TY 2023 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/1099-NEC)
(1) NOAH CARMICHAEL...................................................................... CHAIRPERSON	2.00 ................. 0.00	X	X	0	0
(2) JEFF GLEN...................................................................... VICE CHAIR	2.00 ................. 0.00	X	X	0	0
(3) BRENT OHLINGER...................................................................... TREASURER	2.00 ................. 0.00	X	X	0	0
(4) TODD PRUSATOR...................................................................... SECRETARY	2.00 ................. 0.00	X	X	0	0
(5) DIANE KENNEY...................................................................... PRESIDENT HOSPITAL AUX (TERM ENDED)	2.00 ................. 0.00	X		0	0
(6) MARIA VAN HISE...................................................................... PRESIDENT HOSPITAL AUXILIARY	2.00 ................. 0.00	X		0	0
(7) RENELLE CARMICHAEL...................................................................... CO- PRESIDENT HOSPITAL AUXILIARY	2.00 ................. 0.00	X		0	0
(8) ADRIANA MILAN...................................................................... TRUSTEE (TERM ENDED)	2.00 ................. 0.00	X		0	0
(9) GERI DEE HAYDEN...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0
(10) CRYSTAL DYER...................................................................... TRUSTEE	2.00 ................. 0.00	X		0	0
(11) KERRI VILLA-NANTZ...................................................................... TRUSTEE (TERM ENDED)	2.00 ................. 0.00	X		0	0
(12) JASON POPP MD...................................................................... CHIEF OF MEDICAL STAFF	40.00 ................. 0.00	X		242,144	43,216
(13) AJ QUERCIAGROSSA...................................................................... TRUSTEE - OSF HEALTHCARE	2.00 ................. 0.00	X		0	0
(14) SATHISH CULLATH MD...................................................................... CHIEF OF MEDICAL STAFF ELECT	40.00 ................. 0.00	X		0	0
(15) KAREN TRACY...................................................................... COO, CEO	40.00 ................. 5.00	X	X	275,079	35,592
(16) LORI GUTIERREZ...................................................................... CFO	40.00 ................. 5.00		X	207,671	7,441
(17) GREGORY A OLSON...................................................................... PAST CEO (RETIRED 3/2023)	40.00 ................. 0.00		X	425,306	10,460

(A) Name and business address	(B) Description of services	(C) Compensation
POINTCORE PO BOX 775982 CHICAGO,IL60677	CONTRACT SERVICES	1,063,968
PREMIER HEALTH GROUP LLC 921 KING CANYON DRIVE STREAMWOOD,IL60107	CONTRACT STAFFING	706,115
NOVUS ILLINOIS SERVICE COPRORATION PO BOX 12766 PENSACOLA,FL32591	ANESTHESIA PROFESSIONAL SERVICES	678,413
AUREUS RADIOLOGY LLC PO BOX 310856 DES MOINES,IA50331	RADIOLOGY STAFFING	597,285
EMERGENCY DEPT ASSOCIATES 7032 COLLECTION CTR DR CHICAGO,IL60693	ER STAFFING	587,946
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 25

- TIN:

SCHEDULE A
(Form 990)

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.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

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 12, 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).)

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 agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% 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 33 1/3% 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 on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

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) 2023

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 failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..
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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 5 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 2023 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2022 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2023. 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—2022. 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—2023. 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—2022. 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) 2023

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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) 2019	(b) 2020	(c) 2021	(d) 2022	(e) 2023	(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 on 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 5 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 2023 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2022 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2023 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2022 Schedule A, Part III, line 17 .............

19a

33 1/3% support tests-2023. 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—2022. 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) 2023

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, 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 lines 3b and 3c 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 box 12a or 12b in Part I, answer lines 4b and 4c 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 lines 5b and 5c 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) .

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

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 on 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 on 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) 2023

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 on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, 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 line 2 above, 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 lines 2a and 2b 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 on line 2a, above 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 lines 3a and 3b 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?If "Yes" or "No", 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) 2023

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 (explain in Part VI). 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 0.015 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 0.035	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) 2023

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	1
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity	2
3 Administrative expenses paid to accomplish exempt purposes of supported organizations	3
4 Amounts paid to acquire exempt-use assets	4
5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI)	5
6 Other distributions (describe in Part VI). See instructions	6
7Total annual distributions. Add lines 1 through 6.	7
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions	8
9 Distributable amount for 2023 from Section C, line 6	9
10 Line 8 amount divided by Line 9 amount	10

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2023	(iii) Distributable Amount for 2023
1 Distributable amount for 2023 from Section C, line 6
2 Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2023:
a From 2018.......
b From 2019.......
c From 2020.......
d From 2021.......
e From 2022.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2023 distributable amount
i Carryover from 2018 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2023 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2023 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2023, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2023. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2024. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2019.....
b Excess from 2020.....
c Excess from 2021.....
d Excess from 2022.....
e Excess from 2023.....

Schedule A (Form 990) (2023)

Schedule A (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

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

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Name of the organization

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

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. Don't 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 isn't covered by the General Rule and/or the Special Rules doesn't 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 doesn't 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) (2023)

Schedule B (Form 990) (2023) Page 2

Name of organization ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Part I Contributors	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) (2023)

Schedule B (Form 990) (2023)

Page 3

Name of organization ROCHELLE COMMUNITY HOSPITAL ASSOCIATION		Employer identification number 36-2548549

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) (2023)

Schedule B (Form 990) (2023)

Page 4


Name of organization ROCHELLE COMMUNITY HOSPITAL ASSOCIATION			Employer identification number 36-2548549
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) (2023)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990)

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

right arrow

Complete if the organization is described below. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

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

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

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. See instructions for definition of “political campaign activities."

Political campaign activity expenditures. See instructions .................................................................... right arrow

Volunteer hours for political campaign activities. See instructions ..................................................................

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 ................................ right arrow

Enter the amount of any excise tax incurred by organization managers under section 4955 ....................... right arrow

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 ..... right arrow

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

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

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.

Cat. No. 50084S

Schedule C (Form 990) 2022

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 right arrow

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 right arrow

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) 2019	(b) 2020	(c) 2021	(d) 2022	(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) 2022

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|No

(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

15,889

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

15,889

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:	ROCHELLE COMMUNITY HOSPITAL IS A MEMBER OF THE ILLINOIS HOSPITAL ASSOCIATION AND THE AMERICAN HOSPITAL ASSOCIATION, BOTH OF WHICH CONDUCT LOBBYING ON BEHALF OF THEIR MEMBERS. THE AMOUNT REPORTED IS THE PORTION OF MEMBERSHIP DUES SPENT ON LOBBYING. NO OTHER LOBBYING ACTIVITIES WERE CONDUCTED.

Schedule C (Form 990) 2022

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.
right arrow

Attach to Form 990.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2022

Open to Public Inspection

Name of the organization

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

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 July 25, 2006, 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 right arrow

Number of states where property subject to conservation easement is located right arrow

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
right arrow

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

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 FASB 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 FASB 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 ......................... right arrow

(ii)

Assets included in Form 990, Part X ............................... right arrow

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 FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... right arrow

Assets included in Form 990, Part X ............................... right arrow

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

Cat. No. 52283D

Schedule D (Form 990) 2022

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 ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

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

Board designated or quasi-endowment right arrow

Permanent endowment right arrow

Term endowment right arrow

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)

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

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 .....	1,453,878		1,453,878
b	Buildings ....	22,243,463	14,995,397	7,248,066
c	Leasehold improvements	1,490,090	1,170,086	320,004
d	Equipment ....	25,922,835	16,716,834	9,206,001
e	Other .....	381,764		381,764
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				18,609,713

Schedule D (Form 990) 2022

Page 3

Part VII

Investments - Other 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

Investments - Program 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
DEFERRED COMPENSATION PAYABLE	145,189
RIGHT OF USE LIABILITIES	610,693







Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	755,882
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) 2022

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

Schedule D (Form 990) 2022

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 20a.
Medium right arrow

Attach to Form 990.
Medium right arrow

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

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 %

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) . . .	515,598		515,598	1.030 %
b	Medicaid (from Worksheet 3, column a) . . . . .	6,499,135	5,040,283	1,458,852	2.920 %
c	Costs of other means-tested government programs (from Worksheet 3, column b) . .
d	Total Financial Assistance and Means-Tested Government Programs . . . . .	7,014,733	5,040,283	1,974,450	3.950 %
Other Benefits
e	Community health improvement services and community benefit operations (from Worksheet 4).	91,661		91,661	0.180 %
f	Health professions education (from Worksheet 5) . . .
g	Subsidized health services (from Worksheet 6) . . . .	13,239,175	7,302,342	5,936,833	11.890 %
h	Research (from Worksheet 7) .
i	Cash and in-kind contributions for community benefit (from Worksheet 8) . . . .	10,050		10,050	0.020 %
j	Total. Other Benefits . .	13,340,886	7,302,342	6,038,544	12.090 %
k	Total. Add lines 7d and 7j .	20,355,619	12,342,625	8,012,994	16.040 %

For Paperwork Reduction Act Notice, see the Instructions for Form 990. Cat. No. 50192T Schedule H (Form 990) 2023

Schedule H (Form 990) 2023

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 Healthcare Financial Management Association Statement No. 15? ..........................

Yes

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

991,710

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. ......

495,855

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).....

11,827,428

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

11,877,168

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

-49,740

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 %
1
2
3
4
5
6
7
8
9
10
11
12
13

Schedule H (Form 990) 2023

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?1Name, 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)
1	ROCHELLE COMMUNITY HOSPITAL 900 N 2ND STREET ROCHELLE,IL61068 WWW.ROCHELLEHOSPITAL.COM HF105997	X	X	X	X

Schedule H (Form 990) 2023

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)

	ROCHELLE COMMUNITY HOSPITAL ASSOCIATION
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

The impact of any actions taken to address the significant health needs identified in the hospital facility's prior CHNA(s)

Other (describe in Section C)

Indicate the tax year the hospital facility last conducted a CHNA: 20 22

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

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): SEE PART V, PAGE 8

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 22

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

Yes

If "Yes" (list url): SEE PART V, PAGE 8

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

10b

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) 2023

Page 5

Part VFacility Information (continued)

Financial Assistance Policy (FAP)

	ROCHELLE COMMUNITY HOSPITAL ASSOCIATION
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 300.000000000000%

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)

Was widely publicized 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):

SEE PART V, PAGE 8

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

SEE PART V, PAGE 8

A plain language summary of the FAP was widely available on a website (list url):
SEE PART V, PAGE 8

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)

Individuals were notified about the FAP by being offered a paper copy of the plain language summary of the FAP, by
receiving a conspicuous written notice about the FAP on their billing statements, and via conspicuous public displays or
other measures reasonably calculated to attract patients' attention

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

The FAP, FAP application form, and plain language summary of the FAP were translated into the primary language(s)
spoken by LEP populations

Other (describe in Section C)

Schedule H (Form 990) 2023

Page 6

Part VFacility Information (continued)

Billing and Collections

	ROCHELLE COMMUNITY HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group

Yes

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 nonpayment?..................................

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

Deferring, denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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

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

Deferring , denying, or requiring a payment before providing medically necessary care due to nonpayment of a previous
bill for care covered under the hospital facility's FAP

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):

Provided a written notice about upcoming ECAs (Extraordinary Collection Action) and a plain language summary of the
FAP at least 30 days before initiating those ECAs (if not, describe in Section C)

Made a reasonable effort to orally notify individuals about the FAP and FAP application process (if not, describe in
Section C)

Processed incomplete and complete FAP applications (if not, describe in Section C)

Made presumptive eligibility determinations (if not, describe in Section C)

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)

Schedule H (Form 990) 2023

Page 7

Part VFacility Information (continued)

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

	ROCHELLE COMMUNITY HOSPITAL ASSOCIATION
Name of hospital facility or letter of facility reporting group

Yes

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 a look-back method based on claims allowed by Medicare fee-for-service during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month period

The hospital facility used a look-back method based on claims allowed by Medicaid, either alone or in combination with
Medicare fee-for-service and all private health insurers that pay claims to the hospital facility during a prior 12-month
period

The hospital facility used a prospective Medicare or Medicaid method

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) 2023

Page 8

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, 16j, 18e, 19e, 20a, 20b, 20c, 20d, 20e, 21c, 21d, 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
ROCHELLE COMMUNITY HOSPITAL ASSOCIATION	PART V, SECTION B, LINE 5: THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED BY GATHERING DATA THROUGH FOCUS GROUPS, SECONDARY DATA ANALYSIS AND KEY STAKEHOLDER INTERVIEWS. FOUR FOCUS GROUPS WERE SCHEDULED IN MARCH 2022. FOUR FOCUS GROUPS WERE SCHEDULED TO OCCUR OVER THE COURSE OF TWO WEEKS IN MARCH 2022 TO OBTAIN INFORMATION FROM COMMUNITY RESIDENTS. RCH PROVIDED NAMES AND CONTACT INFORMATION FOR 96 POTENTIAL ATTENDEES. RHI REACHED OUT TO ALL 96 TO INVITE THEM TO PARTICIPATE. ATTENDEES COULD CHOOSE THE FOCUS GROUP THEY PREFERRED TO ATTEND BASED ON THEIR AVAILABILITY. EACH FOCUS GROUP INCLUDED A MIX OF ATTENDEES REPRESENTING THEIR COMMUNITY. ATTENDEES INCLUDED SENIORS, REPRESENTATIVES FROM BUSINESSES, HEALTH CARE CONSUMERS, AND SOCIAL SERVICES. 15 PEOPLE PARTICIPATED IN TOTAL. SECONDARY DATA ANALYSIS WAS CONDUCTED TO COMPARE OGLE COUNTY WITH HENRY AND LASALLE COUNTIES, THE STATE OF ILLINOIS AND THE NATION ON POPULATION CHANGES AND DEMOGRAPHICS, SOCIAL AND ECONOMIC FACTORS, BEHAVIORAL HEALTH RISK FACTORS AND HEALTH OUTCOMES. FIFTEEN RESIDENTS WERE IDENTIFIED BY THE HOSPITAL TO POTENTIALLY PARTICIPATE IN KEY STAKEHOLDER INTERVIEWS IN MARCH 2022. THE KEY STAKEHOLDERS WERE IDENTIFIED BASED ON THE VARIOUS CONSUMER GROUPS OF LOCAL HEALTH SERVICES INCLUDING SENIOR CITIZENS, YOUNG PARENTS, HEALTH CARE PROVIDERS, AND COMMUNITY LEADERS. INVITATIONS WERE EMAILED WITH THE KEY STAKEHOLDER QUESTIONS ATTACHED OR A PHONE CALL WAS MADE TO INVITE THEM. NINE PEOPLE AGREED TO PARTICIPATE. IN TOTAL, FOUR MEN AND FIVE WOMEN PARTICIPATED. THREE PEOPLE CHOSE TO SEND EMAIL RESPONSES TO THE INTERVIEW QUESTIONS. SIX VIRTUAL MEETING SESSIONS WERE APPROXIMATELY 20 MINUTES IN LENGTH AND INCLUDED A REVIEW OF THE SECONDARY DATA AT THE BEGINNING. EACH KEY STAKEHOLDER WAS ASKED THE SAME QUESTIONS. RESULTS WERE PRESENTED IN A TWO PART PROCESS: 1) WEBINAR TO THE ADMINISTRATIVE TEAM HIGHLIGHTING NATIONAL CHANGES IN THE HEALTH CARE SYSTEM AND FINDINGS FROM THE FOCUS GROUPS, KEY STAKEHOLDER INTERVIEWS AND SECONDARY DATA ANALYSIS AND 2) A DISCUSSION WITH A BROAD CROSS SECTION OF THE COMMUNITY TO IDENTIFY COMMUNITY HEALTH PRIORITIES AND TAKE INVENTORY OF LOCAL RESOURCES AND COMMUNITY HEALTH INITIATIVES. INDIVIDUALS WHO PARTICIPATED INCLUDED: HOSPITAL CEO, CFO, CNO, CAO, COO, EMERGENCY DEPARTMENT MANAGER, OUTPATIENT SERVICES MANAGER, MARKETING INTERN, FOUNDATION AND COMMUNITY EVENTS MANAGER, FAMILY PRACTICE PHYSICIAN, OGLE COUNTY HEALTH DEPT, ROCHELLE FIRE CHIEF AND SINNISSIPPI BEHAVIORAL HEALTH AND SOCIAL SERVICES COUNSELORS.
ROCHELLE COMMUNITY HOSPITAL ASSOCIATION	PART V, SECTION B, LINE 11: IN MARCH 2022, ROCHELLE COMMUNITY HOSPITAL ADOPTED ITS MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT. AT THAT TIME, TWO OF THE PRIMARY NEEDS IDENTIFIED WERE:(1) IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES(2) ADDRESS BARRIERS TO ACCESSING CAREIN ADDRESSING THE PRIMARY NEEDS IDENTIFIED IN ROCHELLE COMMUNITY HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT DURING THE CURRENT FISCAL YEAR, THE HOSPITAL TOOK THE FOLLOWING ACTIONS:(1) ROCHELLE COMMUNITY HOSPITAL MET WITH COMMUNITY PARTNERS SUCH AS POLICE, FIRE, NURSING HOME, OUTSIDE COUNSELING SERVICES AND CLERGY TO DETERMINE WHAT MENTAL HEALTH SERVICES ARE NEEDED IN THE COMMUNITY AND RESOURCES ALREADY AVAILABLE.(2) ROCHELLE COMMUNITY HOSPITAL BEGAN WORKING ON A BEHAVIORAL HEALTH MODEL TO FIT OUR ORGANIZATION. WE HAVE DETERMINED THE MODEL WE WOULD LIKE TO USE AND THE LOCATION WE WOULD LIKE TO OFFER SERVICES. OUR PLAN IS TO HIRE A COUNSELOR AND CONTRACT FOR A PSYCHIATRIST THROUGH A TELE-HEALTH SERVICE. WE HAVE BEGUN MEETING WITH COMPANIES THAT PROVIDE THE PSYCHIATRY SERVICES TO SEE WHICH ONE WILL WORK BEST FOR RCH.(3) RCH OFFERED A DE-ESCALATION COURSE TO STAFF TO HELP THEM BECOME BETTER EQUIPPED TO DEAL WITH POTENTIALLY UNSAFE SITUATIONS.(4) RCH JOINED THE ICAHN ACCOUNTABLE CARE ORGANIZATION AND WE ARE RECEIVING GUIDANCE RELATED TO CREATING A CARE COORDINATION PROGRAM FOR OUR PATIENTS. RCH HIRED ONE CARE COORDINATOR FOR THE CLINIC PATIENTS AND IS MAKING PLANS TO HAVE A CARE COORDINATOR FOR HOSPITAL BASED PATIENTS. (5) ROCHELLE COMMUNITY HOSPITAL OPENED A SATELLITE CLINIC IN DEKALB TO OFFER ORTHOPEDIC SERVICES AND OTHER POSSIBLE SERVICES. (6) ROCHELLE COMMUNITY HOSPITAL ENROLLED ADDITIONAL BILINGUAL EMPLOYEES IN MEDICAL INTERPRETATION TRAINING COURSES TO BETTER ENGAGE THE HISPANIC COMMUNITY. MARKETING AND SIGNAGE IS CONTINUING TO BE DEVELOPED AND DISTRIBUTED IN BOTH ENGLISH AND SPANISH.(7) RCH MET WITH THE AREA HIGH SCHOOLS ON CAREER OPTIONS IN HEALTH CARE. WE HAVE HAD SEVERAL AREA STUDENTS TOUR AND/OR JOB SHADOW.(8) RCH MET WITH THE DIRECTOR OF TRANSPORTATION AND HOPING TO BRING MASS TRANSIT ROUTES TO ROCHELLE. WE ALSO WORK WITH THE LEE AND OGLE TRANSPORTATION SYSTEM TO ENSURE RIDES ARE AVAILABLE FOR PATIENTS.
PART V, LINE 7A, CHNA WEBSITE:	HTTPS://WWW.ROCHELLEHOSPITAL.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
PART V, LINE 10A, CHNA IMPLEMENTATION PLAN WEBSITE:	HTTPS://WWW.ROCHELLEHOSPITAL.COM/COMMUNITY-HEALTH/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/
PART V, LINE 16A, FAP WEBSITE:	HTTP://WWW.ROCHELLEHOSPITAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/
PART V, LINE 16B, FAP APPLICATION WEBSITE:	HTTP://WWW.ROCHELLEHOSPITAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/
PART V, LINE 16C, FAP PLAIN LANGUAGE SUMMARY WEBSITE:	HTTP://WWW.ROCHELLEHOSPITAL.COM/PATIENTS-VISITORS/BILLING-INSURANCE/FINANCIAL-ASSISTANCE/

Schedule H (Form 990) 2023

Page 9

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?3
Name and address		Type of Facility (describe)
1	1 - FAMILY HEALTHCARE CENTER 900 N 2ND ST ROCHELLE,IL61068	PHYSICIAN CLINIC
2	2 - ON-THE-GO HEALTHCARE CLINIC 900 PETRO DRIVE ROCHELLE,IL61068	PHYSICIAN CLINIC
3	3 - XCEL ORTHOPEDICS 2670 DEKALB AVENUE SYCAMORE,IL60178	PHYSICIAN CLINIC
4
5
6
7
8
9
10

Schedule H (Form 990) 2023

Page 10

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 3C:	THE ORGANIZATION USED THE FEDERAL POVERTY GUIDELINES (FPG) ALONG WITH OTHER FACTORS TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE. PER THE ORGANIZATION'S CHARITY CARE POLICY, THESE FACTORS INCLUDE: * FAMILY INCOME RELATIVE TO FAMILY SIZE AND OTHER RELATED FACTORS SUCH AS CURRENT FINANCIAL OBLIGATIONS* EMPLOYMENT STATUS, INCLUDING, BUT NOT LIMITED TO, FUTURE EARNING CAPACITY WITH CONSIDERATION OF THE LIKELIHOOD OF A FINANCIAL CAPACITY SUFFICIENT TO MEET THE PATIENT'S FINANCIAL OBLIGATIONS IN AN ACCEPTABLE PERIOD OF TIME* FUTURE AND CURRENT ABILITY TO PAY* MEDICAL EXPENSES AS A PERCENTAGE OF A PATIENT'S ANNUAL GROSS INCOME, THE AMOUNT OF TOTAL MEDICAL BILLS OUTSTANDING, AND THE FREQUENCY OF PAYMENTS TO BE MADE IN RELATION TO THE FACTORS ABOVE* OTHER FACTORS DEEMED APPROPRIATE BY THE ORGANIZATION
PART I, LINE 7:	THE RESPECTIVE IRS WORKSHEETS, AS PROVIDED IN THE INSTRUCTIONS FOR SCHEDULE H, WERE USED TO CALCULATE THE COSTS OF ITEMS WITHIN SCHEDULE H, PART I, LINE 7.
PART I, LINE 7G:	SUBSIDIZED HEALTH SERVICES INCLUDE THE EMERGENCY DEPARTMENT AND PHYSICIAN CLINICS, INCLUDING THE FAMILY HEALTHCARE CLINIC AND OCCUPATIONAL HEALTH CLINIC.
PART I, LN 7 COL(F):	THE CARRYING AMOUNT OF ACCOUNTS RECEIVABLE IS REDUCED BY VALUATION ALLOWANCES THAT REFLECT MANAGEMENT'S BEST ESTIMATE OF AMOUNTS THAT WILL NOT BE COLLECTED. MANAGEMENT USES A SYSTEM FOR ESTIMATING THIRD PARTY CONTRACTUAL ALLOWANCES AND LOSSES FOR UNCOLLECTIBLE ACCOUNTS, WHEREBY CERTAIN PERCENTAGES OF PATIENT REVENUE FOR EACH OF THESE ALLOWANCES IS RECORDED ON A MONTHLY BASIS AS AN OFFSET TO REVENUE AND RECEIVABLES. THE PERCENTAGES USED BY MANAGEMENT ARE BASED OFF OF HISTORICAL TRENDS WITH FINAL ADJUSTMENTS MADE WHEN COST REPORTS ARE FILED. PERIODICALLY MANAGEMENT REVIEWS OUTSTANDING ACCOUNTS FOR CREDITWORTHINESS. IF THERE IS A DETERIORATION OF A MAJOR CUSTOMER'S OR CLASS OF CUSTOMER'S CREDIT WORTHINESS OR ACTUAL DEFAULTS ARE HIGHER THAN HISTORICAL EXPERIENCE, MANAGEMENT'S ESTIMATES OF THE RECOVERABILITY OF AMOUNTS DUE THE HOSPITAL COULD BE ADVERSELY AFFECTED.
PART II, COMMUNITY BUILDING ACTIVITIES:	NO COMMUNITY BUILDING ACTIVITIES ARE REPORTED IN PART II. HOWEVER, ROCHELLE COMMUNITY HOSPITAL IS THE COMMUNITY'S PREDOMINANT LINK TO HEALTH CARE. LISTED BELOW ARE PROGRAMS THAT BENEFITED THE COMMUNITY.PROGRAMS IMPLEMENTED INCLUDE: -PATIENT EDUCATION PROGRAMS IN THE AREAS OF CONGESTIVE HEART FAILURE, CARDIAC AND PULMONARY REHABILITATION.-STROKE CARE PROGRAM USING TELEMEDICINE TO ASSURE THE MOST EFFECTIVE AND IMMEDIATE CARE TO EMERGENCY PATIENTS PRESENTING WITH SYMPTOMS OF STROKE.-DIABETES EDUCATION PROGRAM TO REACH OUT TO THE COMMUNITY. -A PART TIME STAFF POSITION TO FOCUS ON COMMUNITY HEALTH EDUCATION TO INCLUDE COMMUNITY HEALTH AND WELLNESS FAIRS.HOSPITAL EMPLOYEES ARE INVOLVED WITH LOCAL SCHOOLS BY OFFERING EDUCATIONAL PROGRAMS ABOUT SUICIDE PREVENTION, DRUG AND ALCOHOL ABUSE, PARENTING AND CHILDHOOD, SAFE CHILD CARE, FIRST AID AND CPR TRAINING. THE HOSPITAL PROVIDES SPORTS PHYSICALS AND OPPORTUNITIES FOR STUDENTS TO LEARN ABOUT CAREERS IN HEALTH CARE. THE AUXILIARY GIVES HOSPITAL TOURS TO GRADE SCHOOL STUDENTS.HOSPITAL EMPLOYEES AND VOLUNTEERS ARE INVOLVED WITH LOCAL SERVICE CLUBS SERVING ON THE BOARD OR ADVISORY COMMITTEES FOR THE CHAMBER OF COMMERCE, PLANNING AND ZONING COMMISSION, FIRE AND POLICE COMMISSION, UNITED WAY, KISHWAUKEE COLLEGE'S RADIOLOGY PROGRAM, CHILDREN'S ADVOCACY CENTER, DOMESTIC VIOLENCE SHELTER, FOCUS HOUSE FOR JUVENILES, AND THE PARISH NURSING PROGRAM.
PART III, LINE 2:	THE BAD DEBT EXPENSE WAS CALCULATED BY APPLYING THE COST-TO-CHARGE RATIO FROM THE MOST RECENT MEDICARE COST REPORT TO THE ORGANIZATION'S BAD DEBT EXPENSE FOR THE FISCAL YEAR.
PART III, LINE 3:	THE ORGANIZATION EMPLOYS FINANCIAL COUNSELORS THAT WORK WITH ALL SELF-PAY PATIENTS. BASED ON REVIEW OF TAX RETURNS, BANK STATEMENTS, AND OTHER FINANCIAL DOCUMENTS PROVIDED BY THE PATIENT, AN ESTIMATE EQUAL TO 50% OF BAD DEBT PATIENTS WOULD QUALIFY FOR CHARITY CARE BUT FAILED TO PROVIDE THE APPROPRIATE LEVEL OF DOCUMENTATION.
PART III, LINE 4:	THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DO NOT CONTAIN A FOOTNOTE THAT DESCRIBES BAD DEBT EXPENSE. BAD DEBT IS LISTED AS A DEDUCTION FROM REVENUE. THIS TREATMENT IS CONSISTENT WITH THE HFMA PRINCIPLES AND PRACTICES BOARD STATEMENT NO. 15 AND WITH THE AICPA AUDIT AND ACCOUNTING GUIDE FOR HEALTHCARE ORGANIZATIONS. THE COST TO CHARGE RATIO FORMULATED ON THE 2023 MEDICARE COST REPORT WAS USED TO CALULATE BAD DEBT AT COST. PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT ARE UNKNOWN TO THE HOSPITAL ARE WRITTEN OFF TO BAD DEBT AND ARE NOT INCLUDED IN CHARITY CARE. HOWEVER, IF DURING THE COLLECTION PROCESS IT IS DETERMINED THAT THE PATIENT IS ELIGIBLE FOR CHARITY CARE THE DEBT IS RECLASSIFIED AS CHARITY CARE AND COLLECTION EFFORTS CEASE.
PART III, LINE 8:	THE COST TO CHARGE RATIO FROM THE MEDICARE COST REPORT IS UTILIZED IN DETERMINING THE ORGANIZATION'S COMMUNITY BENEFIT.THE SHORTFALL REPORTED IN PART III, LINE 7 SHOULD BE TREATED AS COMMUNITY BENEFIT. BY PARTICIPATING IN MEDICARE AND ABSORBING RELATED SHORTFALLS, WE ARE PROVIDING HEALTHCARE SERVICES TO MEDICARE BENEFICIARIES WHO ARE A SIGNIFICANT PORTION OF OUR COMMUNITY.
PART III, LINE 9B:	SELF PAY PATIENTS AND OTHER PATIENTS WHO DEMONSTRATE FINANCIAL HARDSHIP ARE GIVEN CHARITY APPLICATIONS AND ENCOURAGED TO COMPLETE AND RETURN THEM TO PATIENT FINANCIAL SERVICES. IN DISCUSSING PATIENTS CHARGES, FINANCIAL COUNSELORS WILL SUGGEST COMPLETION OF A CHARITY APPLICATION.
PART VI, LINE 2:	A COMMUNITY HEALTH NEEDS ASSESSMENT WAS CONDUCTED IN FY 2022. THIS STUDY IDENTIFIED SERVICES THE PUBLIC BELIEVES ARE NECESSARY IN THE COMMUNITY. THE TOP COMMUNITY HEALTH NEEDS IDENTIFIED WERE IMPROVE ACCESS TO BEHAVIORAL HEALTH SERVICES AND ADDRESS BARRIERS TO ACCESSING CARE.RCH PARTICIPATES IN THE ILLINOIS PLAN LOCAL ASSESSMENT NEEDS (IPLAN) WHICH ALSO INCLUDES THE OGLE COUNTY HEALTH DEPT AND MEMBERS OF THE COMMUNITY. THE HEALTH STATUS OF THE COUNTY, AS EVIDENCED BY A MULTITUDE OF DATA AND RISK FACTORS, IS REVIEWED BY THE COMMITTEE AND PRIORITIES ARE DETERMINED TO HELP MEET IDENTIFIED NEEDS. THE GOAL IS TO WORK TOWARD ASSURING THAT NEEDS ARE BEING MET BY THE VARIOUS HEALTH CARE PROVIDERS.
PART VI, LINE 3:	IT IS HOSPITAL POLICY TO TREAT ALL PATIENTS WHO PRESENT FOR CARE WITHOUT REGARD FOR THEIR ABILITY TO PAY AND TO ASSIST THEM IN RESOLVING ANY FINANCIAL ISSUES INVOLVED WITH SERVICES PROVIDED. THE HOSPITAL'S CHARITY CARE POLICIES ARE POSTED AT ALL PATIENT ACCESS AREAS, IN INDIVIDUAL PATIENT CARE AREAS, AND ON THE HOSPITAL WEB SITE. UPON REGISTRATION, STAFF WILL EXPLAIN THE POLICY AND OFFER A CHARITY/FINANCIAL ASSISTANCE APPLICATION TO ALL SELF PAY PATIENTS. PATIENT FINANCIAL COUNSELORS WILL ALSO EXPLAIN THE HOSPITAL'S CHARITY POLICY WHEN DISCUSSING A BILL WITH A PATIENT. ALL BILLING STATEMENTS INCLUDE A STATEMENT ALERTING THE PATIENT OF HIS/HER RIGHT TO ACCESS HOSPITAL ASSISTANCE. ASSISTANCE IS PROVIDED TO THE NON INSURED AND UNDER INSURED, INCLUDING ASSISTANCE IN APPLYING FOR MEDICAID IF APPROPRIATE. PATIENTS ARE ENCOURAGED TO ACCESS THE HOSPITAL'S FINANCIAL ASSISTANCE PROGRAM TO INSURE THAT A TRUE NEED IS REFLECTED AS CHARITY RATHER THAN AN EVENTUAL BAD DEBT.
PART VI, LINE 4:	ROCHELLE COMMUNITY HOSPITAL IS A NON PROFIT 501(C)(3) CRITICAL ACCESS HOSPITAL DEDICATED TO PROVIDING QUALITY HEALTH AND WELLNESS SERVICES LOCALLY. THIS IS ACHIEVED BY PROVIDING INPATIENT MEDICAL SURGICAL, INTENSIVE CARE, AND SWING BED SERVICES, OUTPATIENT SURGICAL AND DIAGNOSTIC SERVICES, CARDIAC, PHYSICAL, AND RESPIRATORY THERAPIES, IMMEDIATE CARE, OCCUPATIONAL MEDICINE, CLINICS, AND EMPLOYED PHYSICIANS. RCH SERVES WESTERN DEKALB, NORTHERN LEE, AND OGLE COUNTIES. THE HOSPITAL SERVES A POPULATION OF APPROXIMATELY 18,000 IN THE CITY OF ROCHELLE AND SURROUNDING AREA. THE POPULATION IS DIVIDED ABOUT 25% UNDER AGE 20, 52% BETWEEN 20 AND 64, AND 23% 65 AND OVER. THE GROUP COVERED BY MEDICARE IS AT LEAST 50% OF THE HOSPITAL'S REVENUE. THE ROCHELLE AREA LAGS STATE WIDE NUMBERS IN GROWTH IN EMPLOYMENT AND PER CAPITA INCOME AND HAS A HIGHER PERCENT UNEMPLOYMENT. THE AREA IS DESIGNATED AS AN UNDERSERVED AREA BY CMS THRU HRSA.
PART VI, LINE 5:	ROCHELLE COMMUNITY HOSPITAL REACHES OUT TO THE COMMUNITY IN MANY WAYS TO PROMOTE WELLNESS AND IMPROVE THE OVERALL HEALTH:-FREE PUBLIC HEALTH SCREENINGS, COMMUNITY EDUCATION, HEALTH FAIRS, FIRST AID TENTS AT COMMUNITY EVENTS, FLU CLINICS, COORDINATED BLOOD DRIVES, VISITS TO SENIOR CITIZEN CENTERS, AND FIRST AID TRAINING.-EDUCATION PROGRAMS TO THE PUBLIC IN THE AREAS OF CARDIOLOGY, STROKE, DIABETES, NUTRITION, PARKINSONS, WOMEN'S HEALTH ISSUES, MEN'S HEALTH ISSUES, WELLNESS AND WEIGHT LOSS PROGRAMS.-FITNESS TRAINING CLASSES PROVIDED TO AREA SCHOOL EMPLOYEES AND HOSPITAL STAFF.-SPONSOR SUPPORT GROUPS FOR DIABETES, STROKE, PARKINSONS, ALANON, ALCOHOL ANONYMOUS, AND GROUP HOPE.-SUPPORT BY THE HOSPITAL AND STAFF FOR LOCAL HEALTH RELATED EVENTS- CANCER DRIVES, BLOOD DRIVES, UNITED WAY CAMPAIGN.-PARTICIPATE IN THE REGIONAL DISASTER PREPAREDNESS PLAN WITH OUR POD HOSPITAL AND REGIONAL HOSPITALS AND PROVIDE HAZMAT TRAINING LOCALLY.-PROVIDE SOME HOSPITAL SERVICES AT A FINANCIAL DISADVANTAGE BECAUSE THESE SERVICES ARE CRITICAL TO THE HEALTH AND WELFARE OF THE COMMUNITY, INCLUDING EMERGENCY SERVICES, INTENSIVE CARE, SEVERAL CLINICS, IMMEDIATE CARE, AND OCCUPATIONAL HEALTH. CHAPLAIN SERVICES ARE ALSO PROVIDED TO PATIENTS AND THEIR FAMILIES.-PROVIDING STUDENT INTERNSHIP AND SHADOWING OPPORTUNITIES TO ENCOURAGE INCREASED INTEREST IN HEALTHCARE CAREERS.-MENTOR STUDENTS IN THE AREA OF PHARMACY, RADIOLOGY, HEALTH INFORMATION MANAGEMENT, NURSING, AND NURSING ASSISTANT AND PROVIDE ON SITE HOSPITAL TRAINING FOR THESE PROGRAMS.-DONATE UNUSED OR EXCESS SUPPLIES AND EQUIPMENT TO A NON PROFIT GLOBAL HEALTH NETWORK.-PROVIDE PATIENTS WITH MEDICAL RECORDS UPON REQUEST WITHOUT CHARGE.-EMPLOYEES SUPPORT LOCAL CHARITIES INCLUDING UNITED WAY, LOCAL FOOD AND CLOTHING DRIVES, CURE FOR CANCER, RELAY FOR LIFE.-THE HOSPITAL CAFETERIA PROVIDES A RELAXED DINING EXPERIENCE FOR MANY LOCAL RESIDENTS INCLUDING THOSE AT A NEARBY SENIOR LOW HOUSING UNIT. THESE MEALS ARE NORMALLY SERVED AT OR BELOW HOSPITAL COST.MANY HOSPITAL EMPLOYEES AND VOLUNTEERS (AUXILIARY AND FOUNDATION) ARE NOT ONLY PART OF THE HOSPITAL BUT INTEGRAL MEMBERS OF THE COMMUNITY. THEY HELP CEMENT THE RELATIONSHIP AMONG HEALTH CARE SERVICE PROVIDERS AND THE COMMUNITY.
PART VI, LINE 7, REPORTS FILED WITH STATES	IL

Schedule H (Form 990) 2023

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Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
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Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
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Attach to Form 990.
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Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

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

Yes

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

Yes

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

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

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

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

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

Yes

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

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 nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

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) 2023

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, 1099-MISC compensation, and/or 1099-NEC			(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)
1GADINI DELISCA ORTHOPEDIC PHYSICIAN	(i) (ii)	651,424 ------------- 0	636 ------------- 0	15,125 ------------- 0	11,250 ------------- 0	594 ------------- 0	679,029 ------------- 0	0 ------------- 0
2GREGORY A OLSON PAST CEO (RETIRED 3/2023)	(i) (ii)	117,101 ------------- 0	0 ------------- 0	308,205 ------------- 0	3,517 ------------- 0	6,943 ------------- 0	435,766 ------------- 0	0 ------------- 0
3KAREN TRACY COO, CEO	(i) (ii)	255,642 ------------- 0	636 ------------- 0	18,801 ------------- 0	8,332 ------------- 0	27,260 ------------- 0	310,671 ------------- 0	0 ------------- 0
4JASON POPP MD CHIEF OF MEDICAL STAFF	(i) (ii)	223,383 ------------- 0	636 ------------- 0	18,125 ------------- 0	7,691 ------------- 0	35,525 ------------- 0	285,360 ------------- 0	0 ------------- 0
5KENDALL ELIZABETH VOGELER PHYSICIAN	(i) (ii)	224,209 ------------- 0	636 ------------- 0	11,625 ------------- 0	6,264 ------------- 0	594 ------------- 0	243,328 ------------- 0	0 ------------- 0
6CHRISTINE GORMAN MD PHYSICIAN	(i) (ii)	223,493 ------------- 0	636 ------------- 0	125 ------------- 0	1,116 ------------- 0	16,204 ------------- 0	241,574 ------------- 0	0 ------------- 0
7LORI GUTIERREZ CFO	(i) (ii)	199,301 ------------- 0	636 ------------- 0	7,734 ------------- 0	4,960 ------------- 0	2,481 ------------- 0	215,112 ------------- 0	0 ------------- 0
8KYLE AUMAN CAO	(i) (ii)	159,200 ------------- 0	237 ------------- 0	6,260 ------------- 0	0 ------------- 0	34,653 ------------- 0	200,350 ------------- 0	0 ------------- 0
9RHONDA MARKS CNO	(i) (ii)	172,765 ------------- 0	636 ------------- 0	15,313 ------------- 0	5,659 ------------- 0	4,659 ------------- 0	199,032 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2023

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 1A	DR. GADINI DELISCA'S COMPENSATION INCLUDES A GROSS-UP AMOUNT IN THE REIMBURSEMENT OF HIS SELF-PAID INSURANCE.
PART I, LINES 4A-B	GREGORY A. OLSON RECEIVED THE FOLLOWING AMOUNTS: 457(F) PLAN DISTRIBUTION - $75,000 LINE 4A PAYMENT - $217,039

Schedule J (Form 990) 2023

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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 Ⅵ, line 24a. Provide descriptions,
explanations, and any additional information in Part Ⅵ.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization
ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number
36-2548549

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	CITY OF ROCHELLE OGLE COUNTY ILLINOIS	36-6006075		08-01-2012	5,950,000	REFINANCE BOND ISSUE DATED 8/6/2009		X		X		X
B	OGLE COUNTY ILLINOIS	36-6006637		08-18-2015	5,970,045	MEDICAL OFFICE BUILDING PROJECT		X		X		X

Part Ⅱ

Proceeds

	A		B		C		D
	1 Amount of bonds retired ..................	3,951,000		1,912,290
2 Amount of bonds legally defeased ..............
3 Total proceeds of issue ..................	5,950,000		5,970,045
4 Gross proceeds in reserve funds .............
5 Capitalized interest from proceeds .............
6 Proceeds in refunding escrows ...............
7 Issuance costs from proceeds ...............			119,401
8 Credit enhancement from proceeds .............
9 Working capital expenditures from proceeds .............
10 Capital expenditures from proceeds .............			5,850,644
11 Other spent proceeds .............	5,950,000
12 Other unspent proceeds .............
13 Year of substantial completion .............	2009		2017
	Yes	No	Yes	No	Yes	No	Yes	No
14 Were the bonds issued as part of a current refunding issue of tax-exempt bonds (or, if issued prior to 2020, a current refunding issue)? ........	X			X
15 Were the bonds issued as part of an advance refunding issue of taxable bonds (or, if issued prior to 2020, an advance refunding issue)? ........		X		X
16 Has the final allocation of proceeds been made? ..........	X		X
17 Does the organization maintain adequate books and records to support the final allocation of proceeds? ..................	X		X

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

Cat. No. 50193E

Schedule K (Form 990) 2023

Page 2

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
2 Are there any lease arrangements that may result in private business use of bond-financed property? ...............	X		X
3a Are there any management or service contracts that may result in private business use of bond-financed property? .............		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?
c Are there any research agreements that may result in private business use of bond-financed property? .............		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 ....	0 %		0 %
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 .........	0 %		0 %
6 Total of lines 4 and 5 .............	0 %		0 %
7 Does the bond issue meet the private security or payment test? ...		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
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

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
2 If "No" to line 1, did the following apply? ....
a Rebate not due yet? .......		X		X
b Exception to rebate? ........	X		X
c No rebate due? .........		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

Schedule K (Form 990) 2023

Page 3

Part Ⅳ

Arbitrage (Continued)

	A		B		C		D
	Yes	No	Yes	No	Yes	No	Yes	No
4a Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?		X		X
b Name of provider ..........
c Term of hedge .........
d Was the hedge superintegrated? ......
e Was the hedge terminated? ........
5a Were gross proceeds invested in a guaranteed investment contract (GIC)?		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
7 Has the organization established written procedures to monitor the requirements of section 148? ...	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

Part Ⅵ

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

Return Reference	Explanation

Schedule K (Form 990) 2023

Additional Data

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Schedule L
(Form 990)

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.
Attach to Form 990 or Form 990-EZ.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

Part I

Excess Benefit Transactions (section 501(c)(3), section 501(c)(4), and section 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 the organization managers or disqualified persons during the year under section 4958. ........................... $

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

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) 2023

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) PREMIER HEALTH GROUP LLC	ENTITY MORE THAN 35% OWNED BY DIRECTOR SATHISH CULLATH, MD	706,115	MEDICAL DIRECTOR AND HOSPITALIST FEES		No

Part V

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

Return Reference	Explanation

Schedule L (Form 990) 2023

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

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.
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2023

Open to Public
Inspection

Name of the organization

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

Return Reference	Explanation
FORM 990, PART VI, SECTION A, LINE 1A	THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE HOSPITAL AND UP TO TWO OTHER TRUSTEES. THE EXECUTIVE COMMITTEE MEETS AS NEEDED AND HAS THE POWER TO TRANSACT THE BUSINESS OF THE HOSPITAL DURING THE INTERIM BETWEEN MEETINGS OF THE TRUSTEES, PROVIDED THAT NO ACTION CONFLICTS WITH THE EXPRESSED POLICIES OF THE BOARD AND FURTHER PROVIDED THAT ALL ACTIONS TAKEN ON MATTERS OF MAJOR SIGNIFICANCE ARE REFERRED TO THE BOARD FOR RATIFICATION AT THE NEXT REGULAR MEETING.
FORM 990, PART VI, SECTION A, LINE 6	FROM AND AFTER MAY 1, 1965, ANY PERSON WHO HAS GIVEN $25 OR MORE IN CASH OR PROPERTY CAN BECOME, UPON REQUEST, A MEMBER OF THE ORGANIZATION FOR ONE YEAR. ANY PERSON WHO HAS GIVEN $1,000 OR MORE IN CASH OR PROPERTY CAN BECOME, UPON REQUEST, A MEMBER OF THE ORGANIZATION FOR LIFE, OR IN THE CASE OF A LEGAL ENTITY, FOR THE DURATION OF ITS EXISTENCE.
FORM 990, PART VI, SECTION A, LINE 7A	THE PRESIDENT/CHIEF EXECUTIVE OFFICER POSITION IS A STANDING VOTING MEMBER OF THE BOARD OF TRUSTEES. THE CHIEF OF THE MEDICAL STAFF AND THE CHIEF OF STAFF ELECT ARE STANDARD VOTING MEMBERS AND SHALL BE ELECTED IN ACCORDANCE WITH THE MEDICAL STAFF BYLAWS OF THE HOSPITAL. THE PRESIDENT OF THE ROCHELLE COMMUNITY HOSPITAL ASSOCIATION AUXILIARY IS A STANDARD VOTING MEMBER AND SHALL BE ELECTED IN ACCORDANCE WITH THE ROCHELLE COMMUNITY HOSPITAL ASSOCIATION AUXILIARY BYLAWS. THE OSF REPRESENTATIVE IS A STANDARD VOTING MEMBER OF THE BOARD OF TRUSTEES WHO SHALL BE NOMINATED BY OSF HEALTHCARE SYSTEM AND MUST BE APPROVED BY MAJORITY VOTE OF THE BOARD OF TRUSTEES, FOR A TERM THAT AUTOMATICALLY EXPIRES UPON THE TERMINATION OF HIS OR HER EMPLOYMENT OR AFFILIATION WITH OSF HEALTHCARE SYSTEM OR UPON THE TERMINATION OF THE OSF AFFILIATION AGREEMENT, WHICHEVER OCCURS FIRST. IN THE EVENT THE OSF REPRESENTATIVE IS NO LONGER EMPLOYED OR AFFILIATED WITH OSF HEALTHCARE SYSTEM, THE OSF HEALTHCARE SYSTEM SHALL APPOINT HIS OR HER REPLACEMENT. THE REMAINING TRUSTEES, APPROXIMATELY ONE-THIRD (1/3) OF WHOM SHALL BE ELECTED BY THE BOARD OF TRUSTEES EACH YEAR AT THE BOARD'S REGULAR MEETING THAT IS HELD ON THE SAME DAY AS THE ANNUAL MEETING OF THE MEMBERS, SHALL EACH HOLD OFFICE FOR A TERM OF THREE (3) YEARS; PROVIDED THAT ANY SUCH TRUSTEE SERVING THREE (3) CONSECUTIVE TERMS SHALL BE INELIGIBLE FOR RE-ELECTION FOR THREE (3) YEARS FOLLOWING THE CONCLUSION OF THE THIRD CONSECUTIVE TERM; PROVIDED, HOWEVER, THAT A TRUSTEE WHO IS SERVING OR ELECTED AS CHAIRPERSON MAY CONTINUE TO SIMULTANEOUSLY SERVE AS CHAIRPERSON AND AS A TRUSTEE DURING A FOURTH CONSECUTIVE TERM. THE NOMINATING COMMITTEE SHALL SUBMIT A SLATE OF NOMINEES TO SERVE AS TRUSTEES TO THE BOARD FOR CONSIDERATION FOR ELECTION. AFTER COMPLETING THE TERM AS CHAIRPERSON, SUCH PERSON SHALL BECOME IMMEDIATE PAST CHAIRPERSON AND BE AN EX OFFICIO MEMBER OF THE EXECUTIVE COMMITTEE. IF THE TERM AS A TRUSTEE HAS EXPIRED AND SUCH PERSON IS NOT ELIGIBLE FOR RE- ELECTION, THE PERSON SHALL BE WITHOUT VOTE.
FORM 990, PART VI, SECTION B, LINE 11B	A DRAFT COPY OF FORM 990 IS PROVIDED TO THE GOVERNING BODY (BOARD OF TRUSTEES) AND THE GOVERANCE COMMITTEE FOR REVIEW PRIOR TO FILING. THE ORGANIZATION'S CEO, CFO, AND OTHER MEMBERS OF THE ACCOUNTING DEPARTMENT ALSO REVIEWED A COPY OF THE RETURN. IF CHANGES ARE NECESSARY, THEY ARE REPORTED TO THE RETURN PREPARER AND INCORPORATED INTO THE FINAL RETURN.
FORM 990, PART VI, SECTION B, LINE 12C	CONFLICTS OF INTEREST ARE INVESTIGATED BY APPOINTED MEMBERS OF THE GOVERANCE COMMITTEE ON AN ONGOING BASIS. IF IT IS DETERMINED THAT AN INDIVIDUAL FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT SHALL INFORM THE INDIVIDUAL OF SUCH A BELIEF AND AFFORD HIM AN OPPORTUNITY TO EXPLAIN. AFTER SAID EXPLANATION, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION AS DEEMED NECESSARY. THE CONFLICT OF INTEREST POLICY IS REVIEWED BY THE BOARD ANNUALLY AND UPDATED AS NEEDED. THE BOARD OF TRUSTEES AND ADMINISTRATION TEAM SIGN CONFLICT OF INTEREST DISCLOSURES ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15	THE CHIEF EXECUTIVE, ADMINISTRATOR AND KEY EMPLOYEE (MANAGEMENT) COMPENSATION IS DETERMINED BY THE USE OF COMPARABLE DATA, INCLUDING INDEPENDENT SURVEYS CONDUCTED BY THE ILLINOIS HOSPITAL ASSOCIATION AND ILLINOIS CRITICAL ACCESS HOSPITAL NETWORK. THIS INFORMATION IS COLLECTED FROM LIKE-SIZE ORGANIZATIONS. ADDITIONALLY, COMPARABLE INFORMATION WAS COLLECTED FROM AN INDEPENDENT HEALTHCARE CONSULTING FIRM WHICH INCLUDED SALARY RANGES, MEDIAN AND QUARTERLY PERCENTILE RANK OF COMPARABLE HOSPITALS. THIS INFORMATION IS REVIEWED BY THE HUMAN RESOURCES MANAGER, CHIEF EXECUTIVE AND THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. THE PROCESS WAS LAST COMPLETED IN FISCAL YEAR 2024.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST IN WRITING TO THE BUSINESS OFFICE.
FORM 990, PART IX, LINE 11G	MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 4,862,292. MANAGEMENT AND GENERAL EXPENSES 9,753. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,872,045. PATIENT SERVICES: PROGRAM SERVICE EXPENSES 68,031. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 68,031. MAINTENANCE & HOUSEKEEPING: PROGRAM SERVICE EXPENSES 100,871. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 100,871. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 858,889. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 858,889. COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 408,967. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 408,967. MISCELLANEOUS FEES: PROGRAM SERVICE EXPENSES 37,766. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,766.
FORM 990, PAGE 12, PART XII, LINE 2C	THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.
FORM 990, PAGE 6, PART VI, SECTION A, LINE 7B	MEMBERSHIP IN THE CORPORATION SHALL NOT CONFER ANY VOTING RIGHTS; THIS INCLUDES, WITHOUT LIMITATION, THE ABILITY TO VOTE ON THE DISSOLUTION OF THE CORPORATION; THE SALE, LEASE, OR EXCHANGE OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION, OR NOMINATIONS TO THE BOARD OF TRUSTEES. ANY ISSUE SUBMITTED TO THE MEMBERS OF THE CORPORATION BY THE BOARD OF TRUSTEES SHALL BE FOR DISCUSSION PURPOSES ONLY AND ANY RECOMMENDATIONS FROM THE MEMBERS TO THE BOARD SHALL BE ADVISORY IN NATURE AND ARE SUBJECT TO THE ULTIMATE AUTHORITY OF THE BOARD OF TRUSTEES.

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

Cat. No. 51056K

Schedule O (Form 990) 2023

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.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2023

Open to Public Inspection

Name of the organization

ROCHELLE COMMUNITY HOSPITAL ASSOCIATION

Employer identification number

36-2548549

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)ROCHELLE COMMUNITY HOSPITAL FOUNDATION 900 NORTH SECOND STREET ROCHELLE,IL61068 36-3719223	SUPPORT OF ROCHELLE COMMUNITY HOSPITAL ASSOCIATION	IL	501(C)(3)	LINE 12B, II	ROCHELLE COMMUNITY HOSPITAL ASSOC	Yes

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

Cat. No. 50135Y

Schedule R (Form 990) 2023

Page 2

Part III

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

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(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	(k) Percentage ownership

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	(h) Percentage ownership	(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	(h) Percentage ownership	Yes	No

Schedule R (Form 990) 2023

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

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

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

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

Yes

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

Yes

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

Yes

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

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

Yes

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

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) ROCHELLE COMMUNITY HOSPITAL FOUNDATION	Q	54,253	FMV

Schedule R (Form 990) 2023

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?		(k) Percentage ownership
(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	(k) Percentage ownership

Schedule R (Form 990) 2023

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) 2023

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: PROVIDE LOCAL COMMUNITY-BASED HEALTH & WELLNESS SERVICES FOCUSED ON A SAFE & HIGH QUALITY HEALTHCARE EXPERIENCE.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	12
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2023 (Part V, line 2a) ......	5	390
6	Total number of volunteers (estimate if necessary) .............	6	12
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	71,997	31,939
9	Program service revenue (Part VIII, line 2g) .........	53,201,880	52,747,402
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	326,057	935,618
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	174,375	210,015
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	53,774,309	53,924,974
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	6,350	10,050
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)	26,909,083	25,715,375
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)....	24,120,101	24,209,372
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	51,035,534	49,934,797
19	Revenue less expenses. Subtract line 18 from line 12.......	2,738,775	3,990,177
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	70,539,393	76,215,227
21	Total liabilities (Part X, line 26).............	10,298,299	9,774,759
22	Net assets or fund balances. Subtract line 21 from line 20.....	60,241,094	66,440,468

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 38,309,055 including grants of $ 10,050 ) (Revenue $ 41,520,643 )
	HOSPITAL PATIENT CARE OPERATIONS (EXCLUDING ER) - IN FISCAL YEAR 4/30/24, ROCHELLE HOSPITAL HAD 1,067 INPATIENT DAYS AND PERFORMED 36,227 OUTPATIENT REGISTRATIONS. THE HOSPITAL IS COMMITTED TO PROVIDING THE HIGHEST LEVEL OF HEALTHCARE FOR EVERYONE REGARDLESS OF ABILITY TO PAY. THE HOSPITAL SUBSIDIZES THE COST OF TREATING PATIENTS WHO ARE UNINSURED OR UNABLE TO PAY OR REQUIRE GOVERNMENT ASSISTANCE WHERE REIMBURSEMENT IS LIMITED. ROCHELLE HOSPITAL IS ALSO COMMITTED TO EDUCATING THE COMMUNITY REGARDING HEALTHCARE ISSUES.

4b	(Code: ) (Expenses $ 3,061,432 including grants of $ 0 ) (Revenue $ 11,211,543 )
	ROCHELLE HOSPITAL PROVIDES 24-HOUR EMERGENCY SERVICES IN THE EMERGENCY ROOM, WHICH IS STAFFED BY FULL-TIME ATTENDING PHYSICIANS. PATIENTS ARE SEEN REGARDLESS OF ABILITY TO PAY. THE EMERGENCY ROOM HAD 8,960 VISITS IN FISCAL YEAR 4/30/24.

4c	(Code: ) (Expenses $ 11,938 including grants of $ 0 ) (Revenue $ 15,216 )
	HEALTHWORKS FITNESS PROMOTES THE BELIEF THAT A HEALTHIER LIFESTYLE THROUGH EXERCISES AND EDUCATION REALLY DOES WORK! WE DO THIS NOT ONLY BY WORKING WITH YOU AFTER AN ILLNESS OR SURGERY, BUT BY TRAINING YOU IN PREVENTION AS WELL. THAT'S WHY HEALTHWORKS WAS CREATED. IT'S OUR GOAL TO HELP SATISFY THE HEALTH AND FITNESS NEEDS TO THE COMMUNITY BY PROVIDING FITNESS EQUIPMENT, TRAINING AND SPECIAL INDIVIDUALIZED EXERCISE PRESCRIPTIONS.HEALTHWORKS FITNESS ALSO HOUSES CARDIOPULMONARY REHABILITATION. THIS AREA INCLUDES A CONSULTATION ROOM, REHAB CHECK-IN AREA WHERE PAITENTS CAN MEET WITH CARDIOPULMONARY STAFF TO GET THEIR VITAL READINGS AND DISCUSS REHABILITIATION.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses41,382,425

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)		(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) GADINI DELISCA........................................................................ ORTHOPEDIC PHYSICIAN	40.00 .......................0.00	X	667,185	0	11,844
(19) KENDALL ELIZABETH VOGELER........................................................................ PHYSICIAN	40.00 .......................0.00	X	236,470	0	6,858
(20) CHRISTINE GORMAN MD........................................................................ PHYSICIAN	40.00 .......................0.00	X	224,254	0	17,320
(21) RHONDA MARKS........................................................................ CNO	40.00 .......................0.00	X	188,714	0	10,318
(22) KYLE AUMAN........................................................................ CAO	40.00 .......................0.00	X	165,697	0	34,653

1b	Sub-Total..............
c	Total from continuation sheets to Part VII, Section A..
d	Total (add lines 1b and 1c).........	2,632,520	0	177,702

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d	4,411
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	27,528

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		31,939

		Business Code
2a	NET PATIENT SERVICE REVENUE	621110	41,520,643	41,520,643
b	EMERGENCY SERVICE REVENUE	621110	11,211,543	11,211,543
c	FITNESS CENTER	621110	15,216	15,216
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....		52,747,402

3 Investment income (including dividends, interest, and othersimilar amounts) ......			836,950			836,950
4 Income from investment of tax-exempt bond proceeds			7,193			7,193
5 Royalties...........
			(i) Real	(ii) Personal
6a	Gross rents	6a
b	Less: rental expenses	6b
c	Rental income or (loss)	6c
d	Net rental income or (loss).......
			(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory	7a		139,843
b	Less: cost or other basis and sales expenses	7b		48,368
c	Gain or (loss)	7c		91,475
d	Net gain or (loss).........			91,475			91,475
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..

Business Code
11a	CAFETERIA		621110	185,975			185,975
b	LEASE REVENUE		621110	15,275			15,275
c	CREDENTIALING FEES		621110	6,300			6,300
d	All other revenue ....			2,465			2,465
e	Total. Add lines 11a–11d ......			210,015
12	Total revenue. See instructions.....			53,924,974	52,747,402	0	1,145,633

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	10,050	10,050
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	1,167,148	308,173	858,975
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........	20,335,129	17,129,072	3,206,057
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	428,334	357,493	70,841
9	Other employee benefits .......	2,280,552	1,872,214	408,338
10	Payroll taxes ...........	1,504,212	1,214,792	289,420
11	Fees for services (non-employees):
a	Management ......
b	Legal .........	69,821		69,821
c	Accounting ...........	84,257		84,257
d	Lobbying ...........	15,889		15,889
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	59,205		59,205
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	6,346,569	5,068,960	1,277,609
12	Advertising and promotion ....	339,661	339,179	482
13	Office expenses .......	4,453,264	4,453,264
14	Information technology ......	332,126		332,126
15	Royalties ..
16	Occupancy ...........	584,473	476,551	107,922
17	Travel ............	110,090	87,453	22,637
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	168,554	151,698	16,856
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	4,402,170	3,301,628	1,100,542
23	Insurance ...	569,700	569,700
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	BAD DEBT	2,715,852	2,715,852
b	REPAIRS AND MAINTENANCE	2,450,097	1,908,864	541,233
c	MEDICAID ASSESSMENT TAX	1,004,669	1,004,669
d	FOOD	259,624	259,624
e	All other expenses	243,351	153,189	90,162
25	Total functional expenses. Add lines 1 through 24e	49,934,797	41,382,425	8,552,372	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 ........			25,764	1	45,143
2	Savings and temporary cash investments .........			22,042,295	2	26,625,376
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............			6,609,341	4	6,948,344
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			394,552	8	415,892
9	Prepaid expenses and deferred charges ......			1,228,953	9	1,415,932
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	51,492,030
b	Less: accumulated depreciation	10b	32,882,317	20,345,876	10c	18,609,713
11	Investments—publicly traded securities .			18,946,273	11	21,527,755
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			946,339	15	627,072
16	Total assets. Add lines 1 through 15 (must equal line 33)...			70,539,393	16	76,215,227

17	Accounts payable and accrued expenses .....	4,382,704	17	4,549,827
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........	4,976,987	20	4,469,050
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			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	938,608	25	755,882
26	Total liabilities. Add lines 17 through 25..	10,298,299	26	9,774,759

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	60,241,094	27	66,440,468
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	60,241,094	32	66,440,468
33	Total liabilities and net assets/fund balances ........	70,539,393	33	76,215,227