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NORTHWEST COMMUNITY HOSPITAL: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
NORTHWEST COMMUNITY HOSPITAL (EIN 36-2340313)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-08-03
IRS object ID
201212169349301056
Schema version
2010v3.7
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)
Timestamp2012-08-03T16:33:40-05:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1155 NORTH WACKER DRIVEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362340313EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northwest Community HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlNORTNameControl
Phone8476181000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1800 WEST CENTRAL ROADAddressLine1
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameStephen O ScognaName
TitleEVP/CFOTitle
Date Signed2012-08-03DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3128792000Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonBruce K CrowtherNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1800 W Central RoadAddressLine1
CityArlington HeightsCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
Gross Receipts848122804GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.nch.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1953YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionNCH operates an acute care hospital in Arlington Heights, IL. The hospital exists to provide quality compassionate healthcare services to the people of the Northwest suburban community of Chicago.ActivityOrMissionDescription
Nbr Voting Members Governing Body18NbrVotingMembersGoverningBody
Nbr Independent Voting Members17NbrIndependentVotingMembers
Total Nbr Employees3860TotalNbrEmployees
Total Nbr Volunteers850TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year58803610ContributionsGrantsPriorYear
Contributions Grants Current Year1732845ContributionsGrantsCurrentYear
Program Service Revenue Prior Year429297770ProgramServiceRevenuePriorYear
Program Service Revenue CY464896764ProgramServiceRevenueCY
Investment Income Prior Year3115869InvestmentIncomePriorYear
Investment Income Current Year1384958InvestmentIncomeCurrentYear
Other Revenue Prior Year6127030OtherRevenuePriorYear
Other Revenue Current Year6015024OtherRevenueCurrentYear
Total Revenue Prior Year497344279TotalRevenuePriorYear
Total Revenue Current Year474029591TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year438997GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY2958497GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year236671537SalariesEtcPriorYear
Salaries Etc Current Year242624121SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year216879648OtherExpensePriorYear
Other Expenses Current Year236398778OtherExpensesCurrentYear
Total Expenses Prior Year453990182TotalExpensesPriorYear
Total Expenses Current Year481981396TotalExpensesCurrentYear
Revenues Less Expenses Prior Year43354097RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-7951805RevenuesLessExpensesCY
Total Assets BOY610945530TotalAssetsBOY
Total Assets EOY591409283TotalAssetsEOY
Total Liabilities BOY440717241TotalLiabilitiesBOY
Total Liabilities EOY440310263TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY170228289NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY151099020NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionNORTHWEST COMMUNITY HOSPITAL EXISTS TO IMPROVE THE HEALTH OF THE COMMUNITIES WE SERVE AND TO MEET INDIVIDUALS' HEALTHCARE NEEDS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense53227428Expense
Grants0Grants
Revenue52896610Revenue
DescriptionCARDIAC NORTHWEST COMMUNITY HOSPITAL'S (HOSPITAL) CARDIAC CARE PROGRAM PROVIDED QUALITY, PATIENT-CENTERED COMPASSIONATE CARE, REGARDLESS OF ABILITY TO PAY, TO APPROXIMATELY 32,000 INPATIENTS AND OUTPATIENTS DURING FY 2011. THE TREATMENT WAS PROVIDED IN HOSPITAL'S STATE-OF-THE-ART DIGITAL CARDIAC CATH LAB SUITES, INCLUSIVE OF ITS HIGH TECH OPERATING ROOMS AND PRIVATE FAMILY-CENTERED PATIENT CARE ROOMS. AN ON-CALL TEAM OF NURSES, RADIOLOGY TECHS, OR TECHS, CARDIOLOGISTS AND SURGEONS WERE READILY AVAILABLE 24 HOURS A DAY, 7 DAYS A WEEK, TO PROVIDE EMERGENT CARE TO THOSE WITH CARDIAC DISEASE. THE CARDIAC TEAM WORKS WITH THE EMERGENCY ROOM AND MULTIPLE NEIGHBORING COMMUNITY PARAMEDICS AND EMERGENCY PERSONNEL TO EXCEED THE NATIONAL BENCHMARK OF DOOR TO BALLOON TIME (OR OPEN ARTERY) IN LESS THAN 90 MINUTES FOR PATIENTS PRESENTING IN HOSPITAL'S EMERGENCY ROOM HAVING AN ACUTE MI. HOSPITAL HAS BEEN REPEATEDLY RECOGNIZED FOR ITS COMMITMENT TO QUALITY OUTCOMES AND IS CURRENTLY RECOGNIZED AS AN ACCREDITED CHEST PAIN CENTER BY THE SOCIETY FOR CHEST PAIN CENTERS AND AN ACCREDITED ECHO LAB BY THE INTERSOCIETAL COMMISSION FOR THE ACCREDITATION OF ECHOCARDIOGRAPHY LABORATORIES (ICAEL). IN ADDITION, HOSPITAL HAS ALSO BEEN RECOGNIZED FIVE TIMES BETWEEN 2000 AND 2010 AS A THOMSON REUTERS TOP 100 HEART HOSPITAL FOR PROVIDING EXCELLENCE IN A COST EFFECTIVE MANNER TO MULTIPLE CARDIAC PATIENT POPULATIONS. HOSPITAL HAS ALSO BEEN THE RECIPIENT OF MULTIPLE HEALTHGRADES AWARDS FOR EXCELLENCE IN CARDIAC SERVICES, MOST RECENTLY IN 2010. THE CARDIAC DEPARTMENT ALSO PROVIDES MULTIPLE SCREENING AND EDUCATION PROGRAMS, INCLUDING FREE INDIVIDUAL CONSULTATIONS WITH CARDIAC REHAB PERSONNEL FOR COMMUNITY MEMBERS CONSIDERED TO BE AT RISK FOR DEVELOPING HEART DISEASE BASED ON THEIR COMPLETION OF HOSPITAL'S ON LINE SCREENING TOOL. IN FEBRUARY 2011, HOSPITAL HOSTED A COMMUNITY EVENT WHICH PROVIDED FREE BLOOD PRESSURE, CHOLESTEROL AND BMI SCREENINGS WHICH WERE USED TO CALCULATE AN INDIVIDUAL'S RISKS OF DEVELOPING HEART DISEASE. IN ADDITION, PHYSICIANS PROVIDED EDUCATION ON HEART HEALTH AND WELLNESS. OVER 300 PEOPLE PARTICIPATED IN THE EVENT.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense41491548Expense
Grants0Grants
Revenue33649484Revenue
DescriptionGENERAL SURGERY HOSPITAL'S GENERAL SURGERY PROGRAM PROVIDED QUALITY, PATIENT-CENTERED, COMPASSIONATE CARE, REGARDLESS OF ABILITY TO PAY, TO 3,180 GENERAL SURGICAL PATIENTS (INPATIENT AND OUTPATIENT) DURING FY 2011. PROCEDURES WERE PERFORMED IN STATE-OF-THE-ART OPERATING ROOMS WHICH INCLUDED THREE DEDICATED MINIMALLY INVASIVE SURGERY SUITES. THE GENERAL SURGERY PROGRAM PROVIDED CARE FOR BOTH PEDIATRIC AND ADULT POPULATIONS. IN FY 2011, HOSPITAL PARTNERED WITH CHILDREN'S MEMORIAL HOSPITAL IN CHICAGO TO PLAN FOR A NEONATAL SURGERY PROGRAM TO SUPPORT ITS NEW LEVEL 3 NICU. THE GENERAL SURGERY PROGRAM ALSO INCLUDED DAVINCI ROBOTIC CAPABILITIES AND A DEDICATED PANCREATIC SURGERY PROGRAM. GENERAL SURGERY SERVICES WERE PROVIDED 24 HOURS A DAY, 7 DAYS A WEEK, AND THE PROGRAM WAS DESIGNATED A LEVEL 2 TRAUMA CENTER. HOSPITAL RECEIVED MULTIPLE HEALTHGRADES AWARDS WHICH INCLUDE GI SERVICES. GENERAL SURGERY MORTALITY AND SURGICAL SITE INFECTIONS OBSERVED TO EXPECTED RATIOS WERE IN THE "LOW" RANGE BASED ON HOSPITAL'S CASE MIX INDEX. A MULTIDISCIPLINARY TEAM WORKED TO IMPROVE RESULTS IN THE SURGICAL CARE IMPROVEMENT PROJECT'S CORE MEASURES. AN ADVANCED PRACTICE NURSE WAS HIRED TO OVERSEE SURGICAL OUTCOMES AND IMPROVE PERFORMANCE IN ALL SURGICAL SPECIALTIES. AREAS OF CONCENTRATION INCLUDED: ANTIBIOTICS ADMINISTERED WITHIN 60 MINUTES OF INCISION, APPROPRIATE ANTIBIOTICS ADMINISTERED, ANTIBIOTICS DISCONTINUED WITHIN 24 HOURS, APPROPRIATE HAIR REMOVAL, URINARY CATHETER REMOVED POST-OP DAY 1 OR 2, SURGERY TEMPERATURE MANAGEMENT, BETA BLOCKER PRIOR TO SURGERY AND VTE PROPHYLAXIS. THE MAJORITY OF HOSPITAL'S OUTCOME MEASURES WERE AT OR ABOVE BENCHMARK LEVELS.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense34301326Expense
Grants0Grants
Revenue27461105Revenue
DescriptionORTHOPEDICS HOSPITAL'S ORTHOPEDIC PROGRAM PROVIDES QUALITY, PATIENT CENTERED COMPASSIONATE CARE, REGARDLESS OF ABILITY TO PAY, 24 HOURS A DAY, 7 DAYS A WEEK TO ADULT AND GERIATRIC PATIENTS REQUIRING ORTHOPEDIC INTERVENTION WITH CASE MANAGEMENT INTEGRATED INTO THE DELIVERY OF CARE. THE UNIT TEAM, PRIMARILY COMPOSED OF REGISTERED NURSES, ASSISTED BY PATIENT CARE TECHNICIANS; PHYSICAL, RESPIRATORY, OCCUPATIONAL AND SPEECH THERAPISTS; DIETITIANS; CHAPLAINS AND PHARMACISTS, PROVIDES EVALUATION AND TREATMENT OF ILLNESS IN THE ACUTE PHASE AND ADVANCED CLINICAL MANAGEMENT OF THE ORTHOPEDIC PATIENT. PATIENT-FOCUSED CARE AND EDUCATION ARE PROVIDED IN RESPONSE TO A NUMBER OF DIAGNOSES, INCLUDING: TOTAL JOINT REPLACEMENT, FRACTURES, NON-HEAD INJURIES, BACK PAIN, AND EPIDURAL INTERVENTION. FORM 990, PART III - OTHER PROGRAM SERVICES, LINE 4D GASTROENTEROLOGY HOSPITAL'S GASTROENTEROLOGY (GI) CENTER PROVIDES QUALITY, PATIENT-CENTERED COMPASSIONATE CARE TO PATIENTS, IN NEED OF DIAGNOSTIC AND THERAPEUTIC ENDOSCOPIC PROCEDURES REGARDLESS OF ABILITY TO PAY, 24 HOURS A DAY, 7 DAYS A WEEK. THE GI CENTER HAS BECOME A REGIONAL REFERRAL CENTER FOR PATIENTS IN NEED OF INTERVENTIONAL PROCEDURES INCLUDING ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND ENDOSCOPIC ULTRASOUND. A STATE-OF-THE-ART INTERVENTIONAL SUITE OFFERS PATIENTS ACCESS TO SUPERIOR QUALITY CARE BY PROVIDING DIGITAL IMAGING. HOSPITAL'S INTERVENTIONAL TEAM IS LED BY AN EXPERT INTERVENTIONAL PHYSICIAN AND AN INTERVENTIONAL PROCEDURE CONSULTANT. THIS TEAM PROVIDES SAME-DAY CARE FOR PATIENTS IN AND BEYOND HOSPITAL'S SERVICE AREA WHO ARE IN NEED OF INTERVENTIONAL PROCEDURES. IN FY 2011 THE GI CENTER PROVIDED SERVICE FOR 12,951 PATIENTS. IN ADDITION TO THE PROGRAM SERVICES LISTED ABOVE, HOSPITAL PROVIDES MANY OTHER HEALTHCARE SERVICES ON A DAILY BASIS. THESE ADDITIONAL PROGRAMS INCLUDE CLINICAL EDUCATION AND RESEARCH, NEONATAL CARE, AND EMERGENCY CARE. HOSPITAL IS A SUBSIDIARY ENTITY OF NORTHWEST COMMUNITY HEALTHCARE (NCH). NCH WAS ESTABLISHED TO OWN, OPERATE, CONTROL, AND OTHERWISE COORDINATE THE DELIVERY OF HEALTHCARE WITHIN THE SERVICE AREA OF HOSPITAL AND COORDINATE THE ACTIVITIES OF THE VARIOUS CORPORATIONS AFFILIATED WITH NCH. SUBSIDIARIES OF NCH INCLUDE HOSPITAL, NORTHWEST COMMUNITY HOSPITAL FOUNDATION (FOUNDATION) AND NORTHWEST COMMUNITY DAY SURGERY CENTER, INC., (DAY SURGERY CENTER) WHICH ARE NOT-FOR-PROFIT ENTITIES; NORTHWEST COMMUNITY HEALTH SERVICES, INC., WHICH OWNS AND OPERATES THE NCH MEDICAL GROUP, A MULTI-SPECIALTY PHYSICIAN PRACTICE THAT WAS ESTABLISHED IN 2010 AND NPC-CYBERKNIFE, LLC, WHICH ARE TAXABLE ENTITIES; AND NCH CASUALTY INSURANCE SPC LIMITED (NCHCI), A CAYMAN ISLANDS CORPORATION.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp266880243TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt2958497TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev350889565TotalOfOtherProgramServiceRev
Total Program Service Expense395900545TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
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
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPtrueLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096444NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees3860NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members18NbrVotingGoverningBodyMembers
Number Independent Voting Members17NumberIndependentVotingMembers
Family Or Business RelationshiptrueFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChapterstrueLocalChapters
Policies Reference ChapterstruePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
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 VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonSANDY SORIANamePerson
Telephone Number8476184636TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13060 SALT CREEK LANEAddressLine1
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (41 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
M Shan Atkins
Director1.0X000
James H Bishop
Director1.0X35000
Beth A Brooks
Director1.0X000
Craig E Christell
Director1.0X55000
Dale J Garber
Director1.0X000
Louis A Gatta
Director1.0X55000
Charles A Hempfling
Director1.0X75000
Diane G Hill
Director1.0X5504010
Francis J Lamberta MD
Director/Med Staff Pres. 20111.0X35000
Robert J Longo MD
Director1.0X35000
Allen S Malmed MD
Director/Med Staff Pres. 201010.0X4855000
Louis J Marsico
Director1.0X55000
Ali N Shariatzadeh MD
Director 201010.0X35000
Donald D Torisky
Director 20101.0X75000
Marla E Glabe
Director1.0X000
Mary R Sheahen
Director1.0X35000
William D Soper MD
Director1.0X000
Daniel P DiCaro
Chairperson 20101.0X55000X
Max Brittain Jr
Vice Chair 2010; Chair 201110.0X55000X
Thomas P MacCarthy
Vice Chairperson 201110.0X35000X
Bruce K Crowther
PRESIDENT/CEO/SECRETARY26.0X5730210218463X
Michael B Zenn
Exec Vice Pres/COO/Treas. 201031.063949816381911X
Stephen O Scogna
EXEC VICE PRES/CFO/TREAS. 201131.0000X
Mark Lusson
Exec VP Human Resources40.0291773063908X
Mary Stack
VP Performance Improvement40.0169224042722X
Robert Klasek
VP Facilities Management40.0150676037841X
Gary Skiba
VP Operational Services40.0168119036390X
Dale Beatty
Exec VP Patient Services & CNO38.0272752037913X
Leighton Smith MD
Exec VP Medical Affairs40.0483902078607X
GEORGE MORRIS
VP Info Technology & CIO40.0212991044240X
LAURA POLLACK
VICE PRESIDENT GROWTH40.0142665038451X
Ann Sayvetz
General Counsel40.0250702028330X
Michael C Hartke
Exec VP Clinics Regional Servs40.03556593856230119X
Willis G Parsons MD
Med Dir GI Center40.01735307016642X
Malcolm Bilimoria MD
Gastroenterology Physician40.01439819037765X
Rameez Alasadi MD
Gastroenterology Physician40.0733332026520X
Tahseen Mohammed MD
Medical Dir M H Youth Servs40.0294293027868X
Sonia Mehta MD
Exec Med Dir Immed Care OHS40.0312872036865X
Gail A Finn
Vice President/ CFO0.0256289014404X
Dawn Walden
VP Revenue Cycle Management40.0135715032432X
Angela Stefaniu
VP Mktg Business Development40.0226434044484X
FieldValueIRS element (for citing)
Total Reportable Comp From Org8900493TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs39126TotalReportableCompFrmRltdOrgs
Total Other Compensation975875TotalOtherCompensation
Number Individuals GT100 K191NumberIndividualsGT100K
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
Deloitte Consulting LLP
111 South Wacker DrCHICAGOIL60606CONSULTING SERVICES2941870
Siemens Medical Solutions USA Inc
Dept CH 14195PALATINEIL60055IT SUPPORT2178414
Finelight Inc
1801 South Liberty Drive Suite 300BLOOMINGTONIN47403MARKETING1869827
HLS-Wheeling LLC
13028 Collection Center DrCHICAGOIL60693LAUNDRY SERVICES1794848
Transcend Services Inc
Dept 40089 PO Box 740209ATLANTAGA30374MED. TRANSCRIPTION1581436
FieldValueIRS element (for citing)
Number Of Contractors GT100 K88NumberOfContractorsGT100K
Related Organizations1618852RelatedOrganizations
Government Grants113993GovernmentGrants
Total Contributions1732845TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Net patient services621110460812809460812809
Lab services62150024920492492049
Classes and training90009910681841068184
Nursing services - Palatine Opportunity Center, Li900099176364176364
Research - Hos, GIS900099347358347358
FieldValueIRS element (for citing)
Total Program Service Revenue464896764TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1776082TotalRevenueColumn
Exclusion$1,776,082ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column329TotalRevenueColumn
Exclusion$329ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real2498292Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real1146765Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1351527Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1351527TotalRevenueColumn
Exclusion$1,351,527ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities372116417Securities
Other169443Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities372536151Securities
Other141162Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-419734Securities
Other28281Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-391453TotalRevenueColumn
Exclusion-$391,453ExclusionAmount

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
FieldValueIRS element (for citing)
Gross Sales Of Inventory264132GrossSalesOfInventory
Cost Of Goods Sold269135CostOfGoodsSold

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-5003TotalRevenueColumn
Exclusion-$5,003ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
CAFETERIA7222101800186$1,800,186
Reinsurance Recovery9000991685235$1,685,235
Communications900099336516$336,516

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column846563TotalRevenueColumn
Exclusion$846,563ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue4668500TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column474029591TotalRevenueColumn
Related Or Exempt Function Income464896764RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$7,399,982ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total2958497Total
Program Services2958497ProgramServices

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)
Total4277503Total
Management And General4277503ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total184665591Total
Program Services149061791ProgramServices
Management And General35603800ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total11424292Total
Program Services8945227ProgramServices
Management And General2479065ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total29228060Total
Program Services22794764ProgramServices
Management And General6433296ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total13028675Total
Program Services10394517ProgramServices
Management And General2634158ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total810970Total
Program Services23706ProgramServices
Management And General787264ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total338071Total
Management And General338071ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total30000Total
Management And General30000ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total176215Total
Management And General176215ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total25615079Total
Program Services11473517ProgramServices
Management And General14141562ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total1826109Total
Program Services7220ProgramServices
Management And General1818889ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total80653525Total
Program Services76217639ProgramServices
Management And General4435886ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total6499159Total
Program Services5061262ProgramServices
Management And General1437897ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total9817170Total
Program Services8825108ProgramServices
Management And General992062ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total516077Total
Program Services293237ProgramServices
Management And General222840ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total286877Total
Program Services229226ProgramServices
Management And General57651ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total8193608Total
Program Services8193608ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total40268458Total
Program Services30997149ProgramServices
Management And General9271309ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total6942266Total
Program Services6724572ProgramServices
Management And General217694ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt4196866441968664
Illinois provider tax1167613611676136
Dues31624342370273873
Other46415112335451816

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total481981396Total
Program Services395900545ProgramServices
Management And General86080851ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY16891000BOY
EOY15555289EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2397078BOY
EOY3112463EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY51457091BOY
EOY55078694EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY90465BOY
EOY94386EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY283430BOY
EOY305372EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY4483867BOY
EOY4752063EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY9536463BOY
EOY6193121EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis645198526LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec245766920LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY407905178BOY
EOY399431606EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY104611294BOY
EOY94056794EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY5433417BOY
EOY5753291EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY7856247BOY
EOY7076204EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY610945530BOY
EOY591409283EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY64574817BOY
EOY65928264EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY6463988BOY
EOY3090185EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY288780000BOY
EOY283300000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY80898436BOY
EOY87991814EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY440717241BOY
EOY440310263EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY164794872BOY
EOY145345729EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY4475858BOY
EOY4793222EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY957559BOY
EOY960069EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY170228289BOY
EOY151099020EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY610945530BOY
EOY591409283EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-7951805ReconcilationRevenueExpenses
Reconcilation Other Changes-11177464ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationstrueGrantsOtherOrganizations
Grants Other Organizations$30,000GrantsOtherOrganizationsAmount
Direct Contact LegislatorsfalseDirectContactLegislators
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiestrueOtherActivities
Other Activities$52,045OtherActivitiesAmount
Total Lobbying Expenditures IIB82045TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierLobbying ActivitiesIdentifier
Return ReferencePart II-B, Line 1FReturnReference
ExplanationNorthwest Community Hospital pays dues to certain hospital associations which use a portion of these dues for lobbying.Explanation

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance2248734BeginningOfYearBalance
Contributions169337Contributions
Investment Earnings Or Losses-10576InvestmentEarningsOrLosses
Other Expenditures87845OtherExpenditures
End Of Year Balance2319650EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance2160499BeginningOfYearBalance
Contributions9266Contributions
Investment Earnings Or Losses78969InvestmentEarningsOrLosses
End Of Year Balance2248734EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance2131037BeginningOfYearBalance
Contributions39825Contributions
Investment Earnings Or Losses-10363InvestmentEarningsOrLosses
End Of Year Balance2160499EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.51000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.49000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.00000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgstrueEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RtrueAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1789072OtherCostOrOtherBasis
Book Value1789072BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis307048484OtherCostOrOtherBasis
Depreciation98457960Depreciation
Book Value208590524BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis213114236OtherCostOrOtherBasis
Depreciation90707544Depreciation
Book Value122406692BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis105980254OtherCostOrOtherBasis
Depreciation48206919Depreciation
Book Value57773335BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis17266480OtherCostOrOtherBasis
Depreciation8394497Depreciation
Book Value8871983BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings399431606TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (7 entries)

DescriptionDescriptionAmountAmount
PENSION OBLIGATION$53,071,853
DUE TO THIRD-PARTY PAYORS$30,447,201
INTEREST RATE SWAP LIABILITY$2,127,017
ASSET RETIREMENT OBLIGATION$1,046,437
DUE TO AFFILIATES$145,868
SHORT TERM CAPITAL LEASE OBLIGATION$250,257
LONG TERM CAPITAL LEASE OBLIGATION$903,181
FieldValueIRS element (for citing)
Total Of Amounts87991814TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
TRANSFER AND IMPAIRMENT OF GOODWILLSCHEDULE D, SUPPLEMENTAL INFORMATIONDURING FY 2011, THE HOSPITAL PURCHASED CERTAIN BUSINESS LINES FROM NORTHWEST COMMUNITY HEALTH SERVICES, INC. NEW ACCOUNTING GUIDANCE REQUIRED AN IMPAIRMENT TEST WHICH RESULTED IN THE WRITE-OFF OF GOODWILL IN ITS ENTIRETY ($6,748,415). SEE THE AUDITED FINANCIAL STATEMENTS FOR MORE INFORMATION.
DESCRIPTION OF INTENDED USES OF ENDOWMENT FUNDSSCHEDULE D, PART V, LINE 4ENDOWMENT FUNDS ARE CREATED ACCORDING TO HOSPITAL NEEDS AND DESIGNATION OR PREFERENCES OF THE DONOR(S) SUPPORTING THE ENDOWMENT FUND. SCHOLARSHIP FUNDS, CONTINUED EDUCATION, OR FUNDS FOR PATIENT CARE IN A HOSPITAL DEPARTMENT DESIGNATED BY THE ENDOWMENT FUND ARE EXAMPLES OF FUND USES.

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent400XPcent400
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgetfalseExpensesExceededBudget
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense6886446TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense6886446NetCommunityBenefitExpense
Percent Of Total Expense0.01570PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense39525477TotalCommunityBenefitExpense
Direct Offsetting Revenue26631340DirectOffsettingRevenue
Net Community Benefit Expense12894137NetCommunityBenefitExpense
Percent Of Total Expense0.02930PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense0NetCommunityBenefitExpense
Percent Of Total Expense0.00000PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense46411923TotalCommunityBenefitExpense
Direct Offsetting Revenue26631340DirectOffsettingRevenue
Net Community Benefit Expense19780583NetCommunityBenefitExpense
Percent Of Total Expense0.04500PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1303050TotalCommunityBenefitExpense
Direct Offsetting Revenue66579DirectOffsettingRevenue
Net Community Benefit Expense1236471NetCommunityBenefitExpense
Percent Of Total Expense0.00280PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense1102861TotalCommunityBenefitExpense
Direct Offsetting Revenue546292DirectOffsettingRevenue
Net Community Benefit Expense556569NetCommunityBenefitExpense
Percent Of Total Expense0.00130PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense306964TotalCommunityBenefitExpense
Direct Offsetting Revenue52482DirectOffsettingRevenue
Net Community Benefit Expense254482NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense28000TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense28000NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense612877TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense612877NetCommunityBenefitExpense
Percent Of Total Expense0.00140PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense3353752TotalCommunityBenefitExpense
Direct Offsetting Revenue665353DirectOffsettingRevenue
Net Community Benefit Expense2688399NetCommunityBenefitExpense
Percent Of Total Expense0.00620PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense49765675TotalCommunityBenefitExpense
Direct Offsetting Revenue27296693DirectOffsettingRevenue
Net Community Benefit Expense22468982NetCommunityBenefitExpense
Percent Of Total Expense0.05120PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Bad Debt Expense$11,730,242BadDebtExpenseAmount
Amount Attributable To1055722AmountAttributableTo
Amount Reimbursed By Medicare157977945AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare201103780CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-43125835MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Northwest Community HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1800 W Central RoadAddressLine1
CityArlington HeightsCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Northwest Community HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities11NumberOfOtherFacilities

Other Facilities OtherFacilities (11 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
NCH MENTAL HEALTH & YOUTH CENTER
901 W KIRCHOFF ROADARLINGTON HEIGHTSIL60005IN & OUT MENTAL HEALTH AND YOUTH SUBSTANCE ABUSE TREATMENT
NCH IMMEDIATE CARE & IMAGING CENTER
519 S ROSELLE ROADSCHAUMBURGIL60193WALK IN URGENT CARE CENTER, IMAGING SERVICES & OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH IMMEDIATE CARE & IMAGING CENTER
15 S MCHENRY ROADBUFFALO GROVEIL60089WALK IN URGENT CARE CENTER, IMAGING SERVICES & OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH CARDIAC & PHYSICAL MEDICINE REHAB
900 W CENTRAL ROADARLINGTON HEIGHTSIL60005OUTPATIENT CARDIAC REHAB PROGRAM AND PHYSICAL MEDICINE SERVICES
NORTHWEST COMMUNITY HOSPITAL HOME HEALTH
3060 SALT CREEK LANEARLINGTON HEIGHTSIL60005HOME HEALTHCARE SERVICES
NCH IMMEDIATE CARE & IMAGING CENTER
199 W RAND ROADMOUNT PROSPECTIL60056WALK IN URGENT CARE CENTER AND IMAGING SERVICES
NORTHWEST COMMUNITY HOSPITAL IMAGING
1450 BUSCH PARKWAYBUFFALO GROVEIL60089IMAGING SERVICES
NCH OUTPATIENT CENTER
3300 KIRCHOFF ROADROLLING MEADOWSIL60008OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH IMMEDIATE CARE CENTER
1201 S RAND ROADLAKE ZURICHIL60047WALK IN URGENT CARE CENTER & OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH PHYSICAL MEDICINE & REHAB
1590 N ARLINGTON HEIGHTS ROADARLINGTON HEIGHTSIL60005OUTPATIENT PHYSICAL MEDICINE SERVICES
NCH OCCUPATIONAL WELLNESS & REHAB
455 S ROSELLE ROADSCHAUMBURGIL60193OCCUPATIONAL WELLNESS & REHAB

Form990 Schedule H Part VI Form990ScheduleHPartVI (8 entries)

IdentifierIdentifierExplanationExplanation
PART I, LINE 3CCHARITY CARE POLICY THE HOSPITAL PROVIDES EMERGENT AND MEDICALLY NECESSARY SERVICES TO ALL PATIENTS WITHOUT REGARD TO THE PATIENT'S ABILITY TO PAY. THE WRITTEN CHARITY CARE POLICY IS WIDELY DISTRIBUTED AND COMMUNICATED TO THE COMMUNITY. UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THE AMOUNT OF FREE CARE PROVIDED IS DETERMINED BY FINANCIAL NEED AND IS NOT LIMITED BY BUDGETED AMOUNTS. PATIENTS EARNING LESS THAN 200% OF THE FEDERAL POVERTY GUIDELINES RECEIVE FREE CARE AND THOSE BETWEEN 200% AND 400% OF THE GUIDELINES RECEIVE DISCOUNTED CARE ON A SLIDING SCALE. THE FINANCIAL ASSISTANCE PROGRAM LOOKS AT BOTH THE CURRENT INCOME AND THE INCOME FROM THE PREVIOUS YEAR (AS DISPLAYED IN TAX DOCUMENTS) AND THEN CALCULATES POTENTIAL BENEFITS BASED UPON EACH VARIABLE, OFFERING ITS PATIENT'S THE MOST GENEROUS BENEFIT. THIS POLICY ACKNOWLEDGES THE FRAGILE NATURE OF EMPLOYMENT AND THE IMPACT OF PREVIOUS YEAR HARDSHIPS. CONSISTENT WITH THE ILLINOIS UNINSURED PATIENT DISCOUNT ACT, PATIENTS WITHOUT INSURANCE COVERAGE ARE ELIGIBLE FOR A DISCOUNT IF THEIR INCOME IS AT OR BELOW 600% OF THE FEDERAL POVERTY GUIDELINES. OF THE REMAINING BALANCE, THE PATIENT'S LIABILITY IS CAPPED AT 25% OF THE FAMILY'S ANNUAL INCOME.
PART I, LINE 6ACOMMUNITY BENEFIT REPORT THE HOSPITAL'S COMMUNITY BENEFIT ACTIVITIES ARE INCLUDED IN AN ANNUAL REPORT ISSUED BY NORTHWEST COMMUNITY HEALTHCARE, THE SOLE CORPORATE MEMBER OF THE HOSPITAL.
PART I, LINE 7COSTING METHODOLOGY THE FOLLOWING METHODOLOGIES WERE USED TO DETERMINE THE AMOUNTS REPORTED IN THE TABLE FOR LINE 7: PART I, LINES 7A - 7D, RATIO OF COST TO CHARGES AS DETERMINED USING WORKSHEET 2 IN THE FORM 990, SCHEDULE H INSTRUCTIONS. PART I, LINES 7E - 7I, COSTS WERE DETERMINED USING THE DIRECT COSTS FOR THE SPECIFIC PROGRAM OR SERVICE FROM THE HOSPITAL'S GENERAL LEDGER SYSTEM, WHICH ADDRESSES ALL PATIENT SEGMENTS. PART I, LINE 7G: SUBSIDIZED HEALTH SERVICES THE HOSPITAL HAS NOT INCLUDED ANY COSTS RELATED TO A PHYSICIAN CLINIC AS PART OF SUBSIDIZED HEALTH SERVICES. PART IV, LINE 7, COLUMN (F): BAD DEBT EXPENSE THE AMOUNT OF BAD DEBT EXPENSE INCLUDED IN PART IX, LINE 25, COLUMN (A) THAT WAS EXCLUDED FROM THE CALCULATION OF THIS PERCENTAGE WAS $41,968,664.
PART III, LINE 1BAD DEBT EXPENSE THE HOSPITAL RECORDS BAD DEBT EXPENSE IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES (GAAP). HFMA STATEMENT 15 IS FOLLOWED TO THE EXTENT THAT IT ALIGNS WITH THE GUIDELINES PER GAAP.
PART III, LINE 4BAD DEBT EXPENSE NORTHWEST COMMUNITY HOSPITAL IS INCLUDED IN THE AUDITED FINANCIAL STATEMENTS OF NORTHWEST COMMUNITY HEALTHCARE (NCH) AND SUBSIDIARIES. THE TEXT OF THE FOOTNOTE REFERENCING BAD DEBT EXPENSE IN THE FY 2011 AUDIT IS AS FOLLOWS: "[NCH] EVALUATES THE COLLECTABILITY OF ITS ACCOUNTS RECEIVABLE BASED ON THE LENGTH OF TIME THE RECEIVABLE IS OUTSTANDING, PAYOR CLASS AND THE ANTICIPATED FUTURE COLLECTIBLE AMOUNTS BASED ON HISTORICAL EXPERIENCE. ACCOUNTS RECEIVABLE ARE CHARGED TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS WHEN THEY ARE DEEMED UNCOLLECTIBLE." WRITE-OFFS ARE SHOWN NET OF CONTRACTUALS AND DISCOUNTS. THE HOSPITAL'S BAD DEBT EXPENSE AS REPORTED ON LINES 2 AND 3 WAS DETERMINED USING THE COST TO CHARGE RATIO CALCULATED USING WORKSHEET 2 IN THE FORM 990, SCHEDULE H INSTRUCTIONS. FOR FY 2011, THE HOSPITAL RECORDED PROVISIONS FOR BAD DEBT EXPENSE OF $11,730,242 (AT CHARGES) OF WHICH IT IS ESTIMATED THAT 9% OF THIS AMOUNT WOULD HAVE BEEN REPORTED AS CHARITY IF THE PATIENT WOULD HAVE FULLY COMPLETED THE CHARITY APPLICATION PROCESS. THIS ESTIMATE IS BASED ON PATIENTS WHO BEGAN THE FINANCIAL ASSISTANCE PROCESS BUT DID NOT RESPOND TO THE HOSPITAL'S REQUEST FOR ADDITIONAL INFORMATION AND/OR COMPLETE THE APPLICATION FOR DETERMINATION. THESE PATIENTS WERE DEEMED VIABLE CANDIDATES TO RECEIVE FINANCIAL ASSISTANCE FOR THEIR SERVICES BY THE HOSPITAL'S FINANCIAL COUNSELORS. THE FINANCIAL COUNSELORS FOLLOWED UP IN WRITING AND BY PHONE IN AN ATTEMPT TO OBTAIN THE NECESSARY INFORMATION FOR THE FINANCIAL ASSISTANCE DETERMINATION.
PART III, LINE 8MEDICARE SHORTFALL THE MEDICARE SHORTFALL REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE: (A) WITHOUT THE MEDICARE PROGRAM, IT IS LIKELY THAT MANY OF THESE INDIVIDUALS WOULD QUALIFY FOR CHARITY CARE OR MEDICAID; (B) BY THE HOSPITAL ACCEPTING PAYMENT BELOW COST TO TREAT THESE PATIENTS, THE BURDENS OF GOVERNMENT ARE RELIEVED WITH RESPECT TO THESE INDIVIDUALS; (C) THERE IS A SIGNIFICANT POSSIBILITY THAT CONTINUED REDUCTIONS IN MEDICARE REIMBURSEMENT MAY ACTUALLY REDUCE ACCESS TO CARE FOR THESE INDIVIDUALS; AND (D) THE AMOUNT SPENT BY THE HOSPITAL TO COVER THE MEDICARE SHORTFALL IS MONEY NOT AVAILABLE TO OTHER COMMUNITY NEEDS.
Part III, LINE 9BCOLLECTION PRACTICES IT IS THE POLICY OF THE HOSPITAL TO OFFER PATIENTS A PAYMENT PLAN OR FINANCIAL ASSISTANCE WHEN IT BECOMES KNOWN OR SUSPECTED THAT A PATIENT NEEDS SUCH ASSISTANCE. FINANCIAL COUNSELORS CONTACT AND WORK WITH THE PATIENT OR THEIR FAMILY TO HELP DETERMINE IF THERE ARE ANY THIRD PARTY PAYORS WHICH MAY BE AVAILABLE TO HELP THE PATIENT MEET THEIR OBLIGATIONS, SUCH AS MEDICAID, COBRA, WORKERS COMPENSATION, OR SPECIALIZED GRANT PROGRAMS. IF NO THIRD PARTY PROGRAMS ARE IDENTIFIED, THE FINANCIAL COUNSELORS WORK WITH THE PATIENT TO HELP THEM APPLY FOR CHARITY DISCOUNTS OR PAYMENT PLANS. FORMS ARE AVAILABLE IN ENGLISH AND SPANISH, AND TRANSLATION SERVICES ARE PROVIDED IN MANY LANGUAGES. IN ADDITION, ALL PATIENT BILLS AND STATEMENTS INCLUDE INFORMATION ABOUT HOW TO APPLY FOR FINANCIAL ASSISTANCE AND THE INFORMATION IS ALSO POSTED ON THE HOSPITAL'S WEBSITE. COLLECTION ACTIVITY WILL BE SUSPENDED DURING THE CONSIDERATION OF A COMPLETED FINANCIAL ASSISTANCE APPLICATION OR AN APPLICATION FOR ANY OTHER HEALTHCARE BRACKET (I.E, MEDICARE, MEDICAID, ETC.). A NOTE IS ENTERED INTO THE PATIENT'S ACCOUNT TO SUSPEND COLLECTION ACTIVITY UNTIL THE FINANCIAL ASSISTANCE PROCESS IS COMPLETED. ACCOUNTS IN THE FINANCIAL ASSISTANCE PROCESS WILL BE MONITORED AND, UPON THE DECISION TO APPROVE OR DENY FINANCIAL ASSISTANCE, THE PATIENT'S ACCOUNT WILL BE UPDATED. IF THE FINANCIAL ASSISTANCE APPLICATION IS APPROVED WITH A PERCENTAGE LESS THAN 100% OR DENIED, THE PATIENT'S ACCOUNT WILL BE NOTED AND THE HOSPITAL WILL RESUME THE SELF PAY COLLECTION ACTIVITY IN COMPLIANCE WITH ITS SELF PAY FOLLOW-UP PROCEDURES.
Part VI, LINE 2NEEDS ASSESSMENT IN 2010, THE HOSPITAL PARTICIPATED IN A REGIONAL COMMUNITY HEALTH NEEDS ASSESSMENT OFFERED BY THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL (MCHC) IN PARTNERSHIP WITH PROFESSIONAL RESEARCH CONSULTANTS (PRC). THE ASSESSMENT CONSISTED OF A 30-MINUTE TELEPHONE HEALTH SURVEY THAT WAS CONDUCTED IN ENGLISH AND SPANISH. OVER 1,200 SURVEYS WERE CONDUCTED, WITH 240 IN THE NORTHWEST REGION OF THE COUNTY, WHERE THE HOSPITAL IS LOCATED. CAREFUL CONSIDERATION WAS TAKEN TO ENSURE THAT THE DEMOGRAPHICS OF THOSE PARTICIPATING IN THE SURVEY MIRRORED THE DEMOGRAPHICS OF THE COMMUNITY. THE GOAL OF THE SURVEY WAS TO TARGET ACTUAL HEALTH STATUS, BEHAVIOR AND EXPERIENCES, RATHER THAN PERCEPTIONS. ISSUES ADDRESSED INCLUDED SELF-REPORTED HEALTH STATUS, PHYSICAL HEALTH STATUS, MENTAL HEALTH STATUS, DEATH AND DISABILITY, INFECTION AND CHRONIC DISEASE, BIRTHS, CHILDREN'S HEALTH STATUS, MODIFIABLE HEALTH RISKS, ACCESS TO HEALTHCARE, HEALTH EDUCATION AND OUTREACH, AND HEALTH INFORMATION SOURCES. THE ASSESSMENT ALSO INTEGRATED THE MOST RECENT SECONDARY PUBLIC HEALTH DATA TO COMPLEMENT THE PRIMARY TELEPHONE SURVEY DATA. A HOSPITAL TEAM COMPRISED OF REPRESENTATIVES FROM COMMUNITY SERVICES, IMMEDIATE CARE/WELLNESS, FINANCE, NURSING AND MARKETING DEPARTMENTS THEN REVIEWED RESULTS FOR THE HOSPITAL'S PRIMARY AND SECONDARY SERVICE AREA AND COMPARED IT TO LOCAL, STATE, AND NATIONAL DATA AS WELL AS HEALTHY PEOPLE BENCHMARKS. COMMUNITY HEALTH IMPROVEMENT PLANS WERE DEVELOPED AND PRESENTED TO THE COMMUNITY HEALTH AND OUTREACH COMMITTEE, A COMMITTEE OF THE BOARD OF DIRECTORS, FOR FINAL APPROVAL. THE MOST PREDOMINANT FINDING WAS THE DIFFICULTY THE COMMUNITY HAS IN ACCESSING HEALTHCARE SERVICES WHICH INCLUDES PRIMARY, ORAL, AND BEHAVIORAL HEALTH SERVICES, AS WELL AS PRESCRIPTION MEDICATION. ASSESSMENT FINDINGS SHOWED THAT 39.2% OF THOSE SURVEYED HAD DIFFICULTY ACCESSING PRIMARY HEALTH CARE IN THE PAST YEAR, 22.4% HAD NOT SEEN A DENTIST IN THE PAST YEAR, AND 16.5% OF THE SURVEYED POPULATION REPORTED SKIPPING PRESCRIPTIONS TO SAVE ON COSTS. ANOTHER MAJOR CONCERN AND FOCUS OF THE COMMUNITY HEALTH IMPROVEMENT PLANS WAS IN RESPONSE TO THE STARTLING OBESITY RATES, WITH 48.2% OF THE HOSPITAL'S SERVICE AREA BEING OVERWEIGHT OR OBESE. THROUGHOUT FY 2011, THE HOSPITAL'S COMMUNITY SERVICES DEPARTMENT, WITH OVERSIGHT FROM THE COMMUNITY HEALTH AND OUTREACH COMMITTEE, CONTINUALLY REVIEWED THE IDENTIFIED HEALTH CONCERNS AND THE COMMUNITY HEALTH IMPROVEMENT PLANS THAT WERE IMPLEMENTED TO ADDRESS THE NEEDS. MEASUREMENT TOOLS WERE DEVELOPED FOR ALL PROGRAMS AND MONITORED REGULARLY TO ENSURE THEIR IMPACT AND EFFECTIVENESS. ALSO IN 2011, THE HOSPITAL WAS GIVEN THE OPPORTUNITY TO PROVIDE SUGGESTIONS AND FEEDBACK TO MCHC ON THE 2010 ASSESSMENT TOOL WHICH WILL BE INCORPORATED INTO THE NEXT ASSESSMENT THEY CONDUCT IN 2012. THE HOSPITAL HAS ALREADY COMMITTED TO PARTICIPATING IN THE NEXT ASSESSMENT AND WILL USE THE FINDINGS OF THAT ASSESSMENT TO MAKE ANY MODIFICATIONS NEEDED TO THE CURRENT COMMUNITY HEALTH IMPROVEMENT PLAN. PART VI, LINE 3 PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE THE FINANCIAL ASSISTANCE PROGRAM AT NORTHWEST COMMUNITY HOSPITAL IS COMMUNICATED WIDELY TO PATIENTS AND VISITORS IN ENGLISH AND SPANISH USING THE FOLLOWING METHODS: (1) SIGNAGE IN ENGLISH AND SPANISH IS POSTED THROUGHOUT THE ORGANIZATION AT ALL ACCESS POINTS, INCLUDING THE EMERGENCY DEPARTMENT AND OUTPATIENT REGISTRATION AREAS. THESE AREAS ALSO STOCK AND MAKE AVAILABLE A BROCHURE, PRINTED IN ENGLISH AND SPANISH, DESCRIBING THE HOSPITAL'S POLICY. A FULL-TIME INTERPRETATION SERVICE DEPARTMENT IS AVAILABLE TO ASSIST THOSE WHO NEED ADDITIONAL INFORMATION IN OTHER LANGUAGES. IN 2011 THE HOSPITAL RESPONDED TO OVER 18,000 IN-PERSON REQUESTS AND 4,700 TELEPHONIC REQUESTS IN 45 DIFFERENT LANGUAGES. (2) EACH PAGE OF THE HOSPITAL'S WEBSITE (WWW.NCH.ORG) CONTAINS THE FOLLOWING FOOTNOTE: "NORTHWEST COMMUNITY HOSPITAL IS A CHARITABLE ORGANIZATION AND PROVIDES FINANCIAL ASSISTANCE TO THOSE WHO ARE ELIGIBLE. FOR MORE INFORMATION, CLICK HERE." A LINK TAKES VISITORS TO A SUBSEQUENT PAGE THAT DESCRIBES FINANCIAL ASSISTANCE/CHARITY CARE AND PROVIDES A PHONE NUMBER TO CONTACT AN NORTHWEST COMMUNITY HOSPITAL FINANCIAL COUNSELOR. APPLICATIONS FOR FINANCIAL ASSISTANCE, IN ENGLISH AND SPANISH, ARE AVAILABLE FOR DOWNLOAD ON THE HOSPITAL WEBSITE. (3) ALL EXTERNAL HOSPITAL PUBLICATIONS INCLUDE THE FOLLOWING NOTE: "NORTHWEST COMMUNITY HOSPITAL IS A CHARITABLE ORGANIZATION AND PROVIDES FINANCIAL ASSISTANCE TO PEOPLE WHO ARE ELIGIBLE. FOR MORE INFORMATION PLEASE CALL 847.618.4542 OR VISIT OUR WEBSITE AT WWW.NCH.ORG." (4) INFORMATION ON FINANCIAL ASSISTANCE IS INCLUDED WITH EVERY PATIENT BILL. (5) FINANCIAL COUNSELORS PROVIDE FINANCIAL ASSISTANCE INFORMATION TO PATIENTS DURING THEIR REGISTRATION AND WORK WITH PATIENTS IDENTIFIED AT REGISTRATION OR AFTER ADMISSION TO HELP THEM GET THE ASSISTANCE THEY NEED, ANSWER QUESTIONS, SET UP PAYMENT PLANS AND FACILITATE APPLICATIONS FOR GOVERNMENT PROGRAMS SUCH AS MEDICAID. PART VI, LINE 4 COMMUNITY INFORMATION NORTHWEST COMMUNITY HOSPITAL IS LOCATED IN ARLINGTON HEIGHTS, ILLINOIS, A SUBURB LOCATED APPROXIMATELY 25 MILES NORTHWEST OF CHICAGO. ITS PRIMARY SERVICE AREA CONSISTS OF ARLINGTON HEIGHTS AND THE SURROUNDING SUBURBS OF MT. PROSPECT, PALATINE, AND ROLLING MEADOWS. THE HOSPITAL'S SECONDARY SERVICE AREA IS COMPRISED OF BARRINGTON, BUFFALO GROVE, DES PLAINES, ELK GROVE VILLAGE, HOFFMAN ESTATES, LAKE ZURICH, PROSPECT HEIGHTS, SCHAUMBURG AND WHEELING. THESE AREAS HAVE A COMBINED POPULATION OF APPROXIMATELY 659,000 PEOPLE. THIS NUMBER HAS REMAINED FAIRLY STABLE AND GROWTH OVER THE NEXT 5 YEARS IS EXPECTED TO BE RELATIVELY FLAT. THE HOSPITAL'S TOTAL SERVICE AREA IS PREDOMINATELY CAUCASIAN (70%), FOLLOWED BY HISPANIC (13.9%), ASIAN (12.3%) AND ALL OTHER (3.8%). THE HISPANIC POPULATION IS EXPECTED TO GROW BY 12.1% AND THE ASIAN POPULATION 10.5% OVER THE NEXT 5 YEARS. OF INDIVIDUALS LIVING IN THE HOSPITAL'S TOTAL SERVICE AREA, 8.7% ARE ON MEDICAID AND, PENDING HEALTHCARE REFORM, THIS IS EXPECTED TO GROW BY 18.4% OVER THE NEXT FIVE YEARS. OVER THE PAST 10 YEARS, THERE HAS BEEN A DECIDED SHIFT IN THE AGE OF THOSE LIVING IN THE HOSPITAL'S SERVICE AREA. A PORTION OF THE 18-44 AGE GROUP MOVED INTO THE 45-64 AGE GROUP, RESULTING IN A 19.2% INCREASE. FURTHERMORE, IT IS ESTIMATED THAT IN THE NEXT 5 YEARS, THE AREA WILL SEE FURTHER MIGRATION INTO THE 65+ AGE GROUP. THERE ARE FOUR OTHER HOSPITALS LOCATED IN THE HOSPITAL'S SERVICE AREA. THE ENTIRE PRIMARY SERVICE AREA AND A SIGNIFICANT PORTION OF THE SECONDARY SERVICE AREA HAVE BEEN DESIGNATED AS A MEDICALLY-UNDERSERVED AREA. THE HOSPITAL SUPPORTS BOTH A FEDERALLY QUALIFIED HEALTH CENTER LOCATED ACROSS THE STREET FROM THE HOSPITAL, AND A COUNTY RUN PRIMARY CARE CLINIC, ALSO LOCATED IN THE HOSPITAL'S PRIMARY SERVICE AREA. PART VI, LINE 5 PROMOTION OF COMMUNITY HEALTH THE HOSPITAL PROMOTES THE HEALTH OF ITS COMMUNITY IN MANY WAYS AS FOLLOWS: (1) A MAJORITY OF THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF PERSONS WHO LIVE OR WORK IN THE HOSPITAL'S PRIMARY SERVICE AREA AND ARE NOT EMPLOYEES OR CONTRACTORS OF THE HOSPITAL. (2) A STANDING COMMUNITY HEALTH AND OUTREACH COMMITTEE OF THE HOSPITAL BOARD PROVIDES OVERSIGHT IN MONITORING AND EVALUATING THE EFFECTIVENESS OF ITS COMMUNITY BENEFIT PLAN, INCLUDING CHARITY CARE, COMMUNITY HEALTH EDUCATION, COMMUNITY MEDICAL/DENTAL CLINICS, AND COMMUNITY HEALTH IMPROVEMENT INITIATIVES. (3) MEDICAL STAFF PRIVILEGES ARE EXTENDED TO ALL QUALIFIED PHYSICIANS IN THE HOSPITAL'S COMMUNITY FOR SOME OF ITS DEPARTMENTS. (4) THE HOSPITAL MAINTAINS ANY SURPLUS FUNDS IN THE HOSPITAL ITSELF OR AT NORTHWEST COMMUNITY HEALTHCARE (A 501(C)(3) SUPPORTING ORGANIZATION AND SOLE MEMBER OF THE HOSPITAL) FOR FUNDING CAPITAL IMPROVEMENTS IN TECHNOLOGY, FACILITIES OR PATIENT CARE EQUIPMENT, AND SUPPORTING HOSPITAL OPERATIONS OR COMMUNITY OUTREACH INITIATIVES. (5) THE HOSPITAL HAS DEDICATED STAFF THAT SERVE AS MEMBERS, CHAIRPERSONS, OFFICERS, AND BOARD MEMBERS OF LOCAL AND NATIONAL ORGANIZATIONS DEVOTED TO IMPROVING THE HEALTH AND WELLBEING OF COMMUNITY MEMBERS. THESE ORGANIZATIONS INCLUDE: WINGS (WOMEN IN NEED GROWING STRONGER), NORTHWEST SUBURBAN ALLIANCE ON DOMESTIC VIOLENCE, HARPER COLLEGE NURSING ADVISORY COMMITTEE, METROPOLITAN CHICAGO HEALTHCARE COUNCIL HEALTH CARE WORKFORCE ADVISORY INSTITUTE, SUSAN G. KOMEN FOUNDATION, NORTHERN FOX VALLEY ONCOLOGY NURSING SOCIETY CHAPTER, CHICAGO DENTAL SOCIETY, HOSPICE OF NORTHEASTERN ILLINOIS, HEALTHWORLD, BRIDGE YOUTH AND FAMILY SERVICES, LITTLE CITY FOUNDATION HUMAN RIGHTS COMMITTEE, AS WELL AS LOCAL BOARD OF HEALTH DEPARTMENTS AND ROTARY CLUBS. (6) THE HOSPITAL HAS DEDICATED STAFF THAT ASSIST WITH ADVOCACY INITIATIVES TO PROMOTE COMMUNITY, STATE, AND NATIONAL EFFORTS TO IMPROVE THE HEALTH OF THE POPULATION. THIS INCLUDES THE OBESITY EPIDEMIC THROUGH THE EFFORTS OF THE ILLINOIS ALLIANCE TO PREVENT OBESITY AS WELL AS CANCER RESEARCH AND PREVENTION THROUGH THE AMERICAN CANCER SOCIETY. (7) COLLABORATIVE

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (7 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEIN Of RecipientEINOfRecipientIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantPurpose Of GrantPurposeOfGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistanceMethod Of ValuationMethodOfValuationDescription Of Non Cash AssistanceDescriptionOfNonCashAssistance
AMERICAN CANCER SOCIETY
1114 N ARLINGTON HTS RDARLINGTON HTSIL60067131788491501(c)(3)10000RELAY FOR LIFE
AMERICAN HEART ASSOCIATION
PO BOX 4002902DES MOINESIA50340135613797501(c)(3)5300CHICAGO HEARTWALK
HEKTOEN INSTITUTE LLC
2240 W OGDEN AVECHICAGOIL60612366006541501(c)(3)95405VISTA CLINIC SUPPORT
SPECIAL LEISURE SERVICES FOUNDATION
3000 W CENTRAL STE 205ROLLING MEADOWSIL60008363145710501(c)(3)15000SPECIAL OLYMPICS
NORTHWEST COMMUNITY HEALTHCARE
800 WEST CENTRAL RDARLINGTON HTSIL60005363125209501(c)(3)2750000NET ASSET PAID
GLOBUS RELIEF
1775 W 1500 SOUTHSALT LAKE CITYUT84104841369453501(C)(3)MISSION TRIPS237911FMVMEDICAL SUPPLIES
AMHE INCORPORATED
1166 EASTERN PKWYBROOKLYNNY11213237357680501(C)(3)159687FMVMEDICAL SUPPLIES
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants7TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations0TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationGrants in support of Northwest Community Hospital's (HOSPITAL) mission are monitored by Northwest Community's Finance Committee and Board of Directors as part of the monthly review of Hospital's financial results. Significant grants to unrelated 501(c)(3) or governmental organizations are approved by Hospital's commmunity services department and are monitored through ongoing interactions with officials of those recipients regarding program services provided in Hospital's service area.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgtrueCompBasedOnRevenueOfFilingOrg
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

Form990 Schedule J Part II Form990ScheduleJPartII (20 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Bruce K Crowther
571013000200802018200166430791484000
Michael B Zenn
637690000180816363787018124072140916300
Mark Lusson
224424000673490523330115750355681065291
Mary Stack
16741600018080290160137060211946000
Dawn Walden
10829000027425024421080110168147000
Angela Stefaniu
1015200001249140244190200650270918060356
Robert Klasek
14913000015460269340109070188517000
Gary Skiba
16631100018080244830119070204509000
Willis G Parsons MD
15995480135759000147000194201751949000
Malcolm Bilimoria MD
1439819000001470002306501477584000
Rameez Alasadi MD
66545306787900099000166200759852000
Tahseen Mohammed MD
265490000288030147000131680322161000
Sonia Mehta MD
3032640009608098000270650349737000
Gail A Finn
350300025278601351708870270693024710
Dale Beatty
25494400017808030312076010310665000
Leighton Smith MD
413459000704430647000139070562509000
GEORGE MORRIS
21108300019080271750170650257231000
LAURA POLLACK
14080700018580233270151240181116000
Ann Sayvetz
24889400018080146110137190279032000
Michael C Hartke
3554123831500247247221692169289328883807214361900

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
OFFICES & POSITIONS FOR WHICH PROCESS WAS USED, & YEAR PROCESS WAS BEGUNSCHEDULE J, PART I, LINE 3THE NOMINATION AND COMPENSATION COMMITTEE OF THE NORTHWEST COMMUNITY HEALTHCARE (NCH) BOARD IS RESPONSIBLE FOR SETTING THE COMPENSATION OF THE PRESIDENT/CEO. COMPENSATION IS REVIEWED USING AN EXTERNAL COMPENSATION FIRM, PINP, INC. THE REVIEW ALSO UTILIZES COMPARISONS TO SIMILAR ORGANIZATIONS THROUGH REVIEW OF FORMS 990, USE OF COMPARISON STUDIES FROM THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL AND OTHER SOURCES. THE PROCESS IS DOCUMENTED IN THE MINUTES OF THE NOMINATION AND COMPENSATION COMMITTEE.
SEVERANCE PAYMENTSSCHEDULE J, PART I, LINE 4ATHE FOLLOWING INDIVIDUALS RECEIVED SEVERANCE PAY DURING THE CALENDAR YEAR 2010 PURSUANT TO A WRITTEN SEPARATION AGREEMENT WITH THE HOSPITAL: GAIL A. FINN: $226,468 ANGELA STEFANIU: $48,314
COMPENSATION BASED ON REVENUES OF THE ORGANIZATIONSCHEDULE J, PART I, LINE 5ATHE FOLLOWING GASTROENTEROLOGISTS RECEIVED BONUS PAYMENTS UNDER THE TERMS OF THEIR WRITTEN EMPLOYMENT CONTRACTS. THE AMOUNTS WERE BASED ON A PERCENTAGE OF PROFESSIONAL COLLECTIONS (I.E. COLLECTIONS FROM THE PHYSICIAN'S PERFORMANCE OF PROFESSIONAL MEDICAL SERVICES) EXCEEDING A SPECIFIED THRESHOLD UNTIL A CAP SPECIFIED IN THE CONTRACT IS REACHED. WILLIS G. PARSONS, MD: $135,759 RAMEEZ ALASADI, MD: $67,879
SUPPLEMENTAL INFORMATIONSCHEDULE J, PART II, COLUMN CCERTAIN OFFICERS AND KEY EMPLOYEES OF NORTHWEST COMMUNITY HOSPITAL PARTICIPATE IN A SECTION 457(F) DEFERRED COMPENSATION PLAN. CURRENT YEAR DEFERRED AMOUNTS ARE INCLUDED IN PART VII, COLUMN F AND SCHEDULE J, PART II, COLUMN C. CURRENT YEAR DISTRIBUTIONS, INCLUDED IN PART VII, COLUMN D; SCHEDULE J, PART II, COLUMN B(III); AND SCHEDULE J, PART II, COLUMN (F) ARE: GAIL A. FINN: $24,710 MARK LUSSON: $65,291 ANGELA STEFANIU: $60,356

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
ILLINOIS FINANCE AUTHORITY
86109196745200FNR62008-09-19151075932SEE PART Vfalsefalsefalse
ILLINOIS FINANCE AUTHORITY
86109196745200FNU92008-10-1786820000SEE PART Vfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Amount RetiredAmountRetiredAmount Bond DefeasedAmountBondDefeasedTotal ProceedsTotalProceedsAmount In Reserve FundAmountInReserveFundCapitalized InterestCapitalizedInterestRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementWorking Capital ExpendituresWorkingCapitalExpendituresCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsAmount UnspentAmountUnspentYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
00151417356000146834000149949016002010falsefalsetruetrue
008682000000059807593000008612892502008truefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsefalsefalsefalsefalse0.000000.000000.00000true
0.000000.000000.00000

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsefalsefalsefalsefalsefalse
falsetruefalsefalsefalsetrue

Form990 Schedule K Part V Form990ScheduleKPartV

FieldValueIRS element (for citing)
IdentifierDescription of BondsIdentifier
Return ReferenceSchedule K, Part IReturnReference
ExplanationISSUER NAME: ILLINOIS FINANCE AUTHORITY ISSUER EIN: 86-1091967 CUSIP #: 45200FNR6 ISSUE PRICE: $151,075,932 DESCRIPTION OF PURPOSE: PROCEEDS USED FOR: CONSTRUCTION OF A PATIENT TOWER AND PARKING GARAGE; EXPANSION AND RENOVATION OF THE HOSPITAL'S EMERGENCY DEPARTMENT AND SURGERY SUITES; RELOCATION OF CERTAIN DEPARTMENTS ON THE HOSPITAL'S CAMPUS; AND PURCHASE OF CERTAIN EQUIPMENT USED IN THE HOSPITAL'S BUSINESS. TOTAL PROCEEDS OF ISSUE: THE TOTAL PROCEEDS INCLUDE $341,424 OF INVESTMENT EARNINGS. ISSUER NAME: ILLINOIS FINANCE AUTHORITY ISSUER EIN: 86-1091967 CUSIP #: 45200FNU9 ISSUE PRICE: $86,820,000 DESCRIPTION OF PURPOSE: PROCEEDS WERE USED TO REPAY A TAXABLE LOAN, THE PROCEEDS OF WHICH WERE USED, TOGETHER WITH OTHER FUNDS, TO REDEEM THE AUTHORITY'S SERIES 2002A BONDS (NW COMMUNITY HOSPITAL) IN APRIL 2008.Explanation

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonJames J Smith MDNamePerson
Purpose Of LoanPHYS PRACTICE SUPPTPurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$85,793OriginalPrincipalAmount
Balance Due90465BalanceDue
DefaulttrueDefault
Approved By BoardtrueApprovedByBoard
Written AgreementtrueWrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due90465TotalBalanceDue

Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
ADAM SKIBA
SEE PART V76102SALARYfalse
AMY SKIBA
SEE PART V63033SALARYfalse
MEGAN STACK-SWEET
SEE PART V63882SALARYfalse
CHARLIE CROWTHER
SEE PART V18669SALARYfalse

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierRELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATIONIdentifier
Return ReferenceSCHEDULE L, PART IVReturnReference
ExplanationADAM SKIBA IS THE SON OF KEY EMPLOYEE, GARY SKIBA. AMY SKIBA IS THE DAUGHTER OF KEY EMPLOYEE, GARY SKIBA. MEGAN STACK-SWEET IS THE DAUGHTER OF KEY EMPLOYEE, MARY STACK. CHARLIE CROWTHER IS THE SON OF DIRECTOR AND OFFICER, BRUCE K. CROWTHER.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (11 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF RELATIONSHIPSFORM 990, PART VI, QUESTION 2BRUCE K. CROWTHER, DIRECTOR AND CEO, AND JAMES BISHOP, DIRECTOR, SERVE ON THE NORTHWEST COMMUNITY HOSPITAL (HOSPITAL) BOARD AS WELL AS ON THE BOARDS OF WINTRUST FINANCIAL CORPORATION AND BARRINGTON BANK AND TRUST COMPANY NA. MICHAEL ZENN, HOSPITAL OFFICER, AND JAMES BISHOP, HOSPITAL DIRECTOR, SERVE ON THE BOARD OF VILLAGE BANK AND TRUST (A WINTRUST BANK). HOSPITAL DOES NOT TRANSACT ANY BUSINESS WITH WINTRUST FINANCIAL, BARRINGTON BANK, OR VILLAGE BANK AND TRUST.
DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERSFORM 990, PART VI, QUESTION 6NORTHWEST COMMUNITY HEALTHCARE (NCH) IS THE SOLE CORPORATE MEMBER OF NORTHWEST COMMUNITY HOSPITAL (HOSPITAL). AS SUCH, IT ELECTS OR APPOINTS THE MEMBERS OF HOSPITAL'S GOVERNING BODY AND APPROVES SIGNIFICANT DECISIONS.
DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTSFORM 990, PART VI, QUESTION 7ANCH IS THE SOLE CORPORATE MEMBER OF HOSPITAL. AS SUCH, IT ELECTS OR APPOINTS THE MEMBERS OF THE GOVERNING BODY OF HOSPITAL PERIODICALLY OR AS VACANCIES ARISE.
DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTSFORM 990, PART VI, QUESTION 7BNCH IS THE SOLE CORPORATE MEMBER OF HOSPITAL. AS SUCH, IT MUST APPROVE CERTAIN ACTIONS OF HOSPITAL. ACTION IS TAKEN BY A MAJORITY VOTE OF THE NCH BOARD WITH A QUORUM PRESENT. NCH MUST APPROVE THE FOLLOWING TYPES OF DECISIONS BY HOSPITAL: VOLUNTARY DISSOLUTION, MERGER, CONSOLIDATION OR SALE OR TRANSFER OF 10% OR MORE OF THE HOSPITAL'S ASSETS; SALE OF REAL PROPERTY OR INTEREST THEREIN; CREATION OF A SUBSIDIARY OR AFFILIATE; ANNUAL AND LONG-TERM CAPITAL AND OPERATING BUDGETS; AMENDMENT, ALTERATION OR REPEAL OF HOSPITAL'S ARTICLES OF INCORPORATION OR BYLAWS; SELECTION OF AUDITORS; APPOINTMENT, REMOVAL AND EVALUATION OF HOSPITAL DIRECTORS; DEBT OR INDEBTEDNESS, GUARANTEES OR BORROWINGS; APPOINTMENT, COMPENSATION, BENEFITS AND EVALUATION OF OFFICERS; APPOINTMENT AND EMPLOYMENT OF THE PRESIDENT; AND ACTIONS TAKEN BY TRUSTEES OF THE NORTHWEST COMMUNITY HOSPITAL EMPLOYEES RETIREMENT PLAN.
DESCRIBE THE PROCESS USED BY MANAGEMENT &/OR GOVERNING BODY TO REVIEW 990FORM 990, PART VI, QUESTION 11BA COPY OF FORM 990 WAS MADE AVAILABLE TO THE MEMBERS OF THE BOARD OF HOSPITAL PRIOR TO FILING. THE AUDIT AND COMPLIANCE COMMITTEE OF THE NCH BOARD REVIEWED FORM 990 FOR AFFILIATES OF NCH PRIOR TO DISTRIBUTION TO THE FULL BOARD.
DESCRIPTION OF PROCESS TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTERESTFORM 990, PART VI, QUESTION 12CEACH YEAR, THE CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS SENT TO DIRECTORS, OFFICERS AND KEY EMPLOYEES. EACH RESPONSE IS REVIEWED BY THE GENERAL COUNSEL AND THOSE IN WHICH ANY ACTUAL OR APPARENT CONFLICT WITH THE PRESENT ROLE IS DISCLOSED, ARE REVIEWED BY THE PRESIDENT/CEO AND BOARD CHAIRPERSON. IN THE CASE OF ANY CONFLICT INVOLVING AN ENTITY OR PARTY WITH WHICH HOSPITAL IS DEALING OR COMPETING, THE PERSON WITH THE CONFLICT MAY NOT PARTICIPATE IN ANY DECISIONS REGARDING THAT PARTY. INDIVIDUALS WHO ARE INDEPENDENT CONTRACTORS, OFFICERS, DIRECTORS, OR EMPLOYEES OF OTHER HEALTHCARE FACILITIES IN HOSPITAL'S SERVICE AREA MAY NOT SERVE ON NCH'S OR ANY RELATED ORGANIZATION'S BOARD OR BOARD COMMITTEE. IN ADDITION, THE POLICY INCLUDES A SAMPLE CONFLICT OF INTEREST DISCLOSURE LETTER TO BE USED IF A CONFLICT ARISES AFTER SUBMISSION OF THE ANNUAL QUESTIONNAIRE AND BEFORE THE NEXT. SUCH DISCLOSURE LETTERS WOULD BE REVIEWED AS NOTED ABOVE AT THE TIME THEY ARE RECEIVED.
COMPENSATION DETERMINATION PROCESS FOR TOP MANAGEMENT OFFICIALFORM 990, PART VI, QUESTION 15ATHE NOMINATION AND COMPENSATION COMMITTEE OF THE NCH BOARD IS RESPONSIBLE FOR SETTING THE COMPENSATION OF THE PRESIDENT/CEO WHO IS THE TOP MANAGEMENT OFFICIAL. COMPENSATION IS REVIEWED USING AN EXTERNAL COMPENSATION FIRM, PINP, INC. THE REVIEW ALSO UTILIZES COMPARISONS TO SIMILAR ORGANIZATIONS THROUGH REVIEW OF FORMS 990, USE OF COMPARISON STUDIES FROM THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL AND OTHER SOURCES. THE PROCESS IS DOCUMENTED IN THE MINUTES OF THE NOMINATION AND COMPENSATION COMMITTEE.
COMPENSATION DETERMINATION PROCESS FOR OFFICERS & KEY EMPLOYEESFORM 990, PART VI, QUESTION 15BTHE NOMINATION AND COMPENSATION COMMITTEE OF THE NCH BOARD IS RESPONSIBLE FOR APPROVING THE COMPENSATION OF THE OFFICERS AND KEY EMPLOYEES (VICE PRESIDENTS) OF HOSPITAL BASED ON RECOMMENDATIONS FROM THE PRESIDENT/CEO. THE REVIEW UTILIZES COMPARISONS TO STUDIES FROM THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL AND OTHER SOURCES. THE PROCESS IS DOCUMENTED IN THE MINUTES OF THE NOMINATION AND COMPENSATION COMMITTEE.
AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLICFORM 990, PART VI, QUESTION 19GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE PUBLIC. HOSPITAL'S FINANCIAL STATEMENTS ARE INCLUDED IN THE ANNUAL CONSOLIDATED AUDIT REPORT OF NCH AND SUBSIDIARIES. THE CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC VIA THE MUNICIPAL SECURITIES RULEMAKING BOARD'S ELECTRONIC MUNICIPAL MARKET ACCESS (EMMA) WEBSITE AT WWW.EMMA.MSRB.ORG.
AVERAGE HOURS WORKEDPART VII, SECTION ATHE FOLLOWING INDIVIDUALS ARE EMPLOYEES OF NORTHWEST COMMUNITY HOSPITAL AND GENERALLY WORK 40 HOURS PER WEEK. A PORTION OF THEIR REGULAR WORK WEEK IS SPENT PROVIDING SERVICES TO NORTHWEST COMMUNITY DAY SURGERY CENTER, INC., NCH AND NORTHWEST COMMUNITY HOSPITAL FOUNDATION, WHICH ARE 501(C)(3) AFFILIATES OF HOSPITAL: BRUCE K. CROWTHER (14 HOURS), MICHAEL B. ZENN (9 HOURS), LEIGHTON SMITH, MD (2 HOURS), STEPHEN O. SCOGNA (9 HOURS), AND DALE BEATTY (2 HOURS). STEPHEN O. SCOGNA, NORTHWEST COMMUNITY HOSPITAL CFO, BEGAN HIS EMPLOYMENT IN APRIL OF 2011. AS SUCH, HIS FY2011 COMPENSATION IS APPROPRIATELY INCLUDED ON FORM 990, PART IX; HOWEVER, HE HAD NO CALENDAR YEAR 2010 COMPENSATION TO REPORT ON FORM 990, PART VII.
RECONCILIATION OF NET ASSETS - OTHER CHANGES IN NET ASSETSFORM 990, PART XI, QUESTION 5OTHER CHANGES IN NET ASSETS: UNREALIZED LOSS ON INVESTMENTS (1,910,317) INTEREST RATE SWAP LOSS (151,878) PENSION-RELATED CHANGES OTHER THAN NET PERIODIC PENSION COST(9,400,636) RESTRICTED FUNDS TRANSFER - SILVER LINING PROGRAM (34,507) CHANGE IN TEMPORARILY RESTRICTED NET ASSETS 317,364 CHANGE IN PERMANENTLY RESTRICTED NET ASSETS 2,510 ---------- (11,177,464)

Schedule R IRS990ScheduleR

Form990 Schedule R Part I Form990ScheduleRPartI (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateTotal IncomeTotalIncomeEOY AssetsEOYAssetsDirect Controlling Entity NADirectControllingEntityNABusiness Name Line1DirectControllingEntityName/BusinessNameLine1
NORTHWEST COMMUNITY PHYSICIANS ASSN LLC
3060 SALT CREEK LANEARLINGTON HTSIL60005510457240PATIENT CAREIL3325001628745N/A
NCH SERVICE COMPANY LLC
3060 SALT CREEK LANEARLINGTON HTSIL60005263791362PATIENT CAREIL1965773465970NCPA LLC

Form990 Schedule R Part II Form990ScheduleRPartII (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
NORTHWEST COMMUNITY HEALTHCARE
800 WEST CENTRAL ROADARLINGTON HTSIL60005363125209SUPPORT ORGIL501(C)(3)11 TYPE IINA
NORTHWEST COMMUNITY DAY SURGERY CTR INC
675 WEST KIRCHOFFARLINGTON HTSIL60005363540436OUTPATIENTIL501(c)(3)3NCH
NORTHWEST COMMUNITY HOSPITAL FOUNDATION
3060 SALT CREEK LANEARLINGTON HTSIL60005363125193FUNDRAISINGIL501(c)(3)7NCH

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1NPC-CYBERKNIFE LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1800 WEST CENTRAL ROADAddressLine1
CityARLINGTON HEIGHTSCity
StateILState
ZIP Code60005ZIPCode
FieldValueIRS element (for citing)
EIN204462828EIN
Primary ActivityEQUIPMENT LEASINGPrimaryActivity
Legal Domicile StateDELegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeN/APredominantIncomeType

Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnershipAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryLegal Domicile Foreign CountryLegalDomicileForeignCountry
NORTHWEST COMMUNITY HEALTH SERVICES INC
800 WEST CENTRAL ROADARLINGTON HEIGHTSIL60005363312906HEALTHCARE SVCSILNAC CORP
NORTHWEST COMMUNITY CAPCO INC
800 WEST CENTRAL ROADARLINGTON HEIGHTSIL60005364027717MANAGED CAREILNAC CORP3550008019381.00000
NCH CASUALTY INSURANCE SPC LTD
980442062INSURANCENAC CORP68 WEST BAY ROAD KY1-1102GRAND CAYMANCAYMEN ISLANDSCJCJ
NCH PHYSICIANS COOPERATIVE
800 WEST CENTRAL ROADARLINGTON HEIGHTSIL60005201830299GROUP PURCHASINGILNAC CORP1.00000
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 OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgtruePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1NORTHWEST COMMUNITY CAPCO INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypePTransactionType
Amount Involved239609AmountInvolved