Northwest Community Hospital

“Form 990, part iii, line 4d includes revenue and expenses from all other program services not described on form 990, part iii, lines 4a-4c.”

“Form 990, part vi, question 6 northwest community healthcare (nch) is the sole corporate member of northwest community hospital (hospital). As such, it elects or appoints the members of hospital's governing body and approves significant decisions.”

“Form 990, part vi, question 7a nch is the sole corporate member of hospital. As such, it elects or appoints the members of the governing body of hospital periodically or as vacancies arise.”

“Form 990, part vi, question 7b nch is the sole corporate member of hospital. As such, it must approve certain actions of hospital. Action is taken by a majority vote of the nch board with a quorum present. Nch must approve the following types of decisions by hospital: voluntary dissolution, merger, consolidation or sale or transfer of 10% or more of hospital's assets; sale of real property or interest therein; creation of a subsidiary or affiliate; annual and long-term capital and operating budgets; amendment, alteration or repeal of hospital's articles of incorporation or bylaws; selection of auditors; appointment, removal and evaluation of hospital directors; debt or indebtedness, guarantees or borrowings; appointment, compensation, benefits and evaluation of officers; appointment and employment of the president; and actions taken by trustees of the northwest community hospital employees retirement plan.”

“Form 990, part vi, question 11b a copy of form 990 was made available to the members of hospital's board prior to filing. The audit and compliance committee of the nch board reviewed form 990 for affiliates of nch prior to distribution to the full board.”

“Form 990, part vi, question 12c each year, the conflict of interest policy and questionnaire is sent to directors, officers and key employees. Each response is reviewed by the general counsel and those in which any actual or apparent conflict with the present role is disclosed, are reviewed by the president/ceo and board chairperson. In the case of any conflict involving an entity or party with which hospital is dealing or competing, the person with the conflict may not participate in any decisions regarding that party. Individuals who are independent contractors, officers, directors, or employees of other healthcare facilities in hospital's service area may not serve on nch's or any related organization's board or board committee. In addition, the policy includes a sample conflict of interest disclosure letter to be used if a conflict arises after submission of the annual questionnaire and before submission of the next annual questionnaire. Such disclosure letters would be reviewed as noted above at the time they are received.”

“Form 990, part vi, line 15a the compensation and governance committee of the nch board is responsible for setting the compensation of the president/ceo who is the top management official. Compensation is reviewed using an external compensation firm. The review also utilizes comparisons to similar organizations through review of forms 990, use of comparison studies from the metropolitan chicago healthcare council and other sources. The process is documented in the minutes of the compensation and governance committee. Compensation determination process for officers and key employees form 990, part vi, line 15b the compensation and governance committee of the nch board is responsible for approving the compensation of the officers and key employees (vice presidents) of hospital based on recommendations from the president/ceo. The review utilizes comparisons to studies from the metropolitan chicago healthcare council and other sources. The process is documented in the minutes of the compensation and governance committee.”

“Form 990, part vi, question 19 governing documents and the conflict of interest policy are not made public. Hospital's financial statements are included in the annual consolidated audit report of nch and subsidiaries. These consolidated financial statements are available to the public via the municipal securities rulemaking board's electronic municipal market access (emma) website at www.emma.msrb.org.”

“Form 990, part xi, question 9 basis swap gain 368,221 pension related changes other than net periodic pension cost 1,288,235 management fee for dsc ii 500,223 restricted funds - silver lining program (28,800) change in temporarily restricted funds (838,148) change in permanently restricted funds (119,130) net assets transfer to northwest community healthcare (33,428,004) =========== total (32,257,403)”