2014-07-11T07:57:18-05:00 2013-08-31 861065772 Deloitte Tax LLP 111 S Wacker Drive Chicago IL 60606 990 2012-09-01 362256036 Rehabilitation Institute of Chicago REHA 3122381000 345 E Superior Street Chicago IL 606112654 Edward B Case 3122381000 2014-07-11 1 Samantha Bokori P01057347 3124861000 2012 2015-11-30 17:44:51Z Edward B Case 345 E Superior Street Chicago IL 606112654 355403627 0 X www.ric.org X 1951 IL The Rehabilitation Institute of Chicago is dedicated to provide the highest-quality patient care. 14 13 1901 461 1790691 302306 37653917 74898929 181994709 193667970 10211329 24299072 595300 1617226 230455255 294483197 5493339 5743023 0 0 124826114 138181760 0 0 5110775 75388974 75724388 205708427 219649171 24746828 74834026 488316238 608753863 231441336 222495421 256874902 386258442 X The Rehabilitation Institute of Chicago (RIC) is dedicated to providing the highest-quality patient care through integrated research, scientific discovery, and education for the purpose of maximizing the recovery of the individuals in our care. 0 0 148693481 7860 190048910 Clinical Care - Founded in 1951, RIC, an Illinois not-for-profit corporation, earned the distinction of being named the nation's #1-ranked provider of comprehensive physical medicine and rehabilitation care to patients from around the world for 23 years by U.S. News & World Report - a record for any U.S. hospital. RIC also is the nation's largest rehabilitation research enterprise, advancing the field globally through innovation of the most advanced treatments and technologies. RIC is ranked #1 by the National Institutes of Health for rehabilitation research and is the only hospital in the nation to hold a record six federally designated research programs in the areas of stroke, spinal cord injury, patient outcomes, rehabilitation engineering, bionic medicine, and pediatric orthopedics. RIC's vision is to advance human ability through science and research. In January 2012, RIC opened 24 beds on a renovated patient floor that featured the world's first Ability Lab, an innovative treatment space that combines research and clinical care, surrounding the patient within the hospital setting. RIC's Care Quality and Delivery Highlights:RIC currently operates a system of care consisting of a 182 bed hospital and outpatient facility, located at 345 East Superior Street in Chicago, Illinois, as well as a number of other facilities and joint ventures. On February 5, 2013, the Illinois Health Facilities and Services Review Board granted RIC a licensure for 242 beds for its new research hospital and outpatient facility currently under construction at 355 East Erie, Chicago, IL. The Corporation offers a comprehensive range of inpatient, day rehabilitation and outpatient services throughout the System. Inpatient rehabilitation services are provided using a multidisciplinary approach. Day treatment rehabilitation consists of a multidisciplinary approach for individuals no longer requiring the 24-hour nursing services provided in an inpatient setting. Outpatient care is typically a singular discipline (e.g., physical therapy) and offers various levels of therapeutic intensity, depending on the patient's needs and goals. In FY 2013 RIC treated more than 6,815 inpatients and delivered over a million outpatient therapy units. RIC's facilities are staffed by approximately 1,600 medical professionals and support personnel, a dedicated team treating patients from 50 states and 70 countries.Each patient at RIC is assigned a personalized care team consisting of the field's most well-trained rehabilitation doctors, nurses, therapists, care managers and clinical specialists. No other specialty hospital in the nation has a more experienced track record:- RIC delivers patient outcomes that exceed national and regional averages across all areas of specialty.- RIC is one of only 3% of the nation's nearly 6,000 hospitals to have achieved Magnet designations and their consecutive Magnet redesignation for nursing excellence from the American Nurses Credentialing Center (ANCC). 20453420 5735163 108751 Research - RIC's Research Program is the world's largest physical rehabilitation research enterprise in pursuit of clinical advancement through scientific discovery and is ranked #1 by the National Institutes of Health for rehabilitation research. It is NIH's largest grant recipient. The Research Program has at any given time approximately 300 research projects underway, funded by more than $85 million in donations from both private and public sources. Its experts regularly publish research in the world's foremost medical journals, including the Journal of the American Medical Association (JAMA) and its European equivalent, The Lancet, and it is home to a record six federal research designations to develop cutting-edge solutions for patients.Stroke Research: RIC operates the only Stroke Rehabilitation Research & Training Center as designated by the National Institute on Disability and Rehabilitation Research (NIDRR), in the nation. With stroke as the leading cause of disability in America, RIC is developing exciting new robotic hand orthosis systems and exploring virtual-reality technologies to help patients return to work, to play and to their passions.Neurologic Rehabilitation Research: RIC hosts one of six programs in the country within the National Center for Medical Rehabilitation Research awarded by the National Institutes of Health. Within this network of experts, RIC is the only one focused on the groundbreaking application of neural engineering and robotic techniques to understand, diagnose and treat such neurologic disorders as brain injury, multiple sclerosis and Parkinson's disease. Spinal Cord Injury Research: RIC operates the Midwest Regional Spinal Cord Injury Care System as designated by NIDRR. One of only 14 SCI Model Systems nationwide, RIC advances spinal cord care through clinical research that identifies new standards of care for the industry. It leads multiple independent and collaborative research projects exploring walking therapy technologies that deliver the most effective treatment to advance ability.Engineering Research: Machines assist therapists in providing longer, more consistent and intensive therapies that track progress and improve functional performance. RIC is designated one of 20 NIDRR Rehabilitation Engineering Research Centers dedicated to stroke research and the only one focused on robotics.Outcomes Research: RIC operates the only NIDRR Outcomes Rehabilitation Research & Training Center in the nation leading the way for establishing global, standardized measures and evaluating clinical outcomes to ensure patients receive the best care and best outcomes. Pediatric Orthopedic Research: Awarded in January 2010, a grant from NIDRR supports the research and development of innovative technologies to improve rehabilitative treatment for children with orthopedic disabilities, including cerebral palsy, clubfoot, brittle bone disease, spina bifida and spinal cord injury. 6887703 1822349 Medical Education - Medical Residency Program: The Department of Physical Medicine and Rehabilitation at Northwestern University's Feinberg School of Medicine (Dept of PM&R) is housed within RIC, which has one of the largest and most highly respected residency programs in physical medicine and rehabilitation in the country. Resident physicians spend three to four years rotating through the Dept of PM&R, taught by RIC physicians who are experts in this specialty. In 2013, RIC trained 38 residents. The RIC medical education program also provides opportunities for first-year medical students to meet regularly with patients from RIC's spinal cord injury, general rehabilitation, or pediatric program to gain patients' insights on recovery and needs for independent living.RIC Academy: The RIC Academy Continuing Education program has been offering courses to help health professionals stay at the forefront of their field for over 35 years. In FY 2013 more than 2,300 students attended academy courses which are taught by interdisciplinary teams of recognized specialists from RIC and visiting experts from across the country and around the world. The Academy also provided an online learning program that reached over 500 students. The cost to customers was only $10 to $50, about 50 percent below market for online courses of this type.Fellowships: RIC offers physician fellowships, funded primarily by donations, in pediatric rehabilitation, musculoskeletal sports and spine medicine, spinal cord injury, pain management, and traumatic brain injury. In 2013, four physician fellows were named at RIC. RIC also supports fellowships for therapists, nurses and other non-physicians. Prosthetics and Orthotics (P&O) Residency: Each year, RIC's Prosthetics and Orthotics Clinical (POCC) selects two prosthetist and two orthotist residents for these highly sought after positions. Over a 12-month cycle, P&O residents are tutored by RIC's certified, licensed professionals and get exposure to a variety of clinical presentations and pathologies, clinical evaluation, prescription recommendation, documentation, the actual fabrication of devices, and formal research. 4446077 1448474 Community Health and Education - RIC provides a variety of community health and education programs. LIFE Center: As an addition to its world renowned clinical services, RIC developed the LIFE (Learning, Innovation, Family, Empowerment) Center ten years ago to address the range of emotional, interpersonal, physical and financial requirements for living with a disability. In response to the need for trusted resources in key areas of life, RIC provides this state-of-the-art multimedia education center and web portal as an integrated component of RIC patient care to support seamless and successful transitions throughout life. In 2013, 19,118 persons were served. Teaching activities reflected 2,648 person contacts; patient, family, and community education programs, classes and special events conducted throughout the year also provided service to 3,954 people. In addition, the Center provided dedicated resource assistance and referral to 1,873 people. The Center's public computer area remained in high demand servicing 7,946 people for Internet use and support. The Center's impact spreads globally through its website, which drew 267,733 page views per month with 3,212,792 page views annually in 2013. Cumulative page views since its launch in 2003 have surpassed 26 million from 183 countries. Sports and Fitness Program: The RIC Adaptive Sports and Fitness Program provides wellness opportunities to people with physical disabilities through sports and recreation as well as a full-service accessible health club. All services offered in the adaptive sports program, which marked its 32nd year in 2013, are free of charge. The fitness program, which celebrated its 17th anniversary, provides access to a health club that operates from 7 am to 7 pm five days per week for a nominal fee. The sports and fitness program is funded primarily by grants and generous community donations and is operated by ten and three quarter full time equivalent staff. Additionally, volunteers logged nearly 7,500 hours in 2013. RIC's well-established program is considered a national leader in health promotion for people with disabilities. In 2013, the sports program recorded 6,798 visits by its 245 registered participants, and the fitness program recorded 35,751 visits by its 842 registered participants. A separate program for youth, the Caring for Kids program, recorded 2,750 visits by 225 Chicago children with disabilities. The only program of its kind in Cook County, it was designed specifically to incorporate physical fitness into the lives of children with physical disabilities.Vocational Rehabilitation Program: Beginning a career or returning to gainful employment is important to a patient's financial security and emotional well-being, and can contribute to the achievement of a productive, independent and fulfilling life. For 50 years, RIC has been providing comprehensive vocational rehabilitation services tailored to meet the needs of each client. Services include initial assessment, diagnostic evaluation, work trial assessments, job analysis, return-to-work evaluation, job placement, resume writing and interviewing workshops, an Internet job skills course and internship coordination. RIC covers the cost of initial assessments, which are not covered by most third-party payers. Patients receive vocational services at eight RIC facilities, ensuring that employment assistance is closely tied to community reintegration. During the past five years, the program has served an average of 800 clients annually. Since 2007, the program has worked with inpatient military personnel to evaluate their vocational goals. Assistive Technology Programs: Three areas - Rehabilitation Engineering, the Technology Center, and the Wheelchair Seating & Positioning Center - comprise RIC's Assistive Technology Programs. In 2013, Assistive Technology Programs served more than 2,157 unique patients.Rehabilitation Engineering staff provide evaluation, design and technical expertise to modify commercial products and fabricate custom equipment, creating individualized solutions for people with disabilities. RIC provides free care for services or products, hosts engineering student internships, lectures at Northwestern University's engineering program and provides community-based workshops to disability groups about adaptive equipment, ergonomics and home safety.The RIC Technology Center targets computer access, augmentative communication and electronic aids to daily living for people with disabilities. Occupational therapists and speech language pathologists evaluate and recommend equipment for each individual's needs. Through a lending library, patients can try items before purchasing them or borrow them for short-term use due to changing needs. Staff members speak to universities, schools, organizations for people with disabilities, senior centers and the general public. The center provides free service and home visits to clients who are unable to come to RIC.The Wheelchair Seating & Positioning Center staff evaluate and make recommendations for manual wheelchairs, power wheelchairs, seat cushions to relieve pressure or maintain posture, seating systems, and other durable medical equipment that help clients maintain or increase their independence. Staff help patients at all RIC sites, as well as in schools and other clinical facilities in the Chicago area. 4446077 1448474 180480681 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 1 0 1 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 1 234 0 1 1901 1 1 1 0 0 0 0 1 1 0 0 0 0 X 14 13 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL IN X Edward B Case 3122381000 345 E Superior Street Chicago IL 606112654 M Jude Reyes 1.00 1.00 X 0 0 0 Thomas A Reynolds III 1.00 1.00 X 0 0 0 Wayne R Andersen 1.00 1.00 X 0 0 0 William J Cernugel 1.00 1.00 X 0 0 0 Wesley M Dixon Jr 1.00 1.00 X 0 0 0 Daniel D Dolan Jr 1.00 1.00 X 0 0 0 Michael L Keiser 1.00 1.00 X 0 0 0 Michael P Krasny 1.00 1.00 X 0 0 0 William E Lowry Jr 1.00 1.00 X 0 0 0 David D Olson 1.00 1.00 X 0 0 0 Mark Stephen 1.00 1.00 X 0 0 0 William S Wardrop Jr 1.00 1.00 X 0 0 0 Linda Wolf 1.00 1.00 X 0 0 0 Joanne C Smith MD 40.00 1.00 X X 1282933 0 220273 Edward B Case 40.00 1.00 X 861531 0 208216 Nancy E Paridy 36.00 1.00 X 419789 0 38439 Peggy M Kirk 40.00 0.00 X 577484 0 79739 Lois M Huggins 40.00 0.00 X 492343 0 68074 William Rymer MD PhD 40.00 0.00 X 381046 0 29001 Collins Fitzpatrick MD 40.00 0.00 X 802457 0 58237 Michael S Marinko MD 40.00 0.00 X 569521 0 63151 Steven P Stanos DO 40.00 0.00 X 562769 0 71151 James Sliwa DO 40.00 0.00 X 493889 0 95674 Revathy Ameeruddin MD 40.00 0.00 X 423865 0 36606 6867627 0 968561 134 0 1 0 HDR Architecture Inc 8404 Indian Hills Drive Omaha NE 68114 Architectural Services 6446048 M Arthur Gensler Jr & Assoc Inc Two Harrison Street San Francisco CA 94105 Architectural Services 5036572 Cerner Corporation PO Box 412702 Kansas City MO 64141 IT Services 3391755 Northwestern Memorial Hospital PO Box 73690 Chicago IL 606737690 Medical Services 3361557 Northwestern University 320 East Superior Street Chicago IL 60611 Research Subcontractor 3353089 67 1686656 16663354 56548919 1794490 74898929 Net Patient Revenue 621990 173818679 173818679 Affiliation Income 900099 12154105 10882805 1271300 Medicare GME Payment 621990 958855 958855 Tuition 900099 802748 802748 5933583 5755893 177690 193667970 3662303 341701 3320602 65350 0 65350 65350 65350 66022565 15000000 60385796 0 5636769 15000000 20636769 20636769 175421 1686656 534634 -359213 -359213 EHR Payments 621990 1092972 1092972 Cafeteria Sales 900099 766935 766935 Other Non-Operating 900099 51182 51182 1911089 294483197 193428484 1790691 24365093 5257225 5257225 407260 407260 78538 78538 5993781 885722 5108059 103655691 92671153 9435381 1549157 10164295 8790050 1227709 146536 11237704 10220530 758062 259112 7130289 6271236 747378 111675 3942521 763877 2518521 660123 525250 68459 456791 261631 261631 297003 297003 924653 923763 890 12722411 12126063 541004 55344 680763 307922 280230 92611 4599877 3886949 645635 67293 3471287 2111587 1346238 13462 6088488 5037473 898615 152400 841154 742967 71372 26815 693929 644747 46910 2272 2745067 53610 2691457 12378332 9945427 2420772 12133 1931573 167181 1764392 Medical Supplies 9902825 9880069 22756 Medicaid Provider Tax 6634603 6634603 Patient Transportation 1665635 1665625 10 Loss on Refinancing 1103162 1103162 4314224 1862408 490864 1960952 219649171 180480681 34057715 5110775 52314 65030 34655904 32199452 42504348 70938475 26756446 26765982 1141465 1343547 2798920 2738584 245049380 120879532 105425861 124169848 74779323 91536540 175559552 231295627 11821097 12539690 1994407 3971132 10826601 11189956 488316238 608753863 26703054 32146711 2861830 2531871 90405000 127679950 20000000 0 91471452 60136889 231441336 222495421 X 121974215 218418314 83316602 116097456 51584085 51742672 256874902 386258442 488316238 608753863 X 74834026 24201592 30347922 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 1146 0 1 295857 297003 0 Part IV, Supplemental Information: Part II-B, Line 1(i), Other Lobbying Activites: Rehabilitation Institute of Chicago lobbies Federal and State government on issues related to Medicare, Medicaid and other government health care programs related to the rehabilitation field. Most of the lobbying expenses are to third party lobbying firms as well as the Illinois Hospital Association and the American Medical Rehabilitation Providers Association. RIC does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 82646831 158587 8939449 3498537 88246330 78482474 1187000 5923887 2946530 82646831 57290243 16669084 6784986 2214340 47499 78482474 49985875 5568617 4143619 2407868 57290243 56604191 673884 -5217142 2075058 49985875 0.01000 0.59000 0.40000 0 0 33117116 33117116 111128273 87528884 23599389 7701927 7701927 48173069 33350648 14822421 44928995 44928995 124169848 Cash and cash equivalents 57087060 F Absolute Return 46321499 F Hedged Equity 27116124 F International Equity 7924494 F International Hedged Equity 5762384 F Pvt Eqty, Real Assets & Contracts 42461269 F Gov. Fixed Income & Corporate Bonds 44622797 F 231295627 292119 Self-Insurance Reserves 6540005 Accrued Pension 27302191 Swap Liability 8235033 Deferred Lease Liability 1465089 457 Plan Liabilities 10381330 Cerner Software Contract Liability 1139525 Lease Intentive/Other 852713 Estimated Third Party Settlements Payable 3554414 Ikon Capital Lease Obligation 374470 60136889 X Description of Intended Use of Endowment Funds: Part V, Line 4: The intended use for each of the RIC endowment funds is established by the donor. The majority of the endowment funds are used to support medical education, clinical care, free care, research, medical leadership, fellowships and the RIC Academy. Description of Uncertain Tax Positions Under FIN 48: Part X, Line 2: RII and the Institute are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the "Code") and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Despite the general exemption from income taxes, RII and the Institute are subject to federal and state income taxes at corporate rates on unrelated business income. Included in the consolidated statements of operations and changes in net assets is the provision for current taxes of $44,000 and $255,000 for the years ended August 31, 2013 and 2012, respectively. Part VI, Line 1c: Depreciation for leasehold improvements is included in the same general ledger account as building depreciation. There is related depreciation for leasehold improvements, but it cannot be bifurcated for Form 990 purposes. 1 North America 0 0 Program services Research 500 Europe (including Iceland & Greenland) 0 0 Program services Research 78038 Middle East and North Africa 0 0 Program services Travel related to clinical care, presentation of papers, and business development. 26675 0 0 0 0 0 0 105213 0 105213 Europe (including Iceland & Greenland) Bionic Medical Research 52908 Check Europe (including Iceland & Greenland) Medical Research 25130 Electronic Fund/Wire 1 1 1 0 0 1 1 0 Procedure for Monitoring Grants Outside the U.S.: Schedule F, Part I, Line 2: Each research grant is assigned a Principal Investigator (PI) as well as a Research Administrator (RA). Grant expenditures charged to each grant are approved/reviewed by the respective PI and or RA to ensure allowability. In addition, compliance (A-133) audits are performed by an independent audit firm each year. X X X X X X X 1 Donald A Campbell & Company 1 E Wacker Drive Suite 3350 Chicago IL 60601 Advisory Services for Campaign Planning 0 0 282167 0 282167 IL SkyRise Chicago 1082169 984774 97395 1700 49236 0 1786 2475 176060 Medicine Ball 293890 264501 29389 0 0 0 10000 5000 52941 4 486018 437381 48637 4000 2311 51707 80839 7700 88879 1862077 1686656 175421 5700 51547 51707 92625 15175 317880 534634 -359213 Explanation of Fundraising Payments Schedule G, Part I, Line 2b, Column (v) RIC has an agreement for advisory services for the capital campaign related to its new Research Hospital. The agreement does not provide for separate reimbursement for expenses. 1 1 1 X 250.000000000000 1 X 600.000000000000 1 1 1 0 1 1 1394011 1394011 0.00630 28449579 22776488 5673091 0.02580 490730 380706 110024 0.00050 30334320 23157194 7177126 0.03260 3134224 281159 2853065 0.01300 6875875 1822349 5053526 0.02300 1311853 1167315 144538 0.00070 26085132 21241882 4843250 0.02200 37407084 24512705 12894379 0.05870 67741404 47669899 20071505 0.09130 1 421649 46570 48057588 50352639 -2295051 X 1 1 1 1 Rehabilitation Institute of Chicago

345 E Superior Street Chicago IL 60611

www.ric.org X X X Physical Rehabilitation Rehabilitation Institute of Chicago 1 1 X X X X X X X X X 12 1 0 1 X X X X X X X X 1 0 1 1 250.000000000000 1 600.000000000000 1 X X X X X 1 1 X X X X X X 1 0 X X X X 0 X X 0 0 12 RIC DayRehab Ctr & OP Ctr-Northshore

755 Skokie Boulevard Northbrook IL 60062

Day/Outpatient Rehab & Physician Practice RIC DayRehab Ctr & OP Ctr - Homewood

1055 W 175th Street Suite 101 Homewood IL 60430

Day/Outpatient Rehab & Physician Practice RIC DayRehab Ctr & OP Ctr-Willowbrook

6705 Kingery Highway Willowbrook IL 60527

Day/Outpatient Rehab & Physician Practice RIC DayRehab Ctr - River North

307 W Grand Avenue Chicago IL 60610

Day Rehabilitation RIC DayRehab Ctr - Wheeling

5150 Capitol Drive Wheeling IL 60090

Day Rehabilitation RIC Ctr for Pain Management

980 N Michigan Avenue Suite 800 Chicago IL 60611

Outpatient Rehabilitation & Physician Practice RIC Spine and Sports Rehab Ctr

1030 N Clark Street Chicago IL 60610

Outpatient Rehabilitation & Physician Practice RIC DayRehab Ctr - Ravenswood

1945 W Wilson Avenue Suite 100 Chicago IL 60640

Day Rehabilitation RIC Spine & Sports Rehab Ctr - River For

420 Thatcher Avenue River Forest IL 60305

Outpatient Rehabilitation & Physician Practice RIC OP Center - Northshore (annex)

900 Skokie Boulevard Northbrook IL 60062

Outpatient Rehabilitation & Physician Practice Alexian Rehab Hosp Physician Practice

935 Beisner Road Elk Grove Village IL 60007

Physician Practice RIC Pelvic Health Center

676 North St Clair Room 908 Chicago IL 60611

Outpatient Rehabilitation Part I, Line 7: The best available data was used to calculate the cost amounts reported in item 7. The Medicare cost report was the source used where a program category was separately identifiable. In other cases the internal cost allocation model was used as the source of the cost. The Medicare cost report cost to charge ratio was used to determine the cost of charity and bad debt. Part III, Line 2: The bad debt expense was estimated by multiplying the cost to charge ratio from Worksheet C of the Medicare cost report times the provision for bad debt for the year. Part III, Line 3: Amounts have been reported on Schedule H, Part III, Line 3 for RIC joint ventures to estimate the amount of bad debt expense attributable to patients eligible under these organizations' financial assistance policies. Southern Illinois Hospital (SIH) provided the RIC share amounts for bad debt at cost and bad debt at cost attributable to patients eligible under the SIH financial assistance policy. The percentages of bad debt at cost attributable to patients eligible under the ABMC and IMMC financial assistance policies were taken from the filed Schedule H for Alexian Brothers Medical Center (ABMC) and Illinois Masonic Medical Center (IMMC) and were used to estimate the portion of RIC's share of bad debt for these two organizations that would be attributable to patients eligible for financial assistance under their respective policies.On Schedule H, Part III, Line 3 no amount was included for RIC for bad debt expense attributable to patients eligible under the RIC financial assistance policy. RIC's Presumptive Eligibility Policy sets forth the presumptive eligibility criteria by which a patient's financial need is determined and used by RIC to deem a patient eligible for hospital financial assistance without further scrutiny by RIC. Charity care may be provided to patients who are either uninsured or underinsured who do not have the financial resources to pay their RIC bill and who meet income and other guidelines specified by RIC. As soon as the need for financial assistance is identified, RIC provides the patient or Guarantor with a Program application. Patient Financial Services will review all patient accounts with self pay balances and determine presumptive eligibility after review of the patient's Charity Application and prior to sending the patient a bill requesting payment. Patient Financial Services may use third-party reporting to determine presumptive eligibility of a patient if the patient has not timely returned a completed Charity Application. If a patient is presumed eligible, their balances will not be written off to bad debt. Part III, Line 4: The organization is part of the Rehabilitation Institute, Inc. and Affiliates consolidated audit in which the footnote that discusses the bad debt expense is located on pages 7 and 8. Part III, Line 8: The portion of our Medicare shortfall reported on Part III, Line 7 which relates to patients that are dual eligible for both Medicare and Medicaid should be treated as community benefit consistent with our State of Illinois Annual Non Profit Hospital Community Benefits Plan Report. The amount on Line 7 related to these dual eligible patients is $1,138,080.The cost to charge ratio from Worksheet C of the Medicare cost report times the Medicare gross charges from the cost report less GME payments was used to determine Medicare allowable cost. Part III, Line 9b: The Executive Director-Revenue Cycle/designee will determine if the statutory conditions for pursuing collection have been met and provide written approval before a collection agency or law firm may initiate legal action against the patient for nonpayment of their bill. Rehabilitation Institute of Chicago Part V, Section B, Line 3: The hospital facility took into account input from persons who represent the broad interests of the community served by the hospital facility, including those with special knowledge or expertise in public health. These persons include representatives from the City of Chicago's Mayor's Office for People with Disabilities, the Illinois Department of Human Services, and non-government organizations Access Living, Brain Injury Association of Illinois, Chicagoland Chamber of Commerce, Extended Home Living Services, Great Lakes ADA Center, MobilityWorks, Gridiron Alliance NFP, Northwestern Law School, National Parkinson Foundation, World Chicago, and Zion Lutheran Church.The hospital facility consulted with these persons through telephone interviews and a focus group to which the organizations listed above were invited.Additionally, the hospital facility consulted with other organizations and other groups in conducting its most recent CHNA. These consultations included providing a standard assessment survey to a randomly selected sample of day rehabilitation, outpatient, and inpatient patients across multiple sites of care. Rehabilitation Institute of Chicago Part V, Section B, Line 14g: The admission consent forms at all facilities explain that financial assistance is available and includes a contact and phone number for obtaining financial assistance and alternative payment options. Rehabilitation Institute of Chicago Part V, Section B, Line 20d: The amounts billed to individuals who did not have insurance were determined by the Medicare cost to charge ratio. This is provided annually to the Illinois Attorney General's office. Part VI, Line 2: The needs of our community are assessed on an ongoing basis. We receive input from our community through our patient feedback programs, community support groups and through our clinicians and physicians who are interacting with them every day. The RIC LIFE Center provides education and support for the disabled community regardless if they receive services from RIC or not. The LIFE Center served over 19,000 people in the last year throughout the world. Through this connection we are able to collect and track the resource needs of our community. We also have a number of disabled members on our governing and auxiliary boards. These individuals help guide the mission, vision and services at RIC. Part VI, Line 3: RIC assures that each registration/admission location contains signage (in English and other predominant languages of the RIC patient population) notifying patients that financial assistance is available to qualified individuals. This notice is also posted on RIC's website (www.ric.org), along with RIC's Financial Assistance Program process and application. Information regarding the Financial Assistance Program and the application is available in each RIC registration/admission location. The information regarding financial assistance also appears on every self pay statement sent to our patients. Part VI, Line 4: As a specialty hospital, RIC defines the patients it serves broadly as the disabled community throughout the state of Illinois, the United States and around the world. Due to RIC's unique services and its reputation as the leader in rehabilitation medicine, many patients will travel long distances for care. Approximately 82% of RIC inpatients come from the 7-county area surrounding Chicago. This represents a primary reach of 50 miles. In addition to those Chicagoland area patients, RIC also cares for patients from 50 states and from 70 countries. RIC continues to increase its outreach and has impacted the lives of individuals in North, Central and South America; Europe; Africa; Asia (predominately the Middle East); and Australia.The largest users of rehabilitation medicine are those 45-64 years of age and those 65+. RIC continues to serve this group of people and conducts strategic planning around the needs of the "Baby Boomer" population, which is projected to have substantial growth in the Chicagoland area. Part VI, Line 5: RIC provides a number of services that generally do not generate revenue, solely for the purposes of improving the health and quality of life for our community. These services include: research to improve patient outcomes; educational resources on living with a disability available to anyone through the Internet; vocational training and placement services; support groups to assist in psychological adjustment; fitness and sports training program to promote physical activity and case management for high risk patients discharged to the community. Any surplus funds are used to support these non-revenue patient centered activities as well as develop programs, sponsor research and improve facilities. In the past several years, The Rehabilitation Institute of Chicago (RIC) has implemented multiple sustainable guidelines and procedures to ensure that it is using the most innovative, "green" practices when updating, remodeling, and redecorating facilities and structures. Reports Filed With States Part VI, Line 7 IL 1 Akta Web Studio LLC 223 W Erie 4E Chicago IL 60654 271916880 N/A 45000 Payments for research related activities Archeworks 625 N Kingsbury Chicago IL 606546997 363912263 501(c)(3) 50600 Payments for research related activities Arizona Board of Regents - Arizona State University 2020 Central Ave Phoenix AZ 850044593 860196696 501(c)(3) 12862 Payments for research related activities Brain Injury Association of Illinois 1127 S Manheim Rd 213 Westchester IL 60154 363962297 501(c)(3) 22500 Payments for research related activities Case Western Reserve University PO Box 1591 Nashville TN 37235 341018992 501(c)(3) 100478 Payments for research related activities Communications Programming Inc (Now Susan Parks Consulting Group) 703 Woodbine Ave Oak Park IL 60302 363108511 N/A 17672 Payments for research related activities Haskins Labortories Inc 300 George St 900 New Haven CT 06511 131628174 501(c)(3) 17095 Payments for research related activities Illinois Institute of Technology 3300 S Federal St Room 201 Chicago IL 606163793 362170136 501(c)(3) 91638 Payments for research related activities Johns Hopkins University PO Box 64125 Baltimore MD 212644128 520595110 501(c)(3) 10000 Payments for research related software Marquette University Office of the Comptroller Milwaukee WI 532011881 390806251 501(c)(3) 6093 Payments for research related activities Massachusetts Institute of Technology McGovern Institute for Brain Science BLDG46-6189 Cambridge MA 02140 042103594 501(c)(3) 142120 Payments for research related activities National Aphasia Association 350 7th Avenue Suite 902 New York NY 10001 133411063 501(c)(3) 15000 Payments for research related activities National Stroke Association 9707 E Easter Lane Centennial CO 80112 742317104 501(c)(3) 15000 Payments for research related activities North Carolina State University 2701 Sullivan Drive Campus Box 7514 7514 Raleigh NC 276957514 566000756 501(c)(3) 47695 Payments for research related activities North Shore University Health System 1301 Central St Research Institute Evanston IL 60201 362167060 501(c)(3) 11250 Payments for research related activities Northwestern University 710 N Lakeshore Drive Chicago IL 60611 362167817 501(c)(3) 2604699 Payments for research related activities Paire 3801 Miranda Ave 151p Palo Alto CA 943040038 770207331 501(c)(3) 10455 Payments for research related activities Regents of the University of California - Irvine 111 Academy Way Suite 210 Irvine CA 926971050 952226406 501(c)(3) 18001 Payments for research related activities Regents of the University of Colorado 1800 Grant St 400 Denver CO 80203 846000555 501(c)(3) 167500 Payments for research related activities Regents of the University of Michigan 3003 S State St 2050 Wolverine Tower Ann Arbor MI 48109 386006309 501(c)(3) 28396 Payments for research related activities Schwab Rehabilitation Hospital 1401 S California Blvd Chicago IL 60608 362179802 501(c)(3) 7412 Payments for research related activities Silicon Engines Ltd 3550 West Salt Creek Lane Arlington Heights IL 60005 363678819 N/A 42723 Payments for research related activities Spaulding Rehabilitation Hospital Corporation 125 Nashua Street Boston MA 02114 042551124 501(c)(3) 229590 Payments for research related activities University of Alabama - Birmingham 701 20st South 990 Admin Bldg Birmingham AL 35294 636005396 501(c)(3) 63401 Payments for research related activities University of California - Irvine 111 Academy Way Suite 210 Irvine CA 926971050 952540117 501(c)(3) 7554 Payments for research related activities University of Colorado - Boulder 3100 Main Street Boulder CO 803090572 846049811 501(c)(3) 286703 Payments for research related activities University of Illinois 1305 W Green Street Urbana IL 61801 376006007 501(c)(3) 535230 Payments for research related activities University of Rhode Island 70 Lower College Road 1 Kingston RI 028810811 056014351 501(c)(3) 74452 Payments for research related activities University of Texas Health Science Center at Houston PO Box 203382 Houston TX 772163382 741761309 501(c)(3) 15171 Payments for research related activities University of Utah 201 S Presidents Circle Suite 406 Salt Lake City UT 941129020 876000525 501(c)(3) 48188 Payments for research related activities University of Wisconsin - Lacrosse 1725 State Street Lacrosse WI 54601 390743975 501(c)(3) 51835 Payments for research related activities Vanderbilt University PO Box 351591 Station B Nashville TN 37235 620476822 501(c)(3) 85037 Payments for research related activities Washington University One Brookings Dr Box 1054 Saint Louis MO 63130 430653611 501(c)(3) 351165 Payments for research related activities 30 3 Stipends/Honorariums 7 7440 Research - Professional Services 23 122509 Subject Reimbursements 5976 277311 Procedure for Monitoring Grants in the U.S.: Part I, Line 2: Schedule I, Part I, Line 2: Oversight is provided by executive leadership, supported by the research administration department where active interaction with principal investigators is maintained. Monitoring is done through continued relationships with grantee organizations, whether by membership or community liason. For research grants, each grant is assigned a Principal Investigator (PI) as well as a Research Assistant (RA). Grant expenditures charged to each grant are approved/reviewed by the respective PI and/or RA to ensure allowability. In addition, compliance (A-133) as well as Financial audits are performed by an independent audit firm each year. X 0 1 X X X X X 0 1 0 0 0 0 0 1 0 Joanne C Smith MD 723630 0 538300 0 21003 0 197122 0 23151 0 1503206 0 0 0 Edward B Case 538997 0 315000 0 7534 0 190217 0 17999 0 1069747 0 0 0 Nancy E Paridy 266555 0 150000 0 3234 0 32020 0 6419 0 458228 0 0 0 Peggy M Kirk 359556 0 215000 0 2928 0 58588 0 21151 0 657223 0 0 0 Lois M Huggins 316367 0 173000 0 2976 0 54075 0 13999 0 560417 0 0 0 William Rymer MD PhD 319663 0 58875 0 2508 0 17000 0 12001 0 410047 0 0 0 Collins Fitzpatrick MD 719939 0 80092 0 2426 0 37000 0 21237 0 860694 0 0 0 Michael S Marinko MD 565381 0 0 0 4140 0 42000 0 21151 0 632672 0 0 0 Steven P Stanos DO 498003 0 63132 0 1634 0 50000 0 21151 0 633920 0 0 0 James Sliwa DO 318762 0 172000 0 3127 0 74523 0 21151 0 589563 0 0 0 Revathy Ameeruddin MD 391297 0 30910 0 1658 0 17000 0 19606 0 460471 0 0 0 Part I, Line 1a Gross-up payments: The organization provides additional disability insurance for the Chief Executive Officer. The CEO purchases the policy and then is reimbursed by the organization. The amount is grossed up to cover applicable taxes. Part I, Line 1b The organization does not have a written policy. Reimbursements are made pursuant to an agreement. Part I, Line 4b All employees and amounts listed are voluntary deferrals or company contributions to various non-qualified deferred compensation plans organized under code section 457(b) and 457(f). The exact purpose of each plan varies but they include: compensation limitation make-up plans, voluntary deferral plans, deferral of a portion of incentive bonus type plans, etc. No payments were made to listed persons in Part VII under the various non-qualified deferred compensation plans during the year. Supplemental Information Part III Part I, Line 7: Executive leadership participate in a variable incentive compensation plan. Amounts are a percent of base salary. Certain financial and quality triggers need to be met, and then the percent awards are determined by institutional financial performance, patient satisfaction scores, and individual performance metrics. A Illinois Finance Authority 861091967 45203HTC6 2013-07-11 398898603 Refund bonds issued 11/22/2005 and 12/10/2009; build new research hospital 0 0 0 A 398898829 1025 2592245 31192756 48006174 317106629 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 1 0 0 0 0 A 0 Part I, Column (c): The CUSIP shown here, 45203HTC6, is for the latest maturity of the Series A bonds. The issue as a whole also consists of Series B through E bonds (which mature later than Series A), none of which bear CUSIP numbers. Part II, Line 12: Other unspent proceeds consist of $45,906,156 of trustee held funds and $271,200,473 of undrawn funds (The issue consists of draw-down bonds.). Part III: This section is completed with respect to the new money portion of the bonds, the refunded debt issued 12/10/2009 (which was related to the land for the new building project) and the portion that refunded debt issued 11/22/2005. With respect to the new money portion and the refunded debt issued 12/10/2009, the project has not been completed, so the measurement period has not yet begun. Part III, Line 9: The organization does not have a written procedure. However, we are aware of self remediation requirements and if we realized there is a violation of Federal tax requirements, we will seek professional assistance. Part IV, Line 7: The organization has not established written procedures to monitor the requirement of Section 148 but is aware of the rebate and arbitrage requirements and will seek professional assistance at the appropriate time. Part V: The organization does not have a written procedure. However, we are aware of self remediation requirements and if we realized there is a violation of Federal tax requirements, we will seek professional assistance. Part VI: Differences between the issue price (Part I) and total proceeds (Part II, Line 3) are due to investment earnings. Joanne Smith MD See Part V 88552 See Part V 0 Schedule L, Part IV: Business Transactions Involving Interested Persons: (a) Name of Person: Joanne Smith, M.D.(b) Relationship between Interested Person and Organization: Corporate Director of Hill-Rom, Inc. which sells/leases hospital beds to RIC.(d) Description of Transaction: Asset purchases and rentals. Schedule L, Part IV: Business Transactions Involving Interested Persons: All transactions between RIC and the organization were done at arms-length and for fair market value. X 18000 Cost or selling price X 30 1601715 Cost or selling price X Technology 8 80050 Cost X Travel/Ent 10 92700 Cost X Miscellaneous 7 2025 Cost 0 0 0 1 Method for Determining Number of Contributions: Part I, Column (b): The number in Column(b) refers to the number of contributors. Third Party Use: Part I, Line 32b: Gifts of stock are processed by RIC's brokerage firm, which has an immediate sell order for all stock gifts received. Form 990, Part VI, Section A, line 3 Crothall Services Group managed our facilities and housekeeping services; Morrison Management Specialists managed our food services, and Pharmacy Systems, Inc. managed our pharmacy. No officers, directors, trustees, or key employees (current or former) received compensation from any of these companies. Form 990, Part VI, Section A, line 6 Rehabilitation Institute, Inc. (RII) is the sole corporate member of RIC. Form 990, Part VI, Section A, line 7a RII has the ability to elect members of the governing body. Form 990, Part VI, Section A, line 7b RII is the sole member with the sole voting rights to do the following: appoint RIC board members; approve amendments to the articles of incorporation and bylaws; approve corporation annual budget and long-range plan; approve those contracts and loans in excess of $250,000 not included in previously approved budget; approve any merger, consolidation, voluntary dissolution or creation of any subsidiary; and approve the sale, lease, exchange, mortgage, pledge or other disposition of all or substantially all of the corporation assets. Form 990, Part VI, Section B, line 11 Data for the Form 990 is prepared internally, and a third party tax preparer then prepares the Form 990. It is then reviewed internally and presented in draft form electronically first to the Finance and Audit Committee of the Board and then distributed electronically to the full Board. Form 990, Part VI, Section B, line 12c All newly hired employees are required to complete a conflict of interest disclosure form at the time of new-employee orientation. In addition, all employees are required to complete such a form on an annual basis. Directors and Officers complete a Conflict of Interest Questionnaire on an annual basis. Form 990, Part VI, Section B, line 15 The Compensation and Leadership Development Committee of the Board has authority to approve all executive compensation; an independent consultant specializing in the field of executive compensation and benefits is hired by the Compensation and Leadership Development Committee of the Board to review and provide an opinion about the executive compensation that it is fair, reasonable and market appropriate. During the review and approval of the compensation, documentation of the decision was recorded in the minutes. The individual was not present when her compensation was decided. RIC performed all of the above procedures to obtain the rebuttable presumption respecting compensation arrangements (per IRC Section 4958). Form 990, Part VI, Section C, line 19 RIC does not routinely make documents available to the general public, but the conflict of interest policy and financial statements are made available to the public on an as needed basis after thorough consideration for the use. Changes in Net Assets or Fund Balances: Form 990, Part XI, line 9: Pension Adjustment 30,347,922. Medical Services RIC 345 E Superior Street Chicago IL 60611 911999919 Physician Practice Billing and Collections IL 0 0 N/A Rehabilitation Institute Inc 345 E Superior Street Chicago IL 60611 363310838 Parent IL Section 501(c)(3) 11c, III-FI N/A 0 Rehabilitation Institute of Chicago Enterprises 345 E Superior Street Chicago IL 60611 363428852 Medical Products/Medical Services IL Rehabilitation Institute Inc C 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0