2022-05-02T12:10:47-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2020-07-01 366000085 THOREK MEMORIAL HOSPITAL THOR 7739756806 850 W IRVING PARK ROAD CHICAGO IL 60613 TIM HEINRICH CHIEF FINANCIAL OFFICER 7739756806 2022-04-27 1 TIM HEINRICH 999009999 DAVID LOWENTHAL P00378651 3122071040 2022-04-15 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z TIM HEINRICH 850 W IRVING PARK ROAD CHICAGO IL 60613 164257493 0 X WWW.THOREK.ORG X 1911 IL PROVIDING QUALITY PATIENT CARE, PROMOTING WELLNESS, AND SUPPORTING EDUCATION. 8 5 923 0 2242 0 1618460 12519214 83862267 95900979 9196796 16475581 1686757 3026722 96364280 127922496 32000 0 0 0 38932124 39602210 0 0 0 45972482 53036716 84936606 92638926 11427674 35283570 402112917 512859760 31672509 32210249 370440408 480649511 X THOREK MEMORIAL HOSPITAL IS COMMITTED TO PROVIDING APPROPRIATE PATIENT SERVICES IN A CARING & COST-EFFECTIVE MANNER. THOREK MEMORIAL HOSPITAL SEEKS TO SERVE ITS PATIENTS, PHYSICIANS, EMPLOYEES, & COMMUNITY BY PROVIDING QUALITY SERVICES & ENCOURAGING EMPLOYEE EXCELLENCE. THOREK MEMORIAL HOSPITAL WILL SUPPORT EDUCATION AND WILL ACT AS A RESPONSIBLE MEMBER OF OUR COMMUNITY AND THE HEALTHCARE DELIVERY SYSTEM. 0 0 73381705 0 98927701 THOREK MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICE RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THOREK MEMORIAL HOSPITAL, WE RECOGNIZE THAT IT IS THE HOSPITAL'S MISSION TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION AND THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF OUR COMMUNITY, WE PROVIDE FREE CARE AND OR SUBSIDIZED CARE TO INDIVIDUALS WHO ARE UNABLE TO PAY FOR ESSENTIAL SERVICES, AND PROVIDE HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT OUR COMMUNITY. 73381705 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 135 0 1 923 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 8 5 0 0 0 0 0 0 0 1 0 0 0 1 1 1 1 1 1 1 1 0 IL X TIM HEINRICH CFO 7739756806 850 WEST IRVING PARK ROAD CHICAGO IL 60613 PHILIP GORELICK MD CHIEF MEDICAL OFFICER 40.00 0.00 X 521792 0 321 PETER KAMBEROS CHAIRMAN & COO 40.00 0.00 X X 491070 0 1284 JAMES E NUGENT VICE CHAIR 6.00 0.00 X X 25000 0 0 JAGAN MOHAN MD SECRETARY 6.00 1.00 X X 25000 0 0 EDWIN C LENNOX TREASURER 6.00 0.00 X X 25000 0 0 ROBERT BAUDINO TRUSTEE 6.00 0.00 X 25000 0 0 BONNIE PHIPPS TRUSTEE 6.00 0.00 X 25000 0 0 NEAL SPERO MD TRUSTEE & MEDICAL STAFF PRESIDENT 14.00 0.00 X 65212 0 0 EDWARD BUDD CEO 40.00 1.00 X 473167 0 16686 TIM HEINRICH CFO 40.00 0.00 X 364986 0 16686 GENEVIEVE PRESBITERO CHIEF NURSING OFFICER 40.00 0.00 X 331302 0 7291 JOHN HUNNIFORD MD PHYSICIAN 40.00 0.00 X 437687 0 6649 SUZANNE CHAN NURSE PRACTITIONER 40.00 0.00 X 195161 0 5776 JULIA DYER MD PHYSICIAN 40.00 0.00 X 207082 0 0 NAYNA NAVIK PHYSICIAN 40.00 0.00 X 206352 0 6649 SEEMA ELAHI PHYSICIAN 40.00 0.00 X 242687 0 12548 3661498 0 73890 78 0 1 0 CHICAGO CENTRAL EMERGENCY PO BOX 677979 DALLAS TX 752677979 PHYSICIAN FEES 1126006 UNITED MAINTENANCE SERVICE 1550 S INDIANA AVE SUITE 300 CHICAGO IL 60605 SERVICE CONTRACTS 724888 UIC DEPARTMENT OF SURGERY 840 S WOOD ST SUITE 619V CHICAGO IL 606127322 PHYSICIAN FEES 641323 NORTHERN TRUST COMPANY 50 S LA SALLE ST CHICAGO IL 60603 INVESTMENT MANAGEMENT 579988 CATALYST ANESTHESIA GROUP LLC 1007 FRANKLIN AVENUE RIVER FOREST IL 60305 PHYSICIAN FEES 503500 18 12519214 12519214 PROGRAM SERVICE REVENUE 621110 65585056 65585056 MEDICAID ASSESSMENT 621110 27635315 27635315 RESIDENT FEES 621110 2680608 2680608 95900979 7257703 2242 7255461 1099881 346142 753739 753739 753739 45206733 35988855 9217878 9217878 9217878 DIETARY CASH SALES 900099 79745 79745 MEDICAL RECORD FEES 900099 2111 2111 X-RAY FILM FEES 900099 1340 1340 2189787 2189787 2272983 127922496 98927701 2242 16473339 2414797 2414797 31736775 24498466 7238309 3039293 2431434 607859 2411345 1929076 482269 157482 157482 142069 142069 134747 134747 731530 731530 6562927 5358139 1204788 51981 51981 2281194 1824955 456239 1176989 941591 235398 5375 4300 1075 26299 21039 5260 74033 59226 14807 3680949 3680949 3205602 2564482 641120 CONTRACTED LABOR 11459979 9167983 2291996 CLINICAL EXPENSES 11079123 8863298 2215825 MEDICAID ASSESSMENT 8138773 8138773 BAD DEBT 3111205 3111205 1016459 734808 281651 92638926 73381705 19257221 0 24686676 17233678 1700876 916099 6869628 6446672 1932354 2541535 591237 487938 151465609 81750472 67124840 69715137 291104753 402446929 3778937 8433433 4323616 4638339 402112917 512859760 6780331 7733578 10275482 9343999 5092741 3899774 9523955 11232898 31672509 32210249 X 370236431 480445534 203977 203977 370440408 480649511 402112917 512859760 35283570 74925533 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 134747 134747 0 PART II-B, LINE 1: THOREK IS A MEMBER OF THE AMERICAN HOSPITAL ASSOCIATION ("AHA"), AND THE ILLINOIS HOSPITAL ASSOCIATION ("IHA"). AS A MEMBER OF THESE ORGANIZATIONS, THOREK PAYS DUES, WITH PART OF THESE DUES BEING INDIRECTLY ATTRIBUTABLE TO LOBBYING FEES PAID BY THE ORGANIZATIONS. IN ADDITION TO BEING A MEMBER OF THESE AFOREMENTIONED ORGANIZATIONS, THOREK MEMORIAL HOSPITAL HAS CHOSEN TO RETAIN A LOBBYIST IN ORDER TO STRATEGIZE AND ADVOCATE ON BEHALF OF THE HOSPITAL BEFORE THE ILLINOIS GENERAL ASSEMBLY AND THE GOVERNOR'S ADMINISTRATION. 34737216 34737216 65514474 45093881 20420593 44314824 35088827 9225997 6899095 1567764 5331331 69715137 SELF-INSURANCE RESERVE 6602912 THIRD PARTY PAYOR SETTLEMENTS 2902355 CONSTRUCTION PAYABLE 1727631 11232898 X 199351436 74925533 346142 75271675 124079761 731530 3111205 3842735 127922496 89142333 346142 346142 88796191 731530 3111205 3842735 92638926 PART X, LINE 2: THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AND, IS EXEMPT FROM TAX UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3), AND, ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT, AS OF JUNE 30, 2021 AND 2020, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE HOSPITAL RECOGNIZES INTEREST OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE HOSPITAL DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT JUNE 30, 2021 AND 2020. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2018. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 346,142. PART XI, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 3,111,205. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 346,142. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 3,111,205. 1 1 X 1 X 1 X 600.000000000000 1 1 0 1 1 354400 354400 0.00400 46409789 54087500 0 0.00000 46764189 54087500 354400 0.00400 4401 4401 0.00000 2242229 1856899 385330 0.00430 2246630 1856899 389731 0.00430 49010819 55944399 744131 0.00830 1 3111205 13672671 10449812 3222859 X 1 1 2 1 THOREK MEMORIAL HOSPITAL 850 W IRVING PARK ROAD CHICAGO IL 60613 WWW.THOREK.ORG 0005371 X X X 2 THOREK MEMORIAL HOSPITAL ANDERSONVILLE 5025 NORTH PAULINA STREET CHICAGO IL 60640 HTTPS://THOREKANDERSONVILLE.ORG/ 0000125 X X X THOREK MEMORIAL HOSPITAL 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X HTTPS://TINYURL.COM/RR869FTM X 1 19 1 HTTPS://TINYURL.COM/RR869FTM 0 1 X 200.000000000000 600.000000000000 X X X 1 1 X X X 1 X HTTPS://TINYURL.COM/XBNHBWY5 X HTTPS://TINYURL.COM/XBNHBWY5 X TINYURL.COM/XBNHBWY5 X X X X X X 1 X 0 X X X X 1 X 0 0 THOREK MEMORIAL HOSPITAL ANDERSONVILLE 2 0 1 1 X X X X X X X X X 18 1 0 0 1 X HTTPS://TINYURL.COM/4PSDJEMK X 1 19 1 HTTPS://TINYURL.COM/4PSDJEMK 0 1 X 200.000000000000 600.000000000000 X X X X 1 1 X X X 1 X HTTPS://TINYURL.COM/26NXPCYB X HTTPS://TINYURL.COM/26NXPCYB X TINYURL.COM/26NXPCYB X X X X X X 1 X 0 X X X X 1 X 0 0 THOREK MEMORIAL HOSPITAL ANDERSONVILLE PART V, SECTION B, LINE 2: THOREK MEMORIAL HOSPITAL ANDERSONVILLE (F.K.A. METHODIST HOSPITAL OF CHICAGO) WAS ACQUIRED BY THOREK MEMORIAL HOSPITAL ON SEPTEMBER 30, 2019. THOREK MEMORIAL HOSPITAL PART V, SECTION B, LINE 5: THE HOSPITAL HAS CONSULTED AND RECEIVED INPUT FROM MULTIPLE CONSTITUENTS WHO REPRESENT THE COMMUNITY IN WHICH THE HOSPITAL SERVES. MANAGEMENT ROUTINELY MEETS WITH REPRESENTATIVES FROM THE BUENA PARK NEIGHBORS (BPN), A NOT FOR PROFIT COMMUNITY ORGANIZATION, TO IDENTIFY NEEDS IN THE COMMUNITY OF BUENA PARK. THROUGH DONATIONS, MEETINGS WITH LEADERSHIP OF BPN, AND INVOLVEMENT IN VARIOUS ACTIVITIES OF BPN, THOREK ACTIVELY PARTICIPATES IN THE BUENA PARK COMMUNITY. THOREK ALSO ROUTINELY RECEIVES INPUT FROM ALDERMAN CAPPELMAN'S OFFICE REGARDING ITS STANDING WITHIN THE COMMUNITY AS WELL AS OPPORTUNITIES TO PROVIDE SERVICES OR RESOURCES TO THE LOCAL COMMUNITY AS NEEDS ARE IDENTIFIED. THOREK ALSO SEEKS AND RECEIVES INPUT FROM MANAGEMENT AT SEVERAL LOCAL CHICAGO HOUSING AUTHORITY BUILDINGS WITHIN ITS IMMEDIATE COMMUNITY AND SERVICE AREA. THIS INPUT PRIMARILY FOCUSES ON THE GERIATRIC NEEDS OF THE COMMUNITY AND LEADS TO PROGRAMS AND SERVICES DIRECTED TO MEET THE NEEDS OF SENIORS WITHIN THOREK'S COMMUNITY. ADDITIONALLY, THOREK UTILIZES A COMMUNITY HEALTH ASSESSMENT SURVEY (CONDUCTED DURING THE 2018 TAX YEAR) WITH ASSISTANCE OF AN OUTSIDE RESEARCH FIRM IN ORDER TO CAPTURE PRIMARY AND SECONDARY DATA ON THE HEALTH STATUS AND OPPORTUNITIES FOR IMPROVEMENT OF HEALTH SERVICES IN ITS COMMUNITY. THE PRIMARY DATA WAS OBTAINED THROUGH A TELEPHONE SURVEY OF OVER 3,700 ADULTS IN THE METROPOLITAN CHICAGO HEALTHCARE CARE COUNTY REGION THROUGH A 20-25 MINUTE INTERVIEW WITH 136 INDIVIDUAL QUESTIONS THAT ADDRESSED THE FOLLOWING ISSUES: SELF REPORTED HEALTH STATUS, PHYSICAL AND MENTAL HEALTH STATUS, INFECTIOUS & CHRONIC DISEASE, MODIFIABLE HEALTH RISKS, ACCESS TO HEALTHCARE SERVICES, HEALTH EDUCATION & OUTREACH, AND HEALTH INFORMATION SOURCES. THESE SURVEYS WERE CONDUCTED IN ENGLISH AND SPANISH. THE PRIMARY DATA WAS SUPPLEMENTED WITH SECONDARY DATA INCLUDING SUCH SOURCES AS CDC, FBI, COUNTY AND STATE PUBLIC HEALTH DEPARTMENTS, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU DATA. THE SECONDARY DATA INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING TOPICS: LEADING CAUSES OF DEATH, AGE-ADJUSTED DEATH RATES, VACCINE-PREVENTABLE CONDITIONS, STDS, HIV, AND OTHER INFECTIOUS DISEASES, AND FBI CRIME INDEX. THOREK PLANS TO USE THE ASSESSMENT INFORMATION TO EXPAND EXISTING AND CREATE NEW COMMUNITY HEALTH PROGRAMS MOST NEEDED BY UNDERSTANDING THE PREVALENCE OF CHRONIC CONDITIONS, BARRIERS TO ACCESS, AND OTHER HEALTH ISSUES IN THE COMMUNITY. THOREK MEMORIAL HOSPITAL ANDERSONVILLE PART V, SECTION B, LINE 5: THE HOSPITAL HAS CONSULTED AND RECEIVED INPUT FROM MULTIPLE CONSTITUENTS WHO REPRESENT THE COMMUNITY IN WHICH THE HOSPITAL SERVES. MANAGEMENT ROUTINELY MEETS WITH REPRESENTATIVES FROM THE BUENA PARK NEIGHBORS (BPN), A NOT FOR PROFIT COMMUNITY ORGANIZATION, TO IDENTIFY NEEDS IN THE COMMUNITY OF BUENA PARK. THROUGH DONATIONS, MEETINGS WITH LEADERSHIP OF BPN, AND INVOLVEMENT IN VARIOUS ACTIVITIES OF BPN, THOREK ACTIVELY PARTICIPATES IN THE BUENA PARK COMMUNITY. THOREK ALSO ROUTINELY RECEIVES INPUT FROM ALDERMAN CAPPELMAN'S OFFICE REGARDING ITS STANDING WITHIN THE COMMUNITY AS WELL AS OPPORTUNITIES TO PROVIDE SERVICES OR RESOURCES TO THE LOCAL COMMUNITY AS NEEDS ARE IDENTIFIED. THOREK ALSO SEEKS AND RECEIVES INPUT FROM MANAGEMENT AT SEVERAL LOCAL CHICAGO HOUSING AUTHORITY BUILDINGS WITHIN ITS IMMEDIATE COMMUNITY AND SERVICE AREA. THIS INPUT PRIMARILY FOCUSES ON THE GERIATRIC NEEDS OF THE COMMUNITY AND LEADS TO PROGRAMS AND SERVICES DIRECTED TO MEET THE NEEDS OF SENIORS WITHIN THOREK'S COMMUNITY. ADDITIONALLY, THOREK UTILIZES A COMMUNITY HEALTH ASSESSMENT SURVEY (CONDUCTED DURING THE 2018 TAX YEAR) WITH ASSISTANCE OF AN OUTSIDE RESEARCH FIRM IN ORDER TO CAPTURE PRIMARY AND SECONDARY DATA ON THE HEALTH STATUS AND OPPORTUNITIES FOR IMPROVEMENT OF HEALTH SERVICES IN ITS COMMUNITY. THE PRIMARY DATA WAS OBTAINED THROUGH A TELEPHONE SURVEY OF OVER 3,700 ADULTS IN THE METROPOLITAN CHICAGO HEALTHCARE CARE COUNTY REGION THROUGH A 20-25 MINUTE INTERVIEW WITH 136 INDIVIDUAL QUESTIONS THAT ADDRESSED THE FOLLOWING ISSUES: SELF REPORTED HEALTH STATUS, PHYSICAL AND MENTAL HEALTH STATUS, INFECTIOUS & CHRONIC DISEASE, MODIFIABLE HEALTH RISKS, ACCESS TO HEALTHCARE SERVICES, HEALTH EDUCATION & OUTREACH, AND HEALTH INFORMATION SOURCES. THESE SURVEYS WERE CONDUCTED IN ENGLISH AND SPANISH. THE PRIMARY DATA WAS SUPPLEMENTED WITH SECONDARY DATA INCLUDING SUCH SOURCES AS CDC, FBI, COUNTY AND STATE PUBLIC HEALTH DEPARTMENTS, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU DATA. THE SECONDARY DATA INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING TOPICS: LEADING CAUSES OF DEATH, AGE-ADJUSTED DEATH RATES, VACCINE-PREVENTABLE CONDITIONS, STDS, HIV, AND OTHER INFECTIOUS DISEASES, AND FBI CRIME INDEX. THOREK PLANS TO USE THE ASSESSMENT INFORMATION TO EXPAND EXISTING AND CREATE NEW COMMUNITY HEALTH PROGRAMS MOST NEEDED BY UNDERSTANDING THE PREVALENCE OF CHRONIC CONDITIONS, BARRIERS TO ACCESS, AND OTHER HEALTH ISSUES IN THE COMMUNITY. THOREK MEMORIAL HOSPITAL PART V, SECTION B, LINE 11: AFTER CONSIDERING THE FINDINGS OF THE CHNA IN THE CONTEXT OF CURRENT COMMUNITY-FOCUSED ACTIVITIES AND RESOURCES, THOREK HAS DECIDED TO ADDRESS THE FOLLOWING HEALTH PRIORITY AREAS (IN NO PARTICULAR ORDER) AND DEVELOP DETAILED IMPLEMENTATION PLANS AS DESCRIBED FOR EACH AREA:1) ACCESS TO HEALTH CARE SERVICES:GOAL: INCREASE THE PROPORTION OF PERSONS WITH A USUAL PRIMARY CARE PROVIDER; INCREASE THE NUMBER OF PRIMARY CARE VISITS; AND REDUCE THE PROPORTION OF PERSONS WHO ARE UNABLE TO OBTAIN OR DELAY IN OBTAINING NECESSARY MEDICAL CARE/SCREENINGS.STRATEGIES & OBJECTIVES:1. CONTINUE TO PROVIDE ACCESS TO CARE THROUGH 24/7 EMERGENCY DEPARTMENT.2. CONTINUE TO HOST GET COVERED ILLINOIS REPRESENTATIVES ON-SITE, HELPING COMMUNITY MEMBERS ENROLL IN A MARKETPLACE PLAN.3. CONTINUE TO OPERATE OFF-SITE CLINIC OFFICES IN ORDER TO PROVIDE HIGH QUALITY PRIMARY CARE IN SEVERAL LOCATIONS THROUGHOUT THE PRIMARY SERVICE AREAS.4. INCREASE PRIMARY CARE HOURS BY KEEPING THE PRIMARY CARE CLINIC OPEN SIX DAYS A WEEK, RATHER THAN FIVE.5. DISTRIBUTE A LIST OF THOREK PRIMARY CARE PHYSICIANS AND LOCATIONS AT ALL THOREK SPONSORED EVENTS.6. IMPROVE WEBSITE'S "FIND A PHYSICIAN" SECTION TO MAKE IT EASIER FOR COMMUNITY MEMBERS TO FIND A DOCTOR BASED ON THEIR UNIQUE NEEDS AND PREFERENCES.2) CANCER:GOALS: EARLIER DETECTION OF BREAST CANCER AND SKIN CANCER, ALLOWING FOR TIMELY INTERVENTION AND BETTER PROGNOSIS; AND INCREASE AWARENESS OF HOSPITAL'S CANCER SERVICES.STRATEGIES & OBJECTIVES:1. CONTINUE OFFERING MAMMOGRAMS AT A REDUCED RATE DURING THE MONTH OF OCTOBER.2. CONTINUE THE ANNUAL WOMEN'S HEALTH FAIR EVENT TO PROVIDE INFORMATION ON PREVENTION, EARLY DETECTION AND TREATMENT OF BREAST CANCER, AS WELL AS OTHER WOMEN'S HEALTH NEEDS.3. INCREASE MAMMOGRAM REMINDERS BY SENDING OUT COMMUNICATIONS TO WOMEN IN THE PRIMARY SERVICE AREAS, IN ADDITION TO THE REMINDERS ALREADY SENT TO WOMEN WHO HAVE HAD MAMMOGRAMS AT THOREK IN THE PAST.4. IMPLEMENTATION OF AN ANNUAL FREE SKIN CANCER SCREENING EVENT, WITH SUPPORT FROM THOREK DERMATOLOGIST(S).3) MENTAL HEALTH:GOALS: IMPROVE ACCESS TO AND CREATE ADDITIONAL CAPACITY TO ADDRESS MENTAL HEALTH NEEDS OF THE COMMUNITY; AND IMPROVE HEALTH-RELATED QUALITY OF LIFE AND WELL-BEING FOR ALL INDIVIDUALS.STRATEGIES & OBJECTIVES:1. A NEW, 16-BED INPATIENT MENTAL HEALTH UNIT WAS ADDED JANUARY 1, 2017, INCREASING THOREK'S CAPACITY TO ADDRESS MENTAL HEALTH NEEDS.2. RECENTLY EXPANDED OUTPATIENT MENTAL HEALTH SERVICES BY ADDING A PSYCHIATRIC NURSE PRACTITIONER TO STAFF.3. CONDUCT OUTREACH TO PATIENTS DIAGNOSED WITH DEPRESSION WHO HAVE NOT BEEN SEEN FOR A FOLLOW UP VISIT WITHIN THE PAST YEAR.4. HOLD A "DE-STRESS FEST" SPRING WELLNESS EVENT DESIGNED TO HELP THE COMMUNITY (AND THOREK ASSOCIATES) FIGHT OFF STRESS, WHILE BRINGING ATTENTION TO THE MENTAL HEALTH SERVICES OFFERED BY THE HOSPITAL.4) ORAL HEALTH:GOALS: REDUCE THE PROPORTION OF CHILDREN AND ADULTS WITH UNTREATED DENTAL DECAY; AND INCREASE THE PROPORTION OF CHILDREN AND ADULTS WHO HAVE USED THE ORAL HEALTH SYSTEM IN THE PAST YEAR.STRATEGIES & OBJECTIVES:1. RECENTLY ADDED DR. ARDITA DALIPI TO THE THOREK STAFF. DR. DALIPI SPECIALIZES IN FAMILY DENTISTRY WITH A SPECIFIC FOCUS ON PEDIATRIC DENTISTRY.2. EXPLORE ADDING OTHER DENTISTRY SPECIALISTS TO THE THOREK STAFF, INCREASING THE HOSPITAL'S CAPACITY TO ADDRESS ORAL HEALTH NEEDS.3. OFFER A NUMBER OF DISCOUNTED BACK-TO-SCHOOL DENTAL EXAMS FOR CHILDREN ENTERING GRADES K-12.4. COLLABORATE WITH DR. DALIPI TO EXPAND COMMUNITY OUTREACH AND AWARENESS THROUGH DIRECT COMMUNICATION EFFORTS, OPEN HOUSES, AND OTHER COMMUNITY EVENTS. PLEASE NOTE FOR EACH OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CHNA THAT THOREK WILL NOT BE ADDRESSING ARE IMPORTANT AND ARE ALREADY BEING ADDRESSED BY NUMEROUS PROGRAMS AND INITIATIVES OPERATED BY THOREK, COMMUNITY PARTNERS OF THE HOSPITAL, AND/OR OTHER ORGANIZATIONS WITHIN THOREK'S PRIMARY SERVICE AREAS. AS SUCH,THOREK WILL NOT BE DIRECTLY ADDRESSING AS PART OF THE IMPLEMENTATION PLAN DUE TO LIMITED RESOURCES AND THE NEED TO FOCUS ON THE FOUR PRIORITY HEALTH NEEDS IDENTIFIED ABOVE. THOREK MEMORIAL HOSPITAL ANDERSONVILLE PART V, SECTION B, LINE 11: AFTER CONSIDERING THE FINDINGS OF THE CHNA IN THE CONTEXT OF CURRENT COMMUNITY-FOCUSED ACTIVITIES AND RESOURCES, THOREK HAS DECIDED TO ADDRESS THE FOLLOWING HEALTH PRIORITY AREAS (IN NO PARTICULAR ORDER) AND DEVELOP DETAILED IMPLEMENTATION PLANS AS DESCRIBED FOR EACH AREA:1) ACCESS TO HEALTH CARE SERVICES:GOAL: INCREASE THE PROPORTION OF PERSONS WITH A USUAL PRIMARY CARE PROVIDER; INCREASE THE NUMBER OF PRIMARY CARE VISITS; AND REDUCE THE PROPORTION OF PERSONS WHO ARE UNABLE TO OBTAIN OR DELAY IN OBTAINING NECESSARY MEDICAL CARE/SCREENINGS.STRATEGIES & OBJECTIVES:1. CONTINUE TO PROVIDE ACCESS TO CARE THROUGH 24/7 EMERGENCY DEPARTMENT.2. CONTINUE TO HOST GET COVERED ILLINOIS REPRESENTATIVES ON-SITE, HELPING COMMUNITY MEMBERS ENROLL IN A MARKETPLACE PLAN.3. CONTINUE TO OPERATE OFF-SITE CLINIC OFFICES IN ORDER TO PROVIDE HIGH QUALITY PRIMARY CARE IN SEVERAL LOCATIONS THROUGHOUT THE PRIMARY SERVICE AREAS.4. INCREASE PRIMARY CARE HOURS BY KEEPING THE PRIMARY CARE CLINIC OPEN SIX DAYS A WEEK, RATHER THAN FIVE.5. DISTRIBUTE A LIST OF THOREK PRIMARY CARE PHYSICIANS AND LOCATIONS AT ALL THOREK SPONSORED EVENTS.6. IMPROVE WEBSITE'S "FIND A PHYSICIAN" SECTION TO MAKE IT EASIER FOR COMMUNITY MEMBERS TO FIND A DOCTOR BASED ON THEIR UNIQUE NEEDS AND PREFERENCES.2) CANCER:GOALS: EARLIER DETECTION OF BREAST CANCER AND SKIN CANCER, ALLOWING FOR TIMELY INTERVENTION AND BETTER PROGNOSIS; AND INCREASE AWARENESS OF HOSPITAL'S CANCER SERVICES.STRATEGIES & OBJECTIVES:1. CONTINUE OFFERING MAMMOGRAMS AT A REDUCED RATE DURING THE MONTH OF OCTOBER.2. CONTINUE THE ANNUAL WOMEN'S HEALTH FAIR EVENT TO PROVIDE INFORMATION ON PREVENTION, EARLY DETECTION AND TREATMENT OF BREAST CANCER, AS WELL AS OTHER WOMEN'S HEALTH NEEDS.3. INCREASE MAMMOGRAM REMINDERS BY SENDING OUT COMMUNICATIONS TO WOMEN IN THE PRIMARY SERVICE AREAS, IN ADDITION TO THE REMINDERS ALREADY SENT TO WOMEN WHO HAVE HAD MAMMOGRAMS AT THOREK IN THE PAST.4. IMPLEMENTATION OF AN ANNUAL FREE SKIN CANCER SCREENING EVENT, WITH SUPPORT FROM THOREK DERMATOLOGIST(S).3) MENTAL HEALTH:GOALS: IMPROVE ACCESS TO AND CREATE ADDITIONAL CAPACITY TO ADDRESS MENTAL HEALTH NEEDS OF THE COMMUNITY; AND IMPROVE HEALTH-RELATED QUALITY OF LIFE AND WELL-BEING FOR ALL INDIVIDUALS.STRATEGIES & OBJECTIVES:1. A NEW, 16-BED INPATIENT MENTAL HEALTH UNIT WAS ADDED JANUARY 1, 2017, INCREASING THOREK'S CAPACITY TO ADDRESS MENTAL HEALTH NEEDS.2. RECENTLY EXPANDED OUTPATIENT MENTAL HEALTH SERVICES BY ADDING A PSYCHIATRIC NURSE PRACTITIONER TO STAFF.3. CONDUCT OUTREACH TO PATIENTS DIAGNOSED WITH DEPRESSION WHO HAVE NOT BEEN SEEN FOR A FOLLOW UP VISIT WITHIN THE PAST YEAR.4. HOLD A "DE-STRESS FEST" SPRING WELLNESS EVENT DESIGNED TO HELP THE COMMUNITY (AND THOREK ASSOCIATES) FIGHT OFF STRESS, WHILE BRINGING ATTENTION TO THE MENTAL HEALTH SERVICES OFFERED BY THE HOSPITAL.4) ORAL HEALTH:GOALS: REDUCE THE PROPORTION OF CHILDREN AND ADULTS WITH UNTREATED DENTAL DECAY; AND INCREASE THE PROPORTION OF CHILDREN AND ADULTS WHO HAVE USED THE ORAL HEALTH SYSTEM IN THE PAST YEAR.STRATEGIES & OBJECTIVES:1. RECENTLY ADDED DR. ARDITA DALIPI TO THE THOREK STAFF. DR. DALIPI SPECIALIZES IN FAMILY DENTISTRY WITH A SPECIFIC FOCUS ON PEDIATRIC DENTISTRY.2. EXPLORE ADDING OTHER DENTISTRY SPECIALISTS TO THE THOREK STAFF, INCREASING THE HOSPITAL'S CAPACITY TO ADDRESS ORAL HEALTH NEEDS.3. OFFER A NUMBER OF DISCOUNTED BACK-TO-SCHOOL DENTAL EXAMS FOR CHILDREN ENTERING GRADES K-12.4. COLLABORATE WITH DR. DALIPI TO EXPAND COMMUNITY OUTREACH AND AWARENESS THROUGH DIRECT COMMUNICATION EFFORTS, OPEN HOUSES, AND OTHER COMMUNITY EVENTS. PLEASE NOTE FOR EACH OF THE SIGNIFICANT HEALTH NEEDS OF THE COMMUNITY IDENTIFIED IN THE CHNA THAT THOREK WILL NOT BE ADDRESSING ARE IMPORTANT AND ARE ALREADY BEING ADDRESSED BY NUMEROUS PROGRAMS AND INITIATIVES OPERATED BY THOREK, COMMUNITY PARTNERS OF THE HOSPITAL, AND/OR OTHER ORGANIZATIONS WITHIN THOREK'S PRIMARY SERVICE AREAS. AS SUCH,THOREK WILL NOT BE DIRECTLY ADDRESSING AS PART OF THE IMPLEMENTATION PLAN DUE TO LIMITED RESOURCES AND THE NEED TO FOCUS ON THE FOUR PRIORITY HEALTH NEEDS IDENTIFIED ABOVE. SCHEDULE H, PART V, SECTION B, LINE 22D: THOREK MEMORIAL HOSPITAL CALCULATES AGB UNDER THE PROSPECTIVE MEDICARE METHOD, WHICH MEANS THAT THOREK DETERMINES AGB FOR ANY EMERGENCY OR OTHER MEDICALLY NECESSARY CARE PROVIDED TO AN INDIVIDUAL ELIGIBLE FOR FINANCIAL ASSISTANCE BY USING THE BILLING AND CODING PROCESS THOREK WOULD USE IF THE INDIVIDUAL WERE A MEDICARE FEE-FOR-SERVICE BENEFICIARY AND SETTING THE AGB FOR THE CARE AT THE AMOUNT MEDICARE WOULD ALLOW FOR THE CARE (INCLUDING BOTH THE AMOUNT THAT WOULD BE REIMBURSED BY MEDICARE AND THE AMOUNT THE BENEFICIARY WOULD BE PERSONALLY RESPONSIBLE FOR PAYING IN THE FORM OF CO-PAYMENTS, COINSURANCE AND DEDUCTIBLES). 4 1 - CHINA SQUARE CLINIC 2142 S ARCHER AVENUE CHICAGO IL 60616 CLINIC 2 - CHICAGO AVENUE CLINIC 2331 W CHICAGO AVENUE CHICAGO IL 60622 CLINIC 3 - UKRAINIAN VILLAGE CLINIC 2515 WEST CHICAGO CHICAGO IL 60622 CLINIC 4 - LINCOLN SQUARE CLINIC 5151 N LINCOLN AVENUE CHICAGO IL 60625 CLINIC PART I, LINE 6A: THOREK PREPARES AND FILES THE ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT BY DECEMBER 31 OF EACH YEAR WITH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 3,111,205. PART III, LINE 2: AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. PART III, LINE 4: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD-PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDE BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. PART III, LINE 8: MEDICARE COSTS ARE ALLOCATED BY COST CENTER IN ACCORDANCE WITH MEDICARE REGULATIONS. THE COSTS ARE CALCULATED USING A COST TO CHARGE RATIO. PART III, LINE 9B: THOREK SEEKS TO ENGAGE PATIENTS PROACTIVELY TO DETERMINE IF FINANCIAL ASSISTANCE IS NEEDED, ESPECIALLY AT THE TIME OF SERVICE. THIS SERVICE IS ACCOMPLISHED BY COMMUNICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THE PATIENT THROUGH POSTED SIGNS THROUGHOUT THE HOSPITAL AS WELL AS NOTICES ON THE HOSPITAL WEBSITE AND ALL BILLING CORRESPONDENCE. FURTHERMORE THE HOSPITAL FINANCIAL COUNSELORS PROVIDE ASSISTANCE RANGING FROM ASSISTANCE IN COMPLETING THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION, TO PROVIDING PAYMENT PLANS TO THOSE WITHOUT INSURANCE OR WITH PATIENT RESPONSIBILITIES AFTER REIMBURSEMENT BY THE PRIMARY INSURANCE, AND SEEKING INSURANCE COVERAGE FOR THOSE PATIENTS UNINSURED. THE HOSPITAL'S FINANCIAL COUNSELORS SEEK TO MAKE CONTACT AND WORK WITH THE PATIENT OR THEIR FAMILY TO HELP THEM IN ANY WAY POSSIBLE TO MEET THEIR FINANCIAL RESPONSIBILITIES IN A SUPPORTIVE MANNER OR IDENTIFY ELIGIBILITY FOR THE HOSPITAL'S CHARITY CARE POLICY.FINANCIAL COUNSELORS WORK WITH PATIENTS IN PERSON WHILE STILL AN INPATIENT IF APPROPRIATE, AFTER AN OUTPATIENT SERVICE AT THE HOSPITAL, OR SOON AFTER SERVICE IS PROVIDED TELEPHONICALLY. AS PART OF THIS PROCESS, THE COUNSELORS ATTEMPT TO DETERMINE IF THERE ARE ANY THIRD-PARTY PAYERS WHICH MAY BE AVAILABLE TO HELP THE PATIENT MEET THEIR OBLIGATIONS. THE COUNSELORS WORK WITH OUR PATIENTS TO DETERMINE IF THEY ARE ELIGIBLE FOR MEDICAID OR OTHER STATE OR LOCAL FUNDED PROGRAMS INCLUDING CRIME VICTIMS, ILLINOIS MARKET PLACE INSURANCE PLANS, ALTERNATIVE INSURANCE INCLUDING COBRA, WORKER'S COMPENSATION, AND/OR OTHER APPROPRIATE THIRD-PARTY LIABILITY PAYOR. THE HOSPITAL CONTRACTS WITH AN OUTSIDE FIRM TO PROVIDE SUPPORTING STAFF THAT WORK WITH PATIENT ACCOUNTS IN THIS PROCESS. THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE BEGINS WITH A PHONE CALL OR MEETING WITH THE PATIENT TO COMPLETE THE HOSPITAL CHARITY CARE APPLICATION FORMS AND/OR PROVIDED EVIDENCE OF THE NEED FOR FINANCIAL ASSISTANCE. IF THE CHARITY CARE APPLICATION MEETS THE HOSPITAL CHARITY CARE GUIDELINES OF 200% OF THE FEDERAL POVERTY GUIDELINES, NO FURTHER COLLECTION ACTIVITY OCCURS, AND THE AMOUNT IS APPROPRIATELY RECORDED AS CHARITY CARE AND WRITTEN OFF AFTER THE 53% INITIAL DISCOUNT IS APPLIED. IF THE APPLICATION MEETS THE 201%-300% OF FEDERAL POVERTY GUIDELINE THE ACCOUNT IS DISCOUNTED AT ADDITIONAL 50% AND THE PAYMENT PLAN IS INITIATED FOR THE REMAINING BALANCE. FOR PATIENTS THAT DO NOT MEET CHARITY CARE GUIDELINES, A 53% (BASED ON 300% OF FEDERAL POVERTY GUIDELINES) INITIAL DISCOUNT IS TAKEN. THE REMAINING AMOUNT IS PAID BASED UPON AN AGREED PAYMENT PLAN WITH THE PATIENT OR THE PATIENT RECEIVES A FURTHER DISCOUNT BASED UPON THE INDIVIDUAL PATIENT'S FINANCIAL SITUATION. ANY FINAL AMOUNT TO BE PAID IS DETERMINED AND PAID IN FULL OR ACCORDING TO AN AGREED UPON PAYMENT PLAN WITH THE PATIENT. EVERY OPPORTUNITY IS MADE TO ENSURE THE PATIENT HAS THE CHANCE TO PAY WHAT THEY CAN AFFORD BASED UPON THEIR FINANCIAL SITUATION AT THAT TIME. PART VI, LINE 2: IN ADDITION TO THE CHNA, THOREK MEMORIAL HOSPITAL HAS HISTORICALLY AND CONTINUES TO IDENTIFY PRIORITIES FOR COMMUNITY BENEFIT THROUGH THE FOLLOWING INTERNAL REVIEW: THE THOREK MEMORIAL HOSPITAL (TMH) COMMUNITY NEEDS ASSESSMENT IS AN ONGOING PROCESS CONDUCTED BY TMH MANAGEMENT AND SUMMARIZED ANNUALLY IN THE ANNUAL NON-PROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT SUBMITTED TO THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. THIS PROCESS UTILIZES INFORMATION OBTAINED FROM HEALTH AGENCIES AND PRACTITIONERS, COMMUNITY ORGANIZATIONS, AND COMMUNITY REPRESENTATIVES. THIS INFORMATION HAS BEEN GATHERED EITHER THROUGH REVIEW OF PUBLISHED INFORMATION, WRITTEN FEEDBACK, OR DIRECT INTERVIEWS OR DISCUSSIONS WITH PHYSICIANS AND PATIENTS. INDIVIDUALS INCLUDED ARE PHYSICIANS AND ALLIED HEALTH PROFESSIONALS, REPRESENTATIVES FROM THE ELDERLY POPULATION, LOCAL EMPLOYERS, AND COMMUNITY REPRESENTATIVES. FINDINGS FROM THE ASSESSMENT INDICATE:- TMH SERVES A POPULATION HAVING LIMITED ECONOMIC MEANS- THE POPULATION SERVED BY TMH IS NOT BASED ON GEOGRAPHIC PROXIMITY- THERE IS A CONSENSUS BETWEEN TMH AND ITS MEDICAL STAFF REGARDING GOALS- THERE IS LOW CONSUMER AWARENESS OF TMH SERVICES, HOWEVER, THIS IS IMPROVING.THE TOP PRIORITY UNMET HEALTH NEEDS, BY AGE GROUP, ARE AS FOLLOWS:- ADULTS: ACCESS TO SERVICES (INSURANCE, COST)- SENIORS: COST; MEDICATIONS; POST-HOSPITAL SUPPORT; AND TRANSPORTATIONTHOREK MEMORIAL HOSPITAL HAS ADDRESSED AND/OR PLANS TO ADDRESS THESE IDENTIFIED PRIORITY NEEDS IN THE FOLLOWING WAYS IN THE COMMUNITY:- IMPROVE ACCESS TO SERVICES- AMBULATORY CARE. TMH HAS FOCUSED ON THE EXPANSION AND DIFFERENTIATION OF ITS AMBULATORY CARE PROGRAMS IN ORDER TO IMPROVE ACCESS AND SERVICE. THE AMBULATORY CARE DEPARTMENT HAS BEEN PHYSICALLY EXPANDED AND SE PARA TED INTO DISTINCT COMPONENTS.- CENTER FOR PRIMARY CARE. TMH OPERATES ITS CENTER FOR PRIMARY CARE. THIS NOT ONLY INCREASED THE SPACE DEVOTED TO AMBULATORY CARE BUT PROVIDES A PHYSICALLY DISTINCT AREA DESIGNED TO HAVE THE LOOK AND FEEL OF A PRIVATE MEDICAL OFFICE RATHER THAN A "WALK-IN CLINIC".- COMMUNITY AND LOCAL EMPLOYER HEALTH FAIRS AND EDUCATION SESSIONS FOCUS ON NEEDS AND CONCERNS OF SENIORS- CHA PROGRAM. TMH PROVIDES ACCESS TO MEDICAL SERVICES FOR RESIDENTS OF FIVE NEARBY CHICAGO HOUSING AUTHORITY (CHA) RESIDENTIAL FACILITIES BY OPERATING MEDICAL OFFICES IN THESE BUILDINGS. RESIDENTS OF THESE BUILDINGS ARE PREDOMINANTLY SENIORS WHO QUALIFY FOR SUBSIDIZED HOUSING BASED ON FINANCIAL NEED. TYPICAL OFFICE STAFFING CONSISTS OF AN RN AND A PHYSICIAN. IN ADDITION, PHARMACEUTICALS NEEDED BY RESIDENTS ARE DELIVERED FREE OF CHARGE FOR THOSE RESIDENTS THAT REQUIRE THEM BASED ON AN APPROPRIATE COMPLETED SCRIPTS BY THE PHYSICIANS. IN ADDITION TO THE PROVISION OF HEALTH SERVICES, EDUCATIONAL, SOCIAL, AND OTHER ACTIVITIES ARE ARRANGED BY STAFF FOR THE PATIENTS OF CHA AT FIVE SITES ON THE NORTH SIDE OF CHICAGO, IN THOREK'S PRIMARY SERVICE AREA. NO AMOUNTS ARE BILLED BY THE HOSPITAL FOR HEALTHCARE SERVICES PROVIDED AT THESE SITES. THOREK MEMORIAL HOSPITAL ALSO HELPS TO PROVIDE ACCESS TO SPECIALTY (CONSULTANT) PHYSICIAN SERVICES TO MEMBERS ON AN AS NEEDED BASIS.- MEDICATION. RECOGNIZING THE NEED TO PROVIDE ACCESS, EXPAND ALTERNATIVES, AND IMPROVE CONVENIENCE TO THOSE WE SERVE, TMH CONTINUES TO PROVIDE MEDICATION THROUGH ITS OUTPATIENT PHARMACY TO HOSPITAL PATIENTS AND CHA RESIDENTS.-TRANSPORTATION. TMH PROVIDES TRANSPORTATION VIA HOSPITAL VAN AND CONTRACTED TRANSPORTATION SERVICES BASED ON HOSPITAL TRANSPORTATION POLICIES TO 50+ CLUB MEMBERS AND OTHERS WITHIN DESIGNATED GEOGRAPHIC BOUNDARIES, AS DETERMINED APPROPRIATE BASED ON NEED AND CLINICAL STATUS, WHEN HOSPITAL SERVICES HAVE BEEN SCHEDULED IN ACCORDANCE WITH THE HOSPITAL'S TRANSPORTATION POLICY.INCREASE AWARENESS OF HEALTH PROGRAMS AVAILABLE:- COMMUNICATION OF SERVICES TO THE COMMUNITY AND ITS ORGANIZATIONS.- COMMUNITY HEALTH EDUCATION PROGRAMS DISCUSSING PREVENTION AND WELLNESS- ACCESS TO HOSPITAL AND PHYSICIAN SERVICES PART VI, LINE 3: THOREK UTILIZES SEVERAL METHODS TO COMMUNICATE ITS RESPONSIBILITY TO INFORM AND EDUCATE PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER GOVERNMENTAL PROGRAMS OR THE HOSPITAL'S FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES. THE HOSPITAL POSTS THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE IN ENGLISH AND SPANISH IN ALL REGISTRATION AND MOST WAITING AREAS THROUGHOUT THE HOSPITAL. MEMBERS OF THE BUSINESS OFFICE ALSO WORK WITH PATIENTS TO SEE WHAT OTHER COMMUNITY RESOURCES MAY BE AVAILABLE TO THE PATIENT FOR CURRENT AND FUTURE CARE PROVISION. THE FINANCIAL COUNSELOR AND MOST OTHER EMPLOYEES IN THE HOSPITAL'S BUSINESS OFFICE AND PATIENT REGISTRATION ARE FLUENT IN SPANISH, AND PHONE TRANSLATORS ARE USED FOR OTHER LANGUAGES. THE AVAILABILITY FOR CHARITY CARE AS WELL AS THE WORKSHEET TO CALCULATE ELIGIBILITY FOR CHARITY CARE IS POSTED ON THE HOSPITAL'S WEBSITE. IN ADDITION, ALL BILLS AND STATEMENTS SENT TO PATIENTS INCLUDE INFORMATION REGARDING THE FINANCIAL ASSISTANCE AND CHARITY CARE OPPORTUNITIES IN ENGLISH AND SPANISH. THE HOSPITAL ALSO CONTRACTS FOR A FULL TIME FTE TO PROVIDE FINANCIAL COUNSELING TO PATIENTS WHICH INCLUDES THE ASSISTANCE IN THE MEDICAID APPLICATION PROCESS AS WELL AS A SEARCH FOR OTHER COVERAGE OPTIONS AVAILABLE. PART VI, LINE 4: THOREK MEMORIAL HOSPITAL IS REPRESENTATIVE OF THE WIDE CROSS-SECTION OF THE POPULATION THAT IT SERVES. ITS COMMUNITY INCLUDES A SIZABLE NUMBER OF AFRICAN AMERICAN, ASIAN, AND HISPANIC RESIDENTS AS WELL AS A VARIETY OF OTHER ETHNIC GROUPS. THOREK MEMORIAL HOSPITAL'S LONG-STANDING STATUS AS A PREFERRED PROVIDER OF MEDICAL SERVICES FOR EMPLOYERS, ALSO WITH A MULTL ETHNIC MEMBERSHIP, CONTRIBUTES TO A WELL-ESTABLISHED WORKING CLASS ETHNIC CLIENT BASE. THE DEMOGRAPHICS INCLUDE A LISTING THAT GIVES THE ETHNIC DISTRIBUTION OF INPATIENTS. SINCE THOREK MEMORIAL HOSPITAL'S MEDICAL STAFF ALSO REFLECTS ETHNIC DIVERSITY, WE EXPECT TO MAINTAIN A SIGNIFICANT ETHNIC CUSTOMER BASE. AL THOUGH THOREK MEMORIAL HOSPITAL SERVES PATIENTS THROUGHOUT THE CHICAGO METROPOLITAN AREA AND EVEN AS FAR AWAY AS INDIANA AND WISCONSIN, WE HAVE DEFINED OUR COMMUNITY BASED UPON GEOGRAPHIC PROXIMITY. A PRIMARY SERVICE AREA HAS BEEN IDENTIFIED CONSISTING OF NEARBY ZIP CODE AREAS. THOREK MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF THE FOLLOWING: GRACELAND (60613),LINCOLN PARK (60614), KEDZIE-GRACE (60618), RAVENSWOOD (60625), UPTOWN (60640), LOGAN SQUARE (60647), EDGEWATER (60660), W.ROGERS PARK (60645), ROGERS PARK (60626), DIVISION (60651 ), AUSTIN (60644), BELMONT CRAGIN (60639), GARFIELD PARK (60624), NEAR WEST (60612), HAWTHORNE (60623), PILSEN (60608), AND NEAR SOUTH (60616), AS WELL AS ZIP CODES 60653, 60615, 60621, 60637, 60620, 60619, 60649, AND 60628.THE PRIMARY NOT-FOR-PROFIT COMMUNITY HOSPITALS ALSO SERVING THIS AREA INCLUDE: WEISS MEMORIAL HOSPITAL, ILLINOIS MASONIC MEDICAL CENTER (ADVOCATE), SWEDISH HOSPITAL (NORTHSHORE), ST. JOSEPH HOSPITAL (AMITA), HUMBOLDT PARK HEALTH, AND ST. MARY AND ST ELIZABETH HOSPITALS (AMITA). APPROXIMATELY 85% OF ADMISSIONS SERVED AT THOREK ARE FEDERALLY FUNDED OR SELF PAY/CHARITY. THE HOSPITAL CONTINUES TO MEET THE CRITERIA FOR A DISPROPORTIONATE SHARE HOSPITAL FOR MEDICARE/MEDICAID HIGH-VOLUME ADJUSTMENT FOR THE DEPARTMENT OF HUMAN SERVICES (PUBLIC AID). PART VI, LINE 5: THE GOVERNING BODY OF THOREK INCLUDES MEMBERS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. FURTHERMORE, THOREK EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. A NET COMMUNITY BENEFITS EXPENSE FOR THOREK IN 2020 IS AS FOLLOWS (FROM THE ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT FILED IN ACCORDANCE WITH THE ILLINOIS ATTORNEY GENERAL GUIDELINES): CHARITY CARE AT COST - $354,400; LANGUAGE ASSISTANT SERVICES - $4,401; SUBSIDIZED HEALTH SERVICES - $385,330. THE HOSPITAL PROVIDES (FREE OF CHARGE) GUARDIANSHIP SERVICES THROUGH A LOCAL LEGAL FIRM FOR THOSE INPATIENT PSYCHIATRIC PATIENTS WHO ARE NOT ABLE TO MAKE APPROPRIATE MEDICAL DECISIONS FOR THEMSELVES. ALSO INCLUDED IN OTHER COMMUNITY BENEFIT PROGRAMS IS THE PROVISION OF TRANSPORTATION TO HOSPITAL PATIENTS THAT REQUIRE THIS SERVICE TO RECEIVE APPROPRIATE MEDICALLY NECESSARY HEALTH CARE AND PHYSICIAN SERVICES. THE TRANSPORTATION FOR THESE PATIENTS IS PERFORMED IN ACCORDANCE WITH THE HOSPITAL TRANSPORTATION POLICY. THOREK ORGANIZES THAI HEALTH FAIR AND PROVIDES DIABETIC EDUCATION WITH THE GOAL OF ADVOCATING AND PROMPTING THE HEALTH OF THE COMMUNITY. TOTAL CHARITY CARE AND COMMUNITY BENEFITS: $744,131. IN ADDITION, THOREK REPORTED BAD DEBT EXPENSE OF $3,111,205. PART VI, LINE 7, REPORTS FILED WITH STATES IL X X X X 0 0 0 0 0 0 0 1 0 PHILIP GORELICK MD CHIEF MEDICAL OFFICER 426517 0 95275 0 0 0 0 0 321 0 522113 0 0 0 PETER KAMBEROS CHAIRMAN & COO 407897 0 83173 0 0 0 0 0 1284 0 492354 0 0 0 EDWARD BUDD CEO 385102 0 88065 0 0 0 0 0 16686 0 489853 0 0 0 JOHN HUNNIFORD MD PHYSICIAN 337948 0 99739 0 0 0 0 0 6649 0 444336 0 0 0 TIM HEINRICH CFO 295461 0 69525 0 0 0 0 0 16686 0 381672 0 0 0 GENEVIEVE PRESBITERO CHIEF NURSING OFFICER 273364 0 57938 0 0 0 0 0 7291 0 338593 0 0 0 SEEMA ELAHI PHYSICIAN 242687 0 0 0 0 0 0 0 12548 0 255235 0 0 0 NAYNA NAVIK PHYSICIAN 206352 0 0 0 0 0 0 0 6649 0 213001 0 0 0 JULIA DYER MD PHYSICIAN 207082 0 0 0 0 0 0 0 0 0 207082 0 0 0 SUZANNE CHAN NURSE PRACTITIONER 195161 0 0 0 0 0 0 0 5776 0 200937 0 0 0 PART I, LINE 7 AS INDICATED IN SCHEDULE J, PART II, CERTAIN OFFICERS AND HIGHEST COMPENSATED EMPLOYEES OF THE ORGANIZATION RECEIVED A BONUS BASED ON PERFORMANCE GOALS AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THIS BONUS WAS APPROVED BY THE COMPENSATION COMMITTEE. FORM 990, PART VI, SECTION A, LINE 8B THE ORGANIZATION DID NOT HAVE ANY COMMITTEES WITH THE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. FORM 990, PART VI, SECTION B, LINE 11B THE BOARD OF TRUSTEES RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO PREPARE THE ORGANIZATION'S FORM 990. MANAGEMENT REVIEWS THE COMPLETED FORM 990 AND SUBSEQUENTLY PRESENTS A COPY TO THE HOSPITAL BOARD OF TRUSTEES ALONG WITH THE INDEPENDENT CPA FIRM. THE BOARD OF TRUSTEES HAS THE OPPORTUNITY TO REVIEW THE RETURN, ASK QUESTIONS, AND SUGGEST CHANGES. THE BOARD OF TRUSTEES APPROVES THE FINAL VERSION OF THE RETURN AND MANAGEMENT FILES THIS RETURN WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE HOSPITAL REGULARLY AND CONSISTENTLY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL REVIEW AND COMPLETION OF THE ANNUAL BOARD MEMBER QUESTIONNAIRE AND CONFLICT OF INTEREST POLICY BY EACH MEMBER OF THE BOARD OF TRUSTEES. THE CORPORATE COMPLIANCE OFFICER REVIEWS AND ENFORCES THE CONFLICT OF INTEREST POLICY. IF A CONFLICT ARISES, THE BOARD MEMBER ABSTAINS FROM VOTING ON THE RELEVANT ISSUE. FORM 990, PART VI, SECTION B, LINE 15 AN ANNUAL REVIEW OF COMPENSATION WAS COMPLETED FOR FISCAL YEAR 2021. THE INFORMATION WAS DISTRIBUTED TO THE COMPENSATION COMMITTEE OF THE BOARD. THE COMMITTEE WILL THEN MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES ON AN ANNUAL BASIS. ALL DECISIONS BY THE COMPENSATION COMMITTEE ARE DOCUMENTED IN THE MINUTES OF THE COMPENSATION COMMITTEE. THE HOSPITAL ENGAGED CROWE LLP TO PROVIDE A COMPARATIVE SALARY ANALYSIS FOR ALL EMPLOYEES FOR FISCAL YEAR 2021. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THOREK MEMORIAL FOUNDATION 850 W IRVING PARK ROAD CHICAGO IL 60613 366124318 SUPPORT THOREK MEMORIAL HOSPITAL IL 501(C)(3) LINE 12B, II THOREK MEMORIAL HOSPITAL 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0