TY 2015 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)
(1) CONNIE M VITALI CHAIR (1/1/15-8/31/15), DIRECTOR (9/1/15-12/31/15)	3.0 .................	X	X	0	0
(2) ROWLAND J MCCLELLAN CHAIR (9/1/15-12/31/15)	2.0 .................	X	X	779	0
(3) DENNIS T UEHARA MD VICE-CHAIR (Partial Year)	4.0 ................. 51.5	X	X	565,144	42,640
(4) THOMAS D BUDD TREASURER	2.0 .................	X	X	0	0
(5) THOMAS R POOL SECRETARY	2.0 .................	X	X	19,500	0
(6) JAVON BEA CEO	2.0 ................. 55.0	X	X	8,344,434	37,020
(7) NEYSA ALICEA DIRECTOR (Partial Year)	2.0 .................	X		0	0
(8) PAMELA S FOX DIRECTOR (Partial Year)	2.0 .................	X		0	0
(9) MICHAEL J FUMO MD DIRECTOR (Partial Year)	2.0 ................. 20.0	X		116,667	0
(10) JOHN J MORRISSEY DIRECTOR (Partial Year)	2.0 .................	X		0	0
(11) JEFF R SMITH MD DIRECTOR (Partial Year)	1.0 ................. 42.0	X		504,004	25,114
(12) LARRY E SQUIRE DIRECTOR (Partial Year)	2.0 .................	X		2,119	0
(13) JOHN W CHADWICK DIRECTOR (Partial Year)	2.0 .................	X		0	0
(14) CURTIS D WORDEN DIRECTOR (Partial Year)	2.0 .................	X		0	0
(15) JACK J BECHERER DIRECTOR	2.0 .................	X		0	0
(16) MARK L GOELZER MD DIRECTOR	2.0 ................. 55.0	X		542,283	32,232
(17) PAUL A GREEN DIRECTOR	2.0 .................	X		0	0

(A) Name and business address	(B) Description of services	(C) Compensation
HURON CONSULTING SERVICES 3005 MOMENTUM PL CHICAGO,IL606895330	CONSULTING	888,621
WARBIRD CONSULTING PARTNERS Wells Fargo Capital Finance PO Box 823280 Philadelphia,PA191823280	CONSULTING	586,434
MEDPARTNERS HIM Two Harbour Place 302 Knights Run Avenue Tampa,FL33602	IT SUPPORT SERVICES	467,394
AECOM TECHNICAL SERVICES 1178 Paysphere Circle Chicago,IL60674	CONSULTING	304,278
TRIOSE INC 39 E Lancaster Ave Reading,PA19607	FREIGHT MANAGEMENT	276,229
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 17

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Rockford Health System

Employer identification number

36-3197915

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990 or 990-EZ))

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............. 3

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iii) Type of organization (described on lines 1- 9 above (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)
(i)Name of supported organization	(ii) EIN		Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(A) ROCKFORD MEMORIAL HOSPITAL	362167847	3	Yes		1,900,050	0
(B) ROCKFORD HEALTH PHYSICIANS	363097436	3	Yes		780,870	0
(C) VISITING NURSES ASSN OF THE ROCKFORD AREA	362167945	9	Yes		30,000	0
Total 3					2,710,920	0

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2015

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(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.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2014 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2015. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2014. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2015. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the facts-and-circumstances test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
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......
3	Gross receipts from activities that are not an unrelated trade or business under section 513...
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...
5	The value of services or facilities furnished by a governmental unit to the organization without charge..
6	Total. Add lines 1 through 5.
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...
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.
c	Add lines 7a and 7b..
8	Public support. (Subtract line 7c from line 6.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) 2015	(f) Total
9	Amounts from line 6...
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c	Add lines 10a and 10b.
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..
13	Total support. (Add lines 9, 10c, 11, and 12.)..

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2015 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2014 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2015 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2014 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2015. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2014. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2015

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Yes

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part I of Schedule L (Form 990 or 990-EZ).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990 or 990-EZ) 2015

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

Yes

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Yes

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Yes

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Yes

Schedule A (Form 990 or 990-EZ) 2015

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
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)
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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2015

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations (continued)

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
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
9 Distributable amount for 2015 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-2015	(iii) Distributable Amount for 2015
1 Distributable amount for 2015 from Section C, line 6
2 Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2015:
a
b
c
d From 2013.......
e From 2014.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2015 distributable amount
i Carryover from 2010 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2015 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2015 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2016. Add lines 3j and 4c.
8 Breakdown of line 7:
a
b
c Excess from 2013.......
d From 2014.......
e From 2015.......

Schedule A (Form 990 or 990-EZ) (2015)

Schedule A (Form 990 or 990-EZ) 2015

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation
Schedule A, Part I, Line 11h DESCRIPTION OF NON-MONETARY SUPPORT	ROCKFORD MEMORIAL HOSPITAL: CORPORATE MANAGEMENT SERVICES ROCKFORD HEALTH PHYSICIANS: CORPORATE MANAGEMENT SERVICES VISITING NURSES ASSN OF THE ROCKFORD AREA: CORPORATE MANAGEMENT SERVICES
Schedule A, Part IV, Section D, Line 1 Written notice to supported organizations	As a healthcare system parent organization, Rockford Health System (RHS) appoints or approves the board members of each of the supported organizations, Rockford Memorial Hospital (RMH), Rockford Health Physicians (RHPH), and Visiting Nurses Association of the Rockford Area (VNA), in its capacity as sole corporate member thereof. According to the Bylaws of RHS, among the powers exercised by the RHS board is the power to coordinate the activities of RHS's subsidiary and affiliated organizations, including RMH, RHPH, and VNA. To that end, the organizations communicate on a daily basis in the ordinary course of business on such matters as capital and operating budgets, strategic planning, manpower development and other important matters. RHS meets the notification requirements of a functionally integrated Type III supporting organization because (i) the nature of the support provided by RHS to the supported organizations is established by, and conducted in accordance with, its governing document provisions; (ii) RHS routinely reviews all Forms 990 prepared and filed by the supported organizations; and (iii) RHS routinely reviews all governing documents of the supported organizations (because, as sole corporate member thereof, RHS has the power to approve all amendments to the respective governing documents).
Schedule A, Part IV, Section D, Line 3 Supp. Org. Have Significant Voice In Investment Policies	Because the same individuals serve as directors of RHS, RHPH, and RMH, those individuals, in carrying out their fiduciary duties for the respective organizations, oversee the supporting organization's income, assets, and investments. The RHS Investment Committee, which consists of at least five individuals who are directors of each of RHS, RHPH, and RMH, have adopted an investment policy that addresses investment matters such as asset allocation for various corporate funds and the funds of the entities within the healthcare system, including pension funds, funded depreciation, endowment funds, trustee-held funds, board-designated funds and excess operating funds, the selection of the mix and types of investments which best serve the interests of the healthcare system, and the selection, retention and appointment of investment managers.
Schedule A, Part IV, Section E, Line 3a Power To Appoint/Elect Majority of Officer/Director/Trustee	As a healthcare system parent organization, RHS appoints or approves the board members of each of the supported organizations, RMH, RHPH, and VNA, in its capacity as sole corporate member thereof.
Schedule A, Part IV, Section E, Line 3b Substantial Direction Over Policies/Programs/Activities	RHS exercises a substantial degree of direction over the policies, programs, and activities of each of the supported organizations. According to the Bylaws of RHS, in coordinating the activities of the healthcare system the RHS board has the authority to, among other things, approve amendments to the governing documents of the supported organizations, approve annual and operating budgets and strategic, long-range and health manpower development plans for the supported organizations, require the boards of directors of the supported organizations to take certain actions related to the credit worthiness of the organizations, approve fundamental corporate changes, approve material amendments to the standard compensation system of the supported organizations, etc.

Schedule A (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

If the organization answered "Yes" on Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" on Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" on Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

Rockford Health System

Employer identification number

36-3197915

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures ...................................................................................................................... SchCMd Bullet

Volunteer hours .............................................................................................................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ................................ SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? .........................................

Yes No

Was a correction made? ......................................................................................................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities ..... SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ............................................................................................................................ SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b........... SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ...................................................................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.
1
2
3
4
5
6

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2015

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ...............................................
b	Total lobbying expenditures to influence a legislative body (direct lobbying) ...........................................
c	Total lobbying expenditures (add lines 1a and 1b) .......................................................................
d	Other exempt purpose expenditures .........................................................................................
e	Total exempt purpose expenditures (add lines 1c and 1d) ....................................................................
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) ..........................................................................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ..........................................................................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ...........................................................................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ..............................................................................................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2012	(b) 2013	(c) 2014	(d) 2015	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2015

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response on lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? ...........................................................................................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ........

Media advertisements? ...................................................................................................

Mailings to members, legislators, or the public? .............................................................................

Publications, or published or broadcast statements? ...........................................................

Grants to other organizations for lobbying purposes? ..........................................................

Direct contact with legislators, their staffs, government officials, or a legislative body? .......................

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ..................

Other activities? ...................................................................................................................

Yes

45,000

Total. Add lines 1c through 1i ....................................................................................................

45,000

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 ...........................................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 ...................

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? ........................

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ...............................................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ............................................

Did the organization agree to carry over lobbying and political expenditures from the prior year? .................................

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members ......................................................................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political expenses for which the section 527(f) tax was paid).

Current year .............................................................................................................................

Carryover from last year ............................................................................................................

Total ...........................................................................................................................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ......................................................................................................................

Taxable amount of lobbying and political expenditures (see instructions) .........................................

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
Schedule C, Part II-B, Line 1 DESCRIPTION OF THE ACTIVITIES REPORTED ON LINES 1A THROUGH 1I	TWO CONSULTING FIRMS WERE ENGAGED BY RHS TO REVIEW LEGISLATION AFFECTING HOSPITALS. APPROXIMATELY 50% OF TOTAL PAYMENTS TO THE CONSULTANTS WERE ALLOCABLE TO LOBBYING ACTIVITIES.

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Rockford Health System

Employer identification number

36-3197915

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .........

Yes

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Yes

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization?

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization?

Any related organization? .........................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2015

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1DENNIS T UEHARA MD VICE-CHAIR (Partial Year)	(i) (ii)	0 ------------- 562,498	0 ------------- 0	0 ------------- 2,646	0 ------------- 35,974	0 ------------- 6,666	0 ------------- 607,784	0 ------------- 0
2JAVON BEA CEO	(i) (ii)	0 ------------- 1,130,443	0 ------------- 813,796	0 ------------- 6,400,195	0 ------------- 16,180	0 ------------- 20,840	0 ------------- 8,381,454	0 ------------- 0
3JEFF R SMITH MD DIRECTOR (Partial Year)	(i) (ii)	0 ------------- 503,230	0 ------------- 0	0 ------------- 774	0 ------------- 20,000	0 ------------- 5,114	0 ------------- 529,118	0 ------------- 0
4MARK L GOELZER MD DIRECTOR	(i) (ii)	0 ------------- 129,447	0 ------------- 222,018	0 ------------- 190,818	0 ------------- 16,180	0 ------------- 16,052	0 ------------- 574,515	0 ------------- 0
5HENRY M SEYBOLD CFO	(i) (ii)	398,016 ------------- 0	88,110 ------------- 0	31,382 ------------- 0	24,496 ------------- 0	10,760 ------------- 0	552,764 ------------- 0	0 ------------- 0
6Dennis L'Heureux VP PLANNING & CIO	(i) (ii)	206,557 ------------- 0	64,610 ------------- 0	42,150 ------------- 0	31,251 ------------- 0	5,896 ------------- 0	350,464 ------------- 0	0 ------------- 0
7James Evans VP LEGAL AFFAIRS	(i) (ii)	303,595 ------------- 0	67,149 ------------- 0	2,088 ------------- 0	20,562 ------------- 0	8,001 ------------- 0	401,395 ------------- 0	0 ------------- 0
8DOUG BROOKS VP CAMPUS DEVELOPMENT	(i) (ii)	216,705 ------------- 0	27,057 ------------- 0	20,239 ------------- 0	31,166 ------------- 0	1,596 ------------- 0	296,763 ------------- 0	0 ------------- 0
9Helen Brooks VP COMMUNITY & REGIONAL DEVELOPMENT	(i) (ii)	222,977 ------------- 0	27,815 ------------- 0	17,919 ------------- 0	32,061 ------------- 0	1,596 ------------- 0	302,368 ------------- 0	0 ------------- 0
10Heidi Elsbree VP People & Culture	(i) (ii)	202,616 ------------- 0	26,720 ------------- 0	23,037 ------------- 0	14,931 ------------- 0	13,699 ------------- 0	281,003 ------------- 0	0 ------------- 0
11GARY E KAATZ Former PRESIDENT & CEO	(i) (ii)	352,011 ------------- 0	325,942 ------------- 0	573,659 ------------- 0	48,350 ------------- 0	8,072 ------------- 0	1,308,034 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2015

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 1a Health or social club dues or initiation fees	By policy: Membership to the YMCA 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.
Schedule J, Part I, Line 4a Severance or change-of-control payment	GARY KAATZ BEGAN RECEIVING SEVERANCE PAYMENTS DURING THE 7/10/15 PAY PERIOD AND WILL CONTINUE TO RECEIVE SEVERANCE THROUGH THE 1/5/18 PAY PERIOD. TOTAL PAYMENTS RECEIVED BY GARY KAATZ IN 2015 WAS $433,430.
Schedule J, Part I, Line 7 Non-fixed payments	MANAGEMENT AND EMPLOYEES ARE PERIODICALLY FINANCIALLY REWARDED FOR EXCEEDING COMPANY AND DEPARTMENT PERFORMANCE GOALS. THE AMOUNTS ARE DISCRETIONARY AND ARE NOT RELATED TO NET EARNINGS OF THE ORGANIZATION AND ARE APPROVED BY THE CEO PRIOR TO PAYMENT WITH BOARD OVERSIGHT OF SUCH PAYMENTS. THE CEO'S FINANCIAL INCENTIVES ARE APPROVED BY THE BOARD OF DIRECTORS.

Schedule J (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE N
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Liquidation, Termination, Dissolution, or Significant Disposition of Assets

Complete if the organization answered "Yes" on Form 990, Part IV, lines 31 or 32; or Form 990-EZ, line 36.

Attach certified copies of any articles of dissolution, resolutions, or plans.
bullet

Attach to Form 990 or 990-EZ.
bullet

Information about Schedule N (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
Rockford Health System

Employer identification number
36-3197915

Part I

Liquidation, Termination, or Dissolution. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 31, or Form 990-EZ, line 36.
Part I can be duplicated if additional space is needed.

1(a) Description of asset(s) distributed or transaction expenses paid	(b) Date of distribution	(c) Fair market value of asset(s) distributed or amount of transaction expenses	(d) Method of determining FMV for asset(s) distributed or transaction expenses	(e) EIN of recipient	(f) Name and address of recipient	(g) IRC section of recipient(s) (if tax-exempt) or type of entity

NET ASSETS TRANSFERRED TO AFFILIATE

12-31-2015

6,059,594

Book Value

36-2167847

Rockford Memorial Hospital
2400 N Rockton Ave
Rockford,IL61103

501(c)(3)

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? .........................

Yes

Become an employee of, or independent contractor for, a successor or transferee organization? .....................

Yes

Become a direct or indirect owner of a successor or transferee organization? .....................

Receive, or become entitled to, compensation or other similar payments as a result of the organization's liquidation, termination, or dissolution? ........

If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or Form 990-EZ.

Cat. No. 50087Z

Schedule N (Form 990 or 990-EZ) (2015)

Page 2

Part I

Liquidation, Termination, or Dissolution (continued)

Note. If the organization distributed all of its assets during the tax year, then Form 990, Part X, column (B), line 16 (Total assets), and line 26 (Total liabilities), should equal -0-.

Yes

Did the organization distribute its assets in accordance with its governing instrument(s)? If "No," describe in Part III .............

Yes

Is the organization required to notify the attorney general or other appropriate state official of its intent to dissolve, liquidate, or terminate? ......

Yes

If "Yes," did the organization provide such notice? .....................

Yes

Did the organization discharge or pay all of its liabilities in accordance with state laws? .....................

Yes

Did the organization have any tax-exempt bonds outstanding during the year? .....................

If "Yes" on line 6a, did the organization discharge or defease all of its tax-exempt bond liabilities during the tax year in accordance with the Internal Revenue Code and state laws?

If "Yes" on line 6b, describe in Part III how the organization defeased or otherwise settled these liabilities. If "No" on line 6b, explain in Part III.

Part II

Sale, Exchange, Disposition, or Other Transfer of More Than 25% of the Organization's Assets. Complete this part if the organization answered "Yes" on Form 990, Part IV, line 32, or Form 990-EZ, line 36. Part II can be duplicated if additional space is needed.

1(a) Description of asset(s) distributed or transaction expenses paid	(b) Date of distribution	(c) Fair market value of asset(s) distributed or amount of transaction expenses	(d) Method of determining FMV for asset(s) distributed or transaction expenses	(e) EIN of recipient	(f) Name and address of recipient	(g) IRC section of recipient(s) (if tax-exempt) or type of entity

Yes

Did or will any officer, director, trustee, or key employee of the organization:

Become a director or trustee of a successor or transferee organization? .....................

Become an employee of, or independent contractor for, a successor or transferee organization? .....................

Become a direct or indirect owner of a successor or transferee organization? .....................

Receive, or become entitled to, compensation or other similar payments as a result of the organization’s significant disposition of assets? .....................

If the organization answered "Yes" to any of the questions on lines 2a through 2d, provide the name of the person involved and explain in Part III. bullet

Schedule N(Form 990 or 990-EZ) (2015)

Schedule N (Form 990 or 990-EZ) (2015)

Page 3

Part III

Supplemental Information. Provide the information required by Part I, lines 2e and 6c, and Part II, line 2e. Also complete this part to provide any additional information.

Return Reference	Explanation
Schedule N, Part I, Line 2a Interested person is a director or trustee of successor org.	Rockford Health System was merged into Mercy Health Corporation effective January 1, 2016. The RHS board members at that time are also the board members for Mercy Health Corporation. They include: Javon Bea, Rowland McClellan, Connie Vitali, Thomas Pool, Thomas Budd, Dave Syverson, Jack Becherer, Mark Goelzer, and Paul Green.
Schedule N, Part I, Line 2b Interested person is an employee or ind. contractor of successor org.	Henry Seybold, CFO of Rockford Health System, is also the CFO of Rockford Memorial Hospital, the transferee organization.

Schedule N (Form 990 or 990-EZ) (2015)

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization

Rockford Health System

Employer identification number

36-3197915

Return Reference	Explanation
Form 990, Part I, Line 5 Average compensation per employee	Part I of the Form 990, line 5 reports 360 total employees of Rockford Health System. Total salaries and other compensation reported on the Form 990, Part I, line 15 is $1,339,860. The average compensation for Rockford Health System is higher than this data presents; the salaries and benefits reported do not include the salaries and benefits that were allocated to Rockford Memorial Hospital, Rockford Memorial Development Foundation, Visiting Nurses Association of the Rockford Area, and Rockford Health Physicians, four related entities of which Rockford Health System is the sole corporate member.
Form 990, Part III, Line 3 Significant changes in program services	The Rockford Health System entity was merged into Mercy Health Corporation effective 12/31/15. RHS's assets and liabilities were transferred to Rockford Memorial Hospital prior to that merger.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	The Executive Committee consists of seven individuals, each of whom shall have a vote, including: the RHS CEO, the chairman, vice-chairman, immediate past chairman, treasurer, and 2 additional directors of the board. At least one member of the Executive Committee shall be a physician. The Executive Committee shall in all instances be comprised of at least 51% community members. In the event that one or more of the aforementioned voting members of the Executive Committee is unable to serve in such capacity, then the chairman of the corporation shall designate a replacement from among the board members. The Executive Committee Shall meet as needed. The executive committee shall review reports from the RHS CEO regarding the performance of executives of the corporation and affiliated corporations, monitor the performance of the RHS CEO of the corporation against annual objectives, and determine the compensation level of the RHS CEO. In addition, when the board of directors is not in session, the executive committee shall have all the powers, duties, responsibilities and authority of the board, except as prohibited by law.
Form 990, Part VI, Line 6 Classes of members or stockholders	MERCYROCKFORD HEALTH SYSTEM (MRHS) IS THE SOLE CORPORATE MEMBER OF ROCKFORD HEALTH SYSTEM (RHS). The following actions of RHS must be approved by a majority vote of MRHS's board of directors: (i) Initiation or approval of any sale or other disposition of assets by RHS or its Affiliate having a book or market value exceeding $500,000;provided, however, the Member shall initiate or approve any sale, transfer or other disposition of assets having a current value in excess of $10,000,000 only after obtaining Advice and Input; (ii) Initiation or approval of the formation of a new Affiliate, or an equity investment by RHS or an Affiliate in any unrelated person; (iii) Approval of the annual consolidated operating and capital budgets of RHS and its Affiliates, which shall be consistent with the strategic plans and strategic capital plans of the System; (iv) Initiation or approval of unbudgeted or out-of-budget expenditures by RHS or one or more Affiliates that exceed $500,000 as either a single item or a series of related items; (v) Initiation or approval of capital expenditures by RHS or one or more Affiliates exceeding $1,500,000; (vi) Approval of local banking relationship of RHS or the Affiliates and RHS's or any Affiliate's engagement of independent auditors; (vii) Initiation or approval of loans or other incurrence of debt by RHS or one or more Affiliates exceeding $500,000; (viii) Approval of any action that could impair the tax-exempt status of RHS or any Affiliate, after obtaining Advice and Input.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	SEE NARRATIVE FOR PART VI, LINE 6
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	SEE NARRATIVE FOR PART VI, LINE 6
Form 990, Part VI, Line 11b Review of form 990 by governing body	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 staff. Once the Form 990 was completed, it was reviewed by an independent accounting firm and the organization's CFO.
Form 990, Part VI, Line 12c Conflict of interest policy	By written policy, RHS sends out, on an annual basis, the corporate Conflict and Duality of Interest policy to all Board members, corporate officers and other key individuals (those having responsibility and authority to make final decisions regarding the acquisition of products or services). Each recipient is required to complete a Financial Interest Disclosure Statement, which is submitted to the Vice President, Legal Services/General Counsel for review. With respect to physicians and managers who are key individuals, any potential conflict of interest is reviewed with the appropriate executive staff member for follow up with the disclosing party in order to review the matter in more detail. This includes emphasizing that the disclosing party is not permitted to participate in any negotiations for the purchase of any products or services where the conflict is deemed material, or authorize the subsequent purchase of related goods and services. The disclosing party is also required to identify each and every instance of a potential conflict as they may arise in the ordinary course of business. A similar process is followed for the Board of Directors, except that any potential conflict is reviewed by the Board's Governance Committee. Board members may comment on transactions where there is a potential conflict, but cannot vote on the related matter and may be required to leave any meeting where the potential conflict is reviewed by the Board or where the Board takes action to either approve or not approve the proposed transaction. A board member also has a continuing duty to report any conflicts as they may arise in the ordinary course of business. In the event that a potential conflict of interest is reported or discovered outside the established process, appropriate review and action would be taken. This process was last completed in 2015. The RHS Conflict of Interest Policy is available upon request.
Form 990, Part VI, Line 15a Process to establish compensation of top management official	Compensation for the top management official is governed by the RHS Board of Directors, and overseen by the Executive Committee. 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. This process is documented, and was last completed in 2015.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	Compensation for other officers and key employees 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. This process is documented, and was last completed in 2015.
Form 990, Part VI, Line 19 Required documents available to the public	Financial statements are available through the Illinois Attorney General's Office. Governing documents are available by request from Board Secretary. The conflict of interest policy is not published but is available upon request.
Form 990, Part IX, Line 11g Other Fees	CONSULTING FEES - Total Expense: 909256, Program Service Expense: 909256, Management and General Expenses: , Fundraising Expenses: ;
Form 990, Part XI, Line 9 Other changes in net assets or fund balances	NET TRANSFERS TO AFFILIATED ORGANIZATIONS - -6059594;

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Information about Schedule R (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

Rockford Health System

Employer identification number

36-3197915

Part I

Identification of Disregarded Entities Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ROCKFORD MEMORIAL HOSPITAL 2400 N ROCKTON AVE ROCKFORD,IL61103 36-2167847	HEALTHCARE	IL	501(c)(3	3	ROCKFORD HEALTH SYSTEM	Yes
(2)ROCKFORD MEMORIAL DEVELOPMENT FOUNDATION 2400 N ROCKTON AVE ROCKFORD,IL61103 36-3197918	SUPPORT OF HEALTHCARE	IL	501(c)(3	Type I	ROCKFORD HEALTH SYSTEM	Yes
(3)VISITING NURSES ASSN OF THE ROCKFORD AREA 4223 E STATE STREET ROCKFORD,IL61108 36-2167945	HEALTHCARE	IL	501(c)(3	9	ROCKFORD HEALTH SYSTEM	Yes
(4)ROCKFORD HEALTH PHYSICIANS 2300 N ROCKTON AVE ROCKFORD,IL61103 36-3097436	HEALTHCARE	IL	501(c)(3	3	ROCKFORD HEALTH SYSTEM	Yes
(5)Mercy Health Corporation 2400 N Rockton Ave Rockford,IL61103 47-2158680	Support of Healthcare	IL	501(c)(3	Type I	NA		No
(6)MERCY ALLIANCE INC 1000 MINERAL POINT AVE JANESVILLE,WI53548 39-1679859	SUPPORT OF HEALTHCARE	WI	501(c)(3	Type I	MERCY HEALTH CORPORATION		No
(7)MERCY HEALTH SYSTEM ASSOCIATION OF VOLUNTEERS 1000 MINERAL POINT JANESVILLE,WI53548 39-0912682	SUPPORT OF HEALTHCARE	WI	501(c)(3	Type III-FI	MERCY HEALTH SYSTEM CORPORATION		No
(8)MERCY FOUNDATION INC 1000 MINERAL POINT JANESVILLE,WI53548 23-7275336	SUPPORT OF HEALTHCARE	WI	501(c)(3	Type I	MERCY HEALTH SYSTEM CORPORATION		No
(9)MERCY HEALTH SYSTEM CORPORATION 1000 MINERAL POINT JANESVILLE,WI53548 39-0816848	HEALTHCARE	WI	501(c)(3	3	MERCY ALLIANCE INC		No
(10)MERCY ASSISTED CARE INC 901 MINERAL POINT JANESVILLE,WI53548 39-1035110	HEALTHCARE	WI	501(c)(3	9	MERCY ALLIANCE INC		No
(11)MERCY HARVARD HOSPITAL INC 901 GRANT STREET HARVARD,IL60033 31-1551871	HEALTHCARE	IL	501(c)(3	3	MERCY ALLIANCE INC		No
(12)HARVARD MEMORIAL HOSPITAL FOUNDATION 901 GRANT STREET HARVARD,IL60033 36-4308662	SUPPORT OF HEALTHCARE	IL	501(c)(3	Type I	MERCY HARVARD HOSPITAL INC		No
(13)MERCY CRYSTAL LAKE HOSPITAL AND MEDICAL CENTER 1000 MINERAL POINT JANESVILLE,WI53548 20-1673011	NONE	IL	501(c)(3	3	MERCY ALLIANCE INC		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2015

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	Yes	No
(1) ROCKFORD HEALTH INSURANCE LTD WELLESLEY HOUSE SO 2ND FL PEMBROOKEHM BD	INSURANCE	BD	NA	C Corporation				No
(2) JANESVILLE MEDICAL CENTER INC 1000 MINERAL POINT JANESVILLE,WI53548 39-1520130	MANAGEMENT OF UNION EMPLOYEES	WI	MERCY HEALTH SYSTEM CORPORATION	C Corporation				No
(3) MERCYCARE INSURANCE COMPANY 3430 PALMER DRIVE JANESVILLE,WI53545 39-1768192	INSURANCE	WI	MERCY HEALTH SYSTEM CORPORATION	C Corporation				No
(4) MERCYCARE HMO INC - CONS W MERCYCARE INS CO 3430 PALMER DRIVE JANESVILLE,WI53545 20-1482553	INSURANCE	WI	MERCY HEALTH SYSTEM CORPORATION	C Corporation				No

Schedule R (Form 990) 2015

Page 3

Part V

Transactions With Related Organizations Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

m Performance of services or membership or fundraising solicitations by related organization(s) .................

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

q Reimbursement paid by related organization(s) for expenses ............................

Yes

r Other transfer of cash or property to related organization(s) ............................

Yes

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved
(1) ROCKFORD MEMORIAL HOSPITAL	Q	1,900,050	FMV
(2) ROCKFORD HEALTH PHYSICIANS	Q	780,870	FMV

Schedule R (Form 990) 2015

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No

Schedule R (Form 990) 2015

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R (see instructions).

Return Reference	Explanation

Schedule R (Form 990) 2015

Additional Data

Software ID:	15000238
Software Version:	2015v2.1

1	Briefly describe the organization’s mission or most significant activities: The mission is to improve and protect the health and welfare of the community, with superior care, everyday, for all patients.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	5
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	360
6	Total number of volunteers (estimate if necessary) .............	6	11
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........		0
9	Program service revenue (Part VIII, line 2g) .........	3,782,413	2,748,742
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....		-54
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)		0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	3,782,413	2,748,688
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	5,163,686	1,339,860
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	1,980,672	1,751,924
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	7,144,358	3,091,784
19	Revenue less expenses. Subtract line 18 from line 12.......	-3,361,945	-343,096
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	14,499,373	0
21	Total liabilities (Part X, line 26).............	8,096,683	0
22	Net assets or fund balances. Subtract line 21 from line 20.....	6,402,690	0

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 1,900,050 including grants of $ ) (Revenue $ 1,907,872 )
	RHS PROVIDES SUPPORT FOR ROCKFORD MEMORIAL HOSPITAL (RMH), WHICH CARED FOR AND DISCHARGED 6,677 INPATIENTS DURING THE 6 MONTH PERIOD 7/1/15-12/31/15, WITH 782 DELIVERIES, 26,156 VISITS TO THE EMERGENCY ROOM, AND PROCESSED MORE THAN 773,000 LABORATORY TESTS. RMH IS THE REGIONAL DISASTER PREPAREDNESS CENTER FOR NORTHERN ILLINOIS PROVIDING TRAINING AND EDUCATION FOR COMMUNITY PREPAREDNESS AND ASSISTING 14 OTHER HOSPITALS WITH THEIR EMERGENCY PREPAREDNESS. RMH HAS A LEVEL I TRAUMA CENTER AND OPERATES A STATE-DESIGNATED PERINATAL CENTER WITH THE ONLY LEVEL III NEONATAL INTENSIVE CARE UNIT IN NORTHERN ILLINOIS, WITH 46 BEDS, PLUS A 7 BED PEDIATRIC INTENSIVE CARE UNIT. THROUGH THE AUXILIARY, RMH IS ABLE TO PROVIDE EXTRA FUNDS AND SERVICES TO SUPPORT ITS MISSION. THE AUXILIARY HAS 357 VOLUNTEERS WHO LOGGED NEARLY 15,000 HOURS TO ENHANCE THE RMH EXPERIENCE FOR PATIENTS. RMH PROVIDES OUTREACH LAB SERVICES, HAS STATE-OF-THE-ART ROBOTIC SURGERY AVAILABLE AND HAS THE ONLY REGIONAL GENETIC SERVICES AND CYTOGENETICS LABORATORY.

4b	(Code: ) (Expenses $ 780,870 including grants of $ ) (Revenue $ 780,870 )
	RHS PROVIDES SUPPORT FOR ROCKFORD HEALTH PHYSICIANS (RHPH), WHICH IN TURN PROVIDES STAFFING FOR RMH'S 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 180 PHYSICIANS OF VARYING SPECIALTIES AND CONTINUES TO ASSESS AND RESPOND TO THE COMMUNITY NEEDS WHEN RECRUITING NEW PHYSICIANS. RHPH HAD A TOTAL OF 258,316 OFFICE VISITS DURING THE 6 MONTH PERIOD 7/1/15-12/31/15 AND PROVIDED 159,628 ANCILLARY PROCEDURES IN AREAS SUCH AS LABORATORY, PULMONARY FUNCTION, BONE SCANS, RADIOLOGY, CT SCANS, MAMMOGRAPHY AND PHYSICAL THERAPY.

4c	(Code: ) (Expenses $ 60,000 including grants of $ ) (Revenue $ 60,000 )
	THE 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 (13,434 DAYS), ELDER ADULT COUNSELING/SERVICES (OVER 3,700), AND HOME HEALTH CARE (11,061 VISITS) INCLUDING THERAPISTS/AIDES (4,452 VISITS) FOR CARE THAT ALLOWS PEOPLE TO STAY IN THEIR OWN HOME TO RECOVER AND RECUPERATE. 118 VNA VOLUNTEERS GAVE 1,924.5 HOURS TO MEET THE 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 (RMDF) 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.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses2,740,920

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)				(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) DAVE L SYVERSON DIRECTOR	2.0 .......................0.0	X				0	19,500	0
(19) HENRY M SEYBOLD CFO	40.0 .......................5.0		X			517,508	0	35,256
(20) Dennis L'Heureux VP PLANNING & CIO	40.0 .......................			X		313,317	0	37,147
(21) James Evans VP LEGAL AFFAIRS	40.0 .......................			X		372,832	0	28,563
(22) DOUG BROOKS VP CAMPUS DEVELOPMENT	40.0 .......................			X		264,001	0	32,762
(23) Helen Brooks VP COMMUNITY & REGIONAL DEVELOPMENT	36.0 .......................4.0			X		268,711	0	33,657
(24) Heidi Elsbree VP People & Culture	40.0 .......................			X		252,373	0	28,630
(25) GARY E KAATZ Former PRESIDENT & CEO	0.0 .......................				X	1,251,612	0	56,422

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	3,240,354	10,114,430	389,443

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a-1f:$
h Total.Add lines 1a-1f.......		0

			Business Code
2a	COORDINATE AND SUPPORT AFFILIATE ACTIVITIES	561000	2,748,742	2,748,742
b
c
d
e
f	All other program service revenue.			0	0	0	0
g Total.Add lines 2a–2f.....			2,748,742

3 Investment income (including dividends, interest, and othersimilar amounts) ..........
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss)......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	0
b	Less: cost or other basis and sales expenses	54
c	Gain or (loss)	-54	0
d	Net gain or (loss).....			-54			-54
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			2,748,688	2,748,742	0	-54

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21
2	Grants and other assistance to individuals in the United States. See Part IV, line 22
3	Grants and other assistance to governments, organizations, and individuals outside the United States. See Part IV, lines 15 and 16
4	Benefits paid to or for members
5	Compensation of current officers, directors, trustees, and key employees ....	203,863	203,863
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....
7	Other salaries and wages	858,433	858,433
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	42,777	42,777
9	Other employee benefits .......	208,486	208,486
10	Payroll taxes ...........	26,301	26,301
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	345,829	3,400	342,429
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	909,256	909,256	0	0
12	Advertising and promotion ....
13	Office expenses .......	21,052	21,052
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	55,242	55,242
17	Travel ............	8,312	8,312
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	25,337	25,337
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	25,691	25,691
23	Insurance ...	29,171	29,171
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	Corporate Management Fees	207,214	207,214
b	RECRUITING/RETENTION/EMPLOYEE APPRECIATION	62,289	62,289
c	DUES & MEMBERSHIPS	34,320	34,320
d
e	All other expenses	28,211	19,776	8,435	0
25	Total functional expenses. Add lines 1 through 24e	3,091,784	2,740,920	350,864	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			2,553,691	1	0
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			421,247	4	0
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L
					5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
					6	0
7	Notes and loans receivable, net ....				7
8	Inventories for sale or use ........				8
9	Prepaid expenses and deferred charges ......			1,854,668	9	0
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	0
b	Less: accumulated depreciation	10b	0	8,508,967	10c	0
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			1,160,800	15	0
16	Total assets. Add lines 1 through 15 (must equal line 34)...			14,499,373	16	0

17	Accounts payable and accrued expenses .....	7,366,306	17	0
18	Grants payable ...		18
19	Deferred revenue .........	100,000	19	0
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..		22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D	630,377	25	0
26	Total liabilities. Add lines 17 through 25..	8,096,683	26	0

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	6,402,690	27	0
28	Temporarily restricted net assets ...........		28
29	Permanently restricted net assets		29
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds .....		30
31	Paid-in or capital surplus, or land, building or equipment fund ...		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	6,402,690	33	0
34	Total liabilities and net assets/fund balances ........	14,499,373	34	0