF DIRECTORS OR ITS EXECUTIVE COMMITTEE. THE REVIEW PROCESSES DESCRIBED ABOVE BEGAN IN JULY 2012 FOR FISCAL YEAR 2013 SALARY DATA, AND IT WAS APPROVED TO PROVIDE AN AVERAGE OF 3% SALARY INCREASE FOR MANAGEMENT EFFECTIVE DECEMBER 2012.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5:NET UNREALIZED LOSSES ON INVESTMENTS: -3,840,639.CHANGES IN NET ASSETS OR FUND BALANCES:
FORM 990, PART XII, LINE 2C:THE ORGANIZATION'S GOVERNING BOARD MEETS WITH THE AUDITORS TO REVIEW THE AUDIT REPORT AND MANAGEMENT LETTER.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
OTTAWA REGIONAL HOSPITAL FOUNDATION
1100 EAST NORRIS DRIVEOTTAWAIL61350364007569SUPPORTS OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTERIL501(C)(3)LINE 11A, IOTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER1
OTTAWA REGIONAL HOSPITAL AUXILIARY
1100 EAST NORRIS DRIVEOTTAWAIL61350363854788SUPPORTS OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTERIL501(C)(3)LINE 11C, III-FI0N/A
OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER LIABILITY LOSS FUND
1100 EAST NORRIS DRIVEOTTAWAIL61350363612653LIABILITY TRUST FUNDIL501(C)(3)LINE 11A, IOTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER1

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartnerPercentage OwnershipPercentageOwnership
RADIATION ONCOLOGY OF NORTHERN ILLINOIS LLC
1200 STARFIRE DRIVEOTTAWAIL61350753247165RADIATION ONCOLOGY CENTERILOTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTERRELATED4457321085041000.57000
OTTAWA REGIONAL CARDINAL SLEEP CENTER LLC
1601 MERCURY CIRCLE SUITE 2OTTAWAIL61350273625479SLEEP DISORDER DIAGNOSTIC AND TREATMENT SERVICESILOTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTERRELATED001.00000

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
OTTAWA REGIONAL HEALTHCARE AFFILIATES INC
1100 EAST NORRIS DRIVEOTTAWAIL61350263937519HOLDING COMPANYILOTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTERC-290824028517341.00000
OTTAWA REGIONAL MEDICAL CENTER INC
1614 EAST NORRIS DRIVEOTTAWAIL61350271036071OUTPATIENT MEDICAL AND DIAGNOSTIC SERVICESILOTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTERC1.00000
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 Org1GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities1SharingOfFacilities
Sharing Of Paid Employees1SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
OTTAWA REGIONAL MEDICAL CENTER INC
A404921
OTTAWA REGIONAL MEDICAL CENTER INC
B3392673