MERCYHEALTH DEVELOPMENT FOUNDATION INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MERCYHEALTH DEVELOPMENT FOUNDATION INC (EIN 36-3197918)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-11-07
- IRS object ID
- 201203129349301665
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-11-07T15:32:45-00:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PricewaterhouseCoopers | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2001 Market St Ste 1700 | AddressLine1 |
| City | Philadelphia | City |
| State | PA | State |
| ZIP Code | 19103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363197918 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rockford Memorial Development Foundation | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ROCK | NameControl |
| Phone | 8159714141 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 N Rockton Ave | AddressLine1 |
| City | Rockford | City |
| State | IL | State |
| ZIP Code | 61103 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Henry M Seybold Jr | Name |
| Title | Senior VP Finance CFO | Title |
| Date Signed | 2012-11-06 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Matthew Petroski | Name |
| Phone | 2673303000 | Phone |
| Date Prepared | 2012-11-06 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Gary Kaatz President CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 N Rockton Ave | AddressLine1 |
| City | Rockford | City |
| State | IL | State |
| ZIP Code | 61103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 97088007 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.rhsnet.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1982 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | To support the operations of all entities of Rockford Health System provide assistance to these other 501c3 non-profit organizations by receiving, maintaining, and administering funds received from the public and other available sources to further the exempt purposes of these organizations. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 17 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 5 | TotalNbrEmployees |
| Total Nbr Volunteers | 195 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1427149 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1524646 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 4151869 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2018524 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 152142 | OtherRevenuePriorYear |
| Other Revenue Current Year | -18532 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5731160 | TotalRevenuePriorYear |
| Total Revenue Current Year | 3524638 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 1064883 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 1361232 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 528426 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 553812 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 179034 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 763524 | OtherExpensePriorYear |
| Other Expenses Current Year | 802422 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 2356833 | TotalExpensesPriorYear |
| Total Expenses Current Year | 2717466 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 3374327 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 807172 | RevenuesLessExpensesCY |
| Total Assets BOY | 108988211 | TotalAssetsBOY |
| Total Assets EOY | 106074709 | TotalAssetsEOY |
| Total Liabilities BOY | 859071 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1145594 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 108129140 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 104929115 | NetAssetsOrFundBalancesEOY |
| Mission Description | The mission of Rockford Health System RHS is Superior Care. Everyday. For All Our Patients. Rockford Memorial Development Foundation RMDF assists this mission specifically by applying resources to the vision of RHS which is To fulfill this Committment through Performance Excellence, Lifelong Learning, and Innovation. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1135680 | Expense |
| Grants | 845928 | Grants |
| Description | - Restricted gifts and endowments to Rockford Health System help departments fund equipment, facilities projects, and care and comfort items to benefit patients and their families. In 2011, endowment proceeds supported education and training opportunities for RHS employees to help them enhance the care they provide to patients. For example, endowed funds provided training to pilot a contemplative care initiative on the inpatient oncology unit. Additionally, the Foundation provided a final payment in the amount of 150,000 from a multi-year gift from Cedric W. Blazer for renovations to the Orthopedic and Surgical Unit. This unit serves patients who have had significant surgeries including spine, knee, hip, abdominal and more. These expenditures are just a few examples of what was funded with restricted gifts and endowments in 2011. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 262099 | Expense |
| Grants | 262099 | Grants |
| Description | The Family Giving Campaign raised funds in 2011 for three uses an Employee Crisis Fund, the Wishbook catalogue of care and comfort items, and the Employee Education Fund. The crisis fund provides assistance to employees who have experienced a crisis such as a fire or flood in their homes or the severe illness, traumatic injury or death of a spouse or child. The Wishbook provides small items for caregiving departments throughout Rockford Health System. The Employee Education Fund expands opportunities for employees to attend training and skills development seminars. RMDF donations were also used to assist Visiting Nurses Association to care for the elderly, the homebound, the recovering and those facing end of life. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 256899 | Expense |
| Grants | 256899 | Grants |
| Description | Through charitable contributions, RMDF supports the Ronald McDonald Care Mobile, staffed and operated by RMH, which provides free medical and dental care to uninsured and underinsured children in five counties at numerous sites in Northern Illinois. The Care Mobile visits included vaccinations, lead and/or blood screenings, medical diagnoses, preventative and restorative dental care and treatment/care to avoid an emergency room visit. The Foundation replaced lighting in the Helen M. Howell Lobby with dollars from an estate gift given by Ms. Howell. Donations from the Auxiliary to the Foundation provided some of the Care Mobile funding as well as supplies and education materials for Neonatal Intensive Care Unit library and renovations in the NICU family room, health and wellness resources for patients, nursing scholarships for minority students, the Healing Harp program that creates an atmosphere of care and comfort of hospitalized patients, and a video program in both English and Spanish that helps parents provide care for their newborn babies and other support for the system. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 1654678 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | true | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 15 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 5 | NumberOfEmployees |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | true | QuidProQuoContributions |
| Quid Pro Quo Disclosure | true | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 17 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | false | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | David E Vola Controller | NamePerson |
| Telephone Number | 8159715000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2400 N Rockton Ave | AddressLine1 |
| City | Rockford | City |
| State | IL | State |
| ZIP Code | 61103 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| Carol Armstrong | ||||||
| Director | 000.10 | X | 0 | 0 | 0 | |
| Marc LBarbeau | ||||||
| Director | 001.00 | X | 0 | 0 | 0 | |
| John J Holevas | ||||||
| Director | 000.10 | X | 0 | 0 | 0 | |
| W Walter Boothe | ||||||
| Director | 001.50 | X | 0 | 0 | 0 | |
| Julie Bosma | ||||||
| Director | 002.00 | X | 0 | 0 | 0 | |
| George Bates | ||||||
| Director | 000.10 | X | 0 | 0 | 0 | |
| Paul AGreen | ||||||
| Director | 001.00 | X | 0 | 0 | 0 | |
| Hollis AHanson | ||||||
| Director | 000.50 | X | 0 | 0 | 0 | |
| Linda Heckert | ||||||
| Director | 001.00 | X | 0 | 0 | 0 | |
| Phillip ADHiggins | ||||||
| Director | 001.00 | X | 0 | 432677 | 83848 | |
| Gary EKaatz | ||||||
| President | 003.00 | X | 0 | 1065012 | 210096 | X |
| Scott KLaue | ||||||
| Chairman | 002.00 | X | 0 | 0 | 0 | X |
| John JMorrissey | ||||||
| Director | 000.50 | X | 0 | 0 | 0 | |
| Jay Maddox | ||||||
| Director | 001.00 | X | 0 | 0 | 0 | |
| Jeffrey RSmith | ||||||
| Vice-Chairman | 001.00 | X | 0 | 429230 | 52932 | X |
| Dennis TUehara | ||||||
| Director | 001.00 | X | 0 | 469530 | 71890 | |
| Mark DZarnke | ||||||
| Director | 002.00 | X | 0 | 140800 | 0 | |
| Helen Brooks | ||||||
| Executive Director | 040.00 | 206807 | 0 | 67935 | X | |
| Henry MSeybold | ||||||
| Treasurer | 000.25 | 0 | 494320 | 104980 | X | |
| Vicki Woodhouse | ||||||
| Secretary | 040.00 | 42656 | 0 | 13465 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 249463 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 3031569 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 605146 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | true | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | NA | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Fundraising Events | 218793 | FundraisingEvents |
| Related Organizations | 170000 | RelatedOrganizations |
| All Other Contributions | 1135853 | AllOtherContributions |
| Total Contributions | 1524646 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1868376 | TotalRevenueColumn |
| Exclusion | $1,868,376 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 93573820 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 93423672 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 150148 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 150148 | TotalRevenueColumn |
| Exclusion | $150,148 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 121089 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 218793 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 139697 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -18608 | TotalRevenueColumn |
| Exclusion | -$18,608 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Miscellaneous | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 76 | TotalRevenueColumn |
| Exclusion | $76 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 76 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3524638 | TotalRevenueColumn |
| Exclusion | $1,999,992 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1361232 | Total |
| Program Services | 1361232 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 337460 | Total |
| Program Services | 134984 | ProgramServices |
| Management And General | 121486 | ManagementAndGeneral |
| Fundraising | 80990 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143493 | Total |
| Program Services | 57397 | ProgramServices |
| Management And General | 51658 | ManagementAndGeneral |
| Fundraising | 34438 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 19487 | Total |
| Program Services | 8783 | ProgramServices |
| Management And General | 5698 | ManagementAndGeneral |
| Fundraising | 5006 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41945 | Total |
| Program Services | 19070 | ProgramServices |
| Management And General | 12044 | ManagementAndGeneral |
| Fundraising | 10831 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11427 | Total |
| Program Services | 4571 | ProgramServices |
| Management And General | 4114 | ManagementAndGeneral |
| Fundraising | 2742 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 60000 | Total |
| Management And General | 60000 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8592 | Total |
| Management And General | 8592 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees For Services Prof Fundraising | FeesForServicesProfFundraising |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 589908 | Total |
| Management And General | 589908 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1236 | Total |
| Management And General | 1236 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6716 | Total |
| Program Services | 3500 | ProgramServices |
| Management And General | 3216 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 96124 | Total |
| Program Services | 54070 | ProgramServices |
| Management And General | 15506 | ManagementAndGeneral |
| Fundraising | 26548 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3364 | Total |
| Management And General | 3364 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3358 | Total |
| Management And General | 3358 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2501 | Total |
| Program Services | 1000 | ProgramServices |
| Management And General | 901 | ManagementAndGeneral |
| Fundraising | 600 | Fundraising |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3299 | Total |
| Program Services | 1319 | ProgramServices |
| Management And General | 1188 | ManagementAndGeneral |
| Fundraising | 792 | Fundraising |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 421 | Total |
| Management And General | 421 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Food | 12914 | 7748 | 2583 | 2583 |
| Other Purchased Services | 13661 | 161 | 13500 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 328 | Total |
| Program Services | 1004 | ProgramServices |
| Management And General | -1680 | ManagementAndGeneral |
| Fundraising | 1004 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2717466 | Total |
| Program Services | 1654678 | ProgramServices |
| Management And General | 883754 | ManagementAndGeneral |
| Fundraising | 179034 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 31933 | BOY |
| EOY | 10693 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1215235 | BOY |
| EOY | 1405822 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 653864 | BOY |
| EOY | 589587 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 72 | BOY |
| EOY | 978 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4491 | BOY |
| EOY | 14395 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 153405 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 149674 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3731 | BOY |
| EOY | 3731 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 96946793 | BOY |
| EOY | 94296913 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10132092 | BOY |
| EOY | 9752590 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108988211 | BOY |
| EOY | 106074709 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 797820 | BOY |
| EOY | 1079355 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 61251 | BOY |
| EOY | 66239 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 859071 | BOY |
| EOY | 1145594 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 93493455 | BOY |
| EOY | 90760806 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9269834 | BOY |
| EOY | 8911007 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5365851 | BOY |
| EOY | 5257302 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108129140 | BOY |
| EOY | 104929115 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 108988211 | BOY |
| EOY | 106074709 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 807172 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -4007197 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type1 | X | SupportingOrg509a3Type1 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | false | ContribByControllingIndividual |
| Contribution By Related Party | false | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | false | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (3 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | AmountAmount |
|---|---|---|---|
| Rockford Memorial Hospital | |||
| 362167847 | 3 | true | $0 |
| Visiting Nurses Assn | |||
| 362167945 | 9 | true | $0 |
| Rockford Health Physicians | |||
| 363907436 | 3 | true | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 3 | TotalNumberOfSupportedOrgs |
| Public Support Pertcentage170 | 0.00000 | PublicSupportPertcentage170 |
| Public Support Percentage509 | 0.00000 | PublicSupportPercentage509 |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 97751872 | BeginningOfYearBalance |
| Contributions | 1645735 | Contributions |
| Investment Earnings Or Losses | -1457092 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1361232 | GrantsOrScholarships |
| Other Expenditures | 635634 | OtherExpenditures |
| Administrative Expenses | 596213 | AdministrativeExpenses |
| End Of Year Balance | 95347436 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 88668632 | BeginningOfYearBalance |
| Contributions | 1738649 | Contributions |
| Investment Earnings Or Losses | 9948265 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1064883 | GrantsOrScholarships |
| Other Expenditures | 985990 | OtherExpenditures |
| Administrative Expenses | 552801 | AdministrativeExpenses |
| End Of Year Balance | 97751872 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 72939613 | BeginningOfYearBalance |
| Contributions | 1572227 | Contributions |
| Investment Earnings Or Losses | 17349427 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1990984 | GrantsOrScholarships |
| Other Expenditures | 724771 | OtherExpenditures |
| Administrative Expenses | 476880 | AdministrativeExpenses |
| End Of Year Balance | 88668632 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 99000446 | BeginningOfYearBalance |
| Contributions | 2008929 | Contributions |
| Investment Earnings Or Losses | -25700856 | InvestmentEarningsOrLosses |
| Grants Or Scholarships | 1309396 | GrantsOrScholarships |
| Other Expenditures | 491317 | OtherExpenditures |
| Administrative Expenses | 568193 | AdministrativeExpenses |
| End Of Year Balance | 72939613 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.96000 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.03000 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.01000 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 60859 | OtherCostOrOtherBasis |
| Depreciation | 60859 | Depreciation |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 83301 | OtherCostOrOtherBasis |
| Depreciation | 83301 | Depreciation |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 9245 | OtherCostOrOtherBasis |
| Depreciation | 5514 | Depreciation |
| Book Value | 3731 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 3731 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (3 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Employee Rec-Supplemental Survivor Premium | 42392 |
| Interest in Beneficial Trust | 9643959 |
| Life Insurance and others | 66239 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 9752590 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Life Insurance Value | $54,743 |
| Capital Accumulation Account | $11,318 |
| CAA Fas 124 Valuation | $178 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 66239 | TotalOfAmounts |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| V | 4 | - Funds were used to provide a lecture series, for continuing education for employees wanting to improve their credentials or to focus on a new skill or some technology not currently available in the Rockford community. There were also miscellaneous projects designated by the foundation board in accordance with the specific endowment. All funds were expended per the specific direction of each endowment. |
| X | 2 | - FIN48 ASC 740 was adopted by the Rockford Health System board of directors in 2007. As there was, and has been, no material impact since that time, there was no footnote included in the audit. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Gala | NameOfEvent1 |
| Gross Receipts Event1 | 271136 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 181316 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 89820 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 112727 | OtherDirectExpensesEvent1 |
| Name Of Event2 | Golf | NameOfEvent2 |
| Gross Receipts Event2 | 40439 | GrossReceiptsEvent2 |
| Charitable Contributions Event2 | 16810 | CharitableContributionsEvent2 |
| Gross Revenue Event2 | 23629 | GrossRevenueEvent2 |
| Cash Prizes Event2 | 1948 | CashPrizesEvent2 |
| Rent Facility Costs Event2 | 13912 | RentFacilityCostsEvent2 |
| Other Direct Expenses Event2 | 2094 | OtherDirectExpensesEvent2 |
| Total Number Of Other Events | 1 | TotalNumberOfOtherEvents |
| Gross Receipts Other Events | 28307 | GrossReceiptsOtherEvents |
| Charitable Contrib Other Events | 20667 | CharitableContribOtherEvents |
| Gross Revenue Other Events | 7640 | GrossRevenueOtherEvents |
| Other Direct Expenses Other Events | 9016 | OtherDirectExpensesOtherEvents |
| Gross Receipts Total | 339882 | GrossReceiptsTotal |
| Charitable Contributions Total | 218793 | CharitableContributionsTotal |
| Gross Revenue Total Events | 121089 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 1948 | CashPrizesTotalEvents |
| Rent Facility Costs Total Events | 13912 | RentFacilityCostsTotalEvents |
| Other Direct Expenses Total Events | 123837 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 139697 | DirectExpenseSummaryEvents |
| Net Income Summary | -18608 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (7 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Method Of ValuationMethodOfValuation | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|---|
| Rockford Health Council | ||||||||
| 1601 Parkview Ave | Rockford | IL | 61107 | 363229371 | 501c3 | 20000 | Other | Community Program |
| Metropolitan Chicago Healthcare Council | ||||||||
| 222 S Riverside Plaza | Chicago | IL | 60606 | 362167008 | 501c3 | 13642 | Other | Community Poison Control |
| March of Dimes Foundation | ||||||||
| 5411 E State | Rockford | IL | 61108 | 131846366 | 501c3 | 10000 | Other | Community Event |
| Regional Access & Mobilization Project (RAMP) | ||||||||
| 202 Market Street | Rockford | IL | 61107 | 363149827 | 501c3 | 7500 | Other | Community Program |
| Milestone Inc | ||||||||
| 4060 McFarland Road | Rockford | IL | 61111 | 362769801 | 501c3 | 5000 | Other | Community Program |
| The Haven Network | ||||||||
| 124 N Water Street Ste 303B | Rockford | IL | 61107 | 200620800 | 501c3 | 5000 | Other | Community Program |
| GiGi's Playhouse | ||||||||
| 8801 N 2nd Street Ste 2 | Machesney Park | IL | 61115 | 272251844 | 501c3 | 5000 | Other | Community Program |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 6 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | true | WrittenPolicyReTAndEExpenses |
| Substantiation Required | true | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | true | SeverancePayment |
| Supplemental Nonqual Retire Plan | true | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Phillip ADHiggins | |||||||||||||
| 422025 | 1600 | 9052 | 58500 | 25348 | 516525 | ||||||||
| Gary EKaatz | |||||||||||||
| 627315 | 369197 | 68499 | 84178 | 125919 | 1275108 | 89051 | |||||||
| Jeffrey RSmith | |||||||||||||
| 413485 | 1600 | 14145 | 36500 | 16432 | 482162 | ||||||||
| Dennis TUehara | |||||||||||||
| 455767 | 12215 | 1548 | 58500 | 13390 | 541420 | ||||||||
| Helen Brooks | |||||||||||||
| 164646 | 41472 | 689 | 35681 | 32254 | 274742 | 5668 | |||||||
| Henry MSeybold | |||||||||||||
| 357107 | 128327 | 8886 | 41536 | 63444 | 599300 | 24857 | |||||||
Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| I | 1a | - By policy Membership to the YWCA is paid for the CEO. Two social club memberships are paid for by the organization for the CEO and any personal use of these facilities is reimbursed in full. The actual cost of these memberships is prorated for personal vs business use and that percentage is added to taxable wages. The organization also pays for half of a social club membership for the Executive Director. If personal use exceeds business use, the additional prorated cost is added to taxable |
| I | 4a | - A future increase in severance this year for Gary Kaatz was 26,082 by contract. |
| I | 4b | - The executive team receives annual additions to a non-qualified retirement plan. These amounts, accrued for 2010, are included in compensation and listed in detail in Part II for Gary Kaatz 97,196 Henry Seybold 37,168 and Helen Brooks 6,668. |
| I | 7 | - Short term incentive opportunities, designating threshold, target and maximum annual awards are established for all executives, driven by the strategic initiatives and priorities of RHS. If incentive thresholds are not met, CEO may grant discretionary bonuses for outstanding performance within certain parameters. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990 Part VI | 1a | - Rockford Health System RHS is the sole corporate member of the Foundation and has the authority to elect members to the board and ultimately has the authority to approve or deny all RMDF board actions. |
| Form 990 Part VI | 11a | - The data was gathered by the accounting staff with input from RMDF and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RHS tax analyst. Once the Form 990 was completed, it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intracompany website. A presentation of the return was made to the RHS Finance Committee and at a meeting of the RMDF Board of Directors before filing. |
| Form 990 Part VI | 12c | - RHS Compliance Department acting on behalf of RMDF and following guidelines set forth in the policy generally sends out a copy of the policy with the Conflict of Interest form included. Each member completes the Financial Interest Disclosure Statement which is a part of the policy. The RHS Compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed, potential conflicts reviewed and appropriate actions are taken as a result of the review. Employees are usually given the policy and a statement to complete at the beginning of the year or as a new party is hired or joins the RMDF board. The process was delayed during 2011 notices did not go out until 2012. |
| Form 990 Part VI | 15b | - Compensation for executives is governed by the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for executives from related entities including RMDF. This Board has established a Compensation Committee to establish and review all executive compensation annually based on the established philosophy. An independent external executive compensation firm provides consulting on RHS including RMDF salary ranges and compensation philosophy. The appropriate peer group for compensation comparison purposes is other not-for-profit healthcare systems similar in size and complexity. RHS generally conducts an analysis of total compensation every three years but may vary from this schedule as directed by the Compensation Committee. The RMDF board concedes the authority to set compensation to RHS, the sole corporate member. |
| Form 990 Part VI | 19 | - Financial statements are available through the Illinois Attorney Generals Office. Governing documents are available by request from Board Secretary. |
| Form 990 Part VII | 1 | - Some members of the board were compensated by related organizations for other duties as follows Mark Zarnke Independent surgeon who provides Emergency Trauma coverage and a Medical Staff director was compensated by RMH Phillip Higgins worked 60 hrs Medical Director OB-GYN and active physician, Jeffery Smith 57 hrs Medical Director-General Medicine and active physician, and Dennis Uehara 56 hrs Chair of Emergency Department, practicing physician, and corporate board member and they were compensated by RHPH Rockford Health Physicians and RMH Rockford Memorial Hospital Gary Kaatz as President and CEO also worked an additional 42 hrs. and Henry Seybold an additional 44.25 hrs as CFO Sr VP of Finance they spent most of their time and received compensation for those duties and as board officers for and in support of the other related entities RMH/RHPH/RHS/VNA. |
| Form 990 Part XI | 5 | The change in fund balances for permanent and temporarily restricted net asset was the result of Unrealized gains/losses 4,247,041 Reduction in Pledges Receivables 75,000 Mkt Value Chg in Externally Managed Restricted Funds 388,627 UPMIFA Valuation 6,658 Chg in Unexpended Restricted Funds 35,342 Mkt Value Chg in Endowments 24,936 and endowments expended 707,219. |
| Form 990 Part VI Section A Line 1a - Rockford Health System RHS is the sole corporate member of the Foundation and has the authority to elect members to the board and ultimately has the authority to approve or deny all RMDF board actions. Form 990 Part VI Section B Line 11a - The data was gathered by the accounting staff with input from RMDF and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RHS tax analyst. Once the Form 990 was completed, it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intracompany website. A presentation of the return was made to the RHS Finance Committee and at a meeting of the RMDF Board of Directors before filing. Form 990 Part VI Section B Line 12c - RHS Compliance Department acting on behalf of RMDF and following guidelines set forth in the policy generally sends out a copy of the policy with the Conflict of Interest form included. Each member completes the Financial Interest Disclosure Statement which is a part of the policy. The RHS Compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed, potential conflicts reviewed and appropriate actions are taken as a result of the review. Employees are usually given the policy and a statement to complete at the beginning of the year or as a new party is hired or joins the RMDF board. The process was delayed during 2011 notices did not go out until 2012. Form 990 Part VI Section B Line 15b - Compensation for executives is governed by the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for executives from related entities including RMDF. This Board has established a Compensation Committee to establish and review all executive compensation annually based on the established philosophy. An independent external executive compensation firm provides consulting on RHS including RMDF salary ranges and compensation philosophy. The appropriate peer group for compensation comparison purposes is other not-for-profit healthcare systems similar in size and complexity. RHS generally conducts an analysis of total compensation every three years but may vary from this schedule as directed by the Compensation Committee. The RMDF board concedes the authority to set compensation to RHS, the sole corporate member. Form 990 Part VI Section C Line 19 - Financial statements are available through the Illinois Attorney Generals Office. Governing documents are available by request from Board Secretary. Form 990 Part VII Section A Line 1 - Some members of the board were compensated by related organizations for other duties as follows Mark Zarnke Independent surgeon who provides Emergency Trauma coverage and a Medical Staff director was compensated by RMH Phillip Higgins worked 60 hrs Medical Director OB-GYN and active physician, Jeffery Smith 57 hrs Medical Director-General Medicine and active physician, and Dennis Uehara 56 hrs Chair of Emergency Department, practicing physician, and corporate board member and they were compensated by RHPH Rockford Health Physicians and RMH Rockford Memorial Hospital Gary Kaatz as President and CEO also worked an additional 42 hrs. and Henry Seybold an additional 44.25 hrs as CFO Sr VP of Finance they spent most of their time and received compensation for those duties and as board officers for and in support of the other related entities RMH/RHPH/RHS/VNA. Form 990 Part XI Line 5 The change in fund balances for permanent and temporarily restricted net asset was the result of Unrealized gains/losses 4,247,041 Reduction in Pledges Receivables 75,000 Mkt Value Chg in Externally Managed Restricted Funds 388,627 UPMIFA Valuation 6,658 Chg in Unexpended Restricted Funds 35,342 Mkt Value Chg in Endowments 24,936 and endowments expended 707,219. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg | Direct Controlling Entity NADirectControllingEntityNA |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Rockford Memorial Hospital | |||||||||||
| 2400 N Rockton Ave | Rockford | IL | 61103 | 362167847 | Healthcare | IL | 501c3 | 3 | Rockford Health System | true | |
| Rockford Health System | |||||||||||
| 2400 N Rockton Ave | Rockford | IL | 61103 | 363197915 | Support of Healthcare | IL | 501c3 | 11c | false | N/A | |
| Rockford Health Physicians | |||||||||||
| 2300 N Rockton Ave | Rockford | IL | 61103 | 363097436 | Healthcare | IL | 501c3 | 3 | Rockford Health System | true | |
| Visiting Nurses Assn of the Rockford Area | |||||||||||
| 2400 N Rockton Ave | Rockford | IL | 61103 | 362167945 | Healthcare | IL | 501c3 | 9 | Rockford Health System | true | |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Van Matre Rehab Center LLC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3660 Grandview | AddressLine1 |
| City | Birmingham | City |
| State | AL | State |
| ZIP Code | 35243 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364397130 | EIN |
| Primary Activity | Healthcare | PrimaryActivity |
| Legal Domicile State | IL | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | NA | PredominantIncomeType |
| Disproportionate Allocations | false | DisproportionateAllocations |
| General Or Managing Partner | false | GeneralOrManagingPartner |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rockford Health Insurance LTD | BusinessNameLine1 |
Address Foreign AddressForeign
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Wellesley House So 2nd Flr 90 Pitts | AddressLine1 |
| City | Pembrooke | City |
| Province Or State | HM | ProvinceOrState |
| Country | BD | Country |
| Postal Code | 08 | PostalCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Primary Activity | Insurance | PrimaryActivity |
| Legal Domicile Foreign Country | BD | LegalDomicileForeignCountry |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C Corp | TypeOfEntity |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | true | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | false | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Rockford Memorial Hospital | ||
| b | 529507 | Financial Analysis |
| Visiting Nurses Association | ||
| b | 168752 | Financial Analysis |
| Rockford Memorial Hospital | ||
| c | 160000 | Financial Analysis |
| Rockford Memorial Hospital | ||
| c | 79395 | Financial Analysis |
| Rockford Memorial Hospital | ||
| n | 408125 | Financial Analysis |