KISHHEALTH SYSTEM: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- KISHHEALTH SYSTEM (EIN 36-3649080)
- Tax period
- 2011-05-01 to 2012-04-30
- Filed
- 2012-12-17
- IRS object ID
- 201213529349300711
- Schema version
- 2011v1.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-12-17T09:40:13-06:00 | Timestamp |
| Tax Period End Date | 2012-04-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 114 E EVERETT | AddressLine1 |
| City | DIXON | City |
| State | IL | State |
| ZIP Code | 61021 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363649080 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KISHHEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | KISH | NameControl |
| Phone | 8157561521 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE KISH HOSPITAL DRIVE | AddressLine1 |
| City | DEKALB | City |
| State | IL | State |
| ZIP Code | 60115 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LOREN FOELSKE | Name |
| Title | VICE PRESIDENT - FINANCE, KHS | Title |
| Phone | 8157561521 | Phone |
| Date Signed | 2012-12-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KELLY JACKSON HARDY | Name |
| PTIN | P00747242 | PTIN |
| Phone | 8152842285 | Phone |
| 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 | KEVIN P POORTEN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE KISH HOSPITAL DRIVE | AddressLine1 |
| City | DEKALB | City |
| State | IL | State |
| ZIP Code | 60115 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 19287618 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.KISHHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1988 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | MANAGEMENT AND PARENT ORGANIZATION PROVIDING SERVICES TO 501(C)(3) HEALTH SYSTEM | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 99 | TotalNbrEmployees |
| Total Nbr Volunteers | 14 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 15118192 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 17094568 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 271802 | InvestmentIncomePriorYear |
| Investment Income Current Year | 251703 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -8813 | OtherRevenuePriorYear |
| Other Revenue Current Year | -90650 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15381181 | TotalRevenuePriorYear |
| Total Revenue Current Year | 17255621 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 119811 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 167500 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 10640071 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11328378 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4360853 | OtherExpensePriorYear |
| Other Expenses Current Year | 5542178 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 15120735 | TotalExpensesPriorYear |
| Total Expenses Current Year | 17038056 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 260446 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 217565 | RevenuesLessExpensesCY |
| Total Assets BOY | 16174525 | TotalAssetsBOY |
| Total Assets EOY | 22577087 | TotalAssetsEOY |
| Total Liabilities BOY | 11308718 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 13116831 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4865807 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9460256 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | MANAGEMENT AND PARENT ORGANIZATION PROVIDING SERVICES TO 501 (C) (3) HEALTH SYSTEM. WE ARE THE CORNERSTONE OF HEALTH CARE FOR THE COMMUNITIES WE SERVE-THE FIRST CHOICE FOR SERVICE, COMFORT AND SAFETY. AS A COMMUNITY-OWNED HEALTH SYSTEM, THE KISH FAMILY UNSELFISHLY COMMITS TO EXCELLENCE, EDUCATION AND INNOVATION. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2520400 | Expense |
| Grants | 167500 | Grants |
| Revenue | 17104257 | Revenue |
| Description | KISHHEALTH SYSTEM (KHS) IS THE NON-PROFIT CORPORATE UMBRELLA FOR TWO HOSPITALS, A HOSPICE, CLINIC, AND A HEALTH FOUNDATION PREDOMINATELY SERVING RESIDENTS OF DEKALB, KENDALL AND LASALLE COUNTIES IN ILLINOIS. THE MISSION OF THE HEALTH SYSTEM IS TO BE "THE CORNERSTONE OF HEALTH CARE FOR THE COMMUNITIES WE SERVE-THE FIRST CHOICE FOR SERVICE, COMFORT AND SAFETY. AS A COMMUNITY-OWNED HEALTH SYSTEM, THE KISH FAMILY UNSELFISHLY COMMITS TO EXCELLENCE, EDUCATION AND INNOVATION." IN ADDITION TO THE COMMUNITY BENEFITS PROVIDED BY KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE, COMMUNITY CARES CLINIC, AND KISHHEALTH FOUNDATION, THE HEALTH SYSTEM'S CORPORATE OFFICE PROVIDES COMMUNITY BENEFIT IN THE FOLLOWING AREAS:* KISHHEALTH SYSTEM UNDERWROTE MORE THAN $500,000 IN OPERATIONAL LOSSES IN FY 12 FOR THE COMMUNITY CARES CLINIC, AND MORE THAN $690,000 FOR DEKALB COUNTY HOSPICE, BOTH VITAL SERVICES FOR THE HEALTH OF THE COMMUNITY. IT ALSO MADE $167,500 IN CONTRIBUTIONS TO SEVERAL ORGANIZATIONS IN FY12, NOTABLY A $50,000 GRANT TO DEKALB COUNTY GOVERNMENT FOR A FIBER OPTIC PROJECT THAT IS ESTABLISHING BROADBAND CONNECTIVITY THROUGHOUT DEKALB COUNTY. THIS PROJECT IS ENABLING HIGH SPEED ELECTRONIC COMMUNICATION TO RURAL AREAS AND TO COMMUNITY INSTITUTIONS SUCH AS SCHOOLS, LOCAL GOVERNMENT, LIBRARIES AND THE TWO KISHHEALTH SYSTEM HOSPITALS IN THE COUNTY. ALSO, $75,000 WAS GIVEN TO DEKALB COUNTY COMMUNITY FOUNDATION TO REMODEL A HISTORIC LANDMARK FOR OFFICES; AND $25,000 WAS GIVEN TO THE NORTHERN ILLINOIS UNIVERSITY FOUNDATION TO SUPPORT CONSTRUCTION OF AN INDOOR ATHLETIC FACILITY. * KISHHEALTH SYSTEM LEADERS SERVE ON THE BOARDS OF PIONEERING HEALTHY COMMUNITIES, KISHWAUKEE YMCA, KISHWAUKEE COLLEGE FOUNDATION, VOLUNTARY ACTION CENTER, DEKALB COUNTY YOUTH SERVICES BUREAU, DEKALB COUNTY EDC; DEKALB, SYCAMORE, GENOA, SANDWICH AND PLANO CHAMBERS OF COMMERCE AND EDCS; THE COMMUNITY CARES CLINIC, VOLUNTARY ACTION CENTER, FAMILY SERVICE AGENCY, FOX VALLEY OLDER ADULT SERVICES, KISHWAUKEE UNITED WAY. IN ADDITION, HEALTH SYSTEM EMPLOYEES CONTRIBUTED MORE THAN 1,200 HOURS OF IN-KIND SERVICE TO COMMUNITY ORGANIZATIONS, EDUCATIONAL INSTITUTIONS AND OTHER ACTIVITIES THAT PROMOTE HEALTH, EDUCATION AND QUALITY OF LIFE. SIXTY HOURS OF SENIOR LEADER TIME WAS DEVOTED TO "PIONEERING HEALTHY COMMUNITIES", TRAVELING TO WASHINGTON DC FOR TRAINING ON THE PROGRAM, WHICH IS PART OF ACTIVATE AMERICA -THE YMCA'S RESPONSE TO THE NATION'S HEALTH CRISIS. THE LOCAL EFFORT, "LIVE HEALTHY DEKALB COUNTY" IS EXPANDING EFFORTS TO INCREASE COLLABORATIONS BETWEEN ORGANIZATIONS WITHIN COMMUNITIES TO ELIMINATE BARRIERS THAT ARE PREVENTING KIDS, INDIVIDUALS AND FAMILIES FROM LEADING HEALTHIER LIVES. KISHHEALTH SYSTEM IS A MAJOR PARTNER IN THE LOCAL EFFORT. * THE HEALTH SYSTEM'S NON-PROFIT ENTITIES ARE KISHWAUKEE COMMUNITY HOSPITAL, A 98-BED HOSPITAL IN DEKALB IL, SERVING ALL OF DEKALB COUNTY AND BEYOND; VALLEY WEST COMMUNITY HOSPITAL, A 25-BED CRITICAL ACCESS HOSPITAL IN SANDWICH; DEKALB COUNTY HOSPICE, DEKALB, IL, WHICH PROVIDES FREE CARE AND SUPPORT FOR THE TERMINALLY ILL AS WELL AS GRIEF SUPPORT TO THE PUBLIC; COMMUNITY CARES CLINIC, DEKALB, IL, A PRIMARY CARE CLINIC FOR MEDICAID AND UNINSURED; KISHHEALTH PHYSICIAN GROUP, WHICH PROVIDES ACCESS TO MEDICAL SERVICES, ESPECIALLY THE RURAL AREAS AND ACCEPTS MEDICAID AND UNINSURED PATIENTS, AND KISHHEALTH FOUNDATION IN DEKALB, IL, WHICH RAISES MONEY FOR KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE AND THE COMMUNITY CARES CLINIC AND FUNDS EQUIPMENT PURCHASES AND PATIENT SERVICES PARTICULARLY IN THE AREA OF CANCER CARE FOR THOSE WHO CANNOT AFFORD. | Description |
| Total Program Service Expense | 2520400 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 1 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 4 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 99 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOREN FOELSKE VP - FINANCE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 8157561521 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE KISH HOSPITAL DRIVE | AddressLine1 |
| City | DEKALB | City |
| State | IL | State |
| ZIP Code | 60115 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (34 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| MICHAEL CULLEN | ||||||||
| PAST CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| TERRENCE DUFFY | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| ERIK ENGLEHART MD | ||||||||
| DIRECTOR - THRU NOV 2011 | 2.00 | X | 0 | 0 | 0 | |||
| MICHAEL LARSON | ||||||||
| CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| JOHN MOULTON | ||||||||
| 2ND VICE CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| THOMAS MATYA | ||||||||
| VICE CHAIR | 2.00 | X | 0 | 0 | 0 | |||
| MARY LYNN MCARTOR | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| MICHAEL MOONEY | ||||||||
| DIRECTOR - THRU NOV 2011 | 2.00 | X | 0 | 0 | 0 | |||
| KEVIN POORTEN | ||||||||
| DIRECTOR/PRESIDENT & CEO - | 45.00 | X | X | 698961 | 0 | 102663 | ||
| BRADLEY WALLER | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| ANITA ZURBRUGG | ||||||||
| DIRECTOR - THRU NOV 2011 | 2.00 | X | 0 | 0 | 0 | |||
| BRETT CASSIDY MD | ||||||||
| DIRECTOR - THRU NOV 2011 | 2.00 | X | 0 | 0 | 0 | |||
| JAGDISH PATEL MD | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| PROMOD VOHRA | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| JACK WAGONER | ||||||||
| DIRECTOR - THRU NOV 2011 | 2.00 | X | 0 | 0 | 0 | |||
| THOMAS CHOICE | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| UMESH GOSWAMI MD | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| PHOTINE LIAKOS MD | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| LEONETTA RIZZI | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| ANN WEST MD | ||||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | |||
| LOREN FOELSKE | ||||||||
| VP FINANCE | 45.00 | X | 316761 | 0 | 41819 | |||
| BRAD COPPLE | ||||||||
| PRESIDENT - KCH & VWCH | 45.00 | X | 365900 | 0 | 42075 | |||
| JOSEPH DANT | ||||||||
| VP BUSINESS DEVELOPMENT | 2.00 | 263727 | 0 | 41741 | X | |||
| MICHAEL KOKOTT | ||||||||
| ASST. VP MKTG & PLANNING | 2.00 | 198097 | 0 | 23734 | X | |||
| ROGER HEATH BELL | ||||||||
| VP AND CIO | 2.00 | 253756 | 0 | 39782 | X | |||
| PAM DUFFY | ||||||||
| VP PATIENT CARE SVCS | 45.00 | 241412 | 0 | 27266 | X | |||
| MARK THATE | ||||||||
| VP - HUMAN RESOURCES | 45.00 | 197280 | 0 | 29354 | X | |||
| MICHAEL MUZZILLO | ||||||||
| VP OPERATIONS - VWCH | 45.00 | 179349 | 0 | 27579 | X | |||
| DR MICHAEL KULISZ | ||||||||
| CHIEF MEDICAL OFFICER | 45.00 | 391391 | 0 | 22661 | X | |||
| CHERYL FISHER | ||||||||
| AVP - PATIENT CARE | 45.00 | 150191 | 0 | 32889 | X | |||
| JENNIFER DIETRICH | ||||||||
| DIR OF MATERIALS MGM | 45.00 | 116341 | 0 | 16616 | X | |||
| GARY PAXSON | ||||||||
| DIRECTOR OF INFORMATION SYSTEMS | 45.00 | 113318 | 0 | 33432 | X | |||
| JEFFERY REIFSTECK | ||||||||
| TECHNICAL OPERATIONS MANAG | 45.00 | 115223 | 0 | 9234 | X | |||
| SHELLY JOHNSON | ||||||||
| DIRECTOR OF COMMUNITY CARES CLINIC | 45.00 | 117543 | 0 | 48434 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 3719250 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 539279 | TotalOtherCompensation |
| Number Individuals GT100 K | 17 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| REINHART BOERNER VANDEUREN | |||||
| PO BOX 2965 | MILWAUKEE | IL | 532012965 | LEGAL SERVICES | 736951 |
| AURORA RADIOLOGY | |||||
| 1870 WEST GALENA BLVD | AURORA | IL | 60506 | MEDICAL SERVICES | 428770 |
| MICROSOFT | |||||
| PO BOX 842467 | DALLAS | TX | 75284 | INFORMATION TECHNOLOGY SERVICES | 312379 |
| KAUFMAN HALL & ASSOCIATES INC | |||||
| 5202 OLD ORCHARD ROAD | SKOKIE | IL | 60077 | SOFTWARE SUPPORT SERVICES | 248437 |
| CLIFTONLARSONALLEN LLP | |||||
| 114 EAST EVERETT STREET | DIXON | IL | 61021 | ACCOUNTING SERVICES | 115550 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | KHS ADMINISTRATION HEA | Description |
| Business Code | 551112 | BusinessCode |
| Total Revenue Column | 17094568 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17094568 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 17094568 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 260740 | TotalRevenueColumn |
| Exclusion | $260,740 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 116831 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 217170 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -100339 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -100339 | TotalRevenueColumn |
| Exclusion | -$100,339 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1805790 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 1814827 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -9037 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -9037 | TotalRevenueColumn |
| Exclusion | -$9,037 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS INCOME | Description |
| Business Code | 551112 | BusinessCode |
| Total Revenue Column | 9689 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9689 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 9689 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 17255621 | TotalRevenueColumn |
| Related Or Exempt Function Income | 17104257 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $151,364 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 167500 | Total |
| Program Services | 167500 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3668519 | Total |
| Management And General | 3668519 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4979974 | Total |
| Program Services | 1205468 | ProgramServices |
| Management And General | 3774506 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 228726 | Total |
| Program Services | 64902 | ProgramServices |
| Management And General | 163824 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2011476 | Total |
| Program Services | 320692 | ProgramServices |
| Management And General | 1690784 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 439683 | Total |
| Program Services | 64247 | ProgramServices |
| Management And General | 375436 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1044395 | Total |
| Management And General | 1044395 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 114996 | Total |
| Program Services | 8000 | ProgramServices |
| Management And General | 106996 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 940183 | Total |
| Program Services | 7879 | ProgramServices |
| Management And General | 932304 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 126960 | Total |
| Management And General | 126960 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 416477 | Total |
| Program Services | 42522 | ProgramServices |
| Management And General | 373955 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1487346 | Total |
| Management And General | 1487346 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 490587 | Total |
| Program Services | 55523 | ProgramServices |
| Management And General | 435064 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 224749 | Total |
| Program Services | 19830 | ProgramServices |
| Management And General | 204919 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30846 | Total |
| Management And General | 30846 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 555023 | Total |
| Program Services | 555023 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11084 | Total |
| Program Services | 7403 | ProgramServices |
| Management And General | 3681 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DUES AND SUBSCRIPTIONS | 66103 | 1411 | 64692 |
| RECRUITMENT FEES | 32524 | 0 | 32524 |
| MISCELLANEOUS EXPENSE | 905 | 905 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 17038056 | Total |
| Program Services | 2520400 | ProgramServices |
| Management And General | 14517656 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2543250 | BOY |
| EOY | 2304447 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 88477 | BOY |
| EOY | 82832 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8690 | BOY |
| EOY | 185 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 354789 | BOY |
| EOY | 598705 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7053401 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1519854 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1802458 | BOY |
| EOY | 5533547 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7173923 | BOY |
| EOY | 7909893 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2256680 | BOY |
| EOY | 4412256 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1946258 | BOY |
| EOY | 1735222 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16174525 | BOY |
| EOY | 22577087 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9477311 | BOY |
| EOY | 10255691 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 627760 | BOY |
| EOY | 440206 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1203647 | BOY |
| EOY | 2420934 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11308718 | BOY |
| EOY | 13116831 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4865807 | BOY |
| EOY | 9460256 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4865807 | BOY |
| EOY | 9460256 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16174525 | BOY |
| EOY | 22577087 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 217565 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 4376884 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | X | SupportingOrganization509a3 |
| Supporting Org509a3 Type2 | X | SupportingOrg509a3Type2 |
| Certification Checkbox | X | CertificationCheckbox |
| Written IRS Determination | X | WrittenIRSDetermination |
| Contrib By Controlling Individual | 0 | ContribByControllingIndividual |
| Contribution By Related Party | 0 | ContributionByRelatedParty |
| Contrib By35 Controlled Entity | 0 | ContribBy35ControlledEntity |
Supported Org Information SupportedOrgInformation (6 entries)
| EINEIN | Type Of OrganizationTypeOfOrganization | Listed In Governing DocListedInGoverningDoc | Supported Organization NotifiedSupportedOrganizationNotified | Organized In USOrganizedInUS | AmountAmount |
|---|---|---|---|---|---|
| KISHWAUKEE COMMUNITY HOSPITAL | |||||
| 237087041 | 03 | 1 | 1 | 1 | $0 |
| VALLEY WEST COMMUNITY HOSPITAL | |||||
| 364244337 | 03 | 1 | 1 | 1 | $0 |
| DEKALB COUNTY HOSPICE | |||||
| 363164329 | 07 | 1 | 1 | 1 | $690,000 |
| KISHHEALTH FOUNDATION | |||||
| 363649077 | 07 | 1 | 1 | 1 | $300,000 |
| COMMUNITY CARES CLINIC | |||||
| 800424001 | 07 | 1 | 1 | 1 | $0 |
| KISHWAUKEE PHYSICIANS GROUP INC | |||||
| 651293967 | 04 | 1 | 1 | 1 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Number Of Supported Orgs | 6 | TotalNumberOfSupportedOrgs |
| Sum Of Amounts | 990000 | SumOfAmounts |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1713361 | OtherCostOrOtherBasis |
| Book Value | 1713361 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1197483 | OtherCostOrOtherBasis |
| Depreciation | 185975 | Depreciation |
| Book Value | 1011508 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 608882 | OtherCostOrOtherBasis |
| Depreciation | 20383 | Depreciation |
| Book Value | 588499 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 3083938 | OtherCostOrOtherBasis |
| Depreciation | 1313496 | Depreciation |
| Book Value | 1770442 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 449737 | OtherCostOrOtherBasis |
| Book Value | 449737 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5533547 | TotalOfBookValueLandBuildings |
Closely Held Equity Interests CloselyHeldEquityInterests
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | 3330991 | BookValue |
| Method Of Valuation | C | MethodOfValuation |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| CASH EQUIVALENTS | 234131 | F |
| CERTIFICATES OF DEPOSIT | 776963 | F |
| ACCRUED INTEREST | 70171 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 4412256 | TotalOfBookValueSecurities |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE FROM SUBSIDIARY ORGANIZATIONS | Description |
| Book Value | 1735222 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 1735222 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE TO SUBSIDIARY ORGANIZATIONS | Description |
| Amount | $2,420,934 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 2420934 | TotalOfAmounts |
| Total Revenue | 17255621 | TotalRevenue |
| Total Expenses | 17038056 | TotalExpenses |
| Excess Or Deficit For Year | 217565 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 185791 | NetUnrealizedGLOnInvestments |
| Other | $4,191,093 | OtherAmount |
| Total Adjustments | 4376884 | TotalAdjustments |
| Excess Or Deficit Per FS | 4594449 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | -404894 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 185790 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | 185790 | RevenueNotRptdF990 |
| Revenue Subtotal | -590684 | RevenueSubtotal |
| Other Revenues Not Included | 17846305 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 17846305 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 17255621 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 160657 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 217170 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 217170 | ExpensesNotRptdF990 |
| Expenses Subtotal | -56513 | ExpensesSubtotal |
| Other Expenses Not Included | 17094569 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 17094569 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 17038056 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| PART XI, LINE 8 - OTHER ADJUSTMENTS: | LOSS ON EQUITY METHOD SUBSIDIARY REPORTED ON SEPARATE COMPANY RETURN - HPI -968,907. EQUITY CONTRIBUTION TO SUBSIDIARIES -990,000. EQUITY DISTRIBUTION FROM SUBSIDIARIES 6,150,000. TOTAL TO SCHEDULE D, PART XI, LINE 8: 4,191,093. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | LOSS ON SUBSIDIARY, HPI, REPORTED ON SEPARATE COMPANY RETURN 968,907. MANAGEMENT FEES PAID TO KHS, REPORTED AS EXPENSES ON FINANCIAL STATEMENTS 17,094,568. RENTAL EXPENSES NETTED WITH INCOME FOR FORM 990 -217,170. |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES NETTED WITH INCOME FOR FORM 990 217,170. |
| PART XIII, LINE 4B - OTHER ADJUSTMENTS: | MANAGEMENT FEES PAID TO KHS, REPORTED AS EXPENSES ON FINANCIAL STATEMENTS 17,094,568. ROUNDING 1. |
| PART XI, LINE 10, EXCESS OR (DEFICIT) FOR THE YEAR PER FINANCIAL STATEMENTS: LINE 10 IDENTIFIES FINANCIAL STATEMENT INCOME AS EQUALING $4,594,449. FINANCIAL STATEMENT INCOME IS ACTUALLY $(565,551). THE DIFFERENCE RELATES TO THE FOLLOWING ITEMS: 1. KISHHEALTH SYSTEM RECEIVED A CAPITAL CONTRIBUTION OF $4,440,000 FROM A SUBSIDIARY ORGANIZATION, KISHWAUKEE COMMUNITY HOSPITAL. 2. KISHHEALTH SYSTEM RECEIVED A CAPITAL CONTRIBUTION OF $1,710,000 FROM A SUBSIDIARY ORGANIZATION, VALLEY WEST COMMUNITY HOSPITAL. 3. KISHHEALTH SYSTEM MADE A CAPITAL CONTRIBUTION OF $300,000 TO A SUBSIDIARY ORGANIZATION, KISHHEALTH FOUNDATION. 4. KISHHEALTH SYSTEM MADE A CAPITAL CONTRIBUTION OF $690,000 TO A SUBSIDIARY ORGANIZATION, DEKALB COUNTY HOSPICE. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 1 | RecordsMaintained |
Recipient Table RecipientTable (6 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| RENEW DEKALB | |||||||
| 111 S SECOND STREET 201 | DEKALB | IL | 60115 | 760834191 | 501(C)(3) | 5000 | TO PROVIDE FINANCIAL ASSISTANCE FOR ECONOMIC DEVELOPMENT PROGRAMS AND ACTIVITIES RELATED TO DOWNTOWN DEKALB RENEWAL |
| OSF SAINT ANTHONY MEDICAL CENTER FOUNDATION | |||||||
| 5666 E STATE STREET | ROCKFORD | IL | 61108 | 371259284 | 501(C)(3) | 7500 | TO PROVIDE FINANCIAL ASSISTANCE IN CONNECTION WITH SUPPORT OF PHILANTHROPIC EFFORTS THAT IMPACT THE CARE OF PATIENTS FROM OUR COMMUNITY. |
| DEKALB COUNTY GOVERNMENT | |||||||
| 110 E SYCAMORE STREET | SYCAMORE | IL | 60178 | 366006548 | 115 | 50000 | TO PROVIDE FINANCIAL ASSISTANCE IN CONNECTION WITH ESTABLISHMENT OF BROADBAND CONNECTIVITY THROUGHOUT DEKALB COUNTY. |
| DEKALB COUNTY COMMUNITY FOUNDATION | |||||||
| 475 DEKALB AVE | SYCAMORE | IL | 60178 | 363788167 | 501(C)(3) | 75000 | TO PROVIDE FINANCIAL ASSISTANCE TO COMMUNITY FOUNDATION BUILDING PROJECT. |
| DEKALB COUNTY YOUTH SERVICE BUREAU | |||||||
| 330 GROVE STREET | DEKALB | IL | 60115 | 363034427 | 501(C)(3) | 5000 | TO PROVIDE FINANCIAL ASSISTANCE TO PROGRAMS FOR AT-RISK YOUTH |
| NORTHERN ILLINOIS UNIVERSITY FOUNDATION | |||||||
| ALTGELD HALL 135 | DEKALB | IL | 60115 | 366086819 | 501(C)(3) | 25000 | TO PROVIDE FINANCIAL ASSISTANCE RELATED TO CONSTRUCTION OF NIU ATHLETIC FACIILTY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 5 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 1 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURE FOR MONITORING GRANTS IN THE U.S.: | Identifier |
| Return Reference | PART I, LINE 2: | ReturnReference |
| Explanation | SCHEDULE I, PART I, LINE 2: REQUESTS FOR FINANCIAL ASSISTANCE FROM OTHER CHARITABLE ORGANIZATIONS ARE REVIEWED AND APPROVED BY THE CEO OF KISHHEALTH SYSTEM. IF NECESSARY DUE TO THE DOLLAR AMOUNT OF THE REQUEST, THESE ITEMS MAY ALSO BE PRESENTED TO THE BOARD OF DIRECTORS. A BUDGET IS SET ANNUALLY FOR CHARITABLE ASSISTANCE TO OTHER ORGANIZATIONS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (12 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEVIN POORTEN | |||||||||||||
| 515921 | 0 | 183040 | 0 | 0 | 0 | 79288 | 0 | 23375 | 0 | 801624 | 0 | 0 | 0 |
| LOREN FOELSKE | |||||||||||||
| 249213 | 0 | 67548 | 0 | 0 | 0 | 19288 | 0 | 22531 | 0 | 358580 | 0 | 0 | 0 |
| BRAD COPPLE | |||||||||||||
| 287064 | 0 | 78836 | 0 | 0 | 0 | 19288 | 0 | 22787 | 0 | 407975 | 0 | 0 | 0 |
| JOSEPH DANT | |||||||||||||
| 204572 | 0 | 59155 | 0 | 0 | 0 | 19288 | 0 | 22453 | 0 | 305468 | 0 | 0 | 0 |
| MICHAEL KOKOTT | |||||||||||||
| 161458 | 0 | 36639 | 0 | 0 | 0 | 15303 | 0 | 8431 | 0 | 221831 | 0 | 0 | 0 |
| ROGER HEATH BELL | |||||||||||||
| 191687 | 0 | 62069 | 0 | 0 | 0 | 17393 | 0 | 22389 | 0 | 293538 | 0 | 0 | 0 |
| PAM DUFFY | |||||||||||||
| 196437 | 0 | 44975 | 0 | 0 | 0 | 18566 | 0 | 8700 | 0 | 268678 | 0 | 0 | 0 |
| MARK THATE | |||||||||||||
| 159512 | 0 | 37768 | 0 | 0 | 0 | 14318 | 0 | 15036 | 0 | 226634 | 0 | 0 | 0 |
| MICHAEL MUZZILLO | |||||||||||||
| 145011 | 0 | 34338 | 0 | 0 | 0 | 12707 | 0 | 14872 | 0 | 206928 | 0 | 0 | 0 |
| DR MICHAEL KULISZ | |||||||||||||
| 301391 | 0 | 90000 | 0 | 0 | 0 | 0 | 0 | 22661 | 0 | 414052 | 0 | 0 | 0 |
| CHERYL FISHER | |||||||||||||
| 125884 | 0 | 24307 | 0 | 0 | 0 | 11004 | 0 | 21885 | 0 | 183080 | 0 | 0 | 0 |
| SHELLY JOHNSON | |||||||||||||
| 108106 | 0 | 9437 | 0 | 0 | 0 | 7779 | 0 | 40655 | 0 | 165977 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| PART I, LINE 1A | KISHHEALTH SYSTEM PROVIDES PAYMENT FOR SOCIAL CLUB DUES FOR THE CEO AND PRESIDENT - KCH & VWCH OF THE ORGANIZATION. KISHHEALTH SYSTEM ALSO PROVIDES PAYMENT FOR AUTOMOBILE ALLOWANCE FOR THE CEO, PRESIDENT - KCH & VWCH, VP BUSINESS DEVELOPMENT, AND THE AVP PLANNING & MARKETING OF THE ORGANIZATION. SUCH PAYMENTS ARE REPORTED AS TAXABLE COMPENSATION ON THE INDIVIDUAL'S FORM W-2. |
| PART I, LINE 4B | THE ORGANIZATION'S CEO PARTICIPATES IN A NONQUALIFIED DEFERRED COMPENSATION PLAN. CONTRIBUTIONS FOR CALENDAR YEAR 2011 WERE $60,000. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (15 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| KISHWAUKEE COMMUNITY HOSPITAL | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 12642156 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF KISHWAUKEE COMMUNITY HOSPITAL. THE PURPOSE OF KHS IS TO PROVIDE MANAGEMENT AND SUPPORT SERVICES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH PROVIDE HEALTHCARE SERVICES. FEES PAID TO KHS ARE IN EXCHANGE FOR THESE SERVICES, INCLUDING THE ORGANIZATIONS SHARE OF COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. | 0 |
| VALLEY WEST COMMUNITY HOSPITAL | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 3924864 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF VALLEY WEST COMMUNITY HOSPITAL. THE PURPOSE OF KHS IS TO PROVIDE MANAGEMENT AND SUPPORT SERVICES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH PROVIDE HEALTHCARE SERVICES. FEES PAID TO KHS ARE IN EXCHANGE FOR THESE SERVICES, INCLUDING THE ORGANIZATIONS SHARE OF COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. | 0 |
| DEKALB COUNTY HOSPICE | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 95321 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF DEKALB COUNTY HOSPICE. THE PURPOSE OF KHS IS TO PROVIDE MANAGEMENT AND SUPPORT SERVICES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH PROVIDE HEALTHCARE SERVICES. FEES PAID TO KHS ARE IN EXCHANGE FOR THESE SERVICES, INCLUDING THE ORGANIZATIONS SHARE OF COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. | 0 |
| KISHHEALTH FOUNDATION | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 43606 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF KISHHEALTH FOUNDATION. THE PURPOSE OF KHS IS TO PROVIDE MANAGEMENT AND SUPPORT SERVICES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH PROVIDE HEALTHCARE SERVICES. FEES PAID TO KHS ARE IN EXCHANGE FOR THESE SERVICES, INCLUDING THE ORGANIZATIONS SHARE OF COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. | 0 |
| KISHWAUKEE COMMUNITY HOSPITAL | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 4440000 | KISHWAUKEE COMMUNITY HOSPITAL MADE AN EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM, ITS PARENT ORGANIZATION. | 0 |
| VALLEY WEST COMMUNITY HOSPITAL | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 1710000 | VALLEY WEST COMMUNITY HOSPITAL MADE AN EQUITY DISTRIBUTION TO KISHHEALTH SYSTEM, ITS PARENT ORGANIZATION. | 0 |
| KISHHEALTH FOUNDATION | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 300000 | EQUITY TRANSFER MADE TO SUBSIDIARY ORGANIZATION. TRANSFER WAS INTENDED TO PROVIDE THE ORGANIZATION WITH ADDITIONAL ASSETS TO CARRY ON ITS CHARITABLE ACTIVITIES. | 0 |
| HEALTH PROGRESS INC | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 388619 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. THE PURPOSE OF KHS IS TO PROVIDE MANAGEMENT AND SUPPORT SERVICES TO ITS RELATED ORGANIZATIONS, ALL OF WHICH PROVIDE HEALTHCARE SERVICES. FEES PAID TO KHS ARE IN EXCHANGE FOR THESE SERVICES, INCLUDING THE ORGANIZATIONS SHARE OF COMPENSATION OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES. | 0 |
| (no name) | |||
| 0 | |||
| HEALTH PROGRESS INC | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 55523 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. KHS LEASES BUILDING SPACE FROM HEALTH PROGRESS, INC. | 0 |
| DEKALB COUNTY HOSPICE | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 690000 | EQUITY TRANSFER MADE TO SUBSIDIARY ORGANIZATION. TRANSFER WAS INTENDED TO PROVIDE THE ORGANIZATION WITH ADDITIONAL ASSETS TO CARRY ON ITS CHARITABLE ACTIVITIES. | 0 |
| HEALTH PROGRESS INC | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 400000 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF HEALTH PROGRESS, INC. DURING THE FISCAL YEAR, KHS MADE AN EQUITY CONTRIBUTION TO HEALTH PROGRESS, INC. | 0 |
| COMMUNITY CARES CLINIC | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 500000 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF COMMUNITY CARES CLINIC. DURING THE FISCAL YEAR, KHS MADE AN EQUITY CONTRIBUTION TO COMMUNITY CARES CLINIC. | 0 |
| KISHWAUKEE PHYSICIAN'S GROUP INC | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 2110484 | KISHHEALTH SYSTEM (KHS) IS THE PARENT ORGANIZATION OF KISHWAUKEE PHYSICIAN'S GROUP, INC. DURING THE FISCAL YEAR, KHS MADE AN EQUITY CONTRIBUTION TO KISHWAUKEE PHYSICIAN'S GROUP, INC. | 0 |
| KISHWAUKEE COMMUNITY HOSPITAL | |||
| COMMON DIRECTORS/OFFICERS/KEY EMPLOYEES, SUBSIDIARY ORGANIZATION | 97091 | KISHWAUKEE COMMUNITY HOPSITAL IS AN AFFILIATE OF KISHHEALTH SYSTEM (KHS). KCH RENTS SPACE FROM KHS AT ITS FOXPOINTE FACILITY | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | KEVIN POORTEN AND LOREN FOELSKE ARE BOTH EMPLOYEES OF KISHHEALTH SYSTEM. HOWEVER, THEY ALSO SERVE ON THE BOARD OF DIRECTORS OR AS OFFICERS OF THE RELATED TAX-EXEMPT SUBSIDIARY ORGANIZATIONS, INCLUDING KISHWAUKEE COMMUNITY HOSPITAL, VALLEY WEST COMMUNITY HOSPITAL, DEKALB COUNTY HOSPICE, COMMUNITY CARES CLINIC, INC. AND KISHHEALTH FOUNDATION. MR. POORTEN IS PRESIDENT AND CEO OF KISHHEALTH SYSTEM AND SERVES AS AN EX-OFFICIO DIRECTOR FOR ALL ORGANIZATIONS RELATED TO KISHHEALTH SYSTEM. MR. FOELSKE SERVES AS THE VICE-PRESIDENT - FINANCE OF KISHHEALTH SYSTEM, AND SERVES AS THE TOP FINANCIAL OFFICIAL FOR ALL RELATED ENTITIES. THE FOLLOWING INDIVIDUALS ARE OFFICERS OR KEY EMPLOYEES OF KISHHEALTH SYSTEM AND ARE ALSO CONSIDERED KEY EMPLOYEES OF VALLEY WEST COMMUNITY HOSPITAL AND KISHWAUKEE COMMUNITY HOSPITAL. THEY ARE ALL COMPENSATED BY KISHHEALTH SYSTEM: BRAD COPPLE, PRESIDENT KCH & VWCH PAM DUFFY, VP PATIENT CARE JOE DANT, VP DEVELOPMENT MIKE KOKOTT, ASST. VP MARKETING ROGER HEALTH BELL, VP AND CHIEF INFORMATION OFFICER MARK THATE, VP HUMAN RESOURCES DR. MICHAEL KULISZ, CHIEF MEDICAL OFFICER MICHAEL MUZZILLO, VP OPERATIONS, VWCH SEVERAL MEMBERS OF THE KISHHEALTH SYSTEM BOARD OF DIRECTORS ALSO SERVE ON THE BOARD OF DIRECTORS FOR A RELATED ENTITY. ALL ENTITIES ARE WHOLLY OWNED SUBSIDIARIES OF KISHHEALTH SYSTEM. THESE MEMBERS INCLUDE: MICHAEL MOONEY, ALSO SERVED ON KISHWAUKEE COMMUNITY HOSPITAL BOARD MICHAEL CULLEN, ALSO SERVES ON KISHWAUKEE COMMUNITY HOSPITAL, COMMUNITY CARES CLINIC, AND KISHWAUKEE PHYSICIANS GROUP BOARDS ERIK ENGLEHART, ALSO SERVED ON THE VALLEY WEST COMMUNITY HOSPITAL BOARD, UNTIL BECOMING AN EMPLOYEE OF KISHWAUKEE PHYSICIANS GROUP AND ELECTED A DIRECTOR OF ITS BOARD TERRENCE DUFFY, ALSO SERVES ON VALLEY WEST COMMUNITY HOSPITAL BOARD JOE DANT, ALSO SERVES ON COMMUNITY CARES CLINIC AND HEALTH PROGRESS, INC BOARDS ANN WEST, ALSO SERVES ON KISHHEALTH FOUNDATION BOARD DR. MICHAEL KULISZ, ALSO SERVES ON BOARD OF KISHWAUKEE PHYSICIANS GROUP TOM MATYA, ALSO SERVES ON KISHHEALTH FOUNDATION BOARD AND KISHWAUKEE COMMUNITY HOSPITAL BOARD JOHN MOULTON, ALSO SERVES ON HEALTH PROGRESS, INC. BOARD | |
| FORM 990, PART VI, SECTION A, LINE 6 | KISHHEALTH SYSTEM MAINTAINS SEVERAL CLASSES OF MEMBERS. THEY ARE AS FOLLOWS: KHS SHALL HAVE HONORARY MEMBERS WHO SHALL NOT HAVE VOTING RIGHTS IN THE CORPORATION. HONORARY MEMBERS SHALL CONTINUE AS HONORARY MEMBERS PROVIDED THEY HAVE SATISFIED THE REQUIREMENTS OF MEMBERSHIP. HONORARY MEMBERS SHALL NOT HAVE MEETINGS EXCEPT THAT (I) HONORARY MEMBERS SHALL BE INVITED TO ATTEND INFORMATIONAL MEETINGS AS CALLED BY THE BOARD OF DIRECTORS FROM TIME TO TIME; AND (II) HONORARY MEMBERS SHALL BE INVITED TO ATTEND A SPECIAL INFORMATIONAL MEETING PRIOR TO THE ADOPTION BY THE KHS BOARD OF ANY OF THE ACTIONS THAT ARE DESCRIBED IN SECTION 4.1.D, G, H OR Q BELOW (WITH RESPECT TO KHS, KCH OR VWCH). ANY PERSON (WHICH TERM SHALL INCLUDE, FOR PURPOSES OF THIS SECTION 3.1, INDIVIDUALS AND FIRMS, CORPORATIONS, ASSOCIATIONS, CLUBS, OR SOCIETIES FOR THE DURATION OF THEIR EXISTENCE) MAY BECOME AN HONORARY MEMBER OF KHS PERMANENTLY OR FROM TIME TO TIME, AS THE CASE MAY BE, BY MEETING THE QUALIFICATIONS FOR ONE OF THE FOLLOWING CATEGORIES OF MEMBERS: A. PARTICIPATING MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING $100 OR MORE BUT LESS THAN $500 IN VALUE TO KHS, KCH, VWCH OR THE HEALTH FOUNDATION SHALL BE A PARTICIPATING MEMBER OF KHS. ANY PERSON DESIGNATED A PARTICIPATING MEMBER SHALL RETAIN SUCH DESIGNATION FOR ONE YEAR FOLLOWING THE DATE OF HIS, HER OR ITS QUALIFYING CONTRIBUTION. B. CONTRIBUTING MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING $500 OR MORE BUT LESS THAN $5,000 IN VALUE TO KHS, KCH, VWCH OR THE HEALTH FOUNDATION SHALL BE A CONTRIBUTING MEMBER OF KHS. ANY PERSON DESIGNATED A CONTRIBUTING MEMBER SHALL RETAIN SUCH DESIGNATION FOR ONE YEAR FOLLOWING THE DATE OF HIS, HER OR ITS QUALIFYING CONTRIBUTION. C. LIFE MEMBER. ANY PERSON WHO HAS CONTRIBUTED PROPERTY OR CASH OR BOTH AGGREGATING AT ANY TIME $5,000 OR MORE BUT LESS THAN $10,000 IN VALUE TO KHS, KCH, VWCH OR THE HEALTH FOUNDATION SHALL BE A LIFE MEMBER OF KHS. ANY PERSON DESIGNATED A LIFE MEMBER SHALL RETAIN SUCH DESIGNATION. D. FOUNDER. ANY PERSON WHO HAS CONTRIBUTED OR PLEDGED PROPERTY OR CASH OR BOTH AGGREGATING AT ANY TIME $10,000 OR MORE IN VALUE TO KHS, KCH, VWCH OR THE HEALTH FOUNDATION SHALL BE A FOUNDER OF KHS. ANY PERSON DESIGNATED A FOUNDER SHALL RETAIN SUCH DESIGNATION. E. SERVICE MEMBER. (1) ANY PERSON WHO HAS CONTRIBUTED AT LEAST 60 HOURS ON A FISCAL YEAR BASIS OF UNPAID VOLUNTARY SERVICE TO KCH OR VWCH SHALL BECOME A SERVICE MEMBER OF KHS. (2) ANY PERSON WHO SERVES ON THE KHS BOARD OR ON ANY GOVERNING BOARD OF ANY SUBSIDIARY CORPORATION OF KHS SHALL BE A SERVICE MEMBER OF KHS WHILE SERVING ON THE KHS BOARD OR SUCH SUBSIDIARY CORPORATION BOARD. | |
| FORM 990, PART VI, SECTION A, LINE 7A | A NOMINATING COMMITTEE, COMPRISED OF MEMBERS OF THE KISHHEALTH SYSTEM (KHS) BOARD OF DIRECTORS, IS RESPONSIBLE FOR PREPARATION OF A SLATE OF NOMINEES OR ELECTION TO THE KHS BOARD. SOME MEMBERS OF THE NOMINATING COMMITTEE ARE ALSO CONSIDERED "MEMBERS" OF KISHHEALTH SYSTEM, BY VIRTUE OF THEIR SERVICE TO THE BOARD. | |
| FORM 990, PART VI, SECTION B, LINE 11 | A DRAFT COPY OF FORM 990 IS PROVIDED TO THE GOVERNING BODY (BOARD OF DIRECTORS) AND THE GOVERANCE COMMITTEE FOR REVIEW BY THE RETURN PREPARER PRIOR TO FILING. THE ORGANIZATION'S CEO, CFO, AND OTHER MEMBERS OF THE ACCOUNTING DEPARTMENT ARE ALSO PROVIDED A COPY OF THE RETURN FOR THEIR REVIEW. THE CHAIR OF THE AUDIT COMMITTEE AND THE AUDIT COMMITTEE MEMBERS ARE ALSO PROVIDED DRAFT COPIES AND REVIEW. IF CHANGES ARE NECESSARY, THEY ARE REPORTED TO THE RETURN PREPARER AND INCORPORATED INTO THE FINAL RETURN. | |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICTS OF INTEREST ARE INVESTIGATED BY APPOINTED MEMBERS OF THE GOVERANCE COMMITTEE ON AN ONGOING BASIS. IF IT IS DETERMINED THAT AN INDIVIDUAL FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE INDIVIDUAL OF SUCH A BELIEF AND AFFORD HIM AN OPPORTUNITY TO EXPLAIN. AFTER SAID EXPLANATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION AS DEEMED NECESSARY. THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD ANNUALLY AND UPDATED AS NEEDED. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THROUGH THE OVERSIGHT OF THE BOARD OF DIRECTORS EXECUTIVE COMPENSATION COMMITTEE, THE KISHHEALTH SYSTEM EXECUTIVE TOTAL COMPENSATION PROGRAM WILL BE COMPETITIVELY POSITIONED IN THE MARKET PLACE OF RELEVANT ORGANIZATIONS AND FALL WITHIN THE SAFE HARBOR GUIDELINES ESTABLISHED BY THE INTERMEDIATE SANCTIONS RULES. THE EXECUTIVE COMPENSATION COMMITTEE IS MADE UP OF THREE MEMBERS OF THE BOARD OF DIRECTORS WHO MEET THE BOARD APPROVED DEFINITION OF "INDEPENDENT DIRECTORS". ANNUALLY THE EXECUTIVE COMPENSATION COMMITTEE CONTRACTS WITH SULLIVAN, COTTER AND ASSOCIATES, AN INDEPENDENT HUMAN RESOURCES CONSULTING FIRM TO PROVIDE THE COMMITTEE ANALYSIS AND COMPARABILITY DATA. USING THE SUPPLIED DATA THE COMPENSATION COMMITTEE APPROVES EACH EXECUTIVE'S TOTAL CASH COMPENSATION AND PROVIDES CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATION AND DECISION. TOTAL CASH COMPENSATION IS DEFINED AS THE SUM OF BASE SALARIES PLUS INCENTIVE AWARDS. BASED ON THE COMPARABILITY DATA AND THE PERFORMANCE OF EACH EXECUTIVE IN MEETING GOALS AND STRATEGIC OBJECTIVES, THE EXECUTIVE COMPENSATION COMMITTEE APPROVES INCREASES AND INCENTIVE AWARDS FOR EACH EXECUTIVE WITHIN THE GUIDELINES ESTABLISHED. THE EXECUTIVE COMPENSATION COMMITTEE REPORTS ON ALL COMPENSATION MATTERS TO THE FULL BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN WRITING TO ADMINSTRATION. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED GAINS ON INVESTMENTS: 185,791. LOSS ON EQUITY METHOD SUBSIDIARY REPORTED ON SEPARATE COMPANY RETURN - HPI -968,907. EQUITY CONTRIBUTION TO SUBSIDIARIES -990,000. EQUITY DISTRIBUTION FROM SUBSIDIARIES 6,150,000. TOTAL TO FORM 990, PART XI, LINE 5: 4,376,884. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XI, LINE 2C | NO CHANGES IN THIS PROCESS WERE MADE DURING THE TAX YEAR. THE ORGANIZATION MAINTAINS AN INDEPENDENT AUDIT COMMITTEE WHICH IS RESPONSIBLE FOR OVERSIGHT OF THE AUDITED FINANCIAL STATEMENTS. THIS COMMITTEE IS ALSO RESPONSIBLE FOR THE SELECTION OF THE INDEPENDENT AUDITOR. MEMBERS OF THE AUDIT COMMITTEE ARE ALSO MEMBERS OF THE KISHHEALTH SYSTEM BOARD OF DIRECTORS. | RESPONSIBILITY FOR OVERSIGHT OF FINANCIAL STATEMENTS |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|
| KISHWAUKEE COMMUNITY HOSPITAL | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 237087041 | HEALTHCARE SERVICES, PRIMARILY ACUTE CARE | IL | 501(C)(3) | 3 | KISHHEALTH SYSTEM | 1 |
| VALLEY WEST COMMUNITY HOSPITAL | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 364244337 | HEALTHCARE SERVICES, PRIMARILY ACUTE CARE | IL | 501(C)(3) | 3 | KISHHEALTH SYSTEM | 1 |
| DEKALB COUNTY HOSPICE | ||||||||||
| 2727 SYCAMORE ROAD 1B | DEKALB | IL | 60115 | 363164329 | HEALTHCARE SERVICES, PRIMARILY HOSPICE SERVICES | IL | 501(C)(3) | 7 | KISHHEALTH SYSTEM | 1 |
| KISHHEALTH FOUNDATION | ||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 363649077 | SUPPORT OF KISHWAUKEE HEALTH SYSTEM NOT FOR PROFIT ENTITIES | IL | 501(C)(3) | 7 | KISHHEALTH SYSTEM | 1 |
| COMMUNITY CARES CLINIC | ||||||||||
| 3100 SYCAMORE ROAD SUITE 1024 | DEKALB | IL | 60115 | 800424001 | HEALTHCARE SERVICES, PRIMARILY ACUTE CARE | IL | 501(C)(3) | 7 | KISHHEALTH SYSTEM | 1 |
| KISHWAUKEE PHYSICIAN'S GROUP INC | ||||||||||
| 2240 GATEWAY DRIVE | SYCAMORE | IL | 60178 | 651293967 | HEALTHCARE SERVICES, PRIMARILY FAMILY PRACTICE | IL | 501(C)(3) | 3 | KISHHEALTH SYSTEM | 1 |
Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HEALTH VENTURES LLC | |||||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 753255958 | RENTAL REAL ESTATE PROVIDED TO HEALTHCARE RELATED BUSINESSES | IL | HEALTH PROGRESS INC | RELATED | 20397 | 292570 | 0 | 1 | 0.51000 |
| KISHWAUKEE AREA PHO | |||||||||||||
| ONE KISH HOSPITAL DRIVE | DEKALB | IL | 60115 | 364205273 | MEDICARE SERVICES | IL | KISHWAUKEE COMMUNITY HOSPITAL | RELATED | -27776 | 3022 | 0 | 0 | 0.50000 |
| ILLINOIS REGIONAL CANCER CENTER | |||||||||||||
| 10 HEALTH SERVICES DRIVE | DEKALB | IL | 60115 | 363847273 | CANCER TREATMENT SERVICES | IL | HEALTH PROGRESS INC | RELATED | 521779 | 1412118 | 0 | 0 | 0.51000 |
| KISHWAUKEE CORPORATE HEALTH | |||||||||||||
| 1740 MEDITERRANEAN DRIVE | SYCAMORE | IL | 60178 | 651249587 | MEDICAL SERVICES | IL | HEALTH PROGRESS INC | RELATED | 5802 | 189777 | 0 | 0 | 0.51000 |
| MIDLAND SURGICAL CENTER LLC | |||||||||||||
| 3085 WOLF COURT | DEKALB | IL | 60115 | 352194610 | SURGICAL SERVICES | IL | KISHWAUKEE COMMUNITY HOSPITAL | RELATED | 527223 | 655734 | 0 | 0 | 0.77500 |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH PROGRESS INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE KISH HOSPITAL DRIVE | AddressLine1 |
| City | DEKALB | City |
| State | IL | State |
| ZIP Code | 60115 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363824138 | EIN |
| Primary Activity | INVESTMENT IN HEALTHCARE RELATED SMALL BUSINESS | PrimaryActivity |
| Legal Domicile State | IL | LegalDomicileState |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | -837048 | ShareOfTotalIncome |
| Share Of EOY Assets | 4097972 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 1 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 1 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 1 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 1 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (27 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| KISHHEALTH FOUNDATION | ||
| B | 300000 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| R | 1710000 | FAIR MARKET VALUE |
| VALLEY WEST COMMUNITY HOSPITAL | ||
| R | 4440000 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| N | 12642156 | FAIR MARKET VALUE |
| VALLEY WEST COMMUNITY HOSPITAL | ||
| N | 3924864 | FAIR MARKET VALUE |
| DEKALB COUNTY HOSPICE | ||
| N | 95321 | FAIR MARKET VALUE |
| KISHHEALTH FOUNDATION | ||
| N | 43606 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| N | 388619 | FAIR MARKET VALUE |
| DEKALB COUNTY HOSPICE | ||
| P | 648225 | FAIR MARKET VALUE |
| KISHHEALTH FOUNDATION | ||
| P | 7933 | FAIR MARKET VALUE |
| VALLEY WEST COMMUNITY HOSPITAL | ||
| P | 7515991 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| P | 74768 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| P | 32549716 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| I | 97091 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| O | 539055 | FAIR MARKET VALUE |
| KISHWAUKEE COMMUNITY HOSPITAL | ||
| O | 12932105 | FAIR MARKET VALUE |
| KISHHEALTH FOUNDATION | ||
| O | 1433 | FAIR MARKET VALUE |
| VALLEY WEST COMMUNITY HOSPITAL | ||
| O | 1843078 | FAIR MARKET VALUE |
| COMMUNITY CARES CLINIC INC | ||
| P | 3508 | FAIR MARKET VALUE |
| DEKALB COUNTY HOSPICE | ||
| O | 172509 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| J | 55523 | FAIR MARKET VALUE |
| DEKALB COUNTY HOSPICE | ||
| B | 690000 | FAIR MARKET VALUE |
| COMMUNITY CARES CLINIC INC | ||
| B | 500000 | FAIR MARKET VALUE |
| HEALTH PROGRESS INC | ||
| B | 400000 | FAIR MARKET VALUE |
| KISHWAUKEE PHYSICIANS GROUP | ||
| B | 2110484 | FAIR MARKET VALUE |
| KISHWAUKEE PHYSICIANS GROUP | ||
| O | 113385 | FAIR MARKET VALUE |
| KISHWAUKEE PHYSICIANS GROUP | ||
| P | 595409 | |