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Centegra Health System: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
Centegra Health System (EIN 36-3196559)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-15
IRS object ID
201341359349306329
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)
Timestamp2013-05-15T12:27:23-07:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN363196559EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Centegra Health SystemBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCENTNameControl
Phone8157885800Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1385 Millennium DriveAddressLine1
CityCrystal LakeCity
StateILState
ZIP Code60012ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRobert T GreenName
TitleExec. V.P. & C.F.O.Title
Date Signed2013-05-15DateSigned
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMichael EesleyNameOfPrincipalOfficerPerson
Gross Receipts111271364GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.centegra.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionThe primary mission of the Centegra Health System is to coordinate the delivery of quality healthcare services with the innovative and responsible use of resources and to promote wellness for the greater McHenry County area.ActivityOrMissionDescription
Nbr Voting Members Governing Body21NbrVotingMembersGoverningBody
Nbr Independent Voting Members6NbrIndependentVotingMembers
Total Nbr Employees694TotalNbrEmployees
Total Nbr Volunteers321TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year88879647ProgramServiceRevenuePriorYear
Program Service Revenue CY107379472ProgramServiceRevenueCY
Investment Income Prior Year1104907InvestmentIncomePriorYear
Investment Income Current Year1062299InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year89984554TotalRevenuePriorYear
Total Revenue Current Year108441771TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year40453008SalariesEtcPriorYear
Salaries Etc Current Year51179404SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year60326887OtherExpensePriorYear
Other Expenses Current Year66824721OtherExpensesCurrentYear
Total Expenses Prior Year100779895TotalExpensesPriorYear
Total Expenses Current Year118004125TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-10795341RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-9562354RevenuesLessExpensesCY
Total Assets BOY76016802TotalAssetsBOY
Total Assets EOY68280033TotalAssetsEOY
Total Liabilities BOY88843359TotalLiabilitiesBOY
Total Liabilities EOY80685158TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-12826557NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-12405125NetAssetsOrFundBalancesEOY
Mission DescriptionThe primary mission of the Centegra Health System is to coordinate the delivery of quality healthcare services with the innovative and responsible use of resources and to promote wellness for the greater McHenry County area.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense77684031Expense
Revenue107379472Revenue
DescriptionSee Schedule O.Description
Total Program Service Expense77684031TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationtrueBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096114NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees694NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccounttrueForeignFinancialAccount
Name Of Foreign CountryCJNameOfForeignCountry
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members21NbrVotingGoverningBodyMembers
Number Independent Voting Members6NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiestrueDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturetrueInvestmentInJointVenture
Written Policy Or ProceduretrueWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMichael EesleyNamePerson
Telephone Number8157885800TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1385 Millennium DriveAddressLine1
CityCrystalCity
StateILState
ZIP Code60012ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (47 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
MICHAEL LUECHT
Director1.00X000
TERRENCE BUGNO
Director1.00X000
JOSEPH KEENAN
Director40.00X000
LISA GLOSSON
Director40.00X166062041064
JOSEPH EMMONS
Director40.00X277001051951
JASON SCIARRO
DIRECTOR/COO40.00X609493086546X
JOANNE KNAPIK
DIRECTOR/VCHAIR40.00X179312043507X
LINDA ALIC
Chairman/CEN EM40.00X210201035542X
CHARIE ZANCK
DIRECTOR/CHAIRM2.00X000X
CHARLES RUTH
Director1.00X000
KATHY POWELL
Director1.00X000
JACK PORTER
Director1.00X000
PARMOD NARANG
Director1.00X000
PAT MOREHEAD
DIRECTOR/TREASU2.00X000X
ANGELA MCAULEY
Director1.00X000
LUKE JOHNSOS
Director1.00X000
MICHAEL EESLEY
DIRECTOR/CEO40.00X11398180404262X
MIKE CURRAN
Director/Vice C2.00X000X
WILLIAM COX
Secretary2.00X000X
TOM CAREY
Director1.00X000
KUMAR NATHAN
Director/VP Hea40.00X250103051056
PASQUALE BERNARDI
VP CPC OPERAT40.00259719027018X
NEIL MURPHY
SR VP CNO40.0012901302638X
ZBIGNIEW LORENC
VP MED AFFAIRS40.00258468035290X
SUSAN MILFORD
SVP STRAT MARKE40.00264569084755X
ROBERT ROSENBERGER
SR VP FINANCE40.00449550088573X
RACHEL SEBASTIAN
VP SERV LINE OP40.00195768035926X
LAURA WALCZAK
DIR EMER SERV40.0088656015193X
GAIL RUDOLPH
VP FOUNDATION40.00183760032763X
MICHAEL FORD
VP CPC OPERATIO40.00127829020566X
DAVID TOMLINSON
VP OPERATIONS40.00272730046622X
BARBARA JOHNSON
SR VP HRD40.00330190027447X
AARON SHEPLEY
SR VP ADMIN AFF40.00343200066848X
DUDLEY BROWN
Director40.00234693040160X
MATTHEW TOWLER
VP SUPPORT SRV40.00127085022366X
BERNADETTE SZCZEPANSKI
VP HUMAN RES40.00186442023778X
John M Heinrich
Director, Diagnostics & Oncology40.00156138030940X
James C Adamson
Director, Risk/Regulatory Matters40.00160357021122X
Christopher Westerkamp
Director, Patient Business Serv40.001671420558X
David A Shinherr
Exec Director, Ortho & Rehab40.00177299032161X
Scott L Padjen
Director of Pharmacy40.00162937031298X
Prashant K Sura
Physician40.00320423049651X
Yao A Yvonne
Physician40.00265152051277X
Marcel T Hoffman
Physician40.00261381034917X
Joseph Emmons
Physician40.00271053051951X
Robin Purdy
Physician40.00266716050095X
Angela Mcauley
Retired0.0045999012198X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8538259TotalReportableCompFromOrg
Total Other Compensation1650039TotalOtherCompensation
Number Individuals GT100 K91NumberIndividualsGT100K
Formers ListedtrueFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
PFS Group
7670 Woodway Suite 250HoustonTX77063Collections1054042
McKesson Technologies
PO Box 98347ChicagoIL606938347Information Systems1593414
K&L Gates
70 W Madison St STE 3100ChicagoIL606024207Legal1086159
Deloitte Consulting LLP
111 S Wacker DriveChicagoIL606064301Consulting Firm2435165
Dell Marketing LP
7489 Collection Center DriveChicagoIL60693Information Systems10391306
FieldValueIRS element (for citing)
Number Of Contractors GT100 K48NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Other Rev-Related 501(c)355111441667404166740
Exp Alloc-Related 501(c)35511146298779962987799
Exp Alloc-Other relatedco621111845950845950
Centegra Primary Care Ops6211113760783237607832
Centegra Ins Svcs Operat52412640279134027913

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column-2256762TotalRevenueColumn
Related Or Exempt Function Income-2256762RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue107379472TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1475179TotalRevenueColumn
Exclusion$1,475,179ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2416713Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2829593Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-412880Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-412880TotalRevenueColumn
Exclusion-$412,880ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column108441771TotalRevenueColumn
Related Or Exempt Function Income107379472RelatedOrExemptFunctionIncome
Exclusion$1,062,299ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total6589978Total
Program Services1244438ProgramServices
Management And General5345540ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total36109919Total
Program Services17707051ProgramServices
Management And General18402868ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total1147136Total
Program Services259872ProgramServices
Management And General887264ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4621955Total
Program Services1940337ProgramServices
Management And General2681618ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2710416Total
Program Services1711530ProgramServices
Management And General998886ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total9761023Total
Program Services8358274ProgramServices
Management And General1402749ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total742567Total
Program Services394ProgramServices
Management And General742173ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total166501Total
Management And General166501ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total65757Total
Program Services65757ProgramServices

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total30406363Total
Program Services25082511ProgramServices
Management And General5323852ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1982293Total
Program Services1979796ProgramServices
Management And General2497ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4139699Total
Program Services3752599ProgramServices
Management And General387100ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4115957Total
Program Services2713208ProgramServices
Management And General1402749ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1774384Total
Program Services254576ProgramServices
Management And General1519808ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total262062Total
Program Services141734ProgramServices
Management And General120328ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total214828Total
Program Services82130ProgramServices
Management And General132698ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total2037Total
Management And General2037ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total116298Total
Program Services116298ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total4734864Total
Program Services4734111ProgramServices
Management And General753ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MISCELLANEOUS24635316807978274
SUBSCRIPTIONS & BOOKS25501856703198315
FORMS6646866635321154
BAD DEBT PROVISION52299955229995

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1944036Total
Program Services1421106ProgramServices
Management And General522930ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total118004125Total
Program Services77684031ProgramServices
Management And General40320094ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY37974194BOY
EOY21753239EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1601059BOY
EOY1601568EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2219348BOY
EOY4558139EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY2076507BOY
EOY2658544EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY4905EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2059059BOY
EOY2957894EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5113256LandBuildingsEquipmentBasis

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3619558BOY
EOY5113256EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY25197080BOY
EOY28146754EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY1085358BOY
EOY1304566EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY184639BOY
EOY181168EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY76016802BOY
EOY68280033EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY16866864BOY
EOY15241106EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY17324345BOY
EOY17348521EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY54652150BOY
EOY48095531EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY88843359BOY
EOY80685158EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-12826557BOY
EOY-12405125EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-12826557BOY
EOY-12405125EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY76016802BOY
EOY68280033EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-9562354ReconcilationRevenueExpenses
Reconcilation Other Changes9983786ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (2 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
Memorial Medical Center
3621797643falsetruetrue$25,195,120
Northern Illinos Medical Center
3623388843falsetruetrue$37,792,680
FieldValueIRS element (for citing)
Total Number Of Supported Orgs2TotalNumberOfSupportedOrgs
Sum Of Amounts62987800SumOfAmounts

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1235786InvestmentCostOrOtherBasis
Book Value1235786BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis3877470InvestmentCostOrOtherBasis
Book Value3877470BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5113256TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Intercompany Accounts Payable$36,153,673
Accrued Professional Liability Claims$11,941,858
FieldValueIRS element (for citing)
Total Of Amounts48095531TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteASC Topic 740, Income Taxes, addresses the determination of how tax benefits claimed or expected to be claimed on a tax return should be recorded in the consolidated financial statements. Under ASC Topic 740, the Health System must recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities, based on the technical merits of the position. The tax benefits recognized in the consolidated financial statements from such a position are measured based on the largest benefit that has a greater than fifty percent likelihood of being realized upon ultimate settlement. ASC Topic 740 also provides guidance on derecognition, classification, interest and penalties on income taxes, and accounting in interim periods and requires increased disclosures. At the date of adoption, and as of June 30, 2012, the Health System does not have a liability for unrecognized tax benefits. The adoption of ASC Topic 740 had no impact on the consolidated financial statements of the Health System.
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesTransfers to Affiliates $10816695 Amort Book/Tax Differences $116298 Rounding Difference $1 Amort Book/Tax Differences $ -155793

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PaymentsXIdemnificationGrossUpPayments
Written Policy Re T And E ExpensesfalseWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (29 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
ZBIGNIEW LORENC
23425324215265108780293758
Yao A Yvonne
2651522946521812316429
SUSAN MILFORD
23778726762632002155534932420
Scott L Padjen
1629371018021118194235
Robin Purdy
2667163431715778316811
ROBERT ROSENBERGER
3845855819566687218865381236770
RACHEL SEBASTIAN
177030187382022915697231694
Prashant K Sura
3204233379215859370074
PASQUALE BERNARDI
248718110011110215916286737
MICHAEL EESLEY
7830973529263933781088415440803795256440
Marcel T Hoffman
261381294005517296298
LISA GLOSSON
1660621992721137207126
LINDA ALIC
210201255579985245743
KUMAR NATHAN
2501032940021656301159
JOSEPH EMMONS
2770013047921472328952
Joseph Emmons
2710533047921472323004
John M Heinrich
156138982821112187078
JOANNE KNAPIK
1793122227921228222819
JASON SCIARRO
5384956823564549219976960392763
James C Adamson
16035721122181479
GAIL RUDOLPH
16691116829114432132021652320
DUDLEY BROWN
2346932945710703274853
DAVID TOMLINSON
248581241492490721715319352
David A Shinherr
1772991103021131209460
Christopher Westerkamp
167142558167700
BERNADETTE SZCZEPANSKI
1801196323187085070210220
BARBARA JOHNSON
26320966981168251062235763735419
Angela Mcauley
459992809938958197
AARON SHEPLEY
306968362324499621852410048

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part I, Line 1bPart I, Line 1b: Reason for not following policy regarding payment provisions for expensesCentegra does not have a written policy regarding the payment of the items listed on schedule J, part I, line 1a; however, these expenses were reviewed and approved by management as prudent and fiscally responsible business decisions.
Sch J, Part I, Line 1aPart I, Line 1a: Relevant information in regards to selections on 1a.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (8 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
McHenry County Orthopaedics
Director3852Medical Servicesfalse
Business Graphics
Director33661Contractorfalse
Curran Contracting Company
Director31374Contractorfalse
Carey Electric
Director294753Electrical Workfalse
American Community Bank
Vice Chairman106282Certificate of Depositfalse
American Community Bank
Director106815Certificate of Depositfalse
Home State Bank
Director100000Certificate of Depositfalse
Home State Bank
Treasurer100000Certificate of Depositfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
ExplanationThe business transactions with interested persons are arms length transactions.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (16 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Pat VI, Line 12c - Conflicts1. In connection with any actual or possible conflicts of interest, an interested person or other person subject to this policy must disclose the existence and nature of his or her financial interest in writing to the President of Centegra or the Chief Corporate Responsiblity Officer or designee, who shall provide such written disclosure to the Governors Affairs Committee of Centegra, which shall consider all conflicts of interest issues and, if appropriate, to the directors and members of committees with board-delegated powers considering the proposed transaction of arrangement. The disclosure must occur, at minimum, annually, with a Conflict of Interest Disclosure Statement being submitted no later than January 31st of each year. Copies of disclosure statements filed by Board members shall be distributed to the Board annually at the February Board meeting. 2. When a conflict of interest is disclosed at meeting of the board or committee thereof, after disclosure of the financial interest, the interested person shall leave the board or committee meeting while the financial interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. The interested person's leaving such meeting shall not affect whether a quorum exists at such meeting. 3. Procedures for Addressing the Transaction of Arrangement from Which the Conflict Arose. The chairperson of the board of committee shall, if appropriate, appoint a disinterested person or committee to investigate alternatives to the proposed transaction or arrangement. After exercising due diligence, the board of committee shall determine whether Centegra can obtain a more advantageous transaction or arrangement with reasonable efforts from a person or entity that would not give rise to a conflict of interest. If a more advantageous transaction or arrangement is not reasonably attainable under circumstances that would not give rise to a conflict of interest, the board or committee shall determine by a majority vote of the disinterested directors whether the transaction or arrangement is in Centegra's best interest and for its own benefit and whether the transaction is fair and reasonable to Centegra and shall make its decision as to whether to enter into the transaction or arrangement in conformity with such determination. 4.Violations of the Conflicts of Interest Policy: If the administration, the Board, or a committee has a reasonable cause to believe that a member has failed to disclose actual or possible conflicts of interest, it shall inform the member of the basis for such belief and afford the member an opportunity to explain the alleged failure to disclose. If, after hearing the response of the member and making such further investigation as may be warranted in the circumstances, the Board or committee determines that the member has, in fact, failed to disclose an actual or possible conflict of interest, it shall refer the matter to the Governors Affairs Committee for consideration, which shall subsequently recommend appropriate disciplinary and corrective action to such board or committee. 5. The minutes of the board and all committees with board-delegated powers shall contain the names of the persons who disclosed or otherwise were found to have a financial interest in connection with an actual or possible conflict of interest, the nature of the financial interest, any action taken to determine whether a conflict of interest was present, and the board's or committee's decision as to whether a conflict of interest, in fact, existed. The names of the persons who were present for discussions and votes relating to the transaction or arrangement, the content of the discussion, including any alternatives to the proposed transaction or arrangement, and a record of any votes taken in connection therewith. Continued below.
Form 990, Pat III, Line 4a, Con'tEXERCISE PROGRAMS The Medical Centers, in conjuction with Centegra Health System offer specialized exercise programs that help participants get moving and stay active for a healthier lifestyle. These include: Low Back Water Class, Basketball League, Racquetball League, Seniors in Motion, Arthritis Water Exercise Program, Senior Citizen's Exercise Group, The Get Off Your Rocker Program designed for individuals at least 55 years of age to improve flexibility, strength, and endurance; and the Stroke Exercise Program which is a general physical conditioning exercise program for stroke patients to improve coordination and increase range of motion. Yoga, Tai Chi, Relaxation Management, Weight Management, and a variety of other programs are offered through Health Bridge Fitness Center.
Form 990, Part V, Line 1cCentegra Health System did not have reportable payments to vendors or reportable gaming winnings to prize winners during the fiscal year 2012. If these payments had occured, however, Centegra Health System would have complied with the backup holding rules for these payments as appropriate.
Form 990, Part IV, Ln 12 & Part XI Ln 2bCentegra Health System was audited on a consolidated basis. The consolidated audit is done with the oversight of the Finance and Audit Committee.
Form 990, Part III, Line 4a, Con'tOTHER PROGRAMS Together We Can Immunization Partnership Clinics were instituted at the Medical Centers and Medical Offices to provide immunizations for the unvaccinated children under age 18 in McHenry County. Clinics are held once a month at the medical centers and office buildings providing Hepatitis B, DPT, Hib, OPV, MMR and Td immunizations. Fees are based upon ability to pay with a maximum charge of $12.00 per immunization. The Medical Centers were the first hospitals in the state of Illinois to adopt the E.N.C.A.R.E. program (Emergency Nurses Cancel Alcohol Related Emergencies) program which lets nurses tell teenagers exactly what they have learned on the job -- that alcohol causes death, disability, and pain to thousands of teenagers, throughout the country, every year. The Medical Centers incorporate Independence Square into its physical therapy/rehabilitation program. Using Independence Square, disabled individuals can practice and master the skills required for personal hygiene, home maintenance, financial management, mobility, and social interaction in the security and privacy of the rehabilitation department. Independence Square utilizes these distinctive environments: apartment, ATM/Bank & Office, Boat Dock, Bus & Car,Cafe & Restaurant, Golf Course, Grocery Store, Pharmacy & Department Store, and Porch & Ambulation Course. Therapists and clinical staff are able to assess and evaluate the progress of each patient using a unique form of individual care. When individual confidence and proficiency return, discharge planning and community re-entry training complete the rehabilitation program. The Rehabilitation and Sports Medicine Clinic at Health Bridge Fitness Center provides sports medicine, aquatics, outpatient physical and occupational therapy programs. The Back to Work Program, an industrial injury prevention and rehabilitation program provides physical therapy, ergonomic consultation and back safety programs. The program also uses the aquatic pool located at the Rehabilitation and Sports Medicine Clinic at Health Bridge Fitness Center. The Centegra Pain Management Center specializes in providing advanced, innovative treatments, which succeed in relieving most types of pain. The physicians, pain psychologist, nurses, and staff are specially trained and experienced in the field of pain management. Educational materials on chronic pain were developed and made available to the community at trade/health fairs. The Neurotrauma Day Treatment Program serves individuals who have experienced traumatic brain injury and neurological impairments due to stroke, accident, or disease. It is a comprehensive program for patients requiring intensive, interdisciplinary services on an outpatient basis. The program facilitates the individual's function and independence in the home, work, school, and community with integrated and holistic treatment. Services include physical therapy, occupational therapy, speech therapy, neuropsychology, social work, nursing, vocational counseling, and recreational therapy. This program also has access to facilities at Health Bridge Fitness Center and may work in conjunction with the Back to Work Program. Centegra Health System is a learning center (clinical site) for students from a multitude of colleges and universities. Students have completed internships in programs such as nurse practitioner, nursing, nurse aide, physician assistant, social work, speech therapy, phlebotomy, diagnostic medical sonography, medical imaging, medical records, pharmacy, medical physics, surgical technology, professional counselor, substance abuse counselor, and medical assistant. Centegra Health System is also a learning site for 3rd and 4th year medical students from the University of Illinois Rockford.
Form 990, Part III, Line 4a Con'tSUPPORT GROUPS Centegra Health System, in conjuction with the Medical Centers and Affiliates, sponsors or hosts many support groups for its patients as well as the community. The following ongoing support groups are held at the Medical Centers, Affiliates or in the community and are free of charge. By supporting these groups, the Medical Centers and Affiliates are able to provide one or all of the following three things: 1)Staff professionals who either act as facilitators of the group or function as "Guest Speakers," 2)Space offered free of charge, 3)Free marketing to educate the community about these services. Programs sponsored by the Medical Centers and/or Affiliates in conjunction with Centegra Health System include:*Alcoholics' Anonymous is a twelve-step program for individuals recovering from alcohol dependence.*Alcoholics' Anonymous, Women's Group is a special group for women.*Al-Anon is a twelve-step program group for codependent individuals.*Arthritis Support Group is for individuals with arthritis.*Bariatric Support Group is for those individuals who have had weight loss surgery.*Better Breathers Club is for those individuals with pulmonary disease and their families.*Caregivers' Support Group is for those who care for someone with a chronic or life-threatening illness.*Diabetes Support Group is for individuals with Diabetes and their families.*Epilepsy Support Group is for individuals with Epilepsy and their families.*Families' Anonymous is a support group for families with chemically dependent members.*Fibromyalgia Support Group is for those suffering from Fibromyalgia.*Get Help Live Longer is a smoking cessation education and support group.*Hat's Off is a group for women diagnosed with any type of cancer meeting every month.*Headwinds is a support group offered to survivors of traumatic brain injury and their family members and caregivers. The Medical Centers participate in conjunction with the Pioneer Center.*Infertility Support Group is a group for couples or individuals experiencing infertility problems.*Living with Grief, sponsored by Centegra Pastoral Care, offers support for adults grieving the loss of a loved one.*Looking Beyond is for people diagnosed with Cancer, their family members, and friends.*Make Today Count is a group for anyone with a life-threatening illness as well as their family and friends.*McHenry County Crisis Line provides 24-hour mental health information, referral services, and crisis assistance.*Multiple Sclerosis (MS) Support Group is under the Illinois Chapter of the National Multiple Sclerosis Society. The group is open to persons with MS, their family members and others interested in the treatment and management of the disease.*Narcotics Anonymous is a twelve-step support program for those recovering from narcotics dependence.*Nuts and Bolts is a unique support group for stroke survivors who are 55 years of age or younger. The emphasis of this group is on assisting the families as they adapt to the special lifestyle changes of the young stroke survivor.*Perinatal Grief Support Group is for anyone who has experienced the loss of a newborn or an infant through miscarriage, ectopic pregnancy, or Sudden Infant Death Syndrome (SIDS).*St. Peregrine's Cancer Support Group is a non-denominational support group for patients and their families and friends.*What's Aphasia? is a group for stroke survivors and family members who have an impairment of their ability to speak or comprehend words.*Wingspan is a group that provides the opportunity of open discussions, question and answer sessions, lectures, and social events for people recovering from strokes as well as their families.*Y-Me Breast Cancer Support Program is a national program designed to let participants listen to physicians, survivors, social workers, and nurses who have been invited to speak on topics such as handling anger, considered prostheses, and concerns about breast implant risks.
Form 990, Part III, Line 4a Con'tOTHER COMMUNITY SERVICES The Medical Centers and Affiliates participate in various community projects, such as: Meals on Wheels, Immunization Clinics, National Depression/Anxiety Screening Day, free Flu Vaccination Clinics, and health and county business fairs in order to promote health and awareness in the community. Other community services are hospital tours for area schools, shadowing opportunites for area schools, Flight for Life Helicopter appearances, poison awareness programs, blood drives, mammograms, blood pressure, skin, and colorectal cancer screenings and lipid profiles. Glaucoma, hearing, and other screenings are offered in order to promote health and awareness in the community. The Medical Centers and Affiliates also distribute thousands of informational brochures, service listings, and flyers at the request of area schools, churches, and organizations on an ongoing basis. Centegra S.H.I.P. (Senior Health Insurance Program) provides trained volunteers on a weekly basis to answer questions regarding insurance coverage. Silver Key Club is the senior citizens group for Centegra Health System. It is a free membership group for people 55 years of age and older, which provides four issues of a senior newsletter each year, a health diary for members to list their medications and health history, and a discount in the hospital cafeteria at both NIMC and MMC. At certain times of the year, there are discounted screenings and/or special services available for members. Community education is also made available to Silver Key Members through early bird reservations, or through general news releases. Emergency Room Treatment Forms are parent/guardian permission forms to administer emergency treatment to minors in time of need. The Medical Centers sponsor blood drives every year and was able to provide numerous pints of blood to those in need.The Medical Centers provide Patient Express! transportation services for individuals who require transportation to the Medical Centers. The Patient Express! van is provided and is frequently used by the disabled and elderly individuals of the community. The service is provided free of charge, although donations are accepted to defray the costs of the service. In fiscal year 2012, the service provided 10,754 trips to those in need. The Referral Line is a toll-free phone line sponsored by the Medical Centers. It offers free, computerized service to callers who require information or physician referrals. A trained counselor staffs the line. Several medical specialties are represented, and physicians are on staff for referrals. The line also gives information regarding physician's office hours, locations, insurance, and languages spoken. Additionally, counselors give information on Self-Help and Support Groups.
Form 990, Part III, Line 4a Con'tEDUCATION PROGRAMS The Medical Centers, in conjunction with Centegra Health System, work in cooperation with McHenry County College and Health Bridge Fitness Center to provide a complete series of specialized training for those interested in developing their knowledge of emergency basics, or in pursuing a career in the emergency health care field. There are three levels of training available: First Responder, Emergency Medical Technician - Basic, Emergency Medical Technician - Paramedic. A Medical Dispatcher Course designed to prepare individuals for employment as dispatchers for a public service agency providing dispatch to law enforcement fire service, and/or Emergency Medical Service is also offered. The Medical Centers offer a variety of classes that can help people save lives. The Medical Centers offer Red Cross first aid classes that include First Aid/CPR and a CPR Instructor Course. The Medical Centers' Occupational Health Departments also teach first aid classes on-site as requested by local businesses. Cardio-pulmonary resuscitation (CPR) classes help community members learn CPR prior to certification, or brush up on skills for re-certification. The Medical Centers also offer an American Heart Association Heartsaver CPR, International Trauma Life Support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support training classes. The Medical Centers and Affiliates make a variety of educational programs designed to promote wellness available to all members of the community. Family health and wellness programs presented by the Medical Centers are designed to promote a healthier community. The Medical Centers offer low-cost education classes for expectant families including prenatal and cesarean birth classes, Very Important Sibling Classes, along with free hospital tours. At discharge, new parents are presented with the video, "Baby's First Months: What Do We Do Now". Supersitters is a program which teachs the responsibilities of being a babysitter and includes first aid and accident prevention. The Medical Centers provide various classes to assist with our busy life styles including Relaxation Training and Improving Your Blood Pressure. Lipid screeningsare offered twice each year. Nutrition related offerings include Food and Feelings, Healthy Heart Nutrition and Weight Management Programs. Still more educational programs are offered to assist members of the community take charge of special needs in their lives, in their changing lifestyles for healthier lives, as well as programs to inform the community about Advance Medical Directives. Other programs are the Critical Care Class, Stroke: Are You Doing All You Can?, You're In Control Diabetic Education Program, Men and Depression, and Inderstanding Medicare. Integrative programs include mindful eating, understanding the healing potential of food, and journaling. The Medical Centers sponsor several programs specializing in issues of concern for women as well as reduced fee mammograms, programs on osteoporosis, and programs on menopause. Making Peace with Your Body is a program to teach women body acceptance with an emphasis on what you can realistically change with diet and exercise. Additional Behavioral Health programs offered on a rotating basis include What To Do When Your Loved One Is Depressed, Relationship Addiction, Stepfamilies: Steps to Harmonious Living, and Mind/Body Medicine: An Introduction. Northern Illinois Medical Center's Sage Cancer Center, together with the American Cancer Society and Gavers Community Cancer Foundation, sponsor various Cancer Awareness Programs. The Center offers colorectal cancer screenings, reduced fee mammograms, skin cancer screenings, and reduced fee PSA screenings. Cancer awareness also includes programs on reduction of risk for cancer through good nutrition and healthy lifestyle habits. Northern Illinois Medical Center also sponsors celebrations of cancer survivorship.
Form 990, Part III, Line 4aSTATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS Centegra Health System coordinates the delivery of health care services by assisting in the management of Northern Illinois Medical Center and Memorial Medical Center (The Medical Centers) and Centegra Health System Foundation, Health Bridge Corporation and NIMED Corporation (Affiliates). The Medical Centers' and the Affiliates' program accomplishments are summarized below: The Medical Centers provide optimum quality health care, delivered by competent hospital and medical center staff, to all whom seek its services regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The primary mission of the Medical Centers is to enhance the health of the community as the preferred health care organization providing outstanding service and value. It is the Medical Centers' objective to serve the community with respect to providing health care services and education. Although reimbursement for services rendered is critical to the operation and stability of the Medical Centers, it is recognized that not all individuals possess the ability to purchase essential medical services. Therefore, in keeping with the Medical Centers' commitment to serve all members of its community, free care and/or subsidized care will be considered where the need and/or an individual's inability to pay exist. Medical Services are provided in a dignified manner to Medicare, Medicaid and indigent patients.The Medical Centers' services include, but are not limited to:*351 licensed-bed Comprehensive Medical Center*Level Two Trauma Center*Emergency Medicine Physicians, 24-hours a day*On-site Flight for Life Helicopter*TDD (Telephone Device for the Deaf) in ER: 815-385-0285 and 815-338-0008*Center for New Life including: Level Two Nursery, Antenatal Testing Center, Lamaze Classes, Breastfeeding Classes, Prenatal Classes, Hello Daddy & Dial-A-Dad pagers, and Very Important Sibling Classes*Obstetrics*Surgical and Ambulatory Treatment Services*Intensive and Intermediate Care Unit*Behavioral Health Unit: Adult & Chemical Dependency/Detox Programs, Inpatient Unit, and Partial-Hospitalization Program*Sage Cancer Center*Extended Care Unit*Three-level Cardiac Rehabilitation Program*Cardiac Surveillance*Cardiac Catherization Suite*Heart Failure Clinic*Pediatrics*Full-body CT scanner and Magnetic Resonance Imaging (MRI)*Mammography Screening*Center for Physical Rehabilitation: Inpatient Unit, Independence Square, Occupational, Physical and Speech Therapies, and Outpatient Therapies*Repiratory Therapy*Home Health Care*Back to Work Program for Industrial Injury Prevention and Rehabilitation*Sports Medicine Clinic*First Step Substance Abuse Center: 800-675-8448*McHenry County Crisis Line: 800-892-8900*Pharmacy Information Line: 815-338-9090*Associate Health Program: 815-334-3944*Occupational Health*Women's Diagnostic Services (in Medical Imaging)*Poison Control Hotline: 815-338-5975*Patient Express! Transportation*Extra Touch Program*Sleep Disorders Center*Pastoral Care*Social Service*Community Education Programs*Nutritional Therapy Services*Support Programs/Groups*Neurotrauma Day Treatment Program Centegra Health System Foundation provides fund-raising services for Centegra Health System in conjunction with the Medical Centers. The proceeds of these activities are used to purchase medical equipment and supplies, therefore enabling the Medical Centers to better serve the community. Health Bridge Corporation provides various rehabilitation services for the Medical Centers in conjunction with Centegra Health System, by providing a fitness center and pool that serves the community in various capacities and sponsors and hosts assorted educational programs. NIMED Corporation aids in the management of the Medical Centers and several satellite locations within the Centegra Health System organization.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableThe organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.Form 990, Part VI, Line 19
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsContinued from above. 6. A voting member of any committee whose jurisdiction includes compensation matters and who receives compensation, directly or indirectly, form Centegra for services is precluded from voting on matters pertaining to that member's compensation. Physicians who receive compensation, directly or indirectly, from Centegra, whether as employees or independent contractors, are precluded from membership on any committee whose jurisdiction includes compensation matters and in which such physician may have a direct or indirect interest. 7. Each director, principal officer, and member of a committee with board-delegated powers shall annually sign a statement which affirms that such person has received a copy of the conflicts of interest policy; has read and understands the policy; has agreed to comply with the policy; and understands that Centegra is a charitable organization and that in order to maintain its federal tax exemption, it must engage primarily in activities which accomplish one or more of its tax exempt purposes. 8. To ensure that Centegra operates in a manner consistent with its charitable purposes and that it does not engage in activities that could jeopardize its status as an organization exempt from federal income tax, periodic reviews shall be conducted by the Governors Affairs Committee of Centegra. The periodic reviews shall, at a minimum, include the following subjects: Whether acquisition of physician practices and other provider services result in inurement or impermissible private benefit. Whether partnership and joint venture arrangements and arrangements with management service organizations and physician hospital organizations conform to written policies, are properly recorded, reflect reasonable payment for goods and services, further Centegra's charitable purposes and do not result in inurement or impermissible private benefit. Whether agreements to provide healthcare and agreements with other healthcare providers, employees, and third party payors further Centegra's charitable purposes and do not result in inurement or impermissible private benefit. Whether business transactions on behalf of Centegra or an entity controlled by it are the result of arms-length dealing and are no less advantageous than competitively available goods and services of like grade and quality. 9.In conducting the periodic reviews provided for in Article VII, Centegra may, but need not, use outside advisors. If outside experts are used, their use shall not relieve the board of its responsibility for ensuring the periodic reviews are conducted.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessThe review process for the 990 included review by the Director of Accounting and Chief Financial Officer. The 990 also was sent to an outside auditor for review before submission to the IRS.Form 990, Part VI, Line 11
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderCentegra Health System has a single class of members.Form 990, Part VI, Line 6
Form 990, Part VI, Line 3: Description of Delegated Duties to Management CompanyManagement companies were used for the daily operations and management of the following services for the health system: Sodexho was used for Food & Nutrition, Plant Operations and Maintenance, and Environmental Services work. Dell (Perot) was used for the Information Systems area. Professional Business Consultants is used for the management of the Managed Care department.Form 990, Part VI, Line 3
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtCentegra Health System (CHS) has adopted specific conflict of interest policies for its governing and management staff. The policy includes, but is not limited to, when an individual, governor, committee member, officer, agent or employee believes that he or she, or a member of his or her immediate family might have or does have a real or apparent conflict, he or she should in addition to filing the disclosure notice required, abstain from making motions, voting, executing agreements, or taking any other similar direct action on behalf of CHS. Not withstanding, it is understood that both real and apparent conflicts of interest sometimes naturally occur in the course of conducting daily affairs. Conflicts occur because the many persons associated with CHS should be expected to have, and do in fact generally have multiple interests and affiliations, and various positions of responsibility within the community. The long-range interests of CHS do not require the termination of an association with persons who have real or apparent conflicts, if an effective method can render such conflicts harmless to all concerned. During fiscal year 2012, CHS purchased certain goods and/or services from organizations with director's affiliation. All transactions were competitively bid and conducted at arms length. The fees paid were at fair market value. Director Kathy Powell is an employee and Vice President of Home State Bank. Director Patrick Morehead is on the Board of Directors and a 1% owner of Home State Bank. Chairman Charie Zanck is a Director of American Community Bank & Trust. Director Charles Ruth is the Board Chairman of American Community Bank & Trust. Rachel Sebastian, Vice President of Service Line Operations, is the daughter of the Chief Executive Officer, Michael Eesley. Rachel Sebastian reports directly to the President and Chief Operations Officer, Jason Sciarro.Form 990, Part VI, Line 2
Client Note 1 -

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (4 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile Foreign CountryLegalDomicileForeignCountryTotal IncomeTotalIncomeEOY AssetsEOYAssetsBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeLegal Domicile StateLegalDomicileStateDirect Controlling Entity NADirectControllingEntityNA
Centegra Insurance Services Ltd
23 Lime Tree Bay Ave Box 1051George TownGrand CaymanCJKY1-1102363196559Malpractice Insurance ProviderCJ54073517711219NA
Centegra Clinical Laboratories LLC
364706465Laboratory and pathology services-26736166329385 Millennium DriveCrystal LakeIL60014DEN/A
Centegra Health Bridge Fitness Ctr LLC
261277524Health & Fitness CenterHEALTH BRIDGE CORPORATION385 Millennium DriveCrystal LakeIL60012DE
Centegra Primary Care LLC
364085398Primary Care-109393576203141NA385 Millennium DriveCrystal LakeIL60012DE

Form990 Schedule R Part II Form990ScheduleRPartII (6 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Oak Creek Lodge
385 Millennium DriveCrystal LakeIL60012363591359Hospital OperationsIL501(c)(3)3Centegra Health Systemfalse
Health Bridge Corporation
385 Millennium DriveCrystal LakeIL60012363196550Health & Fitness CenterIL501(c)(3)11cCentegra Health Systemfalse
Centegra Health System Foundation
385 Millennium DriveCrystal LakeIL60012363726310Fundraising for Medical CentersIL501(c)(3)11aCentegra Health Systemfalse
NIMED Corporation
385 Millennium DriveCrystal LakeIL60012363199111Property ManagementIL501(c)(3)11cCentegra Health Systemfalse
Memorial Medical Center
3701 Doty RoadWoodstockIL60098362179764Hospital OperationsIL501(c)(3)3Centegra Health Systemfalse
Northern Illinois Medical Center
4201 Medical Center DriveMcHenryIL60050362338884Hospital OperationsIL501(c)(3)3Centegra Health Systemfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Centegra Management Services IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1385 Millennium DriveAddressLine1
CityCrystal LakeCity
StateILState
ZIP Code60012ZIPCode
FieldValueIRS element (for citing)
EIN364028114EIN
Primary ActivityManagementPrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Centegra Health SystemBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityC CorpTypeOfEntity
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg