2022-07-12T16:00:40-05:00 2021-08-31 350921680 CROWE LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2020-09-01 362256036 Rehabilitation Institute of Chicago REHA 3122381000 355 East Erie Street Chicago IL 60611 Jonathan M Tingstad Senior VP & CFO 2022-07-12 true Jonathan M Tingstad 999009999 Mallory Fairless P01321579 3128997000 2020 2022-09-23 18:48:47Z Shirley Ryan AbilityLab Peggy Kirk President & CEO as of 93021 355 East Erie Street Chicago IL 60611 571524458 false X www.sralab.org X 1951 IL The Rehabilitation Institute of Chicago DBA Shirley Ryan AbilityLab (SRAlab) is dedicated to providing the best patient outcomes through the highest-quality clinical care, translational research, scientific discovery and education. 18 16 2729 41 5879997 1535765 51229707 41697577 276505897 297774258 13736599 20789820 9166431 2362021 350638634 362623676 5143508 5521050 0 202638982 216074095 90000 90000 1881043 124091095 125319861 331963585 347005006 18675049 15618670 1190859768 1284760525 588602053 552299610 602257715 732460915 X SRAlab is dedicated to providing the best patient outcomes through the highest-quality clinical care, translational research, scientific discovery and education. false false 248090270 9000 283990330 The Rehabilitation Institute of Chicago (RIC) was founded in 1951 as, an Illinois not-for-profit corporation. In 2017 RIC with 182 beds, began doing business as the Shirley Ryan Abilitylab (SRAlab) and moved to a new building with 242 licensed beds. This move brought not only a physical change of address but a whole new model to the field of rehabilitation. Upon opening the 1.2-million square foot building, SRAlab became the first-ever "translational" rehabilitation research hospital in which clinicians, scientists, innovators and technologists work together in the same space, surrounding patients, discovering new approaches and applying (or "translating") research in real time. SRAlab's vision is to advance human ability through science and research. The organization has earned the distinction of being named the nation's #1-ranked provider of comprehensive physical medicine and rehabilitation care to patients from around the world every year since the designations inception in 1992 by U.S. News & World Report - a record for any U.S. hospital. In addition to being a large rehabilitation hospital SRAlab is the nation's largest rehabilitation research enterprise, advancing the field globally through innovation of the most advanced treatments and technologies. For 2021 SRAlab's system of care included a 262 bed hospital and numerous outpatient programs, located at 355 East Erie Street in Chicago, Illinois, as well as a number of other facilities and joint ventures throughout the Chicagoland area. The Corporation offers a comprehensive range of inpatient, day rehabilitation and outpatient services. Inpatient rehabilitation services are provided using an interdisciplinary approach with a team bringing unique skills and knowledge to get patients the best possible outcome. Day rehabilitation therapy program is similar to inpatient in that it consists of an interdisciplinary approach for individuals. However patients in DayRehab no longer require the 24-hour nursing services provided in an inpatient setting. Outpatient care is typically a singular discipline (e.g., physical therapy) and offers various levels of therapeutic intensity, depending on the patient's needs and goals. In 2021 we continued to serve patients safely through the pandemic. Inpatient admissions grew 7% year over year. The complexity of patients served also grew as we treated patients with multiple medical and rehabilitation issues, some as a result of their COVID infection. To date, we have admitted over 200 patients with disabling conditions as a result of COVID, including patients who received bilateral lung transplants. We continue to serve patients from all around the country. Outpatient and DayRehab also grew. We continued to offer virtual visits in addition to the in-person services. Once our programs resumed in-person visits most patients chose to return to in-person visits. Despite continued focus on managing through the pandemic we were successful in moving forward important initiatives. The Ability Quotient (AQ) is a clinical outcome tool under development for a number of years. SRAlab developed the AQ with the expertise of a multi-disciplinary group of clinicians and researchers using well established analytical tools. The AQ allows for assessing patients at admission, during intervals during the admission and at discharge. It serves as a way to measure progress, predict patient outcomes and guide interventions based on patient progress (or lack of progress). This year the AQ has been fully implemented throughout the organization and preliminary data suggests it facilitates better outcomes faster. SRAlab formally launched its Diversity, Inclusion and Equity initiative by developing steering committee representing the diverse nature of our patients and staff. Some completed activities include rolling out robust education for our staff, development of policies and practices when faced with discriminatory interactions, or practices within the organization and broadening our recruitment efforts to provide for greater diversity within our communities. 36482100 5512050 5989819 Research Program: SRAlab's Research Program is the world's largest physical rehabilitation research enterprise in pursuit of clinical advancement through scientific discovery. The Research Program has at any given time approximately 130 research projects underway, funded by more than $130 million in donations from both private and public sources. Its experts regularly publish research in the world's foremost medical journals, including the Journal of the American Medical Association (JAMA) and its European equivalent, The Lancet, and it is home to six federal research designations to develop cutting-edge solutions for patients. Biologics Lab and Aphasia Research Integration: We have begun to integrate our biologics laboratory with the rest of the hospital in the aphasia research program. We are now genetically sequencing patients in the stroke rehabilitation program to understand the genetic basis (if any) for response to therapy. This work was funded by NIDILRR. The NIDILRR-funded center is especially for patients with hemispheric stroke - the most debilitating kind. Seven studies address two elemental questions: When is the optimal time to use robotic and computer-based systems during therapy, and how do therapists best interact with robotic devices during therapy, often with minimal hands-on treatment coming from the clinician. Training of undergraduate rehabilitation engineers is included. Manipulation and Mobility Technologies: A NIDILRR-funded Rehabilitation Engineering Research Center award to fund six new projects researching innovations that are directly useful for patients, especially those who have experienced limb-loss or stroke. Projects include body-powered hand prostheses, use of powered exoskeleton for after-stroke patients, and a new wheelchair to allow both sitting and standing. Research will include both technology development and clinical testing. Health and Function in Physical Disability: This Rehabilitation and Training Center, funded by NIDILRR, was created to develop, evaluate, and implement methods to promote optimal health and function of people with physical disabilities. Through a variety of research, training and dissemination activities, we expect to gain a more comprehensive understanding of the efficacy and value of various interventions for achieving and maintaining health and function for people with a disability. Spinal Cord Injury Research: SRAlab operates the Midwest Regional Spinal Cord Injury Care System as designated by NIDILRR. One of only 14 SCI Model Systems nationwide, SRAlab advances spinal cord care through clinical research that identifies new standards of care for the industry. It leads multiple independent and collaborative research projects exploring walking therapy technologies that deliver the most effective treatment to advance ability. We have also added a sophisticated neurophysiological testing division that is dedicated to the measurement and treatment of our inpatient Spinal Cord Injured patients. Engineering Research: This project established a new NIDILRR-funded Rehabilitation Engineering Research Center, Collaborative Machines Enhancing Therapies (COMET), focusing on advancing technologies that work in partnership with patients and clinicians to enhance gait and dexterity outcomes for individuals with stroke and spinal cord injury (SCI) and other people with disabilities in a real-life rehabilitation setting. This project is based at SRAlab and leads four other major research universities around the United States. Wearable and Mobile Sensors: This new center established the, "Center for Smart Use of Technologies to Assess Real World Outcomes (CSTAR). This center serves as a national resource for rehabilitation professionals attempting to measure patient function in objective manners outside of the traditional clinical environment. Our partnership allows us to leverage the collective experience of our clinicians, scientists, engineers, and patients to provide the expertise, instruction, and mentoring to support the smart use of technology. Rapid Non-Invasive Screening for Covid-19: Controlling the spread of the COVID-19 pandemic largely depends on scaling up the testing infrastructure for identifying infected individuals. This project establishes a novel paradigm based on recording the physiological responses elicited by a short (~2 minutes) sequence of activities (i.e. "snapshot"), to detect symptoms associated with COVID-19. We are employing a novel body-conforming soft wearable sensor placed on the suprasternal notch to capture data on physical activity, cardio-respiratory function, and cough sounds. Early results, although preliminary, suggest that a sensor-based snapshot paradigm may be a promising approach for non-invasive and repeatable testing to alert individuals that need further screening. 9210972 0 1362680 Medical Education: The Department of Physical Medicine and Rehabilitation at Northwestern University's Feinberg School of Medicine (Dept of PM&R) is housed within SRAlab, which has one of the largest and most highly respected residency programs in Physical Medicine and Rehabilitation in the country. Resident physicians spend three to four years rotating through the Dept of PM&R, taught by SRAlab physicians who are experts in this special, In FY 2022, SRAlab trained 52 residents. The SRAlab medical education program also provides opportunities for fourth year medical students from Northwestern University Feinberg School of Medicine to rotate in a rehabilitation setting to gain experience with spinal cord injury, brain injury, amputee rehabilitation, cancer rehabilitation, medically complex rehabilitation, and pediatric rehabilitation. There are approximately 180 medical students from Northwestern that rotate with us and additional 40 medical students from other medical school nationally that rotate with us. Fellowships: SRAlab offers 6 physician sub-specialty fellowships, funded primarily by donations, in Sports Medicine, Pain Medicine, Pediatric Rehabilitation, Brain Injury Rehabilitation, Spinal Cord Injury Rehabilitation and Parkinsons/Movement Disorders.. In FY 2021, 14 physician fellows were named at SRAlab, 2 in spinal cord medicine, 4 in sports medicine, 3 in pediatric rehabilitation, 2 in Brain injury, 2 in pain medicine, and 1 in Parkinsons/Movement Disorders. SRAlab also supports residencies for therapists, nurses and other non-physicians. Prosthetics and Orthotics (P&O) Residency: Each year, SRAlab's Prosthetics and Orthotics Clinical Center (POCC) selects three prosthetist and three orthotist residents for these highly sought after positions. The orthotics residency is a 12-month program and the prosthetics residency is an 18-month program to allow additional hands-on experience in research through our Center for Bionic Medicine. Through these training programs, P&O residents are mentored by SRAlab's certified, licensed professionals and get exposure to a variety of clinical presentations and pathologies, clinical evaluation, prescription recommendation, documentation, the actual fabrication of devices, and formal research. Academy: The Academy has offered continuing education aimed at helping healthcare professionals stay at the forefront of their field for 60 years. In FY 2022, over six thousand students participated in academy programs which are taught by interdisciplinary teams of recognized specialists from SRAlab and visiting experts from around the world. These programs were offered in a variety of formats including webinars, courses, and workshops, exclusively delivered online in response to the COVID-19 pandemic. In addition, we expanded our outreach to international participants who were able to participate in asynchronous and live programming that fit with their time zone. 5506802 0 616657 SRAlab's Henry B. Betts LIFE Center is a virtual and multimedia education center providing patient education and consumer health information for patients, families, staff and the community. Everything in the collection relates in some way to people living with a wide range of cognitive and physical impairments, chronic conditions or diseases affecting function. The website enables individuals across the globe to have access to current, peer-reviewed patient education and consumer health resources with real-time updates, printing on demand and a dashboard to save favorite resources for easy access. Resources such as the LIFE Center help individuals and their families navigate the intricacies of health care and minimize the complexity of relevant health information. Having access to information empowers people to partner with their health care team in order to make the best choices for themselves, their families and engage in life-long learning. The Center's resources are organized according to eight topic areas: Medical Information and Care, Caregiving and Equipment, Housing and Transportation, Education and Employment, Support and Wellness, Recreation and Leisure, Finance and Law and Inspiration and Hope. LIFE web traffic in FY 2021 averaged 12,349 page views per month with 148,198 page views annually from more than 173 countries. This past year, the highest international web activity occurred in the United States, Australia, Canada, Philippines, India and Malaysia. In FY 2021, total outreach and service efforts represented 6,490 person contacts served which includes programs, classes, special events, resource requests, teaching activities and tours for patients, families, staff and the community. Sports and Fitness Program: The SRAlab Adaptive Sports and Fitness Program provides wellness opportunities to people with physical disabilities through sports and recreation as well as a full-service accessible health club. All services offered in the adaptive sports program, which marked its 40th year in FY 2021, are free of charge. The fitness program, which celebrated its 25th anniversary, provides access to a health club that operates from 6:15 am to 7 pm five days per week for a nominal annual fee. The sports and fitness program is funded primarily by grants and generous community donations and is operated by eleven full time equivalent staff. Additionally, volunteers logged nearly 5200 hours in FY 2021. The Shirley Ryan Adaptive Sports and Fitness Program is considered a national leader in health promotion for people with disabilities. In FY 2021 we resumed programming, after almost a year hiatus from programming due to the pandemic. While restarting programming was slow the sports program had recorded over 1800 visits by 100+ registered participants, and the fitness program began services slow but sooner than sports but only provided services virtual for a few months then transitioned some participation back to in person recording 4,875 one-on-one visits by its 200 registered participants in addition to 248 virtual class visits. A separate program for youth, the Tengelsen Family Foundation Sports for Kids program, recorded 185 visits by 42 Chicago area children with disabilities. Vocational Rehabilitation Program: Beginning a career or returning to work following an illness or injury is important to a patient's financial security and emotional well-being. It can contribute to the achievement of a productive, independent and fulfilling life. For more than 50 years, the SRAlab has been providing comprehensive vocational rehabilitation services tailored to meet the needs of each client. Services include initial assessment, vocational counseling and guidance, diagnostic evaluation, work trial assessments, job analysis, return-to-work evaluations, job placement, resume writing, job interview workshops and internship coordination. The SRAlab covers the cost of initial assessments, which are not covered by most third-party payers. Patients receive vocational services at nine SRAlab facilities or via telehealth, ensuring that employment assistance is closely tied to community reintegration. During FY 2021 the program served 1054 clients. In the last year, we placed 68 individuals in jobs. We continue to provide no cost GED program for patients with spinal cord injuries to our list of services. Assistive Technology Programs: The Technology Center and the Wheelchair & Seating Center, comprise SRAlab's Assistive Technology Programs. In FY 2021, the Assistive Technology Programs served approximately 1,900 unique patients. The SRAlab Technology Center provides computer access training, augmentative communication devices and electronic aids to daily living, including recommendations for home automation and modifications, for people with different abilities. Occupational therapists and speech language pathologists evaluate and recommend equipment for each individual's needs. Through a lending library, patients can try items before purchasing them or borrow them for short-term use due to changing needs. Staff members speak to universities, schools, organizations for people with disabilities, senior centers and the general public. The center provides 1 to 2 home visits if the client can no longer come to SRALab following their evaluation. We have also integrated the use of telehealth appointments over the past year. Staff recommend applying for SRALab charity funds if Patient's insurance is maxed out. The Technology Center saw 620 inpatients, 290 Day Rehab clients, and 370 outpatients in the past fiscal year. Rehabilitation Engineering staff collaborate with allied health clinicians to provide consultation, evaluation, and design of individual solutions to aid persons with different abilities to complete activities of daily living with increased independence at home, work, and in the community. The team fabricates custom equipment and modifies commercially available equipment and objects to create unique, individualized solutions to help patients navigate obstacles encountered in daily life. SRAlab provides free care for services and products, and provides real-life design experience to students through Northwestern University's engineering design program. The Wheelchair & Seating Center staff evaluate and make recommendations for complex wheelchairs and customized seating systems for patients with significant mobility and postural needs. This includes manual wheelchairs; powered wheelchairs; custom-made and customized seat and back cushions to relieve pressure, prevent pressure sores, and maintain posture; alternative drive controls like sip and puff and head array systems; that help clients maintain or increase their mobility and independence, at home, work, or in the community. During FY20 the Wheelchair & Seating Center integrated the use of telehealth appointments to continue to serve some of our patients during the global pandemic. We served a total of 1,731 patients including 791 inpatients, 23 DayRehab clients, and 917 outpatients. We also participated in a hospital wide quality improvement project to improve the turnaround time from initial evaluation to delivery of the definitive custom wheelchair. 5506802 616657 299290144 true true false true false false false false true true true false false true true false true false false true true false true true false true true true true true true true false false false false false false true true false true false false false true true true true false false true 171 0 true 2729 true true true false false false false true true false false false false true false X 18 16 false true false false true true true true true false false true true true true true true true true false IL IN X Jonathan M Tingstad 3122381000 355 East Erie Street Chicago IL 60611 Joanne C Smith MD President, CEO 40.0 2.0 X X 3868280 0 409566 M Jude Reyes Chairman 1.0 2.0 X X 0 0 0 Michael P Krasney Vice Chairman 1.0 1.0 X X 0 0 0 Thomas A Reynolds III Vice Chairman 1.0 1.0 X X 0 0 0 Christopher Gust Director 1.0 1.0 X 0 0 0 Dan K Webb Director 1.0 1.0 X 0 0 0 Daniel D Dolan Jr Vice Chairman 1.0 1.0 X 0 0 0 James H Litinsky Director 1.0 1.0 X 0 0 0 Linda S Wolf Director 1.0 1.0 X 0 0 0 Mark F Stephan Director 1.0 1.0 X 0 0 0 Michael L Keiser Director 1.0 1.0 X 0 0 0 Richard B Murphy Director 1.0 1.0 X 0 0 0 Robert O Delaney Jr Director 1.0 1.0 X 0 0 0 Sheli Rosenberg Director 1.0 1.0 X 0 0 0 Shirley W Ryan Director 1.0 2.0 X 0 0 0 Wayne R Andersen Director 1.0 1.0 X 0 0 0 William E Lowry Jr Director 1.0 1.0 X 0 0 0 William J Cernugel Director 1.0 1.0 X 0 0 0 Jonathan M Tingstad SVP, Chief Financial Officer 40.0 2.0 X 863095 0 92167 Nancy E Paridy SVP, Chief Administrative Officer 40.0 2.0 X 1075442 0 150954 Peggy M Kirk SVP, Chief Operating Officer 40.0 0.0 X 1392288 0 218315 Collins Fitzpatrick MD Medical Director 40.0 0.0 X 928614 0 57978 Elizabeth Owens SVP,Chief Marketing and Innovation Officer 40.0 0.0 X 897875 0 85520 James Sliwa DO Chief Medical Officer 40.0 0.0 X 946012 0 19296 Richard Lieber PhD SVP of Research, Chief Scientific Officer 40.0 0.0 X 1025195 0 96339 Stacy Fuller McCarty Attending Physician 40.0 0.0 X 526034 0 60821 11522835 0 1190956 341 false true false POWER CONSTRUCTION COMPANY LLC 8750 W BRYN MAWR CHICAGO IL 606313546 Construction Services 6844694 CERNER CORPORATION PO BOX 959156 ST LOUIS MO 631959156 IT Services 5879407 NORTHWESTERN UNIVERSITY 420 E SUPERIOR STREET CHICAGO IL 606113008 Research Services 4550550 CROTHALL FACILITIES MANAGEMENT 1500 LIBERTY RIDGE DR WAYNE PA 19087 Facility Care Services 4367373 MCGAW MEDICAL CENTER NORTHWESTERN UNIVERSITY CHICAGO IL 606110402 Medical Services 3330960 83 0 0 4056710 0 28076420 9564447 1506329 41697577 Net Patient Revenue 621990 264267538 264267538 0 0 Affiliation Income 900099 17550679 12269254 5281425 0 Sponsored Research Rev 541700 5786255 5786255 0 0 Medicare GME Payment 622310 971658 971658 0 0 Consulting 900099 5795212 5261865 533347 3402916 3402916 0 0 297774258 3572263 0 65225 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9551952 9551952 0 0 Patient Transportation 165557 165557 UBI & Excise Tax 1512169 672546 839623 0 6373284 6333647 18009 21628 347005006 299290144 45833819 1881043 165605 144306 16714074 16708784 17307804 14696919 49442242 33878362 0 0 0 0 1865438 2351988 3576350 4243342 732106873 154681669 601917479 577425204 251306739 290373035 203158743 307244151 11755282 13080377 558824 558824 33091188 24055233 1190859768 1284760525 43207143 47686960 4464698 7210855 2366535 4339327 339478242 331018351 0 0 0 0 0 0 0 0 199085435 162044117 588602053 552299610 X 436409618 550867688 165848097 181593227 0 0 0 0 0 0 602257715 732460915 1190859768 1284760525 X 15618670 81198680 33385850 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 208238 208238 false Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY SRALAB LOBBIES FEDERAL AND STATE GOVERNMENT ON ISSUES RELATED TO HEALTHCARE PROVIDER ISSUES, INCLUDING BUT NOT LIMITED TO MEDICARE, MEDICAID AND OTHER GOVERNMENT HEALTH CARE PROGRAMS, AS WELL AS COVID-RELATED ISSUES AND OTHER REHABILITATION FOCUSED ISSUES . THE MAJORITY OF LOBBYING EXPENSES, $190,701, ARE PAID TO THIRD PARTY LOBBYING FIRMS. ADDITIONALLY, A PERCENTAGE OF THE TOTAL DUES FOR THE ILLINOIS HOSPITAL ASSOCIATION (37% IN FISCAL YEAR 2021) GOES TOWARD LOBBYING EFFORTS, WHICH AMOUNTS TO $17,537. SRALAB DOES NOT PARTICIPATE IN OR INTERVENE IN (INCLUDING THE PUBLISHING OR DISTRIBUTING OF STATEMENTS) ANY POLITICAL CAMPAIGN ON BEHALF OF (OR IN OPPOSITION TO) ANY CANDIDATE FOR PUBLIC OFFICE. 109390922 5881 26426874 4681601 131142076 103561767 11061 10290557 4472463 109390922 102581910 2574460 2668502 4263105 103561767 96665403 3848140 6282143 4213776 102581910 90198061 22014 10561102 4115774 96665403 0.0424 0.4262 0.5314 false false 32336315 32336315 545829464 75003249 470826215 24669452 0 24669452 128477904 79678420 48799484 793738 793738 577425204 Cash and Cash Equivalents 7447298 F Absolute Return 76812088 F Hedged Equity 45248057 F International Equity 70657520 F International Hedged Equity 41023260 F Pvt Equity, Real Assets & Contracts 66055928 F 307244151 Self-Insurance Reserves 6838274 Estimated Third Party Settlements Payable 8941992 Due to Affiliates (Pathways) 1096770 Accrued Pension 72677012 457 Plan Liability 22956879 SWAP Liability 13851344 Bond Issuance Fee + Annuity Liability 96830 LT Deferred FICA 3260859 Lease Liability 23406417 Medicare Advance 8914400 Capital Lease Liability - LT 3340 162044117 X Schedule D, Part VI, Line 1c Depreciation for leasehold improvements is included in the same general ledger account as building depreciation. There is related depreciation for leasehold improvements, but it cannot be bifurcated for Form 990 purposes. Schedule D, Part V, Line 4 Intended uses of endowment funds The intended use for each of the SRAlab endowment funds is established by the donor. The majority of the endowment funds are used to support medical education, clinical care, free care, research, medical leadership, fellowships, and the SRAlab Academy. Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote RII, the Shirley Ryan AbilityLab, and Pathways are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the "Code") and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Despite the general exemption from income taxes, RII and the Shirley Ryan AbilityLab are subject to federal and state income taxes at corporate rates on unrelated business income. Included in the consolidated statements of operations and changes in net assets is the provision for current taxes of $1,520,000 and$1,299,000 for the years ended August 31, 2021 and 2020, respectively. The corporations do not have any material tax positions as of August 31, 2021 and 2020. true Middle East and North Africa 0 0 Program Services Travel related to clinical care, education and training, and business development. 112978 Europe (Including Iceland and Greenland) 0 0 Speaking engagements,Conference Travel 15817 North America (Canada & Mexico only) 0 0 Program Services Equipment purchase for research grant. 2231 South Asia 0 0 Program Services Business development. 1654 0 0 0 0 0 0 132680 0 132680 Europe (Including Iceland and Greenland) Payments for research study related activities 130608 Check 0 N/A N/A 0 1 true false false true true true Schedule F, Part I, Line 2 Procedures for monitoring use of grant funds Each research grant is assigned a Principal Investigator (PI) as well as a Research Administrator (RA). Grant expenditures charged to each grant are approved/reviewed by the respective PI and or RA to ensure allowability. In addition, compliance (A-133) audits are performed by an independent audit firm each year. Program services as detailed in Schedule F, Part I, are derived from our Global Services and other foreign designated cost centers. SRALab credit cards were also reviewed for foreign transactions, and where applicable, those transactions were included. Schedule F, Part I, Line 2 PROCEDURES FOR MONITORING USE OF GRANT FUNDS Each research grant is assigned a Principal Investigator (PI) as well as a Research Administrator (RA). Grant expenditures charged to each grant are approved/reviewed by the respective PI and or RA to ensure allowability. In addition, compliance (A-133) audits are performed by an independent audit firm each year. Program services as detailed in Schedule F, Part I, are derived from our Global Services and other foreign designated cost centers. SRALab credit cards were also reviewed for foreign transactions, and where applicable, those transactions were included. 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Schedule H, Part V, Section B, Line 5 Facility , 1 Facility , 1 - Shirley Ryan AbilityLab. As part of developing its 2019 Community Health Needs Assessment, and in order to assess the significant health needs of its community, Shirley Ryan AbilityLab invited a number of leaders within the health community to participate in a Focus Group. These leaders included persons with special knowledge or expertise in public health, federal, state or local health departments, or agencies with current data or other information relevant to the health needs of the community. Participants included leaders, representatives or members of medically underserved, low-income, and minority populations, and populations with chronic disease needs. SRAlab is grateful for the discussion and input provided by the following Focus Group participants: Access Living; Brain Injury Association of Illinois; Chicago Park District; EOA Consulting, LLC.; Illinois DHS - Division of Rehabilitation Services; Open Doors (Consultant); Parkinson's Disease & Movement Disorder Center, Northwestern University; Sliding Board Productions, Inc.; Spinal Cord Injury Association of Illinois; and the SRAlab Peer Mentor Program. The Focus Group meeting was held on May 21, 2019, at SRAlab. Group discussion focused on the rehabilitation health needs of people with physical disabilities, access to information and care, research and clinical trials, education and training, and support programs. In order to identify the significant community health needs, SRAlab analyzed the information obtained in the Assessment process. Focus Group participants were asked to consider the significant rehabilitation health needs of their respective communities. Schedule H, Part V, Section B, Line 11 Facility , 1 Facility , 1 - Shirley Ryan AbilityLab. SRAlab conducted its third Community Health Needs Assessment (CHNA) during its tax year 2018 and adopted the CHNA during its tax year 2019 (2019 CHNA). Tax year 2019 covered the period from September 1, 2019 through August 31, 2020. Tax year 2020 covered the period from September 1, 2020 through August 31, 2021, and is also referred to herein as FY2021. SRAlab identified the following five significant health needs in its 2019 CHNA: rehabilitation health, research, improved access to information about existing resources, education and training, and support programs. All significant health needs identified in this CHNA are being addressed. SRAlab took the following actions during FY2021 to address the identified needs: In the area of rehabilitation health, SRAlab continued to serve an array of patients with rehabilitation needs to improve and eliminate the effects of injury, disease, and debilitating health conditions. The patients treated included adult and pediatric patients with amputations and other limb deficiencies, neuro musculoskeletal injuries, brain injuries, spinal cord injuries, stroke rehabilitation, and cancer rehabilitation. Utilizing all of the state-of-the-art technology and equipment available at its flagship hospital, which opened in March 2017, SRAlab continues its work toward the vision of advancing patient outcomes through the integration of research and clinical care. In addition to this work at the flagship hospital, FY 2021 brought continued improvement and access for the DayRehab programs located throughout the Chicagoland area. DayRehab is a community-based program ranging from three hours of therapy per day, two days a week, to six hours of therapy per day, five days a week. In FY 2021, SRAlab settled in to its Homewood and Arlington Heights clinics, serving many new patients in those communities. Across all DayRehab sites in FY 2021 we cared for 14% more patients than in FY 2020, and we continue to help our patients navigate their new functional abilities and medical needs in the midst of an unprecedented public health emergency. Of great significance in FY2020 was SRAlab's rapid adoption and implementation of telehealth and remote services in response to the COVID-19 pandemic. By providing telehealth and remote services to outpatients and DayRehab patients, SRAlab was able to continue supporting the needs of the community by meeting its patients where they were, protecting them from exposure to infection, and ensuring that patients saw no interruption of their rehabilitation care. The introduction and rollout of highly effective vaccines has made many patients comfortable with resuming in-person services. However, SRAlab continues to provide telehealth and remote services to many patients. In FY2021, SRAlab provided approximately 20,000 telehealth and remote services with physicians, physical therapists, occupational therapists, psychologists, and speech language pathologists across all outpatient sites. In addition to providing telehealth and remote services to patients in Illinois, SRAlab is fully utilizing the waivers and flexibilities put in place by CMS, HHS, and other states to provide telehealth and remote services to patients nationwide. In FY2021, SRAlab provided telehealth and remote services to patients in approximately 15 other states. In FY2021, focus areas for research included the use of portable sensors to monitor patient activity and response to therapy, measurement of brain network activity in chronic pain patients, and measurement of neuromuscular tissue properties in neuromuscular disease. The research conducted at SRAlab ranges from cognitive behavior and decision making to epigenetic modification of stem cells in muscle contractures. In addition, SRAlab's Biologics Lab recently obtained a large federal grant to study the mechanism of action of adult stem cells to ameliorate the effects of aging. Nearly all of the maladies experienced by our patients are exacerbated by aging. Finally, SRAlab was recently awarded a $5M Federal grant entitled, CSTAR-The Center for Smart Use of Technology to Address Real-world Outcomes. This center will develop various types of biological sensors to not only detect movement abnormalities but to evaluate the efficacy of treatment in real-world settings. In addition, the grant contains pilot projects, mentoring opportunities, and visiting scholar opportunities to provide scientific support to the rehabilitation community throughout the world. In FY2021 in the area of improved access to information about existing resources, SRAlab continued to provide patient and family-centered education through its Henry B. Betts LIFE Center ("LIFE Center"). The LIFE Center is a virtual and multimedia education center with a mission of providing opportunities for Learning, Innovation, Family, and Empowerment for patients, families, staff, and the community at large. Everything in the collection relates in some way to people living with a wide range of cognitive and physical impairments, chronic conditions, or diseases affecting function. The website enables individuals across the globe to have access to current, peer-reviewed patient education and consumer health resources with real-time updates, printing on demand, and a dashboard to save favorite resources for easy access. Resources such as the LIFE Center help individuals and their families navigate the intricacies of health care and minimize the complexity of relevant health information. Having access to information empowers people to partner with their health care team in order to make the best choices for themselves and their families, and to engage in life-long learning. The LIFE Center's resources are organized according to eight topic areas: medical information and care, caregiving and equipment, housing and transportation, education and employment, support and wellness, recreation and leisure, finance and law, and inspiration and hope. Shirley Ryan AbilityLab patients and their families participated in both virtual and in-person education sessions, and were provided with companion materials to follow along with in each educational session. LIFE web traffic in FY2021 averaged 12,349 page views per month with 148,198 page views annually from more than 173 countries. This past year, the highest international web activity occurred in the United Kingdom, Australia, Canada, Philippines, India, Malaysia and Singapore. In FY 2021, total outreach and service efforts represented 6,455 person contacts served which includes programs, classes, special events, resource requests, teaching activities, and tours for patients, families, staff and the community. Now in our second year of the COVID-19 pandemic, SRAlab and the LIFE Center have continued to adapt and innovate to safely provide educational programs and services. The Center continues to provide patient and family-centered education by utilizing a wide range of collaborative tools and engagement methods, which serve to promote inclusion and personalization. The LIFE Center staff continues to be available seven days a week to provide resource assistance and virtual education via email, telephone, and web-conferencing. In this way, SRAlab provides ongoing support to individuals across the globe to ensure they have access and guidance to vital information and resources throughout their lifetime. In FY2021 in the area of education and training, SRAlab -- serving as the Northwestern Feinberg School of Medicine's Department of Physical Medicine and Rehabilitation ("PM&R") Physiatry Residency Program -- continued to support the education needs of PM&R physicians. Internally, and for our alliance partners, SRAlab also offered approximately 30 courses for continuing education hours on topics such as oncology care and considerations, stroke rehabilitation principles, burns, orthopedic issues, pain, COVID, mentoring, leadership, and preventing burnout for allied health and nursing staff. SRAlab held nearly fifty (50) grand rounds educational presentations for physicians on a number of topics, including health care disparities and bioethical issues for those with disabilities, nutrition and exercise, medical education, and research. SRAlab's Donnelly Ethics program hosted 5 Schwartz Center Rounds connecting to over 480 staff members on topics including New Challenges and Changing Roles During COVID-19, Tapping into the Spiritual Dimensions of Care: Aligning Expectations and Accepting Misalignments, and Communication and Connection: Transfers for Patients with Complex Communication Needs During COVID-19, which allows staff the time to explore and share the psychosocial and emotional aspects of caring for patients. Schedule H, Part V, Section B, Line 16 Facility , 1 Facility , 1 - Shirley Ryan AbilityLab. The admission consent forms at all facilities explain that financial assistance is available. These forms include a contact and phone number for obtaining financial assistance and alternative payment options. Additionally, they state that financial assistance information can be found online at: www.sralab.org/charity-care-financial-assistance. 9 SRAlab Burr Ridge OP & DayRehab Ctr 7600 County Line Road Burr Ridge IL 60527 Day Rehabilitation & Outpatient Rehabilitation SRAlab Homewood - DayRehab Center 19260 S Halsted Homewood IL 60430 Day Rehabilitation & Physician Practice Streeterville DayRehab Center 345 E Superior Chicago IL 60611 Day Rehabilitation SRALAB Arlington Heights DayRehab Center 3215 N Wilke Rd Arlington Heights IL 60004 Day Rehabilitation Glenview Pediatric & DayRehab Center 2591 Compass Road Suite 100 Glenview IL 60026 Outpatient Rehabilitation, Day Rehabilitation & Physician Practice SRAlab Pain Management Center 345 E Superior Chicago IL 60611 Day Rehabilitation & Physician Practice SRAlab Northbrook OP Ctr (annex) 900 N Skokie Blvd Northbrook IL 60062 Outpatient Rehabilitation & Physician Practice AMITA Health Alexian Bros Elk Grove 935 Beisner Road Elk Grove Village IL 60007 Physician Practice Schedule H, Part I, Line 7g Subsidized Health Services NO COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC ARE INCLUDED ON LINE 7G. Schedule H, Part I, Line 7 Costing Methodology used to calculate financial assistance THE FINANCIAL ASSISTANCE AND MEANS -TESTED GOVERNMENT PROGRAMS, LINE 7A THROUGH 7C, EXPENSE IS CALCULATED BY MULTIPLYING CHARGES IN EACH CATEGORY BY THE MEDICARE COST REPORT COST TO CHARGE RATIO FOR FY 2021. THE OTHER BENEFITS, LINE 7E THROUGH 7H, EXPENSE IS CALCULATED USING BOTH DIRECT AND INDIRECT COST FOR EACH CATEGORY. Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount FOR FINANCIAL STATEMENT PURPOSES, SRAL HAS ADOPTED ACCOUNTING STANDARDS UPDATE NO. 2014-09 (TOPIC 606). IMPLICIT PRICE CONCESSIONS INCLUDES BAD DEBTS. THEREFORE, BAD DEBTS ARE INCLUDED IN NET PATIENT REVENUE IN ACCORDANCE WITH HEALTHCARE FINANCIAL MANAGEMENT ASSOCIATION STATEMENT NO. 15 AND BAD DEBT EXPENSE IS NOT SEPARATELY REPORTED AS AN EXPENSE. Schedule H, Part III, Line 3 Bad Debt Expense Methodology On Schedule H, Part III, Line 3 no amount was included for SRAlab for bad debt expense attributable to patients eligible under the SRAlab financial assistance policy. SRAlab's Presumptive Eligibility Policy sets forth the presumptive eligibility criteria by which a patient's financial need is determined and used by SRAlab to deem a patient eligible for hospital financial assistance without further scrutiny by SRAlab. Charity care may be provided to patients who are either uninsured or underinsured who do not have the financial resources to pay their SRAlab bill and who meet income and other guidelines specified by SRAlab. As soon as the need for financial assistance is identified, SRAlab provides the patient or Guarantor with a Program application. Patient Financial Services will review all patient accounts with self-pay balances and determine presumptive eligibility after review of the patient's Charity Application and prior to sending the patient a bill requesting payment. Patient Financial Services may use third-party reporting to determine presumptive eligibility of a patient if the patient has not timely returned a completed Charity Application. If a patient is presumed eligible, their balances will not be written off to bad debt. Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote The organization is part of the Rehabilitation Institute, Inc. and Affiliates' consolidated audit in which the footnote that discusses the bad debt expense is located on page 10. Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs The hospital continually strives to provide excellent patient care in the most cost-effective fashion. Nonetheless, the Medicare program, in many cases, does not provide payment that covers the full cost of the care provided. The IRS does not classify this shortfall in Medicare payments as Community Benefit. However, we believe it is an important contribution made by the hospital to the health and well-being of the community. If the Medicare program did not exist, many Medicare patients would be eligible for financial assistance or other means-tested government programs. Further, by absorbing this shortfall and providing care below cost to these individuals, the hospital is relieving the burden of government. Accordingly, this shortfall restricts the hospital's ability to make funds available to provide for financial assistance and other Community Benefit. Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance SRALAB'S COLLECTION POLICY REQUIRES THAT, BEFORE ANY EXTRAORDINARY COLLECTION ACTIVITY IS TAKEN, AT LEAST 120 DAYS HAVE PASSED SINCE THE PATIENT'S FIRST POST-DISCHARGE BILLING STATEMENT AND THAT THE PATIENT HAS BEEN GIVEN ADEQUATE NOTICE REGARDING AND OPPORTUNITY TO APPLY FOR FINANCIAL ASSISTANCE. MOREOVER, THE POLICY REQUIRES THAT THE EXECUTIVE DIRECTOR OF REVENUE CYCLE/DESIGNEE VERIFY THAT THESE AND ALL OTHER STATUTORY PRECONDITIONS TO COLLECTION ACTIVITY HAVE BEEN MET BEFORE ANY COLLECTION ACTIVITY IS INITIATED. THE POLICY FURTHER REQUIRES THAT IF SRALAB RECEIVES A FINANCIAL ASSISTANCE APPLICATION WHILE COLLECTION ACTIVITY IS ONGOING, IT WILL SUSPEND SUCH ACTIVITY (AND REQUIRE ANY RETAINED COLLECTION AGENCIES ACTING ON ITS BEHALF TO SUSPEND SUCH ACTIVITY) SO THAT A DETERMINATION OF FINANCIAL ASSISTANCE ELIGIBILITY CAN BE MADE; IF IT IS DETERMINED THAT THE PATIENT IS ELIGIBLE FOR FINANCIAL ASSISTANCE, COLLECTION ACTIVITY WILL BE CEASED AND ANY APPLICABLE REFUNDS/REVERSALS WILL BE MADE. Schedule H, Part V, Section B, Line 16a FAP website - Shirley Ryan AbilityLab: Line 16a URL: https://www.sralab.org/charity-care-financial-assistance; Schedule H, Part V, Section B, Line 16b FAP Application website - Shirley Ryan AbilityLab: Line 16b URL: https://www.sralab.org/charity-care-financial-assistance; Schedule H, Part V, Section B, Line 16c FAP plain language summary website - Shirley Ryan AbilityLab: Line 16c URL: https://www.sralab.org/charity-care-financial-assistance; Schedule H, Part VI, Line 2 Needs assessment The needs of SRAlab's community are assessed on an ongoing basis as part of its routine operations and in accordance with IRS regulations relating to the Community Health Needs Assessment (CHNA). A formal assessment is performed periodically related to the CHNA. SRAlab's Henry B. Betts LIFE Center is a virtual and multimedia education center providing patient education and consumer health information for patients, families, staff and the community. Everything in the collection relates in some way to people living with a wide range of cognitive and physical impairments, chronic conditions or diseases affecting function. The website enables individuals across the globe to have access to current, peer-reviewed patient education and consumer health resources with real-time updates, printing on demand and a dashboard to save favorite resources for easy access. Resources such as the LIFE Center help individuals and their families navigate the intricacies of health care and minimize the complexity of relevant health information. Having access to information empowers people to partner with their health care team in order to make the best choices for themselves, their families and engage in life-long learning. The Center's resources are organized according to eight topic areas: Medical Information and Care, Caregiving and Equipment, Housing and Transportation, Education and Employment, Support and Wellness, Recreation and Leisure, Finance and Law and Inspiration and Hope. LIFE web traffic in FY 2021 averaged 12,349 page views per month with 148,198 page views annually from more than 173 countries. This past year, the highest international web activity occurred in the United States, Australia, Canada, Philippines, India and Malaysia. In FY 2021, total outreach and service efforts represented 6,490 person contacts served which includes programs, classes, special events, resource requests, teaching activities and tours for patients, families, staff and the community. SRAlab monitors and adapts to the needs of its community on an ongoing basis as part of its routine operations. In FY2021, SRAlab will begin the formal process of developing its FY2022 CHNA. The process will include, at a minimum, a review of medical literature relating to significant rehabilitation needs, a community focus group, and a review of historical patient characteristics. Schedule H, Part VI, Line 3 Patient education of eligibility for assistance SRAlab ensures that each registration/admission location contains signage (in English and other predominant languages of the SRAlab patient population) notifying patients that financial assistance is available to qualified individuals. This notice is also posted on SRAlab's website (www.sralab.org), along with SRAlab's Financial Assistance Program process and application. Information regarding the Financial Assistance Program and the application is available in each SRAlab registration/admission location. Furthermore, a summary of this information is provided as part of the intake process. The information regarding financial assistance also appears on every self pay statement sent to our patients. In addition, when SRAlab care managers are involved in the patient's care, the care manager informs and assists the patients in enrolling in appropriate entitlement programs. Schedule H, Part VI, Line 4 Community information As a specialty hospital, SRAlab defines the patients it serves broadly as the disabled community throughout the state of Illinois, the United States and around the world. Due to SRAlab's unique services and its reputation as the leader in rehabilitation medicine, many patients will travel long distances for care. Approximately 80% of SRAlab inpatients come from Chicago and its 8 surrounding counties. This represents a primary reach of approximately 60 miles. Approximately 20% of the population for whom poverty status is determined in Chicago live below the poverty line. (Source: https://datausa.io/profile/geo/chicago-il). Percentage of hospital's patients who are uninsured or Medicaid is 20% within Cook County; where SRAlab is located, there are 24 Medically under-served areas for Primary Care. (Source: https:// data.hrsa.gov/tools/shortage-area/mua-find). Within the city of Chicago, there are approximately 25 hospitals serving approximately 3 million people. In addition, to Chicago area patients, SRAlab also cared for patients from 40 states and handled referrals from 50 countries. SRAlab continues to increase its outreach and has impacted the lives of individuals in North, Central and South America; Europe; Africa; Asia (predominately the Middle East); and Australia. The largest users of rehabilitation medicine are those over the age of 65. However, SRAlab continues to serve patients of all ages, including pediatrics. In addition, SRAlab conducts strategic planning around patients of varying ages. Schedule H, Part VI, Line 5 Promotion of community health SRAlab's governing body is chiefly 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. SRAlab, extends medical staff privileges to qualified physicians. SRAlab provides a number of services that generally do not generate revenue, solely for the purposes of improving the health and quality of life for our community. These services include: research to improve patient outcomes; educational resources on living with a disability available to anyone through the Internet; vocational training and placement services; support groups to assist in psychological adjustment; fitness and sports training program to promote physical activity and case management for high risk patients discharged to the community. Any surplus funds are applied to patient care, education and research as highlighted in greater detail within part III of the Form 990. Surplus funds are allocated during the annual budget process, which includes Board approval. Schedule H, Part VI, Line 7 State filing of community benefit report IL true Agate Publishing Inc 1328 Greenleaf Street Evanston IL 60202 320018966 na 6443 Payments for research study related activities Eckmaahs & Associates Llc 1791 Kirkwood Lane N Plymouth MN 55441 043797792 NA 7964 Payments for research study related activities President And Fellows Of Harvard College Dba Harvard University 1033 Massachusetts Ave 2nd fl Cambridge MA 02138 042103580 501(c)(3) 9542 Payments for research study related activities Marquette University 561 N 15th Street SHC 346 Milwaukee WI 53233 390806251 501(c)(3) 9641 Payments for research study related activities University Of Massachusetts 333 South Street Suite 450 Shrewsbury MA 01545 043167352 Government Entity 10486 Payments for research study related activities University Of Houston 4800 Calhoun Rd Houston TX 77004 746001399 501(c)(3) 11224 Payments for research study related activities Cares- Chicago Association For Research & Education In Science 5000 S 5th Avenue Building One Room C303 Hines IL 60141 363334177 501(c)(3) 12139 Payments for research study related activities Mary Free Bed Hospital & Rehabilitation Center 235 Wealthy St SE Grand Rapids MI 495035299 381359265 501(c)(3) 14229 Payments for research study related activities University Of North Texas 1155 Union Circle311277 Denton TX 762035017 756002149 501(c)(3) 17319 Payments for research study related activities Regents Of The University Of California Irvine 111 Academy Way 210 Irvine CA 92697 952226406 Government Entity 21642 Payments for research study related activities Board Of Trustees Of Michigan State University 360 Administration Building East Lansing MI 48824 386005984 501(c)(3) 30626 Payments for research study related activities University Of Miami 1400 NW 10th Avenue Miami FL 33136 590624458 501(c)(3) 38047 Payments for research study related activities Kessler Foundation 120 Eagle Rock Ave East Hanover NJ 079363147 311562134 501(c)(3) 38177 Payments for research study related activities Henry M Jackson Foundation 6720 A Rockledge Drive Suite 100 Bethesda MD 20817 521317896 501(c)(3) 43362 Payments for research study related activities HCBS Strategies Incorporated 222 Ridgewood Rd Baltimore MD 21210 200958373 na 45613 Payments for research study related activities University Of Notre Dame 731 Grace Hall Notre Dame IN 46556 350868188 501(c)(3) 53867 Payments for research study related activities University Of Alabama - Birmingham 701 20th Street South 770 Admin Bldg Birmingham AL 35294 636005396 Government Entity 57215 Payments for research study related activities North Carolina State University 2701 Sullivan Drive Campus Box 7514 Raleigh NC 276957514 566000756 Government Entity 72550 Payments for research study related activities Virginia Polytechnic Inst & State University 200 Turner Street NW Suite 3300 North End Center MC0312 Blacksburg VA 24061 546001805 501(c)(3) 81559 Payments for research study related activities Indiana University 400 E 7th Street Bloomington IN 47405 356001673 Government Entity 87507 Payments for research study related activities Research Triangle Institute 3040 East Cornwallis Road POBox 12194 Research Triangle Park NC 277092194 560686338 501(c)(3) 88588 Payments for research study related activities University Of California Irvine 111 Academy Way Suite 210 Irvine CA 926971050 952540117 501(c)(3) 125586 Payments for research study related activities Center For Veterans Research And Education 1 Veterans Drive Suite 3M Minneapolis MN 55417 411652941 501(c)(3) 144195 Payments for research study related activities University Of Illinois 1305 W Green St Urbana IL 61801 376000511 Government Entity 203529 Payments for research study related activities University Of Colorado-Boulder 3100 Main St Boulder CO 803090572 846049811 501(c)(3) 223829 Payments for research study related activities University Of Washington 3917 University Way NE Seattle WA 981051122 916001537 Government Entity 294593 Payments for research study related activities Cirtec Medical Llc 101 Cooper Court Los Gatos CA 95032 208007459 NA 541475 Payments for research study related activities Northwestern University 710 N Lakeshore Dr Chicago IL 60611 362167817 501(c)(3) 2711642 Payments for research study related activities Southern Illinois Hospital Foundation 1239 E Main St Suite C Carbondale IL 62901 271933790 501(c)(3) 5000 Operational Support 25 4 Stipends/Honorariums 119 49650 Research - Professional Services 16 76118 Subject Reimbursements 6327 233541 Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. OVERSIGHT IS PROVIDED BY EXECUTIVE LEADERSHIP, SUPPORTED BY THE RESEARCH ADMINISTRATION DEPARTMENT WHERE ACTIVE INTERACTION WITH PRINCIPAL INVESTIGATORS IS MAINTAINED. MONITORING IS DONE THROUGH CONTINUED RELATIONSHIPS WITH GRANTEE ORGANIZATIONS or INDIVIDUALS, WHETHER BY MEMBERSHIP OR COMMUNITY LIAISON. FOR RESEARCH GRANTS, EACH GRANT IS ASSIGNED A PRINCIPAL INVESTIGATOR (PI) AS WELL AS A RESEARCH ASSISTANT (RA). GRANT EXPENDITURES CHARGED TO EACH GRANT ARE APPROVED/REVIEWED BY THE RESPECTIVE PI AND/OR RA TO ENSURE ALLOWABILITY. IN ADDITION, COMPLIANCE (A-133) AS WELL AS FINANCIAL AUDITS ARE PERFORMED BY AN INDEPENDENT AUDIT FIRM EACH YEAR. X false true X X X X false true false false false false false true false Joanne C Smith MD President, CEO 2083100 0 717234 0 1067946 0 236273 0 173293 0 4277846 0 720692 0 Nancy E Paridy SVP, Chief Administrative Officer 441689 0 255000 0 378753 0 133170 0 17784 0 1226396 0 175188 0 Jonathan M Tingstad SVP, Chief Financial Officer 584670 0 220000 0 58425 0 58017 0 34150 0 955262 0 13102 0 Peggy M Kirk SVP, Chief Operating Officer 439346 0 280000 0 672942 0 186495 0 31820 0 1610603 0 392648 0 Richard Lieber PhD SVP of Research, Chief Scientific Officer 650795 0 200000 0 174400 0 76907 0 19432 0 1121534 0 117374 0 Collins Fitzpatrick MD Medical Director 849164 0 10000 0 69450 0 33111 0 24867 0 986592 0 24257 0 Elizabeth Owens SVP,Chief Marketing and Innovation Officer 561420 0 195000 0 141455 0 66858 0 18662 0 983395 0 92438 0 James Sliwa DO Chief Medical Officer 530907 0 192000 0 223105 0 0 0 19296 0 965308 0 193387 0 Stacy Fuller McCarty Attending Physician 491700 0 10000 0 24334 0 26465 0 34356 0 586855 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments Gross-up Payments: The organization provides additional disability insurance for the Chief Executive Officer (CEO). The CEO purchases the policy and then is reimbursed by the organization. The amount is grossed up to cover applicable taxes. Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses The organization does not have a written policy regarding the gross up payments made to cover applicable taxes on the CEO's additional disability insurance. Reimbursements are made pursuant to an agreement. Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan Eligible executives participate in various non-qualified deferred compensation plans organized under code section 457(F). The exact purpose of each plan varies, but they include: compensation limitation make-up plans, voluntary deferral plans, deferral of a portion of incentive bonus type plans, etc. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following listed person(s) participated in the 457(F) plan and received plan payments as follows: Joanne C. Smith, M.D. - $720,692 Nancy E. Paridy - $175,188 Peggy M. Kirk - $392,648 Jonathan Tingstad - $13,102 Elizabeth Owens - $92,438 Richard Lieber, Ph.D. - $117,374 James Sliwa, D.O. - $193,387 Collins Fitzpatrick, M.D. - $24,257 Schedule J, Part I, Line 7 Non-fixed payments Executive leadership participate in a variable incentive compensation plan. Amounts are a percent of base salary. Certain financial and quality triggers need to be met, and then the percent awards are determined by institutional financial performance, quality indicators, and individual performance metrics. A Illinois Finance Authority 861091967 45203HTC6 2013-07-11 398898603 Refund of bonds issued 11/22/2005 and 12/10/2009 & fund construction of Shirley Ryan Ability Lab. false false false B Illinois Finance Authority 861091967 000000000 2016-12-01 274055000 Refund of Series 2013B-E bonds issued 7/11/2013 false false false A 311690000 398962831 16100741 3066076 327613148 52182866 2017 true false true true B 22325000 274055000 1055000 273000000 2017 true false true true A false false true true true true 0.0 0.0 0.0 false false true B false false true true true true 0.0 0.0 0.0 false false true A false true false false false false false true true B false true false false true false false false true A false B false Schedule K, Part I, Column (c) Bond A: The CUSIP shown here, 45203HTC6, is for the latest maturity of the Series A bonds. The issue as a whole also consists of Series B through E bonds (which were scheduled to mature later than Series A), none of which bear CUSIP numbers. Schedule K, Part III Column (A): This section is completed with respect to the new money portion of the bonds, the refunded debt issued 12/10/2009 (which was related to the land for the new building project) and the portion that refunded debt issued 11/22/2005. Schedule K, Part III, Line 9 Part IV, Line 7, and Part V: The organization does not have written compliance procedures. However, we are aware of each of these issues (section 1.141-12 self-remediation procedures, arbitrage restrictions, VCAP), and we will seek professional assistance at the appropriate time, as necessary. Schedule K, Part II, Line 3 Proceeds of Issue Such amounts were appropriately yield restricted. Differences between the issue price (Part I) and total proceeds (Part II, Line 3) are due to investment earnings. Schedule K, Part III Column (B): These bonds refunded a portion of the bonds reported in column (A); Private Business Use reporting for this issue is essentially identical to that for the column (A) bonds. Substantial Contributor Substantial Contributor 795079 Consulting & Risk Services false Substantial Contributor Substantial Contributor 1742355 Banking Services false Substantial Contributor Substantial Contributor 926622 Construction Services false Substantial Contributor Substantial Contributor 321607 Pharmaceutical Goods & Services false Substantial Contributor Substantial Contributor 111663 Banking Services false Substantial Contributor Substantial Contributor 460751 Construction Services false Substantial Contributor Substantial Contributor 381006 Healthcare Services false SRAlab Employee Family member of Trustee 62530 Wages false Schedule L, Part V Business Transactions Involving Interested Persons: All transactions between SRAlab and interested persons were done at arms-length and at fair market value. X 939 Market value X 16 1446773 Market value X 1 40 Market value X Airline Tickets 2 10000 Market value X Entertainment & Gifts 65 33527 Market value X Hotel / Resort Accommodations 3 4700 Market value X Jewelry 3 10350 Market value 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Securities - Publicly traded - The number in Column (b) refers to the number of contributions. Collectibles - The number in Column (b) refers to the number of contributions. Other - Airline Tickets The number in Column (b) refers to the number of contributions. Other - Entertainment & Gifts The number in Column (b) refers to the number of contributions. Other - Hotel / Resort Accommodations The number in Column (b) refers to the number of contributions. Clothing and household goods - The number in Column (b) refers to the number of contributions. Other - Jewelry The number in Column (b) refers to the number of contributions. Form 990, Part III, Line 4d Description of other program services (Expenses $ 5,506,802 including grants of $ 0)(Revenue $ 616,657) SRAlab's Henry B. Betts LIFE Center is a virtual and multimedia education center providing patient education and consumer health information for patients, families, staff and the community. Everything in the collection relates in some way to people living with a wide range of cognitive and physical impairments, chronic conditions or diseases affecting function. The website enables individuals across the globe to have access to current, peer-reviewed patient education and consumer health resources with real-time updates, printing on demand and a dashboard to save favorite resources for easy access. Resources such as the LIFE Center help individuals and their families navigate the intricacies of health care and minimize the complexity of relevant health information. Having access to information empowers people to partner with their health care team in order to make the best choices for themselves, their families and engage in life-long learning. The Center's resources are organized according to eight topic areas: Medical Information and Care, Caregiving and Equipment, Housing and Transportation, Education and Employment, Support and Wellness, Recreation and Leisure, Finance and Law and Inspiration and Hope. LIFE web traffic in FY 2021 averaged 12,349 page views per month with 148,198 page views annually from more than 173 countries. This past year, the highest international web activity occurred in the United States, Australia, Canada, Philippines, India and Malaysia. In FY 2021, total outreach and service efforts represented 6,490 person contacts served which includes programs, classes, special events, resource requests, teaching activities and tours for patients, families, staff and the community. Sports and Fitness Program: The SRAlab Adaptive Sports and Fitness Program provides wellness opportunities to people with physical disabilities through sports and recreation as well as a full-service accessible health club. All services offered in the adaptive sports program, which marked its 40th year in FY 2021, are free of charge. The fitness program, which celebrated its 25th anniversary, provides access to a health club that operates from 6:15 am to 7 pm five days per week for a nominal annual fee. The sports and fitness program is funded primarily by grants and generous community donations and is operated by eleven full time equivalent staff. Additionally, volunteers logged nearly 5200 hours in FY 2021. The Shirley Ryan Adaptive Sports and Fitness Program is considered a national leader in health promotion for people with disabilities. In FY 2021 we resumed programming, after almost a year hiatus from programming due to the pandemic. While restarting programming was slow the sports program had recorded over 1800 visits by 100+ registered participants, and the fitness program began services slow but sooner than sports but only provided services virtual for a few months then transitioned some participation back to in person recording 4,875 one-on-one visits by its 200 registered participants in addition to 248 virtual class visits. A separate program for youth, the Tengelsen Family Foundation Sports for Kids program, recorded 185 visits by 42 Chicago area children with disabilities. Vocational Rehabilitation Program: Beginning a career or returning to work following an illness or injury is important to a patient's financial security and emotional well-being. It can contribute to the achievement of a productive, independent and fulfilling life. For more than 50 years, the SRAlab has been providing comprehensive vocational rehabilitation services tailored to meet the needs of each client. Services include initial assessment, vocational counseling and guidance, diagnostic evaluation, work trial assessments, job analysis, return-to-work evaluations, job placement, resume writing, job interview workshops and internship coordination. The SRAlab covers the cost of initial assessments, which are not covered by most third-party payers. Patients receive vocational services at nine SRAlab facilities or via telehealth, ensuring that employment assistance is closely tied to community reintegration. During FY 2021 the program served 1054 clients. In the last year, we placed 68 individuals in jobs. We continue to provide no cost GED program for patients with spinal cord injuries to our list of services. Assistive Technology Programs: The Technology Center and the Wheelchair & Seating Center, comprise SRAlab's Assistive Technology Programs. In FY 2021, the Assistive Technology Programs served approximately 1,900 unique patients. The SRAlab Technology Center provides computer access training, augmentative communication devices and electronic aids to daily living, including recommendations for home automation and modifications, for people with different abilities. Occupational therapists and speech language pathologists evaluate and recommend equipment for each individual's needs. Through a lending library, patients can try items before purchasing them or borrow them for short-term use due to changing needs. Staff members speak to universities, schools, organizations for people with disabilities, senior centers and the general public. The center provides 1 to 2 home visits if the client can no longer come to SRALab following their evaluation. We have also integrated the use of telehealth appointments over the past year. Staff recommend applying for SRALab charity funds if Patient's insurance is maxed out. The Technology Center saw 620 inpatients, 290 Day Rehab clients, and 370 outpatients in the past fiscal year. Rehabilitation Engineering staff collaborate with allied health clinicians to provide consultation, evaluation, and design of individual solutions to aid persons with different abilities to complete activities of daily living with increased independence at home, work, and in the community. The team fabricates custom equipment and modifies commercially available equipment and objects to create unique, individualized solutions to help patients navigate obstacles encountered in daily life. SRAlab provides free care for services and products, and provides real-life design experience to students through Northwestern University's engineering design program. The Wheelchair & Seating Center staff evaluate and make recommendations for complex wheelchairs and customized seating systems for patients with significant mobility and postural needs. This includes manual wheelchairs; powered wheelchairs; custom-made and customized seat and back cushions to relieve pressure, prevent pressure sores, and maintain posture; alternative drive controls like sip and puff and head array systems; that help clients maintain or increase their mobility and independence, at home, work, or in the community. During FY20 the Wheelchair & Seating Center integrated the use of telehealth appointments to continue to serve some of our patients during the global pandemic. We served a total of 1,731 patients including 791 inpatients, 23 DayRehab clients, and 917 outpatients. We also participated in a hospital wide quality improvement project to improve the turnaround time from initial evaluation to delivery of the definitive custom wheelchair. Form 990, Part VI, Line 1a THE BYLAWS ALLOW FOR FOUR STANDING COMMITTEES: (i) COMPENSATION AND LEADERSHIP DEVELOPMENT; (ii) FINANCE & AUDIT; (iii) TRANSLATIONAL MEDICINE; AND (iv) INVESTMENT. AN ADVISORY COMMITTEE CONSISTING OF ALL FORMER BOARD CHAIRS SHALL ALSO CONSTITUTE A STANDING COMMITTEE. ADVISORY COMMITTEE MEMBERS PARTICIPATE IN FUNDRAISING ACTIVITIES AND UNDERTAKE SPECIAL ASSIGNMENTS. THE FINANCE AND AUDIT COMMITTEE HAS FINANCIAL OVERSIGHT RESPONSIBILITIES AND CORPORATE INTEGRITY OVERSIGHT. THE INVESTMENT COMMITTEE IS RESPONSIBLE FOR THE MANAGEMENT OF FUNDS AND OVERSEES INVESTMENT POLICY. THE TRANSLATIONAL MEDICINE COMMITTEE IS RESPONSIBLE FOR OVERSIGHT OF TRANSFORMATION OF CLINICAL CARE AND PRACTICE. COMPENSATION AND LEADERSHIP COMMITTEE IS RESPONSIBLE FOR RECOMMENDING COMPENSATION POLICIES AND PROGRAMS AS WELL AS LEADERSHIP AND SUCCESSION PLANNING. IN ADDITION, SPECIAL COMMITTEES MAY BE APPOINTED AS CIRCUMSTANCES WARRANT. Form 990, Part VI, Line 3 Delegation of management duties Crothall Services Group managed our facilities and housekeeping services; Morrison Management Specialists managed our food services, and Pharmacy Systems, Inc. managed our pharmacy. No officers, directors, trustees, or key employees (current or former) received compensation from any of these companies. Form 990, Part VI, Line 6 Classes of members or stockholders Rehabilitation Institute, Inc. (RII) is the sole corporate member of SRAlab. Form 990, Part VI, Line 7a Members or stockholders electing members of governing body As the sole corporate member of SRALAB, RII has the following rights, with respect to the organization's governing body: -Appoint all the Directors of the Corporation. -Nominate to the Corporation's Board of Directors all candidates for selection as well as the Corporation's Chairman, Vice Chair(s) and President & Chief Executive Officer. Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders As the sole corporate member of the organization, RII shall have powers and voting rights to do the following: (a) appoint all the Directors of the Corporation. (b) Nominate to the Corporation's Board of Directors all candidates for selection as the Corporation's Chairman, Vice Chair(s) and President & Chief Executive Officer. (c) Approve expressly all amendments to the Corporation's articles of incorporation and Bylaws. (d) Approve each annual budget and long-range plan of the Corporation. (e) Approve each annual list of proposed donors and amounts of donations or grants not included in the annual budget, and make proposals to deviate therefrom throughout each year in excess of $50,000. (f) Approve any contract or loan obligating the Corporation to expend or repay an amount in excess of $250,000 which was not included in a previously approved annual budget, shall be subject to Member approval. (g) Approve all plans of merger, consolidation, or voluntary dissolution and the creation of any subsidiary organization. (h) Approve the sale, lease, exchange, mortgage, pledge or other disposition of all or substantially all, the property and assets of the Corporation. Form 990, Part VI, Line 11b Review of form 990 by governing body First, the Form 990 is prepared internally. Then, a third party tax preparer reviews the Form 990 in its entirety. Next, it is reviewed internally by executive leadership. Finally, it is presented electronically to the full Board. Form 990, Part VI, Line 12c Conflict of interest policy All newly hired employees are required to complete a conflict of interest disclosure form at the time of new-employee orientation. In addition, all employees are required to complete such a form on an annual basis. Directors and Officers complete a Conflict of Interest Questionnaire on an annual basis. THE COMPLIANCE DEPARTMENT REVIEWS ALL DISCLOSURES. THIS DEPARTMENT DETERMINES IF A CONFLICT OF INTEREST EXISTS. IF ONE EXISTS, IT IS DISCUSSED WITH VICE PRESIDENTS AND MANAGED BY THE COMPLIANCE DEPARTMENT. ADDITIONALLY, THIS INFORMATION IS SUMMARIZE AND SHARED WITH THE FINANCE AND AUDIT COMMITTEES OF THE BOARD OF DIRECTORS. Form 990, Part VI, Line 15a Process to establish compensation of top management official The Compensation and Leadership Development Committee of the Board has authority to approve total compensation for the CEO, officers, and key employees; an independent consultant specializing in the field of executive compensation and benefits is hired by the Compensation and Leadership Development Committee of the Board to review and provide an opinion about the executive compensation; namely, that it is fair, reasonable and market appropriate. During the annual review and approval of the total compensation, documentation of the decision related to total compensation for the CEO, officers, and key employees was recorded in the minutes. The individuals involved were not present when their compensation was decided. SRAlab, acting through its Compensation and Leadership Development Committee of the Board, performed all of the above procedures to obtain the rebuttable presumption respecting compensation arrangements (per IRC Section 4958). The process for reviewing and approving compensation is undertaken annually and was last performed in Nov of the tax period covered by this return. Form 990, Part VI, Line 15b Process to establish compensation of other employees see the narrative for Line 15a Form 990, Part VI, Line 19 Required documents available to the public The Governing documents, conflict of interest policy and financial statements are made available to the public upon request after thorough consideration for their use. Form 990, Part VIII, Line 2f Other Program Service Revenue - Total Revenue: 3402916, Related or Exempt Function Revenue: 3402916, 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 - 29471785; Interest Rate Swap - 3914065; Form 990 Coronavirus Pandemic Coronavirus Pandemic Novel Corona Virus 2019 pandemic has materially impact the operations business and financial condition of the corporation. On March 18, 2020, the Centers for Medicare & Medicaid Services formally recommended that health care providers delay all elective surgeries and non essential medical, surgical, and dental procedures during the pandemic. Governor Executive Order no. 2020 19 then required a cancellation of all elective surgeries and non emergency care through May 11, 2020. Beginning May 11, 2020, the Illinois Department of Public Health provided updated guidelines that hospitals and Ambulatory Surgical Treatment Centers may begin to perform elective procedures. The Corporation followed IDPH guidelines and began the process of performing elective services when the Executive Order was eased. Management continues to monitor developments with respect to the COVID 19 pandemic and intends to continue to follow requirements from the Centers for Disease Control and other applicable federal, state and local regulatory agencies. The Corporation has been provided some relief based on payments made to hospitals as a result of the Coronavirus Aid, Relief, and Economic Security Act. Provider Relief Funds of $9,800,000 and $5,700,000 were recorded as grant revenue in the Consolidated Statements of Operations and Changes in Net Assets during the years ended August 31, 2021 and 2020, respectively. In fiscal year 2020, the Corporation also received advanced payments from Medicare of $14,644,000 which was recorded as a current liability in the Consolidated Balance Sheets based on applicable guidance at the time. During fiscal year 2021, the Corporation has paid back $5,729,000 of advanced payments from Medicare and $8,914,000 remains outstanding as of August 31, 2021 which is recorded within current liabilities in the Consolidated Balance Sheets. Medical Services SRALAB 355 East Erie Street Chicago IL 60611 911999919 Physician Practice Billing and Collections IL 0 0 Shirley Ryan Abilitylab Rehabilitation Institute Inc 355 East Erie Street Chicago IL 60611 363310838 Parent IL 501(c)(3) Type II NA false Pathways Foundation 355 East Erie Street Chicago IL 60611 522456469 Rehabilitation Services IL 501(c)(3) 10 Rehabilitation Institute of Chicago dba Shirley Ryan AbilityLab true Rehabilitation Institute of Chicago Medical Rehabilitation Enterprises 355 East Erie Street Chicago IL 60611 363428852 Inactive IL Rehabilitation Institute Inc (RII) C Corporation 0 0 0 false false false false false false false false false false false false false false true true false true false false PATHWAYS FOUNDATION Q 892482 Book Value PATHWAYS FOUNDATION N 127800 Book Value