FURP.ORG / PUBLIC DATA EXPLORER

INGALLS MEMORIAL HOSPITAL: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
INGALLS MEMORIAL HOSPITAL (EIN 36-2170866)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-05-15
IRS object ID
201911359349300331
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2019-05-15T07:46:19-05:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KPMG LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 East Randolph Street Ste 5500AddressLine1Txt
CityChicagoCityNm
State AbbreviationILStateAbbreviationCd
ZIP60601ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362170866EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE INGALLS MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% RICHARD SILVERIAInCareOfNm
Business Name ControlINGABusinessNameControlTxt
Phone7083332300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE INGALLS DRIVEAddressLine1Txt
CityHARVEYCityNm
State AbbreviationILStateAbbreviationCd
ZIP60426ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRICHARD SILVERIAPersonNm
Person TitleEVP AND CFOPersonTitleTxt
Phone7083332300PhoneNum
Signature2019-05-14SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTara D'AgostinoPreparerPersonNm
PTINP01245482PTIN
Phone3126651000PhoneNum
Preparation2019-05-10PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.102.5IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id36104320191355000001FederalOriginalSubmissionId
Federal Original Submission Id2019-05-15FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdAEE1DCD475618EC3E15152F39DEFE7DD5CD6EA23AtSubmissionCreationDeviceId
At Submission Filing Device Id9C37FB02EE77A6FF00EC66693955615721E3AD8AAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2020-01-14 16:20:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMICHAEL A LAWRENCEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE INGALLS DRIVEAddressLine1Txt
CityHARVEYCityNm
State AbbreviationILStateAbbreviationCd
ZIP60426ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$312,142,798GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.INGALLS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1922FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionINGALLS MEMORIAL HOSPITAL IS A NONPROFIT ACUTE CARE HOSPITAL ORGANIZED FOR THE PURPOSE OF PROVIDING PATIENT CARE, EDUCATION, AND RESEARCH.ActivityOrMissionDesc
Voting Members Governing Body19VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee2702TotalEmployeeCnt
Total Volunteers117TotalVolunteersCnt
Total Gross UBI$1,328,236TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$812,146PYContributionsGrantsAmt
CY Contributions Grants$882,936CYContributionsGrantsAmt
PY Program Service Revenue$220,499,037PYProgramServiceRevenueAmt
CY Program Service Revenue$284,840,492CYProgramServiceRevenueAmt
PY Investment Income$27,510,684PYInvestmentIncomeAmt
CY Investment Income$19,510,070CYInvestmentIncomeAmt
PY Other Revenue$983,900PYOtherRevenueAmt
CY Other Revenue$6,142,900CYOtherRevenueAmt
PY Total Revenue$249,805,767PYTotalRevenueAmt
CY Total Revenue$311,376,398CYTotalRevenueAmt
PY Grants And Similar Paid$80,300PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$52,152CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$87,230,531PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$119,580,594CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$134,907,818PYOtherExpensesAmt
CY Other Expenses$205,098,420CYOtherExpensesAmt
PY Total Expenses$222,218,649PYTotalExpensesAmt
CY Total Expenses$324,731,166CYTotalExpensesAmt
PY Revenues Less Expenses$27,587,118PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$13,354,768CYRevenuesLessExpensesAmt
Total Assets BOY$460,853,057TotalAssetsBOYAmt
Total Assets EOY$470,216,480TotalAssetsEOYAmt
Total Liabilities BOY$178,732,078TotalLiabilitiesBOYAmt
Total Liabilities EOY$204,830,332TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$282,120,979NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$265,386,148NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionINGALLS MEMORIAL HOSPITAL IS A NONPROFIT ACUTE CARE HOSPITAL ORGANIZED FOR THE PURPOSE OF PROVIDING PATIENT CARE, EDUCATION, RESEARCH, AND ASSISTANCE TO UCM COMMUNITY HEALTH & HOSPITAL DIVISION.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$149,919,977ExpenseAmt
Grant$52,152GrantAmt
Revenue$29,328,639RevenueAmt
DescINGALLS MEMORIAL (IMH) INCLUDES A 500+ CERTIFIED BED HOSPITAL AND A NETWORK OF COMPREHENSIVE OUTPATIENT CENTERS THAT FEATURE A FULL ARRAY OF HIGH-TECH DIAGNOSTIC AND TREATMENT SERVICES. IMH MAKES SURE THAT OUR RESOURCES ARE DIRECTED TO AREAS THAT RESULT IN THE GREATEST BENEFIT TO OUR PATIENTS AND THE COMMUNITY.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$25,028,622ExpenseAmt
Revenue$129,842,300RevenueAmt
DescINGALLS PERFORMS ARRAY OF SURGICAL SERVICES INCLUDING ELECTIVE, NON-ELECTIVE, COMPLEX AND HIGHLY SPECIALIZED PROCEDURES. SURGEONS ON STAFF AT INGALLS SPECIALIZE IN EVERY AREA OF SURGERY, INCLUDING, BUT NOT LIMITED TO CARDIOTHORACIC SURGERY, ORTHOPEDIC SURGERY, NEUROSURGERY, SPINE SURGERY, GENERAL SURGERY, AND VASCULAR SURGERY. IN FY2018 INGALLS PERFORMED 2,187 INPATIENT SURGERIES AND 2,901 AMBULATORY SURGERIES.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$21,792,499ExpenseAmt
Revenue$14,399,535RevenueAmt
DescTHE PHARMACY PROVIDES SERVICES TO BOTH OUR INPATIENTS AND INFUSION CENTER PATIENTS. INCLUDED IN THE SERVICES PROVIDED ARE ANTIBIOTIC DOSING, DOSING BASED ON KIDNEY FUNCTION, BLOOD GLUCOSE MANAGEMENT, AND ANTICOAGULANT DOSING AND MONITORING. THE INPATIENT PHARMACY IS OPEN 24/7. WE PROCESS APPROXIMATELY 45,000 MEDICATION ORDERS AND MAKE 8,000 INTERVENTIONS PER MONTH.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$65,399,362TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$117,104,040TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$262,140,460TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsYes (true)TaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document402IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2702EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members19GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRICHARD SILVERIAPersonNm
Phone7083332300PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE INGALLS DRIVEAddressLine1Txt
CityHARVEYCityNm
State AbbreviationILStateAbbreviationCd
ZIP60426ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (34 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
SAMUEL J CUTRARA JR
BOARD MEMBER1.01.0Yes (X)$0$0$0
HEATHER DAVIS
BOARD MEMBER1.01.0Yes (X)$0$0$0
ROSEMARY DOMBROWSKI
BOARD MEMBER1.00.0Yes (X)$0$0$0
EUGENE M FEINGOLD
BOARD MEMBER1.03.0Yes (X)$0$0$0
JEFFREY GLASSROTH MD
BOARD MEMBER1.00.0Yes (X)$0$0$0
DENNIS J IRVIN
VICE CHAIRMAN1.00.0Yes (X)$0$0$0
CARL JOHNSON II MD
BOARD MEMBER1.02.0Yes (X)$0$0$0
HENRY K JOHNSON
BOARD MEMBER1.01.0Yes (X)$0$0$0
TIMOTHY D JOHNSON
BOARD MEMBER1.01.0Yes (X)$0$0$0
DOROTHY JONES MD
BOARD MEMBER1.00.0Yes (X)$0$0$0
MICHAEL KAMRADT
BOARD MEMBER1.01.0Yes (X)$0$0$0
RICHARD M KING
BOARD MEMBER1.01.0Yes (X)$0$0$0
NEAL E KITCHELL
SECRETARY/TREASURER1.02.0Yes (X)$0$0$0Yes (X)
MARK F KOZLOFF MD
BOARD MEMBER1.042.0Yes (X)$0$633,981$41,233
KATHLEEN A MIKOS
CHIEF OF NURSING TIL 11/17/1740.00.0Yes (X)$507,826$0$28,568
DAVID H ORTH MD
CHAIRMAN1.02.0Yes (X)$0$0$0
CRESSA PERISH MD
BOARD MEMBER1.00.0Yes (X)$0$0$0
KEVIN M PURCELL
BOARD MEMBER1.01.0Yes (X)$0$0$0
NATHANIEL K SUTTON
BOARD MEMBER1.01.0Yes (X)$0$0$0
KURT E JOHNSON
PRESIDENT & CEO TIL 6/30/1840.04.0Yes (X)$1,789,967$0$30,429Yes (X)
MICHAEL R HICKS
COO TIL 5/4/1840.00.0Yes (X)$594,373$0$30,429Yes (X)
LINDA CONWAY
ASS'T SECRETARY/GENERAL COUNS40.00.0$253,556$0$7,607Yes (X)
MICHAEL A LAWRENCE
CHIEF FINANCIAL OFFICER40.00.0$218,293$0$21,174Yes (X)
ANN MCCOLGAN
ASS'T TREASURER/VP TREASURY1.040.0$0$443,298$61,673Yes (X)
MICHAEL DEVORE
CIO TILL 2/2/1840.00.0$249,186$0$39,309Yes (X)
PAUL DONOHUE
VP PHILANTHROPY AND COMMUNITY40.00.0$253,030$0$32,406Yes (X)
SCOTT STRAUSSER
VP BUSINESS DEVELOPMENT40.00.0$542,202$0$39,999Yes (X)
LAWRENCE KLONOWSKI
MANAGER MEDICAL PHYSICS40.00.0$217,320$0$28,520Yes (X)
MARY JO CRANDALL
VP LEAN TRANSFORMATION40.00.0$217,319$0$6,520Yes (X)
HEIDI RUHE
ASSOC VP BUSINESS DEVELOPMENT40.00.0$203,360$0$36,418Yes (X)
LEAH MONTOYA
VP CARE MANAGEMENT40.00.0$168,351$0$34,496Yes (X)
LYNN PHILIPSON
EXEC DIRECTOR INTEGRATED CARE20.020.0$106,652$136,339$28,464Yes (X)
GARY GASBARRA
INTERIM CFO TIL 6/30/170.040.0$0$883,921$62,746Yes (X)
DIANE JACOBY
ASS'T SECRETARY/VP TIL 2/3/1740.00.0$1,128,842$0$7,542Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$6,450,277TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$2,097,539TotReportableCompRltdOrgAmt
Total Other Compensation$537,533TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K121IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ARAMARK CORPORATION
25271 NETWORK PLACECHICAGOIL60673Food, EVS, Transport$19,957,772
CERNER HEALTH SERVICES
C/O US BANK PO BOX 959167ST LOUISMO63195IT SUPPORT$5,667,447
SYNERGY BEHAVIORAL HEALTHCARE
1566 W ALGONQUIN ROAD 3149HOFFMAN ESTATESIL60192Behavioral Health$5,281,985
REED CONSTRUCTION
600 W JACKSON BLVD STE 500CHICAGOIL606615625CONSTRUCTION$3,429,485
RevMD PARTNERS
1111 PASQUINELLI DRWESTMONTIL60559Patient Accounts$2,756,161
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K82CntrctRcvdGreaterThan100KCnt
Info In Schedule O Part VIIIYes (X)InfoInScheduleOPartVIIIInd
Related Organizations$882,936RelatedOrganizationsAmt
Total Contributions$882,936TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
NET PATIENT REVENUE900099$279,588,341$279,588,341
RENTAL INCOME900099$2,358,427$2,358,427
LAB SERVICES900099$1,325,532$1,325,532
CLIENT SERVICE REVENUE621500$414,150$414,150
MEDIC TRAINING900099$131,101$131,101

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,022,941TotalRevenueColumnAmt
Related Or Exempt Func Income$1,022,941RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$284,840,492TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,443,330TotalRevenueColumnAmt
Unrelated Business Revenue$2,704UnrelatedBusinessRevenueAmt
Exclusion$2,440,626ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,075,278RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$766,400RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$308,878RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$308,878TotalRevenueColumnAmt
Exclusion$308,878ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$16,324,243SecuritiesAmt
Other$742,497OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$16,324,243SecuritiesAmt
Other$742,497OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,066,740TotalRevenueColumnAmt
Exclusion$17,066,740ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
EXPENSE REIMBURSEMENT & MGMT FEES900099$548,156$548,156
GIFT SHOP900099$200,785$200,785
PARKING INCOME900099$67,742$67,742

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,017,339TotalRevenueColumnAmt
Related Or Exempt Func Income$5,017,339RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,834,022OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$311,376,398TotalRevenueColumnAmt
Related Or Exempt Func Income$289,348,982RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$1,328,236UnrelatedBusinessRevenueAmt
Exclusion$19,816,244ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$52,152TotalAmt
Program Services$52,152ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,450,277TotalAmt
Management And General$6,450,277ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$94,296,060TotalAmt
Program Services$84,818,806ProgramServicesAmt
Management And General$9,477,254ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,468,481TotalAmt
Program Services$2,246,318ProgramServicesAmt
Management And General$222,163ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$8,950,872TotalAmt
Program Services$8,145,294ProgramServicesAmt
Management And General$805,578ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$7,414,904TotalAmt
Program Services$6,747,563ProgramServicesAmt
Management And General$667,341ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$9,500,566TotalAmt
Management And General$9,500,566ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$352,994TotalAmt
Management And General$352,994ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$253,379TotalAmt
Management And General$253,379ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$37,707TotalAmt
Management And General$37,707ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$958,912TotalAmt
Management And General$958,912ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$51,582,382TotalAmt
Program Services$44,185,316ProgramServicesAmt
Management And General$7,397,066ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$1,205,938TotalAmt
Management And General$1,205,938ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,620,124TotalAmt
Program Services$1,458,112ProgramServicesAmt
Management And General$162,012ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$15,401,357TotalAmt
Management And General$15,401,357ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$5,146,807TotalAmt
Program Services$3,345,425ProgramServicesAmt
Management And General$1,801,382ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$309,336TotalAmt
Program Services$261,068ProgramServicesAmt
Management And General$48,268ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,886,667TotalAmt
Program Services$4,007,067ProgramServicesAmt
Management And General$879,600ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$14,435,107TotalAmt
Program Services$12,702,894ProgramServicesAmt
Management And General$1,732,213ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$27,575,314TotalAmt
Program Services$25,369,289ProgramServicesAmt
Management And General$2,206,025ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$47,309,004$47,309,004
PUBLIC ASSESSMENT$16,658,494$16,658,494
REPAIRS & MAINTENANCE$3,626,668$3,264,001$362,667
LAUNDRY SERVICES$1,027,138$1,027,138

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,210,526TotalAmt
Program Services$542,519ProgramServicesAmt
Management And General$2,668,007ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$324,731,166TotalAmt
Program Services$262,140,460ProgramServicesAmt
Management And General$62,590,706ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$9,265BOYAmt
EOY$9,265EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$526,691BOYAmt
EOY$502,976EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$40,008,191BOYAmt
EOY$41,813,279EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,737,792BOYAmt
EOY$5,997,840EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,236,035BOYAmt
EOY$2,133,545EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$212,802,358LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$27,024,295LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$177,550,172BOYAmt
EOY$185,778,063EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$212,639,088BOYAmt
EOY$189,034,698EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$3,869,834BOYAmt
EOY$251,804EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$18,275,989BOYAmt
EOY$44,695,010EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$460,853,057BOYAmt
EOY$470,216,480EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$48,201,157BOYAmt
EOY$81,790,056EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$2,593,929BOYAmt
EOY$3,187,744EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$109,610,689BOYAmt
EOY$104,689,455EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$18,326,303BOYAmt
EOY$15,163,077EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$178,732,078BOYAmt
EOY$204,830,332EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$277,978,937BOYAmt
EOY$260,925,127EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,142,042BOYAmt
EOY$4,461,021EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$282,120,979BOYAmt
EOY$265,386,148EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$460,853,057BOYAmt
EOY$470,216,480EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$13,354,768ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$6,055,478NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$2,675,415OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd
FS Audited BasisFSAuditedBasisGrp
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$37,707OtherActivitiesAmt
Total Lobbying Expenditures$37,707TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1IFormAndLineReferenceDesc
ExplanationTHE HOSPITAL PAYS DUES TO THE ILLINOIS HEALTH AND HOSPITAL ASSOCIATION. A PORTION OF THESE DUES ARE USED TO SUPPORT LOBBYING BY THE ASSOCIATION FOCUSED ON ADVOCACY AND REPRESENTATION.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,464,807OtherCostOrOtherBasisAmt
Book Value$6,464,807BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$153,763,822OtherCostOrOtherBasisAmt
Depreciation$9,754,999DepreciationAmt
Book Value$144,008,823BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$49,359,541OtherCostOrOtherBasisAmt
Depreciation$16,721,201DepreciationAmt
Book Value$32,638,340BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,214,188OtherCostOrOtherBasisAmt
Depreciation$548,095DepreciationAmt
Book Value$2,666,093BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$185,778,063TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (5 entries)

DescDescBook ValueBookValueAmt
RESTRICTED INVESTMENTS - FDN$4,461,021
OTHER LONG TERM ASSETS$1,196,474
DUE FROM AFFILIATES$38,001,405
DUE FROM ARAMARK$1,018,409
VHA EQUITY$17,701
FieldValueIRS element (for citing)
Total Book Value Other Assets$44,695,010TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
LEASE OBLIGATIONS$1,365,363
SWAP PAYABLE$7,655,496
OTHER PAYABLES$6,142,218
FieldValueIRS element (for citing)
Total Liability$15,163,077TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$307,484,844TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$6,055,478NetUnrealizedGainsInvstAmt
Other Revenue$2,356,436OtherRevenueAmt
Revenue Not Reported-$3,699,042RevenueNotReportedAmt
Revenue Subtotal$311,183,886RevenueSubtotalAmt
Investment Expenses Not Incld$958,912InvestmentExpensesNotIncldAmt
Other Revenues Not Included-$766,400OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$192,512RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$311,376,398TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$324,538,654TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$766,400OtherExpensesIncludedAmt
Expenses Not Reported$766,400ExpensesNotReportedAmt
Expenses Subtotal$323,772,254ExpensesSubtotalAmt
Investment Expenses Not Incld2$958,912InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$958,912ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$324,731,166TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2THE HEALTH SYSTEM APPLIES THE PROVISIONS OF ASC TOPIC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2018, THE HOSPITAL DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS. THE HOSPITAL IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE.
SCHEDULE D, PART XI, LINE 2DCHANGE IN FAIR VALUE OF DERIVATIVE INSTRUMENTS $2,356,436
SCHEDULE D, PART XI, LINE 4BRECLASS OF RENTAL EXPENSE ($766,400)
SCHEDULE D, PART XII, LINE 2DRECLASS OF RENTAL EXPENSE $766,400

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other600.DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (true)ExpensesExceedBudgetInd
Unable To Provide CarefalseUnableToProvideCareInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$4,913,672TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$4,913,672NetCommunityBenefitExpnsAmt
Total Expense0.01510TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$86,013,281TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$40,710,291DirectOffsettingRevenueAmt
Net Community Benefit Expns$45,302,990NetCommunityBenefitExpnsAmt
Total Expense0.13950TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$90,926,953TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$40,710,291DirectOffsettingRevenueAmt
Net Community Benefit Expns$50,216,662NetCommunityBenefitExpnsAmt
Total Expense0.15460TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,002,690TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$594,364DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,408,326NetCommunityBenefitExpnsAmt
Total Expense0.00430TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$2,002,690TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$594,364DirectOffsettingRevenueAmt
Net Community Benefit Expns$1,408,326NetCommunityBenefitExpnsAmt
Total Expense0.00430TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$92,929,643TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$41,304,655DirectOffsettingRevenueAmt
Net Community Benefit Expns$51,624,988NetCommunityBenefitExpnsAmt
Total Expense0.15890TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReportedInd
Bad Debt Expense$9,543,242BadDebtExpenseAmt
Bad Debt Expense Attributable$0BadDebtExpenseAttributableAmt
Reimbursed By Medicare$109,020,466ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$133,222,018CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$24,201,552MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (true)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (true)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INGALLS MEMORIAL HOSPITALBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1ONE INGALLS DRIVEAddressLine1Txt
CityHARVEYCityNm
State AbbreviationILStateAbbreviationCd
ZIP60426ZIPCd
FieldValueIRS element (for citing)
Website AddressWWW.INGALLS.ORGWebsiteAddressTxt
State License0001099StateLicenseNum
Licensed HospitalYes (X)LicensedHospitalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1INGALLS MEMORIAL HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PYfalseFirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PYfalseTaxExemptHospitalCYOrPYInd
CHNA ConductedYes (true)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Prior CHNA ImpactYes (X)PriorCHNAImpactInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (true)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsfalseCHNAConductedWithOtherFcltsInd
CHNA Conducted With Non FcltsYes (true)CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (true)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLINGALLS.HEALTHFORECAST.NETOwnWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (true)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted WebsiteYes (true)StrategyPostedWebsiteInd
Strategy Website URLINGALLS.HEALTHFORECAST.NETStrategyWebsiteURLTxt
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care600.FPGFamilyIncmLmtDscntCarePct
Income Level CriteriaYes (X)IncomeLevelCriteriaInd
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Explained BasisYes (true)ExplainedBasisInd
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URL(SEE STATEMENT)FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL(SEE STATEMENT)FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URL(SEE STATEMENT)FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill DisplayYes (X)NotifiedFAPCopyBillDisplayInd
Communtity Notified FAPYes (X)CommuntityNotifiedFAPInd
FAP TranslatedYes (X)FAPTranslatedInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit No ActionsYes (X)PermitNoActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
Made Effort Orally NotifyYes (X)MadeEffortOrallyNotifyInd
Processed FAP ApplicationYes (X)ProcessedFAPApplicationInd
Made Presumptive Elig DetermYes (X)MadePresumptiveEligDetermInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Look Back Medicare PrivateYes (X)LookBackMedicarePrivateInd
Amounts Generally BilledfalseAmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, SECTION B, LINE 4THE HOSPITAL IS REPORTING THE TAX YEAR BEGINNING FOR WHICH IT LAST CONDUCTED ITS CHNA. THE CHNA WAS FINALIZED DURING THE TAX YEAR ENDED SEPTEMBER 30, 2016. PART V, SECTION B, LINE 5 IN CONDUCTING ITS MOST RECENT CHNA, THE HOSPITAL SOUGHT TO SOLICIT INPUT FROM INDIVIDUALS WHO HAVE A BROAD INTEREST IN THE HEALTH OF THE COMMUNITY. POTENTIAL PARTICIPANTS IN THE CHNA INCLUDED PHYSICIANS, PUBLIC HEALTH REPRESENTATIVES, OTHER HEALTH PROFESSIONALS, SOCIAL SERVICE PROVIDERS, AND A VARIETY OF OTHER COMMUNITY LEADERS. THESE 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. PARTICIPANTS WERE CONTACTED BY EMAIL AND ASKED TO PARTICIPATE IN A SURVEY. THROUGHOUT THIS PROCESS, INPUT WAS GATHERED FROM SEVERAL INDIVIDUALS WHOSE ORGANIZATIONS WORK WITH LOW-INCOME, MINORITY POPULATIONS, OR OTHER MEDICALLY UNDERSERVED POPULATIONS.
PART V, SECTION B, LINE 6BTHE COMMUNITY HEALTH NEEDS ASSESSMENT WAS SPONSORED BY INGALLS MEMORIAL HOSPITAL IN COOPERATION WITH THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL. THE PROJECT ALSO RECEIVED INPUT FROM A COMMUNITY HEALTH NEEDS COMMITTEE, CREATED FOR THIS PURPOSE, WHICH WAS COMPRISED OF REPRESENTATIVES OF THE PARTNERING ORGANIZATIONS AS WELL AS OTHER CITIZENS CHOSEN FOR THEIR RELEVANT EXPERIENCE AND INTERESTS.
PART V, SECTION B, LINE 9THE HOSPITAL IS REPORTING THE TAX YEAR BEGINNING FOR WHICH IT LAST ADOPTED AN IMPLEMENTATION STRATEGY RELATING TO THE TAX YEAR ENDED SEPTEMBER 30, 2016. PART V, SECTION B, LINE 11 THE SIGNIFICANT NEEDS IN THE COMMUNITY WERE IDENTIFIED AS ACCESS TO CARE; HEART DISEASE AND STROKE; CANCER CARE; NUTRITION, PHYSICAL ACTIVITY & WEIGHT; AND INFANT HEALTH AND FAMILY PLANNING. TO ADDRESS ACCESS TO CARE, INGALLS REFERENCED HEALTH DATA FINDINGS WHICH SUGGEST OPPORTUNITIES TO ADDRESS BARRIERS TO HEALTHCARE ACCESS AROUND APPOINTMENT AVAILABILITY AND LOCATING A PHYSICIAN. PHYSICIAN RECRUITMENT, ENHANCED CLINICAL SERVICES, AND EXPANSION OF OUTPATIENT SERVICES WERE THE PRIMARY REASONS FOR THE MERGER BETWEEN THE UNIVERSITY OF CHICAGO MEDICINE AND INGALLS HEALTH SYSTEM, NOW KNOWN AS UCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC. THE MERGED HEALTH SYSTEMS WILL IMPROVE ACCESS ACROSS THE SPECTRUM OF CARE BE IT FOR A ROUTINE, PREVENTATIVE CHECKUP OR A COMPLEX, LIFE SUSTAINING TREATMENT. INGALLS HELD A COMMUNITY LEADERS FORUM, PARTNERING WITH ELECTED OFFICIALS, EDUCATORS, FAITH LEADERS, COMMUNITY NON-PROFITS, PATIENTS, PHYSICIANS, AND STAFF, TO SHARE INFORMATION AROUND ACCESS TO CARE THROUGH THE UCM/INGALLS MERGER. ADDRESSING THE ISSUE OF HEART DISEASE AND STROKE, INGALLS HAS IMPLEMENTED A NUMBER OF ACTION STEPS FOCUSED ON PREVENTATIVE CARE IN THE COMMUNITY, WHILE ALSO INVESTING MORE THAN $1 MILLION IN DIRECT CARDIAC EQUIPMENT AND PATIENT CARE SERVICES IN THE HOSPITAL. ACTION ITEMS INCLUDE A MONTHLY WALKING PROGRAM WITH HEALTH EDUCATION LECTURES AND SCREENING HELD AT COMMUNITY CENTERS AND LOCAL MALLS; THE 36TH ANNUAL SOUTHLAND HEALTH FAIR DREW NEARLY 600 PEOPLE FROM ALL ACROSS THE METROPOLITAN AREA, WHO TOOK ADVANTAGE OF HEAD-TO-TOE HEALTH SCREENINGS AND EDUCATION WHICH INCLUDE TOTAL CHOLESTEROL BLOOD TESTS AND 12-LEAD EKGS. THIS YEAR, FAIRGOERS BENEFITTED FROM THE EXPERTISE OF REPRESENTATIVES OF THE INGALLS MEDICAL STAFF AND THE UNIVERSITY OF CHICAGO MEDICINE CENTER FOR ADVANCED CARE IN ORLAND PARK, ALONG WITH NEARLY 200 NURSES, TECHNICAL THERAPY, CLERICAL AND VOLUNTEER STAFF. IN ALL, BLOOD WAS DRAWN FROM NEARLY 300 PEOPLE WHO TOOK ADVANTAGE OF MORE THAN ONE THOUSAND TESTS. LIFELINE SCREENING OFFERED TO OVER 100 PATIENTS PER MONTH AT THE INGALLS WELLNESS CENTER; AND COMMUNITY HEALTH FAIRS, FEATURING INFORMATION BOOTHS, FITNESS TESTS, AND OTHER ACTIVITIES OFFERED IN PARTNERSHIP WITH THE AMERICAN HEART ASSOCIATION AND INGALLS CARDIOLOGY DEPARTMENT AND WELLNESS CENTER. TO ADDRESS CANCER, INGALLS WILL CONTINUE TO INVEST IN THE LARGEST COMMUNITY BASED CANCER RESEARCH PROGRAM IN THE SOUTH SUBURBS, SCREENING 300 PATIENTS ANNUALLY AND ENROLLING 60 PARTICIPANTS IN ACTIVE CLINICAL DRUG TRIALS, ONE THIRD OF WHICH ARE MINORITY PATIENTS. IN ADDITION, INGALLS WILL IMPLEMENT A NUMBER OF COMMUNITY BASED INITIATIVES, INCLUDING: CONQUERING BREAST CANCER FORUM, AN ANNUAL EVENT FOR 300-500 PARTICIPANTS IN WHICH A FREE FORUM ADDRESSES HEALTH DISPARITIES IN BREAST CANCER AMONG MINORITY PATIENTS POPULATIONS; FREE MAMMOGRAMS, THROUGH PARTNERSHIP WITH SILVER LINING FOUNDATION, TYPICALLY PROVIDED TO 5-10 PATIENTS PER MONTH; AND THE COMMUNITY IMPACT GRANT, FUNDED THROUGH INGALLS DEVELOPMENT FOUNDATION, WHICH SECURES RESOURCES FOR PATIENTS TO PAY FOR CANCER TREATMENTS. IN RESPONSE TO FINDINGS THAT OBESITY AND OVERWEIGHT CONDITIONS AMONG CHILDREN AND ADULTS ARE UNFAVORABLE IN THE REGION, INGALLS WILL IMPLEMENT A NUMBER OF ACTION STEPS, INCLUDING: NUTRITION COUNSELING OFFERED VIA A SERIES OF FREE WORKSHOPS AND COOKING DEMONSTRATIONS PROMOTING GOOD NUTRITION BY A LICENSED DIETICIAN AND THE COMMUNITY GARDEN. IN ITS SIXTH YEAR, THE GARDEN HELPS SUPPLY FRESH PRODUCE FOR THREE LOCAL FOOD PANTRIES: ST. CLEMENTS CHURCH, RESTORATION MINISTRIES AND THE HARVEY COMMUNITY CENTER. ACCORDING TO CHERYL BACON, INGALLS DIETETIC INTERNSHIP DIRECTOR, PRODUCE FROM THE GARDEN REACHED AN ESTIMATED 4,500 PEOPLE THROUGH HOUSEHOLDS SERVED BY BOTH RESTORATION MINISTRIES AND ST. CLEMENTS CHURCH AND HELPED FEED 350 CHILDREN THROUGH HOME-COOKED MEALS PREPARED DAILY AT THE HARVEY COMMUNITY CENTER. TO ADDRESS FINDINGS THAT THE BIRTH WEIGHT AND INFANT DEATH RATE IN THE INGALLS SERVICE AREA IS WORSE THAN THE REGION, STATE, AND NATION, INGALLS WILL CONTINUE TO INVEST IN THE FOLLOWING ACTIONS: HEALTH BABY NETWORK, WHICH IS DESIGNED TO GET ECONOMICALLY DISADVANTAGED PREGNANT ADOLESCENTS AND TEENS THE HEALTHCARE AND SOCIAL SERVICES THEY NEED IN ORDER TO ENSURE HEALTHIER OUTCOMES FOR THEMSELVES AND THEIR UNBORN CHILDREN. THIS PROGRAM, ON AVERAGE, IS PROVIDED TO 10% OF THE 800-1,000 DELIVERIES MADE BY THE HOSPITAL EACH YEAR; KID FIT CAMP, IN WHICH AN ESTIMATED 500 PARTICIPANTS STRIVE TO ACHIEVE GRADUAL WEIGHT LOSS AND MAINTENANCE TO ENSURE PROPER GROWTH AND DEVELOPMENT; COMMUNITY SCHOLARSHIPS PROVIDE OVER 15 SCHOLARSHIPS TO HIGH SCHOOL SENIORS WHO WILL BE SENIORS GRADUATING TO PURSUE CAREERS STUDYING HEALTHCARE. IN ADDITION TO THE PRIORITY AREAS IDENTIFIED, INGALLS REMAINS COMMITTED AS PART OF THE COMMUNITY HEALTH NEEDS IMPLEMENTATION TO ADDRESS, THROUGH DIRECT PATIENT CARE IN PARTNERSHIP WITH OUR PHYSICIANS, THE FOLLOWING HEALTH NEEDS IDENTIFIED IN THE MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT: CHRONIC KIDNEY DISEASE, DIABETES, HIV/AIDS, INJURY & VIOLENCE, MENTAL HEALTH, POTENTIALLY DISABLING CONDITIONS, RESPIRATORY DISEASE, SEXUALLY TRANSMITTED DISEASES, SUBSTANCE ABUSE, AND TOBACCO ABUSE.
PART V, SECTION B, LINE 13BA PATIENT IS NOT REQUIRED TO PAY MORE THAN 20% OF HIS/HER FAMILY INCOME FOR ALL EMERGENCY AND OTHER MEDICALLY NECESSARY CARE PROVIDED BY IMH IN A 12-MONTH PERIOD. THE MEDICAL INDIGENCY DISCOUNT APPLIES TO ANY PATIENT WHOSE PATIENT BALANCE DUE FOR EMERGENCY AND OTHER MEDICALLY NECESSARY SERVICES EXCEEDS 20% OF HIS/HER ADJUSTED GROSS INCOME IN THE YEAR THAT THE PATIENT RECEIVED CARE.
PART V, SECTION B, LINE 16Ahttps://www.ingalls.org/financial-assistance# PART V, SECTION B, LINE 16B https://www.ingalls.org/financial-assistance# PART V, SECTION B, LINE 16C HTTPS://WWW.INGALLS.ORG/FINANCIAL-ASSISTANCE#
FieldValueIRS element (for citing)
Facility7FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (7 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
INGALLS FAMILY CARE CENTER
1600 TORRENCE AVENUECALUMET CITYIL60409URGENT AID, PRIMARY CARE, AND SPECIALIST SERVICES
INGALLS CARE CENTER
4742 CAL SAG ROADCRESTWOODIL60445QUICK CARE CENTER AND OCCUPATIONAL HEALTH
INGALLS FAMILY CARE CENTER
6701 WEST 159TH STREETTINLEY PARKIL60477URGENT AID, PRIMARY CARE, AND SPECIALIST SERVICES
INGALLS FAMILY CARE CENTER
19550 GOVERNORS HIGHWAYFLOSSMOORIL60422URGENT AID AND SPECIALIST SERVICES
INGALLS WELLNESS CENTER
2920 WELLNESS CENTERHOMEWOODIL60430COMPLEMENTARY MEDICINE AND COMMUNITY HEALTH PROGRAMS
THE VILLA AT SOUTH HOLLAND
16300 WAUSAU AVENUESOUTH HOLLANDIL60473HEALTHCARE AND REHABILITATION CENTER
INGALLS CARE CENTER
16246 PRINCE DRIVESOUTH HOLLANDIL60473INDUSTRIAL, MEDICAL REHABILITATION AND PHYSICIAN OFFICES

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 3CAUTOMATIC UNINSURED SELF-PAY DISCOUNT A DISCOUNT OF 70% OF GROSS CHARGES, PROVIDED TO ALL UNINSURED PATIENTS WITHOUT REQUIRING EVIDENCE OF INABILITY TO PAY. THIS DISCOUNT IS DESIGNED TO ENSURE THAT PATIENTS ARE CHARGED AT A RATE GENERALLY COMPARABLE TO THAT APPLIED TO INSURED PATIENTS. 1. THERE IS NO APPLICATION PROCESS FOR THE PATIENT TO RECEIVE THE UNINSURED DISCOUNT. THE DISCOUNT IS APPLIED BASED ON THE ACCOUNTS SELF-PAY/UNINSURED STATUS. 2. PATIENTS RECEIVING PRE-NEGOTIATED DISCOUNTS FOR HOSPITAL SERVICES WILL NOT BE ELIGIBLE FOR THIS UNINSURED DISCOUNT. 3. IF A PATIENT IS SUBSEQUENTLY APPROVED FOR FINANCIAL ASSISTANCE, THE AUTOMATIC DISCOUNT WILL BE REVERSED SO THAT THE FULL AMOUNT CAN BE RECOGNIZED AS A CHARITY ALLOWANCE. 4. IF A PATIENT SUBSEQUENTLY PROVIDES EVIDENCE OF INSURANCE COVERAGE, THE AUTOMATIC DISCOUNT WILL BE REVERSED AND THE INSURANCE COVERAGE PROVIDED WILL BE BILLED ACCORDINGLY. 5. PATIENT WHO ARE OTHERWISE INSURED AND CHOOSE NOT TO USE THEIR INSURANCE COVERAGE ARE INELIGIBLE FOR THIS AUTOMATIC DISCOUNT. PART I, LINE 7 INGALLS UTILIZES A COST TO CHARGE METHODOLOGY. CHARGES ASSOCIATED WITH THE RELATED CATEGORIES ARE THEN USED TO DETERMINE COST RELATED TO SUCH REVENUE.
PART III, LINE 2THE AMOUNT REPORTED AS BAD DEBT EXPENSE IS DETERMINED BY APPLYING THE RATIO OF COST TO CHARGES (RCC) TO THE TOTAL CHARGES WRITTEN OFF TO BAD DEBT AS REPORTED IN THE AUDITED FINANCIAL STATEMENTS. THE RCC WAS DETERMINED UTILIZING WORKSHEET 2 FROM FORM 990, SCHEDULE H INSTRUCTIONS. THE BASIS FOR THIS COSTING METHODOLOGY IS THE HOSPITALS OPERATING EXPENSES (EXCLUDING BAD DEBT) ADJUSTED BY OTHER OPERATING REVENUE AND COMMUNITY BENEFIT EXPENSE DIVIDED BY GROSS PATIENT CHARGES.
PART III, LINE 4FOOTNOTE TO FINANCIAL STATEMENTS: THE PROCESS FOR ESTIMATING THE ULTIMATE COLLECTABILITY OF RECEIVABLES INVOLVES SIGNIFICANT ASSUMPTIONS AND JUDGEMENT. INGALLS HAS IMPLEMENTED A STANDARDIZED APPROACH TO THIS ESTIMATION BASED ON THE PAYOR CLASSIFICATION AND AGE OF OUTSTANDING RECEIVABLES. ACCOUNT BALANCES ARE WRITTEN OFF AGAINST THE ALLOWANCE WHEN MANAGEMENT FEELS IT IS PROBABLE THE RECEIVABLE WILL NOT BE RECOVERED. THE USE OF HISTORICAL COLLECTION EXPERIENCE IS AN INTEGRAL PART OF ESTIMATION OF THE RESERVE FOR DOUBTFUL ACCOUNTS. REVISIONS IN THE RESERVE FOR DOUBTFUL ACCOUNTS ARE RECORDED AS ADJUSTMENTS TO THE PROVISION FOR DOUBTFUL ACCOUNTS.
PART III, LINE 8THE HOSPITAL BELIEVES THE FULL AMOUNT OF THE SHORTFALL FROM MEDICARE SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE IT SERVES ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY, AND IT CANNOT NEGOTIATE CONTRACTUAL RATES WITH THE MEDICARE PROGRAM. THE HOSPITAL MUST ACCEPT WHAT THE MEDICARE PROGRAM PAYS. THE METHODOLOGY USED IN DETERMINING MEDICARE USED IN THE COMMUNITY BENEFITS REPORT IS MEDICARE CHARGES MULTIPLIED BY THE MEDICARE COST REPORT, COST TO CHARGE RATIO.
PART III, LINE 9BINGALLS MEMORIAL HOSPITAL HAS A FIDUCIARY DUTY TO SEEK REIMBURSEMENT FOR SERVICES IT HAS PROVIDED FROM INDIVIDUALS WHO ARE ABLE TO PAY, FROM THIRD PARTY INSURERS WHO COVER THE COST OF CARE, AND FROM OTHER PROGRAMS OF ASSISTANCE FOR WHICH THE PATIENT IS ELIGIBLE. TO DETERMINE WHETHER A PATIENT IS ABLE TO PAY FOR THE SERVICES PROVIDED AS WELL AS TO ASSIST THE PATIENT IN FINDING ALTERNATIVE COVERAGE OPTIONS IF THEY ARE UNINSURED OR UNDERINSURED, THE HOSPITAL FOLLOWS THE FOLLOWING CRITERIA RELATED TO BILLING AND COLLECTING FROM PATIENTS. COLLECTING INFORMATION ON PATIENT HEALTH COVERAGE AND FINANCIAL RESOURCES PATIENT OBLIGATIONS: PRIOR TO THE DELIVERY OF ANY HEALTH CARE SERVICES (EXCEPT FOR CASES THAT ARE AN EMERGENCY OR URGENT CARE SERVICE LEVEL), THE PATIENT IS EXPECTED TO PROVIDE TIMELY AND ACCURATE INFORMATION ON THEIR INSURANCE STATUS, DEMOGRAPHIC INFORMATION, CHANGES TO THEIR FAMILY INCOME OR INSURANCE STATUS, AND INFORMATION ON ANY DEDUCTIBLES OR CO-PAYMENTS THAT ARE OWED BASED ON THEIR EXISTING INSURANCE OR FINANCIAL PROGRAM'S PAYMENT OBLIGATIONS. THE DETAILED INFORMATION WILL INCLUDE: A. FULL NAME, ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, CITIZENSHIP AND RESIDENCY INFORMATION, AND THE PATIENT'S APPLICABLE FINANCIAL RESOURCES THAT MAY BE USED TO PAY THEIR BILL; B. FULL NAME OF THE PATIENT'S GUARANTOR, THEIR ADDRESS, TELEPHONE NUMBER, DATE OF BIRTH, SOCIAL SECURITY NUMBER (IF AVAILABLE), CURRENT HEALTH INSURANCE COVERAGE OPTIONS, AND THEIR APPLICABLE FINANCIAL RESOURCES THAT MAY BE USED TO PAY FOR THE PATIENT'S BILL; AND C. OTHER RESOURCES THAT MAY BE USED TO PAY THEIR BILL, INCLUDING OTHER INSURANCE PROGRAMS, MOTOR VEHICLE OR HOMEOWNERS INSURANCE POLICIES IF THE TREATMENT WAS DUE TO AN ACCIDENT, WORKER'S COMPENSATION PROGRAMS, AND STUDENT INSURANCE POLICIES, AMONG OTHERS. IT IS ULTIMATELY THE PATIENT'S OBLIGATION TO KEEP TRACK OF AND TIMELY PAY THEIR UNPAID HOSPITAL BILL, INCLUDING ANY EXISTING CO-PAYMENTS, CO-INSURANCE, AND DEDUCTIBLES. THE PATIENT IS FURTHER REQUIRED TO INFORM EITHER THEIR CURRENT HEALTH INSURER (IF THEY HAVE ONE) OR THE AGENCY THAT DETERMINED THE PATIENT'S ELIGIBILITY STATUS IN A PUBLIC HEALTH INSURANCE PROGRAM OF ANY CHANGES IN FAMILY INCOME OR INSURANCE STATUS. THE HOSPITAL MAY ALSO ASSIST THE PATIENT WITH UPDATING THEIR ELIGIBILITY IN A PUBLIC PROGRAM WHEN THERE ARE ANY CHANGES IN FAMILY INCOME OR INSURANCE STATUS, BUT ONLY IF THE HOSPITALS MADE AWARE BY THE PATIENT OF FACTS THAT MAY INDICATE A CHANGE IN THE PATIENT'S ELIGIBILITY STATUS. PATIENTS ARE REQUIRED TO NOTIFY THE STATE PUBLIC PROGRAM (OFFICE OF MEDICAID), INFORMATION RELATED TO ANY LAWSUIT OR INSURANCE CLAIM THAT WILL COVER THE COST OF THE SERVICES PROVIDED BY THE HOSPITAL. HOSPITAL OBLIGATIONS: INGALLS MEMORIAL HOSPITAL WILL MAKE ALL REASONABLE AND DILIGENT EFFORTS TO COLLECT THE PATIENT INSURANCE STATUS AND OTHER INFORMATION TO VERIFY COVERAGE FOR THE HEALTH CARE SERVICES TO BE PROVIDED BY INGALLS MEMORIAL HOSPITAL. THESE EFFORTS MAY OCCUR WHEN THE PATIENT IS SCHEDULING THEIR SERVICES, DURING PREREGISTRATION, WHILE THE PATIENT IS ADMITTED IN THE HOSPITAL, UPON DISCHARGE, OR DURING THE COLLECTION PROCESS WHICH MAY OCCUR FOR A REASONABLE TIME FOLLOWING DISCHARGE FROM THE HOSPITAL. THIS INFORMATION WILL BE OBTAINED PRIOR TO THE DELIVERY OF ANY NONEMERGENT AND NON-URGENT HEALTH CARE SERVICES (I.E., ELECTIVE PROCEDURES AND SCHEDULED PROCEDURES). INGALLS MEMORIAL HOSPITAL WILL DELAY ANY ATTEMPT TO OBTAIN THIS INFORMATION DURING THE DELIVERY OF ANY EMERGENCY MEDICAL TREATMENT AND LABOR ACT (EMTALA) LEVEL EMERGENCY LEVEL OR URGENT CARE SERVICES, IF THE PROCESS TO OBTAIN THIS INFORMATION WILL DELAY OR INTERFERE WITH EITHER THE MEDICAL SCREENING EXAMINATION OR THE SERVICES UNDERTAKEN TO STABILIZE AN EMERGENCY MEDICAL CONDITION. THE HOSPITAL'S REASONABLE AND DILIGENT EFFORTS WILL INCLUDE, BUT IS NOT LIMITED TO, REQUESTING INFORMATION ABOUT THE PATIENT'S INSURANCE STATUS, CHECKING ANY AVAILABLE PUBLIC OR PRIVATE INSURANCE DATABASES, AND FOLLOWING THE BILLINGS RULES OF A KNOWN THIRD PARTY PAYER.IF THE PATIENT OR GUARANTOR/GUARDIAN IS UNABLE TO PROVIDE THE INFORMATION NEEDED, AND THE PATIENT CONSENTS, THE HOSPITAL WILL MAKE REASONABLE EFFORTS TO CONTACT RELATIVES, FRIENDS, GUARANTOR/GUARDIAN, AND THE THIRD PARTY FOR ADDITIONAL INFORMATION. INGALLS MEMORIAL HOSPITAL WILL ALSO MAKE REASONABLE AND DILIGENT EFFORTS TO INVESTIGATE WHETHER A THIRD PARTY RESOURCE MAY BE RESPONSIBLE FOR THE SERVICES PROVIDED BY THE HOSPITAL, INCLUDING BUT NOT LIMITED TO: (1) A MOTOR VEHICLE OR HOMEOWNER'S LIABILITY POLICY, (2) GENERAL ACCIDENT OR PERSONAL INJURY PROTECTION POLICIES, (3) WORKER'S COMPENSATION PROGRAMS, (4) STUDENT INSURANCE POLICIES, AMONG OTHERS. IN ACCORDANCE WITH APPLICABLE STATE REGULATIONS OR THE INSURANCE CONTRACT, FOR ANY CLAIM WHERE INGALLS MEMORIAL HOSPITAL'S REASONABLE AND DILIGENT EFFORTS RESULTED IN A PAYMENT FROM A PRIVATE INSURER OR PUBLIC PROGRAM, INGALLS MEMORIAL HOSPITAL WILL REPORT THE RECOVERY AND OFF SET IT AGAINST THE CLAIM PAID BY THE PRIVATE INSURER OR PUBLIC PROGRAM.THE HOSPITAL FURTHER MAINTAINS ALL INFORMATION IN ACCORDANCE WITH APPLICABLE FEDERAL AND STATE PRIVACY, SECURITY AND ID THEFT LAWS.
PART VI, LINE 2IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS CONDUCTED, THE HOSPITAL HAS A COMMUNITY RELATIONS DEPARTMENT WHOSE SOLE PURPOSE IS TO ASSESS AND ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITY. THE HOSPITAL PARTNERS WITH COMMUNITY GROUPS TO IDENTIFY NEEDS, STRENGTHEN EXISTING COMMUNITY PROGRAMS, AND PLAN NEWLY NEEDED SERVICES. SPECIFIC ATTENTION IS PAID TO THE NEEDS OF LOW INCOME AND VULNERABLE POPULATIONS.
PART VI, LINE 3THE HOSPITAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THE ELIGIBILITY FOR ASSISTANCE BY POSTING SIGNS THROUGHOUT THE PATIENT REGISTRATION AREAS REGARDING PATIENT PAYMENT OPTIONS. IN ADDITION, PATIENTS ARE INFORMED VIA THE HOSPITAL'S WEBSITE, INDIVIDUAL PATIENT STATEMENTS, AND FINANCIAL COUNSELORS. BELOW ARE SOME ADDITIONAL DETAILS REGARDING HOW THE HOSPITAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. SIGNAGE: SIGNS OR SIMILAR WRITTEN NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM WILL BE VISIBLE AT ALL HOSPITAL POINTS OF SERVICE TO CREATE AWARENESS OF THE FINANCIAL ASSISTANCE PROGRAM. AT A MINIMUM, SIGNAGE WILL BE POSTED IN THE EMERGENCY DEPARTMENT AND ADMISSION REGISTRATION AREA. ALL PUBLIC INFORMATION AND/OR FORMS REGARDING THE PROVISION OF FINANCIAL ASSISTANCE PROGRAM WILL USE LANGUAGES THAT ARE APPROPRIATE FOR THE SERVICE AREA IN ACCORDANCE WITH THE STATE'S LANGUAGE ASSISTANCE SERVICES ACT. HOSPITAL BILL/INVOICE: PATIENT BILLS OR STATEMENTS INCLUDE A PROMINENT STATEMENT THAT PATIENTS WHO MEET CERTAIN INCOME REQUIREMENTS MAY QUALIFY FOR FINANCIAL ASSISTANCE AND INFORMATION REGARDING HOW A PATIENT MAY APPLY FOR CONSIDERATION UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. THE FOLLOWING ARE MADE PUBLICLY AVAILABLE VIA THE HOSPITALS WEBSITE, HTTPS://WWW.INGALLS.ORG/FINANCIAL-ASSISTANCE 1. PATIENT BROCHURES 2. FINANCIAL ASSISTANCE POLICY 3. APPLICATION FORMS USED TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE. 4. PLAIN LANGUAGE SUMMARY OF FINANCIAL ASSISTANCE POLICY
PART VI, LINE 4THE HOSPITAL'S IMMEDIATE SERVICES AREA FACES A NUMBER OF DIFFERENT CHALLENGES SUCH AS: *THE HIGHEST RATE IN THE METRO AREA FOR PERSONS BELOW POVERTY LEVEL, *THE GREATEST NUMBERS OF PERSONS ON MEDICAID, *THE HIGHEST RATES OF UNINSURED INDIVIDUALS, AND *THE HIGHEST RATES OF UNEMPLOYED INDIVIDUALS. THE MEDIAN INCOME FOR A HOUSEHOLD IN THE HOSPITAL'S SERVICE AREA WAS $21,909 AND THE MEDIAN INCOME FOR A FAMILY WAS $34,150. ABOUT 30.6% OF FAMILIES AND 37.9% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 51.6% OF THOSE UNDER AGE 18 AND 18.2% OF THOSE AGE 65 OR OVER. THE INFORMATION ABOVE WAS OBTAINED FROM THE UNITED STATES CENSUS BUREAU. FACTFINDER.CENSUS.GOV. 2017 DATA
PART VI, LINE 5INGALLS MEMORIAL HOSPITAL IS LOCATED IN HARVEY, IL, A COMMUNITY WHERE THE MEDIAN HOUSEHOLD INCOME IS $22,000. OF THE APPROXIMATELY 25,000 RESIDENTS, 37.9% LIVE AT OR BELOW THE POVERTY LINE (ACCORDING TO 2012-2016 AMERICAN COMMUNITY SURVEY 5-YEAR PROFILES). INGALLS IS COMMITTED TO PROMOTING THE HEALTH OF THE LOCAL COMMUNITY AND WORKS TO ADDRESS SPECIFIC NEEDS BY LEADING AND COLLABORATING ON PROJECTS THAT WILL DIRECTLY IMPACT THE HEALTHCARE OF AREA RESIDENTS. PROMOTION OF COMMUNITY HEALTH: ONE PROJECT THAT INGALLS OFFERS IS THE HEALTHY BABY NETWORK WHICH IS A COLLABORATION WITH LOCAL SOCIAL SERVICE AGENCIES TO PROVIDE PRENATAL MEDICAL CARE AND LINKAGE WITH SOCIAL SERVICE PROGRAMS FOR MOTHERS WHO ARE AT RISK FOR PRE-TERM DELIVERIES DUE TO LACK OF PRENATAL CARE. INGALLS ALSO OFFERS ACCESS TO FREE AND /DISCOUNTED PHYSICALS, DENTAL SCREENINGS AND VACCINATIONS FOR SCHOOL AGED CHILDREN WHO ARE AT RISK OF NOT STARTING THE SCHOOL YEAR ON TIME BECAUSE OF LACK OF ACCESS TO CARE. EACH YEAR INGALLS PROVIDES CARE TO BETWEEN 500 AND 600 CHILDREN ON DAY. IN ADDITION TO THE HEALTHCARE OFFERINGS, INGALLS HANDS OUT OVER 1,000 BAGS OF SCHOOL SUPPLIES TO CHILDREN IN ATTENDANCE SO THAT SOME OF THE FINANCIAL BURDEN CAN BE LIFTED FROM FAMILIES IN NEED. EACH YEAR INGALLS HOSTS A COMMUNITY HEALTH FAIR. THIS EVENT IS ONE OF THE MOST COMPREHENSIVE HEALTH FAIRS IN CHICAGOS SOUTHLAND REGION AND OFFERS OVER 25 FREE SCREENINGS (INCLUDING TOTAL CHOLESTEROL BLOOD TESTS AND 12-LEAD EKG). ON AVERAGE APPROXIMATELY 600 ATTENDEES TAKE ADVANTAGE OF THE FREE SCREENINGS FOR THIS EVENT AND THERE ARE NO RESIDENCY RESTRICTIONS. COMMUNITY BOARD: THE INGALLS BOARD OF DIRECTORS MEMBERSHIP IS COMPRISED OF LOCAL BUSINESS AND COMMUNITY MEMBERS THAT LIVE IN THE CHICAGO AND THE SOUTH SUBURBAN REGION. IN ADDITION TO THE PRESIDENT, ONE EMPLOYED PHYSICIAN SERVES AS AN ELECTED BOARD MEMBER. ALL MEMBERS ARE IN COMPLIANCE WITH THE BOARD CONFLICT OF INTEREST POLICY AND ARE REQUIRED TO COMPLETE AN ANNUAL CERTIFICATION AND DISCLOSURE FORM. QUALIFIED PHYSICIANS: INGALLS RESPONDS TO REQUESTS FOR APPLICATIONS TO JOIN THE MEDICAL STAFF MADE BY QUALIFIED PHYSICIANS IN THE COMMUNITY. THE INGALLS PROFESSIONAL AFFAIRS COMMITTEE REVIEWS INQUIRIES AND PROVIDES APPLICATIONS TO PHYSICIANS WHO MEET THE MINIMUM QUALIFICATIONS FOR MEDICAL STAFF MEMBERSHIP IF THERE IS A NEED FOR A PARTICULAR SERVICE AND/OR A PATIENT NEED EXISTS WITHIN THE COMMUNITY. STAFF EDUCATION: THE INGALLS MEDICAL STAFF SUPPORTS IMPROVEMENTS IN PATIENT CARE AND ONGOING EDUCATION TO THE MEDICAL AND PROFESSIONAL STAFF THROUGH FUNDING OF MEDICAL EDUCATION ACTIVITIES. INGALLS IS ACCREDITED BY THE ILLINOIS STATE MEDICAL SOCIETY TO AWARD CME CATEGORY 1 CREDIT. THE CME COMMITTEE IS RESPONSIBLE FOR OVERSIGHT OF MONTHLY CME ACTIVITIES WHICH ARE SPONSORED BY THE HOSPITAL. BOTH MEDICAL AND PROFESSIONAL (NURSING, QUALITY MANAGEMENT, ETC.) STAFF ARE INVITED AND ENCOURAGED TO ATTEND THE PROGRAMS.
PART VI, LINE 6THE INGALLS MEMORIAL HOSPITAL IS PART OF THE INGALLS HEALTH SYSTEM THAT IS NOW KNOWN AS UCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC. THE INGALLS HEALTH SYSTEM WAS INCORPORATED TO SUPPORT AND ENCOURAGE HEALTH AND HUMAN SERVICES THROUGH THE FOLLOWING AFFILIATES: *THE INGALLS MEMORIAL HOSPITAL *INGALLS HEALTH VENTURES *MEDCENTRIX, INC. *INGALLS DEVELOPMENT FOUNDATION *INGALLS HEALTH COUNCIL *INGALLS HOME CARE *INGALLS PROVIDER GROUP *INGALLS CASUALTY INSURANCE *INGALLS SAME DAY SURGERY, LTD. *INGALLS CARE NETWORK *PRIMARY HEALTHCARE ASSOCIATES, SC
PART VI, LINE 7THE INGALLS MEMORIAL HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF ILLINOIS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient28RecipientCnt
Cash Grant$52,152CashGrantAmt
Valuation Method UsedCASHValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART III, LINE 1FormAndLineReferenceDesc
ExplanationSCHOLARSHIPS ARE PAID DIRECTLY TO THE EDUCATIONAL INSTITUTIONS IN ORDER TO ENSURE THE FUNDS ARE USED FOR THEIR INTENDED PURPOSE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (true)SupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
MARK F KOZLOFF MD
BOARD MEMBER$0$549,318$0$61,565$0$23,098$0$6,390$0$34,843$0$675,214$0$0
KATHLEEN A MIKOS
CHIEF OF NURSING TIL 11/17/17$484,775$0$0$0$23,051$0$8,100$0$20,468$0$536,394$0$0$0
KURT E JOHNSON
PRESIDENT & CEO TIL 6/30/18$1,771,967$0$0$0$18,000$0$8,100$0$22,329$0$1,820,396$0$0$0
MICHAEL R HICKS
COO TIL 5/4/18$573,682$0$0$0$20,691$0$8,100$0$22,329$0$624,802$0$0$0
LINDA CONWAY
ASS'T SECRETARY/GENERAL COUNS$251,525$0$0$0$2,031$0$7,607$0$0$0$261,163$0$0$0
MICHAEL A LAWRENCE
CHIEF FINANCIAL OFFICER$214,432$0$0$0$3,861$0$0$0$21,174$0$239,467$0$0$0
ANN MCCOLGAN
ASS'T TREASURER/VP TREASURY$0$239,709$0$72,403$0$131,186$0$29,244$0$32,429$0$504,971$0$114,198
MICHAEL DEVORE
CIO TILL 2/2/18$238,286$0$0$0$10,900$0$7,411$0$31,898$0$288,495$0$0$0
PAUL DONOHUE
VP PHILANTHROPY AND COMMUNITY$250,562$0$0$0$2,468$0$6,193$0$26,213$0$285,436$0$0$0
SCOTT STRAUSSER
VP BUSINESS DEVELOPMENT$519,167$0$0$0$23,035$0$8,100$0$31,899$0$582,201$0$0$0
LAWRENCE KLONOWSKI
MANAGER MEDICAL PHYSICS$215,086$0$0$0$2,234$0$6,191$0$22,329$0$245,840$0$0$0
MARY JO CRANDALL
VP LEAN TRANSFORMATION$216,304$0$0$0$1,015$0$6,520$0$0$0$223,839$0$0$0
HEIDI RUHE
ASSOC VP BUSINESS DEVELOPMENT$202,852$0$0$0$508$0$4,520$0$31,898$0$239,778$0$0$0
LEAH MONTOYA
VP CARE MANAGEMENT$168,097$0$0$0$254$0$5,051$0$29,445$0$202,847$0$0$0
LYNN PHILIPSON
EXEC DIRECTOR INTEGRATED CARE$104,978$136,339$0$0$1,674$0$7,290$0$21,174$0$135,116$136,339$0$0
GARY GASBARRA
INTERIM CFO TIL 6/30/17$0$355,193$0$178,150$0$350,578$0$41,011$0$21,735$0$946,667$0$216,878
DIANE JACOBY
ASS'T SECRETARY/VP TIL 2/3/17$84,826$0$0$0$1,044,016$0$2,226$0$5,316$0$1,136,384$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 4ASOME OF THE INDIVIDUALS LISTED ON THE FORM 990 HAVE A SEVERANCE PROVISION IN CONJUNCTION WITH THEIR EMPLOYMENT WITH THE HOSPITAL. DURING CALENDAR YEAR 2017, THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT: DIANE JACOBY $1,042,743
SCHEDULE J, PART I, LINE 4BCERTAIN INDIVIDUALS LISTED IN SCHEDULE J, PART II PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO WHICH UCMC MAKES ANNUAL CONTRIBUTIONS. THESE CONTRIBUTIONS ARE AT RISK AND DO NOT BECOME VESTED AND PAYABLE UNLESS AND UNTIL THE INDIVIDUAL SATISFIES A SUBSTANTIAL FUTURE SERVICE REQUIREMENT. THE FOLLOWING INDIVIDUALS HAD CONTRIBUTIONS MADE TO THE PLAN DURING CALENDAR YEAR 2017: ANN MCCOLGAN $10,660 GARY GASBARRA $20,761 THE FOLLOWING INDIVIDUALS HAD DISTRIBUTIONS FROM THE PLAN DURING CALENDAR YEAR 2017: ANN MCCOLGAN $114,198 GARY GASBARRA $216,878
SCHEDULE J, PART IITAXABLE INCOME REPORTED IN COLUMN (B) MAY INCLUDE PAYMENTS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN MOST CASES, THESE PAYMENTS WERE EARNED OVER MANY YEARS OF EMPLOYMENT AND THE AMOUNTS HAD PREVIOUSLY BEEN SUBJECT TO VESTING RULES. SERP PAYMENT AMOUNTS EARNED IN PRIOR YEARS WERE PREVIOUSLY REPORTED ON THE FORM 990 AS DEFERRED COMPENSATION AND ARE REPORTED IN THIS 2017 FORM 990 ON SCHEDULE J, PART II, COLUMN (F). AN INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD ANNUALLY REVIEWS THESE BENEFITS IN COMPARISON TO MARKET DATA AND HAS CONCLUDED THAT THESE BENEFITS AND ALL OTHER FORMS OF COMPENSATION PROVIDED TO THESE INDIVIDUALS ARE REASONABLE.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
ILLINOIS FINANCE AUTHORITY
A86109196745203HPE62013-02-06$64,815,040REFUNDING/1994 ISSUANCE & CAPITALfalsefalsefalse
ILLINOIS FINANCE AUTHORITY
B8610919672017-12-29$41,180,000REFUNDING 2004 BONDSfalsefalsefalse

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdRetiredRetiredAmtBond DefeasedBondDefeasedAmtTotal ProceedsTotalProceedsAmtIn Reserve FundInReserveFundAmtCapitalized InterestCapitalizedInterestAmtRefunding EscrowRefundingEscrowAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCredit EnhancementCreditEnhancementAmtWorking Capital ExpendituresWorkingCapitalExpendituresAmtCapital ExpendituresCapitalExpendituresAmtOther Spent ProceedsOtherSpentProceedsAmtUnspentUnspentAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintInd
A$945,000$0$64,815,040$0$0$0$1,183,106$0$0$30,160,000$33,471,934$02015Yes (true)falseYes (true)Yes (true)
B$0$0$41,180,000$0$0$0$349,422$0$0$0$40,830,578$02017Yes (true)falseYes (true)Yes (true)

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndEngage Bond Counsel ContractsEngageBondCounselContractsIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndRemedial Action TakenRemedialActionTakenIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
AfalsefalseYes (true)Yes (true)false0.020600.02060falsefalsefalseYes (true)
BfalseYes (true)Yes (true)Yes (true)false0.003000.00300falsefalsefalseYes (true)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndBusiness Name Line1GICProviderName/BusinessNameLine1TxtGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
0
AfalsefalsefalseYes (true)falsefalsefalse0falseYes (true)
0
BfalseYes (true)falsefalseYes (true)falsefalse0falseYes (true)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (true)
BYes (true)

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
REBATE COMPUTATIONPART IV, LINE 2C, COLUMN A THE REBATE CALCULATION WAS COMPLETED 02/06/2018.
BOND POLICYWRITTEN TAX-EXEMPT BOND PROCEDURES WERE ADOPTED ON FEBRUARY 12, 2018.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (18 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 7ATHE INGALLS MEMORIAL HOSPITAL'S UNRELATED BUSINESS TAXABLE INCOME FOR FISCAL YEAR ENDED JUNE 30, 2018 INCLUDED INCOME CREATED UNDER IRC 512(A)(7) RELATED TO QUALIFIED TRANSPORTATION FRINGE BENEFITS. THE UNRELATED BUSINESS REVENUE REPORTED ON FORM 990, PART VIII, STATEMENT OF REVENUE DOES NOT INCLUDE THE EXPENSES THAT CREATE UNRELATED BUSINESS TAXABLE INCOME UNDER IRC 512(A)(7). FORM 990, PART VI, LINE 1A THE BOARD OF DIRECTORS SHALL APPOINT ANNUALLY FROM ITS MEMBERSHIP AN EXECUTIVE COMMITTEE OF NOT LESS THAN FIVE (5) NOR MORE THAN NINE (9) MEMBERS, OF WHICH THREE (3) MEMBERS SHALL BE THE CHAIRMAN, THE VICE CHAIRMAN, AND THE SECRETARY/TREASURER OF THE HOSPITAL. THE EXECUTIVE COMMITTEE SHALL HAVE AND EXERCISE ALL OF THE POWERS OF THE BOARD OF DIRECTORS NOT PROHIBITED BY STATUTE OR SECTION 1 OF THE HOSPITAL'S BYLAWS BETWEEN MEETINGS THEREOF.
FORM 990, PART VI, LINE 6PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE VOTING MEMBER OF THE ORGANIZATION IS UCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC., A RELATED TAX-EXEMPT ORGANIZATION. AS THE ORGANIZATION'S SOLE CORPORATE MEMBER, IT HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE. FORM 990, PART VI, LINE 7A DIRECTORS, OTHER THAN THE DIRECTORS EX OFFICIO, SHALL BE ELECTED ANNUALLY BY UCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC., OR AT SUCH OTHER TIMES AS MAY BE DETERMINED BY THE SOLE MEMBER OF THE CORPORATION.
FORM 990, PART VI, LINE 7BUCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC. SHALL RETAIN THE RIGHT TO REMOVE ANY DIRECTOR, OTHER THAN DIRECTORS EX OFFICIO, WITH OR WITHOUT CAUSE, AT ANY TIME. UCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC. MUST APPROVE ANY MODIFICATION OR AMENDMENT TO ANY MISSION STATEMENT, STATEMENT OF GOALS OR VALUES, THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; THE SALE, LEASE, EXCHANGE OR DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF THE ASSETS OF THE CORPORATION; AND THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION.
FORM 990, PART VI, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM WITH INFORMATION PROVIDED BY MANAGEMENT. THE FULL FORM 990, INCLUDING SUPPLEMENTAL SCHEDULES, WAS PRESENTED BY THE CHIEF FINANCIAL OFFICER TO THE FINANCE COMMITTEE AT A COMMITTEE MEETING. THE FULL BOARD HAS GRANTED TO THE FINANCE COMMITTEE AUTHORITY TO APPROVE THE FORM 990. THE FULL BOARD WILL RECEIVE A REPORT FROM THE FINANCE COMMITTEE DESCRIBING THE FINANCE COMMITTEES REVIEW PERFORMED. PRIOR TO FILING WITH THE IRS, THE FORM 990 WILL BE AVAILABLE AT THE ORGANIZATIONS BOARD MEETING FOR EACH MEMBERS REVIEW.
FORM 990, PART VI, LINE 12CPURSUANT TO THE ORGANIZATIONS CONFLICT OF INTEREST POLICY, ALL OFFICERS, DIRECTORS, BOARD MEMBERS, AND KEY EMPLOYEES MUST AVOID SITUATIONS IN WHICH THEIR PERSONAL INTERESTS MAY CONFLICT, OR APPEAR TO CONFLICT, WITH THE INTEREST OF INGALLS, AND INGALLS REVIEWS ITS OWN RELATIONSHIPS WITH OTHER CARE PROVIDERS, EDUCATIONAL INSTITUTIONS, AND PAYERS TO DETERMINE IF POTENTIAL CONFLICTS EXISTS. BOARD MEMBERS AND EMPLOYEES SHALL HAVE THE CONTINUING AFFIRMATIVE DUTY TO REPORT TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (CEO) OF INGALLS ANY PERSONAL OWNERSHIP OF INTEREST OR OTHER RELATIONSHIP THAT MIGHT AFFECT THEIR ABILITY TO EXERCISE IMPARTIAL, ETHICAL BUSINESS JUDGMENTS IN THE AREA OF THEIR RESPONSIBILITIES. PER THE ORGANIZATIONS CONFLICT OF INTEREST POLICY, BOARD MEMBERS AND EMPLOYEES AT MANAGEMENT LEVEL WILL BE REQUIRED TO COMPLETE A CERTIFICATION AND DISCLOSURE FORM, ON A SCHEDULE DETERMINED BY THE CORPORATE COMPLIANCE OFFICER. COMPLETION OF THIS FORM IS A REQUIREMENT FOR ALL BOARD MEMBERS AND MANAGERIAL EMPLOYEES, AND MAY BE REQUIRED OF NON-MANAGEMENT EMPLOYEES AS DETERMINED BY THE PRESIDENT AND CEO AND CORPORATE COMPLIANCE OFFICER. EMPLOYEES ALSO HAVE A DUTY TO REPORT CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST OF WHICH THEY MAY BE AWARE OF INVOLVING OTHER EMPLOYEES. EACH SITUATION REPORTED SHALL BE REVIEWED BY THE PRESIDENT AND CEO, AND INGALLS CORPORATE COMPLIANCE OFFICER, AND A DETERMINATION SHALL BE MADE AS TO WHETHER A CONFLICT OF INTEREST EXISTS OF MAY ARISE FROM SUCH SITUATION. THE DECISION OF THE PRESIDENT AND CEO AND CORPORATE COMPLIANCE OFFICER REGARDING WHETHER A CONFLICT EXISTS SHALL BE FINAL. PERSONS WITH A CONFLICT ARE PROHIBITED FROM PARTICIPATING IN THE GOVERNING BODYS RESOLUTION OF SUCH CONFLICT. THE ORGANIZATION FURTHER PROMOTES KNOWLEDGE AND UNDERSTANDING OF THE CONFLICT OF INTEREST POLICY IN THE EMPLOYEE HANDBOOK. EACH EMPLOYEE IS REQUIRED TO SIGN AN ACKNOWLEDGEMENT OF THE HANDBOOK UPON EMPLOYMENT.
FORM 990, PART VI, LINE 15AINGALLS MEMORIAL HOSPITAL IS RESPONSIBLE FOR DETERMINING AND ADMINISTERING COMPENSATION FOR ALL OFFICERS OF EACH RESPECTIVE ENTITY WITHIN THE UCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC. CORPORATE STRUCTURE. BELOW IS THE PROCESS USED TO ESTABLISH COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL. IN SETTING THE TOP MANAGEMENT OFFICIALS COMPENSATION, THE EXECUTIVE COMMITTEE RELIES ON RECENT COMPARABILITY STUDIES THAT PROVIDE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS IN COMPARABLE ORGANIZATIONS TO SUPPORT ITS DECISION-MAKING PROCESS. IN ADDITION, THE ORGANIZATION RECEIVED AN INDEPENDENT COMPENSATION REVIEW BY SULLIVAN COTTER IN FY2017. THE COMMITTEE ADEQUATELY DOCUMENTS ITS COMPENSATION DETERMINATIONS, DELIBERATIONS, AND APPROVAL OF THE TOP MANAGEMENT OFFICIALS COMPENSATION IN THE MEETING MINUTES. THE PROCESS FOR REVIEWING AND DETERMINE COMPENSATION FOR THE CEO WAS LAST UNDERTAKEN IN FY2017.
FORM 990, PART VI, LINE 15BAN OUTSIDE COMPENSATION CONSULTANT IS USED TO RENDER A REASONABLE OPINION AS TO WHAT PERCENTAGE OF INCREASE AN OFFICER OR KEY EMPLOYEE SHOULD RECEIVE BY PERFORMING A MARKET COMPARISON FOR ALL OFFICERS AND KEY EMPLOYEES. THE PROCESS TO DETERMINE AN INCREASE IN COMPENSATION OF SALARY INCREASES ARE APPROVED ANNUALLY BY THE PRESIDENT AND EXECUTIVE COMMITTEE ONCE RECEIVED BY THE OUTSIDE CONSULTANT. DIRECTORS AND MANAGERS RECEIVE AN INCREASE IN COMPENSATION BASED ON WHETHER OR NOT PERFORMANCE GOALS HAVE BEEN REACHED BEFORE A FISCAL YEAR STARTS. PERFORMANCE GOALS ARE PUT TOGETHER BY THE DIRECTOR OR MANAGER AND SUBMITTED TO THE VICE PRESIDENT FOR APPROVAL. APPROVED GOALS ARE THEN REVIEWED BY ALL OTHER EXECUTIVES. ONCE APPROVED BY ALL, THESE ARE THE GOALS FOR THE YEAR AFTER THE YEAR IS OVER. THE PERFORMANCE GOALS ARE REVIEWED BY THE VICE PRESIDENT AND DIRECTOR OR MANAGER. MARKET ADJUSTMENTS ARE SET BY THE IMMEDIATE VICE PRESIDENT AND SENT TO ALL EXECUTIVES FOR THEIR APPROVAL.
FORM 990, PART VI, LINE 19ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9FAIR VALUE OF DERIVATIVE INSTRUMENTS $2,356,436 CHANGE IN INTEREST OF FOUNDATION $318,979 TOTAL $2,675,415
FORM 990 PART IX LINE 11GDESCRIPTION:PATIENT CARE SERVICES TOTAL FEES:14618329
FORM 990 PART IX LINE 11GDESCRIPTION:PATIENT FINANCIAL SERVICES TOTAL FEES:4821684
FORM 990 PART IX LINE 11GDESCRIPTION:ENVIRONMENTAL/HOSPITALITY SVCS TOTAL FEES:3082792
FORM 990 PART IX LINE 11GDESCRIPTION:FAMILY CARE CENTER-CALUMET TOTAL FEES:2685222
FORM 990 PART IX LINE 11GDESCRIPTION:FOOD SERVICES TOTAL FEES:2573244
FORM 990 PART IX LINE 11GDESCRIPTION:HEALTH MANAGEMENT CENTER TOTAL FEES:1759971
FORM 990 PART IX LINE 11GDESCRIPTION:FAMILY CARE CENTER-FLOSSMOOR TOTAL FEES:1419419
FORM 990 PART IX LINE 11GDESCRIPTION:LABORATORY SERVICES TOTAL FEES:1215017
FORM 990 PART IX LINE 11GDESCRIPTION:OTHER TOTAL FEES:19406704

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (37 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACdLegal Domicile Foreign CountryLegalDomicileForeignCountryCdAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCd
ARCH DEVELOPMENT CORPORATION
5555 S WOODLAWN AVENUECHICAGOIL60637363485244TECH TRANSFERIL501(C)(3)LINE 12A, IUNIV CHICAGOfalse
ASIAN HEALTH COALITION
180 W WASHINGTON ST SUITE 1000CHICAGOIL60602311607193HLTH ACCESSIL501(C)(3)LINE 10UNIV CHICAGOfalse
CHAPIN HALL CENTER FOR CHILDREN
1313 E 60TH STREETCHICAGOIL60637362167012POL RES CTRIL501(C)(3)LINE 7falseN/A
CHICAGO TUMOR INSTITUTE
5801 S ELLIS AVENUECHICAGOIL60637237136019SUPP RESEARCHIL501(C)(3)LINE 12A, IUNIV CHICAGOfalse
COURT THEATRE FUND
5535 S ELLIS AVENUECHICAGOIL60637363203660SUPP THE ARTSIL501(C)(3)LINE 12A, IUNIV CHICAGOfalse
FERMI RESEARCH ALLIANCE LLC
PO BOX 500BATAVIAIL60510571239010MANAGE LABIL501(C)(3)LINE 7NAfalse
HYMEN MILGROM SUPPORTING ORGANIZATION
33 N LASALLE ST STE 2131CHICAGOIL60602466789522SUPP EDU RESVA501(C)(3)12D, IIIfalseN/A
INGALLS DEVELOPMENT FOUNDATION
ONE INGALLS DRIVEHARVEYIL60426363189150SUPPORTIL501(C)(3)7UCHHDfalse
INGALLS HEALTH VENTURES
ONE INGALLS DRIVEHARVEYIL60426363239703AMBULATORYIL501(C)(3)LINE 12A, IUCHHDfalse
INGALLS HOME CARE
ONE INGALLS DRIVEHARVEYIL60426363367939HEALTHCAREIL501(C)(3)10IMHYes (true)
LAKE PARK ASSOCIATES
5801 S ELLIS AVENUECHICAGOIL60637366111317PROP HOLDGIL501(C)(2)UNIV CHICAGOfalse
NATIONAL OPINION RESEARCH CENTER (NORC)
55 E MONROE AVENUECHICAGOIL60603362167808SO SCI SRVYSIL501(C)(3)LINE 7NAfalse
PHOENIX OVERLAY FUND LTD
401 N MICHIGAN AVE C/O INVSTCHICAGOIL60611INVESTINGUNIV CHICAGOfalseCJ
PRIMARY HEALTHCARE ASSOCIATES SC
71 W 156TH STREETHARVEYIL60426364132865HEALTHCAREIL501(C)(3)10UCHHDfalse
SOUTHEAST CHICAGO COMMISSION
1511 E 53RD STREETCHICAGOIL60615362226282COMM SRVSIL501(C)(3)LINE 7UNIV CHICAGOfalse
THE JOHN CRERAR FOUNDATION
5730 S ELLIS AVENUECHICAGOIL60637363155157SUPP LIBRARYIL501(C)(3)12D,IIIUNIV CHICAGOfalse
THE MARINE BIOLOGICAL LABORATORY
7 MBL STREETWOODS HOLEMA02543042104690RES & EDUMA501(C)(3)LINE 7UNIV CHICAGOfalse
THE QUADRANGLE CLUB
5801 S ELLIS AVENUECHICAGOIL60637361655190SOCIAL CLUBIL501(C)(7)UNIV CHICAGOfalse
THE UNIV OF CHICAGO FDN IN HONG KONG LTD
FUNDRAISINGUNIV CHICAGOfalseHKRM100 FAR E CTR C/O WM FAN COHONG KONGCH
THE UNIVERSITY OF CHICAGO CLOISTERS CLUB
1212 E 59TH STREETCHICAGOIL60637SOCIAL CLUBILUNIV CHICAGOfalse
UCHICAGO RESEARCH BANGLADESH LTD
RESEARCHUCH RS INTLfalseBGHSE 388 ROAD 24 NEW DOHDHAKABG
UCHICAGO RESEARCH INTERNATIONAL LIMITED
5801 S ELLIS AVENUECHICAGOIL60637262741573RESEARCHIL501(C)(3)LINE 12A, IUNIV CHICAGOfalse
UCM COMMUNITY HEALTH & HOSPITAL DIVISION
ONE INGALLS DRIVEHARVEYIL60426363181170MANAGEMENTIL501(C)(3)LINE 12A, IUCMCfalse
UCMC TITLE HOLDING CORPORATION
8201 SOUTH CASS AVENUEDARIENIL60561812126789TITLE HOLDIL501(C)(3)12, IIIUCMCfalse
UCMC TITLE HOLDING CORPORATION II
5841 S MARYLAND AVE MC 1086CHICAGOIL60637821736040TITLE HOLDIL501(C)(3)12, IIIUCMCfalse
UNIV OF CHI BOOTH SCH OF BUS (SINGAPORE)
EDUCATIONUNIV CHICAGOfalseSN101 PENANG ROAD 238466SINGAPORESN
UNIV OF CHI BOOTH SCH OF BUS (UK)
EDUCATIONUNIV CHICAGOfalseUKWOOLGATE EXCHANGE 25 BASINGHALLONDONUK
UNIV OF CHICAGO CANCER RESEARCH FD
5801 S ELLIS AVENUECHICAGOIL60637366056201SUPP RESEARCHIL501(C)(3)LINE 12a, IUNIV CHICAGOfalse
UNIV OF CHICAGO CENTER IN PARIS (FRANCE)
EDUCATIONUNIV CHICAGOfalseFR6 RUE THOMAS MANN 75013PARISFR
UNIV OF CHICAGO CHARTER SCHOOL CORP
5801 S ELLIS AVENUECHICAGOIL60637364225812EDUCATIONIL501(C)(3)LINE 2UNIV CHICAGOfalse
UNIV OF CHICAGO PROPERTY HOLDING CO
5801 S ELLIS AVENUECHICAGOIL60637366108743PROP HLDGIL501(C)(2)UNIV CHICAGOfalse
UNIV OF CHICAGO RETIREE MEDICAL TRUST
5801 S ELLIS AVENUECHICAGOIL60637363999692MEDICAL TRUSTIL501(C)(3)LINE 12A, IUNIV CHICAGOfalse
UNIV OF CHICAGO SELF INSURANCE TRUST
5801 S ELLIS AVENUECHICAGOIL60637363020034MALPRAC TRIL501(C)(3)LINE 12A, IUNIV CHICAGOfalse
UNIVERSITY OF CHICAGO
5801 S ELLIS AVENUECHICAGOIL60637362177139EDUCATIONIL501(C)(3)LINE 2NAfalse
UNIVERSITY OF CHICAGO MEDICAL CENTER
5841 S MARYLAND AVE MC 1086CHICAGOIL60637363488183HOSPITALIL501(C)(3)3UNIV CHICAGOfalse
UNIVERSITY OF CHICAGO TRUST (INDIA)
FUNDRAISINGUNIV CHICAGOfalseINGB10-12 CLAIRMONT APTS RST HSEBANGALOREIN
CHICAGO HOME FOR THE INCURABLES
5801 S ELLIS AVENUECHICAGOIL60637362169138SUPP RESEARCHIL501(C)(3)LINE 12A, IUNIV CHICAGOfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1INGALLS SAME DAY SURGERY CTRBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line16701 W 159TH STAddressLine1Txt
CityTINLEY PARKCityNm
State AbbreviationILStateAbbreviationCd
ZIP60477ZIPCd
FieldValueIRS element (for citing)
EIN363368549EIN
Primary ActivitiesSURGERY CENTERPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (11 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndEINEINLegal Domicile Foreign CountryLegalDomicileForeignCountryCdShare Of Total IncomeShareOfTotalIncomeAmtShare Of EOY AssetsShareOfEOYAssetsAmtOwnershipOwnershipPctAddress Line1ForeignAddress/AddressLine1TxtCityForeignAddress/CityNmCountryForeignAddress/CountryCd
CHARITABLE LEAD TRUST (1)
5801 S ELLIS AVENUECHICAGOIL60637CHAR LEAD TRUSTILUNIV OF CHICAGOTRUSTfalse
CHARITABLE REMAINDER TRUSTS (80)
5801 S ELLIS AVENUECHICAGOIL60637CHAR RMDR TRUSTILUNIV OF CHICAGOTRUSTfalse
INGALLS CASUALTY INSURANCE LTD
ONE INGALLS DRIVEHARVEYIL60426LIAB INSURANCEUCHHDC CORPfalse980485714CJ
INGALLS HEALTH COUNCIL
ONE INGALLS DRIVEHARVEYIL60426PURCHASING GROUPILUCHHDC CORPfalse273226539
INGALLS PROVIDER GROUP
ONE INGALLS DRIVEHARVEYIL60426INSURANCE SERVICEILIMHC CORPYes (true)363485578$14,868,357$2,195,9361.00000
MEDCENTRIX INC
ONE INGALLS DRIVEHARVEYIL60426BILLING & MGMTILUCHHDC CORPfalse363374228
POOLED INCOME FUND (1)
5801 S ELLIS AVENUECHICAGOIL60637POOLED IN FUNDILUNIV OF CHICAGOC CORPfalse474221241
UCHICAGO (BEIJING) CONSULTING CO LTD
CONSULTINGUNIV OF CHICAGOfalseCHUNIT 1-10 CULTURE PL OF REMMIN UNIBEIJINGCH
UCHICAGO CENTER IN INDIA PRIVATE LIMITED
CONSULTINGUNIV OF CHICAGOC CORPfalseINUNIT 5-10 GRD FL DLF CAPITAL POINTNEW DEHLIIN
UCM CARE NETWORK MEDICAL GROUP INC
5841 S MARYLAND AVENUECHICAGOIL60637HEALTH SERVICEILUCMCC CORPfalse474221241
SC CURRICULUM INC
70 WEST MADISON STCHICAGOIL60602SCNC CURRICULUMILUNIV OF CHICAGOC CORPfalse
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsYes (true)ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (true)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (true)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (true)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1INGALLS HOME CAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction Typea(iv)TransactionTypeTxt
Involved$84,000InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt