2016-08-11T12:20:23-05:00 2015-09-30 Deloitte Tax LLP 111 Monument Circle Suite 4200 Indianapolis IN 462045108 990 2014-10-01 362167060 NorthShore University HealthSystem % JEFF BIESCZAT NORT 8475702000 1301 Central Street Evanston IL 60201 GARY E WEISS Treasurer and CFO 8475705103 2016-08-10 true Shawna M Jimenez P01222873 3174648600 2016-08-09 2014 2016-09-27 15:27:22Z Mark R Neaman 1301 Central Street Evanston IL 60201 1967369184 false X northshore.org X 1891 IL The core mission of NorthShore University HealthSystem is to "preserve and improve human life." 24 19 11026 1207 7636642 25159898 22100860 1411552119 1436146921 117493177 99643112 18255785 15323678 1572460979 1573214571 65371492 65771207 0 0 615255602 637887808 0 0 2642167 760622559 730245338 1441249653 1433904353 131211326 139310218 3225538727 3267370040 1362260822 1408536139 1863277905 1858833901 X See Schedule O false false 1059219274 65053700 1417096253 Patient Care - See Schedule O 54725742 0 11271930 Education - See Schedule O 28450371 717507 11215008 Research - See Schedule O 1142395387 true true false true false false false false false true true true false false true true false true false false true false false false true true true true true true true true false false false false false false false false true false true true false false false true true true false false true 618 0 true 11026 true true true true CJ false false false true true false false false false X 24 19 true false false false false false false true true false false true true true true true true true true true true IL X JEFF BIESCZAT 8475705798 1301 CENTRAL STREET Evanston IL 60201 X Toure S Claiborne Director 1.0 0.0 X 0 0 0 Mary Dillon Director 1.0 0.0 X 0 0 0 David A Dohnalek Director 1.0 0.0 X 0 0 0 Connie K Duckworth Director 1.0 0.0 X 0 0 0 William M Farrow III Director 1.0 0.0 X 0 0 0 Morris S Kharasch Director and Physician 8.0 34.0 X 66662 400725 48221 Lester B Knight III Director 1.0 0.0 X 0 0 0 Harry M Jansen Kraemer Jr Director 1.0 0.0 X 0 0 0 Theodore Mazzone Director and Clinical Chairman 37.0 5.0 X 753112 89485 31736 Andrew J Mills Director 1.0 0.0 X 0 0 0 Nancy A Nora Director 1.0 0.0 X 0 0 0 Michael Reinsdorf Director 1.0 0.0 X 0 0 0 Thomas S Ricketts Director 1.0 0.0 X 0 0 0 Scott C Schweighauser Director 1.0 0.0 X 0 0 0 Susan B Sentell Director 1.0 0.0 X 0 0 0 Mark S Talamonti Director and Clinical Chairman 31.0 11.0 X 825258 271013 52588 J Mikesell Thomas Director 1.0 0.0 X 0 0 0 Jeffery S Vender Director and Clinical Chairman 29.0 13.0 X 549752 533759 46243 John R Walter Director 1.0 0.0 X 0 0 0 Sona Wang Director/Prior Board Secretary 1.0 0.0 X X 0 0 0 Kevin Willer Director 1.0 0.0 X 0 0 0 David F Zucker Director 1.0 0.0 X 0 0 0 A Steven Crown Board Chairman 1.0 0.0 X X 0 0 0 Percy L Berger Sr Board Vice Chairman 1.0 0.0 X X 0 0 0 Gregory K Jones Board Past Chairman 1.0 0.0 X X 0 0 0 Mark R Neaman President and CEO 41.0 2.0 X X 3332621 0 122616 Samuel M Mencoff Board Secretary/Prior Director 1.0 0.0 X X 0 0 0 Gerald P Gallagher Chief Operating Officer 41.0 1.0 X 1207303 0 682933 Gary E Weiss Board Treasurer and CFO 41.0 0.0 X 1428829 0 69120 Julian E Bailes Clinical Chairman 15.0 26.0 X 652181 938138 52359 William D Bloomer Clinical Chairman 24.0 17.0 X 393030 670578 52967 Michael S Caplan Clinical Chairman 33.0 8.0 X 622351 134613 29344 Robert R Edelman Clinical Chairman 38.0 3.0 X 848672 223337 59860 Bernard G Ewigman Clinical Chairman 40.0 1.0 X 436086 0 128874 Thomas H Hodges Chief Investment Officer 40.0 0.0 X 610417 0 36188 Harry L Jones Chief Compliance Officer 40.0 0.0 X 375122 0 46129 Karen L Kaul Clinical Chairman 14.0 27.0 X 230275 463450 51411 Jason L Koh Clinical Chairman 22.0 19.0 X 600400 745612 55088 William R Luehrs Chief Human Resources Officer 40.0 0.0 X 880562 0 57562 Demetrius Maraganore Clinical Chairman 29.0 12.0 X 445539 155073 50090 Frederick E Miller Clinical Chairman 35.0 6.0 X 392431 61143 49308 Kristen Murtos President, Skokie Hospital 40.0 0.0 X 808353 0 403467 Sean O'Grady President, Glenbrook Hospital 40.0 0.0 X 445418 0 66902 Jesse Peterson Hall President, Highland Park Hosp. 40.0 0.0 X 870284 0 67828 Nancy Semerdjian Chief Nursing Officer 40.0 0.0 X 435933 0 39269 Richard K Silver Clinical Chairman 34.0 7.0 X 771781 146334 53727 Douglas M Silverstein President, Evanston Hospital 40.0 0.0 X 1106076 0 100478 Steven Smith Chief Information Officer 40.0 0.0 X 491340 0 458383 Brian Washa Senior Vice President 40.0 0.0 X 578736 0 64136 Pablo Gejman VP, Genomic Research 40.0 0.0 X 380234 0 48933 Janardan D Khandekar Medical Director 39.0 1.0 X 592329 14222 43436 William A Knaus Director, Research Informatics 40.0 0.0 X 408709 0 48084 Ari A Robicsek VP, Clinical Analytics 29.0 11.0 X 292724 92971 50924 Jonathan Silverstein VP, Research Informatics 40.0 0.0 X 441394 0 44838 Thomas A Victor Former Clinical Chairman 13.0 28.0 X 99990 303712 48037 22373904 5244165 3261079 742 true true true Aramark Management Services 2300 Warrenville Road DOWNERS GROVE IL 60515 Facilities/Diet Mgmt 57744404 Power Construction Company 2360 North Palmer Drive SCHAUMBURG IL 60173 Construction Mgmt 24160473 Pepper Construction Co 643 North Orleans Street CHICAGO IL 60610 Construction Mgmt 21467360 University of Chicago Medical Ctr 5841 South Maryland Avenue CHICAGO IL 60637 Medical Education 16303257 RelayHealth 5995 Windward Parkway ALPHARETTA GA 30005 IT Services 7200799 249 163000 737535 515876 11707629 328382 8648438 1158792 22100860 PATIENT REVENUE 621990 893858982 893858982 MEDICARE AND MEDICAID REVENUE 621990 504918478 504918478 RENT FROM AFFILIATED EXEMPT ORGS 900003 24945152 24945152 FEES AND CONTRACTS FROM GOVT AGENCIES 541700 6848653 6848653 GRANT INCOME 541700 4366355 4358705 7650 1209301 1209301 1436146921 41732698 1982922 39749776 0 0 3990867 5543132 -1552265 0 -1552265 -1552265 445322412 381138942 6273056 64183470 -6273056 57910414 57910414 870418 515876 646788 223630 223630 35690 747 34943 34943 913542 551948 361594 361594 CAFETERIA 722514 5289427 5289427 LAB REFERENCE TESTING 541380 4191134 4191134 EHR INCENTIVE INCOME 900099 2098004 2098004 4677211 1338266 1454936 1884009 16255776 1573214571 1414630389 7636642 128846680 65659990 65659990 111217 111217 0 0 18390693 8360495 10030198 11510904 3657931 7508912 344061 496341741 422875002 72229163 1237576 42333273 33243126 9090147 37247084 32821478 4206663 218943 32064113 26092866 5875698 95549 95693098 81947174 13745924 20019128 20019128 1097862 1097862 0 0 21562361 21562361 89806413 64058070 25373736 374607 21047285 21047285 29387586 22290705 7060132 36749 18957045 1828927 17128118 0 32527642 21686453 10537673 303516 1083224 862611 205134 15479 0 1848365 1157345 681101 9919 7140542 7140542 0 105055357 72993907 32061450 -26887503 -27999397 1111894 MEDICAL SUPPLIES 268289447 268289447 MEDICAID TAX 38624598 38624598 DUES AND SUBSCRIPTIONS 2503920 1393163 1109414 1343 RESEARCH SUBJECT EXPENSES 835813 835813 1653155 1604466 44264 4425 1433904353 1142395387 288866799 2642167 36417815 62114780 1037098 986669 8472997 4944407 229287252 242739216 0 0 0 0 0 0 21216654 20340080 10095135 11997589 2008475975 1012966770 959896225 995509205 1210453403 1135294071 536768481 562307382 0 0 117928715 117017923 93964952 114118718 3225538727 3267370040 166032055 198076911 0 0 9324030 10367402 357562096 347563968 0 0 0 0 0 0 0 0 829342641 852527858 1362260822 1408536139 X 1671906917 1677846352 115268380 103222668 76102608 77764881 1863277905 1858833901 3225538727 3267370040 X 139310218 -92601072 -51153150 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 141811 141811 false Part II-B 1i - Lobbying Activities NorthShore University HealthSystem (NorthShore) and its employees are members of various organizations that advocate on legal and policy issues that affect healthcare. A portion of the annual membership dues paid by NorthShore to these organizations are attributable to lobbying activities. 136189072 1662274 -1207791 7638111 129005444 120987343 1852969 20724353 7375593 136189072 115113667 1726137 11275287 7127748 120987343 103761994 1404411 18276391 8329129 115113667 103298573 1772373 5671678 6980630 103761994 1.00000 false false 71514092 71514092 1359414191 643972897 715441294 57339068 35647243 21691825 416685952 314713390 101972562 103522672 18633240 84889432 995509205 HEDGE FUNDS 416568872 C PRIVATE EQUITY FUNDS 101506822 C PRIVATE EQUITY FUNDS 15658767 F REAL ASSET FUND 27061172 F OTHER INVESTMENTS 1511749 F 562307382 0 DUE TO AFFILIATES 333918904 RESERVE FOR MALPRACTICE LOSSES 243050000 DEFERRED COMPENSATION 134428556 DUE TO THIRD PARTIES 123590954 CURRENT MATURITY OF LT DEBT 9910000 ASSET RETIREMENT OBLIGATION 7541316 CURRENT BOND PAYABLE PREMIUM 88128 852527858 X 1414402680 -92601072 33113131 -59487941 1473890621 21562361 77761589 99323950 1573214571 1358881951 13389168 13389168 1345492783 21562361 66849209 88411570 1433904353 Part V Line 4 - Endowment Funds Endowment fund earnings are used toward research, special purpose, general operations, and department chair funding, as well as uncompensated care offered to patients who meet the criteria established under NorthShore University HealthSystem's financial assistance policy. Part X Line 2 - Liability for Uncertain Tax Positions NorthShore University HealthSystem (NorthShore) and its related affiliates, except for NorthShore Physician Associates, Inc. (NPA) and Community Care Partners, LLC, known as NorthShore Exempt Group, have been determined to qualify as a tax-exempt organization under 501(c)(3) of the Internal Revenue Code (IRC). Most of the income received by NorthShore Exempt Group is exempt from taxation under Section 501(a) of the IRC, as income related to the mission of the organization. Accordingly, there is no material provision for income tax for these entities. Some of the income received by exempt entities is subject to taxation as unrelated business income. NorthShore and its subsidiaries file federal income tax returns and returns for various states in the U.S. ASC 740-10, Income Taxes, requires that realization of an uncertain income tax position is more likely than not (i.e., greater than 50% likelihood of receiving a benefit) before it is recognized in the financial statements. Furthermore, this interpretation prescribes the benefit to be recorded in the financial statements as the amount most likely to be realized assuming a review by tax authorities having all relevant information and applying current conventions. This interpretation also clarifies the financial statement classification of tax-related penalties and interest and sets forth new disclosures regarding unrecognized tax benefits. No amount was recorded for the periods ended September 30, 2015 or 2014. NorthShore currently has a net operating loss carryforward of $11,335,179, which generated assets of $4,470,798. NPA currently has a net operating loss carryforward of $642,281, which generated assets of $251,228. CCP currently has a net operating loss carryforward of $75,617, which generated assets of $17,828. These assets are 100% offset by valuation allowances. Part XI Line 2d - Other Amount represents expenses deducted from revenues in Form 990 Part VIII and changes in restricted net assets. Part XI Line 4b - Other Amount represents transfers to related organizations, Foundation administrative expenses and investment expenses moved to Form 990 Part IX, and changes in restricted net assets. Part XII Line 2d - Other Amount represents expenses deducted from revenues in Form 990 Part VIII. Part XII Line 4b - Other Amount represents transfers to related organizations and Foundation administrative expenses and investment expenses moved to Form 990 Part IX. Central America and the Caribbean Investments 337614396 Central America and the Caribbean Insurance 3435642 Central America and the Caribbean Program Services Medical Conferences 2572 Central America and the Caribbean Program Services Medical Services 7613 East Asia and the Pacific Program Services Medical Conferences 6568 East Asia and the Pacific Program Services Medical Services 8000 Europe (Including Iceland and Greenland) Program Services Medical Conferences 57397 Europe (Including Iceland and Greenland) Program Services Medical Services 108352 Middle East and North Africa Program Services Medical Conferences 2956 Middle East and North Africa Program Services Medical Services 873 North America Insurance 349 North America Program Services Medical Conferences 14300 North America Program Services Medical Equipment 1801393 North America Program Services Medical Services 38776 North America Program Services Medical Supplies 39414 Russia and the Newly Independent States Program Services Medical Services 2472 South America Program Services Medical Conferences 1311 South America Program Services Medical Services 2000 South Asia Program Services Medical Services 1000 343142384 3000 343145384 true false true true true false Am Craft Expo 595464 217941 377523 2575 67291 301260 Summer Soiree 434405 176054 258351 25627 74095 16675 68691 3 356425 121881 234544 48668 2400 39506 1386294 515876 870418 76870 141386 19075 409457 646788 223630 35690 747 true 1.00000 35690 747 747 34943 IL true false false false 0.00000 1.00000 NorthShore University HealthSystem 1301 Central Street Evanston IL 60201 false Kate Beckering 0 Oversees auxiliary operations including raffles. 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X X X X X true true X X X X true X See Section C X See Section C X See Section C X X X X X true X false X X X true X false false Part V Section B Line 5 - Input From Persons in the Community Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital As part of the fiscal year 2013 Community Health Needs Assessment (CHNA) information gathering process, NorthShore University HealthSystem (NorthShore) utilized multiple mechanisms to receive input from persons who represent broad interests of the community. NorthShore has a Community Relations Department, whose personnel serve as points of contact for NorthShore's involvement with community building, partnership development, program building, local governmental advocacy, and outreach activities. Community Relations has developed relationships with local and state government, public health agencies, clergy, business, civic and social service agencies, and school leaders. Through these relationships, Community Relations identified health needs in the NorthShore community by regularly attending events, meetings, community boards, coalitions, consortiums, and one-on-one engagements. NorthShore's senior leadership also regularly participate in outreach programs to local leaders. NorthShore physicians and staff also play an equally important role in identifying health trends and needs through their leadership, board participation, and involvement in local, regional, and national organizations. Each NorthShore hospital has a Community Advisory Committee (CAC) comprised of a range of community leaders representing local public health agencies, non-profit organizations serving low-income residents, faith based groups, governmental agencies, and business and civic leaders. Each hospital's CAC meets quarterly to discuss the health needs in their communities, identifying gaps in delivery of services and providing strategic recommendations to the hospital to address the identified health needs. All four hospital CACs also meet annually to address more global health and healthcare related issues, promoting discussion about policy and services at the local, state and federal levels. The following organizations were represented on the NorthShore CACs while NorthShore conducted the fiscal year 2013 CHNA: Evanston Hospital - Village of Wilmette, CJE Senior Life, Childcare Network of Evanston, McGaw YMCA, Erie Evanston/Skokie Health Center, City of Evanston, North Shore Senior Center, Kenilworth School District 38, Mather LifeWays, Evanston/Skokie School District 65, Shorefront Legacy, New Trier High School, YWCA Evanston Northshore, and Evanston Township High School. Glenbrook Hospital - Northfield Township, Glenbrook North High School, Glenview Police Department, Village of Glenview, Glenview Park District, Covenant Village of Northbrook, Northfield Police Department, Glenbrook South High School, Family Service Center, Glenview Senior Center, Frisbe Senior Center, The Josselyn Center, and the Northbrook Police Department. Highland Park Hospital - Lake County Health Department, Moraine Township, Lake County Board, City of Highwood, Illinois District 29, Deerfield School District 109, Village of Glencoe, City of Highland Park, Zion Lutheran Church, Township High School District 113, Illinois District 58, Park District of Highland Park, West Deerfield Township, City of Highland Park, Lake Forest Senior Center, and the Village of Deerfield. Skokie Hospital - Niles Township, Village of Skokie, Open Communities, Lincolnwood Parks and Recreation, Oakton Community College, Northwest Suburban United Way, Village of Lincolnwood, Niles Township High School District 219, Skokie Park District, Village of Morton Grove, and the Skokie Chamber of Commerce. NorthShore also conducted a community health needs focus group, consisting of community leaders and public health experts who provide social services and healthcare within NorthShore's community. Discussions during the focus group centered on what pressing health concerns were present, which healthcare resources were available and not available, and what barriers to healthcare resources existed for individuals in the community. The following organizations were represented in the focus group: Evanston Health Department, City of Evanston, New Trier High School, Kenilworth School District 38, Evanston/Skokie School District 65, North Shore Senior Center, Lake County Health Department, Lake Forest Senior Center, Tri-Con Childcare Center, Northfield Township, Northbrook Police Department, Northbrook YMCA, Skokie Health Department, Erie Family Health Center, Metropolitan Family Services, and the Northwest Suburban United Way. Part V Section B Line 6a - Other Hospital Facilities Included in CHNA Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital The Community Health Needs Assessment (CHNA) conducted by NorthShore University HealthSystem (NorthShore) included all four NorthShore hospitals: Evanston Hospital, Glenbrook Hospital, Highland Park Hospital, and Skokie Hospital. Part V Section B Line 7a - Website Address of CHNA Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital The Community Health Needs Assessment (CHNA) can be found at: northshore.org/commmunity-events/community/community-health-needs-assessme nt/. Part V Section B Line 10a - Website Address of Implementation Strategy Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital The most recently adopted Implementation Strategy can be found at northshore.org/globalassets/community-and-events/crimplementationreportrev ised4.pdf. Part V Section B Line 11 - Needs Addressed from the CHNA Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital NorthShore University HealthSystem (NorthShore) has implemented a three-fold strategy to address the identified health needs of the communities it serves, which includes: 1) Community benefit programs and partnerships will address a need identified in the Community Health Needs Assessment (CHNA), with a rationale provided for any identified needs not addressed by NorthShore, 2) Community benefit programs, initiatives, and partnerships will address a need requested by the community, and 3) Community benefit programs, initiatives, and partnerships will be aligned with the guiding principles outlined in Advancing the State of the Art of Community Benefits for Nonprofit Hospitals. The guiding principles are: Disproportionate Unmet Health-Related Needs, Primary Prevention, Seamless Continuum of Care, Build Community Capacity, and Community Collaboration. NorthShore places priority on providing community benefits and services in the communities located nearest to our hospitals, where we believe we have the greatest capacity and responsibility to serve. Community health needs data is also used in NorthShore's annual planning processes. Stakeholder participation is critical and influences NorthShore's prioritization and execution of its community benefits programs. In addition, collaboration with local leadership allows NorthShore to detect urgent and growing needs that may not be represented or absent from aggregate data. Lastly, collaboration with local leaders has facilitated the development of programs and partnerships to provide real time solutions to critical health challenges. For the fiscal year 2013 CHNA, NorthShore is evaluating the impact of the initiatives developed to address the identified needs by collecting data on how many individuals utilize components of the initiative. Measurement of the impact will also be assessed by gathering ongoing feedback from the hospitals' Community Advisory Committees, along with feedback from senior and physician leadership. The following needs identified in the fiscal year 2013 CHNA were not addressed by NorthShore: violence prevention, healthy environment (air/water), and tobacco use prevention. NorthShore decided not to address these needs in order to avoid duplication of services with other organizations dedicating resources to these areas. In addition, these needs were not areas of expertise for NorthShore and therefore would not have a measurable, significant impact on these issues. Actions taken during fiscal year 2015 to address the needs identified in the 2013 CHNA include the following NorthShore programs and service areas: The NorthShore Community Health Center at Evanston Hospital provides medical care to adults and children who lack private medical insurance. Medical services include, but are not limited to: primary care, obstetrics/gynecology, general surgery, orthopaedics, diabetes education, and podiatry. In fiscal year 2015, the clinic treated 3,673 adult patients at 10,605 visits. The Dental Center at Evanston Hospital provides primary care dental services and special consultations for medically underserved adult patients, pre-screenings for cardiovascular patients, and management for oral complications in oncology patients and those with refractory dental problems. The Dental Center provided free and discounted care for adult patients making 3,579 visits during fiscal year 2015. Be Well Lake County is a collaboration between NorthShore, Lake County Health Department and Community Health Center, and supporting community partners. The program goal is to build greater access through a coordinated network of healthcare targeting the underserved diabetes population in Lake County. The program enables the partner organizations to effectively pool and maximize resources in order to provide high quality comprehensive diabetes management, education, and support resources that will address one of the nation's fastest growing health threats. NorthShore provides annual funding to support a diabetes management program to 1,111 current patients. The Evanston Township High School Health Center was established as a collaborative partnership with Evanston Township High School, the Evanston Health Department, and NorthShore. The Health Center is a free school-based health clinic staffed by NorthShore employees that provides physical exams, immunizations, treatment of acute and chronic illnesses, health education, gynecological care, and counseling and support groups to students. During the 2014-2015 school year, 664 students made 2,479 visits to the Health Center. NorthShore's Medication Assistance Program helps patients with the cost of paying for prescription drugs. The Medication Assistance Program assisted 2,653 patients in filling 23,121 prescriptions during fiscal year 2015. The Perinatal Depression Program identifies women who are suffering from perinatal depression and offer referrals for women who many need additional support. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. The hotline provides multilingual interpretation services to assist those with limited or no English-speaking ability. All services are provided free of charge. In fiscal year 2015, NorthShore physicians conducted 8,620 screenings to identify at-risk patients, and the hotline received 785 calls. Free psychological support and referrals were provided for 619 women identified through the screenings as at-risk for perinatal mood disorders. NorthShore's Emergency Departments are staffed 24/7 with physicians, nurses, and technicians who are trained to respond to medical emergencies. In addition, Evanston Hospital provides Level One trauma services. During fiscal year 2015, the NorthShore Emergency Departments had a total of 125,183 patient visits. NorthShore's Cardiovascular Center provides comprehensive cardiology services with a combined expertise of cardiologists and cardiac surgeons working together to develop treatment plans designed to provide patients with exceptional heart care including cardiac imaging, cardiovascular surgery, clinical cardiology, electrophysiology, heart failure, interventional cardiology and a women's heart program. During fiscal year 2015, NorthShore hospitals had a total of 121,736 cardiology procedures including open heart surgeries, coronary interventions, echocardiograms, and stress tests. The Kellogg Cancer Center is a cancer treatment center that offers comprehensive, compassionate cancer care and treatments for oncology patients and their families. NorthShore's collaborative cancer treatment model focuses on each patient's individual needs, providing medical, surgical, radiation, psychological, and emotional care. During fiscal year 2015, the Kellogg Cancer Centers at Evanston, Glenbrook, and Highland Park Hospitals had a total of 79,712 patient visits. Part V Section B Lines 16a-16c - Website Address of FAP Documents Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital The Financial Assistance Policy (FAP), FAP application form, and plain language summary of the FAP can be found at northshore.org/about-us/billing/financial-assistance/. Part V Section B Line 16i - Publication of Financial Assistance Policy Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital In addition to the measures listed, the NorthShore University HealthSystem (NorthShore) Financial Assistance program is publicized on NorthShore billing statements, which include a notice regarding the Financial Assistance program and necessary contact information. In addition, collection agencies coordinate financial assistance to potentially eligible patients. Part V Section B Line 22d - Amounts Charged to FAP-Eligible Individuals Facility Reporting Group A: Reporting Group A consists of the following hospital facilities: 1 - Evanston Hospital 2 - Glenbrook Hospital 3 - Highland Park Hospital 4 - Skokie Hospital NorthShore University HealthSystem follows the Illinois Hospital Uninsured Patient Discount Act, which requires discounts to uninsured patients who qualify for financial assistance that result in bills of no more than 135% of cost. The discounts required under Illinois law are also monitored to ensure they do not exceed the average of the three lowest negotiated commercial insurance rates. 30 Skokie Ambulatory Care Center 9650 Gross Point Road Skokie IL 60076 Outpatient Clinic Glenbrook Ambulatory Care Center 2180 Pfingsten Road Glenview IL 60026 Outpatient Clinic Graham Medical Office Building 1000 Central Street Evanston IL 60201 Outpatient Clinic Gurnee Ambulatory Care Center 7900 Rollins Road Gurnee IL 60031 Outpatient Clinic Highland Park Medical Office Building 767 Park Avenue West Highland Park IL 60035 Outpatient Clinic Old Orchard Medical Office Building 9977 Woods Drive Skokie IL 60077 Outpatient Clinic Glenbrook Medical Office Building South 2050 Pfingsten Road Glenview IL 60026 Outpatient Clinic Glenbrook Medical Office Building North 2150 Pfingsten Road Glenview IL 60026 Outpatient Clinic Highland Park Ambulatory Care Center 757 Park Avenue West Highland Park IL 60035 Outpatient Clinic Lakeshore Imaging 680 N Lake Shore Drive Chicago IL 60611 Outpatient Clinic Vernon Hills Specialty Care Center 225 N Milwaukee Avenue Vernon Hills IL 60061 Outpatient Clinic Bannockburn Medical Office Building 2151 Waukegan Road Bannockburn IL 60015 Outpatient Clinic Ravinia X-Ray and GI Lab 1777 Green Bay Road Highland Park IL 60035 Outpatient Clinic Gurnee Medical Office Building 15 Tower Court Gurnee IL 60031 Outpatient Clinic PM&R Pediatrics Lab Services 9811 Woods Drive Skokie IL 60077 Outpatient Clinic Glenview Park Center 2400 Chestnut Avenue Glenview IL 60026 Outpatient Clinic Fetal Diagnostic Center 71 Waukegan Road Lake Bluff IL 60044 Outpatient Clinic PM&R Fitness Center 1501 Busch Parkway Buffalo Grove IL 60089 Outpatient Clinic PM&R Benson Avenue 1729 Benson Avenue Evanston IL 60201 Outpatient Clinic Adolescent Day School 3633 W Lake Avenue Glenview IL 60026 Therapeutic Day School Northbrook Court Imaging 1182 Northbrook Court Northbrook IL 60062 Outpatient Clinic NorthShore Lab Services - Evanston 2500 Ridge Avenue Evanston IL 60201 Outpatient Clinic Fetal Diagnostic Center 880 West Central Road Arlington Heights IL 60005 Outpatient Clinic Fetal Diagnostic Center 755 S Milwaukee Avenue Libertyville IL 60048 Outpatient Clinic PM&R Old Deerfield Road 1630 Old Deerfield Road Highland Park IL 60035 Outpatient Clinic Breast Health and Mammography Program 71 Old Orchard Shopping Center Skokie IL 60077 Outpatient Clinic River North Same Day Surgery One East Erie Street Chicago IL 60611 Ambulatory Surgery Center North Shore Same Day Surgery 3725 West Touhy Avenue Lincolnwood IL 60712 Ambulatory Surgery Center 25 East Same Day Surgery Center 25 East Washington Street Chicago IL 60602 Ambulatory Surgery Center Ravine Way Surgery Center 2350 Ravine Way Glenview IL 60025 Ambulatory Surgery Center Part I Line 7 - Costing Methodology NorthShore University HealthSystem calculated the cost of charity care and means-tested government programs using the cost-to-charge ratio derived from Schedule H, Worksheet 2, Ratio of Patient Care Cost-to-Charges. Amounts in the other benefits section of Line 7 were calculated using costs charged directly to the individual programs from the financial accounting system. An indirect cost allocation factor for hospital shared services was also calculated and included for each program indicated in other benefits. Part II - Community Building Activities NorthShore University HealthSystem (NorthShore) employees are involved in numerous community building activities which promote the health of the communities it serves. NorthShore encourages its employees to serve on community collaboration boards and participate in health advocacy programs to promote the health of the communities served. Part III Line 2 - Bad Debt Expense Bad debt expense was reported at cost using a cost-to-charge methodology. The Schedule H, Worksheet 2, Ratio of Patient Care Cost-to-Charges calculated to report charity care on Part I, Line 7a was multiplied by the bad debt expense to determine the bad debt expense at cost. Discounts and payments on patient accounts are excluded from bad debt expense in order to reflect the expected amount to be paid. Part III Line 4 - Financial Statement Footnote Accounts Receivable Financial Statement Footnote - The Corporation evaluates the collectibility of its accounts receivable based on the length of time the receivable is outstanding, the payor class, and the anticipated future uncollectible amounts based on historical experience. Accounts receivable are charged to the allowance for uncollectible accounts when they are deemed uncollectible. Part III Line 8 - Medicare Shortfall The Schedule H, Worksheet 2, Ratio of Patient Care Cost-to-Charges was used to determine the Medicare costs reported on Part III, Line 6. NorthShore University HealthSystem (NorthShore) believes that all of the $54,255,238 Medicare shortfall should be considered as community benefit. The Internal Revenue Service Community Benefit Standard includes the provision of care to the elderly and Medicare patients. Medicare shortfalls must be absorbed by NorthShore in order to continue treating the elderly in our community. During fiscal year 2015, Medicare accounted for approximately 47% of hospital gross patient revenues. The hospital provides care regardless of this shortfall and thereby relieves the government of the burden of paying the full cost of care for Medicare beneficiaries. Part III Line 9b - Collection Practices NorthShore University HealthSystem (NorthShore) follows the Illinois Fair Patient Billing Act. The collection policy is the same for all patients. Patients are screened for eligibility for financial assistance before collection procedures begin. After a patient meets the qualifications for financial assistance, the account balance is either partially or entirely written off. Any remaining balance would be collected under the existing debt collection policy. Part VI Line 2 - Needs Assessment NorthShore University HealthSystem (NorthShore) completed a Community Health Needs Assessment (CHNA) during fiscal year 2013. See information reported on the CHNA in Part V Section B. The purpose of the CHNA was to determine the needs of the communities served and align NorthShore programs with the health needs identified. In addition to collecting and analyzing available quantitative and qualitative data on mortality, disease incidence, utilization of and access to healthcare services, NorthShore also established a mechanism in which to actively seek the involvement of our community and public health leaders in an ongoing manner to ensure that our analysis reflected the current public health needs in our community. NorthShore will continue to seek to understand community health needs and track both quantitative and qualitative sources of public health information, as well as solicit feedback from the community. Part VI Line 3 - Patient Education of Eligibility for Assistance NorthShore informs and educates low income patients of our Financial Assistance program across many points within the system. We have posted signs--both English and Spanish--in all our facilities' Emergency Departments and at our Central Registration areas. The NorthShore patient information television channel is available to all patients upon admission and a section describes how to obtain Financial Assistance. The NorthShore billing statements describes the Financial Assistance program and necessary contact information. Our collection agencies and billing offices also coordinate charity care to potentially eligible patients. Finally, the NorthShore website (www.northshore.org) is another useful resource that informs patients about the Financial Assistance program with links to the application process and the actual financial application. NorthShore also has approximately sixteen full time financial counselors and thirty eight Customer Service agents representing our hospitals, clinics, and physician offices. These counselors and representatives are responsible for helping patients understand their bills and coordinating financial assistance and insurance eligibility when appropriate. Any uninsured patient admitted to our hospitals will have their case reviewed by a financial counselor. NorthShore has also earned Certified Application Counselor Organization (CACO) status with the Centers for Medicare and Medicaid Services (CMS). Our counselors are certified and capable of helping patients navigate Medicaid and Insurance Exchange options. Any patient having difficulty paying their portion of the bill or wanting to know if they are eligible for financial assistance will have their case reviewed by calling our centralized Customer Service billing department. Our Customer Service department responds to approximately 1,400 calls per day from patients with questions about their bill or that are unable to pay. In addition to the formal application process for Financial Assistance, NorthShore may also grant Financial Assistance on a presumptive basis. Presumptive Financial Assistance approvals are based upon individual life circumstances such as enrollment in low income government programs with income eligibility below 200 percent of federal poverty level income guidelines or verification of financial indigence through an outside vendor. Part VI Line 4 - Community Information NorthShore University HealthSystem (NorthShore) has four hospital facilities located in the northern suburbs of Chicago, Illinois. The NorthShore service area has a total population size of approximately 1.6 million*. The average household income is approximately $95,000*. During fiscal year 2015, approximately 4% of NorthShore's patients had no insurance and 8% qualified for Medicaid. Within NorthShore's service area, there are three federally-designated medically underserved areas. NorthShore's service area also includes ten other hospitals. *Source: US Census via Thomson Reuters Market Planner Plus Part VI Line 5 - Promotion of Community Health NorthShore University HealthSystem (NorthShore) extends medical staff privileges to all qualified physicians in the NorthShore community. A majority of the NorthShore Board members also reside in NorthShore's service area and are not employees, independent contractors, or family members thereof. NorthShore also uses surplus funds to add new buildings and renovate existing facilities to better serve patients and the community. Additional programs conducted by NorthShore to help promote the health of the community include: Residency and Education Programs - NorthShore is committed to excellence in its academic mission and supports teaching and research in its role as the principal teaching affiliate of the University of Chicago Pritzker School of Medicine. NorthShore also has additional teaching affiliation agreements with Rush University Medical Center, University of Illinois-Chicago, Stroger Hospital, and Northwestern University Feinberg School of Medicine. NorthShore has an extensive selection of training programs and fellowships to offer physicians at our own teaching and research facilities. During fiscal year 2015, a total of 188 resident full time equivalents (FTEs) and 32 fellow FTEs participated in the NorthShore and affiliate-based programs. The NorthShore residency program areas included: Dentistry, Internal Medicine, Pathology, Preliminary Medicine (intern year), Transitional Medicine (first year prior to specialization), and Family Medicine. The NorthShore fellowship program areas included: Emergency Medicine Simulation, Endocrine Surgery, Family Medicine/Sports Medicine, Gastroenterology, Musculoskeletal Imaging, Surgical Pathology, and Urogynecology. The affiliate-based residency program areas included: Anesthesiology, Emergency Medicine, General Surgery, Neurology, Neurosurgery, Obstetrics and Gynecology, Ophthalmology, Orthopaedic Surgery, Otolaryngology, Pediatrics, Plastic Surgery, Podiatry, Psychiatry, Radiology, and Urology. The affiliate-based fellowship program areas included: Advanced Cardiovascular Imaging/Research, Cardiology, Cardiothoracic Surgery, Child Neurology, Child Psychiatry, Colon Rectal Surgery, Electrophysiology, Gynecologic Oncology, Hematology/Oncology, Mammography, Maternal-Fetal Medicine, Medical Microbiology, Molecular Genetics Pathology, Neonatal-Perinatal Medicine, Nephrology, Neuroradiology, Orthopaedic Hand, Orthopaedic Sports, Palliative Medicine, Peripheral Vascular Surgery, and Surgical Oncology. NorthShore also offers a comprehensive Pharmacy residency program, with resident positions located at all four hospitals. The Pharmacy residency program includes both clinical and administrative exposure focusing on inpatient practice. The program consists of a multitude of experiences that reinforce residents' knowledge and skills and help them advance into well-rounded practitioners. During fiscal year 2015, 22 residents participated in the program. The NorthShore School of Nurse Anesthesia operates out of Evanston Hospital. The program has full accreditation from the Council of Accreditation of Nurse Anesthesia Educational Programs. The mission of the School is the enrichment and transmission of knowledge of nurse anesthesia as a discipline and promotion of the health and well-being of individuals, families, and communities. The School seeks to provide graduates with innovative, inquiry-based education that anticipates the rapid pace of change in health care and the knowledge, skills, and attitude necessary to assume leadership roles in the nurse anesthesia profession. During fiscal year 2015, 59 students participated in the program. NorthShore also provided clinical training and internships during the 2015 academic year for 754 high school and college students. Students interned in various areas including Nursing, Physical Therapy, Radiology, Laboratory, and Speech Therapy. Community Advisory Committees - The Community Advisory Committees' (CAC) role is to advise hospital administration on services and initiatives from a community perspective. CACs are structured to ensure NorthShore's accountability to the community by working to fulfill our community relations vision that the more NorthShore and the community connect, the stronger and healthier both will become. The CACs are comprised of primarily community members, along with hospital administrative and professional staff. NorthShore strives for diverse membership to include business, faith community, social services, civic organizations, government officials, elected officials, as well as interested citizens. The CACs meet quarterly and help to identify gaps in healthcare services within the community and seek opportunities for partnerships between the hospitals and community organizations. In addition, the CACs assist NorthShore with the community health needs assessment process. Be Well Lake County - Be Well Lake County is a collaboration between NorthShore, Lake County Health Department and Community Health Center, and supporting community partners. The program goal is to build greater access through a coordinated network of healthcare targeting the underserved diabetes population in Lake County. The program enables the partner organizations to effectively pool and maximize resources in order to provide high quality comprehensive diabetes management, education, and support resources that will address one of the nation's fastest growing health threats. NorthShore Community Health Center - The NorthShore Community Health Center at Evanston Hospital provides medical care to adults and children who lack private medical insurance. Medical services include, but are not limited to: primary care, obstetrics/gynecology, general surgery, orthopaedics, diabetes education, and podiatry. In fiscal year 2015, the clinic treated 3,673 adult patients at 10,605 visits. Dental Center - The Dental Center at Evanston Hospital provides primary care dental services and special consultations for medically underserved adult patients, pre-screenings for cardiovascular patients, and management for oral complications in oncology patients and those with refractory dental problems. The Dental Center provided free and discounted care for adult patients making 3,579 visits at a cost of $181,202 during fiscal year 2015. Evanston Township High School Health Center - Established as a collaborative partnership with Evanston Township High School, the Evanston Health Department, and NorthShore, the Health Center is a free school-based health clinic staffed by NorthShore employees that provides physical exams, immunizations, treatment of acute and chronic illnesses, health education, gynecological care, and counseling and support groups to students. During the 2014-2015 school year, 664 students utilized the Health Center at 2,479 visits at a cost of $616,938. Medication Assistance Program - NorthShore's Medication Assistance Program helps patients with the cost of paying for prescription drugs. The Medication Assistance Program assisted 2,653 patients in filling 23,121 prescriptions at a cost of $147,723 during fiscal year 2015. Home Health and Hospice Services - NorthShore provides intermittent care including skilled nursing, physical therapy, occupational therapy, speech therapy, infusion therapy, and home health aides. NorthShore also provides hospice and palliative care services to patients and their families. During fiscal year 2015, there were 92,620 patient visits and 6,564 admissions. Perinatal Depression Program - The Perinatal Depression Program identifies women who are suffering from perinatal depression and offer referrals for women who many need additional support. The program screens women for perinatal depression during and after their pregnancy and offers a 24/7 crisis hotline for women and their family members who may find themselves in an emergent situation. The hotline provides multilingual interpretation services to assist those with limited or no English-speaking ability. All services are provided free of charge. In fiscal year 2015, NorthShore physicians conducted 8,620 screenings to identify at-risk patients, and the hotline received 785 calls. Free psychological support and referrals were provided for 619 women identified through the screenings as at-risk for perinatal mood disorders. Employee Volunteerism - NorthShore employees participate in various volunteer activities that meet community needs and promote goodwill. Several NorthShore publications include information about volunteer organizations and employee volunteer opportunities. NorthShore also recognizes and rewards employees for community service and volunteerism through the annual Sharing Spirit Volunteer Award. Part VI Line 6 - Affiliated Health Care System NorthShore University HealthSystem (NorthShore) is a comprehensive, fully integrated, healthcare delivery system that includes four hospitals, as well as numerous outpatient departments and clinics. In addition to the hospital organization, there are the following affiliates that help to meet the needs of the community: NorthShore University HealthSystem Foundation - The NorthShore University HealthSystem Foundation (Foundation) seeks to obtain the philanthropic support required to ensure that NorthShore can provide medical care, advanced research, and state-of-the-art facilities and equipment. The Foundation builds relationships with individuals and the community to increase awareness of high-quality services and giving opportunities. NorthShore University HealthSystem Research Institute - The NorthShore University HealthSystem Research Institute (Research Institute) was organized in 1996 to provide a means for integrating leading-edge research into improved clinical care. The Research Institute also creates an environment to recruit and retain externally-funded research leadership in order to achieve the mission and goals of the organization. The Research Institute houses 119 externally funded research faculty who currently occupy 95,000 net square feet of research space and work on 1,200 active research protocols. Total external funding is now approximately $82 million. NorthShore has also made a substantial commitment to develop the Center for Clinical and Research Informatics to conduct expanded research using informatics. Such infrastructure enables large scale efforts on comparative effectiveness, clinical quality/outcomes, and practice based research. The Center and its work build on our award winning Epic medical records system, providing a focus for growing faculty involvement in research. In 2014 the Genomic Health Initiative was launched for members of the community to help shape the future of Personalized Medicine. This research project will give physician and research experts the opportunity to more proactively learn about the science behind diseases and conditions, and apply this knowledge directly to a clinical setting to improve patient outcomes. The Genomic Health Initiative will allow researchers to more precisely predict, prevent, and treat disease while improving the future of healthcare and the medical field for generations to come. The goal is to collect 40,000 - 100,000 participants over the next several years to enable sufficient samples for DNA studies. Health Heritage was also established for patients and their families to have a powerful foundation on which to build personalized plans for improving their health, and potentially the health of family members. Health Heritage was designed and built by researchers and developers at NorthShore along with colleagues at the University of Virginia. This secure, dynamic online family health history will also be an essential part of the legacy NorthShore patients will leave their children and future generations with vital information including a family health history and personalized health risk reports and recommendations. NorthShore University HealthSystem Faculty Practice Associates - The NorthShore University HealthSystem Faculty Practice Associates (FPA) represents more than 900 physicians with over 100 offices in virtually every specialty all on staff at the hospitals of NorthShore. The primary function and activity of FPA is to employ, supervise, and conduct employment-related activities with respect to physicians who provide professional health care services directly for patients of NorthShore. The FPA physicians also conduct medical education and research activities on behalf of NorthShore. Radiation Medicine Institute - The Radiation Medicine Institute (RMI) employs, supervises, and conducts employment-related activities with respect to physicians who provide professional health care services directly for patients of NorthShore. The RMI physicians also conduct medical education and research activities on behalf of NorthShore. Community Care Partners - Community Care Partners is an Accountable Care Entity (ACE) created to better serve the growing population of Medicaid patients. NorthShore has partnered with Erie Family Health Center, Lake County Health Department/Community Health Center, and Vista Health System to form this ACE. The organizations and physicians have come together to create a network of providers to improve efficiency and access to care for over 40,000 Medicaid patients. Part VI Line 7 - State Filing of Community Benefit Report Illinois true American Cancer Society 820 Davis St Evanston IL 60201 362167721 501(c)(3) 20000 Community Event Contribution American Heart Association 208 South LaSalle St Chicago IL 60604 360900700 501(c)(3) 25000 Community Event Contribution Crohn's and Colitis Foundation of America 386 Park Avenue South New York NY 10016 136193105 501(c)(3) 13000 Community Contribution Council for Jewish Elderly 3003 W Touhy Ave Chicago IL 60645 362727597 501(c)(3) 5000 6600 FMV Office Space Community Contribution Evanston Township High School 1600 Dodge Ave Evanston IL 60201 366004393 115 15000 Community Contribution Family Service Center of Wilmette 3545 Lake Ave Wilmette IL 60091 362171173 501(c)(3) 12000 Community Contribution Friends of the Orphans 134 N LaSalle St Chicago IL 60602 651229309 501(c)(3) 11000 Honduras Medical Mission Greater Chicago Food Depository 4100 West Ann Lurie Place Chicago IL 60632 362971864 501(c)(3) 10000 Community Contribution Illinois Hospital Research and Edu Fndn 24676 Network Place Chicago IL 60673 237421930 501(c)(3) 25306 Hospital Mutual Assistance Program Innovation Development Institute Inc 222 W Merch Mart Plaza Chicago IL 60654 463253782 501(c)(3) 25000 Community Contribution Institute of Medicine Chicago 25 Northwest Pnt Blvd Elk Grove IL 60007 362217993 501(c)(3) 10000 Community Contribution John H Stroger Jr Hospital of Cook County 1969 W Ogden Ave Chicago IL 60612 680588634 115 25000 Residency Program Support Lake County Health Department 3010 Grand Ave Waukegan IL 60085 366006600 115 510557 Be Well Lake County Program Lake County Partners for Economic Develop 100 Tri-St Int Dr Lincolnshire IL 60069 364206288 501(c)(3) 10000 Community Contribution March of Dimes 111 W Jackson Blvd Chicago IL 60604 131846366 501(c)(3) 7000 Community Contribution Metropolitan Chicago Healthcare Council 222 S Riverside Plaza Chicago IL 60606 363401846 501(c)(6) 42702 Illinois Poison Center Contribution Misericordia Home 6300 North Ridge Ave Chicago IL 60660 362170153 501(c)(3) 10000 Community Contribution NorthShore Faculty Practice Associates 1301 Central Street Evanston IL 60201 363738206 501(c)(3) 63467084 General Support PADS Lake County Inc 1800 Grand Ave Waukegan IL 60085 362948857 501(c)(3) 10000 Community Contribution Skokie Chamber of Commerce 5002 Oakton St Skokie IL 60077 362192571 501(c)(6) 5430 Community Contribution Turning Point Behavioral Health Care Center 8324 Skokie Blvd Skokie IL 60077 362327294 501(c)(3) 60000 Community Contribution University of Chicago 5801 S Ellis Ave Chicago IL 60637 362177139 501(c)(3) 10000 Residency Program Support University of Chicago Medical Center 5841 S Maryland Ave Chicago IL 60637 363488183 501(c)(3) 500000 Community Contribution Wings Program Inc PO Box 95615 Palatine IL 60095 363456061 501(c)(3) 10000 Community Contribution YWCA EvanstonNorth Shore 1215 Church St Evanston IL 60201 362193618 501(c)(3) 12500 Community Contribution Boston Medical Center 88 E Newton St Boston MA 02118 043314093 501(c)(3) 20517 Research The Medical College of Wisconsin Inc 8701 Watertown Plank Rd Milwaukee WI 53226 390806261 501(c)(3) 183001 Research Northwestern University 633 Clark St Evanston IL 60208 362167817 501(c)(3) 5574 Research Texas Biomedical Research Institute PO Box 760549 San Antonio TX 78245 741109630 501(c)(3) 80577 Research Virginia Polytechnic Institute & State Univ 300 Turner St NW Blacksburg VA 24061 546001805 115 126930 Research University of Chicago 5801 S Ellis Ave Chicago IL 60637 362177139 501(c)(3) 286291 Research University of Michigan 500 S State St Ann Arbor MI 48109 386006309 115 14618 Research 30 2 Scholarships in Medical Field 38 111217 Part I Line 2 - Monitoring of Grant Funds NorthShore University HealthSystem (NorthShore) provides cash and non-cash assistance to organizations that help support NorthShore's mission to preserve and improve human life. Requests to support an outside organization must be reviewed and approved by the Community Relations department and NorthShore management to ensure the organization is aligned with NorthShore's mission and charitable purpose. NorthShore also provides cash grants to sub-recipients of grant awards. NorthShore requires all sub-recipients to sign a consortium agreement stating that the sub-recipient understands and agrees to all applicable compliance requirements. NorthShore meets with the sub-recipients on a regular basis and reviews the sub-recipients' A-133 reports. In addition, NorthShore provides cash support to related organizations. Support to related organizations is monitored through the NorthShore budget and reporting procedures for the consolidated financial statements. NorthShore also provides nursing scholarships to individuals. The scholarship amount depends on the degree sought, and the number of scholarships awarded depends on the available funds for each year. Scholarships are awarded on an annual basis to applicants that meet the eligibility criteria. Applicants must be current employees of NorthShore as a staff nurse or other related clinical position. Applicants must also be currently enrolled in a nursing degree program, and enrollment must be maintained for the year the scholarship is received. In addition, applicants must sign a Scholarship Agreement to work for NorthShore as a staff nurse or in a related clinical position for one year following receipt of the scholarship. X true false X X X X false true false false false false false true false Morris S Kharasch Director and Physician 59995 289683 6667 105000 0 6042 3502 16908 4772 23039 74936 440672 0 0 Theodore Mazzone Director and Clinical Chairman 653112 69537 100000 0 0 19948 18446 1964 10236 1090 781794 92539 0 0 Mark S Talamonti Director and Clinical Chairman 725258 252758 100000 0 0 18255 15135 5275 23862 8316 864255 284604 0 0 Jeffery S Vender Director and Clinical Chairman 549752 244312 0 250000 0 39447 14130 6280 17885 7948 581767 547987 0 0 Mark R Neaman President and CEO 1046554 0 1873950 0 412117 0 106055 0 16561 0 3455237 0 677717 0 Gerald P Gallagher Chief Operating Officer 538418 0 665500 0 3385 0 654957 0 27976 0 1890236 0 210792 0 Gary E Weiss Board Treasurer and CFO 498861 0 646200 0 283768 0 48992 0 20128 0 1497949 0 211499 0 Julian E Bailes Clinical Chairman 569181 924447 83000 0 0 13691 7778 12632 12175 19774 672134 970544 0 0 William D Bloomer Clinical Chairman 393030 259990 0 335000 0 75588 12284 8126 19595 12962 424909 691666 0 0 Michael S Caplan Clinical Chairman 522351 109379 100000 0 0 25234 16876 3534 7387 1547 646614 139694 0 0 Robert R Edelman Clinical Chairman 748672 36687 100000 148800 0 37850 19457 953 37607 1843 905736 226133 0 0 Bernard G Ewigman Clinical Chairman 415086 0 21000 0 0 0 65308 0 63566 0 564960 0 0 0 Thomas H Hodges Chief Investment Officer 412435 0 186000 0 11982 0 20410 0 15778 0 646605 0 0 0 Harry L Jones Chief Compliance Officer 254226 0 117000 0 3896 0 20410 0 25719 0 421251 0 0 0 Karen L Kaul Clinical Chairman 180275 323470 50000 121378 0 18602 7304 13106 11094 19907 248673 496463 0 0 Jason L Koh Clinical Chairman 500400 391000 100000 350000 0 4612 11457 8953 19467 15211 631324 769776 0 0 William R Luehrs Chief Human Resources Officer 356697 0 470000 0 53865 0 40107 0 17455 0 938124 0 154184 0 Demetrius Maraganore Clinical Chairman 395539 149400 50000 0 0 5673 14814 5596 21543 8137 481896 168806 0 0 Frederick E Miller Clinical Chairman 367431 51014 25000 0 0 10129 17922 2488 25375 3523 435728 67154 0 0 Kristen Murtos President, Skokie Hospital 348300 0 457000 0 3053 0 374957 0 28510 0 1211820 0 146893 0 Sean O'Grady President, Glenbrook Hospital 311933 0 129000 0 4485 0 39843 0 27059 0 512320 0 0 0 Jesse Peterson Hall President, Highland Park Hosp. 371339 0 490200 0 8745 0 40967 0 26861 0 938112 0 164260 0 Nancy Semerdjian Chief Nursing Officer 304050 0 121000 0 10883 0 20410 0 18859 0 475202 0 0 0 Richard K Silver Clinical Chairman 705781 117249 66000 0 0 29085 17502 2908 28571 4746 817854 153988 0 0 Douglas M Silverstein President, Evanston Hospital 479469 0 614600 0 12007 0 88287 0 12191 0 1206554 0 199641 0 Steven Smith Chief Information Officer 333439 0 147000 0 10901 0 432988 0 25395 0 949723 0 0 0 Brian Washa Senior Vice President 295048 0 281900 0 1788 0 36965 0 27171 0 642872 0 117772 0 Pablo Gejman VP, Genomic Research 330646 0 38300 0 11288 0 20410 0 28523 0 429167 0 0 0 Janardan D Khandekar Medical Director 434956 9222 100000 5000 57373 0 19986 424 22548 478 634863 15124 0 0 William A Knaus Director, Research Informatics 391338 0 0 0 17371 0 20410 0 27674 0 456793 0 0 0 Ari A Robicsek VP, Clinical Analytics 223208 84129 68000 8842 1516 0 14823 5587 22161 8353 329708 106911 0 0 Jonathan Silverstein VP, Research Informatics 337834 0 102400 0 1160 0 20410 0 24428 0 486232 0 0 0 Thomas A Victor Former Clinical Chairman 99990 198753 0 67352 0 37607 6831 13579 9247 18380 116068 335671 0 0 Part I Line 1a - Benefits Provided First-class airfare was provided to the Chief Executive Officer during calendar year 2014 for business travel purposes and was not treated as taxable compensation. The first-class airfare was purchased through a prepaid airline mileage account, which provided discounted airline fare rates. Part I Line 2 - Reimbursement Substantiation A prepaid airline mileage account was purchased for the travel of the Chief Executive Officer. At the time of the purchase, it was not known what specific travel would occur and therefore the travel could not be substantiated at purchase. The business purpose of each trip was substantiated at the time of travel. Part I Line 4b - Supplemental Nonqualified Retirement Plan The following individuals participated in a supplemental nonqualified retirement plan and accrued the following benefits: Mark R Neaman, President and Chief Executive Officer - $388,105, Gerald P Gallagher, Chief Operating Officer - $602,274, William R Luehrs, Chief Human Resources Officer - $39,988, Kristen Murtos, President, Skokie Hospital - $334,356, Douglas M Silverstein, President, Evanston Hospital - $41,592, Steven Smith, Chief Information Officer - $391,643, Gary E Weiss, Chief Financial Officer - $266,766. Part I Line 7 - Non-Fixed Payments NorthShore University HealthSystem provides incentive payments to certain employees after operating and performance goals are achieved. Incentive payment plans are reviewed and approved by the Compensation Committee of the Board of Directors. Form 990 Part VII Line 5 - Compensation from Unrelated Organizations The salary and benefits reported on Schedule J totaling $564,960 for Dr. Bernard G Ewigman were paid by the University of Chicago Medical Center for services provided to NorthShore University HealthSystem as the Chairman of the Department of Family Medicine. A Illinois Finance Authority 861091967 45200F4D8 2010-07-14 138786145 See Part VI false false false B Illinois Finance Authority 861091967 45200MU93 2008-12-11 75000000 See Part VI false false false A 17085000 0 138786145 0 0 0 1017771 0 0 0 137768374 0 2010 true false true true B 0 0 75000000 0 0 0 433044 131875 0 74435081 0 0 2008 false false true true A 0 B false false true true true true 0.00300 0.00100 0.00400 false false false true A false false false true false false 0 false 0 false true B false false true true true false 0 false 0 false true A true B true Part I Line A Column (f) To refund bonds issued on July 3, 2001. Proceeds were also used to pay termination costs in connection with certain derivative agreements related to the refunded bonds. Part I Line B Column (f) To reimburse NorthShore University HealthSystem for the costs of construction, renovation, and equipment for various projects at Evanston Hospital, Glenbrook Hospital, and Highland Park Hospital. Part IV Line 2c Column A A rebate analysis was performed on April 27, 2015, which found there was no rebate due. Part IV Line 2c Column B A rebate analysis was performed on January 29, 2014, which found there was no rebate due as the issue met an exception to rebate. Substantial Contributor 156 Substantial Contributor 24898382 Construction Management false Substantial Contributor 159 Substantial Contributor 253453 Public Relations false Substantial Contributor 205 Substantial Contributor 377723 Investments false Jamie Dohnalek Family Mbr-David Dohnalek 62581 Employment false April F Victor Family Mbr-Thomas Victor 77933 Employment false X 26 21295 Cost X 25 Cost X 24443 Cost X 29 1158792 Sale Proceeds X 6 3401 Comparables X 11 2576 Cost X Gift Cards/Certificates 226 53480 Cost X Events/Entertainment 69 26632 Cost X Vacation/Property 2 13000 Comparables X Facilities 1 120 Cost X Jewelry 1 260 Cost 0 false true false Part I Column (b) - Number of Contributions The amounts reported in Part I, column (b) represent the number of contributions. Part III Line 1 - Mission Statement The core mission of NorthShore University HealthSystem is to "preserve and improve human life." This mission will be achieved through the provision of superior clinical care, academic excellence, and innovative research. NorthShore is a not-for-profit organization principally formed to provide quality healthcare services for the communities it serves. The delivery of healthcare services is provided in a wide range of inpatient and ambulatory healthcare settings, community-wide, employing modern technology and expertise. Support for qualified patients who may not be able to pay the entire cost of their care is a part of the organization's commitment. In support of its primary mission of patient care, the organization engages in a wide range of academic activities in medical education and research. This statement recognizes the Board of Directors' responsibility to maintain the organization's viability to meet its long-term commitment to the communities it serves. It further recognizes the responsibility to maintain technologically current assets for this purpose. This includes the cultivation and development of our physicians, graduate medical students, employees, physical plant, equipment and other resources to assure orderly growth of our services. Part III Line 4a - Statement of Program Services - Patient Care Headquartered in Evanston, Illinois, NorthShore University HealthSystem, (NorthShore), is a comprehensive, fully integrated, healthcare delivery system serving the Chicago region. NorthShore includes four hospitals: Evanston Hospital, Glenbrook Hospital, Highland Park Hospital, and Skokie Hospital. NorthShore has approximately 10,000 employees and 2,400 affiliated physicians, including a multispecialty group practice with over 900 physicians and 100-plus office locations under NorthShore University HealthSystem Faculty Practice Associates. The integrated health system has significant capabilities in a wide spectrum of leading clinical programs, including the Kellogg Cancer Center, NorthShore Neurological Institute, NorthShore Orthopaedic Institute, NorthShore Cardiovascular Institute, and High-Risk Maternity. NorthShore also supports teaching and research as the principal teaching affiliate for the University of Chicago Pritzker School of Medicine. NorthShore is a Magnet recognized organization and is the first organization in Illinois designated as a system to receive this prestigious honor that demonstrates excellence in nursing and high standards of patient care. NorthShore is a national leader in the implementation of innovative technologies, including electronic medical records (EMR). In 2003, NorthShore was among the first hospital systems in the country to successfully launch a system-wide EMR with demonstrable benefits in quality, safety, efficiency, and service to patients. NorthShore has been recognized by multiple national organizations for this notable achievement. As part of an ongoing relationship between NorthShore and the Mayo Clinic, physicians from these two organizations are working together on the most complex medical cases. NorthShore physicians have direct access to Mayo Clinic physicians to collaborate on the best treatment for patients with hard to solve cases. NorthShore was one of 34 hospitals and health systems nationwide rated as high performing in five common surgical procedures and chronic conditions in the U.S. News & World Report Best Hospitals for Common Care evaluation. The Common Care ratings assessed more than 4,600 hospitals nationwide in hip replacement, knee replacement, heart bypass surgery, congestive heart failure and chronic obstructive pulmonary disease (COPD). NorthShore was ranked in the top tier of health systems nationwide by Truven Health Analytics. The report evaluated 340 health systems of varying sizes nationwide. NorthShore was listed in the top tier of those systems that have effectively confronted financial challenges, while still outperforming national benchmarks for quality care, including patient safety, readmission, and patient loyalty. NorthShore was named one of the "Most Wired" health systems in the country for the 12th straight year by Hospitals & Health Networks magazine's 2015 Most Wired survey. The annual report highlights hospitals and hospital systems at the forefront of adopting health information technology to improve patient care and increase clinical and administrative efficiencies. NorthShore was one of 339 hospitals selected from a field of more than 2,200 survey participants. NorthShore recognizes and embraces its responsibility to ensure that it fulfills its charitable obligations in the most cost-effective and sustainable manner. In order to achieve this goal, NorthShore has aligned its community benefits program with the guiding principles outlined in Advancing the State of the Art of Community Benefit for nonprofit hospitals, which provides a set of uniform standards to increase accountability and align governance, management, and operations to return benefit to local communities. The five guiding principles are: 1) Disproportionate Unmet Health-Related Needs, 2) Primary Prevention, 3) Seamless Continuum of Care, 4) Build Community Capacity, and 5) Community Collaboration. NorthShore informs and educates low income patients of our Financial Assistance program across many points within the system. We have posted signs--both English and Spanish--in all our facilities' Emergency Departments and at our Central Registration areas. The NorthShore patient information television channel is available to all patients upon admission and a section describes how to obtain Financial Assistance. The NorthShore billing statements describes the Financial Assistance program and necessary contact information. Our collection agencies and billing offices also coordinate charity care to potentially eligible patients. Finally, the NorthShore website (www.northshore.org) is another useful resource that informs patients about the Financial Assistance program with links to the application process and the actual financial application. NorthShore also has approximately sixteen full time financial counselors and thirty eight Customer Service agents representing our hospitals, clinics, and physician offices. These counselors and representatives are responsible for helping patients understand their bills and coordinating financial assistance and insurance eligibility when appropriate. Any uninsured patient admitted to our hospitals will have their case reviewed by a financial counselor. NorthShore has also earned Certified Application Counselor Organization (CACO) status with the Centers for Medicare and Medicaid Services (CMS). Our counselors are certified and capable of helping patients navigate Medicaid and Insurance Exchange options. Any patient having difficulty paying their portion of the bill or wanting to know if they are eligible for financial assistance will have their case reviewed by calling our centralized Customer Service billing department. Our Customer Service department responds to approximately 1,400 calls per day from patients with questions about their bill or that are unable to pay. In addition to the formal application process for Financial Assistance, NorthShore may also grant Financial Assistance on a presumptive basis. Presumptive Financial Assistance approvals are based upon individual life circumstances such as enrollment in low income government programs with income eligibility below 200 percent of federal poverty level income guidelines or verification of financial indigence through an outside vendor. Evanston Hospital - With a history dating back to 1891, Evanston Hospital is a 354-licensed bed comprehensive acute-care facility and the nucleus of NorthShore University HealthSystem. Evanston Hospital is a leader in cardiac care, cancer care via the Kellogg Cancer Center and a variety of surgical specialties including neurosurgery, gynecological surgery, robot-assisted surgery, surgical oncology, and urology surgery. Evanston Hospital is certified by the Joint Commission in palliative care and as a Primary Stroke Center. The hospital also is a licensed Level I Trauma Center. Evanston Hospital is also the regional center for high-risk obstetrics. The Infant Special Care Unit and the Women's Hospital offer a comfortable birthing environment where high-risk mothers and their babies have access to the latest technology and a highly trained staff. Evanston Hospital also houses the Grainger Center for Simulation and Innovation, which provides nurses, physicians, residents, paramedics, firefighters and police with simulated clinical care, trauma and emergency preparedness training in a controlled environment. During fiscal year 2015, Evanston Hospital total admissions were 17,365, and total patient days were 93,412. Glenbrook Hospital - Glenbrook Hospital, established in 1977, is a 173-licensed bed comprehensive medical center providing advanced diagnostic and therapeutic interventions. In addition to being a Level II Trauma Center, Glenbrook Hospital is certified by the Joint Commission as a Primary Stroke Center. Glenbrook Hospital provides advanced medical and surgical care for all specialties. Specific specialties include the Kellogg Cancer Center, NorthShore Neurological Institute, NorthShore Spine Center, John and Carol Walter Center for Urological Health, Patricia Nolan Center for Breast Health, Simms Family GI Lab, Eye and Vision Center, Surgical Specialty Suite, and Total Joint Replacement Center. In addition, the hospital offers leading-edge interventional radiology and cardiac catheterization laboratory. During fiscal year 2015, Glenbrook Hospital total admissions were 8,951, and total patient days were 43,712. Part III Line 4a-Statement of Program Services - Patient Care - Continued Highland Park Hospital - Founded in 1918, Highland Park Hospital has provided high-quality healthcare and a wide range of clinical programs for the people of Lake County and beyond for nearly a century. The 139-licensed bed hospital is the site of the first open-heart surgery in Lake County, and continues to provide a full range of cardiac diagnosis and intervention services. Highland Park Hospital's Kellogg Cancer Center offers the most comprehensive subspecialty care for oncology patients. Specialized physicians provide care for the following types of cancer: thoracic and lung, hematology, breast, ovarian, head and neck, melanoma and sarcoma, gastrointestinal, prostate, and stomach. Highland Park Hospital is a Joint Commission certified Primary Stroke Center. The Emergency Department at Highland Park Hospital acts as the region's "pod" hospital for disaster-response activities, coordinating Lake County's efforts when confronted with a disaster. The Pediatric Preparation Program helps to familiarize young patients with the hospital environment through hospital tours and play sessions prior to surgery. NorthShore also has a partnership with the Lake County Health Department and Community Health Center known as Be Well Lake County. The program goal is to build greater access through a coordinated network of healthcare targeting the underserved diabetes population in Lake County. The program enables the partner organizations to effectively pool and maximize resources in order to provide high quality comprehensive diabetes management, education, and support resources that will address one of the nation's fastest growing health threats. During fiscal year 2015, Highland Park Hospital total admissions were 9,152, and total patient days were 42,002. Skokie Hospital - Established in 1963, Skokie Hospital is a 123-licensed bed facility that has provided high-quality healthcare for nearly five decades and is nationally recognized for its expertise in orthopaedics and cardiac care. Skokie Hospital is a Joint Commission certified Primary Stroke Center. Skokie Hospital's key specialties and features also include minimally invasive surgery, total joint replacement, spine surgery, clinical cardiology, and graduate medical education (residency) programs in internal medicine, general surgery, and anesthesia. In addition, Skokie Hospital's Level II Trauma Center is staffed by an experienced trauma team specially trained in pediatric life support. During fiscal year 2015, Skokie Hospital total admissions were 6,478, and total patient days were 31,919. NorthShore University HealthSystem Faculty Practice Associates - In order to increase the efficiency and quality of health care NorthShore provides, NorthShore University HealthSystem Faculty Practice Associates (FPA) was organized to serve as an integral part of its health care mission and activities. FPA represents more than 900 physicians with over 100 offices in virtually every specialty all on staff at the hospitals of NorthShore. FPA physicians provide professional health care services for patients of NorthShore, as well as conduct medical education and research activities on behalf of NorthShore. NorthShore University HealthSystem Foundation - NorthShore University HealthSystem Foundation (Foundation) is dedicated to assisting the integrated healthcare delivery system to fulfill NorthShore's mission to "preserve and improve human life." The Foundation seeks to obtain the philanthropic support required to ensure that NorthShore can provide medical care, advanced research, and state-of-the-art facilities and equipment. The Foundation builds relationships with individuals and the community to increase awareness of NorthShore's high-quality services and giving opportunities. NorthShore Home and Hospice Services - NorthShore Home and Hospice Services offers the full spectrum of home and hospice care, including skilled nursing, physical and occupational therapy, and home medical equipment. The NorthShore Home and Hospice caregivers represent a wide range of medical specialties and work with the patient, family, and physician to tailor home care to meet the individual needs of each patient. Part III Line 4b - Statement of Program Services - Education NorthShore University HealthSystem (NorthShore) is committed to excellence in its academic mission and supports teaching and research in its role as the principal teaching affiliate of the University of Chicago Pritzker School of Medicine. NorthShore also has additional teaching affiliation agreements with Rush University Medical Center, University of Illinois-Chicago, Stroger Hospital, and Northwestern University Feinberg School of Medicine. NorthShore has an extensive selection of training programs and fellowships to offer physicians at our own teaching and research facilities. During fiscal year 2015, a total of 188 resident full time equivalents (FTEs) and 32 fellow FTEs participated in the NorthShore and affiliate-based programs. The NorthShore residency program areas included: Dentistry, Internal Medicine, Pathology, Preliminary Medicine (intern year), Transitional Medicine (first year prior to specialization), and Family Medicine. The NorthShore fellowship program areas included: Emergency Medicine Simulation, Endocrine Surgery, Family Medicine/Sports Medicine, Gastroenterology, Musculoskeletal Imaging, Surgical Pathology, and Urogynecology. The affiliate-based residency program areas included: Anesthesiology, Emergency Medicine, General Surgery, Neurology, Neurosurgery, Obstetrics and Gynecology, Ophthalmology, Orthopaedic Surgery, Otolaryngology, Pediatrics, Plastic Surgery, Podiatry, Psychiatry, Radiology, and Urology. The affiliate-based fellowship program areas included: Advanced Cardiovascular Imaging/Research, Cardiology, Cardiothoracic Surgery, Child Neurology, Child Psychiatry, Colon Rectal Surgery, Electrophysiology, Gynecologic Oncology, Hematology/Oncology, Mammography, Maternal-Fetal Medicine, Medical Microbiology, Molecular Genetics Pathology, Neonatal-Perinatal Medicine, Nephrology, Neuroradiology, Orthopaedic Hand, Orthopaedic Sports, Palliative Medicine, Peripheral Vascular Surgery, and Surgical Oncology. NorthShore also offers a comprehensive Pharmacy residency program, with resident positions located at all four hospitals. The Pharmacy residency program includes both clinical and administrative exposure focusing on inpatient practice. The program consists of a multitude of experiences that reinforce residents' knowledge and skills and help them advance into well-rounded practitioners. During fiscal year 2015, 22 residents participated in the program. The NorthShore School of Nurse Anesthesia operates out of Evanston Hospital. The program has full accreditation from the Council of Accreditation of Nurse Anesthesia Educational Programs. The mission of the School is the enrichment and transmission of knowledge of nurse anesthesia as a discipline and promotion of the health and well-being of individuals, families, and communities. The School seeks to provide graduates with innovative, inquiry-based education that anticipates the rapid pace of change in health care and the knowledge, skills, and attitude necessary to assume leadership roles in the nurse anesthesia profession. During fiscal year 2015, 59 students participated in the program. NorthShore also provided clinical training and internships during the 2015 academic year for 754 high school and college students. Students interned in various areas including Nursing, Physical Therapy, Radiology, Laboratory, and Speech Therapy. Part III Line 4c - Statement of Program Services - Research The NorthShore University HealthSystem Research Institute (Research Institute) was organized in 1996 to provide a means for integrating leading-edge research into improved clinical care. The Research Institute also creates an environment to recruit and retain externally-funded research leadership in order to achieve the mission and goals of the organization. The Research Institute houses 119 externally funded research faculty who currently occupy 95,000 net square feet of research space and work on 1,200 active research protocols. Total external funding is now approximately $82 million. NorthShore has also made a substantial commitment to develop the Center for Clinical and Research Informatics to conduct expanded research using informatics. Such infrastructure enables large scale efforts on comparative effectiveness, clinical quality/outcomes, and practice based research. The Center and its work build on our award winning Epic medical records system, providing a focus for growing faculty involvement in research. In 2014 the Genomic Health Initiative was launched for members of the community to help shape the future of Personalized Medicine. This research project will give physician and research experts the opportunity to more proactively learn about the science behind diseases and conditions, and apply this knowledge directly to a clinical setting to improve patient outcomes. The Genomic Health Initiative will allow researchers to more precisely predict, prevent, and treat disease while improving the future of healthcare and the medical field for generations to come. The goal is to collect 40,000 - 100,000 participants over the next several years to enable sufficient samples for DNA studies. Health Heritage was also established for patients and their families to have a powerful foundation on which to build personalized plans for improving their health, and potentially the health of family members. Health Heritage was designed and built by researchers and developers at NorthShore along with colleagues at the University of Virginia. This secure, dynamic online family health history will also be an essential part of the legacy NorthShore patients will leave their children and future generations with vital information including a family health history and personalized health risk reports and recommendations. Part VI Section A Line 2 - Business Relationships The following directors, officers, and key employees are directors or officers of NorthShore Physician Associates, Inc., a related for-profit corporation, and have a business relationship: Percy L Berger Sr, Toure S Claiborne, A Steven Crown, Mary Dillon, David A Dohnalek, Connie K Duckworth, William M Farrow III, Gerald P Gallagher, Gregory K Jones, Morris S Kharasch, Lester B Knight III, Harry M Jansen Kraemer Jr, Theodore Mazzone, Andrew J Mills, Kristen Murtos, Mark R Neaman, Nancy A Nora, Michael Reinsdorf, Thomas S Ricketts, Scott C Schweighauser, Susan B Sentell, Mark S Talamonti, J Mikesell Thomas, Jeffery S Vender, John R Walter, Sona Wang, Kevin Willer, David F Zucker Business relationship - Harry M Jansen Kraemer Jr and Samuel M Mencoff Business relationship - Gerald P Gallagher and Harry L Jones Business relationship - Gerald P Gallagher and Kristen Murtos Business relationship - Gerald P Gallagher and Gary E Weiss Part VI Section B Line 11b - Governing Body Review of 990 The NorthShore University HealthSystem (NorthShore) Form 990 was reviewed by executive management and an outside accounting firm. The NorthShore Form 990 was then provided to each member of the Board of Directors via email for their review and ability to ask questions of management prior to filing. Part VI Section B Line 12c - Conflict of Interest Policy Monitoring On an annual basis, the Chief Compliance Officer requires all officers, directors, and key employees to complete, sign and return a Conflict of Interest Disclosure Statement. Timely and accurate completion of the Statement is mandatory, and completed Statements must be returned to the Chief Compliance Officer within 15 days. Any disclosures included on the Statements are reviewed and acted upon as necessary by the Chief Compliance Officer and the Corporate Compliance Committee. Part VI Section B Line 15 - Determination of Compensation A detailed compensation review of the top 15 executives, including the Chief Executive Officer, is conducted annually. Market data is collected and assessed by an external independent compensation consultant who specializes in compensation consulting within the healthcare industry. The work product from this study is reviewed separately with Board-retained legal counsel. Market data for base and variable compensation is assessed annually for local, regional and national hospitals, integrated delivery systems, and academic medical centers. A detailed total compensation market review is conducted every two years. The market assessment includes assessing job content in order to make appropriate market data comparisons. Specific recommendations are then reviewed, discussed and approved as appropriate with the Compensation Committee of the Board, in session with legal counsel present, in advance of implementation. A detailed compensation review of the 13 Clinical Chairs is also conducted annually. Market data is collected and assessed by an external independent compensation consultant who specializes in compensation consulting for physicians within the healthcare industry. The work product from this study is reviewed separately with Board-retained legal counsel. Market compensation data for each physician's specialized area of training is assessed annually. A detailed total compensation and Fair Market Value review is conducted every two years. Specific recommendations are then reviewed, discussed and approved as appropriate with the Compensation Committee of the Board, in session with legal counsel present, in advance of implementation. Part VI Section C Line 19 - Public Disclosure of Documents The NorthShore University HealthSystem (NorthShore) governing documents, conflict of interest policy, and financial statements are available to the public upon request. The NorthShore annual audit report and financial statements are also available to the public through GuideStar and the Illinois Attorney General's Office websites as part of the federal and state tax return filings. The NorthShore quarterly and annual financial statements and annual audit are also made available to the public through the Electronic Municipal Market Access (EMMA) website as part of the tax-exempt bond offerings. Part XI Line 9 - Other Changes in Net Assets Other changes in net assets include equity adjustments for the pension and supplemental executive retirement plans. 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