2019-05-15T07:46:19-05:00 2018-06-30 KPMG LLP 200 East Randolph Street Ste 5500 Chicago IL 60601 990 2017-07-01 362170866 THE INGALLS MEMORIAL HOSPITAL % RICHARD SILVERIA INGA 7083332300 ONE INGALLS DRIVE HARVEY IL 60426 RICHARD SILVERIA EVP AND CFO 7083332300 2019-05-14 true Tara D'Agostino P01245482 3126651000 2019-05-10 167.68.102.5 36104320191355000001 2019-05-15 P AEE1DCD475618EC3E15152F39DEFE7DD5CD6EA23 9C37FB02EE77A6FF00EC66693955615721E3AD8A 2017 2020-01-14 16:20:31Z MICHAEL A LAWRENCE ONE INGALLS DRIVE HARVEY IL 60426 312142798 false X WWW.INGALLS.ORG X 1922 IL INGALLS MEMORIAL HOSPITAL IS A NONPROFIT ACUTE CARE HOSPITAL ORGANIZED FOR THE PURPOSE OF PROVIDING PATIENT CARE, EDUCATION, AND RESEARCH. 19 17 2702 117 1328236 0 812146 882936 220499037 284840492 27510684 19510070 983900 6142900 249805767 311376398 80300 52152 0 0 87230531 119580594 0 0 0 134907818 205098420 222218649 324731166 27587118 -13354768 460853057 470216480 178732078 204830332 282120979 265386148 X INGALLS 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. false false 149919977 52152 29328639 INGALLS 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. 25028622 129842300 INGALLS 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. 21792499 14399535 THE 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. 65399362 117104040 262140460 true true false true false false false false false false true false false true true true false true false false false false false false false false true true false true true true false false false false false false false false false false false false false false false true true true false false true 402 0 true 2702 true true true false false false false false false false false false X 19 17 false false false false true true true true true false false true true true true true true true true false IL X RICHARD SILVERIA 7083332300 ONE INGALLS DRIVE HARVEY IL 60426 SAMUEL J CUTRARA JR BOARD MEMBER 1.0 1.0 X 0 0 0 HEATHER DAVIS BOARD MEMBER 1.0 1.0 X 0 0 0 ROSEMARY DOMBROWSKI BOARD MEMBER 1.0 0.0 X 0 0 0 EUGENE M FEINGOLD BOARD MEMBER 1.0 3.0 X 0 0 0 JEFFREY GLASSROTH MD BOARD MEMBER 1.0 0.0 X 0 0 0 DENNIS J IRVIN VICE CHAIRMAN 1.0 0.0 X 0 0 0 CARL JOHNSON II MD BOARD MEMBER 1.0 2.0 X 0 0 0 HENRY K JOHNSON BOARD MEMBER 1.0 1.0 X 0 0 0 TIMOTHY D JOHNSON BOARD MEMBER 1.0 1.0 X 0 0 0 DOROTHY JONES MD BOARD MEMBER 1.0 0.0 X 0 0 0 MICHAEL KAMRADT BOARD MEMBER 1.0 1.0 X 0 0 0 RICHARD M KING BOARD MEMBER 1.0 1.0 X 0 0 0 NEAL E KITCHELL SECRETARY/TREASURER 1.0 2.0 X X 0 0 0 MARK F KOZLOFF MD BOARD MEMBER 1.0 42.0 X 0 633981 41233 KATHLEEN A MIKOS CHIEF OF NURSING TIL 11/17/17 40.0 0.0 X 507826 0 28568 DAVID H ORTH MD CHAIRMAN 1.0 2.0 X 0 0 0 CRESSA PERISH MD BOARD MEMBER 1.0 0.0 X 0 0 0 KEVIN M PURCELL BOARD MEMBER 1.0 1.0 X 0 0 0 NATHANIEL K SUTTON BOARD MEMBER 1.0 1.0 X 0 0 0 KURT E JOHNSON PRESIDENT & CEO TIL 6/30/18 40.0 4.0 X X 1789967 0 30429 MICHAEL R HICKS COO TIL 5/4/18 40.0 0.0 X X 594373 0 30429 LINDA CONWAY ASS'T SECRETARY/GENERAL COUNS 40.0 0.0 X 253556 0 7607 MICHAEL A LAWRENCE CHIEF FINANCIAL OFFICER 40.0 0.0 X 218293 0 21174 ANN MCCOLGAN ASS'T TREASURER/VP TREASURY 1.0 40.0 X 0 443298 61673 MICHAEL DEVORE CIO TILL 2/2/18 40.0 0.0 X 249186 0 39309 PAUL DONOHUE VP PHILANTHROPY AND COMMUNITY 40.0 0.0 X 253030 0 32406 SCOTT STRAUSSER VP BUSINESS DEVELOPMENT 40.0 0.0 X 542202 0 39999 LAWRENCE KLONOWSKI MANAGER MEDICAL PHYSICS 40.0 0.0 X 217320 0 28520 MARY JO CRANDALL VP LEAN TRANSFORMATION 40.0 0.0 X 217319 0 6520 HEIDI RUHE ASSOC VP BUSINESS DEVELOPMENT 40.0 0.0 X 203360 0 36418 LEAH MONTOYA VP CARE MANAGEMENT 40.0 0.0 X 168351 0 34496 LYNN PHILIPSON EXEC DIRECTOR INTEGRATED CARE 20.0 20.0 X 106652 136339 28464 GARY GASBARRA INTERIM CFO TIL 6/30/17 0.0 40.0 X 0 883921 62746 DIANE JACOBY ASS'T SECRETARY/VP TIL 2/3/17 40.0 0.0 X 1128842 0 7542 6450277 2097539 537533 121 true true false ARAMARK CORPORATION 25271 NETWORK PLACE CHICAGO IL 60673 Food, EVS, Transport 19957772 CERNER HEALTH SERVICES C/O US BANK PO BOX 959167 ST LOUIS MO 63195 IT SUPPORT 5667447 SYNERGY BEHAVIORAL HEALTHCARE 1566 W ALGONQUIN ROAD 3149 HOFFMAN ESTATES IL 60192 Behavioral Health 5281985 REED CONSTRUCTION 600 W JACKSON BLVD STE 500 CHICAGO IL 606615625 CONSTRUCTION 3429485 RevMD PARTNERS 1111 PASQUINELLI DR WESTMONT IL 60559 Patient Accounts 2756161 82 X 882936 882936 NET PATIENT REVENUE 900099 279588341 279588341 RENTAL INCOME 900099 2358427 2358427 LAB SERVICES 900099 1325532 1325532 CLIENT SERVICE REVENUE 621500 414150 414150 MEDIC TRAINING 900099 131101 131101 1022941 1022941 284840492 2443330 2704 2440626 0 0 1075278 766400 308878 0 308878 308878 16324243 742497 16324243 742497 17066740 17066740 0 0 0 0 0 0 0 0 0 EXPENSE REIMBURSEMENT & MGMT FEES 900099 548156 548156 GIFT SHOP 900099 200785 200785 PARKING INCOME 900099 67742 67742 5017339 5017339 5834022 311376398 289348982 1328236 19816244 X 0 52152 52152 0 0 6450277 6450277 0 94296060 84818806 9477254 0 2468481 2246318 222163 8950872 8145294 805578 7414904 6747563 667341 9500566 9500566 352994 352994 253379 253379 37707 37707 0 958912 958912 51582382 44185316 7397066 1205938 1205938 1620124 1458112 162012 15401357 15401357 0 5146807 3345425 1801382 309336 261068 48268 0 0 4886667 4007067 879600 0 14435107 12702894 1732213 27575314 25369289 2206025 MEDICAL SUPPLIES 47309004 47309004 PUBLIC ASSESSMENT 16658494 16658494 REPAIRS & MAINTENANCE 3626668 3264001 362667 LAUNDRY SERVICES 1027138 1027138 3210526 542519 2668007 324731166 262140460 62590706 0 9265 9265 526691 502976 0 0 40008191 41813279 0 0 0 0 0 0 5737792 5997840 2236035 2133545 212802358 27024295 177550172 185778063 212639088 189034698 3869834 251804 0 0 0 0 18275989 44695010 460853057 470216480 48201157 81790056 0 0 2593929 3187744 109610689 104689455 0 0 0 0 0 0 0 0 18326303 15163077 178732078 204830332 X 277978937 260925127 4142042 4461021 0 0 282120979 265386148 460853057 470216480 X -13354768 -6055478 2675415 X false true true false X false false false false false false false false true 37707 37707 false PART II-B, LINE 1I THE 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. 6464807 6464807 153763822 9754999 144008823 49359541 16721201 32638340 3214188 548095 2666093 185778063 RESTRICTED INVESTMENTS - FDN 4461021 OTHER LONG TERM ASSETS 1196474 DUE FROM AFFILIATES 38001405 DUE FROM ARAMARK 1018409 VHA EQUITY 17701 44695010 0 LEASE OBLIGATIONS 1365363 SWAP PAYABLE 7655496 OTHER PAYABLES 6142218 15163077 X 307484844 -6055478 2356436 -3699042 311183886 958912 -766400 192512 311376398 324538654 766400 766400 323772254 958912 958912 324731166 SCHEDULE D, PART X, LINE 2 THE 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 2D CHANGE IN FAIR VALUE OF DERIVATIVE INSTRUMENTS $2,356,436 SCHEDULE D, PART XI, LINE 4B RECLASS OF RENTAL EXPENSE ($766,400) SCHEDULE D, PART XII, LINE 2D RECLASS OF RENTAL EXPENSE $766,400 true true true X true X 600. true true true false true true 4913672 4913672 0.01510 86013281 40710291 45302990 0.13950 90926953 40710291 50216662 0.15460 2002690 594364 1408326 0.00430 2002690 594364 1408326 0.00430 92929643 41304655 51624988 0.15890 false 9543242 0 109020466 133222018 -24201552 X true true 1 1 INGALLS MEMORIAL HOSPITAL ONE INGALLS DRIVE HARVEY IL 60426 WWW.INGALLS.ORG 0001099 X X X INGALLS MEMORIAL HOSPITAL 1 false false true X X X X X X X X X 15 true false true true X INGALLS.HEALTHFORECAST.NET X true 15 true INGALLS.HEALTHFORECAST.NET false true X 200. 600. X X X X X true true X X X true X (SEE STATEMENT) X (SEE STATEMENT) X (SEE STATEMENT) X X X X X X true X false X X X true X false false PART V, SECTION B, LINE 4 THE 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 6B THE 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 9 THE 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 13B A 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 16A https://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# 7 INGALLS FAMILY CARE CENTER 1600 TORRENCE AVENUE CALUMET CITY IL 60409 URGENT AID, PRIMARY CARE, AND SPECIALIST SERVICES INGALLS CARE CENTER 4742 CAL SAG ROAD CRESTWOOD IL 60445 QUICK CARE CENTER AND OCCUPATIONAL HEALTH INGALLS FAMILY CARE CENTER 6701 WEST 159TH STREET TINLEY PARK IL 60477 URGENT AID, PRIMARY CARE, AND SPECIALIST SERVICES INGALLS FAMILY CARE CENTER 19550 GOVERNORS HIGHWAY FLOSSMOOR IL 60422 URGENT AID AND SPECIALIST SERVICES INGALLS WELLNESS CENTER 2920 WELLNESS CENTER HOMEWOOD IL 60430 COMPLEMENTARY MEDICINE AND COMMUNITY HEALTH PROGRAMS THE VILLA AT SOUTH HOLLAND 16300 WAUSAU AVENUE SOUTH HOLLAND IL 60473 HEALTHCARE AND REHABILITATION CENTER INGALLS CARE CENTER 16246 PRINCE DRIVE SOUTH HOLLAND IL 60473 INDUSTRIAL, MEDICAL REHABILITATION AND PHYSICIAN OFFICES PART I, LINE 3C AUTOMATIC 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 2 THE 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 4 FOOTNOTE 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 8 THE 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 9B INGALLS 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 2 IN 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 3 THE 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 4 THE 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 5 INGALLS 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 6 THE 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 7 THE INGALLS MEMORIAL HOSPITAL FILES A COMMUNITY BENEFIT REPORT WITH THE STATE OF ILLINOIS. true SCHOLARSHIPS 28 52152 CASH N/A PART III, LINE 1 SCHOLARSHIPS ARE PAID DIRECTLY TO THE EDUCATIONAL INSTITUTIONS IN ORDER TO ENSURE THE FUNDS ARE USED FOR THEIR INTENDED PURPOSE. X X X X true true false false false false false false false MARK F KOZLOFF MD BOARD MEMBER 0 549318 0 61565 0 23098 0 6390 0 34843 0 675214 0 0 KATHLEEN A MIKOS CHIEF OF NURSING TIL 11/17/17 484775 0 0 0 23051 0 8100 0 20468 0 536394 0 0 0 KURT E JOHNSON PRESIDENT & CEO TIL 6/30/18 1771967 0 0 0 18000 0 8100 0 22329 0 1820396 0 0 0 MICHAEL R HICKS COO TIL 5/4/18 573682 0 0 0 20691 0 8100 0 22329 0 624802 0 0 0 LINDA CONWAY ASS'T SECRETARY/GENERAL COUNS 251525 0 0 0 2031 0 7607 0 0 0 261163 0 0 0 MICHAEL A LAWRENCE CHIEF FINANCIAL OFFICER 214432 0 0 0 3861 0 0 0 21174 0 239467 0 0 0 ANN MCCOLGAN ASS'T TREASURER/VP TREASURY 0 239709 0 72403 0 131186 0 29244 0 32429 0 504971 0 114198 MICHAEL DEVORE CIO TILL 2/2/18 238286 0 0 0 10900 0 7411 0 31898 0 288495 0 0 0 PAUL DONOHUE VP PHILANTHROPY AND COMMUNITY 250562 0 0 0 2468 0 6193 0 26213 0 285436 0 0 0 SCOTT STRAUSSER VP BUSINESS DEVELOPMENT 519167 0 0 0 23035 0 8100 0 31899 0 582201 0 0 0 LAWRENCE KLONOWSKI MANAGER MEDICAL PHYSICS 215086 0 0 0 2234 0 6191 0 22329 0 245840 0 0 0 MARY JO CRANDALL VP LEAN TRANSFORMATION 216304 0 0 0 1015 0 6520 0 0 0 223839 0 0 0 HEIDI RUHE ASSOC VP BUSINESS DEVELOPMENT 202852 0 0 0 508 0 4520 0 31898 0 239778 0 0 0 LEAH MONTOYA VP CARE MANAGEMENT 168097 0 0 0 254 0 5051 0 29445 0 202847 0 0 0 LYNN PHILIPSON EXEC DIRECTOR INTEGRATED CARE 104978 136339 0 0 1674 0 7290 0 21174 0 135116 136339 0 0 GARY GASBARRA INTERIM CFO TIL 6/30/17 0 355193 0 178150 0 350578 0 41011 0 21735 0 946667 0 216878 DIANE JACOBY ASS'T SECRETARY/VP TIL 2/3/17 84826 0 0 0 1044016 0 2226 0 5316 0 1136384 0 0 0 SCHEDULE J, PART I, LINE 4A SOME 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 4B CERTAIN 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 II TAXABLE 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. A ILLINOIS FINANCE AUTHORITY 861091967 45203HPE6 2013-02-06 64815040 REFUNDING/1994 ISSUANCE & CAPITAL false false false B ILLINOIS FINANCE AUTHORITY 861091967 2017-12-29 41180000 REFUNDING 2004 BONDS false false false A 945000 0 64815040 0 0 0 1183106 0 0 30160000 33471934 0 2015 true false true true B 0 0 41180000 0 0 0 349422 0 0 0 40830578 0 2017 true false true true A false false true true false 0.02060 0.02060 false false false true B false true true true false 0.00300 0.00300 false false false true A false false false true false false 0 false 0 false true B false true false false true false 0 false 0 false true A true B true REBATE COMPUTATION PART IV, LINE 2C, COLUMN A THE REBATE CALCULATION WAS COMPLETED 02/06/2018. BOND POLICY WRITTEN TAX-EXEMPT BOND PROCEDURES WERE ADOPTED ON FEBRUARY 12, 2018. FORM 990, PART I, LINE 7A THE 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 6 PURSUANT 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 7B UCM 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 11B THE 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 12C PURSUANT 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 15A INGALLS 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 15B AN 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 19 ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9 FAIR VALUE OF DERIVATIVE INSTRUMENTS $2,356,436 CHANGE IN INTEREST OF FOUNDATION $318,979 TOTAL $2,675,415 FORM 990 PART IX LINE 11G DESCRIPTION:PATIENT CARE SERVICES TOTAL FEES:14618329 FORM 990 PART IX LINE 11G DESCRIPTION:PATIENT FINANCIAL SERVICES TOTAL FEES:4821684 FORM 990 PART IX LINE 11G DESCRIPTION:ENVIRONMENTAL/HOSPITALITY SVCS TOTAL FEES:3082792 FORM 990 PART IX LINE 11G DESCRIPTION:FAMILY CARE CENTER-CALUMET TOTAL FEES:2685222 FORM 990 PART IX LINE 11G DESCRIPTION:FOOD SERVICES TOTAL FEES:2573244 FORM 990 PART IX LINE 11G DESCRIPTION:HEALTH MANAGEMENT CENTER TOTAL FEES:1759971 FORM 990 PART IX LINE 11G DESCRIPTION:FAMILY CARE CENTER-FLOSSMOOR TOTAL FEES:1419419 FORM 990 PART IX LINE 11G DESCRIPTION:LABORATORY SERVICES TOTAL FEES:1215017 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER TOTAL FEES:19406704 ARCH DEVELOPMENT CORPORATION 5555 S WOODLAWN AVENUE CHICAGO IL 60637 363485244 TECH TRANSFER IL 501(C)(3) LINE 12A, I UNIV CHICAGO false ASIAN HEALTH COALITION 180 W WASHINGTON ST SUITE 1000 CHICAGO IL 60602 311607193 HLTH ACCESS IL 501(C)(3) LINE 10 UNIV CHICAGO false CHAPIN HALL CENTER FOR CHILDREN 1313 E 60TH STREET CHICAGO IL 60637 362167012 POL RES CTR IL 501(C)(3) LINE 7 N/A false CHICAGO TUMOR INSTITUTE 5801 S ELLIS AVENUE CHICAGO IL 60637 237136019 SUPP RESEARCH IL 501(C)(3) LINE 12A, I UNIV CHICAGO false COURT THEATRE FUND 5535 S ELLIS AVENUE CHICAGO IL 60637 363203660 SUPP THE ARTS IL 501(C)(3) LINE 12A, I UNIV CHICAGO false FERMI RESEARCH ALLIANCE LLC PO BOX 500 BATAVIA IL 60510 571239010 MANAGE LAB IL 501(C)(3) LINE 7 NA false HYMEN MILGROM SUPPORTING ORGANIZATION 33 N LASALLE ST STE 2131 CHICAGO IL 60602 466789522 SUPP EDU RES VA 501(C)(3) 12D, III N/A false INGALLS DEVELOPMENT FOUNDATION ONE INGALLS DRIVE HARVEY IL 60426 363189150 SUPPORT IL 501(C)(3) 7 UCHHD false INGALLS HEALTH VENTURES ONE INGALLS DRIVE HARVEY IL 60426 363239703 AMBULATORY IL 501(C)(3) LINE 12A, I UCHHD false INGALLS HOME CARE ONE INGALLS DRIVE HARVEY IL 60426 363367939 HEALTHCARE IL 501(C)(3) 10 IMH true LAKE PARK ASSOCIATES 5801 S ELLIS AVENUE CHICAGO IL 60637 366111317 PROP HOLDG IL 501(C)(2) UNIV CHICAGO false NATIONAL OPINION RESEARCH CENTER (NORC) 55 E MONROE AVENUE CHICAGO IL 60603 362167808 SO SCI SRVYS IL 501(C)(3) LINE 7 NA false PHOENIX OVERLAY FUND LTD 401 N MICHIGAN AVE C/O INVST CHICAGO IL 60611 INVESTING CJ UNIV CHICAGO false PRIMARY HEALTHCARE ASSOCIATES SC 71 W 156TH STREET HARVEY IL 60426 364132865 HEALTHCARE IL 501(C)(3) 10 UCHHD false SOUTHEAST CHICAGO COMMISSION 1511 E 53RD STREET CHICAGO IL 60615 362226282 COMM SRVS IL 501(C)(3) LINE 7 UNIV CHICAGO false THE JOHN CRERAR FOUNDATION 5730 S ELLIS AVENUE CHICAGO IL 60637 363155157 SUPP LIBRARY IL 501(C)(3) 12D,III UNIV CHICAGO false THE MARINE BIOLOGICAL LABORATORY 7 MBL STREET WOODS HOLE MA 02543 042104690 RES & EDU MA 501(C)(3) LINE 7 UNIV CHICAGO false THE QUADRANGLE CLUB 5801 S ELLIS AVENUE CHICAGO IL 60637 361655190 SOCIAL CLUB IL 501(C)(7) UNIV CHICAGO false THE UNIV OF CHICAGO FDN IN HONG KONG LTD RM100 FAR E CTR C/O WM FAN CO HONG KONG CH FUNDRAISING HK UNIV CHICAGO false THE UNIVERSITY OF CHICAGO CLOISTERS CLUB 1212 E 59TH STREET CHICAGO IL 60637 SOCIAL CLUB IL UNIV CHICAGO false UCHICAGO RESEARCH BANGLADESH LTD HSE 388 ROAD 24 NEW DOH DHAKA BG RESEARCH BG UCH RS INTL false UCHICAGO RESEARCH INTERNATIONAL LIMITED 5801 S ELLIS AVENUE CHICAGO IL 60637 262741573 RESEARCH IL 501(C)(3) LINE 12A, I UNIV CHICAGO false UCM COMMUNITY HEALTH & HOSPITAL DIVISION ONE INGALLS DRIVE HARVEY IL 60426 363181170 MANAGEMENT IL 501(C)(3) LINE 12A, I UCMC false UCMC TITLE HOLDING CORPORATION 8201 SOUTH CASS AVENUE DARIEN IL 60561 812126789 TITLE HOLD IL 501(C)(3) 12, III UCMC false UCMC TITLE HOLDING CORPORATION II 5841 S MARYLAND AVE MC 1086 CHICAGO IL 60637 821736040 TITLE HOLD IL 501(C)(3) 12, III UCMC false UNIV OF CHI BOOTH SCH OF BUS (SINGAPORE) 101 PENANG ROAD 238466 SINGAPORE SN EDUCATION SN UNIV CHICAGO false UNIV OF CHI BOOTH SCH OF BUS (UK) WOOLGATE EXCHANGE 25 BASINGHAL LONDON UK EDUCATION UK UNIV CHICAGO false UNIV OF CHICAGO CANCER RESEARCH FD 5801 S ELLIS AVENUE CHICAGO IL 60637 366056201 SUPP RESEARCH IL 501(C)(3) LINE 12a, I UNIV CHICAGO false UNIV OF CHICAGO CENTER IN PARIS (FRANCE) 6 RUE THOMAS MANN 75013 PARIS FR EDUCATION FR UNIV CHICAGO false UNIV OF CHICAGO CHARTER SCHOOL CORP 5801 S ELLIS AVENUE CHICAGO IL 60637 364225812 EDUCATION IL 501(C)(3) LINE 2 UNIV CHICAGO false UNIV OF CHICAGO PROPERTY HOLDING CO 5801 S ELLIS AVENUE CHICAGO IL 60637 366108743 PROP HLDG IL 501(C)(2) UNIV CHICAGO false UNIV OF CHICAGO RETIREE MEDICAL TRUST 5801 S ELLIS AVENUE CHICAGO IL 60637 363999692 MEDICAL TRUST IL 501(C)(3) LINE 12A, I UNIV CHICAGO false UNIV OF CHICAGO SELF INSURANCE TRUST 5801 S ELLIS AVENUE CHICAGO IL 60637 363020034 MALPRAC TR IL 501(C)(3) LINE 12A, I UNIV CHICAGO false UNIVERSITY OF CHICAGO 5801 S ELLIS AVENUE CHICAGO IL 60637 362177139 EDUCATION IL 501(C)(3) LINE 2 NA false UNIVERSITY OF CHICAGO MEDICAL CENTER 5841 S MARYLAND AVE MC 1086 CHICAGO IL 60637 363488183 HOSPITAL IL 501(C)(3) 3 UNIV CHICAGO false UNIVERSITY OF CHICAGO TRUST (INDIA) GB10-12 CLAIRMONT APTS RST HSE BANGALORE IN FUNDRAISING IN UNIV CHICAGO false CHICAGO HOME FOR THE INCURABLES 5801 S ELLIS AVENUE CHICAGO IL 60637 362169138 SUPP RESEARCH IL 501(C)(3) LINE 12A, I UNIV CHICAGO false INGALLS SAME DAY SURGERY CTR 6701 W 159TH ST TINLEY PARK IL 60477 363368549 SURGERY CENTER IL NA CHARITABLE LEAD TRUST (1) 5801 S ELLIS AVENUE CHICAGO IL 60637 CHAR LEAD TRUST IL UNIV OF CHICAGO TRUST false CHARITABLE REMAINDER TRUSTS (80) 5801 S ELLIS AVENUE CHICAGO IL 60637 CHAR RMDR TRUST IL UNIV OF CHICAGO TRUST false INGALLS CASUALTY INSURANCE LTD ONE INGALLS DRIVE HARVEY IL 60426 980485714 LIAB INSURANCE CJ UCHHD C CORP false INGALLS HEALTH COUNCIL ONE INGALLS DRIVE HARVEY IL 60426 273226539 PURCHASING GROUP IL UCHHD C CORP false INGALLS PROVIDER GROUP ONE INGALLS DRIVE HARVEY IL 60426 363485578 INSURANCE SERVICE IL IMH C CORP 14868357 2195936 1.00000 true MEDCENTRIX INC ONE INGALLS DRIVE HARVEY IL 60426 363374228 BILLING & MGMT IL UCHHD C CORP false POOLED INCOME FUND (1) 5801 S ELLIS AVENUE CHICAGO IL 60637 474221241 POOLED IN FUND IL UNIV OF CHICAGO C CORP false UCHICAGO (BEIJING) CONSULTING CO LTD UNIT 1-10 CULTURE PL OF REMMIN UNI BEIJING CH CONSULTING CH UNIV OF CHICAGO false UCHICAGO CENTER IN INDIA PRIVATE LIMITED UNIT 5-10 GRD FL DLF CAPITAL POINT NEW DEHLI IN CONSULTING IN UNIV OF CHICAGO C CORP false UCM CARE NETWORK MEDICAL GROUP INC 5841 S MARYLAND AVENUE CHICAGO IL 60637 474221241 HEALTH SERVICE IL UCMC C CORP false SC CURRICULUM INC 70 WEST MADISON ST CHICAGO IL 60602 SCNC CURRICULUM IL UNIV OF CHICAGO C CORP false true false true false false false false false false false true true true true true true true true INGALLS HOME CARE a(iv) 84000 FMV