2014-05-15T09:12:47-05:00 2013-06-30 420714325 McGladrey LLP 1 South Wacker Drive Suite 800 Chicago IL 60606 990 2012-07-01 364037473 Elmhurst Memorial Healthcare ELMH 3312211000 155 E Brush Hill Road Elmhurst IL 60126 Henry Zeisel 3312211000 2014-05-10 1 Wayne Harder P00294296 3126343400 2012 2015-11-30 17:44:51Z Mary Lou Mastro 155 E Brush Hill Road Elmhurst IL 60126 60692143 0 5467 X www.emhc.org X 1926 IL A comprehensive health system designed to enhance the health of the community. 18 16 0 903 0 0 0 0 47588292 50507587 10179796 9287654 931068 814652 58699156 60609893 0 0 0 0 4103637 6143859 0 0 0 65682231 71601357 69785868 77745216 -11086712 -17135323 365736196 364506371 574158492 546615667 -208422296 -182109296 X To enhance the health of the communities and customers we serve and to provide quality care to everyone who needs it. 0 0 51892802 50507587 For more than 50 years, the Elmhurst Clinic has worked to provide more than just good medical care. It has established itself in DuPage County as one of the premier multi-specialty medical groups, providing a range of care for the entire family. Today, the Clinic has expanded to include more than 100 multi-specialty providers in eight locations, including in Addison, Bloomingdale, Elmhurst, Lombard, Oak Park, Oakbrook Terrace and Wood Dale. In fiscal year 2012, the Clinic logged more than 270,000 physician office visits. Elmhurst Memorial Primary Care Associates became affiliated with Elmhurst Memorial Healthcare in 2009. The group's model of care is built around having small practices where patients receive personalized, holistic care with state-of-the-art services. Elmhurst Medical Associates became affiliated with Elmhurst Memorial Healthcare in 2010. With an office location in Elmhurst, the seven physicians in the group are committed to enhancing the services offered to their patients, as is evidenced by efforts to adopt an electronic medical records system as well as implementing a more integrated, holistic approach to offer convenient health care. Elmhurst Memorial Oncology Services' approach to care brings patients the best of both worlds - exceptional care that is close to home. An affiliation with the Cancer Center at Elmhurst Memorial Hospital means patients will receive a complete continuum of care with the same leading-edge procedures available at a university hospital. In fiscal year 2012, the Elmhurst Clinic, Elmhurst Memorial Primary Care Associates, Elmhurst Medical Associates and Elmhurst Memorial Oncology Services merged to become the comprehensive Elmhurst Physician Practice Division, which is wholly owned by the Hospital. Assets and substantial activities were transferred to the Hospital. 51892802 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 14 0 1 0 0 0 0 0 0 0 0 0 X 18 16 0 0 0 0 1 0 0 1 1 0 1 1 1 1 1 1 1 1 0 0 1 1 IL X Kym Benson 3312211000 155 E Brush Hill Road Elmhurst IL 60126 See Elmhurst Memorial Healthcare 1.00 X 0 0 0 0 0 0 0 0 0 0 Elmhurst Clinic LLC 172 Schiller Elmhurst IL 60126 Physician Services 32964364 Elmhurst Medical Associates LLC 183 Addison Elmhurst IL 60126 Physician Services 2344901 Elmhurst Memorial Primary Care 305 N York Rd Elmhurst IL 60126 Physician Services 1838983 Elmhurst Memorial Hematology 200 Berteau Ave Elmhurst IL 60126 Physician Services 1565495 Medical Management Resource 855 N Church Ct Elmhurst IL 60126 I.T. Services 408651 13 Net Patient Serv. Rev. 623000 48404677 48404677 2102910 2102910 50507587 2622623 2622623 742195 0 742195 742195 742195 6747281 0 82250 6747281 -82250 6665031 6665031 Finance Charges 900099 71590 71590 867 867 72457 60609893 50580044 0 10029849 X 5322949 3253471 2069478 820910 820910 663806 663806 185920 39275 146645 3466917 3466917 42436519 41552208 884311 298083 298083 167652 167652 179733 250071 -70338 4047 4047 8629 8629 15033260 15033260 1130908 379153 751755 1908671 1908671 Swap Settlement 2583719 2583719 Bad Debt Expense 2422585 2422585 Clinical Expense 1098806 1098806 12102 12102 77745216 51892802 25852414 0 15871077 31347904 5614933 5234232 1393312 436357 85684779 4454137 81703007 81230642 174275864 169381625 30283462 33150451 892602 871235 55701939 42853925 365736196 364506371 13350113 14690279 33767022 22293291 506873222 499463961 20000000 10000000 168135 168136 574158492 546615667 X -208422296 -182109296 -208422296 -182109296 365736196 364506371 X -17135323 20310885 23137438 X 0 1 X 1 0 X 68793083 68793083 10571356 2803789 7767567 103850 35501 68349 3526092 1260421 2265671 2690398 354426 2335972 81230642 Investment in Subsidiary 661988 F Hedge Fund 32488463 F 33150451 Bonds 8792986 Debt Service Reserve 15198472 Investment in PHO 131000 Interest Rate Swap Agreement 18731467 42853925 Due to Affiliates 24435 Other Long-Term Borrowings 143701 168136 X Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: Elmhurst Memorial Healthcare files a Form 990 (Return of Organization Exempt from Income Tax) annually. When the returns is 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 taxable income (UBTI). UBTI is reported on Form 990T, 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 percent 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 is 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 Financial Accounting Standards Board (FASB)-issued guidance at July 1, 2008, and as of each subsequent fiscal year-end, there were no unrecognized tax benefits identified and recorded as a liability. Central America and the Caribbean 0 0 Investments 32488463 0 0 0 0 0 0 32488463 0 32488463 0 0 0 1 0 0 A Village of Lombard Illinois 366005975 0541593AP 2004-04-07 6482000 Construct Lombard Memorial Health Center 0 0 0 B Illinois Finance Authority 861091967 45200FGW3 2008-05-22 119829861 Construct new hospital 0 0 0 C Illinois Finance Authority 861091967 45200FHAO 2008-05-22 250000000 Construct new hospital 0 0 0 D Illinois Finance Authority 861091967 45200BN61 2006-12-12 47000000 Acquire land, construct and equip facilities 1 0 0 A 6482000 146213 114358 6335987 2006 0 0 1 1 B 119829861 10365829 1073976 21439587 104974355 2011 0 0 1 1 C 250000000 1192837 11719129 248293412 2011 1 0 1 1 D 48126166 235000 47891166 2008 0 0 1 1 A 0 0 0 0 0 0 0 B 0 0 0 0 0.01000 0.01000 0 0 0 C 0 0 0 0 0.01000 0.01000 0 0 0 D 0 0 0 0 0 0 0 A 1 1 0 0 0 0 B 0 1 0 0 0 0 0 0 0 C 0 1 0 0 1 0 0 0 0 D 1 1 0 0 0 0 Midwest Heart Specialists Lou McKeever, MD, trustee, is an officer on the board of MHS 1228727 Cardiology services 0 Form 990, Part VI, Section A, line 6 The Board of Governors and Emeritus members are the members of Elmhurst Memorial Healthcare. Form 990, Part VI, Section B, line 11 A review of the Form 990 was done by the Finance Committee before it was filed with the IRS. The review was led by the Finance Committee chair at its April meeting and comprised of an overview of the Form 990 and selected detailed items. The final Form 990 is provided to the board members before filing. Form 990, Part VI, Section B, line 12c EHMC regularly and consistently monitors its conflict of interest policy by requiring prompt and full disclosure of existing or potential conflicts of interest and in addition, sends out an annual conflict of interest questionnaire to members of the Boards of Trustees of Elmhurst Memorial Healthcare and each affiliate, non-Trustee members of Board committees, Nutrition and Therapeutics Committee, Healthcare Management Council, Department Heads and those with purchasing authority in excess of $50,000. The annual questionnaires are reviewed by the Director, Risk Management/Corporation Compliance Officer and the appropriate Board or committee chairman. In the event that a potential conflict arises, the results may be discussed with any and all individuals necessary to come to a final determination. In the event that the conflict of interest may potentially impair that person's ability to fulfill their duty to EMHC or affiliate, that person will be given an opportunity to eliminate the conflict or to resign, as reasonably determined. All compensation is paid by Elmhurst Memorial Hospital. Below is the Hospitals compensation policy: The executive compensation program has been designed under the direction of the Human Resource Committee (Committee) of the Board of Trustees, to attract and retain a highly qualified executive team and directly link their pay to the attainment of both corporate and personal performance objectives. The Committee is comprised of outside, independent individuals with relevant expertise in a range of fields. The Committee reviews executive compensation annually with input from Towers Perrin, an independent expert consulting firm. Included in this review are tests of the executive pay structure against a number of available comparator groups and data sources. The process is designed to meet the requirements of the IRS' rebuttable presumption of reasonableness. Base salaries for executives are established by the Committee to reflect each executive's scope of responsibility and individual performance. The Committee uses a "scorecard" approach to evaluate performance which provides comprehensive performance measures and indicators and enables the Committee to evaluate performance and progress with respect to critical goals. The Committee maintains minutes of its proceedings and deliberations and makes recommendations to the Board of Trustees for their consideration and action. Form 990, Part VI, Section C, line 19 EMHC and its subsidiaries' audited financial statements are made available on the organization's website. Governing documents and conflict of interest policy are not available to the general public. Other Fees Form 990, Part IX, line 11g Physician Services: Program service expenses 41,552,208. Management and general expenses 0. Fundraising expenses 0. Total expenses 41,552,208. Consulting Fees: Program service expenses 0. Management and general expenses 730,868. Fundraising expenses 0. Total expenses 730,868. Other Purchased Services: Program service expenses 0. Management and general expenses 153,443. Fundraising expenses 0. Total expenses 153,443. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Amortization of gain on discontinuation of hedge accounting 177,334. Gain from Subsidiary 184,087. Transfers to Affiliates 22,776,017. Elmhurst Physician Practice Division 155 E Brush Hill Road Elmhurst IL 60126 263633852 Physician Division IL 1580353 6460392 Elmhurst Memorial Healthcare Elmhurst Memorial Hospital 155 E Brush Hill Road Elmhurst IL 60126 362167784 Healthcare provider IL 501(c)(3) Line 3 Elmhurst Memorial Healthcare 1 Elmhurst Memorial Home Health 855 North Church Court Elmhurst IL 60126 363962253 Patient care services IL 501(c)(3) Line 9 Elmhurst Memorial Hospital 1 Elmhurst Memorial Hospital Foundation 155 E Brush Hill Road Elmhurst IL 60126 363083197 Fundraising IL 501(c)(3) Line 7 Elmhurst Memorial Hospital 1 Elmhurst Outpatient Surgery Center LLC 1200 S York Road Elmhurst IL 60126 364150045 Outpatient Surgery IL N/A Elmhurst Memorial Health Technologies LLC 855 North Church Court Elmhurst IL 60126 363229839 Practice Management IL Elmhurst Memorial Healthcare C 2309591 1.00000 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 Elmhurst Memorial Hospital R 13486811 Elmhurst Memorial Home Health S 5334503 Elmhurst Memorial Health Technologies LLC M 406481