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) William R Gorski MD...................................................................... President & CEO	40.00 ................. 6.00	X	X	1,301,696	0	295,608
(2) Thomas R Walsh...................................................................... Chairman of the Board	2.00 ................. 6.00	X	X	100	0	0
(3) Daniel T Ross...................................................................... First Vice Chairman	2.00 ................. 6.00	X	X	100	0	0
(4) William Roop...................................................................... Immediate Past Chairman	2.00 ................. 6.00	X	X	100	0	0
(5) James Waddell...................................................................... Audit/Compliance Chairman	2.00 ................. 6.00	X	X	100	0	0
(6) Patrick Derry...................................................................... Quality and Safety Chairman	2.00 ................. 6.00	X	X	100	0	0
(7) Jeffrey J Kaney Sr...................................................................... Chairman of Joint Conference	2.00 ................. 6.00	X	X	100	0	0
(8) Danny L Copeland MD...................................................................... Trustee	40.00 ................. 6.00	X		203,751	0	44,278
(9) Michael E Dallman...................................................................... Trustee	2.00 ................. 4.00	X		0	336,240	44,251
(10) James L Gingrich...................................................................... Trustee	2.00 ................. 6.00	X		100	0	0
(11) Robert L Head PhD...................................................................... Trustee	2.00 ................. 6.00	X		100	0	0
(12) Helen Chung Hill...................................................................... Trustee	2.00 ................. 6.00	X		100	0	0
(13) Michael Houselog PhD...................................................................... Trustee	2.00 ................. 6.00	X		100	0	0
(14) Gregory Jury...................................................................... Trustee	2.00 ................. 8.00	X		100	0	0
(15) Marco T Lenis...................................................................... Trustee	2.00 ................. 6.00	X		100	0	0
(16) Fran Morrissey...................................................................... Trustee	2.00 ................. 6.00	X		100	0	0
(17) David R Rydell...................................................................... Trustee	2.00 ................. 6.00	X		100	0	0

(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)	(F) Estimated amount of other compensation from the organization and related organizations
(18) Steven C Sjogren........................................................................ Trustee	2.00 .......................8.00	X					100	0	0
(19) Frank Walter........................................................................ Trustee	2.00 .......................8.00	X					100	0	0
(20) Amy Wilcox........................................................................ Trustee	2.00 .......................6.00	X					100	0	0
(21) Allen Williams MD........................................................................ Trustee	40.00 .......................6.00	X					263,306	0	52,489
(22) Rev Dr Kenneth Board........................................................................ Trustee	2.00 .......................6.00	X					100	0	0
(23) Michael Broski........................................................................ Trustee	2.00 .......................6.00	X					100	0	0
(24) Robert Flannery........................................................................ Trustee	2.00 .......................44.00	X					0	472,820	59,232
(25) Peter Christman........................................................................ Trustee (until Sept 2015)	2.00 .......................42.00	X					0	748,978	58,667
(26) John Scheub........................................................................ Trustee (until Sept 2015)	2.00 .......................6.00	X					100	0	0
(27) John Shiro MD........................................................................ Ex-officio, Medical Staff President	2.00 .......................0.00	X					7,000	0	0
(28) Frank Bonelli MD........................................................................ Ex-officio, Medical Staff Past President	2.00 .......................0.00	X					0	0	0
(29) Mark Cormier MD........................................................................ Ex-officio, Medical Staff Vice-President	2.00 .......................0.00	X					3,000	0	0
(30) Patricia DeWane........................................................................ Chief Financial Officer	40.00 .......................8.00		X				300,855	0	45,702
(31) Donald Daniels........................................................................ Chief Operating Officer	40.00 .......................6.00		X				492,198	0	92,857
(32) Donald Haring........................................................................ Chief Financial Officer (until 1/4)	40.00 .......................8.00		X				615,326	0	84,699
(33) Kathy Kelly MD........................................................................ Chief Clinical Integration Officer	40.00 .......................0.00			X			491,558	0	51,728
(34) Michael J Born MD........................................................................ Chief Medical Officer	40.00 .......................0.00			X			420,721	0	51,648
(35) Harvey Einhorn MD........................................................................ Physician	40.00 .......................0.00				X		672,509	0	62,560
(36) Howard Kaufman DO........................................................................ Physician	40.00 .......................0.00				X		591,479	0	50,424
(37) Mohamed Zeater MD........................................................................ Physician	40.00 .......................0.00				X		691,901	0	47,594
(38) Merat Karbasian-Esfahani MD........................................................................ Physician	40.00 .......................0.00				X		696,044	0	61,484
(39) Steven Milos MD........................................................................ Physician	40.00 .......................0.00				X		661,851	0	53,545
(40) Richard Walsh........................................................................ Former Chief Operating Officer	0.00 .......................0.00					X	680,082	0	17,813

(A) Name and business address	(B) Description of services	(C) Compensation
Advocate Medical Group 2311 West 22nd Street Suite 202 Oakbrook,IL60523	Physician Services	4,550,262
Eagle Hospital Physicians 16000 North Dallas Pkwy Suite 450 Dallas,TX75248	Physician Services	3,325,866
Universal Hospital Services Inc 2601 Crossroads Drive Suite 105 Madison,WI53704	Equipment Services	2,597,831
Ringland Johnson Construction 1725 Huntwood Drive Cherry Valley,IL61016	Construction Services	2,388,703
Rockford Anesthesiologists 2202 Harlem Road Suite 200 Loves Park,IL61111	Physician Services	2,002,126
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 154

- 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

SwedishAmerican Hospital

Employer identification number

36-2222696

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 ..............

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

(i)Name of supported organization	(ii) EIN	(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)


Total

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.

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).

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.

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.

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.

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 (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

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

OMB No. 1545-0047

2015

Name of the organization

SwedishAmerican Hospital

Employer identification number

36-2222696

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

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

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015) Page 2

Name of organization SwedishAmerican Hospital

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 3

Name of organization SwedishAmerican Hospital		Employer identification number 36-2222696

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No.from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Page 4


Name of organization SwedishAmerican Hospital			Employer identification number 36-2222696
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No.from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2015)

Additional Data

Software ID:
Software Version:

- 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

SwedishAmerican Hospital

Employer identification number

36-2222696

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

248,949

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

248,949

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
Part II-B, Line 1:	Portions of the 2015/2016 Illinois Hospital and American Hospital Association dues used for lobbying: $45,678. A law firm was engaged to review legislation affecting hospitals: $203,271

Schedule C (Form 990 or 990EZ) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SwedishAmerican Hospital

Employer identification number

36-2222696

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

			(a) Donor advised funds	(b) Funds and other accounts

1	Total number at end of year ....
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ....

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ...........

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ............................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

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

Cat. No. 52283D

Schedule D (Form 990) 2015

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ........

Part V

Endowment Funds. Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	(c)Two years back	(d)Three years back	(e)Four years back

1a	Beginning of year balance ....	7,112,945	7,122,296	7,093,718	6,571,756	6,007,307
b	Contributions ...	10,986		15,490	10,038	11,537
c	Net investment earnings, gains, and losses	-203,624	-9,351	405,420	655,660	668,467
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...	258,013		392,332	143,736	115,555
f	Administrative expenses ....
g	End of year balance ......	6,662,294	7,112,945	7,122,296	7,093,718	6,571,756

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

0 %

Permanent endowment SchDMd Bullet

87.820 %

Temporarily restricted endowment SchDMd Bullet

12.180 %

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations .................

3a(i)

(ii) related organizations .................

3a(ii)

Yes

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Yes

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land ...	7,272,306		7,272,306
b	Buildings	229,091,990	9,425,841	219,666,149
c	Leasehold improvements	16,497,567	1,796,627	14,700,940
d	Equipment ...	75,169,540	23,338,944	51,830,596
e	Other ...	4,433,723	539,241	3,894,482
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				297,364,473

Schedule D (Form 990) 2015

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b)Book value	(c)Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
Due to Third Party Payors	41,823,918
Reserve for Self Insurance	23,504,137
Deferred Compensation	6,879,708
Asbestos Retirement Obligation	294,886
Current Maturities of Long-term Debt	4,554,699
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	77,057,348
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2015

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Part V, Line 4:

1) Needs of the Mother/Baby Family Birthplace 2) Medical and Non-medical health improvement initiatives 3) Rehabilitation or orthopedic programming and services within the greater Rockford community 4) Oncology patient services 5) Educational materials for the families of oncology patients 6) Chaplaincy program including grief services and counseling 7) Cardiology services 8) Medical programs and care for children 9) Cardiac education for women

Part X, Line 2:

Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with the tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheet along with any associated interest and penalties that would be payable to the taxing authorities upon examination. At June 30, 2016 and 2015, there were no unrecognized tax benefits identified or recorded as liabilities.

Schedule D (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE H
(Form 990)

Department of the Treasury
Internal Revenue Service

Hospitals

Complete if the organization answered "Yes" on Form 990, Part IV, question 20.
MediumBullet

Attach to Form 990.
MediumBullet

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

OMB No. 1545-0047

2015

Open to Public Inspection

Name of the organization

SwedishAmerican Hospital

Employer identification number

36-2222696

Part I

Financial Assistance and Certain Other Community Benefits at Cost

Yes

Did the organization have a financial assistance policy during the tax year? If "No," skip to question 6a . . . .

Yes

If "Yes," was it a written policy? ......................

Yes

If the organization had multiple hospital facilities, indicate which of the following best describes application of the financial assistance policy to its various hospital facilities during the tax year.

Applied uniformly to all hospital facilities Applied uniformly to most hospital facilities Generally tailored to individual hospital facilities

Answer the following based on the financial assistance eligibility criteria that applied to the largest number of the organization's patients during the tax year.

Did the organization use Federal Poverty Guidelines (FPG) as a factor in determining eligibility for providing free care?

If "Yes," indicate which of the following was the FPG family income limit for eligibility for free care:

Yes

100% 150% 200% Other %

Did the organization use FPG as a factor in determining eligibility for providing discounted care? If "Yes," indicate

which of the following was the family income limit for eligibility for discounted care: . . . . . . . .

Yes

200% 250% 300% 350% 400% Other 60000.0000000000 %

If the organization used factors other than FPG in determining eligibility, describe in Part VI the criteria used for determining eligibility for free or discounted care. Include in the description whether the organization used an asset test or other threshold, regardless of income, as a factor in determining eligibility for free or discounted care.

Did the organization's financial assistance policy that applied to the largest number of its patients during the tax year provide for free or discounted care to the "medically indigent"? . . . . . . . . . . . . .

Yes

Did the organization budget amounts for free or discounted care provided under its financial assistance policy during
the tax year? . . . . . . . . . . . . . . . . . . . . . . .

Yes

If "Yes," did the organization's financial assistance expenses exceed the budgeted amount? . . . . . .

Yes

If "Yes" to line 5b, as a result of budget considerations, was the organization unable to provide free or discountedcare to a patient who was eligibile for free or discounted care? . . . . . . . . . . . . .

Did the organization prepare a community benefit report during the tax year? . . . . . . . . .

Yes

If "Yes," did the organization make it available to the public? . . . . . . . . . . . . .

Yes

Complete the following table using the worksheets provided in the Schedule H instructions. Do not submit these worksheets with the Schedule H.

Financial Assistance and Certain Other Community Benefits at Cost

Financial Assistance and Means-Tested Government Programs		(c) Total community benefit expense	(d) Direct offsetting revenue	(e) Net community benefit expense	(f) Percent of total expense
a	Financial Assistance at cost (from Worksheet 1) . . .	3,254,887		3,254,887	0.680 %
b	Medicaid (from Worksheet 3, column a) . . . . .	108,990,550	83,047,658	25,942,892	5.440 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .	2,486,994	1,088,947	1,398,047	0.290 %
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	114,732,431	84,136,605	30,595,826	6.410 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).
f	Health professions education (from Worksheet 5) . . .	7,434,671	1,894,241	5,540,430	1.160 %
g	Subsidized health services (from Worksheet 6) . . . .	22,638,022	590,900	22,047,122	4.620 %
h	Research (from Worksheet 7) .	319,939		319,939	0.070 %
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	940,446	237,782	702,664	0.150 %
j	Total. Other Benefits . .	31,333,078	2,722,923	28,610,155	6.000 %
k	Total. Add lines 7d and 7j .	146,065,509	86,859,528	59,205,981	12.410 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2015

Schedule H (Form 990) 2015

Page

Part II

Community Building Activities Complete this table if the organization conducted any community building activities during the tax year, and describe in Part VI how its community building activities promoted the health of the communities it serves.

		(a) Number of activities or programs (optional)	(b) Persons served (optional)	(c) Total community building expense	(d) Direct offsetting revenue	(e) Net community building expense	(f) Percent of total expense
1	Physical improvements and housing
2	Economic development
3	Community support
4	Environmental improvements
5	Leadership development and training for community members
6	Coalition building
7	Community health improvement advocacy
8	Workforce development
9	Other
10	Total

Part III

Bad Debt, Medicare, & Collection Practices

Section A. Bad Debt Expense

Yes

Did the organization report bad debt expense in accordance with Heathcare Financial Management Association Statement No. 15? ..........................

Enter the amount of the organization's bad debt expense. Explain in Part VI the methodology used by the organization to estimate this amount. ......

33,591,411

Enter the estimated amount of the organization's bad debt expense attributable to patients eligible under the organization's financial assistance policy. Explain in Part VI the methodology used by the organization to estimate this amount and the rationale, if any, for including this portion of bad debt as community benefit. ......

5,038,712

Provide in Part VI the text of the footnote to the organization’s financial statements that describes bad debt expense or the page number on which this footnote is contained in the attached financial statements.

Section B. Medicare

Enter total revenue received from Medicare (including DSH and IME).....

71,029,034

Enter Medicare allowable costs of care relating to payments on line 5.....

77,387,598

Subtract line 6 from line 5. This is the surplus (or shortfall)........

-6,358,564

Describe in Part VI the extent to which any shortfall reported in line 7 should be treated as community benefit.Also describe in Part VI the costing methodology or source used to determine the amount reported on line 6.Check the box that describes the method used:

Cost accounting system Cost to charge ratio Other

Section C. Collection Practices

Did the organization have a written debt collection policy during the tax year? ..........

Yes

If "Yes," did the organization’s collection policy that applied to the largest number of its patients during the tax year
contain provisions on the collection practices to be followed for patients who are known to qualify for financial assistance? Describe in Part VI .........................

Yes

Part IV

Management Companies and Joint Ventures(owned 10% or more by officers, directors, trustees, key employees, and physicians—see instructions)

(a) Name of entity	(b) Description of primary activity of entity	(c) Organization's profit % or stock ownership %	(d) Officers, directors, trustees, or key employees' profit % or stock ownership %	(e) Physicians' profit % or stock ownership %
11 Featherstone Partnership LLC	Ambulatory Surgery Center	28.570 %	0 %	71.430 %
22 Northern Illinois Vein Clinic LLC	Outpatient Physician Clinic	50.000 %	0 %	50.000 %
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2015

Page

Part VFacility Information

Section A. Hospital Facilities (list in order of size from largest to smallest—see instructions) How many hospital facilities did the organization operate during the tax year?2 Name, address, primary website address, and state license number (and if a group return, the name and EIN of the subordinate hospital organization that operates the hospital facility)							Facility reporting group
1	SwedishAmerican Hospital 1401 E State Street Rockford,IL61104	X	X	X	X	X	A
2	SwedishAmerican Medical Ctr Belvidere 1625 S State Street Belvidere,IL61008	X	X			X	A

Schedule H (Form 990) 2015

Page 4

Part VFacility Information (continued)

Section B. Facility Policies and Practices

(Complete a separate Section B for each of the hospital facilities or facility reporting groups listed in Part V, Section A)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Line number of hospital facility, or line numbers of hospital facilities in a facility
reporting group (from Part V, Section A):

Yes

Community Health Needs Assessment

Was the hospital facility first licensed, registered, or similarly recognized by a state as a hospital facility in the current tax year or the immediately preceding tax year?........................

Was the hospital facility acquired or placed into service as a tax-exempt hospital in the current tax year or the immediately preceding tax year? If “Yes,” provide details of the acquisition in Section C...............

During the tax year or either of the two immediately preceding tax years, did the hospital facility conduct a community health needs assessment (CHNA)? If "No," skip to line 12......................

Yes

If "Yes," indicate what the CHNA report describes (check all that apply):

A definition of the community served by the hospital facility

Demographics of the community

Existing health care facilities and resources within the community that are available to respond to the health needs of the community

How data was obtained

The significant health needs of the community

Primary and chronic disease needs and other health issues of uninsured persons, low-income persons, and minority groups

The process for identifying and prioritizing community health needs and services to meet the community health needs

The process for consulting with persons representing the community’s interests

Information gaps that limit the hospital facility’s ability to assess the community’s health needs

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 15

In conducting its most recent CHNA, did the hospital facility take into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge of or expertise in public health? If "Yes," describe in Section C how the hospital facility took into account input from persons who represent the community, and identify the persons the hospital facility consulted .................

Yes

6 a

Was the hospital facility’s CHNA conducted with one or more other hospital facilities? If "Yes," list the other hospital facilities in Section C..................................

Yes

Was the hospital facility’s CHNA conducted with one or more organizations other than hospital facilities?” If “Yes,” list the other organizations in Section C. ............................

Did the hospital facility make its CHNA report widely available to the public?..............

Yes

If "Yes," indicate how the CHNA report was made widely available (check all that apply):

Hospital facility’s website (list url): www.swedishamerican.org/about/chna

Other website (list url):

Made a paper copy available for public inspection without charge at the hospital facility

Other (describe in Section C)

Did the hospital facility adopt an implementation strategy to meet the significant community health needs
identified through its most recently conducted CHNA? If "No," skip to line 11. ..............

Yes

Indicate the tax year the hospital facility last adopted an implementation strategy: 20 15

Is the hospital facility's most recently adopted implementation strategy posted on a website?.........

Yes

If "Yes" (list url): www.swedishamerican.org/about/chna

If "No," is the hospital facility’s most recently adopted implementation strategy attached to this return? ......

10b

Yes

Describe in Section C how the hospital facility is addressing the significant needs identified in its most recently conducted CHNA and any such needs that are not being addressed together with the reasons why such needs are not being addressed.

12a

Did the organization incur an excise tax under section 4959 for the hospital facility's failure to conduct a CHNA as required by section 501(r)(3)?...............................

12a

If "Yes" on line 12a, did the organization file Form 4720 to report the section 4959 excise tax?........

12b

If "Yes" on line 12b, what is the total amount of section 4959 excise tax the organization reported on Form 4720 for all of its hospital facilities? $

Schedule H (Form 990) 2015

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility have in place during the tax year a written financial assistance policy that:

Explained eligibility criteria for financial assistance, and whether such assistance included free or discounted care?

Yes

If “Yes,” indicate the eligibility criteria explained in the FAP:

Federal poverty guidelines (FPG), with FPG family income limit for eligibility for free care of 200.000000000000% and FPG family income limit for eligibility for discounted care of 600.000000000000%

Income level other than FPG (describe in Section C)

Asset level

Medical indigency

Insurance status

Underinsurance discount

Residency

Other (describe in Section C)

Explained the basis for calculating amounts charged to patients?.................

Yes

Explained the method for applying for financial assistance?...................

Yes

If “Yes,” indicate how the hospital facility’s FAP or FAP application form (including accompanying instructions) explained the method for applying for financial assistance (check all that apply):

Described the information the hospital facility may require an individual to provide as part of his or her application

Described the supporting documentation the hospital facility may require an individual to submit as part of his or
her application

Provided the contact information of hospital facility staff who can provide an individual with information about the
FAP and FAP application process

Provided the contact information of nonprofit organizations or government agencies that may be sources of
assistance with FAP applications

Other (describe in Section C)

Included measures to publicize the policy within the community served by the hospital facility?........

Yes

If "Yes," indicate how the hospital facility publicized the policy (check all that apply):

The FAP was widely available on a website (list url):

www.swedishamerican.org/patients_visitors/charity_care_policy/

The FAP application form was widely available on a website (list url):

www.swedishamerican.org/patients_visitors/charity_care_policy/

A plain language summary of the FAP was widely available on a website (list url):
www.swedishamerican.org/patients_visitors/charity_care_policy/

The FAP was available upon request and without charge (in public locations in the hospital facility and by mail)

The FAP application form was available upon request and without charge (in public locations in the hospital facility
and by mail)

A plain language summary of the FAP was available upon request and without charge (in public locations in the
hospital facility and by mail)

Notice of availability of the FAP was conspicuously displayed throughout the hospital facility

Notified members of the community who are most likely to require financial assistance about availability of the FAP

Other (describe in Section C)

Billing and Collections

Did the hospital facility have in place during the tax year a separate billing and collections policy, or a written financial assistance policy (FAP) that explained all of the actions the hospital facility or other authorized party may take upon non-payment?..................................

Yes

Check all of the following actions against an individual that were permitted under the hospital facility's policies during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

None of these actions or other similar actions were permitted

Schedule H (Form 990) 2015

Page 6

Part VFacility Information (continued)

	Facility Reporting Group - A
Name of hospital facility or letter of facility reporting group

Yes

Did the hospital facility or other authorized party perform any of the following actions during the tax year before making reasonable efforts to determine the individual’s eligibility under the facility’s FAP?............

If "Yes," check all actions in which the hospital facility or a third party engaged:

Reporting to credit agency(ies)

Selling an individual’s debt to another party

Actions that require a legal or judicial process

Other similar actions (describe in Section C)

Indicate which efforts the hospital facility or other authorized party made before initiating any of the actions listed (whether or not checked) in line 19. (check all that apply):

Notified individuals of the financial assistance policy on admission

Notified individuals of the financial assistance policy prior to discharge

Notified individuals of the financial assistance policy in communications with the individuals regarding the individuals’ bills

Documented its determination of whether individuals were eligible for financial assistance under the hospital facility’s financial assistance policy

Other (describe in Section C)

None of these efforts were made

Policy Relating to Emergency Medical Care

Did the hospital facility have in place during the tax year a written policy relating to emergency medical care that required the hospital facility to provide, without discrimination, care for emergency medical conditions to individuals regardless of their eligibility under the hospital facility’s financial assistance policy?..................

Yes

If "No," indicate why:

The hospital facility did not provide care for any emergency medical conditions

The hospital facility’s policy was not in writing

The hospital facility limited who was eligible to receive care for emergency medical conditions (describe in Section C)

Other (describe in Section C)

Charges to Individuals Eligible for Assistance Under the FAP (FAP-Eligible Individuals)

Indicate how the hospital facility determined, during the tax year, the maximum amounts that can be charged to FAP-eligible individuals for emergency or other medically necessary care.

The hospital facility used its lowest negotiated commercial insurance rate when calculating the maximum amounts that
can be charged

The hospital facility used the average of its three lowest negotiated commercial insurance rates when calculating the maximum amounts that can be charged

The hospital facility used the Medicare rates when calculating the maximum amounts that can be charged

Other (describe in Section C)

During the tax year, did the hospital facility charge any FAP-eligible individual to whom the hospital facility provided emergency or other medically necessary services more than the amounts generally billed to individuals who had insurance covering such care? ...............................

If "Yes," explain in Section C.

During the tax year, did the hospital facility charge any FAP-eligible individual an amount equal to the gross charge for any service provided to that individual? ...........................

If "Yes," explain in Section C.

Schedule H (Form 990) 2015

Page 7

Part V

Facility Information (continued)

Section C. Supplemental Information for Part V, Section B. Provide descriptions required for Part V, Section B, lines 2, 3j, 5, 6a, 6b, 7d, 11, 13b, 13h, 15e, 16i, 18d, 19d, 20e, 21c, 21d, 22d, 23, and 24. If applicable, provide separate descriptions for each hospital facility in a facility reporting group, designated by facility reporting group letter and hospital facility line number from Part V, Section A (“A, 1,” “A, 4,” “B, 2,” “B, 3,” etc.) and name of hospital facility.
Form and Line Reference	Explanation
Part V, Section B	Facility Reporting Group A
Facility Reporting Group A consists of:	- Facility 1: SwedishAmerican Hospital, - Facility 2: SwedishAmerican Medical Ctr. Belvidere
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 5:	Primary data was obtained from the 2014 Healthy Community Study provided by Rockford Health Council which contained results and analytics from both a Healthy Community Survey and the Key Informant Questionnaire. The 2014 Healthy Community Study consists of two sections. Section I contains questions relating to four categories - (1) general health, (2) behavioral health, (3) maternal, prenatal, and early childhood health and (4) chronic disease and obesity. Section II contains six demographic questions. Surveys were developed in English and Spanish language format with written and electronic versions. The Surveys were distributed in three phases. In Phase 1, the surveys requesting parent survey participation were distributed to students in Rockford Public School District 205. In Phase 2, surveys were mailed to residents of Boone and Winnebago County through a third party vendor. In Phase 3, a postcard was delivered to a random sample of households in Winnebago County providing access information to the survey on the Rockford Health Council Website. The Rockford Health Council identified a group of 49 individuals as Key Informants and distributed a questionnaire to them that asked them to rate their awareness of efforts to address each of the key focus areas identified in the 2010 Healthy Community Study that needed improvement.
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 6a:	SA Hospital has two hospital facilities, SwedishAmerican Hospital located in Rockford Illinois, and SwedishAmerican Medical Center Belvidere located in Belvidere, Illinois. The definition of the community for purposes of the Community Health Needs Assessment (CHNA) was based on the internal patient origin information by zip code for SAH and SAMC's combined emergency room and inpatient discharges. Both Hospital Facilities defined its community for the CHNA as Boone and Winnebago Counties, Illinois since over 89% of emergency room patients and 84% of inpatients draw from this area. The CHNA was conducted together for both facilities.
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 11:	In acknowledging the wide range of priority health issues that emerged from the CHNA process, the hospital determined that it could only effectively focus on those which it deemed most under-addressed and most within its ability to influence.
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 16i:	The hospital's financial assistance policy is transparent and available to all, at all points in the continuum, in languages appropriate for Hospital's service area. The hospital's financial assistance policy, application form, signage, and financial counselor contact information are available in English and Spanish. Signage is posted prominently at all points of admission and registration (including the emergency department). Written information about the hospital's financial assistance policy and copies of the financial assistance form are available in admission and registration areas. The hospital's financial assistance policy, application form and financial counselor contact information are also posted on the hospital's website. The hospital will make efforts to publicize its policy in print and television media, wherever practicable.Patient billing communications also inform patients of the availability of financial assistance. Each bill, invoice, or other summary of charges to an uninsured patient includes with it, or on it, a prominent statement that an uninsured patient who meets certain income requirements may qualify for financial assistance and information on how to apply for consideration under the hospital's financial assistance policy. All third-party agents who submit or collect bills on behalf of hospital are required to follow this policy.
Group A-Facility 1 -- SwedishAmerican Hospital Part V, Section B, line 22d:	The maximum amount that may be collected in a 12-month period from an uninsured patient with family income greater than 200% of the federal poverty guidelines and less than or equal to 600 percent of the federal poverty guidelines for medically necessary services is 25 percent of that patient's family income. The Hospital will determine, on a case-by-case basis, whether to extend the same or similar 12-month maximum collectible amount to any other qualifying self-pay patient with family income of less than or equal to 600 percent of the federal poverty guidelines for qualifying services. The hospital reserves the right to exclude patients having assets with a value in excess of 600 percent of the federal poverty guidelines from the application of the 12-month maximum collectible amount. For purposes of determining the applicability of the 12-month maximum collectible amount, the following assets shall not be counted:A. The uninsured patient's primary residence.B. Personal property exempt from judgment under Section 12-1001 of the Code of Civil Procedure.C. Any amounts held in a pension or retirement plan, provided, however, that distributions and payments from pension or retirement plan may be included as income.To be eligible to have this maximum amount applied to subsequent charges, a patient shall inform the Hospital, in subsequent hospital in-patient admissions or outpatient encounters, that the patient has previously received medically necessary services from the hospital and was determined to be entitled to discounted care under this policy.In no event shall a patient who receives financial assistance under this policy be charged "gross charges" in violation of the Internal Revenue Code Section 501(r)(5)(b). For emergency or other medically necessary care provided to patients who receive financial assistance under this policy, hospital shall not charge amounts in excess of charges allowed under Internal Revenue Code 501(r)(5)(a). Assets are not considered in determining a self-pay patient's eligibility for financial assistance under this policy, except for purposes of:A. Determining the applicability of the 12-month maximum collectible amount described above; andB. In the case of a Medicare beneficiary, applying the mandatory asset test for Medicare beneficiaries described above.The hospital facility used the average prior fiscal year 12 month period of paid in full Medicare and commercial insurance rates when calculating the maximum amounts that can be charged.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 5:	Primary data was obtained from the 2014 Healthy Community Study provided by Rockford Health Council which contained results and analytics from both a Healthy Community Survey and the Key Informant Questionnaire. The 2014 Healthy Community Study consists of two sections. Section I contains questions relating to four categories - (1) general health, (2) behavioral health, (3) maternal, prenatal, and early childhood health and (4) chronic disease and obesity. Section II contains six demographic questions. Surveys were developed in English and Spanish language format with written and electronic versions. The Surveys were distributed in three phases. In Phase 1, the surveys requesting parent survey participation were distributed to students in Rockford Public School District 205. In Phase 2, surveys were mailed to residents of Boone and Winnebago County through a third party vendor. In Phase 3, a postcard was delivered to a random sample of households in Winnebago County providing access information to the survey on the Rockford Health Council Website. The Rockford Health Council identified a group of 49 individuals as Key Informants and distributed a questionnaire to them that asked them to rate their awareness of efforts to address each of the key focus areas identified in the 2010 Healthy Community Study that needed improvement.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 6a:	SA Hospital has two hospital facilities, SwedishAmerican Hospital located in Rockford Illinois, and SwedishAmerican Medical Center Belvidere located in Belvidere, Illinois. The definition of the community for purposes of the Community Health Needs Assessment (CHNA) was based on the internal patient origin information by zip code for SAH and SAMC's combined emergency room and inpatient discharges. Both Hospital Facilities defined its community for the CHNA as Boone and Winnebago Counties, Illinois since over 89% of emergency room patients and 84% of inpatients draw from this area. The CHNA was conducted together for both facilities.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 11:	In acknowledging the wide range of priority health issues that emerged from the CHNA process, the hospital determined that it could only effectively focus on those which it deemed most under-addressed and most within its ability to influence.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 16i:	The hospital's financial assistance policy is transparent and available to all, at all points in the continuum, in languages appropriate for Hospital's service area. The hospital's financial assistance policy, application form, signage, and financial counselor contact information are available in English and Spanish. Signage is posted prominently at all points of admission and registration (including the emergency department). Written information about the hospital's financial assistance policy and copies of the financial assistance form are available in admission and registration areas. The hospital's financial assistance policy, application form and financial counselor contact information are also posted on the hospital's website. The hospital will make efforts to publicize its policy in print and television media, wherever practicable.Patient billing communications also inform patients of the availability of financial assistance. Each bill, invoice, or other summary of charges to an uninsured patient includes with it, or on it, a prominent statement that an uninsured patient who meets certain income requirements may qualify for financial assistance and information on how to apply for consideration under the hospital's financial assistance policy. All third-party agents who submit or collect bills on behalf of hospital are required to follow this policy.
Group A-Facility 2 -- SwedishAmerican Medical Ctr. Belvidere Part V, Section B, line 22d:	The maximum amount that may be collected in a 12-month period from an uninsured patient with family income greater than 200% of the federal poverty guidelines and less than or equal to 600 percent of the federal poverty guidelines for medically necessary services is 25 percent of that patient's family income. The Hospital will determine, on a case-by-case basis, whether to extend the same or similar 12-month maximum collectible amount to any other qualifying self-pay patient with family income of less than or equal to 600 percent of the federal poverty guidelines for qualifying services. The hospital reserves the right to exclude patients having assets with a value in excess of 600 percent of the federal poverty guidelines from the application of the 12-month maximum collectible amount. For purposes of determining the applicability of the 12-month maximum collectible amount, the following assets shall not be counted:A. The uninsured patient's primary residence.B. Personal property exempt from judgment under Section 12-1001 of the Code of Civil Procedure.C. Any amounts held in a pension or retirement plan, provided, however, that distributions and payments from pension or retirement plan may be included as income.To be eligible to have this maximum amount applied to subsequent charges, a patient shall inform the Hospital, in subsequent hospital in-patient admissions or outpatient encounters, that the patient has previously received medically necessary services from the hospital and was determined to be entitled to discounted care under this policy.In no event shall a patient who receives financial assistance under this policy be charged "gross charges" in violation of the Internal Revenue Code Section 501(r)(5)(b). For emergency or other medically necessary care provided to patients who receive financial assistance under this policy, hospital shall not charge amounts in excess of charges allowed under Internal Revenue Code 501(r)(5)(a). Assets are not considered in determining a self-pay patient's eligibility for financial assistance under this policy, except for purposes of:A. Determining the applicability of the 12-month maximum collectible amount described above; andB. In the case of a Medicare beneficiary, applying the mandatory asset test for Medicare beneficiaries described above.The hospital facility used the average prior fiscal year 12 month period of paid in full Medicare and commercial insurance rates when calculating the maximum amounts that can be charged.

Schedule H (Form 990) 2015

Page 8

Part VFacility Information (continued)

Section D. Other Health Care Facilities That Are Not Licensed, Registered, or Similarly Recognized as a Hospital Facility (list in order of size, from largest to smallest) How many non-hospital health care facilities did the organization operate during the tax year?28
Name and address		Type of Facility (describe)
1	1 - Regional Cancer Center 3535 N Bell School Road Rockford,IL61114	Outpatient Clinic
2	2 - Midwest Heart Specialists 1340 Charles Street Suite 300 Rockford,IL61104	Outpatient Clinic
3	3 - Stateline Clinic 4282 E Rockton Road Roscoe,IL61073	Outpatient Clinic
4	4 - Woodside Clinic 3775 N Mulford Road Rockford,IL61114	Outpatient Clinic
5	5 - Lundholm Orthopedics 1340 Charles Street Rockford,IL61104	Outpatient Clinic
6	6 - Brookside Specialty Center 1253 N Alpine Road Rockford,IL61107	Outpatient Clinic
7	7 - Dixon Oncology 101 W 2nd Street Dixon,IL61021	Outpatient Clinic
8	8 - SwedishAmerican Home Health Care 2550 Charles Street Rockford,IL61108	Home Health
9	9 - Belvidere Clinic 1700 Henry Luckow Lane Belvidere,IL61008	Outpatient Clinic
10	10 - SAMG Obstetrics & Gynecology 209 9th Street Rockford,IL61104	Outpatient Clinic
11	11 - Rock Valley Women's Health Center 6861 Villagreen View Rockford,IL61107	Outpatient Clinic
12	12 - Neuro and Headache Center 1340 Charles Street Suite 400 Rockford,IL61104	Outpatient Clinic
13	13 - Rockford Ambulatory Surgery Center 1016 Featherstone Road Rockford,IL61107	Ambulatory Surgery Center
14	14 - Five Points Clinic 2404 Charles Street Suite 800 Rockford,IL61108	Outpatient Clinic
15	15 - SA Immediate Care 2473 McFarland Road Rockford,IL61107	Outpatient Clinic
16	16 - UW Health Surgery at SwedishAmerican 1340 Charles Street Suite 301 Rockford,IL61104	Outpatient Clinic
17	17 - Valley Clinic 6824 Newburg Road Rockford,IL61108	Outpatient Clinic
18	18 - Wound Care & Hyperbaric Clinics 1415 E State Street Suites 408 and 609 Rockford,IL61104	Outpatient Clinic
19	19 - Pulmonary and Sleep Disorder Clinic 1401 E State Street Rockford,IL61104	Outpatient Clinic
20	20 - Midtown Clinic 1340 E State Street Suite 405 Rockford,IL61104	Outpatient Clinic
21	21 - Davis Junction Clinic 5665 North Junction Way Davis Junction,IL61020	Outpatient Clinic
22	22 - CamelotState St OBGYN 1415 E State Street Rockford,IL61104	Outpatient Clinic
23	23 - Cardiothorasic Surgery 1340 Charles Street Suite 300 Rockford,IL61104	Outpatient Clinic
24	24 - Byron Clinic 220 W Blackhawk Drive Byron,IL61010	Outpatient Clinic
25	25 - Northern Illinois Vein Clinic 1340 Charles Street Suite 404 Rockford,IL61104	Outpatient Clinic
26	26 - Maternal Fetal Medicine 1401 E State Street Rockford,IL61104	Outpatient Clinic
27	27 - Rochelle Clinic 380 Illinois Route 38 East Rochelle,IL61068	Outpatient Clinic
28	28 - Marengo Clinic and Immediate Care 204 E Prairie Street Marengo,IL60152	Outpatient Clinic

Schedule H (Form 990) 2015

Page 9

Part VI

Supplemental Information

Provide the following information.

1	Required descriptions. Provide the descriptions required for Part I, lines 3c, 6a, and 7; Part II and Part III, lines 2, 3, 4, 8 and 9b.
2	Needs assessment. Describe how the organization assesses the health care needs of the communities it serves, in addition to any CHNAs reported in Part V, Section B.
3	Patient education of eligibility for assistance. Describe how the organization informs and educates patients and persons who may be billed for patient care about their eligibility for assistance under federal, state, or local government programs or under the organization’s financial assistance policy.
4	Community information. Describe the community the organization serves, taking into account the geographic area and demographic constituents it serves.
5	Promotion of community health. Provide any other information important to describing how the organization’s hospital facilities or other health care facilities further its exempt purpose by promoting the health of the community (e.g., open medical staff, community board, use of surplus funds, etc.).
6	Affiliated health care system. If the organization is part of an affiliated health care system, describe the respective roles of the organization and its affiliates in promoting the health of the communities served.
7	State filing of community benefit report. If applicable, identify all states with which the organization, or a related organization, files a community benefit report.

Form and Line Reference	Explanation
Part I, Line 7g:	The following subsidized health services are for physicians. These physicians are necessary to serve the community, are difficult to recruit, and the reimbursement does not cover the cost of the services.Hospital based physicians' specialty clinics and coverage payments: $18,286,489Emergency department physicians: $1,297,749Total: $19,584,238
Part I, Ln 7 Col(f):	The bad debt expense in part IX Column A was subtracted for the purpose of calculating the percentage of expense is $33,591,411.
Part I, Line 7:	7a and 7f costs were calculated using the 2015 Medicare cost report cost to charge ratio. Lines 7b and 7c costs were calculated using the cost accounting system. The cost accounting system addresses all patient segments. All other amounts in line 7 were calculated using direct costs.
Part III, Line 2:	Methodology for determining bad debt expense: It is our practice to identify, to the extent possible, charity cases at the time of service. If a patient provides documentation they meet our charity care policy, they are not sent to collection. Those patients who do not meet presumptive eligibility and fail to apply or provide documentation are sent to collection after 90 days. The organization and its agents follow the fair patient billing act. If during the collection process we or our agents become aware of a patient qualifying for charity care or financial assistance and the patient cooperates with the requirements of the charity care policy, collection efforts are ceased and the account is written off to charity. Bad debt expense reported on line 2 represents the allowance for doubtful accounts. It is determined based on historical experience of uncollectible amounts, after contractual discounts, patient payments and amounts qualifying under charity assistance policy.
Part III, Line 3:	SwedishAmerican Hospital's charity policy allows a 100% charity write-off for those with household income of 200% or less of the federal poverty level and partial charity write-off for those up to 600% of the poverty level. The latest data from the U.S. Census bureau QuickFacts for Winnebago and Boone counties, which are the counties served by the healthcare facilities, indicates the following: Winnebago County - 14.7% of the population is below the poverty level, the median household income was $48,225 and a household size of 2.51, Boone County - 10.3% of the population is below the poverty level, the median household income was $58,248 and a household size of 2.95. The 2016 poverty guidelines per the Office of Assistant Secretary for Planning and Evaluation, (http://aspe.hhs.gov) indicate for a household size of 3, an income $40,320 is 200% of the poverty level and $120,960 is 600% of the poverty level. Approximately 72% of our charity write-offs are for patients without insurance while 57% of our bad debt write-offs are for patients without insurance. In 2016 only 13% of all accounts written off to bad debt were recovered. Based on this demographic and internal data we believe that a minimum of 15% of the amounts written off as bad debt would qualify for charity, and as such 15% of the bad debt expense from line 2 is reported on line 3.
Part III, Line 4:	Patient accounts receivable are reduced by an allowance for uncollectible accounts. In evaluating the collectability of accounts receivable, the hospital identifies troubled accounts, reviews historical experience and identifies trends for each of its major payer sources of revenue to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. Management regularly reviews data about these major payer sources of revenue in evaluating the sufficiency of the allowance for uncollectible accounts. For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts, if necessary (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payer has not yet paid, or for payers who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. The difference between the standard rates (or the discounted rates if negotiated) and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for uncollectible accounts.
Part III, Line 8:	SA Hospital must treat patients regardless of their ability to pay. The government sets non-negotiable Medicare rates and the reimbursement from Medicare has not kept pace with the rising cost of providing those services. The cost of care has increased due to: wages and benefits necessary to keep high demand skilled practitioners, medical supplies in particular cardiovascular and orthopedic implants and pharmaceuticals, malpractice insurance costs, and capital equipment. SA Hospital's treatment of Medicare beneficiaries relieves the federal government burden of directly providing medical care which by law they are required to provide to eligible beneficiaries. Due to the requirement to provide care and the inability of Medicare reimbursement to keep pace with the cost of providing services, we feel the loss from services provided to Medicare beneficiaries is a part of our mission and is a benefit to our community. The following is a reconciliation of the shortfall from Medicare reported on the cost report on Line 7 to the Medicare shortfall from all of the Medicare programs at SA Hospital. These shortfalls were calculated using the cost to charge ratio.Medicare shortfall hospital programs Part III, line 7: ($6,358,564)Medicare shortfall physician programs: ($29,645,554)Total Medicare Shortfall: ($36,004,117)
Part III, Line 9b:	The organization and its agents follow the fair patient billing act. If during the collection process we or our agents become aware of a patient qualifying for charity care of financial assistance and the patient cooperates with the requirements of the charity care policy, collection efforts are ceased.
Part VI, Line 2:	SA hospital has provided monetary support for the 2014 Healthy Community Study, conducted by the Rockford Health council. The Council consists of the major health care providers in our metropolitan area such as the three hospitals, Crusader Clinic (a federally qualified healthcare clinic), the University of Illinois College of Medicine, Janet Wattles Mental Health Center, Rosecrance Substance Abuse Center as well as several representatives of not-for-profit agencies, and member of the corporate community. Since 2001, an assessment has been completed every three years to identify and track trends as well as areas to address. These stakeholders understand the need for a comprehensive community study that is focused on the overall needs of the community. SA has used this data to launch innovative programs and collaborative partnerships such as cardiac screenings within minority communities. In April of 2015, SA Hospital contracted with RSM-US LLP to complete a three year follow-up Community Health Needs Assessment (CHNA) for both SA Hospital and SA Medical Center Belvidere as required by the Internal Revenue Code, Section 501(r). An implementation strategy has been adopted to meet the prioritized needs identified by the CHNA.
Part VI, Line 3:	For services provided in the hospital, our employees and our agents follow the fair patient billing act and provide information regarding the availability of charity and financial assistance at all points during the collection process. We have posted signage disclosing the availability of charity care and financial assistance in emergency rooms and on our website. Inpatients are provided various written communications regarding the availability of charity care and financial assistance and any uninsured discount eligibility. For services provided in physician offices, financial counselors are instructed to make the patients aware of the charity care and financial assistance policy during the collection process and educate them on the process of applying for Medicaid. For services provided by home health, social workers assist patients by screening for Medicaid eligibility and completing the application, completing charity care application, assisting in applying for Medicare and social security disability benefits, and assisting with applications for food stamps, low income energy assistance, and circuit breaker/Illinois cares prescription programs.
Part VI, Line 4:	The communities served by SA Hospital include the Rockford Metropolitan Service Area (MSA) and the counties of Winnebago, Boone, and to a lesser degree Ogle and Stephenson Counties. Ogle and Winnebago counties have medically underserved area (MUA) designations for the White Rock Service Area (MUA 916) and Winnebago Service Area (MUA 7011). The U.S. Census bureau had the 2015 estimated population for the Rockford MSA at 340,663. Today, the unemployment rate of the Rockford MSA is 5.8%, ranking in the bottom 10% of the nation. SA Hospital is located in the city of Rockford, Illinois, in Winnebago County, where the percentage of households below the poverty level is 14.7%. SwedishAmerican Medical Center Belvidere is located in the city of Belvidere, Illinois, in Boone County, where the percentage of households below the poverty level is 10.3%. Of the patients served by SA Hospital at all facilities, 28.4% are uninsured or Medicaid recipients. Five different facilities exist in the community to address inpatient needs, all of which offer discounts or charity care to uninsured and needy patients. There is one federally qualified healthcare facility. SA Hospital helped fund the 2014 Rockford Healthy Community Study in partnership with the University of Illinois, College of Medicine at Rockford and the Rockford Health Council. In addition to general health issues, the study also focuses on three other areas of need identified by Rockford Health Council. They are: 1)Behavioral Health 2)Maternal, Prenatal, and Early Childhood Health 3)Chronic Disease and ObesityGeneral Health:Both Boone and Winnebago counties have a lower rate of primary care physicians (PCP) 78% compared to the state 96% and the nation 86% and the rate of access to PCP is lower for Boone County 59% than for Winnebago Counties 82%. In contrast, the percentage of adults in the region without a regular doctor 14% is lower than the state 18% and the nation 22%. Nevertheless, 54% of Boone and Winnebago population has been identified as living within an area where there is a shortage of healthcare professionals.Behavioral Health:The Study revealed that half of the respondents know where to find resources for mental health and suicide issues and almost half believe that both issues have no impact on their neighborhoods. Approximately 20% believe there is a lack of social or emotional support for the region which is consistent with that of the state and national rates.Maternal, Prenatal, and Early Childhood Health:The Study found that most respondents believe that regular prenatal care is necessary and that it is easy for mothers and their children to access these types of resources within their neighborhoods. Only 6% of mothers in the region are without prenatal care or receive it late in their pregnancy compared to 5% for the state and 17% for the nation. This is further supported by low infant mortality rates for Boone County 5% and below state and national rates but not for Winnebago County at 8% and above the state and national rates per 1,000 live births. Additionally, the teen birth rate for Boone County 30% is lower than the state 35% and Winnebago County at 46% and the incidences of teen birth rate for all comparative groups have declined over a 10 year period between 2002 and 2012.Chronic Disease:Respondents to the Healthy Community Study recognize that obesity plays a significant role in chronic disease and that it has an impact on their neighborhood. More than half acknowledge that healthy food options and access to community parks, recreational areas and fitness facilities are crucial to a reduction in chronic disease and obesity. However, the Study illustrates less than 5% of Boone County and 11% of Winnebago County live within 1/2 mile of a park and for each 100,000 it is estimated that 5 facilities exist in Boone County and 9 facilities in Winnebago County with an estimated regional population of 350,000. By virtue of its mission, location in the central city and relationships with other providers, SwedishAmerican serves the needs of many of the community's underserved. Finding ways to improve the health of all and to make Rockford a model community in which to live, work and worship are significant and strategic initiatives for SA Hospital.
Part VI, Line 5:	Although SA Hospital's community service efforts reach a broad segment of the population throughout northern Illinois, the hospital devotes a great deal of its energy and resources to serving the city's neediest people, many of whom live in the urban core where SwedishAmerican is located. Our organization contributes millions of dollars to charity and Medicaid care each year.Recognizing that healthy communities are characterized by strong interconnections between residents, infrastructure, organizations and services, we have worked in partnership with other community-based organizations as part of the non-profit Rockford Health Council Inc. The council seeks to build and improve community health through education, action, dialogue and legislative activity and serves as a catalyst and coordinator for agency and individual action to ensure access, cost effectiveness and quality. Beyond our work with the council, some of our initiatives take place in concert with other individual community organizations and healthcare providers, while others are carried out by SA Hospital teams.For example, SwedishAmerican has worked with the City of Rockford and other area development groups-including ZION Development, Habitat for Humanity and Kids Around the World-to serve as a catalyst for revitalizing the area surrounding our campus with homes, green space and commerce. A large part of this movement was a $100 million campus expansion and renovation project. Despite economic and strategic pressures to move eastward, as many businesses in our area have done, SwedishAmerican joined several other area organizations and made a commitment to remain in central Rockford. One immediate benefit of our redevelopment effort was the expansion of the hospital's emergency department. Among the state's busiest, this is where many of our community's underserved residents come for medical care. In order to improve the low rate of home ownership identified in the healthy community studies, SwedishAmerican initiated a Neighborhood Revitalization Program in an 81-block area adjacent to our hospital campus. Working with the City of Rockford and local Habitat for Humanity officials, we have replaced substandard dwellings with new Habitat homes. Additionally, we partnered with the William Charles Charitable Trust and Kids Around the World to build a new playground that allows neighborhood children the opportunity for play, without having to cross major thoroughfares and traffic hazards. In the past decade, the SA Foundation purchased two, 12-unit apartment buildings adjacent to the hospital campus which were in a state of disrepair. Approximately three-quarters of a million dollars were invested in these two buildings to bring them to "market rate" status. Encouraged by our commitment to renovate our campus and revitalize the surrounding area, a number of commercial developments have occurred. Among them is a Walgreens' drug store, which returned retail pharmacy services to the area for the first time in years. A three-story office building south of the new Walgreens' was completed, followed by a 60,000-square-foot medical office building south of the hospital. SwedishAmerican has sought to improve the community's health by taking effective lifestyle modification programs to the people who need them most. Although this applies to the community at large, we have taken special efforts to bring these strategies to the city's elderly and underserved residents. This is demonstrated by our successful program to improve the health of residents at Longwood Plaza, a senior housing facility located two blocks from our hospital's campus. Finally, beyond lifestyle modification our ongoing community health initiatives involve research-based health screening programs, as well as unique health education events that target both at-risk members of the community and healthcare providers. SwedishAmerican's organization-led efforts to improve the quality of life in our community are not exclusively health-related. One example is the partnership we formed twenty years ago with nearby public schools, where a very high percentage of the students come from underserved families. The long-term and ongoing goal of our partnership with area schools has been to improve the academic and socio-emotional wellbeing of the school environment and student body. While SwedishAmerican has come forward with a number of ideas and proposals for additional ways in which it can impact the students and faculty at area schools, it always has been sensitive to the wishes and desires of the community in implementing only those programs that correspond with the school's agenda and strategic goals. Beyond large-scale, organization-led initiatives, our employees independently devote extensive amounts of time and resources to a large number of programs, services and activities throughout northern Illinois.
Part VI, Line 6:	SA Hospital a division of UW Health offers services at two acute care hospital facilities, physician clinics, physician emergency services, and home health care. SwedishAmerican Foundation is a subsidiary of SA Hospital and supports it through fundraising activities.Following a campus renovation project that began in 2000, the SwedishAmerican Foundation (SAF) implemented a massive neighborhood revitalization and replacement initiative to transform a large area surrounding the hospital campus into "a neighborhood of choice...not chance." This project brought together the forces of SwedishAmerican, SAF, the City of Rockford and countless charitable and commercial entities to improve the quality and availability of area housing. In March of 2015 the program was recognized by The United Way of Rock River Valley with the inaugural Strong Neighbor Award. Because strong neighborhoods make a strong community, United Way is leading a place-based strategy that will dramatically improve the quality of life for children and families. Two of the region's most challenged neighborhoods (Ellis Heights and Midtown District) are the strategic focus of this plan. SwedishAmerican was cited for being a vital partner to the Strong Neighborhoods initiative and for building better neighborhoods for our children and families. United Way noted SwedishAmerican's commitment to transforming the area surrounding the Hospital from an at-risk, predominantly rental-occupied part of Rockford to a stable, owner-occupied neighborhood.SwedishAmerican's neighborhood revitalization effort includes:Habitat for Humanity Homes: Several years ago SwedishAmerican entered into a formal agreement with the Rockford Habitat for Humanity Chapter to construct new area homes. By the end of 2015, dozens of Habitat for Humanity homes have now been completed and sold to low-income home owners who qualify through Habitat For Humanity. Habitat For Humanity now holds annual application seminars on SwedishAmerican campus for our employees and members of the neighborhood.Midtown Community Work Day: In June 2016 SwedishAmerican Foundation collaborated and co-sponsored the first annual Midtown Community work day. Together with Rockford Habitat for Humanity and Thrivent Financial we initiated an exterior home improvement grant application for Midtown District homeowners. This was a one day event that utilized volunteers from Swedes, Habitat, Rockford Police, Thrivent, East High School, Rockford Fire and community members to work with grant recipients to help complete exterior repairs to six homes which totaled $15,000 of improvements to the community - all in just one day! Neighborhood Playground and Parks: Because area children did not have a safe place to play, SAF purchased three contiguous pieces of property, removed existing commercial and residential structures and partnered with two local charities to construct a new neighborhood playground. Since the completion of these projects, SwedishAmerican Foundation maintains their appearances with regular visits from our landscaping company. This ensures we maintain the beauty of the parks and playgrounds for our neighborhood to enjoy. Homeowner Grants to Employees: Since 2004, SwedishAmerican has offered $5,000 down payment assistance to employees to help encourage home ownership in the six-block area surrounding the hospital. This initiative includes a five-year forgivable grant to employees in good standing-with no income restrictions and a second possible $5,000 grant for low-income employees. Since inception, this program has assisted 33 employees purchase homes in the SwedishAmerican neighborhood.Home Restoration: Since inception of the Neighborhood Revitalization Program, SAF has purchased dozens of homes in the neighborhood target area, rehabbed them and made them available to employees, firefighters, police officers and public school teachers, at discount (less than the cost of purchase and repairs). This year, through a competitive process, 14 additional properties were identified and work completed. To date, 70 50/50 property improvement projects have taken place. Other completed projects include: - 3 new construction homes - 28 rehab houses by SAF - 23 Habitat for Humanity houses rehabbed with SAF - 2 apartment buildings rehabbed (24 units) - 2 duplexes rehabbed (4 units) - 16 grants for new garages/driveways - 32 houses purchased in the neighborhood by SwedishAmerican employeesStrong Neighborhood House:This year, SwedishAmerican collaborated with the Rockford Police Department and City of Rockford to open the first-ever community "Strong Neighborhood House." SwedishAmerican purchased and renovated the house and licensed it to the Rockford Police Department as a place for officers to build a closer relationship with neighbors. Additionally, it is a space where officers can help facilitate problem solving and ultimately reduce crime in the neighborhood. The house has set office hours each morning, Monday through Friday. Officers patrol the neighborhood throughout the day and evening and stop by the house at any time. Showing a strong police presence in the neighborhood is giving residents a hope for change and a better future.Over the last year the Rockford Community Police Officer has been working hard to increase programing and utilization of the house to better serve the needs of the neighborhood. Jackson Oaks Neighborhood Association holds monthly meetings at the Strong House along with The Fatherhood Project, Girl Scouts, and La Voz Latina. United Way and Goodwill also host special programs throughout the year, more specifically during times when children have a "no school day". SwedishAmerican Foundation will continue to collaborate with the Rockford Police Department to grow these programs and introduce new programs in years to come. Lifestyle Medicine and Wellness Programs:SwedishAmerican is committed to building a healthier community of senior adults. More than a decade ago, the health system and ZION Development Corporation began discussing the unique health needs of low-income senior residents living at Longwood Plaza, a 65-unit facility located two blocks from SwedishAmerican Hospital's campus. The two partners wanted to not only provide a way for seniors to have safe housing; they also wanted to equip residents with the tools and education for living healthier lives. With the assistance of a generous donation by the Walter D. Williams estate, SwedishAmerican and ZION created a wellness program to meet the needs of seniors' right where they lived.The wellness program involves three components: assessment, data analysis and program implementation. SwedishAmerican developed the program, set the budget, established staffing needs and recruited initial participants. Participants are then screened for blood pressure, cholesterol, blood sugar, weight and body mass index measurements. Health and diet histories also were completed at this time. Data was later compiled and analyzed, the program was further developed and staff was hired. Every week, participants are encouraged to meet with a Licensed Clinical Professional Counselor, Registered Nurse, Personal Trainer, Licensed Massage Therapist and attend exercise class twice a week. In the initial project, on-site services began for 34 participants. Each participant met individually with staff members to discuss recent changes in health status and completed stress, depression and hostility scales. Those who did not have a primary care physician were referred to a doctor for an initial physical. Individuals at high risk of depression were identified and given initial consultations with specially trained registered nurses. Participants met with a licensed dietitian to review specific nutritional needs and selected one or two nutritional goals that encouraged optimal health and that could be measured in future screenings. Nutrition and exercise classes also began meeting weekly and biweekly, respectively, at Longwood Plaza.Every year, participants are required to complete a Health Risk Assessment, Biometric Screen and Program Satisfaction Survey. Based on this data, programming for the upcoming year is planned/appropriate staff is hired.Because of the "food desert created when a grocery store left the area several years ago, participants receive $10 worth of fresh fruits and vegetables every week as an incentive for participation.
Part VI, Line 6 Continued:	Results for FY2015-2016:To track health and wellness, participants complete biometric tests (cholesterol, weight, blood pressure and glucose), diet diaries and psychosocial testing at the start of the program and every year thereafter. This year's results include: - Body Mass Index: 25% (5/20) improved - Triglycerides: 20% (4/20) reduced triglyceride to normal range - Fasting Blood Sugar: 15% (3/20) improved their level to normal range - Blood Pressure: 45% (9/20) reduced their blood pressure to normal rangeStaff continues to receive positive comments about the benefits of the wellness program. The objective data appears to support these positive remarks. Goals have been set for FY 2016-2017 to continue to increase individual healthy changes.Better Life Wellness/YMCA Partnership:SwedishAmerican created a medical wellness center called BetterLife Wellness within the downtown Rockford YMCA. The center offers a variety of services for members and the general public, including: - Wellness educational programs, classes and support groups - Screenings and health risk assessments - Personal health coaching - Weight management programs - Therapeutic massages, Reiki and reflexology - Healthy cooking classes and grocery tours - Smoking cessation classes - Relaxation and stress management education - Healthy Heart screensBetterLife expands our capacity to help people of all ages, physical abilities and limitations lead healthier lives. Our unique holistic health experience and expertise will be incorporated into the individualized wellness prescriptions and coaching offered to our participants. The powerful combination of active medical oversight, experienced and credentialed staff, and the utilization of an individual's personal health status are intended to reduce health risks, improve well-being and bring a measureable impact upon improving the overall health of our community.
Part VI Line 7:	SA Hospital files a community benefit report with the Illinois Attorney General.

Schedule H (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," on Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
SwedishAmerican Hospital

Employer identification number
36-2222696

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ........................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" on Form 990, Part IV, line 21, for any recipient

that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(e) Amount of non-cash assistance	(f) Method of valuation (book, FMV, appraisal, other)	(g) Description of non-cash assistance	(h) Purpose of grant or assistance

(1) Illinois Hospital Research & Education Foundation
1151 East Warrenville Road
Naperville,IL60566

23-7421930

501(c)(3)

169,320

Quality Healthcare for Illinois

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................. Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

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

Cat. No. 50055P

Schedule I (Form 990) 2015

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" on Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a) Type of grant or assistance	(b) Number of recipients	(c) Amount of cash grant	(d) Amount of non-cash assistance	(e) Method of valuation (book, FMV, appraisal, other)	(f) Description of non-cash assistance

(1) Scholarship - educational scholarship for children of non-management employees.	24	24,000
(1)
(2)
(3)
(4)
(5)
(6)
(7)

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
Part I, Line 2:	IHREF is a tax exempt research entity. SA Hospital works closely with grantee organizations or receives reports from them as appropriate.

Schedule I (Form 990) 2015

Additional Data

Software ID:
Software Version:

- 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

SwedishAmerican Hospital

Employer identification number

36-2222696

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 .........

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? ..

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? ................

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

Yes

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)
1William R Gorski MDPresident & CEO	(i) (ii)	722,446 ------------- 0	354,373 ------------- 0	224,877 ------------- 0	276,126 ------------- 0	19,482 ------------- 0	1,597,304 ------------- 0	224,877 ------------- 0
2Danny L Copeland MDTrustee	(i) (ii)	203,751 ------------- 0	0 ------------- 0	0 ------------- 0	15,890 ------------- 0	28,388 ------------- 0	248,029 ------------- 0	0 ------------- 0
3Michael E DallmanTrustee	(i) (ii)	0 ------------- 308,427	0 ------------- 27,813	0 ------------- 0	0 ------------- 25,740	0 ------------- 18,511	0 ------------- 380,491	0 ------------- 0
4Allen Williams MDTrustee	(i) (ii)	263,306 ------------- 0	0 ------------- 0	0 ------------- 0	18,910 ------------- 0	33,579 ------------- 0	315,795 ------------- 0	0 ------------- 0
5Robert FlanneryTrustee	(i) (ii)	0 ------------- 439,446	0 ------------- 33,374	0 ------------- 0	0 ------------- 34,851	0 ------------- 24,381	0 ------------- 532,052	0 ------------- 0
6Peter ChristmanTrustee (until Sept 2015)	(i) (ii)	0 ------------- 700,533	0 ------------- 48,445	0 ------------- 0	0 ------------- 34,851	0 ------------- 23,816	0 ------------- 807,645	0 ------------- 0
7Patricia DeWaneChief Financial Officer	(i) (ii)	245,820 ------------- 0	45,573 ------------- 0	9,462 ------------- 0	39,552 ------------- 0	6,150 ------------- 0	346,557 ------------- 0	0 ------------- 0
8Donald DanielsChief Operating Officer	(i) (ii)	354,793 ------------- 0	137,405 ------------- 0	0 ------------- 0	73,709 ------------- 0	19,148 ------------- 0	585,055 ------------- 0	0 ------------- 0
9Donald HaringChief Financial Officer (until 1/4)	(i) (ii)	412,934 ------------- 0	159,400 ------------- 0	42,992 ------------- 0	67,347 ------------- 0	17,352 ------------- 0	700,025 ------------- 0	42,992 ------------- 0
10Kathy Kelly MDChief Clinical Integration Officer	(i) (ii)	340,073 ------------- 0	123,542 ------------- 0	27,943 ------------- 0	49,596 ------------- 0	2,132 ------------- 0	543,286 ------------- 0	0 ------------- 0
11Michael J Born MDChief Medical Officer	(i) (ii)	333,248 ------------- 0	87,473 ------------- 0	0 ------------- 0	33,355 ------------- 0	18,293 ------------- 0	472,369 ------------- 0	0 ------------- 0
12Harvey Einhorn MDPhysician	(i) (ii)	672,509 ------------- 0	0 ------------- 0	0 ------------- 0	21,200 ------------- 0	41,360 ------------- 0	735,069 ------------- 0	0 ------------- 0
13Howard Kaufman DOPhysician	(i) (ii)	591,479 ------------- 0	0 ------------- 0	0 ------------- 0	16,015 ------------- 0	34,409 ------------- 0	641,903 ------------- 0	0 ------------- 0
14Mohamed Zeater MDPhysician	(i) (ii)	691,901 ------------- 0	0 ------------- 0	0 ------------- 0	7,950 ------------- 0	39,644 ------------- 0	739,495 ------------- 0	0 ------------- 0
15Merat Karbasian-Esfahani MDPhysician	(i) (ii)	696,044 ------------- 0	0 ------------- 0	0 ------------- 0	16,033 ------------- 0	45,451 ------------- 0	757,528 ------------- 0	0 ------------- 0
16Steven Milos MDPhysician	(i) (ii)	661,851 ------------- 0	0 ------------- 0	0 ------------- 0	16,033 ------------- 0	37,512 ------------- 0	715,396 ------------- 0	0 ------------- 0
17Richard WalshFormer Chief Operating Officer	(i) (ii)	84,460 ------------- 0	47,600 ------------- 0	548,022 ------------- 0	1,208 ------------- 0	16,605 ------------- 0	697,895 ------------- 0	428,444 ------------- 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
Part I, Line 3	All compensation is determined by SwedishAmerican Health System and is paid by SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the President, CEO, and Officers, SwedishAmerican Health System follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by the SA Hospital's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes. All physician compensation arrangements are approved by the Finance Committee and full Board of Directors using comparability data, and are contemporaneously documented in the minutes.
Part I, Line 4b	Compensation for the plan year 2015 include: William Gorski M.D. 457(f) - $236,926; Donald Haring 457(f) - $46,147; Donald Daniels 457(f) - $35,274; Kathleen Kelly M.D. 457(f) - $28,396; Michael Born M.D. 457(f) - $26,465; Patricia DeWane 457(f) - $20,155. Contributions to the 457(f) plan during 2015 include: William Gorski, M.D. - $236,925; Donald Haring - $46,147; Donald Daniels - $35,274; Patricia DeWane - $20,155; Kathleen Kelly M.D. - $28,396; Michael Born M.D. - $26,465. Payments from the 457(f) plan during 2015 include: William Gorski, M.D. - $224,877; Richard Walsh - $548,022; Donald Haring - $42,992. These payments are reported as taxable income on Part II, column (B)(iii).
Part I, Line 7	SwedishAmerican Hospital has a formal plan for short term incentives and bonuses. The incentives are paid based on a combination of both individual goal achievement and corporate goal achievement (i.e. the Pillar goals). The executive compensation committee, comprised of board members, has discretion to approve the incentives and bonuses.
Part II, Column F:	The amounts shown in column F were reported as deferred compensation in prior years but paid out in the current year. The amounts are also included in column B(iii).

Schedule J (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule K
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information on Tax Exempt Bonds

Complete if the organization answered "Yes" to Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
SchKMediumBullet

Attach to Form 990.
SchKMediumBullet

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

OMB No. 1545-0047

2015

Open to Public
Inspection

Name of the organization
SwedishAmerican Hospital

Employer identification number
36-2222696

Part I

Bond Issues

(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	(g) Defeased		(h) On behalf of issuer		(i) Pool financing
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued	(e) Issue price	(f) Description of purpose	Yes	No	Yes	No	Yes	No
A	Illinois Finance Authority - 2010	86-1091967		04-19-2010	25,000,000	See Part IV		X		X		X
B	Illinois Finance Authority - 2012	86-1091967	45203HLW0	09-27-2012	41,833,485	See Part IV		X		X		X
C	Illinois Finance Authority - 2015	86-1091967	45203HY89	03-27-2015	76,980,000	See Part IV		X		X		X

Part II

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	7,500,000				3,135,000
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	25,000,000		41,888,629		76,980,000
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............			648,001
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			41,240,628
11 Other spent proceeds .............	25,000,000				76,980,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2010		2013		2007
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue? ....		X		X		X
15 Were the bonds issued as part of an advance refunding issue? .....	X			X	X
16 Has the final allocation of proceeds been made? ..........	X			X	X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X		X

Part III

Private Business Use

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds? .............		X		X		X
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............		X		X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2015

Page 2

Part III

Private Business Use (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		X	X			X
b If "Yes" to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?			X
c Are there any research agreements that may result in private business use of bond-financed property? .............		X		X		X
d If "Yes" to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4 Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government ....			1.850 %
5 Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government .........
6 Total of lines 4 and 5 .............			1.850 %
7 Does the bond issue meet the private security or payment test? ...		X		X		X
8a Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?.............		X		X		X
b If "Yes" to line 8a, enter the percentage of bond-financed property sold or disposed of. ..
c If "Yes" to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2? .............
9 Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2? ........	X		X		X

Part IV

Arbitrage

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
1 Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate? ...		X		X		X
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X	X			X
b Exception to rebate? ........	X			X	X
c No rebate due? .........		X		X		X
If "Yes" to line 2c, provide in Part VI the date the rebate computation was performed ......
3 Is the bond issue a variable rate issue? .....		X		X		X
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........

Schedule K (Form 990) 2015

Page 3

Part IV

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		X		X		X
b Name of provider ..........
c Term of GIC .........
d Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied? ........
6 Were any gross proceeds invested beyond an available temporary period?		X		X		X
7 Has the organization established written procedures to monitor the requirements of section 148? ...	X		X		X

Part V

Procedures To Undertake Corrective Action

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation is not available under applicable regulations?	X		X		X

Part VI

Supplemental Information. Provide additional information for responses to questions on Schedule K (see instructions).

Return Reference	Explanation
Part II, Line 7:	Bond insurance of $3,672,397 was purchased from bond proceeds and is included as a cost of issuance.
Part I, column (f):	2010 Bond: Construction & Equipment Cardiac pavilion, renovate operating room & catheterization lab completed in 2007. Bond was re-issued in 2010 as a direct bank placement. 2012 Bond: Construction & Equipment Regional Cancer Center 2015 Bond: Construction & Equipment Cardiac pavilion, renovate operating room & catheterization lab completed in 2007. The bond was remarketed on 3/27/15.

Schedule K (Form 990) 2015

Additional Data

Software ID:
Software Version:

- TIN:

Schedule L
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Transactions with Interested Persons

Complete if the organization answered
"Yes" on Form 990, Part IV, lines 25a, 25b, 26, 27, 28a, 28b, or 28c,
or Form 990-EZ, Part V, line 38a or 40b.
MediumBullet

Attach to Form 990 or Form 990-EZ.
MediumBullet

Information about Schedule L (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

SwedishAmerican Hospital

Employer identification number

36-2222696

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and 501(c)(29) organizations only).
Complete if the organization answered "Yes" on Form 990, Part IV, line 25a or 25b, or Form 990-EZ, Part V, line 40b.

1(a) Name of disqualified person	(c) Description of transaction	(d) Corrected?
1(a) Name of disqualified person	(c) Description of transaction	Yes	No

Enter the amount of tax incurred by organization managers or disqualified persons during the year under section 4958. ........................... Bullet Image

Enter the amount of tax, if any, on line 2, above, reimbursed by the organization ........ Bullet Image

Part II

Loans to and/or From Interested Persons.
Complete if the organization answered "Yes" on Form 990-EZ, Part V, line 38a, or Form 990, Part IV, line 26; or if the organization reported an amount on Form 990, Part X, line 5, 6, or 22

(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	(d) Loan to or from the organization?		(e)Original principal amount	(f)Balance due	(g) In default?		(h) Approved by board or committee?		(i)Written agreement?
(a) Name of interested person	(b) Relationship with organization	(c) Purpose of loan	To	From	(e)Original principal amount	(f)Balance due	Yes	No	Yes	No	Yes	No










Total ............... $

Part III

Grants or Assistance Benefiting Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 27.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of assistance	(d) Type of assistance	(e) Purpose of assistance

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

Cat. No. 50056A

Schedule L (Form 990 or 990-EZ) 2015

Page 2

Part IV

Business Transactions Involving Interested Persons.
Complete if the organization answered "Yes" on Form 990, Part IV, line 28a, 28b, or 28c.

(a) Name of interested person	(b) Relationship between interested person and the organization	(c) Amount of transaction	(d) Description of transaction	(e) Sharing of organization's revenues?
(a) Name of interested person		(c) Amount of transaction	(d) Description of transaction	Yes	No
(1) Sheryl Head	Robert L. Head, PhD, Trustee, Spouse	111,629	Employee compensation		No

Part V

Supplemental Information
Provide additional information for responses to questions on Schedule L (see instructions).

Return Reference	Explanation

Schedule L (Form 990 or 990-EZ) 2015

Additional Data

Software ID:
Software Version:

- 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

SwedishAmerican Hospital

Employer identification number

36-2222696

Return Reference	Explanation
Form 990, Part VI, Section A, line 4	The bylaws were amended on October 1, 2015 to include a new description for the members of the Executive Committee. The Executive Committee shall consist of the same individuals who serve as the members of the Executive Committee of SwedishAmerican Health System Corporation.
Form 990, Part VI, Section A, line 6	SwedishAmerican Health System (Parent Corporation) is the sole corporate member of SwedishAmerican Hospital (Hospital).
Form 990, Part VI, Section A, line 7a	SwedishAmerican Health System (Parent Corporation) is the sole corporate member of SwedishAmerican Hospital (Hospital) and as such appoints all trustees.
Form 990, Part VI, Section A, line 7b	SwedishAmerican Health System (Parent Corporation) is the sole corporate member of SwedishAmerican Hospital (Hospital) and as such appoints all trustees and has the authority to approve certain decisions of the Hospital.
Form 990, Part VI, Section B, line 11	A draft version of the Form 990 was reviewed by legal counsel and the Chief Financial Officer. Subsequently, the Audit/Compliance Committee of the Board of Directors of SwedishAmerican Health System (Parent Corporation) reviewed a final draft of the Form 990 and was provided with the opportunity to comment and ask questions. The entire Board of Directors was provided with a copy of the Form 990 before it was filed.
Form 990, Part VI, Section B, line 12c	The organization regularly and consistently monitors and enforces compliance with its conflict of interest policies, which apply to all members of the board of directors and to all employees. Procedures are in place to identify conflicts of both directors and employees. Director conflicts are handled by board deliberation and board vote from which the interested director is excluded. Employee conflicts are handled by the compliance department and in certain instances may require separate board action. The Board is provided with periodic compliance reports regarding conflicts of interest.
Form 990, Part VI, Section B, line 15	All compensation is determined by SwedishAmerican Health System and is paid by SwedishAmerican Hospital. All compensation decisions are made by independent persons. With respect to the president, CEO, and officers, and key employees, SwedishAmerican Health System follows a compensation approval procedure annually that involves approval of proposed and final compensation arrangements by the organization's Executive Compensation Committee using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes. All physician compensation arrangements are approved by the Finance Committee and full Board of Directors using comparability data, as well as contemporaneous documentation of compensation decisions in the minutes.
Form 990, Part VI, Section C, line 19	The governing documents, conflict of interest policy and financial statements have not been previously made available to the public. The consolidated audited financial statements of SwedishAmerican Hospital are available from the Illinois Attorney General Website and from the U.S. Securities and Exchange Commission electronic municipal market access system.
Form 990, Part XI, line 9:	Interest in Recipient Organization -476,619. Surgi Center Book/Tax Difference -58,603. Decrease Due to Merger -31,825. SwedishAmerican Foundation -187,330.

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:
Software Version:

- 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

SwedishAmerican Hospital

Employer identification number

36-2222696

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)University of WI Hospital and Clinics 600 Highland Avenue Madison,WI53792 39-1835630	Hospital and Clinics	WI	501(c)(3)	Line 3	N/A		No
(2)University of WI Medical Foundation 600 Highland Avenue Madison,WI53792 39-1824445	Supported Organization	WI	501(c)(3)	Line 9	University of WI Hospital and Clinics		No
(3)Regional Division Inc 301 South Westfield Road Suite 320 Madison,WI53717 39-1446049	Regional Parent Corporation to manage and direct activities of entities	WI	501(c)(3)	Line 11a	University of WI Hospital and Clinics		No
(4)University Health Care Inc 301 South Westfield Road Madison,WI53717 47-2553196	Support Organization	WI	501(c)(3)	Line 11a	University of WI Hospital and Clinics		No
(5)SwedishAmerican Health System Corporation 1401 East State Street Rockford,IL61104 36-3241458	Parent Corporation to manage and direct activites of entities	IL	501(c)(3)	Line 11a	Regional Division Inc		No
(6)SwedishAmerican Foundation 1401 East State Street Rockford,IL61104 36-3097493	Supporting Organization for SwedishAmerican Hospital fundraising	IL	501(c)(3)	Line 7	SwedishAmerican Hospital	Yes
(7)SwedishAmerican Realty Corporation 1313 East State Street Rockford,IL61104 36-3248013	Title Holding Company	IL	501(c)(2)		SwedishAmerican Health System Corporation		No
(8)SwedishAmerican Hospital Self Insurance Trust 1401 East State Street Rockford,IL61104 36-6652702	Hospital Malpractice Trust	VT	501(c)(3)	Line 11a	SwedishAmerican Hospital	Yes
(9)Wisconsin Therapies Inc 600 Highland Avenue Madison,WI53792 39-1807425	Support Organization	WI	501(c)(3)	Line 11d	University of WI Hospital and Clinics		No
(10)Generations Fertility Care 2365 Deming Way Middleton,WI53562 27-3496527	Reproductive endocrinology and infertility services	WI	501(c)(3)	Line 9	N/A		No
(11)Wisconsin Dialysis 3034 Fish Hatchery Road Fitchburg,WI53713 30-0072647	Dialysis Services	WI	501(c)(3)	Line 11c	N/A		No
(12)Madison Surgery Center 7974 UW Health Court Middleton,WI53562 39-1940656	Health care services and training	WI	501(c)(3)	Line 9	N/A		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	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(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?		(k) Percentage ownership
(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
(1) Three Rivers Partners LLC 1313 East State Street Rockford,IL61104 26-2231757	Information Technology Services	IL	N/A	N/A				No			No
(2) Northern Illinois Vein Clinic 2550 Charles Street Rockford,IL61108 20-1642329	Outpateint Health Services	IL	N/A	RELATED	113,321	58,281		No		Yes		50.000 %
(3) Chartwell Wisconsin Enterprises LLC 2241 Pinehurst Drive Middleton,WI53562 39-1796267	Parent entity of CMW and CMW-HR	WI	N/A	N/A				No			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) SARI Insurance Company 76 St Paul Street Suite 500 Burlington,VT054014477 03-0308753	Captive Insurance Company	VT	SAHS Corporation	C			Yes
(2) LSG Building Corporation 1313 East State Street Rockford,IL61104 36-3033985	Real Estate	IL	SAHS Corporation	S			Yes
(3) State & Charles Inc 1313 East State Street Rockford,IL61104 36-3321193	Holding Company	IL	SAHS Corporation	C			Yes
(4) SwedishAmerican Health Management Corp 1313 East State Street Rockford,IL61104 36-3246511	Management Services	IL	State & Charles Inc	C			Yes
(5) Physician's Care Network 1313 East State Street Rockford,IL61104 36-3455791	Health Services	IL	State & Charles Inc	C			Yes
(6) Unity Health Insurance 840 Carolina Street Sauk City,WI53583 39-1450766	Health Maintenance Organization	WI	University Health Care Inc	C			Yes
(7) Health Professionals of Wisconsin 301 South Westfield Road Madison,WI53717 39-1806711	Real Estate	WI	University Health Care Inc	C			Yes

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) ............................

Yes

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

Yes

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) .......................

Yes

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

Yes

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) ...................

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

Yes

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

Yes

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) ............................

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) SwedishAmerican Foundation	C	187,330	Cost
(2) SwedishAmerican Self Insurance Trust	Q	903,000	Cost
(3) SwedishAmerican Self Insurance Trust	R	4,150,000	Cost
(4) SwedishAmerican Realty Corporation	K	6,624,790	Cost
(5) TriRivers Partners LLC	J	292,811	Cost
(6) SwedishAmerican Realty Corporation	D	109,499	Cost
(7) University Health Care Inc	P	1,816,126	Cost
(8) University of WI Medical Foundation	P	2,022,600	Cost
(9) University of WI Hospital and Clinics	P	559,892	Cost
(10) Regional Division Inc	J	569,535	Cost
(11) Regional Division Inc	Q	464,516	Cost

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:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: Through excellence in healthcare and compassionate service, we care for our community.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	27
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	21
5	Total number of individuals employed in calendar year 2015 (Part V, line 2a) ......	5	3,449
6	Total number of volunteers (estimate if necessary) .............	6	265
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	214,746
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	87,822

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	179,492	1,350,615
9	Program service revenue (Part VIII, line 2g) .........	40,142,419	512,634,446
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	356,336	6,079,924
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	349,289	4,608,476
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	41,027,536	524,673,461
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	193,320
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	18,598,880	242,130,283
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	20,434,939	268,254,806
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	39,033,819	510,578,409
19	Revenue less expenses. Subtract line 18 from line 12.......	1,993,717	14,095,052
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	678,988,654	692,738,272
21	Total liabilities (Part X, line 26).............	252,743,465	252,114,223
22	Net assets or fund balances. Subtract line 21 from line 20.....	426,245,189	440,624,049

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 268,384,524 including grants of $ 193,320 ) (Revenue $ 395,863,097 )
	SwedishAmerican Hospital (SAH) operates two full service acute care hospitals with a combined total of 367 licensed beds serving the greater Rockford region, Northern Illinois and Southern Wisconsin. Our vision is to develop a fully integrated healthcare delivery network that will continuously set the standard for quality care and service, accept responsibility for building a healthier population, provide regional access, improve resource utilization through collaboration with key stakeholders, and manage patient care and our resources in such a way that we create value for our patients and benefit for our community. During 2016, we cared for 17,533 inpatients and performed 848,298 outpatient procedures. This includes 86,580 emergency room visits and 2,443 deliveries. We sponsor the University of Illinois - College of Medicine Program and provided $5.9 million in education for primary care residents. Our employees and volunteers provided over 38,000 hours in unpaid community services. SwedishAmerican recognizes its responsibility to all the people of our community, regardless of their ability to pay for care.

4b	(Code: ) (Expenses $ 79,134,008 including grants of $ ) (Revenue $ 65,577,118 )
	SwedishAmerican Hospital employs primary care and specialty physicians who practice at 28 locations throughout our service area. We employ specialists in orthopedics, cardiology, cardiothoracic surgery, endocrinology, allergy, neurology, neurosurgery, pulmonology/critical care, hematology/oncology, obstetrics and gynecology, maternal fetal medicine, rheumatology, psychiatry, podiatry, otolaryngology, as well as internal medicine, family practice, immediate care and pediatric physicians. During 2016 our physician encounters were 362,499.

4c	(Code: ) (Expenses $ 38,636,435 including grants of $ ) (Revenue $ 48,206,019 )
	SwedishAmerican Regional Cancer Center opened to the public in October 2013. The center is part of a collaboration with UW Health and its nationally recognized University of Wisconsin Carbone Cancer Center. The two-story facility offers radiation therapy, medical oncology, chemotherapy and infusion services. Patients have access to clinical trials, state-of-the-art linear acceleratory treatments such as IGRT, IMRT, Rapid Arc, OBI and stereotactic services, and advanced medical imaging. The Regional Cancer Center is staffed by medical and radiation oncologists, physicists, dosimetrists, radiation therapists and nurses. During 2016 our out-patient encounters were over 23,561.

	(Code: ) (Expenses $ 7,584,449 including grants of $ ) (Revenue $ 7,352,235 )
	SwedishAmerican Home Health Care is a quality leader in providing individualized care in patients' homes. Working in partnership with a patient's doctor, our certified, trained staff provides a wide range of services and specializes in helping patients to remain independent and comfortable. Our experienced caregivers include registered nurses; certified nursing assistants, dietitians; physical, occupational and speech therapists; and medical social workers. RNs provide assessments, treatments and medication administration. Our therapists provide assessments and treatments. Medical social workers assist with assessments, counseling and helping patients and their families' access available community resources. SNAs provide baths and personal grooming. Our staff has the credentials and advanced training needed to assure that patients receive the highest quality of care possible. During 2016 we performed 29,456 episodes of care.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 7,584,449 including grants of $ ) (Revenue $ 7,352,235 )
4e	Total program service expenses393,739,416

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	8,095,277	1,558,038	1,174,579

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	187,330
e	Government grants (contributions)		1e	1,163,285

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.......		1,350,615

			Business Code
2a	Patient Services	621990	342,376,718	342,376,718
b	Medicare/Medicaid	621990	168,232,850	168,232,850
c
d
e
f	All other program service revenue.			2,024,878	2,024,878
g Total.Add lines 2a–2f.....			512,634,446

3 Investment income (including dividends, interest, and othersimilar amounts) ..........			7,458,158			7,458,158
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents		112,472
b	Less: rental expenses		82,765
c	Rental income or (loss)		29,707
d	Net rental income or (loss)......			29,707			29,707
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory	361,870	91,355,274
b	Less: cost or other basis and sales expenses	732,119	92,363,259
c	Gain or (loss)	-370,249	-1,007,985
d	Net gain or (loss).....			-1,378,234			-1,378,234
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	Cafeteria & Vending		561000	1,517,407	1,508,476	8,931
b	Day Care Center		624410	1,513,298	1,513,298
c	Interdept. Billing		900099	1,342,249	1,342,249
d	All other revenue ....			205,815		205,815
e	Total. Add lines 11a–11d ......			4,578,769
12	Total revenue. See Instructions......			524,673,461	516,998,469	214,746	6,109,631

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21	169,320	169,320
2	Grants and other assistance to individuals in the United States. See Part IV, line 22	24,000	24,000
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 ....	5,778,450	556,796	5,221,654
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	182,190,043	139,337,517	42,852,526
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	8,122,593	6,737,815	1,384,778
9	Other employee benefits .......	33,666,894	26,479,602	7,187,292
10	Payroll taxes ...........	12,372,303	9,102,400	3,269,903
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	1,595,465	52,949	1,542,516
c	Accounting ...........	177,768		177,768
d	Lobbying ...........	248,949		248,949
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	508,014		508,014
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	44,699,080	30,681,977	14,017,103
12	Advertising and promotion ....	2,934,544	90,406	2,844,138
13	Office expenses .......	9,067,644	5,862,387	3,205,257
14	Information technology ......	6,492,567	5,966,833	525,734
15	Royalties ..
16	Occupancy ...........	16,168,567	8,963,986	7,204,581
17	Travel ............	278,644	230,198	48,446
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	662,149	225,991	436,158
20	Interest ...........	2,919,523	602,060	2,317,463
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	24,616,449	20,162,700	4,453,749
23	Insurance ...	10,260,772	2,303,453	7,957,319
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	Patient Supplies	85,004,857	84,355,503	649,354
b	Bad Debts	33,591,411	33,591,411
c	IPA Provider Tax	11,073,107	11,073,107
d	Repairs & Maintenence	8,466,399	5,801,383	2,665,016
e	All other expenses	9,488,897	1,367,622	8,121,275
25	Total functional expenses. Add lines 1 through 24e	510,578,409	393,739,416	116,838,993	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 ........				1
2	Savings and temporary cash investments .........			30,206,767	2	16,485,197
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			63,840,136	4	71,565,153
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
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
7	Notes and loans receivable, net ....			7,078,539	7	75,000
8	Inventories for sale or use ........			9,550,795	8	9,586,404
9	Prepaid expenses and deferred charges ......			11,919,956	9	15,005,294
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	332,465,126
b	Less: accumulated depreciation	10b	35,100,653	298,291,188	10c	297,364,473
11	Investments—publicly traded securities .			230,393,079	11	249,167,469
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..			1,754,592	13	2,092,767
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			25,953,602	15	31,396,515
16	Total assets. Add lines 1 through 15 (must equal line 34)...			678,988,654	16	692,738,272

17	Accounts payable and accrued expenses .....	50,266,590	17	47,273,462
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	133,123,242	20	127,783,413
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	69,353,633	25	77,057,348
26	Total liabilities. Add lines 17 through 25..	252,743,465	26	252,114,223

	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets	416,122,919	27	430,804,204
28	Temporarily restricted net assets ...........	3,905,562	28	3,968,728
29	Permanently restricted net assets	6,216,708	29	5,851,117
	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 ...........	426,245,189	33	440,624,049
34	Total liabilities and net assets/fund balances ........	678,988,654	34	692,738,272