2021-05-17T15:49:42-05:00 2020-06-30 132781641 MITCHELL & TITUS LLP 80 PINE STREET NEW YORK NY 10005 990 2019-07-01 362200248 LORETTO HOSPITAL LORE 7738545267 645 S CENTRAL AVENUE CHICAGO IL 60644 DORAN HAMMETT VICE PRESIDENT OF FINANCE 7738545267 2021-05-17 1 FREDERICK E DAVIS JR P00446023 2127094500 2019 2022-09-23 18:48:47Z DORAN HAMMETT 645 S CENTRAL AVENUE CHICAGO IL 60644 70570000 0 X WWW.LORETTOHOSPITAL.ORG X 1939 IL LORETTO HOSPITAL IS A COMMUNITY BASED ORGANIZATION FOCUSED TO PROVIDE QUALITY PATIENT CENTERED CARE AND PROMOTE WELLNESS AND EDUCATION 7 5 714 6 0 0 179394 5731067 64933638 54503063 6970 20771 3602358 10315099 68722360 70570000 0 0 0 0 41997141 40301668 0 0 0 39005888 35644819 81003029 75946487 -12280669 -5376487 34384134 40069690 18428051 28497254 15956083 11572436 LORETTO HOSPITAL IS A NOT-FOR-PROFIT COMMUNITY BASED ORGANIZATION, WHICH PARTNERS WITH ITS PHYSICIANS, EMPLOYEES, AND COMMUNITY IT SERVES TO PROVIDE QUALITY PATIENT CENTERED CARE AND PROMOTES WELLNESS AND EDUCATION. 0 0 59918558 48229067 LORETTO IS A 187 BED NOT-FOR-PROFIT FACILITY STAFFED AND COMMUNITY FOCUSED HEALTHCARE PROVIDER WITH AN INTERDISCIPLINARY TEAM OF SOME OF THE FINEST DOCTORS, SPECIALIST AND NURSING IN CHICAGO WHICH SERVES OVER 33,000 PATIENTS EACH YEAR IN THE CHICAGO'S AUSTIN AND SURROUNDING COMMUNITIES. WITH OUR MEDICAL AND ANCILLARY SERVICES UNDER ONE ROOF, WE MAKE QUALITY HEALTH CARE MORE CONVENIENT AND ACCESSIBLE. OUR MEDICAL SERVICES ARE: AMBULATORY CARE CLINIC, EMERGENCY MEDICINE, MEDICAL/SURGERY & CRITICAL CARE, DIAGNOSTIC IMAGING, PHYSICAL THERAPY AND REHABILITION AND OTHER CLINICAL PROGRAMS. 4331771 4916423 2305068 1190958 66555397 1 1 0 1 0 0 0 0 0 0 1 0 1 0 1 1 0 0 0 1 1 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 85 0 1 714 1 0 1 CJ 0 0 0 0 0 0 0 0 0 0 X 7 5 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 0 0 IL X GEORGE MILLER 7738544605 645 S CENTRAL AVENUE CHICAGO IL 60644 EDWARD HOGAN CHAIR 1.00 0.00 X X 0 0 0 MICHELLE COLLINS SECRETARY/TREASURER 1.00 0.00 X X 0 0 0 KIMBERLY LIGHTFORD VICE CHAIR 1.00 0.00 X X 0 0 0 GEORGE MILLER BOARD MEMBER/PRESIDENT/CEO 40.00 0.00 X X 407329 0 21705 JAMES MONTGOMERY BOARD MEMBER 1.00 0.00 X X 0 0 0 MARK TOMERA MD BOARD MEMBER 1.00 0.00 X X 0 0 0 ANOSH AHMED MD CHIEF OPERATING OFFICER/CHIEF FINANCIAL OFFICER 40.00 0.00 X 463161 0 10583 TESA ANEWISHKI VP FOUNDATION 40.00 0.00 X 112908 0 0 KENNETH MCGEE CFO 40.00 0.00 X 225805 0 4579 ERIN BORDERS VP BUSINESS DEVELOPMENT 40.00 0.00 X 114806 0 0 TANESHA DANIELS VP ANCILLARY SERVICES 40.00 0.00 X 152209 0 627 DEATRA HOWARD CHIEF NURSING OFFICER 40.00 0.00 X 210275 0 19659 NIKHILA JUVVADI MD VP OPERATIONS 40.00 0.00 X 331273 0 5670 MELINDA MALECKI JD GENERAL COUNSEL/RISK MANAGEMENT 40.00 0.00 X 134821 0 7626 DAHIR SHEIKHALI VP INFORMATION TECHNOLOGY 40.00 0.00 X 159739 0 16505 JOSEPH DIPIAZZA PHYSICIAN 40.00 0.00 X 348211 0 4722 LOIS CLARKE PHYSICIAN 40.00 0.00 X 312712 0 18455 CARRIE WILSON PHYSICIAN 40.00 0.00 X 311011 0 4579 PARDEEP BHANOT PHYSICIAN 40.00 0.00 X 224260 0 16505 SHITAL SHAH PHYSICIAN 40.00 0.00 X 231837 0 0 3740357 0 131215 53 0 1 0 ONE HEALTH BILLING CO 401 N WABASH AVE UNIT 31A CHICAGO IL 60611 BILLING SERVICES 2118889 METROPOLITAN BEHAVIORAL ASSOCIATES INC 155 N MICHIGAN AVENUE STE 634 CHICAGO IL 60601 COUNSELING SERVICES 980000 SKS HEALTHCARE MANAGEMENT GROUP 155 N MICHIGAN AVENUE STE 634 CHICAGO IL 60601 LABRATORY SERVICES 887188 CIMPAR SC 101 MADISON ST OAK PARK IL 60302 HOSPITALIST 453333 JAY ANESTHESIA AND PAIN MANAGEMENT LLC 687 S BRYAN ST ELMHURST IL 60126 ANESTHESIA SERVICES 440000 21 5731067 5731067 PATIENT REVENUE 622000 54503063 54503063 54503063 20771 20771 8080 0 8080 8080 8080 MISCELLANEOUS PHYSICIAN 900099 7117464 7117464 MISCELLANEOUS EXPENSE 900099 2591287 2591287 MEDICARE SETTLEMENT 900099 431407 431407 166861 65087 101774 10307019 70570000 64716388 0 122545 2312326 1849165 463161 32957338 29822417 3134921 447578 447578 2267384 1999946 267438 2317042 1811389 505653 120000 120000 146539 146539 71151 71151 7206955 6611892 595063 55546 27773 27773 1306534 1088415 218119 1742872 1394298 348574 1180127 1062114 118013 31199 31199 283198 283198 2788303 2788303 2547218 509444 2037774 PURCHASED SERVICES 6182831 4845920 1336911 PROVIDER ASSESSMENT 3764568 3764568 PHYSICIAN FEES 3337715 3337715 PHARMACEUTICALS 1348334 1348334 3531729 3531729 75946487 66555397 9391090 0 481082 1392749 300477 1218990 7394920 11890729 350334 1243072 131150 105617 54630176 35259602 21371316 19370574 256041 256305 4098814 4591654 34384134 40069690 17404561 27488964 1023490 1008290 18428051 28497254 X 15819869 11436222 136214 136214 15956083 11572436 34384134 40069690 X -5376487 992840 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 71151 71151 0 PART II-B, LINE 1: THE HOSPITAL HIRES AN OUTSIDE CONSULTING GROUP TO LOBBY ON THEIR BEHALF FOR A VARIETY OF PROGRAMS FOCUSED ON ADVOCACY AND REPRESENTATION 429028 429028 42431613 25481011 16950602 52143 40418 11725 11717392 9738173 1979219 19370574 WESTSIDE INSURANCE 4101059 C INTEREST IN AFFILIATED NOT-FOR-PROFIT ENTITY 490595 C 4591654 ASSET RETIREMENT OBLIGATION 1008290 1008290 X PART X, LINE 2: THE HOSPITAL AND THE FOUNDATION ARE NOT-FOR-PROFIT CORPORATIONS AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND ARE EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE. WESTSIDE DOES NOT CONSIDER ITSELF TO BE ENGAGED IN A UNITED STATES TRADE OR BUSINESS AND THEREFORE, IS NOT CONSIDERED SUBJECT TO UNITED STATES INCOME TAXES. IF WESTSIDE SHOULD BE CONSIDERED TO BE ENGAGED IN A UNITED STATES TRADE OR BUSINESS, IT COULD BE SUBJECT TO FEDERAL INCOME TAX, FEDERAL ALTERNATIVE MINIMUM TAX, AND BRANCH PROFITS TAX. UNDER THE CAYMAN ISLANDS TAX CONCESSIONS LAW, THE GOVERNOR IN CABINET ISSUED AN UNDERTAKING TO WESTSIDE ON NOVEMBER 11, 2014 EXEMPTING IT FROM ALL LOCAL INCOME, PROFIT, OR CAPITAL GAINS TAXES. THE UNDERTAKING HAS BEEN ISSUED FOR A PERIOD OF 20 YEARS AND, AT THE PRESENT TIME, NO SUCH TAXES ARE LEVIED IN THE CAYMAN ISLANDS. ACCORDINGLY, NO PROVISIONS FOR TAXES ARE MADE IN THESE FINANCIALS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY LORETTO HOSPITAL. A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. LORETTO HOSPITAL DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. DUE TO ITS TAX-EXEMPT STATUS, LORETTO HOSPITAL IS NOT GENERALLY SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. LORETTO HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS. INTEREST AND/ OR PENALTIES RELATED TO INCOME TAX MATTERS ARE RECOGNIZED IN INCOME TAX EXPENSE. NO AMOUNTS WERE ACCRUED FOR INTEREST AND PENALTIES AT JUNE 30, 2020 OR 2019. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR THE YEARS PRIOR TO JUNE 30, 2017 CENTRAL AMERICA AND THE CARIBBEAN 0 0 INVESTMENTS, BOOK VALUE 3814345 0 0 0 0 0 0 3814345 0 3814345 1 0 1 0 0 0 PART I, LINE 3: CENTRAL AMERICA AND THE CARIBBEAN: OTHER PART III ACCOUNTING METHOD: 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 0 7076882 7076882 0.09320 19163904 8989683 10174221 0.13630 26240786 8989683 17251103 0.22950 169148 65087 104061 0.00140 169148 65087 104061 0.00140 26409934 9054770 17355164 0.23090 1 1326625 179989 11102194 13041925 -1939731 X 1 1 1 1 LORETTO HOSPITAL 645 S CENTRAL AVE CHICAGO IL 60644 WWW.LORETTOHOSPITAL.ORG HF109508 ID#0001289 X X X LORETTO HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 1 0 1 X HTTPS://WWW.LORETTOHOSPIT AL.ORG/DOCUMENTS/2015-CHNA-REPORT-LORETTO-HOSPITA 0 0 1 X 100.000000000000 600.000000000000 X X X X X 1 1 X X X 1 X WWW.LORETTOHOSPITAL.ORG X WWW.LORETTOHOSPITAL.ORG X WWW.LORETTOHOSPITAL.ORG X X X X X X 1 X 0 X X X 1 X 0 0 LORETTO HOSPITAL PART V, SECTION B, LINE 5: FACILITY NAME:LORETTO HOSPITALDESCRIPTION:QUALITATIVE INPUT WAS OBTAINED THROUGH TELEPHONE SURVEYS AND KEY INFORMANT INTERVIEWS. THE SAMPLE DESIGN FOR THE TELEPHONE SURVEY WAS CONFIGURED TO OBTAIN A REPRESENTATIVE SAMPLE OF PARTICIPANTS TO MATCH THE GEOGRAPHIC DISTRIBUTION AND DEMOGRAPHIC CHARACTERISTICS OF THE POPULATION RESIDING IN THE PRIMARY AND SECONDARY SERVICE AREA OF THE HOSPITAL.TO SOLICIT INPUT FROM KEY STAKEHOLDERS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY, AN ONLINE KEY INFORMANT SURVEY WAS ALSO IMPLEMENTED AS PART OF THIS PROCESS. A LIST OF RECOMMENDED PARTICIPANTS WAS PROVIDED BY METROPOLITAN CHICAGO HEALTHCARE COUNCIL; THIS LIST INCLUDED NAMES AND CONTACT INFORMATION FOR PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. POTENTIAL PARTICIPANTS WERE CHOSEN BECAUSE OF THEIR ABILITY.TO IDENTIFY PRIMARY CONCERNS OF THE POPULATIONS WITH WHOM THEY WORK, AS WELL AS OF THE COMMUNITY OVERALL. 37 INDIVIDUALS PARTICIPATED IN KEY INFORMANT SURVEY INCLUDING COMMUNITY AND BUSINESS LEADERS, PHYSICIANS, PUBLIC HEALTH EXPERTS, SOCIAL SERVICE REPRESENTATIVES AND OTHER HEALTH PROVIDERS. LORETTO HOSPITAL PART V, SECTION B, LINE 6A: FACILITY NAME:LORETTO HOSPITALDESCRIPTION:THE 2015 CHNA WAS FACILITATED BY THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL (MCHC) ON BEHALF OF PARTICIPATING MEMBER HOSPITALS AND HEALTH SYSTEMS. THESE HOSPITALS AND HEALTH SYSTEMS INCLUDE: ALEXIAN BROTHERS HEALTH SYSTEM/AMITA HEALTH (ALEXIAN BROTHERS BEHAVIORAL HEALTH HOSPITAL, ALEXIAN BROTHERS MEDICAL CENTERS, ST. ALEXIUS MEDICAL CENTER); AMITA HEALTH (ADVENTIST BOLINGBROOK HOSPITAL, ADVENTIST GLENOAKS HOSPITAL, ADVENTIST HINSDALE HOSPITAL, ADVENTIST LAGRANGE MEMORIAL HOSPITAL); EDWARD-ELMHURST HEALTHCARE (EDWARD HOSPITAL & HEALTH SERVICES, ELMHURST MEMORIAL HOSPITAL); FRANCISCAN ALLIANCE (FRANCISCAN ST. JAMES HEALTH); INGALLS HEALTH SYSTEM (INGALLS MEMORIAL HOSPITAL); LITTLE COMPANY OF MARY HOSPITAL AND HEALTH CARE CENTERS; LORETTO HOSPITAL; NORTHWEST COMMUNITY HEALTH CARE (NORTHWEST COMMUNITY HOSPITAL, NORTHWESTERN MEMORIAL HOSPITAL); NORTHWESTERN MEDICINE (CENTRAL DUPAGE HOSPITAL, NORTHWESTERN LAKE FOREST HOSPITAL); PALOS COMMUNITY HOSPITAL; RUSH SYSTEM FOR HEALTH BRUSH OAK PARK HOSPITAL, RUSH UNIVERSITY MEDICAL CENTER); SAINT ANTHONY HOSPITAL; ST. BERNARD HOSPITAL AND HEALTH CARE CENTER; SWEDISH COVENANT HOSPITAL; THOREK MEMORIAL HOSPITAL; AND THE UNIVERSITY OF CHICAGO MEDICINE. PART I, LINE 6A: THE LORETTO FOUNDATION PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED VARY ACCORDING TO THE INFORMATION REQUESTED AND THE MOST ACCURATE MEANS OF GATHERING THE REQUIRED INFORMATION. THE IRS PROVIDED AN INSTRUCTIONAL WORKSHEET THAT WAS USED TO CALCULATE A COST TO CHARGE RATIO USING THE INFORMATION FROM THE ORGANIZATION'S GENERAL LEDGER AND COST REPORT. THE RATIO WAS USED IN CONJUNCTION WITH THE IRS WORKSHEET TO CALCULATE THE COST OF CHARITY CARE PROVIDED AND TO CALCULATE UNREIMBURSED MEDICAID AMOUNTS. PART III, LINE 2: DATA ABOUT THE MAJOR PAYOR SOURCES IS ANALYZED TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES AND PROVISION FOR BAD DEBT. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, CONTRACTUALLY DUE AMOUNTS ARE ANALYZED AND COMPARED TO ACTUAL CASH OVERTIME TO ENHANCE THE QUALITY OF THE ESTIMATE OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND THE PROVISION OF BAD DEBT. AN ESTIMATE OF THE DIFFERENCE BETWEEN CONTRACTED RATES AND AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS CHARGED TO THE PROVISION FOR PATIENT BAD DEBTS AND CREDITED TO THE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS. PART III, LINE 3: THE METHODOLOGY USED IN DETERMINING BAD DEBT IS BASED ON A HISTORICAL PERCENTAGE COST OF PAYMENTS RECEIVED AGAINST WHAT IS BILLED CREATING A PERCENTAGE VARIANCE ON NET RECEIVABLES. PART III, LINE 4: THE NOTE RELATED TO BAD DEBT AND ACCOUNTS RECEIVABLE IS LOCATED ON PAGE 4 PART III, LINE 8: THE SOURCE USED IN CALCULATING MEDICARE ALLOWABLE COST OF CARE COMES FROM THE ANNUAL MEDICARE COST REPORT. PART III, LINE 9B: WHILE MEETING THE CRITERIA FOF FINANCIAL ASSISTANCE, LORETTO CANNOT SEND STATEMENT OR PURSUE FOR COLLECTIONS. HOWEVER, IF THE PATIENT DOESN'T QUALIFY OR HAS FINANCIAL ASSISTANCE WITH A REMAINING BALANCE, LORETTO CAN SEND BILLING STATEMENTS AND PURSUE COLLECTIONS. PART VI, LINE 2: A COMMUNITY HEALTH NEEDS ASSESSMENT PROVIDES INFORMATION SO THAT COMMUNITIES MAY IDENTIFY ISSUES OF GREATEST CONCERN AND DECIDE TO COMMIT RESOURCES TO THOSE AREAS, THEREBY MAKING THE GREATEST POSSIBLE IMPACT ON COMMUNITY HEALTH STATUS. THIS COMMUNITY HEALTH NEEDS ASSESSMENT WILL SERVE AS A TOOL TOWARD REACHING THREE BASIC GOALS:TO IMPROVE RESIDENTS' HEALTH STATUS, INCREASE THEIR LIFE SPANS, AND ELEVATE THEIR OVERALL QUALITY OF LIFE. A HEALTHY COMMUNITY IS NOT ONLY ONE WHERE ITS RESIDENTS SUFFER LITTLE FROM PHYSICAL AND MENTAL ILLNESS, BUT ALSO ONE WHERE ITS RESIDENTS ENJOY A HIGH QUALITY OF LIFE. TO REDUCE THE HEALTH DISPARITIES AMONG RESIDENTS. BY GATHERING DEMOGRAPHIC INFORMATION ALONG WITH HEALTH STATUS AND BEHAVIOR DATA, IT WILL BE POSSIBLE TO IDENTIFY POPULATION SEGMENTS THAT ARE MOST AT-RISK FOR VARIOUS DISEASES AND INJURIES. INTERVENTION PLANS AIMED AT TARGETING THESE INDIVIDUALS MAY THEN BE DEVELOPED TO COMBAT SOME OF THE SOCIOECONOMIC FACTORS WHICH HAVE HISTORICALLY HAD A NEGATIVE IMPACT ON RESIDENTS' HEALTH.TO INCREASE ACCESSIBILITY TO PREVENTIVE SERVICES FOR ALL COMMUNITY RESIDENTS. MORE ACCESSIBLE PREVENTIVE SERVICES WILL PROVE BENEFICIAL IN ACCOMPLISHING THE FIRST GOAL (IMPROVING HEALTH STATUS, INCREASING LIFE SPANS, AND ELEVATING THE QUALITY OF LIFE), AS WELL AS LOWERING THE COSTS ASSOCIATED WITH CARING FOR LATE-STAGE DISEASES RESULTING FROM A LACK OF PREVENTIVE CARE.IN THE ABSENCE OF A FORMAL COMMUNITY HEALTH NEEDS ASSESSMENT DURING THE TAX YEAR; THE HOSPITAL USED VARIOUS SOURCES TO ENGAGE THE NEEDS OF THE COMMUNITY. WE HOSTED SEVERAL EVENTS SUCH AS BREAST SCREENING AND TREATMENT; AMERICAN HEART ASSOCIATION; AND MEN'S HEALTH FAIR. IN ADDITION, THE HOSPITAL DID MONTHLY ANALYSIS OF THE PATIENTS SEEN IN THE HOSPITAL. PART VI, LINE 3: EVERY PATIENT IS PROVIDED A BROCHURE AND DOCUMENT UPON DOCTOR VISIT, UPON ADMITTING, AND DISCHARGE. IN ADDITION, THE POLICY IS POSTED IN THE WAITING ROOMS, ADMITTING, ONLINE AND AVAILABLE UPON REQUEST. PART VI, LINE 4: LORETTO HOSPITAL IS AN ILLINOIS SAFETY-NET HOSPITAL. ILLINOIS' 36 SAFETY-NET HOSPITALS CARE FOR THE STATE'S MOST VULNERABLE CITIZENS; ARE A MAJOR SOURCE OF MEDICAL CARE FOR LOW-INCOME, UNINSURED AND VULNERABLE POPULATIONS IN THE STATE OF ILLINOIS; AND TREAT A DISPROPORTIONATE SHARE OF MEDICAID PATIENTS. LORETTO SERVES THE AUSTIN COMMUNITY OF CHICAGO, SPECIFICALLY IN COOK COUNTY. LORETTO HOSPITAL GEOGRAPHICALLY SERVES PATIENTS IN THE SOUTH AND WEST SIDE OF CHICAGO. WE SERVE MANY PATIENTS THAT ARE INDIGENT, UNDER-SERVED, UNDER-INSURED, UNINSURED, AND/OR NEGLECTED. WHILE A MAJORITY OF PATIENTS ARE CAUCASIAN, LATINO, MIDDLE EASTERN, AND AFRICAN AMERICAN, MANY CULTURES ARE ALSO REPRESENTED THROUGHOUT THE SOUTH AND WEST SIDE OF CHICAGO, AND LORETTO TAKES THE STANCE OF PROVIDING HEALTH CARE REGARDLESS OF RACE, RELIGION, AND ABILITY TO PAY. PART VI, LINE 5: A MAJORITY OF LORETTO HOSPITAL'S GOVERNING BODY IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA AND WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. LORETTO HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN ITS COMMUNITY. LORETTO IS DEDICATED TO PROMOTING THE HEALTH AND WELLBEING OF ALL THE PEOPLE IN THE COMMUNITIES WE SERVE. OUR MISSION IS GUIDED BY THE VALUES: COMPASSION, COLLABORATION, QUALITY, STEWARDSHIP, INTEGRITY, ACCOUNTABILITY AND RESPECT. LORETTO ALSO HAS EXTENDED ITS SERVICES BEYOND HOSPITAL WALLS AND INTO THE NEIGHBORHOOD WHERE PEOPLE LIVE AND WORK. LINE 7 - STATE FILING OF COMMUNITY BENEFIT REPORT IL X 0 0 0 0 0 0 0 0 0 GEORGE MILLER BOARD MEMBER/PRESIDENT/CEO 407329 0 0 0 0 0 5200 0 16505 0 429034 0 0 0 ANOSH AHMED MD CHIEF OPERATING OFFICER/CHIEF FINANC 463161 0 0 0 0 0 0 0 10583 0 473744 0 0 0 KENNETH MCGEE CFO 225805 0 0 0 0 0 0 0 4579 0 230384 0 0 0 TANESHA DANIELS VP ANCILLARY SERVICES 152209 0 0 0 0 0 627 0 0 0 152836 0 0 0 DEATRA HOWARD CHIEF NURSING OFFICER 210275 0 0 0 0 0 3154 0 16505 0 229934 0 0 0 NIKHILA JUVVADI MD VP OPERATIONS 331273 0 0 0 0 0 0 0 5670 0 336943 0 0 0 DAHIR SHEIKHALI VP INFORMATION TECHNOLOGY 159739 0 0 0 0 0 0 0 16505 0 176244 0 0 0 JOSEPH DIPIAZZA PHYSICIAN 348211 0 0 0 0 0 0 0 4722 0 352933 0 0 0 LOIS CLARKE PHYSICIAN 312712 0 0 0 0 0 1950 0 16505 0 331167 0 0 0 CARRIE WILSON PHYSICIAN 311011 0 0 0 0 0 0 0 4579 0 315590 0 0 0 PARDEEP BHANOT PHYSICIAN 224260 0 0 0 0 0 0 0 16505 0 240765 0 0 0 SHITAL SHAH PHYSICIAN 231837 0 0 0 0 0 0 0 0 0 231837 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE RETURN IS PREPARED AND REVIEWED BY A THIRD PARTY ACCOUNTING FIRM, AND IS REVIEWED BY MANAGEMENT BEFORE FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THERE IS A CONFLICT OF INTEREST SURVEY ISSUED TO ALL BOARD MEMBERS ON AN ANNUAL BASIS. WHERE A POSSIBLE CONFLICT EXISTS RELATIVE TO ANY MATTER PRESENTED OF THE BOARD OF TRUSTEES, INCLUDING THOSE THAT POSE A THREAT TO PATIENT SAFETY OR ANY COMMITTEE THEREOF FOR CONSIDERATION, THE MEMBERS OF THE BOARD OF TRUSTEES AFFECTED THEREBY SHALL CALL ATTENTION THERETO, AND SHALL REFRAIN FROM AND BE INELIGIBLE TO CAST A VOTE RELATIVE TO SUCH MATTER. FORM 990, PART VI, SECTION B, LINE 15A THE CEO AND EXECUTIVE MANAGEMENT COMPENSATION IS PRESENTED AND REVIEWED BY THE BOARD COMMITTEE ON AN ANNUAL BASIS. RECOMMENDATIONS AND FINDINGS ARE PRESENTED FOR REVIEW AND APPROVAL BY THE COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES PRIOR TO PRESENTATION TO THE BOARD FOR FINAL APPROVAL. FORM 990, PART VI, SECTION C, LINE 18 COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: NET INCOME FROM WHOLLY OWNED SUBSIDIARY 786,714. NET LOSS FROM AFFILIATED NOT-FOR-PROFIT ENTITY 206,126. NET ASSET FROM LAST YEAR ADJUSTMENT WESTSIDE INSURANCE COMPANY 189 CHURCH STREET CAYMAN ISLANDS CJ KY1-1000 1ST LAYER INSURANCE CJ LORETTO HOSPITAL 1 LORETTO HOSPITAL FOUNDATION 645 SOUTH CENTRAL AVENUE CHICAGO IL 60644 364344125 FUNDRAISING IL 501(C)(3) LINE 7 LORETTO HOSPITAL 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0