Lurie Children's Surgical Foundation Inc: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- Lurie Children's Surgical Foundation Inc (EIN 83-1650513)
- Tax period
- 2021-09-01 to 2022-08-31
- Filed
- 2023-07-12
- IRS object ID
- 202341939349301784
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-07-12T22:31:19+00:00 | ReturnTs |
| Tax Period End | 2022-08-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 346565596 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 155 N WACKER DRIVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-09-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 831650513 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lurie Children's Surgical Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LURI | BusinessNameControlTxt |
| Phone | 3122277133 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE BOX 282 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606112991 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALEX P MILLER | PersonNm |
| Person Title | SR. VP/CFO | PersonTitleTxt |
| Phone | 3122277133 | PhoneNum |
| Signature | 2023-07-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ALEX | PersonFirstNm |
| Person Last | MILLER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jess Wagener | PreparerPersonNm |
| PTIN | P01622613 | PTIN |
| Phone | 3128792000 | PhoneNum |
| Preparation | 2023-06-30 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERIK C KING MD | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE BOX 282 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606112991 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $90,498,635 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LURIECHILDRENS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2018 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | LURIE CHILDREN'S SURGICAL FOUNDATION, INC. PROVIDES PEDIATRIC AND SUBSPECIALTY SURGICAL, RESEARCH, AND EDUCATIONAL SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 87 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $26,084,341 | PYContributionsGrantsAmt |
| CY Contributions Grants | $27,279,013 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $61,204,204 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $63,219,622 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $87,288,545 | PYTotalRevenueAmt |
| CY Total Revenue | $90,498,635 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $68,600,711 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $73,282,374 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $21,084,474 | PYOtherExpensesAmt |
| CY Other Expenses | $20,071,684 | CYOtherExpensesAmt |
| PY Total Expenses | $89,685,185 | PYTotalExpensesAmt |
| CY Total Expenses | $93,354,058 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,396,640 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,855,423 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,407,357 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,288,753 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,221,530 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,617,737 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $185,827 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$2,328,984 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE PEDIATRIC AND SUBSPECIALTY SURGICAL, RESEARCH, AND EDUCATIONAL SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $91,035,633 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $63,219,622 | RevenueAmt |
| Desc | SEE SCHEDULE O. | Desc |
| Total Program Service Expenses | $91,035,633 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 87 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALEX P MILLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3122277133 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606112991 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ANTHONY CHIN MD | ||||||||
| DIRECTOR/TREASURER/PHYSICIAN | 40.0 | 0 | Yes (X) | Yes (X) | $734,958 | $0 | $45,500 | |
| BRUCE LINDGREN MD | ||||||||
| DIRECTOR/VICE CHR/VP/PHYSICIAN | 40.0 | 0 | Yes (X) | Yes (X) | $700,439 | $0 | $41,250 | |
| ERIK C KING MD | ||||||||
| DIRECTOR/CHAIR/PRESIDENT/PHYS | 40.0 | 3.0 | Yes (X) | Yes (X) | $806,939 | $0 | $38,500 | |
| JEFFREY RASTATTER MD | ||||||||
| DIRECTOR & PHYSICIAN & BOARD SECRETARY | 40.0 | 0 | Yes (X) | Yes (X) | $535,299 | $0 | $38,500 | |
| ANDREA PIPITONE BEIRNE | ||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| JOHN J GRAYHACK MD | ||||||||
| DIRECTOR/PHYSICIAN UNTIL 12/31/21 | 40.0 | 0 | Yes (X) | $793,617 | $0 | $38,500 | ||
| JOHN MADDALOZZO MD | ||||||||
| DIRECTOR/BOARD SEC/PHYSICIAN UNTIL 12/31/21 | 40.0 | 0 | Yes (X) | $578,191 | $0 | $38,500 | ||
| JOHN N HOURIHANE JR | ||||||||
| DIRECTOR | 1.0 | 0 | Yes (X) | $0 | $0 | $0 | ||
| MARLETA REYNOLDS MD | ||||||||
| EX-OFFICIO DIRECTOR/PHYSICIAN UNTIL 11/15/21 | 40.0 | 3.0 | Yes (X) | $1,027,375 | $0 | $38,500 | ||
| ROBIN BOWMAN MD | ||||||||
| DIRECTOR & PHYSICIAN | 40.0 | 0 | Yes (X) | $1,041,525 | $0 | $40,500 | ||
| THOMAS INGE MD | ||||||||
| EX-OFFICIO DIRECTOR, SURGEON IN CHIEF | 40.0 | 2.0 | Yes (X) | $138,938 | $0 | $0 | ||
| THOMAS P SHANLEY MD | ||||||||
| EX-OFFICIO DIRECTOR/LCH CEO | 1.0 | 46.0 | Yes (X) | $0 | $1,719,745 | $514,785 | ||
| BRENDA DAVIS | ||||||||
| INTERIM CFO | 1.0 | 46.0 | Yes (X) | $0 | $299,219 | $26,552 | ||
| FATEMA ZANZI | ||||||||
| SENIOR VP, CHF LEGAL OFFICER | 1.0 | 46.0 | Yes (X) | $0 | $683,437 | $109,102 | ||
| RON BLAUSTEIN | ||||||||
| CHIEF FINANCIAL OFFICER UNTIL 5/6/22 | 1.0 | 46.0 | Yes (X) | $0 | $855,364 | $196,021 | ||
| MICHAEL C MONGE MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $1,004,378 | $0 | $38,500 | Yes (X) | ||
| OSAMA M ELTAYEB MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $1,009,478 | $0 | $38,500 | Yes (X) | ||
| SANDI K LAM MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $1,026,693 | $0 | $38,500 | Yes (X) | ||
| SUNJAY KAUSHAL MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $1,830,000 | $0 | $38,500 | Yes (X) | ||
| TORD D ALDEN MD | ||||||||
| PHYSICIAN | 40.0 | 0 | $1,026,434 | $0 | $38,500 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $12,254,264 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $3,557,765 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $1,358,710 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 86 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $26,120,089 | RelatedOrganizationsAmt |
| Government Grants | $1,158,924 | GovernmentGrantsAmt |
| Total Contributions | $27,279,013 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621111 | $42,889,259 | $42,889,259 |
| MED ADMIN AN EDUCATION | 621111 | $3,834,329 | $3,834,329 |
| PROF SVCS PROV TO RSCH | 621111 | $532,249 | $532,249 |
| PHYSICIAN CONTRACT | 621111 | $6,168,144 | $6,168,144 |
| MEDICARE/MEDICAID PAYMENTS | 621111 | $9,196,186 | $9,196,186 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $599,455 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $599,455 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $63,219,622 | TotalProgramServiceRevenueAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $90,498,635 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $63,219,622 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,571,182 | TotalAmt |
| Program Services | $4,571,182 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,981,194 | TotalAmt |
| Program Services | $55,060,505 | ProgramServicesAmt |
| Management And General | $1,920,689 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,854,620 | TotalAmt |
| Program Services | $5,854,620 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,084,756 | TotalAmt |
| Program Services | $4,040,968 | ProgramServicesAmt |
| Management And General | $43,788 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,790,622 | TotalAmt |
| Program Services | $1,745,659 | ProgramServicesAmt |
| Management And General | $44,963 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,103 | TotalAmt |
| Management And General | $4,103 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,225 | TotalAmt |
| Program Services | $1,225 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,280,100 | TotalAmt |
| Program Services | $1,179,423 | ProgramServicesAmt |
| Management And General | $100,677 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199 | TotalAmt |
| Program Services | $199 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,631 | TotalAmt |
| Program Services | $48,899 | ProgramServicesAmt |
| Management And General | $732 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,837 | TotalAmt |
| Program Services | $33,899 | ProgramServicesAmt |
| Management And General | $8,938 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,345,406 | TotalAmt |
| Program Services | $3,297,394 | ProgramServicesAmt |
| Management And General | $48,012 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $455,604 | TotalAmt |
| Program Services | $449,062 | ProgramServicesAmt |
| Management And General | $6,542 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,114 | TotalAmt |
| Program Services | $38,114 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,652,202 | TotalAmt |
| Program Services | $5,652,202 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $1,266,398 | $1,266,398 | |
| BILLING COLLECTION FEES | $2,802,866 | $2,802,866 | |
| DUES AND LICENSES | $291,461 | $281,585 | $9,876 |
| EDUCATION EXPENSE | $24,258 | $24,258 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,817,280 | TotalAmt |
| Program Services | $4,687,175 | ProgramServicesAmt |
| Management And General | $130,105 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,354,058 | TotalAmt |
| Program Services | $91,035,633 | ProgramServicesAmt |
| Management And General | $2,318,425 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,679,761 | BOYAmt |
| EOY | $8,228,753 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $0 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $0 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $727,596 | BOYAmt |
| EOY | $60,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,407,357 | BOYAmt |
| EOY | $8,288,753 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,826,448 | BOYAmt |
| EOY | $5,942,471 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,395,082 | BOYAmt |
| EOY | $4,675,266 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,221,530 | BOYAmt |
| EOY | $10,617,737 | EOYAmt |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,827 | BOYAmt |
| EOY | -$2,328,984 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,827 | BOYAmt |
| EOY | -$2,328,984 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,407,357 | BOYAmt |
| EOY | $8,288,753 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,855,423 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $340,612 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $0 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $0 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $0 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
| Private Foundation509 | Yes (X) | PrivateFoundation509Ind |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Adj Net Income Distributable | $0 | CYAdjNetIncomeDistributableAmt |
| CY Pct85 Adjusted Net Income | $0 | CYPct85AdjustedNetIncomeAmt |
| CY Total Min Ast Distributable | $0 | CYTotalMinAstDistributableAmt |
| CY Greater Adjusted Minimum | $0 | CYGreaterAdjustedMinimumAmt |
| CY Income Tax Imposed PY | $0 | CYIncomeTaxImposedPYAmt |
| CY Distributable As Adjusted | $0 | CYDistributableAsAdjustedAmt |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part I, Line 3 DISCLOSURE FOR NOT FILING SCHEDULE H | FormAndLineReferenceDesc |
| Explanation | LCSF DOES NOT FILE A SCHEDULE H EVEN THOUGH THE ENTITY MARKS THE HOSPITAL BOX IN SCHEDULE A BECAUSE IT IS NOT REQUIRED TO BE LICENSED, REGISTERED OR SIMILARLY RECOGNIZED BY THE STATE AS A HOSPITAL. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PENSION LIABILITY | Desc |
| Amt | $4,675,266 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,675,266 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANTHONY CHIN MD | ||||||||||||||
| DIRECTOR/TREASURER/PHYSICIAN | $734,958 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $7,000 | $0 | $780,458 | $0 | $0 | $0 |
| ERIK C KING MD | ||||||||||||||
| DIRECTOR/CHAIR/PRESIDENT/PHYS | $806,939 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $845,439 | $0 | $0 | $0 |
| BRUCE LINDGREN MD | ||||||||||||||
| DIRECTOR/VICE CHR/VP/PHYSICIAN | $700,439 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $2,750 | $0 | $741,689 | $0 | $0 | $0 |
| JEFFREY RASTATTER MD | ||||||||||||||
| DIRECTOR & PHYSICIAN & BOARD SECRETARY | $535,299 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $573,799 | $0 | $0 | $0 |
| JOHN J GRAYHACK MD | ||||||||||||||
| DIRECTOR/PHYSICIAN UNTIL 12/31/21 | $793,617 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $832,117 | $0 | $0 | $0 |
| JOHN MADDALOZZO MD | ||||||||||||||
| DIRECTOR/BOARD SEC/PHYSICIAN UNTIL 12/31/21 | $578,191 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $616,691 | $0 | $0 | $0 |
| MARLETA REYNOLDS MD | ||||||||||||||
| EX-OFFICIO DIRECTOR/PHYSICIAN UNTIL 11/15/21 | $1,027,375 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $1,065,875 | $0 | $0 | $0 |
| THOMAS P SHANLEY MD | ||||||||||||||
| EX-OFFICIO DIRECTOR/LCH CEO | $0 | $1,020,468 | $0 | $564,421 | $0 | $134,856 | $0 | $483,972 | $0 | $30,813 | $0 | $2,234,530 | $0 | $0 |
| ROBIN BOWMAN MD | ||||||||||||||
| DIRECTOR & PHYSICIAN | $1,041,525 | $0 | $0 | $0 | $0 | $0 | $40,500 | $0 | $0 | $0 | $1,082,025 | $0 | $0 | $0 |
| RON BLAUSTEIN | ||||||||||||||
| CHIEF FINANCIAL OFFICER UNTIL 5/6/22 | $0 | $488,279 | $0 | $249,902 | $0 | $117,183 | $0 | $160,274 | $0 | $35,747 | $0 | $1,051,385 | $0 | $0 |
| BRENDA DAVIS | ||||||||||||||
| INTERIM CFO | $0 | $240,708 | $0 | $58,158 | $0 | $353 | $0 | $12,301 | $0 | $14,251 | $0 | $325,771 | $0 | $0 |
| FATEMA ZANZI | ||||||||||||||
| SENIOR VP, CHF LEGAL OFFICER | $0 | $457,906 | $0 | $225,041 | $0 | $490 | $0 | $105,304 | $0 | $3,798 | $0 | $792,539 | $0 | $0 |
| TORD D ALDEN MD | ||||||||||||||
| PHYSICIAN | $1,026,434 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $1,064,934 | $0 | $0 | $0 |
| SANDI K LAM MD | ||||||||||||||
| PHYSICIAN | $1,026,693 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $1,065,193 | $0 | $0 | $0 |
| OSAMA M ELTAYEB MD | ||||||||||||||
| PHYSICIAN | $1,009,478 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $1,047,978 | $0 | $0 | $0 |
| SUNJAY KAUSHAL MD | ||||||||||||||
| PHYSICIAN | $1,830,000 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $1,868,500 | $0 | $0 | $0 |
| MICHAEL C MONGE MD | ||||||||||||||
| PHYSICIAN | $1,004,378 | $0 | $0 | $0 | $0 | $0 | $38,500 | $0 | $0 | $0 | $1,042,878 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 3 Arrangement used to establish the top management official's compensation | PURSUANT TO THE BYLAWS OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER ("MEDICAL CENTER"), THE COMPENSATION COMMITTEE OF THE MEDICAL CENTER IS CHARGED WITH REVIEWING AND APPROVING SENIOR EXECUTIVE COMPENSATION FOR THE MEDICAL CENTER AND ITS AFFILIATES AND THE COMPENSATION FOR ANY PHYSICIAN WHO MEETS THE CRITERIA FOR REVIEW AND APPROVAL BY THE COMMITTEE. THE COMPENSATION COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY, WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT. THE COMPENSATION PHILOSOPHY IS SUBJECT TO PERIODIC REVIEW BY THE COMPENSATION COMMITTEE FOR CONTINUED APPROPRIATENESS IN THE CURRENT MARKET. WITH THE ASSISTANCE OF INDEPENDENT COMPENSATION CONSULTANTS AND INFORMATION FROM A VARIETY OF SOURCES (SPECIFIED ON SCHEDULE J), THE COMPENSATION COMMITTEE CONFIRMED THE TOTAL AMOUNTS TO BE PAID TO IDENTIFIED EXECUTIVES AND PHYSICIANS WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS TO INDIVIDUALS IN FUNCTIONALLY SIMILAR POSITIONS. LEGAL COUNSEL PERIODICALLY ADVISES THE COMPENSATION COMMITTEE WITH RESPECT TO FEDERAL TAX REQUIREMENTS IN SETTING COMPENSATION AND THE ESTABLISHMENT OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL TAX LAW INTERMEDIATE SANCTIONS RULES. THE PROCESS FOLLOWED BY THE COMPENSATION COMMITTEE, INCLUDING A DESCRIPTION OF THE DATA RELIED UPON AND THE COMPENSATION COMMITTEE'S DECISIONS, WAS THOROUGHLY AND CONTEMPORANEOUSLY DOCUMENTED. THE COMPENSATION COMMITTEE HAS EXPRESSLY REVIEWED THE REASONABLENESS OF COMPENSATION PAID TO IDENTIFIED EXECUTIVES AND PHYSICIANS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED. THE COMPENSATION COMMITTEE IS COMPRISED OF MEMBERS OF THE MEDICAL CENTER BOARD OF DIRECTORS HAVE BEEN DETERMINED TO BE DISINTERESTED (WHICH MEANS NO COMMITTEE MEMBER HAS A CONFLICT OF INTEREST) FOR THESE PURPOSES. THE COMPENSATION COMMITTEE CONDUCTS AN ONGOING, REGULAR REVIEW OF THE DISINTERESTED STATUS OF ITS MEMBERS, AND WILL TAKE APPROPRIATE ACTION WITH RESPECT TO ANYONE HAVING AN INTEREST WITH RESPECT TO ONE OR MORE EXECUTIVES SO AS TO PRESERVE THE DISINTERESTED STATUS OF THE COMMITTEE AND, AS A RESULT, THE APPLICATION OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS. |
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | LURIE CHILDREN'S MAINTAINS A DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("DC SERP"), WHICH WAS ESTABLISHED ON JANUARY 1, 2017 AND IS A NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EMPLOYEES IN EXECUTIVE POSITIONS. THE BENEFITS IN THE DC SERP ARE IN THE FORM OF A FIXED ANNUAL CONTRIBUTION RATE AND AN EARNINGS CREDIT. EACH YEAR'S CONTRIBUTION AND EARNINGS ARE AT RISK AND WILL BECOME FULLY VESTED AND TAXABLE ONLY AFTER FIVE YEARS OF FUTURE EMPLOYMENT SERVICE, OR UPON REACHING AGE 62 WITH AT LEAST THREE YEARS OF SERVICE. SEVERAL LISTED PERSONS IN THIS FORM 990 PARTICIPATE IN THE DC SERP, AND THE UNVESTED CONTRIBUTIONS MADE FOR THEM ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). CEO DEFERRED COMPENSATION LISTED INDIVIDUAL THOMAS SHANLEY MD IS THE SOLE PARTICIPANT IN AN ADDITIONAL SUPPLEMENTAL RETIREMENT BENEFIT ARRANGEMENT THAT BEGAN IN 2021. HE IS ELIGIBLE TO EARN A BENEFIT THAT WILL NOT BECOME VESTED FOR SEVERAL YEARS. A PRORATED PORTION OF THE BENEFIT (REPRESENTING THE PORTION EARNED IN 2022) IS REPORTED IN COLUMN (C) AS UNVESTED DEFERRED COMPENSATION, AND WILL BE REPORTED AGAIN AS COMPENSATION IF AND WHEN THE FULL BENEFIT BECOMES VESTED AND IS SUBJECT TO TAX. THE INDEPENDENT COMPENSATION COMMITTEE OF THE CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER BOARD, WHOSE DILIGENT REVIEW AND APPROVAL PROCESS IS DESCRIBED ELSEWHERE IN THESE NARRATIVES, HAS REVIEWED AND APPROVED DR. SHANLEY'S TOTAL COMPENSATION IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER THE FEDERAL TAX LAW INTERMEDIATE SANCTIONS RULES, AND AS PART OF THIS REVIEW PROCESS TOOK INTO ACCOUNT THE BENEFIT BEING EARNED UNDER THIS ADDITIONAL ARRANGEMENT. |
| Schedule J, Part II RELATED COMPENSATION | THE FOLLOWING INDIVIDUALS ARE NOT COMPENSATED BY THE REPORTING ORGANIZATION FOR HIS OR HER SERVICE AS A DIRECTOR OR OFFICER. RATHER, THE COMPENSATION REPORTED ON FORM 990, PART VII AND ON SCHEDULE J, PART II REFLECTS COMPENSATION PAID BY ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO (LURIE CHILDREN'S) FOR THE INDIVIDUAL'S SUBSTANTIAL AND FULL-TIME SERVICES AS AN EMPLOYEE. FOR MORE DETAILS, PLEASE REFER TO THE 2021 FORM 990 OF LURIE CHILDREN'S, FEIN 36-2170833. BRENDA DAVIS FATEMA ZANZI RON BLAUSTEIN THOMAS P. SHANLEY, MD |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 4a PROGRAM SERVICE DESCRIPTION | LURIE CHILDREN'S SURGICAL FOUNDATION, INC. ("LCSF") IS AN ILLINOIS NOT FOR PROFIT CORPORATION AND AN ORGANIZATION DESCRIBED UNDER SECTION 501(C)(3) OF THE CODE. ON JANUARY 1, 2019, CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER ("PARENT") (FEIN 36-3357004) BECAME THE SOLE CORPORATE MEMBER OF LCSF. LCSF EMPLOYS PEDIATRIC SURGICAL SPECIALISTS AND SUBSPECIALISTS. SUCH PHYSICIANS ARE BASED AND PRACTICE AT ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO ("LURIE CHILDREN'S"), ANOTHER AFFILIATED ENTITY OF LCSF, AND AT THE LURIE CHILDREN'S OUTREACH LOCATIONS. LURIE CHILDREN'S OFFERS OVER 70 TYPES OF PEDIATRIC SUBSPECIALTY CARE, MORE THAN ANY OTHER ILLINOIS HOSPITAL. LCSF EMPLOYS PEDIATRIC SURGICAL SPECIALISTS AND SUBSPECIALISTS WHO PROVIDE SURGICAL SERVICES TO PATIENTS OF LURIE CHILDREN'S IN THE AREAS OF CARDIAC SURGERY, FETAL SURGERY, NEUROSURGERY, OPHTHALMOLOGY, ORTHOPAEDICS, OTOLARYNGOLOGY, PEDIATRIC SURGERY, PLASTIC SURGERY, TRANSPLANT SURGERY, AND UROLOGY. LCSF PROVIDES SERVICES REGARDLESS OF THE PATIENT'S ABILITY TO PAY. IT ACCEPTS PATIENTS COVERED BY MEDICARE AND MEDICAID AND PROVIDES FINANCIAL ASSISTANCE UNDER ITS FINANCIAL ASSISTANCE POLICY. |
| Form 990, Part V, Line 1a FORM 1099/1096 FILING | VENDORS FOR THE FILING ORGANIZATION ARE PAID BY LURIE CHILDREN'S (EIN 36-2170833). AS SUCH, ALL REQUIRED FORM 1099 AND FORMS 1096 REPORTING IS FILED UNDER THE LURIE CHILDREN'S EIN. |
| Form 990, Part VI, Line 15 EXECUTIVE COMPENSATION | DESCRIPTION OF THE PROCESS BY WHICH THE COMPENSATION OF CERTAIN EXECUTIVES WAS DETERMINED THE AUTHORITY TO REVIEW AND APPROVE EXECUTIVE COMPENSATION HAS BEEN DELEGATED TO THE COMPENSATION COMMITTEE OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER BOARD OF DIRECTORS ("COMPENSATION COMMITTEE"). THE COMPENSATION COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT. THE COMPENSATION PHILOSOPHY IS SUBJECT TO PERIODIC REVIEW FOR CONTINUED APPROPRIATENESS BY THE COMPENSATION COMMITTEE. WITH THE ASSISTANCE OF A COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (SPECIFIED ON SCHEDULE J), THE COMPENSATION COMMITTEE CONFIRMED THE TOTAL AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. LEGAL COUNSEL ADVISES THE COMPENSATION COMMITTEE WITH RESPECT TO FEDERAL TAX REQUIREMENTS IN SETTING COMPENSATION AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS. THE PROCESS FOLLOWED BY THE COMPENSATION COMMITTEE, INCLUDING A DESCRIPTION OF THE DATA RELIED UPON AND THE COMPENSATION COMMITTEE'S DECISIONS, WAS THOROUGHLY AND CONTEMPORANEOUSLY DOCUMENTED. THE COMPENSATION COMMITTEE HAS EXPRESSLY REVIEWED THE REASONABLENESS OF COMPENSATION PAID TO IDENTIFIED EXECUTIVES, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED. THE COMPENSATION COMMITTEE IS COMPRISED OF MEMBERS OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER BOARD OF DIRECTORS HAVE BEEN DETERMINED TO BE DISINTERESTED FOR THESE PURPOSES. THE COMPENSATION COMMITTEE CONDUCTS AN ONGOING AND PERIODIC REVIEW OF THE DISINTERESTED STATUS OF ITS MEMBERS, AND WILL TAKE APPROPRIATE ACTION WITH RESPECT TO ANYONE HAVING AN INTEREST WITH RESPECT TO ONE OR MORE EXECUTIVES SO AS TO PRESERVE THE APPLICATION OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS. |
| Form 990, Part VI, Line 6 Classes of members or stockholders | CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER ("MEDICAL CENTER") IS THE ORGANIZATION'S SOLE CORPORATE MEMBER. |
| Form 990, Part VI, Line 7a Members or stockholders electing members of governing body | THE ORGANIZATION'S SOLE CORPORATE MEMBER, THE MEDICAL CENTER, HAS CERTAIN RESERVED POWERS, INCLUDING THE POWER TO APPOINT AND REMOVE PHYSICIAN DIRECTORS OF THE LCSF BOARD. |
| Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders | THE MEDICAL CENTER, THROUGH ITS BOARD OF DIRECTORS OR DESIGNATED COMMITTEE, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS CERTAIN RESERVED POWERS WITH RESPECT TO APPOINTMENT AND REMOVAL OF CERTAIN DIRECTORS, APPOINTMENT OF CERTAIN OFFICERS, APPROVAL OF AMENDMENTS TO GOVERNING DOCUMENTS, APPROVAL OF FINANCIAL MATTERS, AND APPROVAL OF SIGNIFICANT TRANSACTIONS INCLUDING, BUT NOT LIMITED TO, MERGER, DISSOLUTION, DISPOSITION OF ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS, AND CREATION OF SUBSIDIARIES. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | A FULL COPY OF THE ORGANIZATION'S FORM 990 WAS PROVIDED TO EACH MEMBER OF THE MEDICAL CENTER BOARD'S AUDIT AND COMPLIANCE COMMITTEEFOR REVIEW AND APPROVAL, AS WELL AS THE RESPECTIVE FILING ORGANIZATION'S BOARD FOLLOWING THE COMMITTEE'S APPROVAL. THE AUDIT AND COMPLIANCE COMMITTEE IS THE COMMITTEE OF THE MEDICAL CENTER BOARD CHARGED WITH THE OVERSIGHT OF AUDIT AND TAX MATTERS FOR THE PARENT AND AFFILIATES. DURING A SPECIAL AUDIT AND COMPLIANCE COMMITTEE MEETING, AND BEFORE FORM 990 WAS FILED, THE AUDIT AND COMPLIANCE COMMITTEE WAS PROVIDED A REVIEW OF FORM 990 BY THE CHIEF FINANCIAL OFFICER ("CFO"). THE CFO AND OUTSIDE TAX ADVISOR ALSO RESPONDED TO THE AUDIT AND COMPLAINCE COMMITTEE MEMBERS' QUESTIONS AND AFFORDED THEM THE OPPORTUNITY FOR DETAILED DISCUSSION OF FORM 990, PRIOR TO THE AUDIT AND COMPLIANCE COMMITTEE TAKING ACTION TO APPROVE THE FILING OF FORM 990. AS PART OF ITS ANNUAL RETURN PREPARATION PROCESS, THE ORGANIZATION, ON AN ONGOING BASIS, CONSULTED ITS TAX CONSULTING FIRM AND OUTSIDE TAX LEGAL COUNSEL, BOTH OF WHICH POSSESS EXPERTISE IN HEALTH CARE AND TAX-EXEMPT RETURN PREPARATION, TO ADVISE AND ASSIST IN THE PREPARATION OF FORM 990. THESE ADVISORS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER MEMBERS OF THE ORGANIZATION'S TEAM ASSEMBLED TO PARTICIPATE IN THE PREPARATION OF FORM 990. PRIOR TO PRESENTING FORM 990 TO THE MEDICAL CENTER BOARD'S AUDIT AND COMPLIANCE COMMITTEE, THE ORGANIZATION'S TEAM, INCLUDING ITS ADVISORS, MET FREQUENTLY TO DISCUSS AND REVIEW DRAFTS OF FORM 990. SUBSEQUENT TO THE AUDIT AND COMPLIANCE COMMITTEE REVIEW AND APPROVAL, FORM 990 WAS PROVIDED TO THE RESPECTIVE FILING ORGANIZATION'S BOARD OF DIRECTORS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | ON AN ANNUAL BASIS, CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER (THE "MEDICAL CENTER") AND ITS AFFILIATES (COLLECTIVELY THE "CORPORATION") PROVIDE A COMPREHENSIVE QUESTIONNAIRE TO ITS BOARD MEMBERS, SENIOR MANAGEMENT AND PURCHASING PERSONNEL POSING QUESTIONS ABOUT ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE MEDICAL CENTER INITIATES FOLLOW UP CONTACT TO THOSE WHO DO NOT RESPOND AND TO CLARIFY RESPONSES, WHERE NECESSARY. THE MEDICAL CENTER REVIEWS EACH DISCLOSURE AND PROVIDES A SUMMARY OF RELEVANT DISCLOSURES FOR THE REVIEW AND APPROVAL OF ITS NOMINATING AND GOVERNANCE COMMITTEE. PURSUANT TO THE CONFLICTS OF INTEREST POLICY OF THE CORPORATION, DIRECTORS, OFFICERS, PHYSICIAN LEADERS, AND OTHERS WHO ARE SUBJECT TO THE POLICY ARE REQUIRED TO PROMPTLY AND FULLY DISCLOSE IN WRITING ANY ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO THE PRESIDENT OF THE CORPORATION AND CHIEF LEGAL OFFICER. DISCLOSURES ARE PROVIDED TO THE NOMINATING AND GOVERNANCE COMMITTEE OF THE MEDICAL CENTER BOARD OF DIRECTORS, WHICH CONSIDERS ALL CONFLICTS OF INTEREST ISSUES AND, IF APPROPRIATE, PROVIDES SUCH WRITTEN DISCLOSURE TO THE DIRECTORS AND/OR BOARD COMMITTEES CONSIDERING THE PROPOSED TRANSACTION OR OTHER APPROPRIATE PARTIES. IN ADDITION, ON AN ANNUAL BASIS, THE CORPORATION SURVEYS EACH INDIVIDUAL SUBJECT TO THE POLICY AS TO THE EXISTENCE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE CORPORATION WILL NOT ENTER INTO AN AGREEMENT, TRANSACTION OR OTHER ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS THE DISINTERESTED MEMBERS OF THE NOMINATING AND GOVERNANCE COMMITTEE OF THE CORPORATION'S BOARD OF DIRECTORS DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF THE CORPORATION HAVE BEEN IMPLEMENTED. THE SUBJECT INTERESTED PERSON MAY NOT BE PRESENT WHEN THE VOTE IS TAKEN. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, A DISINTERESTED PERSON OR COMMITTEE OF DISINTERESTED MEMBERS MAY BE ASSIGNED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT, WITH REASONABLE EFFORTS, FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION'S ARTICLES OF INCORPORATION AND ANNUAL REPORTS ARE AVAILABLE THROUGH THE ILLINOIS SECRETARY OF STATE. THE ORGANIZATION ALSO MAKES ITS GENERAL GOVERNING DOCUMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. |
| Form 990, Part VII, Section B, Line 1 INDEPENDENT CONTRACTORS | VENDORS FOR THE FILING ORGANIZATION ARE PAID BY LURIE CHILDREN'S. AS SUCH, THE FIVE HIGHEST COMPENSATED INDEPENDENT CONTRACTORS ARE REPORTED ON THE FORM 990 FOR ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO (EIN 36-2170833). |
| Form 990, Part VIII, Line 2f Other Program Service Revenue | Miscellaneous - Total Revenue: 599455, Related or Exempt Function Revenue: 599455, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | PENSION ADJUSTMENT - 595212; INTERCOMPANY TRANSFERS - -254600; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ALMOST HOME KIDS | |||||||||||
| 7 S 721 ROUTE 53 | NAPERVILLE | IL | 60540 | 363822010 | TRANSITION CR | IL | 501(c)(3) | 10 | MEDICAL CTR | false | |
| STANLEY MANNE CHILDREN'S RESC INSTITUTE | |||||||||||
| 225 E CHICAGO AVE | CHICAGO | IL | 60611 | 363357005 | RESEARCH | IL | 501(c)(3) | 4 | MEDICAL CTR | false | |
| LURIE CHILDREN'S HOSPITAL OF CHICAGO FDN | |||||||||||
| 225 E CHICAGO AVE | CHICAGO | IL | 60611 | 363357006 | FUNDRAISING | IL | 501(c)(3) | 7 | MEDICAL CTR | false | |
| CHILDREN'S HOSPITAL OF CHICAGO MED CTR | |||||||||||
| 225 E CHICAGO AVE | CHICAGO | IL | 60611 | 363357004 | HEALTH CARE | IL | 501(c)(3) | 10 | NA | false | |
| PEDIATRIC FACULTY FOUNDATION INC | |||||||||||
| 225 E CHICAGO AVE | CHICAGO | IL | 60611 | 363279680 | HLTH CRE/RSCH | IL | 501(c)(3) | 10 | MEDICAL CTR | false | |
| LURIE CHILDRENS LIABILITY PROTECTION PRG | |||||||||||
| 225 E CHICAGO AVE | CHICAGO | IL | 60611 | 366638400 | INSURANCE | IL | 501(c)(3) | Type III-FI | MEDICAL CTR | false | |
| LURIE CHILDREN'S | |||||||||||
| 225 E CHICAGO AVE | CHICAGO | IL | 60611 | 362170833 | HOSPITAL | IL | 501(c)(3) | 3 | MEDICAL CTR | false | |
| CHILDREN'S HOSPITAL OF CHICAGO FPP | |||||||||||
| 737 NORTH MICHIGAN AVE | CHICAGO | IL | 60611 | 363393780 | SUPPORTING ORG | IL | 501(c)(3) | Type I | MEDICAL CTR | false | 2040 |
| LURIE CHILDREN'S PEDIATRIC ANESTHESIA AN | |||||||||||
| 225 E CHICAGO AVE | CHICAGO | IL | 60611 | 371838535 | HEALTH CARE | IL | 501(c)(3) | 3 | MEDICAL CTR | false | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LURIE CHILDRENS CIN LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60611 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 901025439 | EIN |
| Primary Activities | CONTRACTING SVCS | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMMC INSURANCE CO LTD | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60611 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 981049532 | EIN |
| Primary Activities | SELF INSURANCE | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C Corporation | EntityTypeTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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