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Rockford Health System: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Rockford Health System (EIN 36-3197915)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-10-31
IRS object ID
201133049349300953
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)
Timestamp2011-10-31T10:43:33-00:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PricewaterhhouseCoopersBusinessNameLine1

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)
EIN363197915EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Rockford Health SystemBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlROCKNameControl
Phone8159715000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12400 N Rockton AveAddressLine1
CityRockfordCity
StateILState
ZIP Code61103ZIPCode

Officer Officer

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

Preparer Preparer

FieldValueIRS element (for citing)
NameMatthew PetroskiName
Phone2673303000Phone
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 Receipts6569842GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.rhsnet.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1982YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionRockford Health System (RHS) is responsible for supporting the entities that comprise the system: Rockford Memorial Hospital (RMH), Rockford Health Physicians (RHPH), the Visiting Nurses Association of the Rockford Area (VNA), and Rockford Memorial Development Foundation (RMDF). The mission is to improve and protect the health and welfare of the community, with superior care, everyday, for all patients. Rockford Health System RHS is responsible for supporting the entities that comprise the system Rockford Memorial Hospital RMH, Rockford Health Physicians RHPH, the Visiting Nurses Association of the Rockford Area VNA, and Rockford Memorial Development Foundation RMDF. The mission is to improve and protect the health and welfare of the community, with superior care, everyday, for all patients.ActivityOrMissionDescription
Nbr Voting Members Governing Body15NbrVotingMembersGoverningBody
Nbr Independent Voting Members9NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers11TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Current Year484065ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8056341ProgramServiceRevenuePriorYear
Program Service Revenue CY5967391ProgramServiceRevenueCY
Investment Income Current Year-1207InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year8056341TotalRevenuePriorYear
Total Revenue Current Year6450249TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year277064GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY57574GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year5095298SalariesEtcPriorYear
Salaries Etc Current Year4715086SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2683979OtherExpensePriorYear
Other Expenses Current Year3963123OtherExpensesCurrentYear
Total Expenses Prior Year8056341TotalExpensesPriorYear
Total Expenses Current Year8735783TotalExpensesCurrentYear
Revenues Less Expenses CY-2285534RevenuesLessExpensesCY
Total Assets BOY7236864TotalAssetsBOY
Total Assets EOY19531913TotalAssetsEOY
Total Liabilities BOY5076026TotalLiabilitiesBOY
Total Liabilities EOY7638731TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY2160838NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11893182NetAssetsOrFundBalancesEOY
Mission DescriptionTo support the entities within RHS and enable them to fulfill their committment to the RHS vision with performance excellence, innovation, and lifelong learning.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense4093398Expense
Revenue4097251Revenue
DescriptionRHS provides support for Rockford Memorial Hospital RMH, which cared for 15,078 inpatients in 2010, with 1,677 deliveries 392,342 outpatients treated, including 47,507 who visited the emergency room, and processed more than 1.5 million laboratory tests. RMH is the Regional Disaster Preparedness Center for northern Illinois and provides training and education for community preparedness and assists 14 other hospitals with their emergency preparedness. RMH has a Level I Trauma Center, operates a state-designated Perinatal Center with the only Level III Neonatal Intensive Care Unit in northern Illinois with 46 beds, plus an 8 bed Pediatric Intensive Care Unit. Through the Auxiliary, RMH is able to provide extra funds and services to support its mission. The Auxiliary has 345 volunteers who logged 35,847 hours to enhance RMH experience for patients. RHM provides outreach lab services, has state-of-the-art robotic surgery available, and the only regional genetic services and cytogenetics laboratory.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense1750140Expense
Revenue1750140Revenue
DescriptionRHS provides support for Rockford Health Physicians RHPH which includes staffing for RMHs specialized units such as the NICU and the PICU, adult and pediatric hospitalists, as well as neurologists, neuro and trauma surgeons. RHPH also provides anesthesiologists to assist the RMH surgical program. RHPH physicians, with specialties in brain, spine, and orthopedics as well as trained Emergency Medicine specialists are available 24/7 to staff the Emergency Department and fill immediate needs in the Level I Trauma Center. RHPH employs over 150 physicians of varying specialties and continues to assess and respond to the community needs when recruiting new physicians. RHPH had a total of 401,816 office visits in 2010 and provided 315,264 ancillary procedures and 279,997 clinical tests in areas such as pulmonary function, bone scans, Radiology, CT scans, mammography and physical therapy.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense177574Expense
Grants57574Grants
Revenue120000Revenue
DescriptionThe RHS commitment to support the entities within the system includes collaboration with community partners in both time staff volunteers and money to improve the quality of life. To fulfill the vision, RHS provides support for the Visiting Nurses Association of the Rockford Area VNA serving the community with hospice care 13,526 days, elder adult counseling/services over 7,000, and home health care 30,574 visits and therapists/aides 10,574 visits for care that allows people to stay in their own home to recover and recuperate. VNA volunteers gave 4,737 hrs to meet needs of the elderly. Staff participated in community health/wellness events to bring awareness, education and medical screenings to over 100 events. RHS also provides support for Rockford Memorial Development Foundation which, through fundraising activities, provides resources to enhance all areas of RHS. RMDF funds are used for special capital projects, assisting VNA in hospice and home care, adding comfort and extended care items for RMH and RHPH, as well as crisis support and education for employees.Description
FieldValueIRS element (for citing)
Total Program Service Expense6021112TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
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 AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
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 RequiredtrueScheduleORequired
Number Forms Transmitted With109643NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members15NbrVotingGoverningBodyMembers
Number Independent Voting Members9NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
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 VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDavid E 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 (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployeeFormerFormer
Jack J Becherer
Director002.00X000
James WBreckenridge
Director002.90X0478500103356
Thomas DBudd
Director000.70X000
John WChadwick
Director001.50X000
Eleanor FDoar
Director001.00X000
John TDorsey
Director001.00X027371649864
Pamela SFox
Director001.00X000
Jos LGonzalez
Director000.70X037451168096
Alphonso NGoode
Director003.00X000
Dennis TUehara
Director002.00X041249970487
Connie MVitali
Director002.00X000
Curtis DWorden
Director002.00X000
Paul AGreen
Chairman001.00X000X
Duane RBach
Treas/Vice-Chair002.00X000X
John DWitcher
ViceChair000.10X000X
Gary EKaatz
President035.80X9690510150705X
Henry MSeybold
Treasurer030.00439582059187X
Julie APeterson
Secretary042.5071646027194X
Milton G Schmitt Jr
CMO020.00263489034172X
Earl JBarnes II
VP Legal Affairs015.00000X
Dan Parod
Sr VP Hospital Admin Affairs040.00370451057161X
Dennis L'Heureux
VP Planning CIO055.00302944056609X
Steven Strode
VP Ambulatory Services040.00304588058340X
William Dilts
VP Riverside Campus Development015.00249786051069X
John Rhoades
COO Rockford Health Physicians005.000326686191703X
Diane McKeon
VP Quality Perf Measurement040.003217790129751X
Kevin Ruggles
Chief Physician-RHPh025.000603200103178X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3293316TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs2469112TotalReportableCompFrmRltdOrgs
Total Other Compensation1210872TotalOtherCompensation
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
McKesson Technologies
PO Box 98347ChicagoIL60693License/Maintenance1669694
McDermott Will & Emery
227 W Monroe StChicagoIL60606Legal Services1349414
Epic Systems Corp
PO Box 88314MilwaukeeWI53288License/Maintenance1190820
IBM
PO Box 643600PittsburghPA15264License/Maintenance1064336
Microsoft Licensing
1401 Elm StreetDallasTX75202License/Maintenance768754
FieldValueIRS element (for citing)
Number Of Contractors GT100 K29NumberOfContractorsGT100K
Government Grants484065GovernmentGrants
Total Contributions484065TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionCoordinate and support affiliate activitiesDescription
Business Code561000BusinessCode
Total Revenue Column5967391TotalRevenueColumn
Related Or Exempt Function Income5967391RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue5967391TotalProgramServiceRevenue

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other118386Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other119593Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-1207Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-1207TotalRevenueColumn
Exclusion-$1,207ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6450249TotalRevenueColumn
Related Or Exempt Function Income5967391RelatedOrExemptFunctionIncome
Exclusion-$1,207ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total57574Total
Program Services57574ProgramServices

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)
Total3875553Total
Management And General3875553ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total0Total

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total126678Total
Management And General126678ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total551286Total
Management And General551286ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total161569Total
Management And General161569ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total1886Total
Management And General1886ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

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)
Total3463932Total
Management And General3463932ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total24666Total
Management And General24666ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total110484Total
Management And General110484ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total16273Total
Management And General16273ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total80634Total
Management And General80634ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total34391Total
Management And General34391ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total32416Total
Management And General32416ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalManagement And GeneralManagementAndGeneralProgram ServicesProgramServices
Recruiting/Retention/Employee appreciation126296126296
Allocation for Program Services0-59635385963538
Equipment Rental2104421044
Miscellaneous5110151101

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total8735783Total
Program Services6021112ProgramServices
Management And General2714671ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4182911BOY
EOY3700128EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY95162BOY
EOY313769EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY153754BOY
EOY157780EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1019075BOY
EOY2435937EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis40205357LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec27991314LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1174730BOY
EOY12214043EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY611232BOY
EOY710256EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7236864BOY
EOY19531913EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY4487859BOY
EOY6953435EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY588167BOY
EOY685296EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5076026BOY
EOY7638731EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY2160838BOY
EOY11893182EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY2160838BOY
EOY11893182EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7236864BOY
EOY19531913EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2285534ReconcilationRevenueExpenses
Reconcilation Other Changes12017878ReconcilationOtherChanges
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)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type3 Func IntXSupportingOrg509a3Type3FuncInt
Certification CheckboxXCertificationCheckbox
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation (3 entries)

EINEINType Of OrganizationTypeOfOrganizationListed In Governing DocListedInGoverningDocSupported Organization NotifiedSupportedOrganizationNotifiedOrganized In USOrganizedInUSAmountAmount
Rockford Memorial Hospital
3621678473truetruetrue$4,093,398
Rockford Health Physicians
3630974363truetruetrue$1,750,140
Visiting Nurses Assn of the Rockford Area
3621679459truetruetrue$60,000
FieldValueIRS element (for citing)
Total Number Of Supported Orgs3TotalNumberOfSupportedOrgs
Sum Of Amounts5903538SumOfAmounts
Public Support Pertcentage1700.00000PublicSupportPertcentage170
Public Support Percentage5090.00000PublicSupportPercentage509
Investment Income Percentage0.00000InvestmentIncomePercentage

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Included On FSfalseIncludedOnFS

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis590080OtherCostOrOtherBasis
Depreciation146398Depreciation
Book Value443682BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis36602183OtherCostOrOtherBasis
Depreciation27808966Depreciation
Book Value8793217BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3013094OtherCostOrOtherBasis
Depreciation35950Depreciation
Book Value2977144BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings12214043TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Capital Accumulation Liability$521,229
Life Insurance Liability$164,067
FieldValueIRS element (for citing)
Total Of Amounts685296TotalOfAmounts
Total Revenue6450249TotalRevenue
Total Expenses8735783TotalExpenses
Excess Or Deficit For Year-2285534ExcessOrDeficitForYear
Other$12,017,878OtherAmount
Total Adjustments12017878TotalAdjustments
Excess Or Deficit Per FS9732344ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt6451456TotRevenueEtcAuditedFinclStmt
Revenue Subtotal6451456RevenueSubtotal
Total Revenue Per Form9906451456TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt8735783TotExpensesEtcAuditedFinclStmt
Expenses Subtotal8735783ExpensesSubtotal
Total Expenses Per Form9908735783TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
X2Rockford Health system 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, 2008, 2009 or 2010.
XI8Net asset differences result from 12,017,878 transfers from affiliates.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1Rkfd Area Economic CouncilBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 Park AveAddressLine1
CityRockfordCity
StateILState
ZIP Code61101ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient363055858EINOfRecipient
IRC Section501c6IRCSection
Amount Of Cash Grant55000AmountOfCashGrant
Purpose Of GrantCommunity buildingPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of Other Organizations1TotalNbrOfOtherOrganizations

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsBonus Related OrgsBonusRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgsBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
James WBreckenridge
2901921871741134861601719658185679750
John TDorsey
26114911434113441396846932358231409
Jos LGonzalez
351014223641134523561574044260825212
Dennis TUehara
3874092354315485326617220482986
Gary EKaatz
55228730497111179212471925986111975576766
Henry MSeybold
3166871153877509478781131049877125145
Milton G Schmitt Jr
19016850000233211957114602297662
Dan Parod
2676131017581080451001206142761224496
Dennis L'Heureux
2396486000032963215724451359552
Steven Strode
246791567921005324362590436292813357
William Dilts
180041531731657228296227733008559276
John Rhoades
2638136078620881678472685652139020579
Diane McKeon
14827935638137862114851149014515318053
Kevin Ruggles
40814217376921290806072257170637946668

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- Severance payments made to Diane McKeon in 2010 totalled 105,214 and a severance agreement made for John Rhoades 139,631 to begin in 2011. Future increase in severance for Gary Kaatz was 7,971by contract.
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 forWilliam Dilts 9,693 Gary Kaatz 93,816 Dennis LHeureux 8,938 Dan Parod 28,790 Steven Strode 17,174 Diane McKeon 4,819 John Rhoades 16,143 Kevin Ruggles 58,810 and Henry Seybold 29,736.
I7- Short term incentive opportunities, designating threshold, target and maximum annual awards are established for all executives, driven by the strategic initiatives and priorities of RHS. If incentive thresholds are not met, CEO may grant discretionary bonuses for outstanding performance within certain parameters.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990 Part VI11a- The data was gathered by the accounting staff with input from the executive staff. The data was reviewed and the Form 990 prepared by the RHS tax analyst. Once the Form 990 was completed, it was reviewed by an independent accounting firm. A copy of the Form 990 was made available to all board members on a secure intracompany website. A presentation of the return was made to the RHS Finance Committee and at a meeting of the Board of Directors before filing
Form 990 Part VI12c- RHS Compliance Department 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. 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 VNA 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. This Board has established a Compensation Committee to establish and review all executive compensation annually based on the established philosophy. An external executive compensation firm provides consulting on RHS 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.
Form 990 Part VI19- Financial statements are available through the Illinois Attorney Generals Office. Policies including the Conflict of Interest policy are available on our Intracompany Website and are not accessible to the general public. Governing documents are available by request from Board Secretary.
Form 990 Part VII1- Some members of the board were compensated by related organizations for other duties James Breckenridge 45.8 hrs physician/Chair Anesthesiology Dept, John Dorsey 40 hrs physician/Lead Physician for Quality Internal Medicine, Jose Gonzalez 70.5 physician/Medical Director-Neonatology, and Dennis Uehara 38 hrs physician/Chair Emergency Department and a board member of RMDF Rockford Memorial Development Foundation they were compensated as physicians by RHPH Rockford Health Physiciansand for administrative duties by RMH Rockford Memorial Hospital. Gary Kaatz as President and CEO - 8.1 hrs for related organizations, Julie Peterson - 4.4 hrs as executive secretary, Henry Seybold - 12 hrs as CFO/Sr VP of Finance, Milt Schmitt - 10 hrs as board liason on mulitple RMH and RHPHcommittees, as well as VanMatrePartnerships governing Chair.
Form 990 Part XI6- This amount 12,017,878 is net transfers from affilated organziations.

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 OrgControlledOrg
Rockford Memorial Hospital
2400 N Rockton AveRockfordIL61103362167847HealthcareIL501c33Rockford Health Systemtrue
Rockford Health Physicians
2300 N Rockton AveRockfordIL61103363097436HealthcareIL501c33Rockford Health Systemtrue
Rockford Memorial Development Foundation
2400 N Rockton AveRockfordIL61103363197918Support of HealthcareIL501c311Rockford Health Systemtrue
Visiting Nurses Assn of the Rockford Area
2400 N Rockton AveRockfordIL61103362167945HealthcareIL501c39Rockford Health Systemtrue

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 Ste 200AddressLine1
CityBirminghamCity
StateALState
ZIP Code35243ZIPCode
FieldValueIRS element (for citing)
EIN364397130EIN
Primary ActivityHealthcarePrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Rockford Memorial HospitalBusinessNameLine1
FieldValueIRS element (for citing)
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 Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Rockford Memorial HospitalBusinessNameLine1
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 AssetstrueExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgtrueOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (12 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
Rockford Memorial Hospital
h8214446Financial Analysis
Rockford Health Physicians
h68793Financial Analysis
Rockford Health Physicians
m110484Financial Analysis
Rockford Memorial Development Foundation
n85136Financial Analysis
Rockford Health Physicians
n3212181Financial Analysis
Visiting Nurses Association
n202866Financial Analysis
Rockford Memorial Hospital
n8867301Financial Analysis
Rockford Memorial Hospital
p5305827Financial Analysis
Visiting Nurses Association
p153371Financial Analysis
Rockford Health Physicians
p2580708Financial Analysis
Rockford Health Physicians
q15200000Financial Analysis
Rockford Memorial Hospital
r15200000Financial Analysis