SOUTH SHORE HOSPITAL CORPORATION: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- SOUTH SHORE HOSPITAL CORPORATION (EIN 36-1799520)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-02
- IRS object ID
- 202323069349300512
- Schema version
- 2022v5.0
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-02T13:00:12+00:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 350921680 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 West Wacker Drive Suite 2600 | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606061224 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 361799520 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Shore Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 7733565312 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8012 South Crandon Avenue | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60617 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Leslie Rogers | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7733565312 | PhoneNum |
| Signature | 2023-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Leslei | PersonFirstNm |
| Person Last | Rogers | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kim Scifres | PreparerPersonNm |
| PTIN | P01316095 | PTIN |
| Phone | 3128997000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | 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 | Leslie Rogers | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8012 South Crandon Avenue | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60617 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $47,067,481 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.southshorehospital.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | South Shore Hospital Corporation is a not-for-profit hospital dedicated to providing the highest quality of healthcare possible to the south shore community. The charges forgone for services furnished under its charity care policy during the year ended December 31, 2022 approximated $997,654. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 466 | TotalEmployeeCnt |
| Total Volunteers | 37 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,012,213 | PYContributionsGrantsAmt |
| CY Contributions Grants | $16,214,391 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $33,285,705 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $30,693,416 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $246,747 | PYOtherRevenueAmt |
| CY Other Revenue | $132,021 | CYOtherRevenueAmt |
| PY Total Revenue | $44,544,665 | PYTotalRevenueAmt |
| CY Total Revenue | $47,039,828 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $24,470,329 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,690,871 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $22,081,730 | PYOtherExpensesAmt |
| CY Other Expenses | $19,005,034 | CYOtherExpensesAmt |
| PY Total Expenses | $46,552,059 | PYTotalExpensesAmt |
| CY Total Expenses | $47,695,905 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$2,007,394 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$656,077 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,996,532 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,381,938 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,177,349 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,218,832 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,819,183 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,163,106 | NetAssetsOrFundBalancesEOYAmt |
| Mission | South Shore Hospital Corporation is a not-for-profit hospital dedicated to providing the highest quality of healthcare possible to the south shore community. The costs for services and supplies furnished under its charity care policy during the year ended December 31, 2022, approximated $342,208. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $36,786,330 | ExpenseAmt |
| Revenue | $30,801,240 | RevenueAmt |
| Desc | THE HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT NO CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY DURING THE YEAR ENDED DECEMBER 31, 2022 APPROXIMATED $342,208. IN ADDITION TO CHARITY CARE, THE HOSPITAL ALSO OFFERS OTHER COMMUNITY BENEFITS SUCH AS PROVIDING MENTORS AND VOLUNTEERS, AND IT ALSO SPONSORS HEALTH FAIRS THROUGHOUT THE COMMUNITY. EMPLOYEES OF THE HOSPITAL PARTICIPATE IN A MENTORING PROGRAM FOR CHILDREN WITHIN THE COMMUNITY. THE PROGRAM'S GOAL IS TO MOTIVATE STUDENTS TO COMPLETE THEIR HIGH SCHOOL EDUCATION WITH AN EMPHASIS ON THE OVERALL IMPORTANCE OF EDUCATION AND PRE-EMPLOYMENT PREPARATION. | Desc |
| Total Program Service Expenses | $36,786,330 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 | Yes (true) | 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 | false | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | Yes (true) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (true) | AuditedFinancialStmtAttInd |
| 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 | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 327 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 466 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | 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 | Leslie Rogers | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7733565200 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8012 SOUTH CRANDON AVENUE | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60617 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Julius R Alexander II | ||||||||
| Vice Chairman | 10.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Leslie Rogers | ||||||||
| Assistant Administrator/ CEO | 40.0 | Yes (X) | Yes (X) | $246,634 | $0 | $49,208 | ||
| Lupe Valadez | ||||||||
| Vice President/Secretary | 10.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Nick Valadez | ||||||||
| Chairman of the Board | 10.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Timothy Caveney | ||||||||
| President and CEO | 40.0 | Yes (X) | Yes (X) | $279,247 | $0 | $38,709 | ||
| Todd H Stroger | ||||||||
| Treasurer | 10.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Betty Johnson | ||||||||
| Director | 10.0 | Yes (X) | $0 | $0 | $0 | |||
| Blair Dietrich | ||||||||
| Director | 10.0 | Yes (X) | $0 | $0 | $0 | |||
| Jacqueline Hawkins RN | ||||||||
| Director | 10.0 | Yes (X) | $0 | $0 | $0 | |||
| Jason Chen | ||||||||
| Director | 60.0 | Yes (X) | $0 | $0 | $0 | |||
| Joyce Johnson-Miller | ||||||||
| Director | 10.0 | Yes (X) | $0 | $0 | $0 | |||
| Linda Sanders | ||||||||
| Director | 10.0 | Yes (X) | $0 | $0 | $0 | |||
| Olusegun Apata | ||||||||
| Director | 10.0 | Yes (X) | $0 | $0 | $0 | |||
| Satya Ahuja | ||||||||
| Director | 10.0 | Yes (X) | $0 | $0 | $0 | |||
| Mary E Foley | ||||||||
| Assistant Secretary | 40.0 | Yes (X) | $129,609 | $0 | $30,488 | |||
| Brent Fitzgerald | ||||||||
| Chief Operating Officer - COO | 40.0 | $57,478 | $0 | $6,761 | Yes (X) | |||
| Nikesha Dunn | ||||||||
| Registered Nurse | 40.0 | $221,095 | $0 | $17,684 | Yes (X) | |||
| Pamela Humphries | ||||||||
| Charge Nurse | 40.0 | $224,667 | $0 | $11,711 | Yes (X) | |||
| Rosaline Sledge | ||||||||
| Registered Nurse | 40.0 | $183,228 | $0 | $7,634 | Yes (X) | |||
| Uchechi Ohuonu | ||||||||
| Registered Nurse | 40.0 | $186,111 | $0 | $19,492 | Yes (X) | |||
| Vera H Ray | ||||||||
| Director of Lab | 40.0 | $200,804 | $0 | $12,040 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,728,873 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $193,727 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 50 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| COMPLETE RX LTD | ||||||
| 3100 S GESSNER SUITE 640 | HOUSTON | TX | 77063 | PHARMACY MANAGEMENT | $2,035,782 | |
| ILIND EM-I MEDICAL SERVICES INC | ||||||
| 7032 COLLECTION CENTER DR | CHICAGO | IL | 60693 | EMERGENCY ROOM PHYSICIANS | $1,624,993 | |
| PROFESSIONAL NURSING INC | ||||||
| 3300 W PETERSON AVE | CHICAGO | IL | 606593585 | NURSING AGENCY | $962,541 | SUITE E |
| PULMONARY EXCHANGE LTD | ||||||
| 9840 SOUTHWEST HWY | OAK LAWN | IL | 60453 | NURSING AGENCY | $930,744 | |
| STEVEN GREENWALD MD | ||||||
| 8012 S CRANDON AVE | CHICAGO | IL | 606171124 | PHYSICIAN | $453,750 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $13,717 | FundraisingAmt |
| Government Grants | $16,200,674 | GovernmentGrantsAmt |
| Total Contributions | $16,214,391 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE/MEDICAID PAYMENTS | 622110 | $27,827,174 | $27,827,174 |
| PATIENT SERVICE REVENUE | 622110 | $2,711,744 | $2,711,744 |
| RENTAL INCOME | 531120 | $154,498 | $154,498 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| 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) |
|---|---|---|
| Total Program Service Revenue | $30,693,416 | 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $51,850 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $13,717 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $27,653 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,197 | TotalRevenueColumnAmt |
| Exclusion | $24,197 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAFETERIA REVENUE | 722514 | $89,917 | $89,917 |
| Miscellaneous | 900099 | $17,907 | $17,907 |
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 | $107,824 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,039,828 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,801,240 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $24,197 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $835,135 | TotalAmt |
| Program Services | $835,135 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,106,406 | TotalAmt |
| Program Services | $18,826,898 | ProgramServicesAmt |
| Management And General | $5,279,508 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,749,330 | TotalAmt |
| Program Services | $3,363,689 | ProgramServicesAmt |
| Management And General | $385,641 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,157,587 | TotalAmt |
| Program Services | $7,882,795 | ProgramServicesAmt |
| Management And General | $2,274,792 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $845,444 | TotalAmt |
| Program Services | $236,378 | ProgramServicesAmt |
| Management And General | $609,066 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $893,089 | TotalAmt |
| Program Services | $45,455 | ProgramServicesAmt |
| Management And General | $847,634 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $844,292 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $844,292 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$350,094 | TotalAmt |
| Program Services | -$350,094 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medicaid Provider Tax | $3,293,652 | $3,293,652 | |
| Medical & Surgical Supplies | $1,707,222 | $1,703,160 | $4,062 |
| Food | $495,443 | $241,449 | $253,994 |
| Medicine | $525,493 | $525,493 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $592,906 | TotalAmt |
| Program Services | $182,320 | ProgramServicesAmt |
| Management And General | $410,586 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,695,905 | TotalAmt |
| Program Services | $36,786,330 | ProgramServicesAmt |
| Management And General | $10,909,575 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,362,153 | BOYAmt |
| EOY | $4,634,316 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $414,622 | BOYAmt |
| EOY | $414,622 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,548,934 | BOYAmt |
| EOY | $3,872,034 | 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 |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $550,421 | BOYAmt |
| EOY | $555,418 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $388,081 | BOYAmt |
| EOY | $130,532 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,806,400 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $47,120,855 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,490,277 | BOYAmt |
| EOY | $8,685,545 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| 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 |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,044 | BOYAmt |
| EOY | $89,471 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,996,532 | BOYAmt |
| EOY | $18,381,938 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,255,704 | BOYAmt |
| EOY | $7,419,741 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,921,645 | BOYAmt |
| EOY | $9,799,091 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,177,349 | BOYAmt |
| EOY | $17,218,832 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,819,183 | BOYAmt |
| EOY | $1,163,106 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,819,183 | BOYAmt |
| EOY | $1,163,106 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,996,532 | BOYAmt |
| EOY | $18,381,938 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$656,077 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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 | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $4,200 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $4,200 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY | FormAndLineReferenceDesc |
| Explanation | The Hospital is a member of the Illinois Health and Hospital Association and accordingly pays dues annually for its membership. A portion of South Shore's membership dues are attributable to lobbying activities, which is the amount reported on Schedule C, Part II-B, Line 1i. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,428,579 | OtherCostOrOtherBasisAmt |
| Book Value | $1,428,579 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $18,186,797 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,795,541 | DepreciationAmt |
| Book Value | $5,391,256 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,210,272 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,112,063 | DepreciationAmt |
| Book Value | $98,209 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $33,528,753 | OtherCostOrOtherBasisAmt |
| Depreciation | $32,686,081 | DepreciationAmt |
| Book Value | $842,672 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,451,999 | OtherCostOrOtherBasisAmt |
| Depreciation | $527,170 | DepreciationAmt |
| Book Value | $924,829 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,685,545 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED LIABILITY FOR PROFFESSIONAL AND GENERAL LIABILITY | $3,542,097 |
| ESTIMATED THIRD-PARTY PAYER SETTLEMENTS | $5,434,013 |
| OPERATING LEASE OBLIGATIONS | $822,981 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $9,799,091 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF OUTING | Event1Nm |
| Gross Receipts Event1 | $41,407 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $13,717 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $27,690 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $11,483 | FoodAndBeverageEvent1Amt |
| Event2 | AMETHYST BALL | Event2Nm |
| Gross Receipts Event2 | $24,160 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $24,160 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $10,795 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $2,750 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $2,625 | OtherDirectExpensesEvent2Amt |
| Gross Revenue Other Events | $0 | GrossRevenueOtherEventsAmt |
| Gross Receipts Total | $65,567 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $13,717 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $51,850 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $22,278 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $2,750 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $2,625 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $27,653 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $24,197 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (true) | FinancialAssistancePolicyInd |
| Written Policy | Yes (true) | WrittenPolicyInd |
| All Hospitals Policy | Yes (X) | AllHospitalsPolicyInd |
| FPG Reference Free Care | Yes (true) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (true) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (true) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (true) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (true) | ExpensesExceedBudgetInd |
| Unable To Provide Care | false | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (true) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (true) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $342,208 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $342,208 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0072 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $23,613,297 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,995,692 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,617,605 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1597 | TotalExpensePct |
Unreimbursed Costs UnreimbursedCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $23,955,505 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $15,995,692 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $7,959,813 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1669 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $235,209 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $235,209 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0049 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $3,658,527 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,407,216 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,251,311 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0262 | TotalExpensePct |
Research ResearchGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $3,893,736 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,407,216 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $1,486,520 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0312 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $27,849,241 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $18,402,908 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $9,446,333 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.1981 | TotalExpensePct |
Physical Imprv And Housing PhysicalImprvAndHousingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Economic Development EconomicDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Community Support CommunitySupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Environmental Improvements EnvironmentalImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Leadership Development LeadershipDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Coalition Building CoalitionBuildingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Health Improvement Advocacy HealthImprovementAdvocacyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Workforce Development WorkforceDevelopmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Other Communtity Building Acty OtherCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
Total Communtity Building Acty TotalCommuntityBuildingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $0 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (true) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $5,088,117 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $24,011 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $6,015,482 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,661,281 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$2,645,799 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (true) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (true) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Shore Hospital Corporation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8012 SOUTH CRANDON AVENUE | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60617 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | www.southshorehospital.com | WebsiteAddressTxt |
| State License | 0003459 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | South Shore Hospital Corporation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | false | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | false | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (true) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (true) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (true) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (true) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (true) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | https://www.southshorehospital.com/wp-content/uploads/2023/01/FINAL-South-Shore-Hospital-Report_30De | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (true) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (true) | StrategyPostedWebsiteInd |
| Strategy Website URL | https://www.southshorehospital.com/wp-content/uploads/2023/06/South-Shore-Hospital_CHIP_June2023.pdf | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (true) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.0 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.0 | FPGFamilyIncmLmtDscntCarePct |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | Yes (true) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (true) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (true) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | https://www.southshorehospital.com/fap-summary/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | https://www.southshorehospital.com/fap-summary/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | https://www.southshorehospital.com/fap-summary/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (true) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | false | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (true) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | false | AmountsGenerallyBilledInd |
| Gross Charges | false | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5 Facility , 1 | Facility , 1 - SOUTH SHORE HOSPITAL. Between August 2021 and February 2022, Alliance for Health Equity partners collaborated to conduct a total of 43 focus groups with priority populations such as veterans, individuals living with mental illness, communities of color, older adults, caregivers, teens and young adults, LGBTQ+ community members, adults and teens experiencing homelessness, families with children, faith communities, adults with disabilities, and children and adults living with chronic conditions such as diabetes and asthma. In addition, the Illinois Public Health Institute (IPHI) partnered with South Shore Hospital to hold a focus group with leaders in the South Shore community in November 2022. In total, 8 focus groups were held with community members and service providers in South Shore Hospital's service area. |
| Schedule H, Part V, Section B, Line 6a Facility , 1 | Facility , 1 - South Shore Hospital. SSH and members of the Alliance for Health Equity (AHE), a collaborative of 30 non-profit hospitals (displayed on page 4 of the CHNA), two public hospitals, health departments, and nearly 100 community-based organizations, worked together between March 2021 through June 2022 to conduct a comprehensive Community Health Needs Assessment (CHNA) for Chicago and Suburban Cook County. |
| Schedule H, Part V, Section B, Line 6b Facility , 1 | Facility , 1 - South Shore Hospital. SSH and members of the Alliance for Health Equity (AHE), a collaborative of 30 non-profit hospitals (displayed on page 4 of the CHNA), two public hospitals, health departments, and nearly 100 community-based organizations, worked together between March 2021 through June 2022 to conduct a comprehensive Community Health Needs Assessment (CHNA) for Chicago and Suburban Cook County. |
| Schedule H, Part V, Section B, Line 11 Facility , 1 | Facility , 1 - SOUTH SHORE HOSPITAL. Based on the 2019 CHNA, South Shore Hospital identified four focus areas for implementation: 1. Mental Health Treatment and Referrals 2. Substance Use Disorders 3. Chronic Disease: HIV/Aids Treatment and Prevention 4. Access to Care for Uninsured South Shore Hospital prioritized these needs to address throughout 2019-2022 implementation cycle because they were deemed the most important and urgent, under-addressed, and within South Shore Hospital's ability to influence. The following is a summary of community health implementation activities carried out during the period 2019-2022. Covid-19 Pandemic Response, Treatment, Vaccines, and Outreach: Starting in 2020, South Shore Hospital (like all hospitals in our area) shifted a majority of attention, time, and effort to Covid-19 pandemic response including treatment, vaccines, and outreach. As part of our work with other healthcare institutions, public health, and the community on Covid-19: South Shore Hospital provided medical treatment and access to care for community members with Covid in addition to other ongoing conditions. In addition, we participated with the City's racial equity rapid response efforts and partnered with local city council members and civic leaders to help support community response to Covid, prioritizing communities most impacted, and supported vaccine access for priority communities including our own South Shore community which was identified as a priority community area from the outset of Covid. Behavioral Health - Mental Health Treatment/Referrals and Substance Use Disorders: South Shore Hospital's goal was to provide mental health treatment and education in the South Shore community to improve patients' quality of life and understanding of mental illness. To achieve this goal, the hospital maintained a 15-bed geriatric psychiatric unit. South Shore Hospital continued and expanded partnerships with Chicago Family Health Center, Metropolitan Family Services, Human Resource Development Institute (HRDI), and Horizon Healthcare Treatment Centers to refer patients to quality community-based outpatient care. The hospital also continued an inpatient chemical dependency unit. In addition, South Shore Hospital partnered with South East Alcohol and Drug Abuse Center and a Suboxone clinic to refer patients to community-based care and recovery assistance. HIV/Aids (Access to Care and Chronic Disease): South Shore Hospital's goal was to improve HIV/Aids treatment and education in the South Shore community to improve patients' quality of life and understanding of the disease. To accomplish this goal, South Shore Hospital maintains a clinic at 2525 E. 83rd Street in the South Shore/South Chicago community to provide primary healthcare services and HIV/Aids patients. Health education, outreach, and testing were also conducted, including education and outreach by a peer coordinator and screener working directly within communities. Access to Care for Uninsured and Underinsured: South Shore Hospital had two additional goals related to access to care: to improve access to care for uninsured and to build partnerships with clinics and FQHCs for primary care access for uninsured and underinsured community members. The hospital maintained a part-time financial counselor who assists self-pay patients with enrollment to public benefits and insurance plans with reasonable deductibles in order to continue improving access to care for community members. the hospital also increased partnerships with Chicago Family Health Center and other local clinics for both primary care and outpatient behavioral referrals. In addition, the hospital provided approximately $1 million in charity care per year between 2019 and 2022. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 6 | FacilityNum |
Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp
Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | FacilityFacilityTxt |
|---|---|---|---|---|
| SENIORS & GENERAL WELLNESS CENTER | ||||
| 2525 EAST 83RD STREET | CHICAGO | IL | 60617 | PHYSICIAN OFFICE |
| EAST SIDE MEDICAL HEALTH CENTER | ||||
| 10551 SOUTH EWING AVENUE | CHICAGO | IL | 60617 | PHYSICIAN OFFICE |
| SOUTH SIDE PROFESSIONAL BUILDING | ||||
| 7906 SOUTH CRANDON AVENUE | CHICAGO | IL | 60617 | PHYSICIAN OFFICE |
| HIGHLAND MEDICAL CENTER | ||||
| 8201 SOUTH ASHLAND | CHICAGO | IL | 60620 | PHYSICIAN OFFICE |
| FAMILY MEDICAL CENTER | ||||
| 1424 WEST 87TH STREET | CHICAGO | IL | 60620 | PHYSICIAN OFFICE |
| SHARED PHYSICIAN OFFICE SPACE | ||||
| 8012 SOUTH CRANDON AVENUE | CHICAGO | IL | 60617 | PHYSICIAN OFFICE |
Supplemental Information Detail SupplementalInformationDetail (15 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7g Subsidized Health Services | Line 7g does not include costs attributable to a physician clinic. |
| Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance | Calculations for Lines 7a and 7b were based on the hospital's coST-TO-CHARGE RATIO. FOR LINE 7E, ANY OFFSETTING EXPENSES DIRECTLY ATTRIBUTABLE TO THE COMMUNITY BENEFIT ACTIVITY were reported. Cost for line 7g was based on the Medicare cost-to-charge ratio for the services reported. |
| Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount | THE BAD DEBT RESERVE IS AN ESTIMATE OF THE ACCOUNT BALANCES THAT WE EXPECT TO NOT COLLECT DESPITE THE PATIENTS ABILITY TO PAY. THE ESTIMATE WHICH IS UPDATED MONTHLY IS BASED ON HISTORICAL WRITE OFF PERCENTAGES. THESE PERCENTAGES ARE ADJUSTED TO REFLECT ANY BAD DEBT RECOVERIES. |
| Schedule H, Part III, Line 3 Bad Debt Expense Methodology | The Method used to determine the amount that reasonably could be attributed to patients who likely would qualify for financial assistance under our Financial Assistance Policy is based on our outside eligibility vendor's experience with qualifying accounts as financial assistance. Our vendor screens all self pay accounts, and based on an initial screening, will classify the account as falling under our Financial Assistance Program guidelines. OCCASIONALLY, PATIENT ACCOUNTS WILL BE WRITTEN OFF TO BAD DEBT BUT THEN ARE LATER DETERMINED TO BE UNCOLLECTIBLE DUE TO THE PATIENT BEING UNINSURED OR ELIGIBLE FOR PUBLIC AID. ONCE DETERMINED THAT THE PATIENT HAS NO ABILITY TO PAY, THE ACCOUNTS ARE WRITTEN OFF AS CHARITY WRITE-OFFS. THE METHODOLOGY IS TO TAKE TOTAL BAD EXPENSE LESS THE BAD DEBT FROM THE MEDICARE COST REPORT. THE HOSPITAL INCURS A LOSS FOR THE BENEFIT OF THE COMMUNITY. |
| Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote | The provision for bad debts is based upon management's assessment of historical and expected collections of accounts receivable considering business and economic conditions, trends in healthcare coverage, and other collection indicators. Accounts receivable are written off and charged to the provision for bad debts after collection efforts have been made in accordance with the Hospital's policies. Recoveries are treated as a reduction to the provision for bad debts. Accounts receivable are reduced by an allowance for doubtful accounts. Periodically, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by major payor category. Income from incentive payments is subject to retrospective adjustment as the incentive payments are calculated using Medicare cost report data that is subject to audit. Data about the major payor sources of revenue is analyzed to establish an appropriate allowance for uncollectible receivables and provision for bad debts. For receivables associated with services provided to patients who have third-party coverage, contractually due amounts are analyzed and compared to actual cash collected over time to enhance the quality of the estimate of the allowance for doubtful accounts and the provision for bad debts (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). For receivables associated with self-pay patients (which includes both patients without insurance and patients with deductible and copayment balances due for which third-party coverage exists for part of the bill), a significant allowance for doubtful accounts is recorded on the basis of historical experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. An estimate of the difference between contracted rates and amounts actually collected, after all reasonable collection efforts have been exhausted, is charged to the provision for bad debts and credited to the allowance for doubtful accounts. |
| Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs | Medicare allowable costs were determined by applying the Medicare cost to charge ratio from the 2022 Medicare cost report to the Medicare charges. Approximately 60% of our patients are seniors with Medicare insurance, but are unable to pay their coinsurance and deductible amounts. Consistent with the Hospital's Financial Assistance policy, these accounts are either written off to Charity care or Bad Debt expense. Most of the Medicare shortfall is the result of these accounts. Hence, the Hospital is subsidizing the Medicare reimbursement as part of our community benefit program. |
| Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance | In recognizing the medical needs of the indigent, South Shore Hospital provides quality medical health care regardless of race, creed, color, sex, natural origin, sexual orientation, handicap, age or ability to pay. Our financial assistance policy identifies circumstances under which South Shore Hospital will extend care free of charge or at a discount, commensurate with the ability to pay, to a patient whose financial status makes it impractical or impossible to pay for necessary medical expenses. The necessity for medical treatment of any patient is based upon clinical judgement without regard to the financial status of the patient. If a patient is determined to be eligible for financial assistance, then collection actions will be stopped. |
| Schedule H, Part V, Section B, Line 16a FAP website | - South Shore Hospital Corporation: Line 16a URL: https://www.southshorehospital.com/fap-summary/; |
| Schedule H, Part V, Section B, Line 16b FAP Application website | - South Shore Hospital Corporation: Line 16b URL: https://www.southshorehospital.com/fap-summary/; |
| Schedule H, Part V, Section B, Line 16c FAP plain language summary website | - South Shore Hospital Corporation: Line 16c URL: https://www.southshorehospital.com/fap-summary/; |
| Schedule H, Part VI, Line 2 Needs assessment | The Hospital goes above and beyond the core needs of the community as stipulated in the CHNA, by providing diabetes education, language assistance, and transportation services. Meetings are scheduled throughout the year with ministers, community leaders and representatives of the communities school districts. |
| Schedule H, Part VI, Line 3 Patient education of eligibility for assistance | All uninsured patients are advised of our financial assistance policy as part of the admissions process. Whenever possible, South Shore Hospital provides assistance to uninsured patients in obtaining health care insurance at no cost to the patient. This assistance includes visits with the patient while in the hospital, and follow-up visits to their home to ensure that insurance applications are completed and filed in a timely manner. Then appropriate follow up is done with Medicaid and other insurers to ensure the applications are processed timely. All self pays receive a charity application, and are assessed. They are given a discount based on the State of Illinois poverty guidelines. For patients that are presumptive eligible, they are written off to Charity once they go through the process and are denied. According to the Hospital's FAP: 1. Every patient will, upon admission as an inpatient or outpatient, receive a written notice that shall contain information about the availability of financial assistance, including information about this policy as well as contact information for a hospital employee or office from which the person may obtain further information about the policy. 2. Signs will be posted conspicuously in the admission and registration areas to notify patients and visitors about the availability of financial assistance. The signage will contain the following language, in accordance with the Illinois Hospital Fair Patient Billing Act: "You may be eligible for financial assistance under the terms and conditions the hospital offers to qualified patients. For more information contact South Shore Hospital Financial Counselors at 773-356-5212." 3. Each hospital bill, invoice, or other summary of charges to an uninsured patient shall include with it, or on it, a prominent statement, in accordance with the Illinois Hospital Uninsured Patient Discount Act, to the effect that an uninsured patient who meets certain income requirements may qualify for an uninsured discount and information regarding how an uninsured patient may apply for consideration under South Shore Hospital's FAP. 4. The FAP, Financial Assistance Application and plain language summary of the FAP will be available on South Shore Hospital's website at http://www.southshorehospital.com. The documents will be posted in a format that will allow any individual with access to the Internet to access, download, view, and print a hard copy of the documents without requiring special computer equipment and without the payment of a fee. South Shore Hospital will provide any individual who asks how to obtain online access to a copy of the FAP, Financial Assistance Application form, or plain language summary of the FAP with the direct website address, or URL, of the web page on which these documents are posted. 5. Paper copies of the FAP, Financial Assistance Application and plain language summary of the FAP will be readily available in the admitting department and waiting areas. Patients may also call to obtain a copy and it will be mailed it to them at no cost. 6. The Patient Access Department will also notify those patients with no insurance of the availability of Financial assistance and will give a copy of the Financial Assistance Application and plain language summary of the FAP to patients. |
| Schedule H, Part VI, Line 4 Community information | The South Shore Hospital service area consists of twelve zip codes in the southeast side of the city of Chicago. Six of the zip codes comprise about 80% of our admissions (Zips 60617, 60619, 60649, 60620, 60637, and 60628). These zip code areas have a combined estimated population of about 200,000. Some of the key healthcare needs of this core zip code area are: -There is a disproportionately large population of uninsured people in this area. As a result, South Shore Hospital treats a large percentage of our patients free of charge or at a discount. -There is a disproportionately large population of insured people in this area that cannot afford to pay their copays and deductibles. As a result, the annual Hospital bad debt expense is very large. -There is also a disproportionately large population of indigent people insured with Medicaid in this area. On average, about 25% of our Inpatients have Medicaid health coverage. About 30% of the emergency room outpatient visits are Medicaid patients using the emergency room as a doctors office. Drug abuse is a serious problem in our area with the need for Detox and Rehab services. An increasing number of people in our core zip codes are infected with HIV. There are three other hospital serving the community: St. Bernard Hospital, Advocate Trinity Hospital, and Jackson Park Hospital. South Shore Hospital serves the medically under served. African Americans are nearly 90 percent of inpatient admits. |
| Schedule H, Part VI, Line 5 Promotion of community health | In addition to the services previously noted in this schedule, the Hospital also provides free immunizations, patient education assistance, language assistance, transportation services, and senior wellness programs, at no cost to the patient. The Hospital also participates with local, independent organizations in conducting about 20 health screening events per year. In addition, the Hospital contributes funds to local, non-profit organizations actively engaged in meeting the social, economic, spiritual, mental and healthcare needs of our community. While most of our patients have healthcare insurance through Medicare or Medicaid, neither of these programs cover the cost of providing the care. As a result, the Hospital usually operates at a loss while subsidizing these programs. The members of the governing body are comprised of persons who reside in the organization's primary service area who are neither employees nor independent contractors of the organization, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in the community for all of its departments and specialties. |
| Schedule H, Part VI, Line 7 State filing of community benefit report | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Timothy Caveney | ||||||||||||||
| President and CEO | $279,247 | $0 | $0 | $0 | $0 | $0 | $16,941 | $0 | $21,768 | $0 | $317,956 | $0 | $0 | $0 |
| Leslie Rogers | ||||||||||||||
| Assistant Administrator/ CEO | $244,812 | $0 | $0 | $0 | $1,822 | $0 | $21,199 | $0 | $28,009 | $0 | $295,842 | $0 | $0 | $0 |
| Mary E Foley | ||||||||||||||
| Assistant Secretary | $129,609 | $0 | $0 | $0 | $0 | $0 | $22,189 | $0 | $8,299 | $0 | $160,097 | $0 | $0 | $0 |
| Vera H Ray | ||||||||||||||
| Director of Lab | $200,804 | $0 | $0 | $0 | $0 | $0 | $12,040 | $0 | $0 | $0 | $212,844 | $0 | $0 | $0 |
| Pamela Humphries | ||||||||||||||
| Charge Nurse | $223,795 | $0 | $0 | $0 | $872 | $0 | $0 | $0 | $11,711 | $0 | $236,378 | $0 | $0 | $0 |
| Nikesha Dunn | ||||||||||||||
| Registered Nurse | $221,095 | $0 | $0 | $0 | $0 | $0 | $17,684 | $0 | $0 | $0 | $238,779 | $0 | $0 | $0 |
| Uchechi Ohuonu | ||||||||||||||
| Registered Nurse | $185,738 | $0 | $0 | $0 | $373 | $0 | $11,193 | $0 | $8,299 | $0 | $205,603 | $0 | $0 | $0 |
| Rosaline Sledge | ||||||||||||||
| Registered Nurse | $183,228 | $0 | $0 | $0 | $0 | $0 | $7,634 | $0 | $0 | $0 | $190,862 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN OF THE BOARD OF DIRECTORS AS CHAIRMAN, VICE-CHAIRMAN, THE PRESIDENT, TREASURER, AND SUCH OTHER DIRECTORS AS THE CHAIRMAN OF THE BOARD MAY APPOINT. THE PRESIDENT OF THE MEDICAL STAFF SHALL BE A MEMBER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF DIRECTORS. IN ADDITION, THE EXECUTIVE COMMITTEE MAY ACT IN ALL PERSONNEL MATTERS INVOLVING EXECUTIVE PERSONNEL AND MEDICAL STAFF AS WELL AS OTHER PERSONNEL, INCLUDING SEARCH, SELECTION, EMPLOYMENT, COMPENSATION, CONTRACTS, GENERAL WAGE SCALES, BENEFITS FOR ALL EMPLOYEES AND PERFORMANCE EVALUATION. THE CHAIRMAN MAY APPOINT AN AD HOC COMMITTEE TO RECOMMEND TO IT ANY PARTICULAR SITUATION. |
| Form 990, Part VI, Line 2 Family/business relationships amongst interested persons | LUPE VALADEZ & NICK VALADEZ - Family relationship, BETTY JOHNSON & JOYCE JOHNSON-MILLER - Family relationship |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | PRINTED COPY OF THE FORM 990 WILL BE PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Each officer, director, trustee and key employee is subject to the conflict of interest policy. the board's conflict of interest committee reviews each member's conflict of interest statement on an annual basis. the board compares prior and current year conflict of interest statements, and reports any potential or actual conflicts of interest to the organization's human resources department. actual conflicts of interest are documented with the organization's human resources department annually. Officers, Directors, Trustees and employees are all covered under the organizations conflict of interest policy. Should there become known, at any time, a conflict of interest between any member staff, hospital personnel or other healthcare providers and the hospital, and the hospital or any of its agents, the individual (s) may excuse himself/ herself from discussions and/ or determinations with the identified healthcare provider(s). |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The board of directors reviews the CEO's performance on an annual basis. In setting the compensation of the organization's CEO, the board compares industry compensation figures to the CEO's compensation package. The final determination and deliberations regarding the CEO's compensation package are documented in the minutes of the board of directors meeting. The process for determining compensation of the CEO was last undertaken in 2022. |
| Form 990, Part VI, Line 15b Process to establish compensation of other employees | The board of directors reviews the performance of the officers and key employees on an annual basis. In setting the compensation of these individuals, the board compares industry compensation figures to their financial packages. If any individual's compensation is discussed during the meeting, that individual is required to recuse themselves. The process for determining compensation of other officers and key employees was last undertaken in 2022. |
| Form 990, Part VI, Line 19 Required documents available to the public | Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are available upon request |
| Form 990, Part VII, Section A Reportable Compensation | No board member received compensation for services performed as a board member. Board members who have reported compensation from the filing entity were paid for provision of other services to the organization. |
| Form 990, Part IX, Line 11g Other Fees | PURCHASED SERVICES - Total Expense: 4631496, Program Service Expense: 3510925, Management and General Expenses: 1120571, Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 3789988, Program Service Expense: 3720878, Management and General Expenses: 69110, Fundraising Expenses: ; REPAIRS AND MAINTENANCE - Total Expense: 592906, Program Service Expense: 182320, Management and General Expenses: 410586, Fundraising Expenses: ; OTHER - Total Expense: 1143197, Program Service Expense: 468672, Management and General Expenses: 674525, Fundraising Expenses: ; |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTH SHORE HOSPITAL AUXILIARY | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8012 S CRANDON AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606171199 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363200759 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Exempt Code Section | 501(c)(3) | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SSHC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| 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 | false | 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 | false | 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 | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Comments