2014-11-17T12:18:24-06:00 2013-12-31 ERNST & YOUNG US LLP 155 N Wacker Drive Chicago IL 60606 990 2013-01-01 362644178 Presence Our Lady of the Resurrection Medical Center % ANTHONY J FILER PRES 7735948544 5645 West Addison Street Suite Chicago IL 60634 ANTHONY J FILER Treasurer 2014-11-17 2013 2015-11-30 17:44:51Z JOHN BAIRD 5645 WEST ADDISON STREET CHICAGO IL 60634 143351574 false 0928 X www.presencehealth.org X 1966 IL SEE SCHEDULE O 5 4 0 116 86036 236338 245551 122059253 136049657 2355791 3171130 2077237 3885236 126728619 143351574 0 0 0 0 55749713 54948161 0 0 0 78814837 88904407 134564550 143852568 -7835931 -500994 88725718 60226566 54018082 26019924 34707636 34206642 X SEE SCHEDULE O false false 126438293 0 139848857 SEE SCHEDULE O 0 0 0 126438293 true true false false false false false false false false true false false true true true false true false false false false false false false false true true false false true false false false false false false false false false false false false false true true true false false true X 0 0 0 true true false false false false false false false false false X 5 4 false false true false true true true true true false false true true true true true true false false false X ANTHONY J FILER 8478133728 100 NORTH RIVER ROAD DES PLAINES IL 60016 X Paul Skiem DIRECTOR 1.0 44.0 X 0 485624 94131 John Baird Dir Ex-Officio/President/CEO 1.0 42.0 X X 0 568227 122033 Shirish Shah MD Director 1.0 0.0 X 0 0 0 Joseph D'Silva MD Director 1.0 0.0 X 0 0 0 Father Jason Malave DIRECTOR 1.0 0.0 X 0 0 0 Martin Judd EX-OFFICIO/CEO (TERMED 4/2013) 1.0 40.0 X 0 495621 82880 Robert Bulger DIRECTOR (TERM EXPIRED 1/2013) 1.0 40.0 X 0 312244 26295 TIVANDOR SZABO DIRECTOR (TERM EXP 12/2013) 1.0 0.0 X 0 0 0 Anthony J Filer TREASURER 1.0 50.0 X 0 878902 172661 Patrick Quinn Assistant Treasurer 1.0 40.0 X 0 290799 40263 Julie Roknich Assistant Secretary 1.0 40.0 X 0 173049 26630 Jeannie C Frey SECRETARY 1.0 50.0 X 0 653365 135768 JOHN A ORSINI CPA TREASURER (TERM EXP 1/2013) 1.0 42.0 X 0 228935 9651 Dennis Fitzmaurice Vice President 40.0 0.0 X 268108 0 14842 Mary Anne Bajgrowicz VP PTNT CARE/CNO RESIGNED 7/13 40.0 0.0 X 235829 0 112548 David Bordo VICE PRESIDENT 40.0 0.0 X 386115 0 45799 Bina Walsh RGN Lead Pharmacy-CNW 40.0 0.0 X 148676 0 35110 Rosemarie Wade STAFF NURSE I WKND 40.0 0.0 X 160600 0 31118 Diane Ortolano Director Rehab Services 40.0 0.0 X 147044 0 11608 Leah Dela Merced STAFF NURSE II WKND 40.0 0.0 X 131773 0 35823 1478145 4086766 997160 53 false true false LEIDOS HEALTH LLC PO BOX 223866 PITTSBURG PA 152512866 PROFESSIONAL SERVICE 1467216 SHIFTWISE US BANK CORPORATE TRUS PO BOX 70870 ST PAUL MN 551709705 CLINICAL AGENCY 539979 EA HEALTH CORPORATION 440 STEVENS AVENUE SUITE 150 SOLANA BEACH CA 92075 PHYSICIANS SERVICES 301052 MILLENNIUM LABORATORIES INC 16981 VIA TAZON SAN DIEGO CA 921271645 LAB SERVICES 252415 BEAR CONSTRUCTION 1501 ROHLWING ROLLING MEADOWS IL 600081336 CONSTRUCTION MGMT 178829 9 0 234991 10560 0 245551 NET PATIENT SERVICE REVENUE 621990 136049657 136049657 0 0 136049657 3167459 3167459 0 0 0 0 0 3671 0 3671 3671 3671 0 0 0 0 MEANINGFUL USE & BLUE CROSS BONUS 900099 3143755 3143755 0 0 CHILD CARE CENTER 621500 81952 81952 0 0 LAB SERVICES 621500 86036 0 86036 0 573493 573493 0 3885236 143351574 139848857 86036 3171130 0 0 0 0 0 0 0 0 631327 631327 0 0 0 0 0 0 44267563 44267563 0 0 1899586 1899586 0 0 4906981 4906981 0 0 3242704 3242704 0 0 17313048 0 17313048 0 101227 0 101227 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 15226423 15226423 0 0 249 249 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1332933 1332933 0 0 14507 14507 0 0 0 0 0 0 28197 28197 0 0 1085795 1085795 0 0 0 0 0 0 6428117 6428117 0 0 -6327398 -6327398 0 0 PROVISION FOR BAD DEBTS 28454120 28454120 0 0 MEDICAL SUPPLIES 16929968 16929968 0 0 IL MEDICAID TAX 5788382 5788382 0 0 REPAIRS AND SERVICES 430327 430327 0 0 2098512 2098512 143852568 126438293 17414275 0 0 25395 36110 0 0 0 0 21849148 21104309 0 0 0 0 0 0 2187195 1743017 0 0 125905087 101275455 26186794 24629632 36199919 0 0 0 0 0 0 0 2277267 12713498 88725718 60226566 3350494 1207705 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50667588 24812219 54018082 26019924 X 34707636 34206642 0 0 0 0 34707636 34206642 88725718 60226566 -500994 X X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1760349 1760349 73747144 58262784 15484360 2520848 2267114 253734 47876746 40745557 7131189 24629632 REINSURANCE RECEIVABLE 1281278 SUNDRY RECEVIABLE 1154302 DUE FROM AFFILIATES 10277918 12713498 0 DUE TO THIRD PARTY PAYORS 7735855 DUE TO / FROM AFFILIATES 620086 MALPRACTICE LIABILITY 16456278 24812219 X FIN 48(ASC740) Footnote PRESENCE HEALTH RECOGNIZES THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF DECEMBER 31, 2013 AND 2012, PRESENCE HEALTH DOES NOT HAVE ANY LIABILITIES FOR UNRECOGNIZED TAX BENEFITS. true true X true X true X 600. true true false true true 4391960 0 4391960 0.03810 22301033 19991660 2309373 0.02000 0 0 0 0 0.00000 0 26692993 19991660 6701333 0.05810 28 124147 13086 111061 0.00100 10 559809 2000 557809 0.00480 1080283 1005589 74694 0.00060 1 22451 0 22451 0.00020 8 834272 0 834272 0.00720 47 2620962 1020675 1600287 0.01380 47 0 29313955 21012335 8301620 0.07190 2 95097 19523 75574 0.00070 2 95097 19523 75574 0.00070 true 28454120 44217541 45639282 -1421741 X true true 1 1 PRESENCE OUR LADY OF RES MED CTR 5645 WEST ADDISON STREET CHICAGO IL 60634 HTTP://WWW.PRESENCEHEALTH.ORG/LOCATIONS 0001719 X X X A A-PRESENCE OUR LADY OF RES MED CTR 1 true X X X X X X X X X 13 true false true X X X X X X X X true false true true 200. true 600. true X X X X X X X X X true true X X X X true false X X X X true X false false PART V, SECTION B, LINE 2 In Presence Health's 2012 Schedule H (Form 990), it was indicated that the CHNA was completed in 2012. Although the quantitative and qualitative data was collected and compiled in 2012, the CHNA report was not made publicly available until the beginning of 2013. The CHNA completion date has been updated on this form to 2013 to be consistent with when the IRS deems the CHNA to be conducted (the date on which the CHNA report is published and made "widely available.") PART V, SECTION B, LINE 3 A community health needs assessment (CHNA) is a collaborative community process of identifying and prioritizing a community's health needs, accomplished through the collection and analysis of data, including input from community stakeholders. In July 2012, a CHNA Steering Committee was formed to represent stakeholders within the POLRMC community, as well as to provide oversight and input throughout the CHNA process. The committee's role is also to assist in the identification of data-driven community priorities and to engage stakeholders in community solutions through partnerships and collaboration. By taking on a community approach to both the assessment and implementation strategies, the goal is to ensure the data, processes, and outputs add value to all community partners, not just the hospital. Engagement of Public Health Expertise Presence Health formally engaged the Illinois Public Health Institute (IPHI) for assistance in planning and executing the CHNA process. IPHI served as an expert public health consultant throughout the CHNA timeline. Further, IPHI provided invaluable assistance in obtaining partnerships with the local and county Health Departments. Given the vast number of county hospitals served by the same Health Department in Cook County, resource allocation was difficult to obtain. As such, IPHI functioned as a liaison role between Presence Health and the Health Departments so as to obtain engagement through public data sharing and linkages with implementation plans. Conversations were facilitated between the Cook County Department of Public Health so as to continually inform all parties of CHNA process inputs and obtain both feedback and support. CHNA Steering Committee To provide community level oversight for the process, a diverse group of community stakeholders and Presence Our Lady of the Resurrection Medical Center representatives from its service area (the Chicago community areas of: Jefferson Park, Dunning, Montclare, Belmont Cragin, Hermosa and Portage Park) were invited to participate on the CHNA Steering Committee. To ensure representative engagement, personal invitations were sent to organizations representing cultural, linguistic, racial, ethnic, and other minority groups. In addition, individuals with specialized qualifications in dealing with special populations or clinical groups were solicited for their participation. Finally, efforts were made to include individuals on the CHNA Steering Committee with public health expertise. Those who committed to the assessment and planning process became the 30 members of the CHNA Steering Committee, which continues to meet regularly to provide feedback and oversight, assess progress, and modify plans as needed. The agencies represented on the CHNA Steering Committee are listed below: - Portage Park Chamber of Commerce - Hermosa Community Organization - Metropolitan Family Services, North Center - PrimeCare Community Health Center - Polish American Association - Lutheran Social Services of Illinois - Belmont-Central Chamber of Commerce - Sister Bonaventure Children's Choice Learning Center - Coalition to Save Our Mental Health Centers - Old Irving Park Community Clinic - Mather LifeWays - Northwest Side Housing Center Community Health Profile The Community Health Profile is a compilation of secondary data (data already published and available) about a particular community. The profile provides comparative information to assist in understanding the needs and priorities of a community. The Community Health Profile for POLRMC analyzed over 50 indicators. Example indicators include: population trends, race, income, poverty levels, and percentage of uninsured, health professional shortages, leading causes of death, teen births, birth weights, tobacco use, physical activity, crime rates, and food insecurity. The Community Health Profile can be found online at www.presencehealth.org/community. Community Input Report The community input process was completed between August and October 2012. The process included creating and administering a community input survey in Spanish, Polish and Russian as well as English, facilitating three focus groups, and completing an asset and resources inventory. The community survey explored residents' perceptions of issues surrounding quality of life, health, and social factors and collected respondents' demographics including insurance coverage. Nine hundred fifty one (951) community residents completed the survey. The Community Input Report can be found online at www.presencehealth.org/community. In conjunction with the CHNA Steering Committee and numerous community stakeholders, an inventory of community assets was then conducted so as to determine existing health resources that could be built upon or collaborated with to conduct the work of POLRMC's ministry. The Community Asset Matrix can be found in Appendix 1 of the Community Input Report online at www.presencehealth.org/community. PART V, SECTION B, LINE 5D The CHNA Report was made widely available to the general public on our website. The specific URL is provided here: http://www.presencehealth.org/sites/default/files/pdfs/CommunityReports/PO LRMC/CHNA_Report_POLRMC.pdf. Print copies are available upon request. In addition, copies were mailed to community partners who collected community input and participated in the CHNA process for more specific dissemination of findings. Partners were also provided links to the website via email for dissemination to their mailing lists and respective constituents. PART V, SECTION B, LINE 12I Federal Poverty Guidelines are also used in determining the basis of calculating amounts charged to patients. PART I. FINANCIAL ASSISTANCE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST PART I, LINE 3C This question is not applicable because Presence Health uses the Federal Poverty Guidelines. PART I, LINE 6A Presence Health, the System parent corporation of Presence Our Lady of the Resurrection Medical Center (POLRMC), published a Community Benefit Report for 2013, which details the combined charitable impact Presence Health facilities have within the communities they serve. In addition to the Community Benefit Report for 2013, POLRMC publishes a ministry-specific Implementation Strategy which outlines the goals and objectives POLRMC has established to address the prioritized needs of its community. The Presence Health system is referenced in this document, but other hospitals within the Presence Health system file their own 990s and Schedule H. PART I, LINE 6B The 2013 Presence Health Community Benefit Report was made publicly available through a variety of ways to share the information with the community at large: - Print version of report. The report will be mailed to community partners, elected officials and local leaders. - Website. A robust community section has been developed and can be found online at www.presencehealth.org/community. This section includes an online, downloadable file of the 2013 Community Benefit Report. Presence Our Lady of the Resurrection Medical Center has its own ministry link on this page. Through this link, Community Health Needs Assessment (CHNA) documents specific to Presence Our Lady of the Resurrection Medical Center can be downloaded, including a community-friendly CHNA flipbook, the source documents of all data reviewed, an overall CHNA Report, and an Implementation Strategy. - PowerPoint presentation. A standard PowerPoint of the entire 2013 Community Benefit Report has been made available. A customized version of this presentation has also been created for Presence Our Lady of the Resurrection Medical Center to share with the community, which shows the local community benefit contributions, persons served, and the 2013 prioritized community needs. PART I, LINE 7G Costs from physician clinics are not included in subsidized service totals. PART I, LINE 7K, COLUMN F Per 2013 Instructions for Schedule H (Form 990), the Bad Debt Expense of $28,454,120 has been removed from the denominator in calculating the percentage of total expense in Line 7. PART I, LINE 7 - EXPLANATION OF COSTING METHODOLOGY THE COST-TO-CHARGE RATIO WAS USED TO DETERMINE SCHEDULE H, PART I, LINE 7A, FINANCIAL ASSISTANCE AT COST. SCHEDULE H, PART I, LINE 7B, UNREIMBURSED MEDICAID, WAS DERIVED FROM WORKSHEET 2, RATIO OF PATIENT CARE COST TO CHARGES. THE REMAINING AMOUNTS REPORTED ON LINE 7 ARE REPORTED AT COST. PART II. COMMUNITY BUILDING ACTIVITIES Community building activities include programs that improve the community's health and safety by addressing the root causes and social determinants of health problems, such as poverty, homelessness and environmental hazards. Participation in collaborative community efforts to promote public health initiatives is also included, such as engagement in coalitions and advocacy for health improvement. These activities strengthen the community's capacity to promote the health and well-being of its residents by offering the expertise and resources of the health care organization. Presence Our Lady of the Resurrection Medical Center engages in a variety of community-building activities which ultimately improve the health of the communities we are privileged to serve, even though they are not specific health activities. Examples of community building activities include: - All of our hospitals work to support disaster readiness and emergency preparedness. This work goes above and beyond any licensure requirements to proactively ensure our communities are safe and prepared if a disaster should present itself. - Presence Our Lady of the Resurrection Medical Center participates in several community coalitions, such as Building a Healthier Chicago. Building a Healthier Chicago is a collaborative of more than 150 local and national stakeholders including: US Department of Health and Human Services - Region V, Chicago Department of Public Health, Institute of Medicine in Chicago, and the Chicago Medical Society. The goal of Building a Healthier Chicago is to improve the health of Chicago's residents and employees through the integration of new and existing public health, business, medicine and community efforts. The goals are geared toward achieving: reduction of health risks, improvement of health systems, and elimination of health disparities. It is our belief that working in collaboration with community partners helps to build the foundation for a healthier community. PART III. BAD DEBT, MEDICARE, & COLLECTION PRACTICES PART III, SECTION A, LINE 2 There are no estimates of bad debt included. Bad debt is at total expense. PART III, SECTION A, LINE 3 The Provision for Financial Assistance Policy allows for accounts in bad debt to be approved for Financial Assistance if the patient meets the criteria. There are possible financial assistance accounts in bad debt, although the exact percentage is unknown as we do not have the appropriate tools to determine this percentage accurately. PART III, SECTION A, LINE 4 FOR TAX RETURN PURPOSES THE BAD DEBT EXPENSE IS SHOWN ON PART IX, STATEMENT OF FUNCTIONAL EXPENSE. FOR AUDIT PURPOSES THE ORGANIZATION FOLLOWS ASU 2011-07 PRESENTATION. PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. IN EVALUATING THE COLLECTIBILITY OF PATIENTS' ACCOUNTS RECEIVABLE, PRESENCE HEALTH ANALYZES ITS PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF ITS MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, PRESENCE HEALTH ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS AND A PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE, IF NECESSARY. FOR RECEIVABLES ASSOCIATED WITH PATIENT RESPONSIBILITY (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE PATIENTS ARE SCREENED AGAINST PRESENCE HEALTH CHARITY CARE POLICY AND UNINSURED DISCOUNT POLICY. FOR ANY REMAINING PATIENT RESPONSIBILITY BALANCE, PRESENCE HEALTH RECORDS A PROVISION FOR UNCOLLECTIBLE ACCOUNTS RECEIVABLE 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. THE DIFFERENCE BETWEEN THE STANDARD RATE (OR DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. PART III, SECTION B, LINE 8 The organization computes the Medicare shortfall based on a ratio of cost to charges. Presence Our Lady of the Resurrection Medical Center believes it is important for the community and the IRS to be made aware of government shortfalls, specifically Medicare. However, we acknowledge that Medicare shortfalls may be experienced by other non-profit healthcare organizations. As such, Presence Our Lady of the Resurrection Medical Center does not believe that Medicare shortfall should be considered community benefit. PART III, SECTION C, LINE 9B Collection policies are the same for all Presence Health entities, which includes Presence Our Lady of the Resurrection Medical Center's patients. Patients are notified of the financial assistance policy at the time of registration via posted notifications and on every account statement that is sent to them. This information is available in a number of languages. Patients may apply for financial assistance at any time during the revenue cycle. Per the Provision for Financial Assistance Policy, the collection process is as follows: - Pre-Litigation Review. Prior to an account being authorized for the filing of suit for non-payment of a patient bill, a final review of the account will be conducted and approved by the Financial Counseling Representative (or designee) to make sure that no application of financial assistance was ever received and that there exists objective evidence that the patient does have sufficient financial means to pay all or part of his/her bill. Prior to a collections suit being filed, the Self-pay Collections Director must review and approve. - Residential Liens. No hospital will place a lien on the primary residence of a patient who has been determined to be eligible for Financial Assistance/Charity Care, for payment of the patient's undiscounted balance due. Further, in no case will any hospital execute a lien by forcing the sale or foreclosure of the primary residence of any patient to pay for any outstanding medical bill. - No Use of Body Attachments. No hospital will use body attachment to require any person, whether receiving Financial Assistance/Charity Care discounts or not, to appear in court. - Collection Agency Referrals. Each hospital Finance accounting will ensure that all collection agencies used to collect patient bills promptly refer any patient who indicates financial need, or otherwise appears to qualify for Financial Assistance/Charity Care discounts, to a financial counselor to determine if the patient is eligible for such a charitable discount. For more information about the Presence Health Financial Assistance Program, see www.presencehealth.org/patients-and-visitors/financial-assistance. PART V. FACILITY INFORMATION PART V, SECTION A Our Lady of the Resurrection Medical Center 5645 West Addison St. Chicago, IL 60634 http://www.presencehealth.org/locations/hospitals/presence-our-lady-resurr ection-medical-center Presence Our Lady of the RESURRECTION Medical Center is a licensed hospital, general medical & surgical facility, and operates a 24-hour ER. PART VI. SUPPLEMENTAL INFORMATION PART VI, 2: NEEDS ASSESSMENT In addition to conducting CHNAs every three (3) years, Presence Our Lady of the Resurrection Medical Center joins forces with local community organizations to assess the health needs of the community on an ongoing basis. We participate in a variety of coalitions, commissions, committees, boards, partnerships and panels. Our community outreach workers and liaisons spend ample time in the community POLRMC serves, and bring back first-hand knowledge of community needs. We also solicit guidance and invite input from a group of external participants to review our community benefit plan, neighborhood relations, and data supplements to advise us on the priority needs and directions with regard to community needs. External group participants include representatives from the Public Health Department, local aldermen and representatives, leaders from community based organizations, foundations, churches, colleges, coalitions and associations. These participants are experts in a wide range of areas including: public health, minority populations, health care disparities, mental health, and health and social services. Soliciting feedback from this group helps us to ensure we are aware of the most pressing community health needs. Presence Health ministries also complete medical staff development plans. These plans are conducted by external consultants, who provide an independent assessment of the need for physicians by specialty within the hospital's primary service area as defined by Stark regulations. We also review and analyze our own internal patient data (Inpatient and Emergency Department utilization) on an annual basis to uncover any new community health trends. We review purchased and publicly available data and analyses on the market, demographics, and health service utilization. PART VI, 3: PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE Presence Health hospital ministries proactively communicate the availability of our financial assistance/charity care programs by using multiple types of appropriate media and in multiple appropriate languages. The mechanisms used by Presence Health hospitals to communicate the availability of Financial Assistance/Charity Care include, but are not limited to the following: 1. Signage. Signs are posted prominently throughout high traffic areas of our ministries, as well as within our inpatient and outpatient registration/patient admitting areas and emergency departments. Signs state that patients may be eligible for Financial Assistance/Charity Care discounts, and describe how to obtain more information, including identification of appropriate hospital representatives by title. Signs are in multiple languages. 2. Provision of Financial Assistance Materials to Uninsured Patients. Presence Health hospitals provide a summary of its Financial Assistance Programs and a Financial Assistance application to all persons receiving hospital care that it identifies as uninsured patients at the time of in-person registration, admission, or such later time that the patient is first identified as an uninsured patient. For patients presenting in the Emergency Department, all Presence Health hospitals provide such Financial Assistance materials at such time and in such manner as is consistent with their obligations under EMTALA to access for and stabilize any patient with an emergency medical condition before making inquiry of the patient's ability to pay. 3. Brochures. Brochures, information sheets and similar forms of written communication regarding the hospital's Financial Assistance/Charity Care policy are maintained in appropriate areas of the hospital (e.g. Emergency Department, organized registration areas and the Business Office). These communications state in multiple languages that the hospital offers Financial Assistance/Charity Care discounts and describes how to obtain more information. 4. Website. Comprehensive information about our financial assistance programs - including eligibility criteria, application details, and contact information - is also available on our consumer Web site (http://presencehealth.org/patients-and-visitors/financial-assistance). 5. Billing Notices. Each Presence Health hospital includes a note on or with the hospital bill and/or statement regarding the hospital's Financial Assistance/Charity Care program and how the patient may apply for consideration under this program. 6. Financial Counselors. Each Presence Health hospital has one or more financial counselors whose contact information is listed or provided with other information concerning the Financial Assistance/Charity Care discount program. These counselors are available to discuss eligibility and other questions concerning the program, and provide assistance with applications. They are also available to meet with patients during their stay if they have questions about their ability to pay for services and our financial assistance programs. 7. Notification of Determination. When a Presence Health hospital makes a determination that a patient's bill is discounted or adjusted based on a determination of financial need, the hospital notifies the patient of such eligibility determination and that there is no further collection action taken on the discounted portion of the patient's bill. PART VI, 4: COMMUNITY INFORMATION Presence Health provides services at 150 sites, including twelve acute care hospitals with a total of 2,997 staffed beds and over 90 primary and specialty care clinics. These ministries offer a broad range of services from highly specialized tertiary services to an extended network of primary and ambulatory care. Presence Health has identified a separate service area for each of its acute care hospitals utilizing a consistent methodology and reflecting a combination of geographic location and market share criteria. The total service area of each ministry represents approximately 80% to 90% of the total inpatient discharges from that facility. The primary service area (the "Primary Service Area") of each facility represents approximately 65% to 75% of such discharges and the secondary service area (the "Secondary Service Area") of each facility represents approximately 15% to 25% of such discharges. The Primary Service Areas and Secondary Service Areas have been determined by utilizing a patient origin analysis to identify those zip codes that represent inpatient discharges. These zip codes are then mapped to identify geographic coverage of the Primary Service Areas and Secondary Service Areas. Many of the Presence Health hospital ministries facilities are located in population growth areas. Based upon population estimates and projections obtained from Claritas, Inc., the population of the our hospitals' combined service area is expected to grow at a rate of 1.9% annually between 2012 and 2017, compared with a growth rate of 1.3% and 1.6% per year in the Chicago MSA and in Illinois, respectively. Of Presence's total service area population, 10.7% is over the age of 65, compared to 11.1% and 12.3% in the Chicago MSA and in Illinois, respectively. The Presence Our Lady of the Resurrection Medical Center CHNA service area includes the zip codes 60630, 60634, 60639, and 60641, which correspond to the Chicago community areas of Jefferson Park, Dunning, Montclare, Belmont Cragin, Hermosa and Portage Park. The total population of zip codes 60630, 60634, 60639, and 60641 in 2010 was 248,683, making up the service area of POLRMC. Presence Our Lady of the Resurrection Medical Center has been providing health care to residents of Chicago's northwest side since 1955. POLRMC specializes in providing its neighbors with comprehensive medical and surgical services plus specialized services that meet the diverse health care needs of the community. According to a 2012 market share analysis, ten (10) other hospitals serve the POLRMC service area communities. Demographics. In the past ten years, population change was modest in the POLRMC service area communities, with decreases in the 1% to 2% range for Jefferson Park, Dunning, Belmont Cragin and Portage Park, and 7% for Hermosa. The Montclare population increased by 6%. In contrast, the population of Chicago decreased by 7%, and the Illinois and U.S. populations saw increases of 3% and 10%, respectively. Roughly a quarter of the population is under 20 years of age in the POLRMC service area, the one exception being zip code 60639 at 34%. These percentages are similar to those for Cook County, Chicago, Illinois and the U.S. Two of the zip codes had less than 10% of their population over 65 (60639 and 60641). Zip codes 60630 and 60634 have proportions of senior populations that are quite similar to the percentages in Cook County, Illinois and the United States, which range from 10% to 13%. The zip codes 60630 (Jefferson Park), 60634 (Dunning and Montclare) and 60641 (Portage Park) experienced slight decreases in the proportion of people over 65 from 2000 to 2010. The proportion of Hispanic/Latinos increased in each of the communities in the POLRMC service area. The communities have Hispanic/Latino populations that ranged from about 20% in Jefferson Park to almost 90% in Hermosa. The largest increase in the Hispanic/Latino population was in Jefferson Park, nearly doubling from 2000 to 2010. The Caucasian population decreased in all the communities in the service area while the Asian population remained below 10% for all of the communities, the largest proportion being 9% in Jefferson Park. The service area has a considerable percentage of limited English speaking population with the most common language being Spanish, with rates over 30% in Belmont Cragin and Hermosa. Polish was the second most common language spoken with Dunning the leader at 16% followed by Jefferson Park and Portage Park. Socioeconomics The median household income in Dunning ($61,584) and Jefferson Park ($60,592) exceeded the U.S. median. Montclare's median household income was very near that for Chicago while Belmont Cragin and Hermosa fell slightly below that at a little over $42,000. Belmont Cragin and Hermosa had 19% of their population living below the poverty line, a percentage just below the Chicago rate but 6 percentage points above the Illinois rate. Belmont Cragin at 26% and Hermosa at 27% had rates of children living in poverty that were above the Cook County percentage and twice the County Health Ranking (CHR)'s Benchmark. The other communities had rates ranging from 21% to 5%, all below the Cook County rate of 22%. Over half the population in Belmont Cragin and Hermosa lives below 200% of the federal poverty level. Portage Park and Montclare have about a third of their population below 200% of the federal poverty level, a number near the Cook County, Illinois and U.S. rates. The rates in Dunning and Jefferson Park were near 20%. Four of the service area communities, Belmont Cragin, Montclare, Portage Park and Hermosa, had 70% or more students eligible for free and reduced lunch. All but one of the high schools in the service area had graduation rates that exceeded the Chicago rate (73.8%). Six of the seven communities had rates of residents without high school diplomas that exceeded the 15% rate in the U.S. Four of the six communities had double digit unemployment rates ranging from 12.9% in Hermosa to 10.8% in Portage Park and Montclare. These rates are all similar to the Chicago and Cook County rates, but above that for the U.S. Jefferson Park and Dunning had rates that were similar to the Illinois rate of 8.6%. Access to Care The rate of uninsured for Chicago is nearly 20%, considerably above the CHR benchmark and the Illinois rate of 13.1%. Each of the zip codes in the service area had rates of Medicaid enrollees that were higher than the state rate. Zip code 60639 had the highest rate at 41% while 19% in zip code 60630 was the lowest. Of almost 1,300 requests for interpreters in the ER, 80% were for Spanish and Polish, however requests for 28 different languages were received. Belmont Cragin, Hermosa and Montclare are designated as Health Professional Shortage Areas for Primary Care. Belmont Cragin, Hermosa, Montclare, Portage Park and Dunning all have shortages of mental health providers. A full Community Health Profile of demographic and other health indicators can be found of Presence Our Lady of the Resurrection Medical Center at www.presencehealth.org/community. PART VI, 5: PROMOTION OF COMMUNITY HEALTH Presence Health hospitals are faith-based ministries that provide services consistent with the Ethical and Religious Directives for Catholic Health Care Services. Presence Health enhances the public health of our communities by: 1. Ensuring our medical staff is open to all qualified physicians. 2. Ensuring all of our hospitals are accredited and in good standing with the Joint Commission Accreditation of Healthcare Organizations. 3. Ensuring our board of directors is diverse and able to provide expertise, and includes independent members of the communities we serve. Our board members must follow a conflict of interest policy. 4. Reinvesting surplus funds into the organization to improve patient care through new programs and technology. 5. Providing financial assistance, sliding scale discounts and having collection practices that are in compliance with state and federal guidelines. In addition, we follow the financial assistance and charity guidelines of the Catholic Health Association. 6. Participating in all government sponsored health care programs, Medicare, Medicaid, CHAMPUS, Tricare, SCHIP and others. 7. Providing emergency room services in all of our communities and provide training to local fire departments and ambulances. Our emergency room participates with local police and fire departments in disaster drills. 8. Staffing Board Certified Emergency Room Physicians in our emergency room and urgent care services. We treat patients according to EMTALA guidelines and serve all patients regardless of ability to pay. In addition, we are committed to determining the needs of our communities and creating ways to meet those needs. The obligation to reach out to those in need and improve health flows directly from our Catholic identity and the heritage of our founding congregations. The POLRMC Senior Leadership Team and the Governing Board have a strong commitment to community health initiatives. Community initiatives and activities have ongoing monitoring and evaluation for program effectiveness. The following programs are existing community benefit programs POLRMC sponsors in the community. WALKING CLUB AT PORTAGE PARK Program Description This free program was developed by the physical therapy department to promote physical activity, fitness and mobility to community members. Once a week a physical therapist meets a small group in a local park to provide education and encourage walking. Outcomes are measured by monitoring if there is an increase in each participant's endurance level. Many members of the POLRMC health team such as dieticians, occupational therapists, and nurses provided education to the group. Community members learned zumba, nutrition, yoga, and even did water exercises in the Portage Park pool. The group met for 17 weeks for 1-2 hours each week. Health information handouts, cookbooks, and water bottles were provided to those attending. To further promote walking, a POLRMC physician sponsored the group and paid admission fees to the POLRMC Fall into Fitness walk/run held each September. LET'S MOVE OUR NUMBERS Program Description The Let's Move Our Numbers program provides community education and screening programs on a variety of health and wellness topics both in the community and main hospital location. Components of the program include: blood pressure, blood glucose, blood lipid panel, body mass index (BMI) and/or body fat analysis. Health education topics on chronic disease include obesity, hypertension, heart disease, stroke, diabetes, and cancer. PART VI, 6: AFFILIATED HEALTH CARE SYSTEM The Provena Health and Resurrection Health Care systems came together on November 1, 2011 to form a new health system, Presence Health, creating a comprehensive family of not-for-profit health care services and the single largest Catholic health system in Illinois. The name Presence Health embodies the act of being present in every moment we share with those we serve and is the cornerstone of a patient, resident and family-centered care environment. "Presence" Health embodies the way we choose to be present in our communities, as well as with one another and those we serve. Presence Health is sponsored by five congregations of Catholic religious women: the Franciscan Sisters of the Sacred Heart, the Servants of the Holy Heart of Mary, the Sisters of the Holy Family of Nazareth, Sisters of Mercy of the Americas and the Sisters of the Resurrection. As was the case from our very beginnings, Presence Health is called to be much more than just a provider of health services. Presence Health has instilled within all of its ministries that are committed to responding to the needs of those we are privileged to serve; delivering high quality care that is accessible to all. It is this culture of caring and giving that drives our diligent efforts to ensure we return the optimal value of our charitable assets to our local communities. As a not-for-profit health system, Presence Health invests its net gains from operations into the community through programs to serve vulnerable populations, such as the poor and uninsured, manage chronic conditions, and promote health education and promotion outreach and initiatives. In fiscal year 2013, this included $199 million in community benefit activities. Presence Health takes a systems approach to its community benefit efforts, and therefore ensures its member hospitals and other entities and affiliates are helping to promote and address the health needs of the communities they serve. For more information on Presence Health, visit www.presencehealth.org PART VI, 7: STATE FILING OF COMMUNITY BENEFIT REPORT Presence Health files its annual community benefit report in Illinois. true true false false false false false false false Paul Skiem DIRECTOR 0 355428 0 130196 0 0 0 76560 0 17571 0 579755 0 41160 John Baird Dir Ex-Officio/President/CEO 0 434943 0 133284 0 0 0 99574 0 22459 0 690260 0 39498 Anthony J Filer TREASURER 0 629462 0 139487 0 109953 0 146954 0 25707 0 1051563 0 0 Patrick Quinn Assistant Treasurer 0 212851 0 35937 0 42011 0 23604 0 16659 0 331062 0 0 Julie Roknich Assistant Secretary 0 173049 0 0 0 0 0 5934 0 20696 0 199679 0 0 Jeannie C Frey SECRETARY 0 466882 0 186483 0 0 0 108779 0 26989 0 789133 0 36617 David Bordo VICE PRESIDENT 362795 0 23320 0 0 0 19216 0 26583 0 431914 0 0 0 Bina Walsh RGN Lead Pharmacy-CNW 148676 0 0 0 0 0 8375 0 26735 0 183786 0 0 0 Rosemarie Wade STAFF NURSE I WKND 160600 0 0 0 0 0 4848 0 26270 0 191718 0 0 0 Diane Ortolano Director Rehab Services 147044 0 0 0 0 0 6468 0 5140 0 158652 0 0 0 Leah Dela Merced STAFF NURSE II WKND 131773 0 0 0 0 0 7053 0 28770 0 167596 0 0 0 Dennis Fitzmaurice Vice President 199351 0 68757 0 0 0 12311 0 2531 0 282950 0 20208 0 Martin Judd EX-OFFICIO/CEO (TERMED 4/2013) 0 386147 0 109474 0 0 0 82872 0 8 0 578501 0 32885 Mary Anne Bajgrowicz VP PTNT CARE/CNO RESIGNED 7/13 138230 0 41777 0 55822 0 112487 0 61 0 348377 0 9300 0 Robert Bulger DIRECTOR (TERM EXPIRED 1/2013) 0 38397 0 27847 0 246000 0 24130 0 2165 0 338539 0 24970 JOHN A ORSINI CPA TREASURER (TERM EXP 1/2013) 0 48134 0 180801 0 0 0 8600 0 1051 0 238586 0 56655 DETERMINATION OF COMPENSATION OF ORGANIZATION'S CEO/EXECUTIVE DIRECTOR SCEDULE J, PART I, LINE 3 Compensation for the corporation's CEO and other officers or key employees is determined in accordance with written policies and procedures adopted by the board of directors of the corporation's sole member, presence rhc corporation (PRHCC) and PRHCC's sole member, the system parent corporation. Such policies and procedures are applied by the human resources committee of the system parent corporation, which consists wholly of independent directors. The parent corporation uses market data compiled by an independent compensation consultant to establish base salaries and total cash compensation opportunities. The human resources committee monitors executive total compensation, annually reviewing and approving compensation changes for each executive, and regularly reporting its activities to the board. SEVERANCE PAYMENTS SCHEDULE J, PART I, LINE 4 Presence has three Severance Plans depending upon level. These plans allow individuals whose jobs have been eliminated and who have not been able to find a similar position within the System time to transition. The number of weeks of wage continuation are based upon length of service. The plans are not funded. THE FOLLOWING INDIVIDUAL RECEIVED SEVERANCE PAYMENTS IN CALENDAR YEAR 2013: Robert Bulger $246,000 MARY ANNE BAJGROWICZ $ 55,822 PAYMENTS FROM A SUPPLEMENTAL NON QUALIFIED RETIREMENT PLAN Schedule J, Part I, Question 4B In order to enhance the ability of Presence Health to attract and retain qualified management personnel by providing eligible executives with additional retirement benefits on a deferred basis, Presence Health Network maintains an unfunded supplemental retirement plan (the "Plan") for a select group of management, which is intended to comply with Section 457(f), and Section 409A of the Internal Revenue Code. Under the Plan, Presence Health Network credits to such eligible executive's retirement account an amount based on a percentage of salary. Earnings and/or losses on investments are credited at a rate equal to the rate of return over the same period on investment options selected by the Eligible Executive. Eligible executives are entitled to receive benefits on the earliest of (I) January 1 of the third calendar year beginning after the year in which such contribution is credited, (II) attaining age 62, or (III) attaining the age of 60 if the eligible executive has completed ten (10) years of service. The following listed individuals participated in the organization's section 457(f) plan and earned unvested benefits during 2013 which are reported in column (C): MARTIN JUDD $64,961 PAUL SKIEM $56,877 JEANNIE C. FREY $86,745 JOHN BAIRD $80,850 PATRICK QUINN $23,604 ANTHONY J. FILER $146,954 Also in response to question 4B, the following listed individuals became vested in supplemental retirement benefits under the SERP, and therefore had benefits included in their taxable income: MARTIN JUDD $32,898 ROBERT BULGER $27,785 PAUL SKIEM $45,044 JOHN A. ORSINI $56,971 JEANNIE C. FREY $41,988 DENNIS FITZMAURICE $47,310 JOHN BAIRD $44,059 MARY ANNE BAJGROWICZ $21,639 GROUP EXEMPTION FORM 990, BOX H (C) Presence OUR LADY OF THE RESURRECTION MEDICAL CENTER IS PART OF THE OFFICIAL CATHOLIC DIRECTORY GROUP EXEMPTION. IT ASLO HAS ITS OWN INDEPENDENT EXEMPTION RULING. MISSION STATEMENT FORM 990, PART I, LINE 1 Presence Our Lady of the Resurrection provides compassionate medical and nursing care as well as advanced diagnostic and treatment services that promote patients' well-being. The hospital features a 269-licensed bed main building with a nearby professional office building, a convenient radiology center and an extensive outpatient services center. MISSION STATEMENT FORM 990, PART III, QUESTION 1 THE CORPORATION IS PART OF THE PRESENCE HEALTH SYSTEM AND ACTS IN ACCORDANCE WITH THE PRESENCE HEALTH MISSION, WHICH IS AS FOLLOWS: INSPIRED BY THE HEALING MINISTRY OF JESUS CHRIST AND AS PART OF PRESENCE HEALTH, A CATHOLIC HEALTH SYSTEM, PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER PROVIDES HEALTHCARE SERVICES IN A COMPASSIONATE, HOLISTIC MANNER IN THE SPIRIT OF HEALING AND HOPE. PROGRAM SERVICE ACCOMPLISHMENTS FORM 990, PART III, LINE 4A PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER SPECIALIZES IN PROVIDING ITS NEIGHBORS WITH COMPREHENSIVE MEDICAL AND SURGICAL SERVICES PLUS SPECIALIZED SERVICES THAT MEET THE DIVERSE HEALTH CARE NEEDS OF THE COMMUNITY. THE HOSPITAL FEATURES A 264-LICENSED BED MAIN BUILDING WITH A NEARBY PROFESSIONAL OFFICE BUILDING, A CONVENIENT RADIOLOGY CENTER AND AN EXTENSIVE OUTPATIENT SERVICES CENTER. THE HOSPITAL PROVIDED PATIENT CARE OF 30,977 ACUTE PATIENT DAYS AND HAD 6,839 ACUTE DISCHARGES. SKILLED NURSING PATIENT DAYS WERE 13,234 AND DISCHARGES WERE 1,125. THERE WERE 46,054 EMERGENCY ROOM VISITS, 3,436 SURGERIES AND 102,620 OUTPATIENT VISITS. COMPENSATION AND FORM W-3 TRANSMITTAL OF WAGES AND TAX STATEMENT FORM 990, PART I, QUESTION 5, AND PART V, QUESTION 2 PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER (THE "CORPORATION") REPORTS 0 EMPLOYEES ON FORM 990, PART I, QUESTION 5 AND FORM 990, PART V, QUESTION 2A AS IT IS NOT REQUIRED TO FILE FORM W-3, TRANSMITTAL OF WAGES AND TAX STATEMENT. THE CORPORATION'S COMPENSATION IS PAID BY PRESENCE RESURRECTION MEDICAL CENTER ("PRMC"), WHICH ISSUES THE FORMS W-2 AND W-3, AND THE EXPENSE IS TRANSFERRED TO THE CORPORATION. THE COMPENSATION AMOUNTS REPORTED IN THIS 990 REFLECT THE AMOUNT TRANSFERRED TO THE CORPORATION FROM PRMC. FORM 1096 TRANSMITTAL OF U.S. INFORMATION RETURNS FORM 990, PART V, QUESTION 1A PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER (THE "CORPORATION") REPORTS 0 ON FORM 990, PART V, QUESTION 1A AS IT IS NOT REQUIRED TO FILE FORM 1096, TRANSMITTAL OF U.S. INFORMATION RETURNS. ALL OF THE CORPORATION'S ACCOUNTS PAYABLE REPORTABLE ON FORM 1096 ARE PAID BY PRESENCE RESURRECTION MEDICAL CENTER ("PRMC"), WHICH ISSUES ALL FORMS 1099, AND THE EXPENSE IS TRANSFERRED TO THE CORPORATION. THE COMPENSATION AMOUNTS REPORTED IN THIS 990 REFLECT THE AMOUNT TRANSFERRED TO THE CORPORATION FROM PRMC. CHANGES TO ORGANIZATIONAL DOCUMENTS FORM 990, PART VI, QUESTION 4 THE BYLAWS OF THE CORPORATION WERE AMENDED EFFECTIVE DECEMBER 6, 2013 TO CLARIFY MEMBER'S POWERS AND TO FURTHER FACILITATE UNIFORMITY IN ORGANIZATION BETWEEN ENTITIES FROM THE RESURRECTION AND PROVENA HEALTHCARE SYSTEMS INTO ONE SYSTEM, KNOWN AS PRESENCE HEALTH. MEMBERS OR SHAREHOLDERS FORM 990, PART VI, QUESTION 6 PRESENCE OUR LADY OF THE RESURRECTION MEDICAL CENTER HAS ONE MEMBER, PRESENCE RHC CORPORATION. PERSONS WITH AUTHORITY TO ELECT MEMBERS OF THE GOVERNING BODY FORM 990, PART VI, QUESTION 7A THE CORPORATION'S SOLE MEMBER, PRESENCE RHC CORPORATION, HAS THE POWER TO APPOINT MEMBERS OF THE GOVERNING BODY, OTHER THAN EX-OFFICIO DIRECTORS. DECISIONS OF GOVERNING BODY APPROVAL BY MEMBERS OR SHAREHOLDERS FORM 990, PART VI, QUESTION 7B PRESENCE RHC CORPORATION (THE "MEMBER"), THROUGH ITS BOARD OF DIRECTORS, HAS CERTAIN RESERVE POWERS WITH RESPECT TO THE FOLLOWING. GENERAL POWERS AND RESPONSIBILITIES: THE MEMBER SHALL PROVIDE OVERSIGHT AND SUPPORT FOR THE ACTIVITIES OF THE CORPORATION, FOR THE PURPOSE OF ASSURING THAT ALL ACTIONS OF THE CORPORATION ARE CONSISTENT WITH THE MISSION AND VALUES OF THE SYSTEM; THE PURPOSES OF THE CORPORATION; THE ETHICAL AND RELIGIOUS DIRECTIVES; THE PRESENCE HEALTH SYSTEM STRATEGIC PLAN; AND BEST PRACTICES. MEMBER RESERVED POWERS: IN FURTHERANCE OF THE EXERCISE OF ITS GENERAL POWERS AND RESPONSIBILITIES, THE MEMBER SHALL HAVE THE SOLE POWER TO TAKE THE ACTIONS SPECIFIED BELOW WITH RESPECT TO THE FOLLOWING MATTERS, SUBJECT TO ANY NOTICES OR FURTHER APPROVALS REQUIRED BY APPLICABLE CIVIL OR CANON LAW, OR THE MEMBER'S BYLAWS: A) BYLAWS. AMEND OR REPEAL THE BYLAWS OF THE CORPORATION. B) OFFICERS AND DIRECTORS. APPOINT AND REMOVE ALL OFFICERS OF THE CORPORATION AND ALL DIRECTORS OF THE CORPORATION, OTHER THAN ANY EX-OFFICIO DIRECTORS. C) BUDGETS. APPROVE CAPITAL AND OPERATING BUDGETS, AND LONG-TERM CAPITAL EQUIPMENT PLANS FOR THE CORPORATION. D) UNBUDGETED EXPENDITURES. APPROVE UNBUDGETED EXPENDITURES IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME. E) DEBT, SALE, LEASE AND OTHER REAL PROPERTY TRANSACTIONS. APPROVE ANY BORROWING OR SIGNIFICANT INCURRENCE OF DEBT BY THE CORPORATION IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME, OR ANY SALE, PURCHASE, ALIENATION, EXCHANGE, SIGNIFICANT LEASES (OTHER THAN IN THE ORDINARY COURSE) OR ENCUMBRANCES OF THE CORPORATION'S REAL PROPERTY, EXCEPT THOSE MADE PURSUANT TO APPROVED BUDGETS. F) REAL ESTATE DOCUMENTS, EQUIPMENT LEASES. APPROVE EXECUTION OF ANY DEEDS, MORTGAGES, BONDS, OR MAJOR EQUIPMENT LEASES, EXCEPT THOSE ENTERED INTO PURSUANT TO APPROVED BUDGETS. G) SIGNIFICANT UNBUDGETED TRANSACTIONS. APPROVE ANY OTHER SIGNIFICANT AND UNBUDGETED SALE, PURCHASE, EXCHANGE, LEASE (OTHER THAN IN THE ORDINARY COURSE) TRANSFER, LITIGATION OR LEGAL SETTLEMENT, BENEFITS PACKAGES, ENCUMBRANCE OR OTHER DISPOSITION OR OTHER SIGNIFICANT TRANSACTION INVOLVING THE NON-REAL-ESTATE ASSETS OF THE CORPORATION IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER FROM TIME TO TIME. H) MATERIAL CHANGES IN SERVICES. APPROVE MATERIAL CHANGES IN THE KIND OF SERVICES RENDERED, SUCH AS THE ADDITION OR DISCONTINUATION OF ANY MAJOR SERVICE LINE (E.G., OBSTETRICS) OR CHANGE IN THE FUNDAMENTAL NATURE OF SERVICES PROVIDED BY THE CORPORATION (E.G., A CHANGE REQUIRING A DIFFERENT KIND OF LICENSE). I) STRATEGIC PLAN. APPROVE STRATEGIC PLANS FOR THE CORPORATION CONSISTENT WITH AND IN FURTHERANCE OF SYSTEM MISSION AND VALUES, AND RESPONSIVE TO THE NEEDS OF THE COMMUNITIES SERVED BY THE CORPORATION AND SUPPORT THE ABILITY OF THE CORPORATION AND ITS AFFILIATES TO PROVIDE HIGH-QUALITY CARE AND SERVICES. J) MANAGEMENT CONTRACTS. APPROVE ANY CONTRACT FOR THE MANAGEMENT OF ALL OR SUBSTANTIALLY ALL OF THE CORPORATION OR ANY HEALTH CARE FACILITIES OWNED BY THE CORPORATION. K) BUSINESS NAME, LOGO. APPROVE ANY SELECTION OR MODIFICATION OF THE BUSINESS NAME OR LOGO OF THE CORPORATION OR ANY PROGRAM OR DIVISION OF THE CORPORATION, OR THE USE OF ANY CORPORATE OR BUSINESS NAME OF THE CORPORATION BY AN ENTITY OTHER THAN THE MEMBER OR AN AFFILIATE. L) ADMINISTRATIVE SERVICES. PROVIDE OR ASSURE THE PROVISION OF APPROPRIATE INSURANCE COVERAGE, STANDARDIZED EMPLOYEE BENEFITS, INFORMATION SYSTEMS AND TECHNOLOGY, FINANCIAL MANAGEMENT SERVICES, LEGAL, MARKETING, RISK MANAGEMENT AND OTHER ADMINISTRATIVE SERVICES NECESSARY TO SUPPORT THE CORPORATION'S OPERATIONS. M) SIGNIFICANT JOINT VENTURES. APPROVE THE ESTABLISHMENT, TERMINATION, OR SALE OF ANY SIGNIFICANT JOINT VENTURE RELATIONSHIP BY THE CORPORATION. N) UNRELATED BUSINESS ACTIVITY. APPROVE THE ACQUISITION OR DEVELOPMENT OF ANY BUSINESS OR ACTIVITY UNRELATED TO THE PROVISION OF HEALTH CARE SERVICES. O) NEW AFFILIATES. APPROVE THE CREATION OF ANY NEW AFFILIATE TO BE OWNED OR CONTROLLED BY THE CORPORATION. P) CONTRIBUTIONS TO MEMBER. DIRECT AND APPROVE ANY CONTRIBUTIONS, DONATIONS OR OTHER ASSET TRANSFERS WITHOUT CONSIDERATION TO THE MEMBER OR ANY AFFILIATE, IN FURTHERANCE OF THE MISSION AND VALUES. Q) CONTRIBUTION ACCEPTANCE. APPROVE ACCEPTANCE OF A CONTRIBUTION THAT IMPOSES A MATERIAL OBLIGATION ON THE CORPORATION, IF APPROVED BY THE CORPORATION'S APPLICABLE FOUNDATION OR FUNDRAISING AFFILIATE AS CONSISTENT WITH THE CORPORATION'S AND SYSTEM'S MISSION AND GOALS. R) BANKING. DEFINE THE CRITERIA FOR THE SELECTION OF BANKS AND OTHER FINANCIAL DEPOSITORIES TO BE USED BY THE CORPORATION, AND AUTHORIZE THE PROCESS BY WHICH SIGNATORIES ON ALL BANK AND SIMILAR ACCOUNTS OF THE CORPORATION ARE APPROVED. S) AUDITORS. SELECT INDEPENDENT AUDITORS FOR THE CORPORATION, IN CONNECTION WITH THE CONSOLIDATED AUDIT OF ALL SYSTEM ENTITIES. T) REGISTERED AGENT. APPROVE OR CHANGE THE CORPORATION'S REGISTERED AGENT OR REGISTERED OFFICE, AS APPROPRIATE FROM TIME TO TIME. U) TAX-EXEMPTION. APPROVE ANY VOLUNTARY CHANGE TO THE CORPORATION'S STATUS OF AN ORGANIZATION EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AS AMENDED FROM TIME TO TIME. APPROVAL AND RECOMMENDATION POWERS: TO BE EFFECTIVE, THE ACTIONS SET FORTH BELOW MUST BE APPROVED BY BOTH THE CORPORATION'S BOARD OF DIRECTORS AND THE MEMBER. SUCH ACTIONS MAY BE INITIATED EITHER BY THE MEMBER OR THE CORPORATION'S BOARD. A) ADOPTION, AMENDMENT OR REPEAL OF THE ARTICLES OF INCORPORATION OF THE CORPORATION. B) ADOPTION OF ANY PLAN OF MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION. FORM 990 REVIEW PROCESS FORM 990, PART VI, QUESTION 11B THE DRAFT FORM 990 IS PREPARED BY THE CORPORATION'S ACCOUNTING FIRM WITH ASSISTANCE FROM THE SYSTEM FINANCE DEPARTMENT. THE RETURN IS THEN REVIEWED BY MANAGEMENT, INCLUDING SENIOR LEADERS FROM LEGAL, COMPLIANCE, HUMAN RESOURCES AND THE SYSTEM CEO FOR ACCURACY AND COMPLETENESS. AS NECESSARY, MANAGEMENT CONSULTS WITH EXTERNAL LEGAL AND OTHER EXPERTS TO ASSURE ACCURACY. THE FINAL FORM 990 IS PROVIDED TO THE CORPORATION'S BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING. PROCEDURES FOR ADDRESSING CONFLICTS OF INTEREST FORM 990, PART VI, QUESTION 12C THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE INTERESTS OF PRESENCE HEALTH NETWORK AND ALL OF ITS AFFILIATED MINISTRIES (COLLECTIVELY "PRESENCE HEALTH") WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF ANY DIRECTOR, TRUSTEE, OFFICER, CORPORATE MEMBER APPOINTEE, MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, SENIOR LEADERS, AND OTHERS IN A RECENT POSITION TO EXERCISE SUBSTANTIAL INFLUENCE OVER PRESENCE HEALTH ("INTERESTED PERSONS"), AND CLARIFY THE STANDARDS OF CONDUCT, DUTIES AND OBLIGATIONS OF INTERESTED PERSONS IN THE CONTEXT OF POTENTIAL CONFLICTS OF INTEREST BY PROVIDING A METHOD FOR DISCLOSING AND RESOLVING SUCH POTENTIAL CONFLICTS. NO PRESENCE HEALTH ENTITY WILL ENGAGE IN ANY CONTRACT, TRANSACTION OR ARRANGEMENT INVOLVING A CONFLICT OF INTEREST UNLESS DISINTERESTED MEMBERS OF THE APPLICABLE BOARD OF DIRECTORS OR OTHER GOVERNING BODY DETERMINE BY A MAJORITY VOTE THAT APPROPRIATE SAFEGUARDS TO PROTECT THE CHARITABLE MISSION OF PRESENCE HEALTH HAVE BEEN IMPLEMENTED. TO FACILITATE THIS POLICY, ALL INTERESTED PERSONS HAVE A CONTINUING OBLIGATION TO PROMPTLY DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE. ALL DISCLOSURES MUST BE PROVIDED TO THE SYSTEM COMPLIANCE OFFICER AND GENERAL COUNSEL IN A WRITTEN DESCRIPTION OF THE MATERIAL FACTS. DISCLOSURE SHALL BE ON A CONFLICTS OF INTEREST QUESTIONNAIRE OR SIMILAR FORMAT AS DESCRIBED IN THE CONFLICTS OF INTEREST POLICY. ALL INTERESTED PERSONS SHALL ALSO COMPLETE A QUESTIONNAIRE BASED ON THE ASSUMPTION OF THE BOARD (OR OTHER RELEVANT) POSITION, AND THEREAFTER ON AT LEAST AN ANNUAL BASIS OR WHEN AN ACTUAL, APPARENT, OR POTENTIAL CONFLICT ARISES. AT ANY TIME THAT AN ACTUAL, APPARENT OR A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED TO THE CORPORATION'S BOARD OF DIRECTORS, WHETHER THROUGH THE VOLUNTARY SUBMISSION OF A DISCLOSURE STATEMENT BY AN INTERESTED PERSON, OR BY A DISCLOSURE BY A PERSON OTHER THAN THE SUBJECT INTERESTED PERSON, THE CORPORATION'S BOARD OR APPLICABLE COMMITTEE SHALL REVIEW THE MATTER AND DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, ONLY DISINTERESTED DIRECTORS/COMMITTEE MEMBERS VOTE TO DETERMINE WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT IS FOUND TO EXIST THE INTERESTED PERSON WILL GENERALLY BE REQUIRED TO RECUSE HIM OR HERSELF DURING ANY MEETING IN WHICH THE BOARD OF DIRECTORS OR APPLICABLE COMMITTEE CONDUCTS THE EVALUATION OF THE SUBJECT TRANSACTION, EXCEPT TO ANSWER QUESTIONS AS MAY BE NECESSARY. TO ENSURE THAT THE PRESENCE HEALTH OPERATES IN A MANNER CONSISTENT WITH ITS CHARITABLE PURPOSES AND THAT IT DOES NOT ENGAGE IN ACTIVITIES THAT COULD JEOPARDIZE ITS EXEMPT STATUS, TRANSACTIONS INVOLVING INTERESTED PERSONS ARE ONLY APPROVED IF, AFTER EXERCISING REASONABLE DUE DILIGENCE, THE BOARD DETERMINES THEY ARE FAIR AND REASONABLE, TAKING INTO ACCOUNT FACTORS SUCH AS WHETHER PRESENCE HEALTH COULD OBTAIN A MORE ADVANTAGEOUS CONTRACT, TRANSACTION OR ARRANGEMENT. HOWEVER, LENDING MONEY OR GUARANTYING AN OBLIGATION OF A DIRECTOR, OFFICER, OR EMPLOYEE OF PRESENCE HEALTH (EXCLUSIVE OF CUSTOMARY INSURANCE COVERAGE FOR ACTS DONE IN CONNECTION WITH SUCH INDIVIDUAL'S SERVICE TO OR EMPLOYMENT BY PRESENCE HEALTH) IS STRICTLY PROHIBITED. COMPENSATION AND APPROVAL PROCESS FOR OFFICERS AND KEY EMPLOYEES FORM 990 PART VI, QUESTIONS 15A AND 15B, AND PART V, QUESTION 2A COMPENSATION FOR THE CORPORATION'S CEO AND OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED IN ACCORDANCE WITH WRITTEN POLICIES AND PROCEDURES ADOPTED BY THE BOARD OF DIRECTORS OF THE CORPORATION'S SOLE MEMBER, PRESENCE RHC CORPORATION (PRHCC) AND PRHCC'S SOLE MEMBER, PRESENCE HEALTH NETWORK, THE SYSTEM PARENT CORPORATION. SUCH POLICIES AND PROCEDURES ARE APPLIED BY THE HUMAN RESOURCES COMMITTEE OF THE SYSTEM PARENT CORPORATION, WHICH CONSISTS WHOLLY OF INDEPENDENT DIRECTORS. THE SYSTEM PARENT CORPORATION USES MARKET DATA COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT TO ESTABLISH BASE SALARIES AND TOTAL CASH COMPENSATION OPPORTUNITIES. THE SYSTEM PARENT'S HUMAN RESOURCES COMMITTEE MONITORS EXECUTIVE TOTAL COMPENSATION AND APPROVES ALL COMPONENTS OF EXECUTIVE TOTAL COMPENSATION, ANNUALLY REVIEWING AND APPROVING COMPENSATION CHANGES FOR EACH EXECUTIVE, AND REGULARLY REPORTING ITS ACTIVITIES TO THE SYSTEM PARENT'S BOARD. DOCUMENT AVAILABILITY FORM 990, PART VI, QUESTION 19 THE CORPORATION'S ARTICLES OF INCORPORATION ARE ON FILE WITH THE STATE OF ILLINOIS. THE CONSOLIDATED AUDITED FINANCIAL STATEMENTS OF THE CORPORATION, TOGETHER WITH ITS AFFILIATES, ARE AVAILABLE FROM THE NATIONAL DISSEMINATION AGENT AS REQUIRED BY PRESENCE HEALTH SYSTEM'S BOND DOCUMENTS. CONFLICTS OF INTEREST POLICIES ARE NOT MADE AVAILABLE TO THE PUBLIC, HOWEVER A SUMMARY OF THE CURRENT POLICY IS ANNUALLY INCLUDED IN SCHEDULE O OF THE CORPORATION'S FORM 990. COMMON PAYMASTER FORM 990, PART VII, SECTIONS A & B PRESENCE RESURRECTION MEDICAL CENTER ("PRMC") (FEIN 36-3330926) ACTS AS THE AGENT FOR THE CORPORATION. CASH IS SWEPT FROM THE CORPORATION ON A DAILY BASIS TO PRMC AND PRMC ISSUES ALL PAYROLL AND ACCOUNTS PAYABLE CHECKS ON BEHALF OF AND AS AGENT FOR THE CORPORATION AND THE APPROPRIATE ACCOUNTING ENTRIES ARE RECORDED. AUDITED FINANCIAL STATEMENTS FORM 990, PART XII, LINE 2B AN INDEPENDENT ACCOUNTANT ANNUALLY AUDITS THE CONSOLIDATED FINANCIAL STATEMENTS OF PRESENCE HEALTH NETWORK AND ITS AFFILIATES. THE AUDIT OPINION IS ISSUED ON THE CONSOLIDATED FINANCIAL STATEMENTS AND EACH AFFILIATE IS NOT SEPARATELY AUDITED. Presence Health Network 200 South Wacker Chicago IL 60606 361649520 Health Care IL 501(C)(3) 3 na false Medicare Value Partners 100 North River Road Des Plaines IL 60016 363495969 Health Care IL 501(C)(3) 3 PRHCC true Presence Holy Family Medical Center 100 North River Road Des Plaines IL 60016 362439318 Health Care IL 501(C)(3) 3 PRHCC true Mount Loretto Nursing Home Inc 302 Swart Hill Road Amsterdam NY 12010 141363014 Senior Living NY 501(C)(3) 3 RM New York true Presence Care Home 18927 Hickory Creek Drive 300 Mokena IL 60448 460483587 Health Care IL 501(C)(3) 9 PLC true Presence PRV Health 9223 W St Francis Road Frankfort IL 60423 363366652 Health Care IL 501(C)(3) 11 PHN false Presence Home Care 18927 Hickory Creek Drive 300 Mokena IL 60448 460483581 Health Care IL 501(C)(3) 9 PLC true Presence Hospitals PRV 9223 W St Francis Road Frankfort IL 60423 364195126 Health Care IL 501(C)(3) 3 PPRVH true Laverna Terrace Housing Corporation 18927 Hickory Creek Drive 300 Mokena IL 60448 363438977 Senior Living IL 501(C)(3) 9 PHPRV true Provena Self-Insurance Trust 9223 W St Francis Road Frankfort IL 60423 362987310 Insurance IL 501(C)(3) 9 PPRVH true Presence Life Connections 18927 Hickory Creek Drive 300 Mokena IL 60448 371127787 Health Care IL 501(C)(3) 7 PPRVH true Presence Behavioral Health 1820 South 25th Avenue Broadview IL 60155 362709982 Health Care IL 501(C)(3) 3 PHS true Presence Ambulatory Services 100 North River Road Des Plaines IL 60016 364286236 Health Care IL 501(C)(3) 3 PRHCC true Presence Health fndn bot 100 North River Road Des Plaines IL 60016 363330929 Fundraising IL 501(C)(3) 7 PRHCC true Presence RHC Corporation 200 S Wacker Chicago IL 60606 362235165 Parent Corp IL 501(C)(3) 3 PHN false Presence Home Care Services 5747 West Dempster Morton Grove IL 60053 362893936 Home Care IL 501(C)(3) 3 PRHCC true Presence Resurrection Medical Center 7435 West Talcott Avenue Chicago IL 60631 363330926 Health Care IL 501(C)(3) 3 PRHCC true Resurrection Nursing Home Inc 90 North Main Street Castleton NY 12033 141348691 Nursing NY 501(C)(3) 3 RM New York true Presence RHC Senior Services 100 North River Road Des Plaines IL 60016 237061646 Nursing IL 501(C)(3) 3 PRHCC true Presence Healthcare Services 100 North River Road Des Plaines IL 60016 363330928 Health Care IL 501(C)(3) 3 PRHCC true Presence Saint Francis Hospital 355 Ridge Avenue Evanston IL 60202 362167800 Health Care IL 501(C)(3) 3 PRHCC true St Francis Hospital Aux OF EVANSTON 355 Ridge Avenue Evanston IL 60202 366143349 Fundraising IL 501(C)(3) 7 PSFH true PRESENCE ST MARY & ELIZABETH MED CNTR 2233 West Division Street Chicago IL 60622 362171079 Health Care IL 501(C)(3) 3 PRHCC true Presence Saint Joseph Hospital Chicago 2900 North Lake Shore Drive Chicago IL 60657 363200170 Health Care IL 501(C)(3) 3 PRHCC true Presence Nazarethville 300 North River Road Des Plaines IL 60016 362801392 Nursing IL 501(C)(3) 11, Type II PRHC Snr Srv true Arthur Merkle - Clara Knipprath Nursing 1190 E 2900 N Road Clifton IL 60927 362841358 Nursing IL 501(C)(3) 9 PLC true Bel Harlem Surg cntr 3101 N harlem chgo IL 60634 412237162 Medical Service IL PRHCS RH SLEEP CTR CHI 665 W N AVE Lombard IL 60148 261519627 Medical Service IL PRHCS RH SLEEP CTR EVAN 665 W N AVE Lombard IL 60148 261519556 Medical Service IL PRHCS RH SLEEP CTR LP 665 W N AVE Lombard IL 60148 261519667 Medical Service IL PRHCS RH SLEEP CTR RF 665 W N AVE Lombard IL 60148 262189763 Medical Service IL PRHCS ALVERNO CLIN LAB 2434 INT PLZ Hammond IN 46324 203240648 Medical Service IN NA L GILBRAITH INSURANCE SPC LTD 68 W Bay Road PO Box 1109 GRAND CAYMAN CJ INSURANCE CJ PRHCC FOREIGN COMPANY true Provena Health Assurance SPC 23 Lime Tree Bay Ave po box 1051 grand cayman CJ 980420054 INSURANCE CJ PPRVH FOREIGN COMPANY true PRESENCE PROPERTIES INC 9223 W ST FRANCIS ROAD FRANKFORT IL 60423 363520630 MEDICAL IL PPRVH C CORP true PRESENCE SERVICE CORPORATION 9223 W ST FRANCIS ROAD FRANKFORT IL 60423 364314354 MEDICAL IL PHPRV C CORP true PRESENCE VENTURES INC 9223 W ST FRANCIS ROAD FRANKFORT IL 60423 371168085 MEDICAL IL PPRVH C CORP true RESURRECTION MEDICAL CENTER AUX 7435 WEST TALCOTT AVENUE CHICAGO IL 60631 366109825 FUNDRAISING IL PR MED CTR C CORP true RESURRECTION MINISTRIES OF NEW YORK 90 NORTH MAIN STREET CASTLETON NY 12033 141720818 PARENT CORP NY PRHCC C CORP true PRESENCE HEALTH CARE PREFERRED 100 NORTH RIVER ROAD DES PLAINES IL 60016 363974620 MGD CARE CONT IL PRHCC C CORP true false false true false false false false false false false false false false false true false false false PRESENCE HEALTH FOUNDATION BOARD OF TRUSTEES c 234991 COST PRESENCE RESURRECTION MEDICAL CENTER p 114214469 COST Form 990, Schedule R, Part V Presence Resurrection Medical Center (FEIN: 36-3330926) pays all of the compensation and accounts payable for all entities under the Presence Health System that were historically part of the Resurrection Health Care System ("Legacy Resurrection Entities"). Cash is deposited into an account by all Legacy Resurrection Entities and swept on a monthly basis to reimburse Presence Resurrection Medical Center for these expenses at cost. The amounts reported on Part V of Schedule R reflect the total cash transfers to/from Presence Resurrection Medical Center.