JACKSON PARK HOSPITAL FOUNDATION: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- JACKSON PARK HOSPITAL FOUNDATION (EIN 36-2448028)
- Tax period
- 2016-04-01 to 2017-03-31
- Filed
- 2018-02-15
- IRS object ID
- 201840469349302084
- Schema version
- 2016v3.0
- 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
- Form 990
- Schedule A
- Schedule D
- Schedule G
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-02-15T16:04:47-07:00 | ReturnTs |
| Tax Period End | 2017-03-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362448028 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JACKSON PARK HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JACK | BusinessNameControlTxt |
| Phone | 7739477989 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | William Dorsey MD | PersonNm |
| Person Title | Chairman/CEO | PersonTitleTxt |
| Phone | 7739477920 | PhoneNum |
| Signature | 2018-02-15 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 207.181.195.34 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | William Dorsey MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $90,425,092 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | jacksonparkhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1960 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | The mission of the physicians, staff and Board of Directors of the organization is to provide compassionate and high quality healthcare services to meet the needs of the patients and communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 927 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $347,219 | PYContributionsGrantsAmt |
| CY Contributions Grants | $147,048 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $60,711,660 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $58,571,802 | CYProgramServiceRevenueAmt |
| PY Investment Income | $31,014 | PYInvestmentIncomeAmt |
| CY Investment Income | $27,666 | CYInvestmentIncomeAmt |
| PY Other Revenue | $26,197,426 | PYOtherRevenueAmt |
| CY Other Revenue | $31,678,576 | CYOtherRevenueAmt |
| PY Total Revenue | $87,287,319 | PYTotalRevenueAmt |
| CY Total Revenue | $90,425,092 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $41,819,113 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $43,940,811 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $38,882,008 | PYOtherExpensesAmt |
| CY Other Expenses | $38,455,043 | CYOtherExpensesAmt |
| PY Total Expenses | $80,701,121 | PYTotalExpensesAmt |
| CY Total Expenses | $82,395,854 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,586,198 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,029,238 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $137,907,122 | TotalAssetsBOYAmt |
| Total Assets EOY | $146,583,721 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $24,909,325 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $25,530,175 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $112,997,797 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $121,053,546 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of the physicians, staff and Board of Directors of the organization is to provide compassionate and high quality healthcare services to meet the needs of the patients and communities we serve | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,278,866 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $16,937,131 | RevenueAmt |
| Desc | Jackson Park Hospital Foundation provides inpatient and outpatient medical care to Chicago's south side communities regardless of the patient's ability to pay. Inpatient services include medical surgical, ICU, obstetrics, labor and delivery and hospice. in 2016 the hospital serverd 5,759 acute care admissions which amounted to 20,757 patient days | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,711,275 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,094,573 | RevenueAmt |
| Desc | Jackson Park Hospital Foundation provides inpatient and outpatient behavioral medicine services to the greater Chicagoland area. Jackson Park Hospital is one of the few hospitals in Chicago that continues to provide behavioral medicine services to its community. In 2016 Jackson Park Hospital served 2,509 inpatient behavioral medicine patients which amounted to 10,637 patient days. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $6,612,191 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,954,983 | RevenueAmt |
| Desc | Jackson Park Hospital provides basic emergency room services to its community 24 hours a day, seven days a week regardless of the patient's ability to pay. In 2016, the hospital served 28,498 emergency patients. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $50,286,070 | ExpenseAmt |
| Revenue | $36,243,380 | RevenueAmt |
| Desc | Other outpatient revenue and support services | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $50,286,070 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $36,243,380 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $75,888,402 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 66 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 927 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 2 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Nelson Vasquez | PersonNm |
| Phone | 7739477989 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|---|
| William Dorsey MD | ||||||||||
| Chairman/CEO | 40 | 0 | Yes (X) | Yes (X) | $684,735 | $0 | $7,087 | |||
| Harshad Mehta | ||||||||||
| Director | 40 | Yes (X) | $135,380 | $0 | $5,050 | |||||
| Dr Arol Augsburger | ||||||||||
| Director | 2 | Yes (X) | $0 | $0 | $0 | |||||
| James Clark | ||||||||||
| Director | 2 | Yes (X) | $0 | $0 | $0 | |||||
| Haroon Olomi MD | ||||||||||
| Director | 4 | 36 | Yes (X) | $87,756 | $205,686 | $14,341 | ||||
| Bangalore R Murthy MD | ||||||||||
| Director | 40 | Yes (X) | $165,507 | $129,334 | $18,679 | |||||
| Lakshmi Dodda MD | ||||||||||
| Director | 2 | 0 | Yes (X) | $225,040 | $99,618 | $14,342 | ||||
| James Nunn MD | ||||||||||
| Director | 2 | 40 | Yes (X) | $67,679 | $350,236 | $18,679 | ||||
| Sameera Qureshi MD | ||||||||||
| Director | 2 | 32 | Yes (X) | $19,652 | $141,914 | $18,679 | ||||
| Siddiq Hasan MD | ||||||||||
| Director | 2 | 40 | Yes (X) | $157,694 | $299,675 | $18,679 | ||||
| Merritt Hasbrouck | ||||||||||
| President | 40 | Yes (X) | $803,019 | $0 | $201 | |||||
| G Randall Smith | ||||||||||
| Executive Vice President | 40 | Yes (X) | $582,216 | $0 | $18,679 | |||||
| Nelson Vasquez | ||||||||||
| Vice President Finance | 40 | $231,721 | $0 | $18,679 | Yes (X) | |||||
| Barry Mandell | ||||||||||
| Vice President Special Projects | 40 | $194,110 | $0 | $18,679 | Yes (X) | |||||
| M Patrica Simon | ||||||||||
| Senior Vice President Quality & Compliance | 40 | $207,577 | $0 | $13,985 | Yes (X) | |||||
| Thodur Ranganathan MD | ||||||||||
| Physician | 40 | $415,940 | $0 | $18,042 | Yes (X) | |||||
| Matthew Malters MD | ||||||||||
| Physician | 4 | 40 | $29,336 | $618,759 | $0 | Yes (X) | ||||
| Karen Carranza MD | ||||||||||
| Physician | 0 | 40 | $204,002 | $407,496 | $0 | Yes (X) | Yes (X) | |||
| Surrenthia R Parker MD | ||||||||||
| Physician | 0 | 40 | $268,077 | $417,095 | $0 | Yes (X) | ||||
| Pratap Kumar MD | ||||||||||
| Physician | 0 | 40 | $189,014 | $296,646 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,668,455 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,966,459 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $203,801 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 69 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| Northern Illinois Clinical Laboratory | ||||||
| 306 E Era Drive | Northbrook | IL | 60062 | Clinical Laboratory Services | $3,419,186 | |
| White Cap Nursing Inc | ||||||
| 2600 Michigan Ave | Chicago | IL | 60616 | Temporary Nurse Staffing | $2,167,560 | 60649 |
| Rush Nursing Services | ||||||
| 7531 Stony Island | Chicago | IL | 60649 | Temporary Nursing Services | $972,913 | |
| Emergency Room Care Providers | ||||||
| 6111 N River Road | Rosemont | IL | 60018 | Emergency Room Physician Services | $1,513,060 | Suite 800 |
| McKesson | ||||||
| 6111 N River Road | Rosemont | IL | 60018 | Technology Services | $1,272,299 | Suite 110 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 66 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $147,048 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $0 | GovernmentGrantsAmt |
| All Other Contributions | $0 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $147,048 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Patient Service Revenue | Desc |
| Business | 622110 | BusinessCd |
| Total Revenue Column | $58,571,802 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $58,571,802 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $58,571,802 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,666 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,666 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $168,752 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $168,752 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $168,752 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $168,752 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $147,048 | ContriRptFundraisingEventAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Provider Tax Proceeds | 622110 | $27,797,973 | $27,797,973 | $0 | $0 |
| Miscellaneous Income | 622110 | $3,711,851 | $3,711,851 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $31,509,824 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $90,425,092 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $90,278,044 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,014,953 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $4,014,953 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,657,445 | TotalAmt |
| Program Services | $32,657,445 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $348,635 | TotalAmt |
| Program Services | $348,635 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,302,089 | TotalAmt |
| Program Services | $4,302,089 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,617,689 | TotalAmt |
| Program Services | $2,617,689 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,395 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $162,395 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $553,203 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $553,203 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379,666 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $379,666 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,397,235 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,397,235 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,254,643 | TotalAmt |
| Program Services | $1,254,643 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $404,888 | TotalAmt |
| Program Services | $404,888 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,357,678 | TotalAmt |
| Program Services | $2,357,678 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $619,443 | TotalAmt |
| Program Services | $619,443 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,325,892 | TotalAmt |
| Program Services | $31,325,892 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,395,854 | TotalAmt |
| Program Services | $75,888,402 | ProgramServicesAmt |
| Management And General | $6,507,452 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,517,879 | BOYAmt |
| EOY | $7,579,150 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,157,956 | BOYAmt |
| EOY | $112,705,949 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $12,275 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $935,993 | BOYAmt |
| EOY | $975,581 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,477 | BOYAmt |
| EOY | $287,075 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $89,061,844 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $64,525,228 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,276,384 | BOYAmt |
| EOY | $24,536,616 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $637,433 | BOYAmt |
| EOY | $487,075 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,907,122 | BOYAmt |
| EOY | $146,583,721 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,524,180 | BOYAmt |
| EOY | $9,763,203 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,559,111 | BOYAmt |
| EOY | $10,043,778 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,826,034 | BOYAmt |
| EOY | $5,723,194 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,909,325 | BOYAmt |
| EOY | $25,530,175 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,997,797 | BOYAmt |
| EOY | $121,053,546 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,997,797 | BOYAmt |
| EOY | $121,053,546 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $137,907,122 | BOYAmt |
| EOY | $146,583,721 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $8,029,238 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $26,511 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,482,024 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Book Value | $2,482,024 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $53,933,738 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,130,952 | DepreciationAmt |
| Book Value | $16,802,786 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $32,011,765 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,008,923 | DepreciationAmt |
| Book Value | $5,002,842 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $634,317 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $385,353 | DepreciationAmt |
| Book Value | $248,964 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $24,536,616 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Liability | $677,991 |
| professional liability | $5,045,203 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,723,194 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $90,425,092 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $0 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Recoveries Prior Year Grants | $0 | RecoveriesPriorYearGrantsAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $90,425,092 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $0 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $90,425,092 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $82,395,854 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $0 | DonatedServicesUseFcltsAmt |
| Prior Year Adjustments | $0 | PriorYearAdjustmentsAmt |
| Losses Reported | $0 | LossesReportedAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $82,395,854 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $0 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $82,395,854 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part X, Line 2 | Other liabilities includes Pension and Professional Liabilities |
| Schedule D, Part XI, Line 2d | Investment Income |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Annual Gala | Event1Nm |
| Gross Receipts Event1 | $125,133 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $0 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $125,133 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $0 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $0 | NonCashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $0 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $0 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $0 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $0 | OtherDirectExpensesEvent1Amt |
| Event2 | Annual Golf Outing | Event2Nm |
| Gross Receipts Event2 | $21,915 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $0 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $21,915 | GrossRevenueEvent2Amt |
| Cash Prizes Event2 | $0 | CashPrizesEvent2Amt |
| Non Cash Prizes Event2 | $0 | NonCashPrizesEvent2Amt |
| Rent Facility Costs Event2 | $0 | RentFacilityCostsEvent2Amt |
| Food And Beverage Event2 | $0 | FoodAndBeverageEvent2Amt |
| Entertainment Event2 | $0 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $0 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $147,048 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $0 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $147,048 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $0 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $0 | NonCashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $0 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $0 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $0 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $0 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $0 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $147,048 | NetIncomeSummaryAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | 0 | FinancialAssistancePolicyInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,602,539 | TotalCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $2,602,539 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,033,495 | TotalCommunityBenefitExpnsAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,539,054 | TotalCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $13,572,549 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $16,175,088 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $6,341,049 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $3,170,525 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $17,369,745 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $17,369,745 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $0 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jackson Park Hospital Foundation | BusinessNameLine1Txt |
| Business Name Line2 | Chicago | BusinessNameLine2Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | jacksonparkhospital.org | WebsiteAddressTxt |
| State License | 0001115 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jackson Park Hospital Foundation | BusinessNameLine1Txt |
| Business Name Line2 | Chicago | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | Yes (1) | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 15 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | Yes (1) | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | Yes (1) | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | jacksonparkhospital.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 17 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | jacksonparkhospital.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Residency Criteria | Yes (X) | ResidencyCriteriaInd |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Other Method | Yes (X) | OtherMethodInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | jacksonparkhospital.org | FAPAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | jacksomparkhospital.org | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| Communtity Notified FAP | Yes (X) | CommuntityNotifiedFAPInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5-Jackson Park Hospital Foundation | Jackson Park Hospital Foundation begins outreach and assessment of its community health by evaluating which health conditions and diseases are prevalent among its inpatients and outpatients. The hospital prepared it community health needs their bill including discounts and charity care. The hospital has contracted with a third party that assist any patient through the application process of assessment using Professional Research Consultant's Inc. data on behalf of the Metropolitan Chicago Health Care Council which included focus groups with-in our primary service area. Together, they confirm the need for education and other interventions for diabetes, asthma Medicaid, Medicare and the affordable care act. This same company will also assist a patient and or family through the hospital's charity and specialty clinics. and behavioral medicine. The hospital has responded to these needs through the development of several community education programs |
| Schedule H, Part V, Section B, Line 6a-Jackson Park Hospital Foundation | Other hospital participants in the Community Health Needs Assessment include Amita Health Behavioral Health Hospital Alexian Brothers Medical Center Alexian Brothers Women & Children's Hospital St. Alexius Medical Center Memorial Hospital Edward Elmhurst Healthcare Edward Hospital & Health Services Elmhurst Memorial Hospital Franciscan Alliance LaGrange Memorial Hospital The University of Chicago Medicine Council (MCHC) contracted with Professional Research Consultants, Inc. to conduct focus groups and collect data in our primary zip codes. strengthening current relationships and building new alliances with agencies and organizations that have the same goals and dedications To improve and maintain health within our communities. |
| Schedule H, Part V, Section B, Line 6b-Jackson Park Hospital Foundation | The hospital participated with the Metropolitan Health Care Council in preparation of the Community Health Needs Assessment with over twenty hospital participating in the project. |
| Schedule H, Part V, Section B, Line 11-Jackson Park Hospital Foundation | In response to the Community Health Needs Assessment data for our primary service area, the hospital has added a diabetes, weight loss and smoking cessation program to our out patient clinic |
| Schedule H, Part V, Section B, Line 15e-Jackson Park Hospital Foundation | The hospital has contracted with FirstSource to assist patients and their families in the application for financial assistance and charity care |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7 | The hospital used the actual cost of services provided based on the total cost to charge ratio derived from the hospitals Medicare cost Report |
| Schedule H, Part III, Section A, Line 4 | The footnote concerning bad debts is on page 11 Schedule H, Part III, Section A, Line 4 The organization estimate of bad debt expenses included in community benefits is based on the Medicare cost report ratio of cost to charges |
| Schedule H, Part III, Section B, Line 8 | The Medicare cost to charge ratio was used |
| Schedule H, Part III, Section C, Line 9b | The hospital's collection policies clearly state how to treat patients that cannot pay their portion of their bill including discounts and charity care |
| Schedule H, Part VI, Line 2 | Jackson Park Hospital Foundation begins outreach and assessment of its community health by evaluating which health conditions and diseases are prevalent among its inpatients and outpatients The hospital prepared its community health needs assessment using Professional Research Consultant's Inc. data on behalf of the Metropolitan Chicago Health Care Council which included focus groups with-in our primary service area Together they confirm the need for education and other interventions for diabetes, asthma and behavioral medicine The hospital has responded to these needs through the development of several community education programs and speciality clinics |
| Schedule H, Part VI, Line 3 | The hospital has contracted with a third party named First Source to assist any patient through the financial application process to qualify for Medicaid, Medicare and the affordable care act. This same company will also assist a patient and or family through the hospital's charity application process |
| Schedule H, Part VI, Line 4 | Jackson Park Hospital's primary service area is 60649, 60620, 60617 and 60628 Our primary care service area for behavioral patients is much broader and encompass the City of Chicago The average income in the hospital's primary service area is approximately 53% of the State of Illinois average |
| Schedule H, Part VI, Line 5 | In addition to various education programs with-in the hospital, the hospital has begun regular education and outreach programs at local grocery stores and banks In January 2018, the hospital began a outreach program for senior patients This senior program will manage the primary healthcare needs and match the patient with a physician |
| Schedule H, Part VI, Line 7 | Jackson Park Hospital Foundation prepares and submits an annual Community Benefits Report to the Attorney General of the State of Illinois This report is also made available to the general public upon request |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (20 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| William Dorsey MD | ||||||||||||||
| Chairman/CEO | $684,735 | $0 | $0 | $0 | $12,000 | $0 | $0 | $0 | $7,087 | $0 | $703,822 | $0 | $0 | $0 |
| Merritt Hasbrouck | ||||||||||||||
| President | $803,019 | $0 | $0 | $0 | $12,000 | $0 | $0 | $0 | $201 | $0 | $815,220 | $0 | $0 | $0 |
| G Randall Smith | ||||||||||||||
| Executive Vice President | $582,216 | $0 | $0 | $0 | $12,000 | $0 | $0 | $0 | $18,679 | $0 | $612,895 | $0 | $0 | $0 |
| Nelson Vasquez | ||||||||||||||
| Vice President Finance | $231,721 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $18,679 | $0 | $250,400 | $0 | $0 | $0 |
| Barry Mandell | ||||||||||||||
| Vice President Special Projects | $194,110 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $18,679 | $0 | $212,789 | $0 | $0 | $0 |
| Harshad Mehta | ||||||||||||||
| Director | $136,724 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $13,985 | $0 | $150,709 | $0 | $0 | |
| M Patrica Simon | ||||||||||||||
| Senior Vice President Quality & Compliance | $207,577 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $13,985 | $0 | $221,562 | $0 | $199,244 | $0 |
| Dr Arol Augsburger | ||||||||||||||
| Director | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| James Clark | ||||||||||||||
| Director | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 |
| Haroon Olomi MD | ||||||||||||||
| Director | $87,756 | $205,686 | $0 | $0 | $0 | $0 | $0 | $0 | $14,342 | $0 | $102,098 | $205,686 | $0 | |
| Thodur Ranganathan MD | ||||||||||||||
| Physician | $267,709 | $148,230 | $0 | $0 | $0 | $0 | $0 | $0 | $18,042 | $0 | $285,751 | $148,230 | $0 | $0 |
| Bangalore R Murthy MD | ||||||||||||||
| Director | $165,507 | $0 | $0 | $0 | $0 | $129,334 | $0 | $0 | $18,679 | $0 | $184,186 | $129,334 | $0 | $137,718 |
| Lakshmi Dodda MD | ||||||||||||||
| Director | $189,904 | $0 | $0 | $0 | $0 | $35,136 | $0 | $0 | $14,342 | $0 | $204,246 | $35,136 | $0 | $0 |
| James Nunn MD | ||||||||||||||
| Director | $67,679 | $0 | $0 | $0 | $0 | $350,236 | $0 | $0 | $18,679 | $0 | $86,358 | $350,236 | $0 | $0 |
| Sameera Qureshi MD | ||||||||||||||
| Director | $19,652 | $141,914 | $0 | $0 | $0 | $0 | $0 | $0 | $18,679 | $0 | $38,331 | $141,914 | $0 | $0 |
| Siddiq Hasan MD | ||||||||||||||
| Director | $120,520 | $0 | $0 | $0 | $0 | $299,675 | $0 | $0 | $18,679 | $0 | $139,199 | $299,675 | $0 | $0 |
| Matthew Malters MD | ||||||||||||||
| Physician | $29,336 | $618,759 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $29,336 | $618,759 | $0 | $0 |
| Karen Carranza MD | ||||||||||||||
| Physician | $0 | $204,002 | $0 | $0 | $0 | $407,496 | $0 | $0 | $0 | $0 | $0 | $611,498 | $0 | $0 |
| Surrenthia R Parker MD | ||||||||||||||
| Physician | $59,530 | $0 | $0 | $0 | $208,547 | $417,095 | $0 | $0 | $0 | $0 | $268,077 | $417,095 | $0 | $0 |
| Pratap Kumar MD | ||||||||||||||
| Physician | $0 | $0 | $0 | $0 | $189,014 | $296,646 | $0 | $0 | $0 | $0 | $189,014 | $296,646 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Bangalore Murthy MD | |||
| Director | $378,375 | Medical Education | 0 |
| Bangalore Murthy MD | |||
| Director | $726,325 | Temporary Nurse Staffing | 0 |
| Bangalore Murthy MD | |||
| Director | $117,602 | Medical Education Billing | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, Line 11b | The Management and the Chairman of the Audit Committee review the return prior to its release |
| Form 990, Part VI, Section B, Line 12c | All officers, Directors or Trustees and key employees are required to complete a conflict of interest disclosure for annually and submit it to the Compliance Officer. This process was completed in February 2017 |
| Form 990, Part VI, Section B, Line 15 | Jackson Park Hospital Foundation has a compensation committee. The Chairman of the Board reviews the compensation of senior management and key employees on an annual basis |
| Form 990, Part VI, Section C, Line 19 | Jackson Park Hospital Foundation makes its community health needs assessment available on its own website and by appointment with its Vice President Finance The conflict of interest policy, Community Benefit Report, form 990 and financial statements are available to the public by appointment with its Vice President of Finance or its Senior Vice President of Quality and Compliance |
| Form 990, Part IX, Line 24e | Other expenses include contract labor and purchased services $11,371,931, supplies $10,033,913, professional fees $3,378,885, repair and maintenance $378,376 and provider tax expense $8,655,285 |
| Form 990, Part XI, Line 9 | Investment in Friedell Clinic |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Friedell Clinic SC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363290656 | EIN |
| Primary Activities | Primary Health Care | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jackson Park Hospital Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Ownership | 1 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | There was a delay in completing our audited financial statements | ExplanationTxt |
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