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ROCKFORD HEALTH PHYSICIANS: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
ROCKFORD HEALTH PHYSICIANS (EIN 36-3907436)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-10-31
IRS object ID
201103049349300675
Schema version
2010v3.4
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)
Timestamp2011-10-31T11:31:56-00:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PriceWaterhouseCoopers LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line12001 Market St Ste 1700AddressLine1
CityPhiladelphiaCity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN363907436EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Rockford Health PhysiciansBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlROCKNameControl
Phone8159715000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12300 N Rockton AveAddressLine1
CityRockfordCity
StateILState
ZIP Code61103ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameHenry M SeyboldName
TitleSenior Vice President of Finance CFTitle
Phone8159715000Phone
Date Signed2011-10-20DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMatthew PetroskiName
Phone2673303000Phone
Date Prepared2011-10-20DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonGary KaatzNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12400 N Rockton AveAddressLine1
CityRockfordCity
StateILState
ZIP Code61103ZIPCode
FieldValueIRS element (for citing)
Gross Receipts82147023GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.RHSNET.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1993YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionTo improve and protect the health and welfare of the community we have 179 providers skilled at 30 specialites. Our physicians also staff the Level I Trauma Center, as well as the Brain & Spine Center, and the area's only Level III Regional Perinatal Center including a 44-bed Neonatal Intensive Care Unit. We have both adult and pediatric critical care Intensivists along with our adult & pediatric Hospitalists to care for all in-house patients. To improve and protect the health and welfare of the community we have 179 providers skilled at 30 specialites. Our physicians also staff the Level I Trauma Center, as well as the Brain Spine Center, and the areas only Level III Regional Perinatal Center including a 44-bed Neonatal Intensive Care Unit. We have both adult and pediatric critical care Intensivists along with our adult pediatric Hospitalists to care for all in-house patients.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees746TotalNbrEmployees
Total Nbr Volunteers12TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year31800ContributionsGrantsPriorYear
Contributions Grants Current Year35954ContributionsGrantsCurrentYear
Program Service Revenue Prior Year77995168ProgramServiceRevenuePriorYear
Program Service Revenue CY81150885ProgramServiceRevenueCY
Investment Income Prior Year26052InvestmentIncomePriorYear
Investment Income Current Year22667InvestmentIncomeCurrentYear
Other Revenue Prior Year294145OtherRevenuePriorYear
Other Revenue Current Year622692OtherRevenueCurrentYear
Total Revenue Prior Year78347165TotalRevenuePriorYear
Total Revenue Current Year81832198TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year82001622SalariesEtcPriorYear
Salaries Etc Current Year84105815SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year39974779OtherExpensePriorYear
Other Expenses Current Year38398767OtherExpensesCurrentYear
Total Expenses Prior Year121976401TotalExpensesPriorYear
Total Expenses Current Year122504582TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-43629236RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-40672384RevenuesLessExpensesCY
Total Assets BOY55021629TotalAssetsBOY
Total Assets EOY57821261TotalAssetsEOY
Total Liabilities BOY79248955TotalLiabilitiesBOY
Total Liabilities EOY78177386TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-24227326NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-20356125NetAssetsOrFundBalancesEOY
Mission DescriptionThe goal of Rockford Health Physicians RHPH is to improve and protect the health and welfare of the community in accordance with our mission Superior Care. Everyday. For all our patients. We will fulfill our committment through performance excellence, innovation, and lifelong learning.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense93440661Expense
Revenue68526157Revenue
DescriptionPhysician primary and specialty care services were provided to the community on an outpatient basis. Physician services were also provided for hospital inpatients, adult pediatric intensive care, inpatient and outpatient surgical services, and support to inpatients for anesthesia, high risk pregnancies, neonatology trauma services. These services were available at 9 locations throughout the region including 4 Convenient Care locations that provide for non-life threatening emergencies after regular hours. Physicians are available oncall 24-7 for the Level I Trauma Center. There were 401,816 office visits in 2010.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense4187893Expense
Revenue11974686Revenue
DescriptionAncillary Medical Services were performed to allow physicians to provide the proper care to achieve the best outcome for each patient. There were 315,264 ancillary procedures performed during 2010. RHPH provided 279,997 tests and procedures in clincial areas such as laboratory and radiology including CT scans and mammography. Other support services included pulmonary function testing, bone scans, and physical therapy.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense404456Expense
Revenue650042Revenue
DescriptionThe Clinical Research Department participates with various studies to provide additional benefits to our patients one tracks the survivors of breast cancer another pharmaceutical study evaluates the effects of a drug that treats osteo/rheumatoid arthritis and another studies gout. RHPH participates in a Physician Quality Report Incentive program through Medicare to measure data for quality evaluation. RHPH is also committed to providing services for Maternal and Child care as well as families through Illinois Health Connect, a means-tested program that helps kids and families get health care and stay healthy by choosing a medical home. RHPH also partners with neighboring schools to provide physicals and screenings. Staff and physicians participated in various health fairs and hosted educational forums in the communities to bring residents an awareness of a variety of health/wellness related topics - such as heart disease and prevention, healthy eating, childrens health concerns, and aging issues.Description
FieldValueIRS element (for citing)
Total Program Service Expense98033010TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With109657NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees746NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
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 Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
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 ChaptersfalseLocalChapters
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 VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDavid Vola ControllerNamePerson
Telephone Number8159715000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12400 N Rockton AvenueAddressLine1
CityRockfordCity
StateILState
ZIP Code61103ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Duane RBach
Treas000.10X000
Jack JBecherer
Director000.60X000
James WBreckenridge
Director047.00X4785000103356
Thomas DBudd
Director000.30X000
John WChadwick
Director000.30X000
Eleanor FDoar
Vice Chair000.10X000
John TDorsey
Director060.00X273716049864
Pamela SFox
Director000.10X000
Jos LGonzalez
Director052.20X374511068096
Alphonso NGoode
Director001.00X000
Paul AGreen
Chairman000.10X000
Gary EKaatz
President001.00X0969051150705X
Dennis TUehara
Director029.00X412499070487
Connie MVitali
Director000.10X000
Curtis DWorden
Director000.30X000
Henry MSeybold
Treasurer001.00043958359187X
Julie APeterson
Secretary002.0007164627194X
Kevin Ruggles
Chief Phy Exec000.106032000103178X
John Rhoades
COO040.003266860191703X
James Sturm
Physician040.0010599340391943X
Allan Gocio
Physician040.00624284022092X
Scott Weintraub
Physician040.005959770147216X
Arthur Rettig
Physician040.00777762050958X
Paula Melone
Physician040.00632841022961X
Dennis Oltz
VP Finance040.00196419036164X
FieldValueIRS element (for citing)
Total Reportable Comp From Org6356329TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1480280TotalReportableCompFrmRltdOrgs
Total Other Compensation1495104TotalOtherCompensation
Number Individuals GT100 K14NumberIndividualsGT100K
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
Bratislav Velimirovic
1031 W Newport Ave 3ChicagoIL60657Healthcare Services1099855
Athena Health
PO Box 7247-6482PhiladelphiaPA19170Billing Services4060311
Rock Valley Industries
5549 International DriveRockfordIL61109Janitorial Services619418
Integrity Rehab Group In
1945 Scottsville Rd B-2 PMB356Bowling GreenKY42104Healthcare Services623415
CompHealth
PO Box 972651DallasTX753972651Healthcare Services754479
FieldValueIRS element (for citing)
Number Of Contractors GT100 K20NumberOfContractorsGT100K
Related Organizations26898RelatedOrganizations
All Other Contributions9056AllOtherContributions
Total Contributions35954TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Physician Medical Services6211104334740143347401
Ancillary Medical Services62140075747947574794
Medicare/Medicaid9000992957864829578648
Clinical Research900099112892112892
Health Connect, PQRI and MCH621400537150537150
FieldValueIRS element (for citing)
Total Program Service Revenue81150885TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column23525TotalRevenueColumn
Exclusion$23,525ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real539449Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real313937Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real225512Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column225512TotalRevenueColumn
Exclusion$225,512ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities30Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities888Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-858Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-858TotalRevenueColumn
Exclusion-$858ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnExclusionExclusionAmount
Partnership Income62130031873$31,873
Purchase Discounts9000999963$9,963
Support Services56149960662$60,662

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column294682TotalRevenueColumn
Exclusion$294,682ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue397180TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column81832198TotalRevenueColumn
Related Or Exempt Function Income81150885RelatedOrExemptFunctionIncome
Exclusion$645,359ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total3288380Total
Program Services2537408ProgramServices
Management And General750972ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total67116944Total
Program Services61388889ProgramServices
Management And General5728055ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total3019817Total
Program Services2777357ProgramServices
Management And General242460ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7490605Total
Program Services6343554ProgramServices
Management And General1147051ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3190069Total
Program Services2878384ProgramServices
Management And General311685ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1750140Total
Management And General1750140ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total351674Total
Management And General351674ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total69321Total
Management And General69321ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Fees For Services Prof FundraisingFeesForServicesProfFundraising

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total4770916Total
Program Services4149742ProgramServices
Management And General621174ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total746396Total
Program Services100ProgramServices
Management And General746296ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2603353Total
Program Services1574080ProgramServices
Management And General1029273ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1220139Total
Program Services910102ProgramServices
Management And General310037ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total5412768Total
Program Services432767ProgramServices
Management And General4980001ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total60210Total
Program Services35640ProgramServices
Management And General24570ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total94358Total
Program Services45704ProgramServices
Management And General48654ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total974908Total
Management And General974908ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total3640867Total
Program Services626459ProgramServices
Management And General3014408ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total2228670Total
Program Services1913191ProgramServices
Management And General315479ManagementAndGeneral

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Bad Debt44916104491610
Drugs and Medical Supplies44325204431700820
Other Purchased Services431404529011131412932

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1236872Total
Program Services595210ProgramServices
Management And General641662ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total122504582Total
Program Services98033010ProgramServices
Management And General24471572ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY14265BOY
EOY18435EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2577702BOY
EOY3628746EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY7316396BOY
EOY7134367EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY474037BOY
EOY628180EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1121536BOY
EOY598268EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis83118517LandBuildingsEquipmentBasis

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY40267242BOY
EOY41911635EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY332857BOY
EOY325043EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY2917594BOY
EOY3576587EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY55021629BOY
EOY57821261EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY51231724BOY
EOY50160155EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY28017231BOY
EOY28017231EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY79248955BOY
EOY78177386EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-24227326BOY
EOY-20356125EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-24227326BOY
EOY-20356125EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY55021629BOY
EOY57821261EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-40672384ReconcilationRevenueExpenses
Reconcilation Other Changes44543585ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
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
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

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 D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FSfalseIncludedOnFS

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1539430InvestmentCostOrOtherBasis
Other Cost Or Other Basis5611372OtherCostOrOtherBasis
Book Value5534636BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis59640200OtherCostOrOtherBasis
Book Value31244889BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis14385303OtherCostOrOtherBasis
Book Value3189898BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1942212OtherCostOrOtherBasis
Book Value1942212BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings41911635TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Bond Insurance Costs347220
Deferred Comp Valuation3091803
Capital Accumulation Account137564
FieldValueIRS element (for citing)
Total Book Value Other Assets3576587TotalBookValueOtherAssets
Total Revenue81832198TotalRevenue
Total Expenses122504582TotalExpenses
Excess Or Deficit For Year-40672384ExcessOrDeficitForYear
Other$44,543,585OtherAmount
Total Adjustments44543585TotalAdjustments
Excess Or Deficit Per FS3871201ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt82146135TotRevenueEtcAuditedFinclStmt
Other Revenues313937OtherRevenues
Revenue Not Rptd F990313937RevenueNotRptdF990
Revenue Subtotal81832198RevenueSubtotal
Total Revenue Per Form99081832198TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt122818519TotExpensesEtcAuditedFinclStmt
Other Expenses Included313937OtherExpensesIncluded
Expenses Not Rptd F990313937ExpensesNotRptdF990
Expenses Subtotal122504582ExpensesSubtotal
Total Expenses Per Form990122504582TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
X2- Audit Footnote for FIN 48 Rockford Health Physicians RHPH as a part of the System, Rockford Health System RHS, adopted FIN 48 in 2007 and the impact was not material. The System did not record any additional liabilities due to the implementation of FIN 48 for the years ended December 31, 2010 and 2009.
XII2d- Rental expenses deducted from Income, netted in Part VIII
XIII2d- Rental Expenses were not included with other 990 Part IX expense
XI8- The following were adjusting items in the Audited Income Statement Pension related changes other than periodic pension cost 62,381 Post retirement medical benefit changes other than post retirement medical benefit cost 36,985 and Transfers to or from affiliates 44,642,951. The difference is due to rounding to thousands for the audit

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
James WBreckenridge
2901921871741134861601719658185679750
John TDorsey
26114911433113441395846932358031409
Jos LGonzalez
351014223631134523561574044260725212
Gary EKaatz
55228730497111179212471925986111975576766
Dennis TUehara
3874092354315485326617220482986
Henry MSeybold
3166871153877509478771131049877025145
Kevin Ruggles
40814217376821290806072257170637846668
John Rhoades
2638136078520881648472685651838920579
James Sturm
520870538434630370928210151451877240321
Allan Gocio
6225506001134526816824646376
Scott Weintraub
28157431386454012640420812743194121030
Arthur Rettig
7430252885318522293228026828720
Paula Melone
52253210923910702276919265580215625
Dennis Oltz
16248030095384313869222962325833820

Form990 Schedule J Part III Form990ScheduleJPartIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
I1a- By policy Membership to the YWCA is paid for the CEO. Two social club memberships are paid for by the organization for the CEO and any personal use of these facilities is reimbursed in full. The actual cost of these memberships is prorated for personal vs business use and that percentage is added to taxable wages.
I4a- Chief Operating Officer left the organization in 2010 and was given a severance payment that began in 2011. The expense 139,631 was accrued in 2010 and attributed to him as deferred compensation.
I4b- The executive team receives annual additions to a non-qualified retirement plan. These amounts, accrued for 2010, are included in compensation and listed in detail in Part II for Gary Kaatz 93,816 John Rhoades 16,143 Kevin Ruggles 58,810 Dennis Oltz 4,242 and Henry Seybold 29,736.
I7- Physician compensation for productivity-based providers is calculated using wRVU worked Relative Value Units as defined by CMS-Centers for Medicare/Medicaid Services. Short term incentive opportunities, designating threshold, target and maximum annual awards are established for physicians and executives, driven by the strategic initiatives and priorities of RHS. If incentive thresholds are not met, CEO may grant discretionary bonuses for outstanding performance within certain parameters.

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Illinois Finance AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN861091967IssuerEIN
CUSIP Number45000GFS5CUSIPNumber
Date Issued2008-12-11DateIssued
Issue Price29792000IssuePrice
Description Of PurposeRefund 1994 Series Bonds, Issuance Costs, SWAP PaymentDescriptionOfPurpose
DefeasedfalseDefeased
On Behalf Of IssuerfalseOnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds29792000TotalProceeds
Issuance Costs From Proceeds464742IssuanceCostsFromProceeds
Year Of Subst Completion2008YearOfSubstCompletion
Current RefundingtrueCurrentRefunding
Advance RefundingfalseAdvanceRefunding
Final Allocation MadetrueFinalAllocationMade
Adequate Books And Recds MaintaindtrueAdequateBooksAndRecdsMaintaind

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T FiledfalseForm8038TFiled
Variable Rate IssuetrueVariableRateIssue
Hedge Identified In Books And RecdstrueHedgeIdentifiedInBooksAndRecds

Name Of Hedge Provider NameOfHedgeProvider

FieldValueIRS element (for citing)
Business Name Line1JP Morgan ChaseBusinessNameLine1
FieldValueIRS element (for citing)
Term Of Hedge0000000009.600000000000TermOfHedge
Gross Proceeds Invested In GICfalseGrossProceedsInvestedInGIC
Gross Proceeds InvestedfalseGrossProceedsInvested
Exception To RebatefalseExceptionToRebate

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990 Part VI6, 7a, b- Rockford Health System RHS is the sole corporate member of Rockford Health Physicians RHPh and has the authority to elect members to the board and ultimately has the authority to approve or deny all RHPh board actions.
Form 990 Part VI11- The data was gathered by the accounting staff with input from RHPh and RHS executive staffs. The data was reviewed and the Form 990 prepared by the RHPh tax analyst. Once the Form 990 was completed, it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intracompany website. A presentation of the return was made to the RHPh Finance Committee and at a meeting of the Board of Directors before filing.
Form 990 Part VI12- RHS Compliance Department acting on behalf of RHPh annually sends out a copy of the policy with the Conflict of Interest form included. Each member completes the Financial Interest Disclosure Statement which is a part of the policy. The RHS Compliance Department reviews and retains these statements. If a conflict is identified, all affected parties are informed, potential conflicts are reviewed and appropriate actions are taken as a result of the review. Employees are given the policy and a statement to complete at the beginning of the year or as a new party is hired or joins the RHPh board.
Form 990 Part VI15 a, b- Compensation for executives is governed by the RHS Board of Directors. The RHS Board has established a total compensation philosophy that directs the compensation practices for all executives from all related entities including RHPH. This Board has established a Compensation Committee to establish and review all executive compensation annually based on the established philosophy. An independent external executive compensation firm provides consulting on RHS including RHPh salary ranges and compensation philosophy. The appropriate peer group for compensation comparison purposes is other not-for-profit healthcare systems similar in size and complexity. RHS generally conducts an analysis of total compensation every three years but may choose to vary from this schedule as determined by the Compensation Committee. The RHPh board of directors concedes the authority to set compensation to RHS as the sole corporate member.
Form 990 Part VI19- Financial statements are available through the Illinois Attorney Generals Office. Governing documents are available by request from Board Secretary.
Form 990 Part VII- These members of the board were compensated by related organizations for other duties as well as unpaid service as board members James Breckenridge 13.4 hrs Chair of Anesthesiology at Rockford Memorial Hospital RMH and service to RMH and RHS boards, John Dorsey 3 hrs Lead Physician for Quality Internal Medicine and RMH and RHS boards, Jose Gonzalez 8 Medical Director-Neonatology, RMH and RHS boards, Dennis Uehara 17 hrs Chairperson - Emergency Department, RMH and RHS and Foundation RMDF boards. Gary Kaatz had 41.4 additional hrs as President and CEO, Julie Peterson had 45.13 hrs as an executive secretary, and Henry Seybold had 37 hrs as CFO Sr VP of Finance these employees compensation includes duties within the RHPh organization and for supporting all of the related entities RHS/RMH/RMDF/VNA.
Form 990 Part XIIC- RHPh is included as part of a consolidated audit performed for RHS by independent accountants. The RHS audit committee selects and recommends the independent auditors to the RHS board and annually reviews the audit.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrgDirect Controlling Entity NADirectControllingEntityNA
Rockford Memorial Hospital
2400 N Rockton AveRockfordIL61103362167847HealthcareIL501c33Rockford Health Systemfalse
Rockford Memorial Development Foundation
2400 N Rockton AveRockfordIL61103363197918Support of HealthcareIL501c311Rockford Health Systemfalse
Visiting Nurses Assn of the Rockford Area
2400 N Rockton AveRockfordIL61103362167945HealthcareIL501c39Rockford Health Systemfalse
Rockford Health System
2400 N Rockton AveRockfordIL61103363197915Support of HealthcareIL501c311falseN/A

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Van Matre Rehabilitation Center LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13660 Grandview PkwyAddressLine1
CityBirminghamCity
StateALState
ZIP Code35243ZIPCode
FieldValueIRS element (for citing)
EIN364397130EIN
Primary ActivityHealthcarePrimaryActivity
Legal Domicile StateILLegalDomicileState
Direct Controlling Entity NAN/ADirectControllingEntityNA
Predominant Income TypeNAPredominantIncomeType
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Rockford Health Insurance LTDBusinessNameLine1

Address Foreign AddressForeign

FieldValueIRS element (for citing)
Address Line1Wellesley House So 2nd Flr 90 PittsAddressLine1
CityPembrookeCity
Province Or StateHMProvinceOrState
CountryBDCountry
Postal Code08PostalCode
FieldValueIRS element (for citing)
Primary ActivityInsurancePrimaryActivity
Legal Domicile Foreign CountryBDLegalDomicileForeignCountry
Direct Controlling Entity NAN/ADirectControllingEntityNA
Type Of EntityC CorpTypeOfEntity
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (6 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Rockford Memorial Hospital
k4868113Financial Analysis
Rockford Memorial Hospital
l226659Financial Analysis
Rockford Memorial Hospital
m406730Financial Analysis
Rockford Memorial Hospital
n5685246Financial Analysis
Rockford Memorial Hospital
o2504191Financial Analysis
Rockford Memorial Hospital
p506557Financial Analysis