Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 0 | 0 | 0 | 0 | 0 | 0 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 8,303,829 | 8,739,187 | 9,286,380 | 9,685,176 | 9,357,284 | 45,371,856 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | 127,975 | 179,998 | 166,520 | 299,216 | 328,116 | 1,101,825 |
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 6 | Total. Add lines 1 through 5. | 8,431,804 | 8,919,185 | 9,452,900 | 9,984,392 | 9,685,400 | 46,473,681 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 183,195 | 182,950 | 188,445 | 211,240 | 258,245 | 1,024,075 |
| c | Add lines 7a and 7b.. | 183,195 | 182,950 | 188,445 | 211,240 | 258,245 | 1,024,075 |
| 8 | Public support (Subtract line 7c from line 6.) | 45,449,606 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2010 | (b) 2011 | (c) 2012 | (d) 2013 | (e) 2014 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 8,431,804 | 8,919,185 | 9,452,900 | 9,984,392 | 9,685,400 | 46,473,681 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 4,504 | 1,365 | 6,641 | 4,001 | 3,000 | 19,511 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 2,205 | 25,397 | 18,407 | 4,701 | 50,710 | |
| c | Add lines 10a and 10b. | 4,504 | 3,570 | 32,038 | 22,408 | 7,701 | 70,221 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 1,850,122 | 2,164,273 | 1,971,359 | 2,007,180 | 2,410,844 | 10,403,778 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 10,286,430 | 11,087,028 | 11,456,297 | 12,013,980 | 12,103,945 | 56,947,680 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e | Discount claimed for blockage or other factors (explain in detail in Part VI): | |||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| 7 | Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions) | |||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
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| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
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| 9 Distributable amount for 2014 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2014 |
(iii) Distributable Amount for 2014 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2014 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2014: | ||||
| a From 2009.......X | ||||
| b From 2010.......X | ||||
| c From 2011.......X | ||||
| d From 2012.......X | ||||
| e From 2013....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2014 distributable amount | ||||
|
i
Carryover from 2009 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2014 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2014 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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7 Excess distributions carryover to 2015. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a From 2010.......X | ||||
| b From 2011.......X | ||||
| c From 2012.......X | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| Form 990 Part III Line 1 | The primary mission of Health Bridge Corporation is to assist individuals of the community in the achievement of a greater quality of life through health and fitness in a professional, customer-focused and state of the art environment. Health Bridge Corporation is an instrument and wholly owned subsidiary of Centegra Health System. It exists as a community benefit to improve the community's overall health status. Its presence in McHenry County will enhance Centegra Health System's image and diversify its services. |
| Form 990 Part III Line 4a | The primary mission of Health Bridge Corporation is to assist individuals of the community in the achievement of a greater quality of life through health and fitness in a professional, customer-focused and state of the art environment. Health Bridge Corporation is an instrument and wholly owned subsidiary of Centegra Health System. HBC exists as a community benefit to improve the community's overall health status. Its presence in McHenry County enhances Centegra Health System's image and diversifies its services. The organization provides wellness and fitness services to, and makes wellness and fitness facilities available to, a significant and broad segment of the community served by Centegra Health System and its tax-exempt affiliates, including Northern Illinois Medical Center-(NIMC) and Memorial Medical Center - Woodstock-(Memorial). NIMC and Memorial are both tax-exempt hospitals that provide acute care services to the Chicago northwest suburban metropolitan area. The organization believes that its dues and rate structure permits a significant or broad segment of the community to utilize the organization's programs and facilities. The organization also offers charitable memberships based on evidence of hardship and need, consistent with the financial assistance policy applicable to all organizations within Centegra Health System. The organization also offers a variety of educational programs for free or at low fees to help defray costs, which is waived for those participants who are unable to pay. There were 159 charitable memberships provided during fiscal year 2015. The organization promotes the health of the community served by Centegra Health System and its tax-exempt affiliates through patient rehabilitation programs, including sports medicine, aquatics, outpatient physical and occupational therapy programs, industrial injury prevention and rehabilitation programs, specialized exercise programs and health screenings for various injuries, diseases and disorders. These programs are offered directly by the organization or indirectly through NIMC, which leases space at the organization's facility in Crystal Lake, Illinois. The organization also offers a variety of bridge memberships for rehabilitation, bariatric and cancer patients who receive care through Centegra Health System and its affiliated physicians. Bridge memberships are free 60-day memberships that allow rehabilitation, bariatric and cancer patients the opportunity to bridge the gap between therapy and or treatment and lifestyle modification. A total of 951 60-day Wellbridge memberships were provided during the current fiscal year. The organization provides health education for the community served by Centegra Health System and its tax-exempt affiliates through programs designed to promote community wellness and to educate the community on the benefits of total health wellness. Community lectures are offered to the public and several of these lectures and programs are offered without charge. The organization participates in various health fairs and community affairs in order to promote health and awareness in the community. The operations and programs of the organization are integrated into and are an important component of the community benefits provided by Centegra Health System and its tax-exempt affiliates. Several of the community healthcare priorities set forth in the Centegra community benefits plan are furthered directly by the organization. These priorities include access to health care, accident prevention and treatment, cancer prevention, detection, treatment and support, heart disease screenings, immunization clinics, lung cancer, respiratory disease, tobacco use cessation, weight and obesity education, support and activities, physical activity-lectures, screenings, activities, fairs and workshops; and community development and support. Health Bridge services include, but are not limited to- Health Fitness facility, tennis courts, indoor and outdoor pools, instructors, and fitness classes Back to Work Program for Industrial Injury Prevention and Rehabilitation Sports Medicine clinic Physical Rehabilitation Occupational Health Community Educational Programs Support Programs Rehabilitation and Sports Medicine Clinic at Health Bridge Fitness Center provides sports medicine, aquatics, outpatient physical and occupational therapy programs. The Back to Work Program, an industrial injury prevention and rehabilitation program, provides physical therapy, ergonomic consultation and back safety programs. This program also uses the aquatic pool located at the Rehabilitation and Sports Medicine Clinic. Health Bridge Corporation, as part of Centegra Health System, believes in total care that embraces the physical, psychological, spiritual, social and economic needs of the public served. In order to provide this care, Health Bridge supports a variety of services and educational programs. The organization sponsors many programs. In sponsoring programs, Health Bridge provides facilities as well as employees who act as facilitators for the group. In hosting programs, Health Bridge provides space free of charge or at a reduced or nominal fee to the group. SCREENINGS Health Bridge held free screenings for: Diabetes Movement and Posture-screenings where participants are assessed and screened on posture, balance, bio-mechanics and then were educated on possible causes for deficiencies. Sports Injuries: Sports Injury screenings allow participants to meet with a Physical Therapist to have their injuries analyzed and then receive information on how to improve the injury. Health Bridge also offers reduced fee lipid screenings. EXERCISE PROGRAMS In addition to providing the facilities, equipment and professional staff, Health Bridge offers specialized exercise programs which help participants get moving and stay active for a healthier lifestyle. These include- Arthritis Water Exercise Program focuses on progressive improvement in strength, endurance and range of motion. Multiple Sclerosis Water Exercise helps to improve muscle strength, balance and coordination Low Back Water Exercise classes were offered to improve flexibility, strength and endurance. Yoga, Meditation, Tai Chi and Ai Chi classes are offered to help reduce stress and increase flexibility. A Health Bridge certified fitness professional guided and educated persons on how to develop a safe and effective fitness plan. Seniors in Motion and Fit over Fifty are exercise classes designed for the senior population and are available to the community. The Pre- & Post-Natal exercise class is a land and water exercise program designed to meet the special needs of mothers and mothers-to-be. There are a variety of Swim Lessons provided to the community- There are adult swim programs including, Masters Swim Workout, Adult Beginner Swim Lesson, and Adult Swim Stroke Improvement. These programs offer assistance on the basics of swimming up to training with a coach. There were 63 participants in adult swim lessons during this fiscal year. Children's Group Swim Lessons and Private Swim Lessons are offered and are Red Cross Certified. During this fiscal year, there were 4,122 participants in group lessons and 1,992 participants in private lessons. Free swim evaluations were held for the community. OFF-SITE PROGRAMS Health Bridge provided massages twice a month at Sage Cancer Center. Health Bridge participates in various health fairs and various community fairs in order to promote health and awareness in the community. Health Bridge staff was able to have direct contact with the community to answer fitness questions and offer ways to increase activity.Health Bridge also offers assistance with corporate health fairs. COMMUNITY OUTREACH Health Bridge held a Northwest Trail Run for the Centegra Health System Foundation. There were 202 participants. During the planning and implementation of this event Health Bridge used approximately 133 manager hours for the race at an average rate of $20 per hour. Health Bridge staff participated in the holiday bell ringing for the Salvation Army in order to collect donations for needy families. They also participated in the Toyland toy drive for the Salvation Army by organizing donated toys for needy families. Health Bridge provided free flu shots to members and associates of Centegra Health System. Child care staff had a card-making activity for the children being looked after. The cards were for U.S. Troops. Gift certificates for Health Bridge services were donated to other organizations for fundraising purposes with an associated cost of $5,441. Food drives were held at Health Bridge to collect items for the Crystal Lake Food Pantry. |
| Form 990 Part VI Line 6 | The Centegra Health System Foundation has one corporate member, Centegra Health System. Centegra Health System has a single class of members. |
| Form 990 Part VI Line 7a | The powers and duties of the Centegra Health System members in fulfilling the purposes and objectives of the Corporation shall include, but not limited to, the taking of action with respect to the following matters: The election of governors and the filling of vacancies on the Board of Governors, which shall be in accordance with the procedures set forth in the Bylaws. The Nominating Committee shall select one candidate for each position on the Board having a term to be voted upon for the office of governor at the next annual meeting of members. The Nominating Committee shall consider and approve a list of candidates and submit such list to the Board of Governors not less than 10 days prior to the date of the last meeting of the Board of Governors prior to the date on which notice of the annual meeting of members is to be sent, and the candidates set forth on such list shall be subject to approval by the Board of Governors. The names of the candidates so selected by the Nominating Committee and approved by the Board of Governors shall be included in the notice of the annual meeting of the members of the Corporation and shall be presented to the members of the Corporation at the annual meeting. The voting members of the Corporation may nominate candidates for positions on the Board of Governors. Nominations by such members may be effected by means of written nomination signed by not less than 20 voting members in good standing, accompanies by a written statement of such nominee indicating a willingness to serve as a governor of the Corporation if elected. Any such nomination must be received by the Nominating Committee of the Corporation not less than 60 days prior to the annual meeting of members in order to be considered at such annual meeting. All elections shall be by secret ballot if there are more nominees than vacancies to be filled on the Board. All voting members present in person or by proxy at a meeting at which an election occurs shall be entitled to vote for governors. To be valid a ballot must not have more votes than there are vacancies. If there are more nominees than vacancies to be filled on the Board, those nominees who receive the most votes shall be elected to the Board of Governors. Members shall not be entitled to cumulate their votes in the election of governors. |
| Form 990 Part VI Line 11b | The review process for the Form 990 includes compilation by internal staff, detailed review by an outside tax preparer, bond counsel, and the Centegra Health System (CHS) Controller and Chief Financial Officer, prior to submission to the IRS. The tax return will be made available for the Board to review after submission to the IRS. |
| Form 990 Part VI Line 12c | The Centegra Health System Foundation (CHSF) affirmative policy regarding conflicts of interest shall be to require that all actual or apparent conflicts be disclosed promptly and fully to all necessary parties and to prohibit specified involvement in the affairs of the Centegra Health System Foundation by persons having such conflicts. This policy shall apply to all members of the Board of Directors and corporate officers, agents, and employees of Centegra Health System Foundation, and other such persons as the Board shall determine. CHSF management shall have the affirmative obligation to publicize periodically this policy to all such parties. All persons to whom this policy applies shall disclose all real and apparent conflicts which they discover or have brought to their attention in connection with the Centegra Health System Foundation's activities. Disclosure, as stated in the bylaws, shall mean providing promptly to the appropriate persons a written description of the facts comprising the real or apparent conflict. An annual disclosure statement shall be circulated to all persons to whom this policy applies to assist them in considering such disclosures, but disclosure is appropriate whenever conflicts arise. The written disclosure notices of conflicts shall be filed with the President of the Member (Centegra Health System) or any other person designated by him from time to time to receive such notifications. All disclosure notices received shall be noted for record in the minutes of a meeting of the Board of Directors. When an individual director, officer, agent, or employee believes that he/she or a member of his/her immediate family might have or does have a real or apparent conflict, he/she should, in addition to filing the disclosure notice, abstain from making motions, voting, executing agreements, or taking any other similar direct action on behalf of Centegra Health System Foundation where the conflict might pertain, but shall not be precluded from debate or other similar involvement on behalf of the CHSF. Upon any person's written request or at the Board's own initiative, the Board of Directors may establish further guidelines consistent with the interests of the Centegra Health System Foundation for resolution of any real or apparent conflicts at any time. |
| Form 990 Part VI Line 15b | The Board of Directors of Centegra Health System, through a Compensation Committee comprised of independent members free of conflict, reviewed executive compensation levels and other features of the compensation plan in accordance with the organization's approved compensation philosophy and strategy. The Compensation Committee is comprised of members of the Board of Directors, who are independent of Centegra management, have no personal interest in the compensation arrangements, are not related to, or under the control of any individual whose compensation arrangement is being reviewed and have no material business relationship with Centegra. The Chief Executive Officer's compensation is determined by the Compensation Committee in relation to appropriate comparability data. Compensation for other members of the executive staff are developed by the CEO, reviewed by the Committee, evaluated against market data, and approved by the Committee. The Committee approves all compensation decisions in advance of their implementation and documents its determinations and discussions. Its decisions and deliberations are thoroughly documented and meeting minutes are kept and distributed to the Committee members (for historical reference). The Board of Directors of Centegra Health System, through a Compensation Committee which is comprised of independent members free of conflict, reviewed executive compensation levels and other features of the compensation plan in accordance with the organizations approved compensation philosophy and strategy. The Compensation Committee is comprised of members of the Board of Directors who are independent of Centegra management, have no personal interest in the compensation arrangements, are not related to any individual whose compensation is under review, are not under the control of anyone whose compensation is under review, and have no material business relationship with Centegra Health System. The Compensation Committee uses a number of external resources and comparisons, and their review includes total compensation (cash compensation, plus benefits provided by Centegra) in relation to organizational performance and prevailing industry practices of comparably-sized organizations. They have engaged the services of a compensation consulting firm (Sullivan Cotter) specializing in the not-for-profit sector that has worked with Centegra and reports directly to the Compensation Committee. |
| Form 990 Part VI Line 19 | The Organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. |
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