Lurie Children's Surgical Foundation Inc: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- Lurie Children's Surgical Foundation Inc (EIN 83-1650513)
- Tax period
- 2019-09-01 to 2020-08-31
- Filed
- 2021-07-14
- IRS object ID
- 202111959349301581
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-07-14T14:06:41-05:00 | ReturnTs |
| Tax Period End | 2020-08-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 155 N Wacker Drive | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-09-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 831650513 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lurie Children's Surgical Foundation Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % RON BLAUSTEIN | InCareOfNm |
| Business Name Control | LURI | BusinessNameControlTxt |
| Phone | 3122277133 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE BOX 282 | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606112991 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON BLAUSTEIN | PersonNm |
| Person Title | Sr. VP/CFO | PersonTitleTxt |
| Phone | 3122277133 | PhoneNum |
| Signature | 2021-07-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JESS WAGENER | PreparerPersonNm |
| PTIN | P01622613 | PTIN |
| Phone | 3128792000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Erik C King MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE BOX 282 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606112991 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $75,950,609 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.luriechildrens.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2018 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE PEDIATRIC AND SUBSPECIALTY SURGICAL, RESEARCH, AND EDUCATIONAL SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 79 | TotalEmployeeCnt |
| Total Volunteers | 2 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $27,000,019 | PYContributionsGrantsAmt |
| CY Contributions Grants | $22,311,077 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $36,116,113 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $53,639,532 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $63,116,132 | PYTotalRevenueAmt |
| CY Total Revenue | $75,950,609 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $43,380,616 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $65,700,447 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,699,911 | PYOtherExpensesAmt |
| CY Other Expenses | $18,238,997 | CYOtherExpensesAmt |
| PY Total Expenses | $52,080,527 | PYTotalExpensesAmt |
| CY Total Expenses | $83,939,444 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $11,035,605 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$7,988,835 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,900,887 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,457,594 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,798,137 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,320,148 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,102,750 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $137,446 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDE PEDIATRIC AND SUBSPECIALTY SURGICAL, RESEARCH, AND EDUCATIONAL SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $81,675,270 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $53,639,532 | RevenueAmt |
| Desc | LURIE CHILDREN'S SURGICAL FOUNDATION, INC. ("LCSF") IS AN ILLINOIS NOT FOR PROFIT CORPORATION AND AN ORGANIZATION DESCRIBED UNDER SECTION 501(C)(3) OF THE CODE. ON JANUARY 1, 2019, CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER ("PARENT") (FEIN 36-3357004) BECAME THE SOLE CORPORATE MEMBER OF LCSF. LCSF EMPLOYS PEDIATRIC SURGICAL SPECIALISTS AND SUBSPECIALISTS. SUCH PHYSICIANS ARE BASED AND PRACTICE AT ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO ("LURIE CHILDREN'S"), ANOTHER AFFILIATED ENTITY OF LCSF, AND AT THE LURIE CHILDREN'S OUTREACH LOCATIONS. LURIE CHILDREN'S OFFERS OVER 70 TYPES OF PEDIATRIC SUBSPECIALTY CARE, MORE THAN ANY OTHER ILLINOIS HOSPITAL. LCSF EMPLOYS PEDIATRIC SURGICAL SPECIALISTS AND SUBSPECIALISTS WHO PROVIDE SURGICAL SERVICES TO PATIENTS OF LURIE CHILDREN'S IN THE AREAS OF CARDIAC SURGERY, FETAL SURGERY, NEUROSURGERY, OPHTHALMOLOGY, ORTHOPAEDICS, OTOLARYNGOLOGY, PEDIATRIC SURGERY, PLASTIC SURGERY, TRANSPLANT SURGERY, AND UROLOGY. LCSF SURGEONS PERFORMED OVER 15,000 SURGICAL PROCEDURES DURING THE TWELVE MONTHS ENDED AUGUST 31, 2020. | Desc |
| Total Other Prog Srvc Expense | $0 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $81,675,270 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 79 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RON BLAUSTEIN | PersonNm |
| Phone | 3122277133 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606112991 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| Patrick M Magoon | ||||||||
| Ex-Off/LCH Pres/CEO untl 12/19 | 1.0 | 45.0 | Yes (X) | $0 | $2,497,744 | $59,225 | ||
| Carl D Backer MD | ||||||||
| Physician | 40.0 | 0.0 | $1,528,174 | $0 | $0 | Yes (X) | ||
| Joseph M Forbess MD | ||||||||
| Physician | 40.0 | 0.0 | $1,519,000 | $0 | $0 | Yes (X) | ||
| Fizan Abdullah MD | ||||||||
| Physician | 40.0 | 0.0 | $1,016,201 | $0 | $100,000 | Yes (X) | ||
| Thomas P Shanley MD | ||||||||
| Ex-Officio Director & LCH CEO | 1.0 | 46.0 | Yes (X) | $0 | $907,472 | $196,830 | ||
| Marleta Reynolds MD | ||||||||
| Ex-Off Dir/Chf of Surgery,DH | 40.0 | 5.0 | Yes (X) | $977,810 | $0 | $0 | ||
| Tadanori Tomita MD | ||||||||
| Physician | 40.0 | 0.0 | $959,755 | $0 | $2,700 | Yes (X) | ||
| Aimen F Shaaban MD | ||||||||
| Physician | 40.0 | 0.0 | $931,400 | $0 | $0 | Yes (X) | ||
| Nancy M Borders | ||||||||
| Gen Counsl/Corp Sec untl 12/19 | 1.0 | 46.0 | $0 | $802,521 | $124,548 | Yes (X) | ||
| Ron Blaustein | ||||||||
| Sr. VP/Chief Financial Officer | 1.0 | 46.0 | $0 | $675,774 | $164,959 | Yes (X) | ||
| John J Grayhack MD | ||||||||
| Director & Physician | 40.0 | 0.0 | Yes (X) | $804,018 | $0 | $2,700 | ||
| Bruce Lindgren MD | ||||||||
| Director/Vice Chr/VP/Physician | 40.0 | 0.0 | Yes (X) | $700,567 | $0 | $2,700 | Yes (X) | |
| Anthony Chin MD | ||||||||
| Director/Treasurer/Physician | 40.0 | 0.0 | Yes (X) | $695,265 | $0 | $7,000 | ||
| Erik C King MD | ||||||||
| Director/President/Physician | 40.0 | 3.0 | Yes (X) | $700,796 | $0 | $0 | Yes (X) | |
| John Maddalozzo MD | ||||||||
| Director/Board Secr/Physician | 40.0 | 0.0 | Yes (X) | $534,446 | $0 | $8,396 | ||
| John N Hourihane Jr | ||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Andrea Pipitone Beirne | ||||||||
| Director | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Fatema Zanzi | ||||||||
| Sr. VP/CLO/Corp Sec BEGN 2/20 | 1.0 | 46.0 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $10,367,432 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,883,511 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $669,058 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 77 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| REVENUE INTEGRITY MANAGEMENT SERVIC | |||||
| 737 N MICHIGAN AVE SUITE 1650 | CHICAGO | IL | 60611 | BILLING SERVICES | $1,467,190 |
| NORTHWESTERN MEDICAL GROUP | |||||
| 676 N ST CLAIR | CHICAGO | IL | 60611 | Physician Services | $216,630 |
| WOMEN'S HEALTH CONSULTANTS SC | |||||
| 58 E Walton St | CHICAGO | IL | 60612 | Physician Services | $111,254 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $21,491,637 | RelatedOrganizationsAmt |
| Government Grants | $819,440 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Total Contributions | $22,311,077 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621111 | $42,603,638 | $42,603,638 |
| PHYSICIAN CONTRACT | 621111 | $7,032,603 | $7,032,603 |
| MED ADMIN AND EDUCATION | 621111 | $3,834,084 | $3,834,084 |
| OTHER PROGRAM SERVICE REVENUE | 621111 | $169,207 | $169,207 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $53,639,532 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $75,950,609 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,639,532 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,436,249 | TotalAmt |
| Program Services | $9,213,513 | ProgramServicesAmt |
| Management And General | $222,736 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,848,804 | TotalAmt |
| Program Services | $42,813,783 | ProgramServicesAmt |
| Management And General | $1,035,021 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,057,827 | TotalAmt |
| Program Services | $3,407,191 | ProgramServicesAmt |
| Management And General | $650,636 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,512,943 | TotalAmt |
| Program Services | $6,417,424 | ProgramServicesAmt |
| Management And General | $95,519 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,844,624 | TotalAmt |
| Program Services | $1,827,670 | ProgramServicesAmt |
| Management And General | $16,954 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,305 | TotalAmt |
| Program Services | $11,305 | ProgramServicesAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,002,425 | TotalAmt |
| Program Services | $2,908,933 | ProgramServicesAmt |
| Management And General | $93,492 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $305,249 | TotalAmt |
| Program Services | $305,098 | ProgramServicesAmt |
| Management And General | $151 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,484 | TotalAmt |
| Program Services | $47,045 | ProgramServicesAmt |
| Management And General | $1,439 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,607,854 | TotalAmt |
| Program Services | $3,471,945 | ProgramServicesAmt |
| Management And General | $135,909 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,567 | TotalAmt |
| Program Services | $158,407 | ProgramServicesAmt |
| Management And General | $160 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,195 | TotalAmt |
| Program Services | $8,195 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,493,707 | TotalAmt |
| Program Services | $5,487,786 | ProgramServicesAmt |
| Management And General | $5,921 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| BILLING COLLECTION FEES | $2,449,773 | $2,449,773 |
| PATIENT EXPENSES | $1,659,213 | $1,659,213 |
| BAD DEBT EXPENSE | $678,742 | $678,742 |
| MEDICAL SUPPLIES | $329,511 | $329,511 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $485,972 | TotalAmt |
| Program Services | $479,736 | ProgramServicesAmt |
| Management And General | $6,236 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,939,444 | TotalAmt |
| Program Services | $81,675,270 | ProgramServicesAmt |
| Management And General | $2,264,174 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,705,298 | BOYAmt |
| EOY | $9,161,193 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,589 | BOYAmt |
| EOY | $296,401 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,900,887 | BOYAmt |
| EOY | $9,457,594 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,933,066 | BOYAmt |
| EOY | $2,865,181 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,865,071 | BOYAmt |
| EOY | $6,454,967 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,798,137 | BOYAmt |
| EOY | $9,320,148 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,102,750 | BOYAmt |
| EOY | $137,446 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,102,750 | BOYAmt |
| EOY | $137,446 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,900,887 | BOYAmt |
| EOY | $9,457,594 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$7,988,835 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $3,023,531 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
| Public Support CY509 | 0.00000 | PublicSupportCY509Pct |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SUPPLEMENTAL INFORMATION | FormAndLineReferenceDesc |
| Explanation | DISCLOSURE FOR NOT FILING SCHEDULE H LCSF DOES NOT FILE A SCHEDULE H EVEN THOUGH THE ENTITY MARKS THE HOSPITAL BOX IN SCHEDULE A BECAUSE IT IS NOT REQUIRED TO BE LICENSED, REGISTERED OR SIMILARLY RECOGNIZED BY THE STATE AS A HOSPITAL. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp | |
| Equipment | EquipmentGrp | |
| Other Land Buildings | OtherLandBuildingsGrp | |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PENSION LIABILITY | Desc |
| Amt | $6,454,967 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $6,454,967 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | Yes (true) | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Patrick M Magoon | ||||||||||||||
| Ex-Off/LCH Pres/CEO untl 12/19 | $0 | $1,489,362 | $0 | $1,000,000 | $0 | $8,382 | $0 | $35,223 | $0 | $24,002 | $0 | $2,556,969 | $0 | $505,259 |
| Marleta Reynolds MD | ||||||||||||||
| Ex-Off Dir/Chf of Surgery,DH | $977,810 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $977,810 | $0 | $0 | $0 |
| Anthony Chin MD | ||||||||||||||
| Director/Treasurer/Physician | $695,265 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,000 | $0 | $702,265 | $0 | $0 | $0 |
| John J Grayhack MD | ||||||||||||||
| Director & Physician | $804,018 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,700 | $0 | $806,718 | $0 | $0 | $0 |
| Erik C King MD | ||||||||||||||
| Director/President/Physician | $700,796 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $700,796 | $0 | $0 | $0 |
| Bruce Lindgren MD | ||||||||||||||
| Director/Vice Chr/VP/Physician | $700,567 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,700 | $0 | $703,267 | $0 | $0 | $0 |
| John Maddalozzo MD | ||||||||||||||
| Director/Board Secr/Physician | $534,446 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $8,396 | $0 | $542,842 | $0 | $0 | $0 |
| Ron Blaustein | ||||||||||||||
| Sr. VP/Chief Financial Officer | $0 | $470,753 | $0 | $204,245 | $0 | $776 | $0 | $135,503 | $0 | $29,456 | $0 | $840,733 | $0 | $0 |
| Nancy M Borders | ||||||||||||||
| Gen Counsl/Corp Sec untl 12/19 | $0 | $378,113 | $0 | $215,312 | $0 | $209,096 | $0 | $98,964 | $0 | $25,584 | $0 | $927,069 | $0 | $0 |
| Thomas P Shanley MD | ||||||||||||||
| Ex-Officio Director & LCH CEO | $0 | $640,986 | $0 | $265,970 | $0 | $516 | $0 | $166,674 | $0 | $30,156 | $0 | $1,104,302 | $0 | $0 |
| Joseph M Forbess MD | ||||||||||||||
| Physician | $1,519,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,519,000 | $0 | $0 | $0 |
| Carl D Backer MD | ||||||||||||||
| Physician | $1,528,174 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,528,174 | $0 | $0 | $0 |
| Aimen F Shaaban MD | ||||||||||||||
| Physician | $853,400 | $0 | $78,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $931,400 | $0 | $0 | $0 |
| Tadanori Tomita MD | ||||||||||||||
| Physician | $959,755 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,700 | $0 | $962,455 | $0 | $0 | $0 |
| Fizan Abdullah MD | ||||||||||||||
| Physician | $916,201 | $0 | $0 | $0 | $100,000 | $0 | $0 | $0 | $100,000 | $0 | $1,116,201 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE J, PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | PURSUANT TO THE BYLAWS OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER ("MEDICAL CENTER") AND THE ORGANIZATION, THE GOVERNANCE COMMITTEE OF THE ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO ("LURIE CHILDREN'S") AND MEDICAL CENTER, SERVES AS THE COMPENSATION COMMITTEE OF LURIE CHILDREN'S AND THE ORGANIZATION. THE GOVERNANCE COMMITTEE IS CHARGED TO REVIEW AND APPROVE SENIOR EXECUTIVE COMPENSATION FOR THE MEDICAL CENTER AND ITS AFFILIATES AND THE COMPENSATION FOR ANY PHYSICIAN WHO MEETS THE CRITERIA FOR REVIEW AND APPROVAL BY THE COMMITTEE. THE GOVERNANCE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT. THE GOVERNANCE COMMITTEE HAS ALSO APPROVED THE COMPENSATION PLAN AND COMPENSATION PHILOSOPHY FOR THE ORGANIZATION. THESE COMPENSATION PLANS AND PHILOSOPHIES ARE SUBJECT TO PERIODIC REVIEW BY THE GOVERNANCE COMMITTEE FOR CONTINUED APPROPRIATENESS IN THE CURRENT MARKET. WITH THE ASSISTANCE OF INDEPENDENT COMPENSATION CONSULTANTS AND INFORMATION FROM A VARIETY OF SOURCES (SPECIFIED ON SCHEDULE J), THE GOVERNANCE COMMITTEE CONFIRMED THE TOTAL AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS. OUTSIDE LEGAL COUNSEL PERIODICALLY ADVISES THE GOVERNANCE COMMITTEE WITH RESPECT TO FEDERAL TAX REQUIREMENTS IN SETTING COMPENSATION AND THE ESTABLISHMENT OF THE "REBUTTABLE PRESUMPTION OF REASONABLENESS" UNDER THE FEDERAL TAX LAW INTERMEDIATE SANCTIONS RULES. THE PROCESS FOLLOWED BY THE GOVERNANCE COMMITTEE, INCLUDING A DESCRIPTION OF THE DATA RELIED UPON AND THE GOVERNANCE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND CONTEMPORANEOUSLY DOCUMENTED. THE GOVERNANCE COMMITTEE HAS EXPRESSLY REVIEWED THE REASONABLENESS OF ALL SUCH PAYMENTS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED. THE GOVERNANCE COMMITTEE WAS COMPRISED OF MEMBERS OF THE MEDICAL CENTER AND LURIE CHILDREN'S BOARDS OF DIRECTORS WHO WERE DETERMINED TO BE DISINTERESTED (WHICH MEANS NO COMMITTEE MEMBER HAS A CONFLICT OF INTEREST) FOR THESE PURPOSES. THE GOVERNANCE COMMITTEE CONDUCTS AN ONGOING, REGULAR REVIEW OF THE DISINTERESTED STATUS OF ITS MEMBERS, AND WILL TAKE APPROPRIATE ACTION WITH RESPECT TO ANYONE HAVING AN INTEREST WITH RESPECT TO ONE OR MORE EXECUTIVES SO AS TO PRESERVE THE DISINTERESTED STATUS OF THE COMMITTEE AND, AS A RESULT, THE APPLICATION OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS. FORM 990, SCHEDULE J, PART I, QUESTION 4B ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO ("LURIE CHILDREN'S") MAINTAINS A DEFINED BENEFIT SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("DB SERP"), WHICH WAS EFFECTIVE ON JANUARY 1, 2001, AND IS CLOSED TO NEW PARTICIPANTS. THE DB SERP IS A DEFERRED COMPENSATION PLAN THAT ASSISTS IN PROVIDING COMPETITIVE TOTAL RETIREMENT BENEFITS TO A VERY LIMITED GROUP OF EXECUTIVE-LEVEL EMPLOYEES OF "LURIE CHILDREN'S" (INCLUDING ONE OR MORE PERSONS LISTED IN THIS FORM 990). THESE BENEFITS ARE PROVIDED IN EXCHANGE FOR ALL OF THE EMPLOYEE'S YEARS OF SERVICE TO THE ORGANIZATION, AND THE COST OF THE BENEFITS WILL VARY FROM YEAR TO YEAR BASED ON INTEREST RATES, AGE, AND OTHER FACTORS. THE AMOUNTS ARE AT RISK AND WILL NOT BE PAID UNLESS AND UNTIL THE EMPLOYEE HAS PROVIDED SUBSTANTIAL FUTURE SERVICES TO THE ORGANIZATION. BENEFITS UNDER THE DC SERP VEST AT AGE 62, AND ARE FORFEITED IF THE EMPLOYEE LEAVES THE ORGANIZATION VOLUNTARILY BEFORE AGE 62 (EXCEPT UNDER THE SOLE DISCRETION OF THE LURIE CHILDREN'S BOARD, AND ONLY IF THE PARTICIPANT HAS REACHED AT LEAST AGE 55 WITH AT LEAST 10 YEARS OF SERVICE). PARTICIPANTS WHO VOLUNTARILY LEAVE THE ORGANIZATION BEFORE AGE 55 FORFEIT THEIR ENTIRE SERP BENEFIT UPON TERMINATION. LURIE CHILDREN'S MAINTAINS A DEFINED CONTRIBUTION SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ("DC SERP"), WHICH WAS ESTABLISHED ON JANUARY 1, 2017 AND IS A NONQUALIFIED DEFERRED COMPENSATION PLAN FOR CERTAIN EMPLOYEES IN EXECUTIVE POSITIONS, WHO ARE NOT PARTICIPANTS IN THE DB SERP. THE BENEFITS IN THE DC SERP ARE IN THE FORM OF A FIXED ANNUAL CONTRIBUTION RATE AND AN EARNINGS CREDIT. EACH YEAR'S CONTRIBUTION AND EARNINGS ARE AT RISK AND WILL BECOME FULLY VESTED AND TAXABLE ONLY AFTER FIVE YEARS OF FUTURE EMPLOYMENT SERVICE, OR UPON REACHING AGE 62 WITH AT LEAST THREE YEARS OF SERVICE. SEVERAL LISTED PERSONS IN THIS FORM 990 PARTICIPATE IN THE DC SERP, AND THE UNVESTED CONTRIBUTIONS MADE FOR THEM ARE INCLUDED IN SCHEDULE J, PART II, COLUMN (C). THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE SERP AND RECEIVED A VESTED PAYMENT DURING 2019 WHICH IS REPORTED IN COLUMN B (III): NANCY M. BORDERS $206,411 THE PAYMENT WAS ACCRUED AND RECEIVED IN 2019. SCHEDULE J, PART I, QUESTION 5B ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO ("LURIE CHILDREN'S"), A RELATED ORGANIZATION TO THE ORGANIZATION, ALSO PROVIDES ANNUAL INCENTIVE COMPENSATION TO SENIOR MANAGEMENT UNDER A SENIOR MANAGEMENT INCENTIVE COMPENSATION PLAN. THESE AMOUNTS ARE INCLUDED IN SCHEDULE J, PART II, COLUMN B (II). THE PLAN IS DESIGNED TO OFFER OPPORTUNITIES FOR ADDITIONAL COMPENSATION TIED TO PERFORMANCE AGAINST PRE-DETERMINED FINANCIAL, PATIENT SATISFACTION, PATIENT SAFETY AND INDIVIDUAL GOALS APPROVED IN ADVANCE BY THE GOVERNANCE COMMITTEE. THE GOVERNANCE COMMITTEE HAS EXPRESSLY REVIEWED THE REASONABLENESS OF ALL SUCH PAYMENTS AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED. FORM 990, SCHEDULE J, PART II THE FOLLOWING INDIVIDUALS ARE NOT COMPENSATED BY THE REPORTING ORGANIZATION FOR HIS OR HER SERVICE AS A DIRECTOR OR OFFICER. RATHER, THE COMPENSATION REPORTED ON FORM 990, PART VII AND ON SCHEDULE J, PART II REFLECTS COMPENSATION PAID BY PEDIATRIC FACULTY FOUNDATION FOR THE INDIVIDUAL'S SUBSTANTIAL AND FULL-TIME SERVICES AS AN EMPLOYEE. FOR MORE DETAILS, PLEASE REFER TO THE 2019 FORM 990 OF PEDIATRIC FACULTY FOUNDATION, FEIN 36-3279680. THOMAS P. SHANLEY, MD THE FOLLOWING INDIVIDUALS ARE NOT COMPENSATED BY THE REPORTING ORGANIZATION FOR HIS OR HER SERVICE AS A DIRECTOR OR OFFICER. RATHER, THE COMPENSATION REPORTED ON FORM 990, PART VII AND ON SCHEDULE J, PART II REFLECTS COMPENSATION PAID BY ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO (LURIE CHILDREN'S) FOR THE INDIVIDUAL'S SUBSTANTIAL AND FULL-TIME SERVICES AS AN EMPLOYEE. FOR MORE DETAILS, PLEASE REFER TO THE 2019 FORM 990 OF LURIE CHILDREN'S, FEIN 36-2170833. NANCY M. BORDERS PATRICK M. MAGOON RON BLAUSTEIN | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, QUESTION 6 | DESCRIPTION OF CLASSES OF MEMBERS OR STOCKHOLDERS CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER ("MEDICAL CENTER") IS THE ORGANIZATION'S SOLE CORPORATE MEMBER. |
| FORM 990, PART VI, QUESTION 7A | DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS THE ORGANIZATION'S SOLE CORPORATE MEMBER, THE MEDICAL CENTER, HAS CERTAIN RESERVED POWERS, INCLUDING THE POWER TO APPOINT AND REMOVE ALL DIRECTORS OF THE ORGANIZATION. |
| FORM 990, PART VI, QUESTION 7B | DESCR CLASSES OF PERSONS, DECISIONS REQUIRING APPR & TYPE OF VOTING RIGHTS THE MEDICAL CENTER, THROUGH ITS BOARD OF DIRECTORS OR DESIGNATED COMMITTEE, AS THE SOLE CORPORATE MEMBER OF THE ORGANIZATION, HAS CERTAIN RESERVED POWERS WITH RESPECT TO APPOINTMENT AND REMOVAL OF DIRECTORS, APPOINTMENT OF CERTAIN OFFICERS, APPROVAL OF AMENDMENTS TO GOVERNING DOCUMENTS, APPROVAL OF FINANCIAL MATTERS, AND APPROVAL OF SIGNIFICANT TRANSACTIONS INCLUDING, BUT NOT LIMITED TO, MERGER, DISSOLUTION, DISPOSITION OF ASSETS OTHER THAN IN THE ORDINARY COURSE OF BUSINESS, AND CREATION OF SUBSIDIARIES. |
| FORM 990, PART VI, QUESTION 11B | DESCRIPTION OF THE PROCESS USED BY MANAGEMENT OR THE GOVERNING BODY TO REVIEW THE FORM 990 THE ORGANIZATION'S FORM 990 WAS PROVIDED TO EACH MEMBER OF THE MEDICAL CENTER'S AND LURIE CHILDREN'S AUDIT COMMITTEE (OF THE BOARD) AS WELL AS THE FILING ORGANIZATIONS BOARD. THE AUDIT COMMITTEE IS THE COMMITTEE OF THE MEDICAL CENTER CHARGED WITH THE OVERSIGHT OF AUDIT AND TAX MATTERS FOR THE PARENT AND AFFILIATES. DURING A SPECIAL AUDIT COMMITTEE MEETING, AND BEFORE THE FORM 990 WAS FILED, THE AUDIT COMMITTEE WAS PROVIDED A REVIEW OF THE FORM 990 BY THE CHIEF FINANCIAL OFFICER ("CFO"). THE CFO AND OUTSIDE TAX ADVISOR ALSO RESPONDED TO THE AUDIT COMMITTEE MEMBERS' QUESTIONS AND AFFORDED THE OPPORTUNITY FOR DETAILED DISCUSSION OF THE FORM 990, PRIOR TO THE AUDIT COMMITTEE TAKING ACTION TO APPROVE THE FILING OF THE FORM 990. AS PART OF ITS ANNUAL RETURN PREPARATION PROCESS, THE ORGANIZATION, ON AN ONGOING BASIS, CONSULTED ITS TAX CONSULTING FIRM AND OUTSIDE TAX LEGAL COUNSEL, BOTH OF WHICH POSSESS EXPERTISE IN HEALTH CARE AND TAX-EXEMPT RETURN PREPARATION, TO ADVISE AND ASSIST IN THE PREPARATION OF THE FORM 990. THESE ADVISORS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER MEMBERS OF THE ORGANIZATION'S TEAM ASSEMBLED TO PARTICIPATE IN THE PREPARATION OF THE FORM 990. PRIOR TO PRESENTING THE FORM 990 TO THE BOARD'S AUDIT COMMITTEE, THE ORGANIZATION'S TEAM, INCLUDING ITS ADVISORS, MET FREQUENTLY TO DISCUSS AND REVIEW DRAFTS OF THE FORM. SUBSEQUENT TO THE AUDIT COMMITTEE REVIEW AND APPROVAL, FORM 990 WAS PROVIDED TO THE FILING ORGANIZATIONS BOARD OF DIRECTORS. |
| FORM 990, PART VI, QUESTION 12C | DESCRIPTION OF THE PROCESS USED TO MONITOR TRANSACTIONS FOR CONFLICTS OF INTEREST ON AN ANNUAL BASIS THE MEDICAL CENTER AND ITS AFFILIATES SUBMIT A COMPREHENSIVE QUESTIONNAIRE TO BOARD MEMBERS, SENIOR MANAGEMENT AND PURCHASING PERSONNEL REQUIRING DISCLOSURE OF ALL INTERESTS THAT COULD GIVE RISE TO ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE MEDICAL CENTER INITIATES FOLLOW UP CONTACT WITH THOSE WHO DO NOT RESPOND AND TO CLARIFY RESPONSES, WHERE NECESSARY. THE MEDICAL CENTER REVIEWS EACH DISCLOSURE AND PROVIDES A SUMMARY OF RELEVANT DISCLOSURES FOR THE REVIEW AND APPROVAL OF ITS GOVERNANCE COMMITTEE. PURSUANT TO THE CONFLICTS OF INTEREST POLICY OF THE MEDICAL CENTER AND AFFILIATES ("CORPORATION"), DIRECTORS, OFFICERS, PHYSICIAN LEADERS, AND OTHERS WHO ARE SUBJECT TO THE POLICY ARE REQUIRED TO PROMPTLY AND FULLY DISCLOSE IN WRITING ANY ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST TO THE PRESIDENT OF THE CORPORATION AND GENERAL COUNSEL. DISCLOSURES ARE PROVIDED TO THE GOVERNANCE COMMITTEE OF THE CORPORATION WHICH CONSIDERS ALL CONFLICTS OF INTEREST ISSUES AND, IF APPROPRIATE, PROVIDES SUCH WRITTEN DISCLOSURE TO THE DIRECTORS AND/OR BOARD COMMITTEES CONSIDERING THE PROPOSED TRANSACTION OR OTHER APPROPRIATE PARTIES. IN ADDITION, ON AN ANNUAL BASIS, THE CORPORATION SURVEYS EACH INDIVIDUAL SUBJECT TO THE POLICY AS TO THE EXISTENCE OF ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THE CORPORATION WILL NOT ENTER INTO AN AGREEMENT, TRANSACTION OR OTHER ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS THE DISINTERESTED MEMBERS OF THE GOVERNANCE COMMITTEE OF THE CORPORATION'S BOARD OF DIRECTORS DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF THE CORPORATION HAVE BEEN IMPLEMENTED. THE SUBJECT INTERESTED PERSON MAY NOT BE PRESENT WHEN THE VOTE IS TAKEN. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, A DISINTERESTED PERSON OR COMMITTEE OF DISINTERESTED MEMBERS MAY BE ASSIGNED TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CORPORATION CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT, WITH REASONABLE EFFORTS, FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY ATTAINABLE UNDER CIRCUMSTANCES THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST, THE BOARD OR COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION IS IN THE CORPORATION'S BEST INTEREST AND FOR ITS OWN BENEFIT AND WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO THE CORPORATION, AND SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. |
| FORM 990, PART VI, QUESTIONS 15A & 15B | DESCRIPTION OF THE PROCESS BY WHICH THE COMPENSATION OF CERTAIN EXECUTIVES WAS DETERMINED THE AUTHORITY TO REVIEW AND APPROVE EXECUTIVE COMPENSATION HAS BEEN DELEGATED TO THE GOVERNANCE COMMITTEE OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER AND ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO BOARDS OF DIRECTORS ("GOVERNANCE COMMITTEE"). THE GOVERNANCE COMMITTEE HAS ADOPTED A WRITTEN EXECUTIVE COMPENSATION PHILOSOPHY WHICH IT FOLLOWS WHEN IT REVIEWS AND APPROVES THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S SENIOR MANAGEMENT, INCLUDING THE PRESIDENT. THE COMPENSATION PHILOSOPHY IS SUBJECT TO PERIODIC REVIEW FOR CONTINUED APPROPRIATENESS BY THE GOVERNANCE COMMITTEE. WITH THE ASSISTANCE OF A COMPENSATION CONSULTANT AND INFORMATION FROM A VARIETY OF EXTERNAL SOURCES (SPECIFIED ON SCHEDULE J), THE GOVERNANCE COMMITTEE CONFIRMED THE TOTAL AMOUNTS TO BE PAID WERE REASONABLE AND COMPARABLE TO AMOUNTS PAID BY SIMILARLY SITUATED ORGANIZATIONS FOR FUNCTIONALLY SIMILAR POSITIONS. OUTSIDE LEGAL COUNSEL ADVISES THE GOVERNANCE COMMITTEE WITH RESPECT TO FEDERAL TAX REQUIREMENTS IN SETTING COMPENSATION AND THE ESTABLISHMENT OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS. THE PROCESS FOLLOWED BY THE GOVERNANCE COMMITTEE, INCLUDING A DESCRIPTION OF THE DATA RELIED UPON AND THE GOVERNANCE COMMITTEE'S DECISIONS, WAS THOROUGHLY AND CONTEMPORANEOUSLY DOCUMENTED. THE GOVERNANCE COMMITTEE HAS EXPRESSLY REVIEWED THE REASONABLENESS OF ALL SUCH PAYMENTS, AND HAS CONCLUDED, AS THE RESULT OF A PROCESS THAT IS DESIGNED TO QUALIFY FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW, THAT ALL SUCH AMOUNTS ARE REASONABLE AND DO NOT EXCEED FAIR MARKET VALUE FOR THE SERVICES PROVIDED.THE GOVERNANCE COMMITTEE WAS COMPRISED OF MEMBERS OF CHILDREN'S HOSPITAL OF CHICAGO MEDICAL CENTER AND ANN & ROBERT H. LURIE CHILDREN'S HOSPITAL OF CHICAGO BOARDS OF DIRECTORS WHO WERE DETERMINED DISINTERESTED FOR THESE PURPOSES. THE GOVERNANCE COMMITTEE CONDUCTS AN ONGOING AND PERIODIC REVIEW OF THE DISINTERESTED STATUS OF ITS MEMBERS, AND WILL TAKE APPROPRIATE ACTION WITH RESPECT TO ANYONE HAVING AN INTEREST WITH RESPECT TO ONE OR MORE EXECUTIVES SO AS TO PRESERVE THE APPLICATION OF THE REBUTTABLE PRESUMPTION OF REASONABLENESS. |
| FORM 990, PART VI, QUESTION 19 | AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY, & FIN STMTS TO GEN PUBLIC THE ORGANIZATION'S FINANCIAL STATEMENTS ARE PUBLICLY AVAILABLE ONLINE AT WWW.DACBOND.COM. THE ORGANIZATION'S ARTICLES OF INCORPORATION AND ANNUAL REPORTS ARE AVAILABLE THROUGH THE ILLINOIS SECRETARY OF STATE. THE ORGANIZATION ALSO MAKES ITS GENERAL GOVERNING DOCUMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS OR FUND BALANCES PENSION ADJUSTMENT $3,023,531 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| ALMOST HOME KIDS | ||||||||||
| 7 S 721 ROUTE 53 | NAPERVILLE | IL | 60540 | 363822010 | TRANSITION CR | IL | 501(C)(3) | 10 | Medical Ctr | false |
| STANLEY MANNE CHILDREN'S RESC INSTITUTE | ||||||||||
| 225 E CHICAGO AVE | Chicago | IL | 60611 | 363357005 | RESEARCH | IL | 501(C)(3) | 4 | Medical Ctr | false |
| LURIE CHILDREN'S HOSPITAL OF CHICAGO FDN | ||||||||||
| 225 E CHICAGO AVE | Chicago | IL | 60611 | 363357006 | FUNDRAISING | IL | 501(C)(3) | 7 | Medical Ctr | false |
| CHILDREN'S HOSPITAL OF CHICAGO MED CTR | ||||||||||
| 225 E CHICAGO AVE | Chicago | IL | 60611 | 363357004 | HEALTH CARE | IL | 501(C)(3) | 10 | NA | false |
| PEDIATRIC FACULTY FOUNDATION INC | ||||||||||
| 225 E CHICAGO AVE | Chicago | IL | 60611 | 363279680 | HLTH CRE/RSCH | IL | 501(C)(3) | 10 | Medical Ctr | false |
| LURIE CHILDRENS LIABILITY PROTECTION PRG | ||||||||||
| 225 E CHICAGO AVE | Chicago | IL | 60611 | 366638400 | INSURANCE | IL | 501(C)(3) | 12 III-FI | MEDICAL CTR | false |
| LURIE CHILDREN'S | ||||||||||
| 225 E CHICAGO AVE | CHICAGO | IL | 60611 | 362170833 | HOSPITAL | IL | 501(C)(3) | 3 | MEDICAL CTR | false |
| CHILDREN'S HOSPITAL OF CHICAGO FPP | ||||||||||
| 737 NORTH MICHIGAN AVE 2040 | CHICAGO | IL | 60611 | 363393780 | SUPPORTNG ORG | IL | 501(C)(3) | 12 TYPE I | MEDICAL CTR | false |
| LURIE CHILDREN'S PEDIATRIC ANESTHESIA AS | ||||||||||
| 225 E CHICAGO AVE | Chicago | IL | 60611 | 371838535 | HEALTH CARE | IL | 501(C)(3) | 3 | MEDICAL CTR | false |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LURIE CHILDRENS CIN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 606112991 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 901025439 | EIN |
| Primary Activities | CONTRACTING SVCS | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CMMC INSURANCE CO LTD | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 225 E CHICAGO AVE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60611 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 981049532 | EIN |
| Primary Activities | SELF INSURANCE | PrimaryActivitiesTxt |
| Legal Domicile Foreign Country | CJ | LegalDomicileForeignCountryCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | CORPORATION | EntityTypeTxt |
| Share Of EOY Assets | $0 | ShareOfEOYAssetsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
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