2015-05-05T12:54:43-05:00 2014-06-30 420714325 MCGLADREY LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2013-07-01 362246719 Little Company of Mary Hospital Inc LITT 7082295111 2800 West 95th Street Evergreen Park IL 60805 Randy Ruther Assistant Treasurer and CFO 3176817440 2015-05-05 1 Zack Fortsch P00052725 3126343400 2013 2016-03-07 17:11:31Z Randy Ruther 2800 West 95th Street Evergreen Park IL 60805 432532297 0 X www.lcmh.org X 1893 IL In solidarity with the Sisters of the Little Company of Mary, we are entrusted to serve the community through our ministry of Catholic Health Care. We are the empowered laity - the Greater Company of Mary. Rooted in a deep heritage of prayerful support of the sick and dying, we strive to enhance the sacredness of life and human dignity. 18 13 2284 702 0 0 3672233 2256250 186086105 198452448 24254973 57663942 4614053 1781339 218627364 260153979 130000 35000 0 0 100185421 102270419 0 0 0 93132488 101403490 193447909 203708909 25179455 56445070 841825887 931780083 339221182 335281753 502604705 596498330 X In solidarity with the Sisters of the Little Company of Mary, we are entrusted to serve the community through our ministry of Catholic Health Care. We are the empowered laity - the Greater Company of Mary. Rooted in deep heritage of prayerful support of the sick and dying, we strive to enhance the sacredness of life and human dignity. 0 0 157974097 35000 199499280 Little Company of Mary Hospital operates 288 staffed beds in its hospital facilities. During fiscal year ended June 30, 2014, the Hospital admitted 12,882 patients and also had 4,092 observation cases. These admissions drove the 56,580 inpatient days the hospital had during the fiscal year. Furthermore, the Hospital provided its outpatients with 50,027 of equivalent patient days worth of care. Included in that 50,027 are emergency room visits of 46,816 along with various other outpatient visits. Some of the major service lines the Hospital offers are in the fields of cardiology, dermatology, endocrinology, GI medicine, hematology, infectious disease, medical trauma, neurology, oncology, pulmonary medicine, renal care, rheumatology, gynecology and obstetrics, behavioral health, cardiac surgery, cancer surgery, dental surgery, general surgery, GI surgery, neuro surgery, orthopedic surgery, trauma surgery, urology surgery, and vascular surgery. Little Company of Mary Hospital strives to offer excellent quality care. This can be seen in the many accreditations that it currently holds. Some of the accreditations are: -American College of Radiology Commission on Radiation Quality and Safety;-Baby Friendly Status from Baby Friendly USA;-Stroke Center Accredited by the Joint Commission on Accreditation of Healthcare Organizations;-Breast Health Center Accredited by the American College of Surgeons; -Bariatric Surgery Center of Excellence awarded by the American Society of Bariatric Surgery;-Gold Seal of Approval by the Joint Commission;-2014 Women's Choice award winner by America's Best Breast Centers;-Seal of Approval by the National Accreditation Program for Breast Centers;-Breast Imaging Center of Excellence by American College of Radiology;-American Diabetes Association recognizes the Hospital's diabetes center as meeting the national standards for diabetes self-management education;-Cancer Center has been recognized by the Commission on Cancer of the American College of Surgeons as offering the very best in cancer care;-Sleep Disorder Center accredited by American Academy of Sleep Medicine. 157974097 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 310 0 1 2284 1 0 0 0 0 0 0 0 0 0 0 X 18 13 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 0 1 0 X Walter Furtner 7082295100 2800 West 95th Street Evergreen Park IL 60805 Sister Kathleen McIntyre Chairperson 1.00 2.00 X X 0 0 0 Thomas Fahey Vice Chairperson 1.00 1.00 X X 0 0 0 Dennis Reilly President & CEO 40.00 1.00 X X 859670 0 21291 Dennis Kelly Treasurer 1.00 0.00 X X 0 0 0 Sister Jean Stickney Secretary 1.00 0.00 X X 0 0 0 Randy Ruther Assistant Treasurer & CFO 40.00 2.00 X X 493388 0 21291 Violet Clark Director 1.00 0.00 X 0 0 0 Brian Farrell MD Director 1.00 0.00 X 0 0 0 Patrick Folliard CPA Director 1.00 0.00 X 0 0 0 John P Hanlon MD Director 1.00 1.00 X 30000 0 0 Joseph Pedota Director 1.00 0.00 X 0 0 0 Daniel Rowan DO Director 1.00 0.00 X 37869 0 0 Robert Sheehy Director 1.00 0.00 X 0 0 0 Janice Stewart Director 1.00 0.00 X 0 0 0 Jayanthi Ramadurai MD Director 1.00 0.00 X 0 0 0 Jay B Sterns Director 1.00 0.00 X 0 0 0 Sister Sharon Ann Walsh Director 1.00 1.00 X 0 0 0 Michael Schwartz MD Director 1.00 0.00 X 32200 0 0 Kent Armbruster MD Vice President of Medical Affairs 40.00 1.00 X 271266 0 15907 Mary Freyer COO 40.00 0.00 X 324025 0 10503 Ann Haskins VP of Physician Business Development 40.00 1.00 X 298888 0 10303 Kevin Rehder VP Clinical Svcs. & Facilities Dvlp. 40.00 0.00 X 214038 0 21291 Jane Sullivan RN CNO 40.00 0.00 X 218410 0 15076 Colleen Rohan Director of Human Resources 40.00 0.00 X 167928 0 21291 Gina Knox General Counsel 40.00 0.00 X 160134 0 16434 Emuata U Bassey MD OB Hospitalist 40.00 0.00 X 224793 0 10609 Richard J Lopez MD Physician 40.00 0.00 X 152824 0 11231 Marilyn Daley Exec. Director Ambulatory Service 40.00 0.00 X 159754 0 18967 3645187 0 194194 47 0 1 0 University of Chicago Peds 5721 South Maryland Avenue K160 Chicago IL 60637 Pediatrics Hospitalists 1736103 Signature Healthcare Solutions 107 Forest Edge Drive Palos Park IL 60464 Hospitalist Services 1518327 Mayo Medical Laboratories PO Box 9146 Minneapolis MN 55480 Medical Laboratory Services 921666 M & O Environmental PO Box 759 Homewood IL 60430 Asbestos Removal Service 913100 Anderson Rasor & Partners LLP 100 South Wacker Drive Ste 1000 Chicago IL 60606 Legal Services 772645 19 1949000 40665 266585 2256250 Patient Services 621400 196369276 196369276 Other Program Services 621400 1099628 1099628 Related Support Services 900099 983544 983544 198452448 19019801 19019801 297311 0 297311 297311 297311 211018609 3850 172280931 97387 38737678 -93537 38644141 38644141 Meaningful Use 900099 749521 749521 Food Service Revenue 900099 696449 696449 Vending 900099 14119 14119 23939 23939 1484028 260153979 199499280 0 58398449 35000 35000 2829000 2829000 138260 138260 82641873 57849311 24792562 1372896 961027 411869 8778308 6144816 2633492 6510082 4557057 1953025 92886 83597 9289 82373 74136 8237 12198306 9758645 2439661 765176 612141 153035 36023574 28818857 7204717 1609220 1287376 321844 3343511 2507633 835878 129672 64836 64836 117994 82596 35398 3837966 3454169 383797 12833236 8983265 3849971 895082 626557 268525 IL Medicaid Assessment 12771046 12771046 Provision for Bad Debts 10220817 10220817 Demolition Expense 3946047 3946047 Linens 1369072 1232165 136907 1167512 935743 231769 203708909 157974097 45734812 0 7658133 9294781 23916883 27476872 24987 4237 1248190 1140735 7006611 4610428 359271628 152890668 203434673 206380960 583481818 667993737 13977070 14541925 1077522 336408 841825887 931780083 37165110 39440717 188334923 184782254 113721149 111058782 339221182 335281753 X 500087852 594241485 2516853 2256845 502604705 596498330 841825887 931780083 X 56445070 30063027 7385528 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1650000 68188 68188 1650000 1650000 71273 71273 1650000 1650000 132935 132935 1650000 1650000 111578 111578 1650000 1650000 46183 46183 1650000 1.00000 0 1 1 8954323 8954323 246125465 83701086 162424379 93617747 69189582 24428165 10574093 10574093 206380960 Self-Insurance Reserve 88031236 Settlements Due to Third Party 23027546 111058782 X Part V, Line 4: The endowment funds are intended to be used for nursing scholarship opportunities for future employed nurses ($650,000) and for the Values, Vision, and Innovation Project ($1,000,000). Part X, Line 2: The Hospital has received a determination letter from the Internal Revenue Service stating that it is exempt from the payment of income taxes under Section 501(c)(3) of the Internal Revenue Code. The Hospital adopted the FASB-issued guidance for accounting for uncertainty in income taxes on July 1, 2007. The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When these returns are filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the following: the tax-exempt status of each entity, the continued tax-exempt status of bonds issued by the obligated group, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business income (UBI). UBI is reported on Form 990-T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more-likely-than-not" recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above would be reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Upon the adoption of the FASB-issued guidance at July 1, 2007, and since that date through June 30, 2014, there were no unrecognized tax benefits identified and recorded as a liability. Forms 990 and 990-T filed by the Hospital are subject to examination by the Internal Revenue Service (IRS) up to three years from the extended due date of each return. Forms 990 and 990-T filed by the Hospital are no longer subject to examination for the years 2010 and prior. 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 5572897 5572897 0.02880 22526925 14513778 8013147 0.04140 28099822 14513778 13586044 0.07020 1908023 1908023 0.00990 1908023 1908023 0.00990 30007845 14513778 15494067 0.08010 1 10220817 65888551 71535743 -5647192 X 1 1 1 1 Little Company of Mary Hospital Inc 2800 West 95th Street Evergreen Park IL 60805 X X X Little Company of Mary Hospital Inc 1 1 X X X X X X X X X 12 1 1 1 X www.lcmh.org X lcmh.healthforecast.net X X X X X X X 0 0 1 1 600.000000000000 1 600.000000000000 1 X X X X X 1 1 X X X X X X 1 0 X X X X 1 X 0 0 Little Company of Mary Hospital, Inc. Part V, Section B, Line 3: As part of the Community Health NeedsAssessment, there were five Key Informant Focus Groups held in the region. These key informant focus groups allowed for input from persons with special knowledge of or expertise in public health, as well as others who represent the broad interests of the community served by the Hospital. Participants included 61 key informants in the region, including physicians, other health professionals, social service providers, business leaders and other community leaders.Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Participants included a representative of public health, as well as several individuals who work with low-income, minority or other medically underserved populations, and those who work with persons with chronic disease conditions. Specific names/titles of those participating are available upon request. Little Company of Mary Hospital, Inc. Part V, Section B, Line 4: Edward Hospital; Swedish Covenant Hospital; Northwest Community Hospital; Ingalls Memorial Hospital; Little Company of Mary Hospital & Health Care Centers; St. Anthony Hospital; St. Bernard Hospital and Health Care Centers; Central DuPage Hospital; University of Illinois Medical Center at Chicago; Elmhurst Memorial Healthcare; Franciscan St. James Health - Chicago Heights; Thorek Memorial Hospital; Palos Community Hospital; Rush University Medical Center; Northwestern Memorial Hospital; Lake Forest Hospital; Adventist Hinsdale Hospital; University of Chicago Medical Center; Mercy Hospital and Medical Center; Adventist Glen Oaks Hospital; Jackson Park Hospital and Medical Center; Adventist LaGrange Memorial Hospital; La Rabida Children's Hospital; Norwegian American Hospital; Rush Oak Park; Vanguard Health Chicago (including: West Suburban Medical Center; Westlake Hospital; Weiss Hospital and MacNeal Hospital); Resurrection Health Care (including: Holy Family Medical Center; Our Lady of the Resurrection Medical Center; Resurrection Medical Center; Saint Francis Hospital; Saint Joseph Hospital and Saints Mary & Elizabeth Medical Center); Alexian Brothers Hospital Network (including: Alexian Brothers Behavioral Health Hospital; Alexian Brothers Medical Center; Alexian Brothers Rehabilitation Hospital and St. Alexius Medical Center). Little Company of Mary Hospital, Inc. Part V, Section B, Line 5d: The Community Health Needs Assessment is available to the public using the following URL: http://lcmh.healthforecast.net. HealthForecast.net is an interactive, dynamic tool designed to share CHNA data with community partners and the public at large.This site:- Informs readers that the CHNA Report is available and provides instructions for downloading it;- Offers the CHNA Report document in a format that, when accessed, downloaded, viewed, and printed in hard copy, exactly reproduces the image of the report;- Grants access to download, view, and print the document without special computer hardware or software required for that format (other than software that is readily available to members of the public without payment of any fee) and without payment of a fee to the hospital organization or facility or to another entity maintaining the website.Links to this dedicated healthForecast.net site are also made available at LCMH's website at: http://www.lcmh.org. LCMH will provide any individual requesting a copy of the written report with the direct website address, or URL, where the document can be accessed. LCMH will also maintain at its facilities a hardcopy of the CHNA report that may be viewed by any who request it. Little Company of Mary Hospital, Inc. Part V, Section B, Line 7: In acknowledging the wide range of priority health issues that emerged from the CHNA process, the Hospital determined that it could only effectively focus on those which it deemed most under-addressed, and most within its ability to influence. 5 Homecare and Hospice Building 9800 S Southwest Highway Oak Lawn IL 60453 Home Care and Hospice Halsted Building 736 West 95th Street Chicago IL 60628 Healthcare Heritage Building 2800 West 87th Street Chicago IL 60652 Healthcare Carestation East 5660 West 95th Street Oak Lawn IL 60453 Other Outpatient Center Carestation West 6700 West 95th Street Oak Lawn IL 60453 Other Outpatient Center Part I, Line 3c: The Hospital uses Federal Poverty Guidelines to determine eligibility for free or discounted care. Part I, Line 6a: The Hospital's community benefit report is prepared in a separate report presented by the organization. Part I, Line 7: The Hospital used the cost to charge ratio from the Medicare cost report (Worksheet C, Part 1). Part I, Ln 7 Col(f): Bad debt expense of $10,220,817 was included on Form 990, Part IX, Line 25, Column (A) but subtracted for purposes of calculating the community benefit percentage on Schedule H, Part I, Line 7, Column (f). Part III, Line 3: Information is not available to reasonably estimate the portion of bad debt expense attributable to patients eligible for financial assistance. Part III, Line 4: Patient receivables, where a third-party payer is responsible for paying the amount, are carried at a net amount determined by the original charge for the service provided, less an estimate made for contractual allowances or discounts provided to third-party payers. Patient accounts receivable are stated at net realizable value. The Hospital evaluates the collectability of its accounts receivable based on the length of time the receivable is outstanding, major payer sources of revenue, historical collection experience, and trends in health care insurance programs to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. For receivables associated with services provided to patients who have third-party payer coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts. For receivables for self-pay patients, the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. These allowances are recorded on an estimated basis and are adjusted as needed in future periods. Accounts receivable are charged to the allowance for doubtful accounts when the accounts are deemed uncollectible. Part III, Line 8: The Hospital used the cost to charge ratio from the Medicare cost report (Worksheet C, Part 1). Part III, Line 9b: For patients who are classified as uninsured, the financial counselor will complete a financial evaluation worksheet to determine if the patient qualifies for a government assistance program. If not, the counselor will ascertain whether the patient is eligible under the Hospital's charity care policy. Also, for insured patients there will be no collection agency referral if the patient has requested a reasonable payment plan or requested financial assistance and is eligible under the Hospital's charity policy. Part VI, Line 2: Needs Assessment:The Hospital gathers information on the community's health needs from many sources including the following: 1) Internal records - These records provide a reliable source of timely information about what services are used by our community. Information is compiled and analyzed on many levels, including by major diagnostic category and diagnostic related group, to track changes in the community's utilization of health services. 2) Patient surveys - Results are reviewed and program, screening, and health lectures are added and modified based on this feedback from the community. 3) External data - The Hospital engages outside studies of services used by the community. 4) Physician input - Physicians are periodically surveyed to assess the healthcare services needed by their patients. In addition to surveys, physician input is gathered through the Medical Executive Committee and departmental meetings. Physicians also serve on the Hospital's Board of Directors, Strategic Planning Committee, Mission Committee and Performance Improvement Council. Part VI, Line 3: Patient Education of Eligibility for Assistance: At registration, patient's employment status or lack of basic insurance coverage will prompt the staff to offer a charity application. Notice of this charity assistance policy is posted in locations visible to the public including the emergency department, admission areas and the business office. Notices are available in general patient brochures, on the Hospital's website and on patient billing statements explaining how to apply for charity consideration. Part VI, Line 4: Community Information:The Hospital is located in Evergreen Park, Illinois and is just 20 minutes from downtown Chicago. The Hospital's primary service area includes many Chicago neighborhoods as well as the suburban communities of Oak Lawn and Hometown. Data was compiled by analysis of inpatient and outpatient discharges by ZIP code.Within the primary service area, approximately:41.7% is African American34.8% is White21.1% is Hispanic or Latino2.4% is Asian or Native American53.9% is Female17.3% is over 6523.5% is under 1834% speaks a language other than English at home59.8% own a homeMedian household income is $54,59816% is below the poverty rateThree other hospitals are located within the primary service area. Part VI, Line 5: Promotion of Community Health:The hospital currently has well over 60 separate programs to provide ongoing care to its target population, including:- Heart Failure Clinic offers education and extra time and medical attention- Wellness events- Health screenings- Physician-led community programs- Senior billing assistance- Mobile medical home visits by our staff physicians and nurses- Diabetes center and diabetes education and awareness community-led forums- Weight management programs for the community, hypnosis, and multiple physician presentations on nutrition- Smoking cessation classes and participation in the Great American Smokeout- Weekly healthy heart screenings throughout the year- Wakeup call screening (for strokes)- Monthly blood pressure screenings - Sponsorships/partnering or support services to local elementary and high schools, church parishes and local community service organizations.The Hospital furthers relationships with local townships, villages and schools by holding quarterly meetings with health service coordinators and by participating in collaborative health and wellness initiatives in its community through the Healthier Evergreen Committee by holding multiple meetings throughout the year.The majority of the Hospital's governing body is comprised of persons residing in and around the primary service area who are not employees or independent contractors (nor family members thereof) of the Hospital.The Hospital extends medical staff privileges to all qualified physicians in its community.The Hospital uses any surplus funds to fund operations, charity care, capital, and programs for the community. Part VI, Line 6: The Hospital communicates with the community to provide ongoing care to its target population by providing physician-led community programs, health fairs, and health events. LCM Affiliated Services promotes the health of the community by providing ambulatory services and employing physicians in a variety of specialties. The employed physicians see and treat patients from the community and are part of the health programs offered by the Hospital.LCM Foundation promotes the health of the community by supporting the Hospital. The Foundation collects donations which are used to fund the programs of the Hospital. Part VI, Line 7, Reports Filed With States IL 1 Student Nursing Tuition 7 35000 Part I, Line 2: The hospital monitors use of grants in scholarships by following its policy. The Director of Human Resoures makes sure that each scholarship recipient adheres to the policy and the agreement that each recipient signed. Tuition payments are either made directly to the school or tuition receipts must be submitted to the Hospital. At the end of each semester, grade reports must be provided to the Hospital. Any deviation results in the recipient having to repay the grant to the hospital. X X X X 0 0 0 0 0 0 0 1 0 Dennis Reilly President & CEO 554126 0 300000 0 5544 0 5100 0 16191 0 880961 0 0 0 Randy Ruther Assistant Treasurer & CFO 380874 0 110000 0 2514 0 5100 0 16191 0 514679 0 0 0 Kent Armbruster MD Vice President of Medical Affairs 250360 0 15000 0 5906 0 5100 0 10807 0 287173 0 0 0 Mary Freyer COO 271827 0 50000 0 2198 0 5100 0 5403 0 334528 0 0 0 Ann Haskins VP of Physician Business Development 264435 0 32000 0 2453 0 5100 0 5203 0 309191 0 0 0 Kevin Rehder VP Clinical Svcs. & Facilities Dvlp. 179465 0 34000 0 573 0 5100 0 16191 0 235329 0 0 0 Jane Sullivan RN CNO 187186 0 28600 0 2624 0 5100 0 9976 0 233486 0 0 0 Colleen Rohan Director of Human Resources 144233 0 22421 0 1274 0 5100 0 16191 0 189219 0 0 0 Gina Knox General Counsel 156515 0 3025 0 594 0 3228 0 13206 0 176568 0 0 0 Emuata U Bassey MD OB Hospitalist 201610 0 23000 0 183 0 4070 0 6539 0 235402 0 0 0 Richard J Lopez MD Physician 152651 0 0 0 173 0 3100 0 8131 0 164055 0 0 0 Marilyn Daley Exec. Director Ambulatory Service 148434 0 10000 0 1320 0 2566 0 16401 0 178721 0 0 0 Part I, Line 7 The Board of Directors exercises discretion over executive bonus payments. A Illinois Finance Authority 861091967 45200FFV6 2008-04-29 134340000 See Part VI 0 0 0 B Illinois Finance Authority 861091967 45200F6D6 2010-10-20 72000000 See Part VI 0 0 0 A 21640000 134483633 704492 25000 13730097 120024044 2008 1 0 1 1 B 71229134 618241 70610893 2010 0 0 1 1 A 0 1 0 0 0 0 0 B 0 0 0 0 0 0 0 A 0 0 1 0 1 0 0 0 0 B 0 0 0 0 0 0 0 0 0 A 1 B 1 Form 990, Schedule K, Part 1, Column F Bond A: The 4/29/2008 bonds were used to (I) refinance a bank loan; (II) pay expenses incurred with the issuance of the bonds and credit enhancements. On March 13, 2008 the Hospital entered into a revolving credit agreement with JP Morgan Chase Bank and applied proceeds of the term loan advanced thereunder to currently refund the series 1997B bonds, issued 11/20/1997, on March 13, 2008 and the series 2007 bonds, issued 8/16/2007 on April 1, 2008. Proceeds of $120,024,044 from the bonds were used to refund the bank loan. Bond B: The proceeds of the series 2010 bonds, were used to (I) construct and equip a new, approximately 295,000 square foot pavilion (II) modernize 40,000 square feet in the corporation's two oldest buildings that provide patient care (built in 1956 and 1984, and (III) following completion of the demolition of the tower building, build-out a structural link between the North Pavilion and the West Pavilion, and construct and landscape the east entry of the West Pavilion. The project also includes the construction of the area's first comprehensive women's health center (The Women's Center for Life and Health). Mary Coners Family Member of Dennis Reilly 69825 Employment 0 Elizabeth Freyer Family Member of Mary Freyer 52504 Employment 0 Timothy Ruther Family Member of Randy Ruther 15931 Employment 0 Form 990, Part VI, Section A, line 6 American Province of The Little Company of Mary Sisters, Inc. is the sole corporate member and is an Illinois not-for-profit corporation whose purpose is to represent the interest of the congregation of Little Company of Mary Sisters. Form 990, Part VI, Section A, line 7a American Province of The Little Company of Mary has the power to appoint members of the governing body. Form 990, Part VI, Section A, line 7b The sole corporate members retain reserved powers to approve, among other things, the Hospital's annual budget, election of directors, and the incurrence of debt or transfer of property in excess of certain limits. Form 990, Part VI, Section B, line 11 Form 990 is reviewed by the accounting manager and CFO prior to filing. Form 990, Part VI, Section B, line 12c Each director, principal officer, key employee, and member of a committee with Board delegated powers shall annually sign a conflict of interest statement which affirms that such person has received, read, understood and agreed to comply with the directive. All conflict of interest statements are reviewed annually by the CEO and the Corporate Compliance Officer and the results presented to the Corporate Compliance Committee. The results and any recommendations are reported at the next Board of Directors' meeting. If a conflict is deemed to exist, such person shall not vote on, nor use his or her personal influence on, nor participate (other than to present factual information or to respond to questions) in the discussions of deliberations with respect to such contract or transaction. Such person may not be counted in determining the existence of a quorum at any meeting where the contract or transaction is under discussion or is being voted upon. The minutes of the meeting shall reflect the disclosure made, the vote thereon and, where applicable, the abstention from voting and participation, and whether a quorum was present. Form 990, Part VI, Section B, line 15a The Board Executive Committee annually reviews external benchmark compensation drafts and determines compensation adjustments based on market data and internal performance results for the CEO, CFO, and COO positions. The organization uses an outside consultant and outside surveys to determine appropriateness of executive pay. The process of determining executive compensation is documented and retained by the CEO. For other top management positions, the compensation committee is comprised of the CEO, CFO, and COO. Form 990, Part VI, Section C, line 19 The conflict of interest policy is available by request. Form 990, Part XI, line 9: Net Asset Transfer -5,283,658. Pension-Related Changes 13,385,444. Net Assets Released From Restriction -716,258. Little Company of Mary Health Systems 2800 West 95th Street Evergreen Park IL 60805 363823627 Health Services IL 501(c)(3) Line 1 American Pronvince 0 Little Company of Mary Affiliated Services 2800 West 95th Street Evergreen Park IL 60805 363383867 Health Services IL 501(c)(3) Line 7 Little Company of Mary Health Systems 0 Little Company of Mary Foundation 2800 West 95th Street Evergreen Park IL 60805 363993337 Support Organization IL 501(c)(3) Line 11a, I Little Company of Mary Hopsital 0 American Province of the Little Company of Mary Sisters 2800 West 95th Street Evergreen Park IL 60805 237294648 Religious IL 501(c)(3) Line 1 N/A 0 Durable Medical Equipment Center 2800 West 95th Street Evergreen Park IL 60805 363511877 Durable Goods IL Little Company of Mary Excluded 0 1 Southwest Health Systems Inc Little Co of Mary Health Providers 2800 West 95th Street Evergreen Park IL 60805 363425830 Managed Care IL Little Company of Mary Hospital C 2290597 1.00000 1 Mary Cap Insurance Inc 76 St Paul Street Ste 500 Burlington VT 05401 030304812 Captive Insurance VT Little Company of Mary Hospital C 3186038 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 Little Company of Mary Foundation C 1899000 FMV Little Company of Mary Foundation Q 1239041 FMV Durable Medical Equipment Center Q 740471 FMV