2014-11-14T12:00:56-06:00 2013-12-31 CROWE HORWATH LLP 70 WEST MADISON STREET SUITE 700 CHICAGO IL 606024903 990 2013-01-01 361799520 SOUTH SHORE HOSPITAL CORPORATION SOUT 7733565312 8012 South Crandon Avenue Chicago IL 60617 TIMOTHY CAVENEY PRESIDENT & CEO 2014-11-14 true NICOLE BENCIK P00756195 3128997000 2013 2015-11-30 17:44:51Z TIMOTHY CAVENEY 8012 South Crandon Avenue Chicago IL 60617 41127245 false X WWW.SOUTHSHOREHOSPITAL.COM X 1976 IL SOUTH SHORE HOSPITAL CORPORATION IS A NOT-FOR-PROFIT HOSPITAL DEDICATED TO PROVIDING THE HIGHEST QUALITY OF HEALTHCARE POSSIBLE TO THE SOUTH SHORE COMMUNITY. THE CHARGES FORGONE FOR SERVICES FURNISHED UNDER ITS CHARITY CARE POLICY DURING THE YEAR ENDED DECEMBER 31, 2013 APPROXIMATED $6,409,262. 10 8 657 34 0 0 1488771 195834 35867333 37164655 404771 748768 379976 2999702 38140851 41108959 0 0 0 0 23511666 23334268 0 0 0 18340494 19836130 41852160 43170398 -3711309 -2061439 32927140 30058681 12839787 12636970 20087353 17421711 SOUTH SHORE HOSPITAL CORPORATION IS A NOT-FOR-PROFIT HOSPITAL DEDICATED TO PROVIDING THE HIGHEST QUALITY OF HEALTHCARE POSSIBLE TO THE SOUTH SHORE COMMUNITY. THE COSTS FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY DURING THE YEAR ENDED DECEMBER 31, 2013 APPROXIMATED $2,448,338. false false 40971473 40003700 THE HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT NO CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY DURING THE YEAR ENDED DECEMBER 31, 2013 APPROXIMATED $6,409,262. IN ADDITION TO CHARITY CARE, THE HOSPITAL ALSO PROVIDES OTHER COMMUNITY BENEFITS SUCH AS PROVIDING MENTORS AND VOLUNTEERS, AND IT ALSO SPONSORS HEALTH FAIRS THROUGHOUT THE COMMUNITY. EMPLOYEES OF THE HOSPITAL PARTICIPATE IN A MENTORING PROGRAM FOR CHILDREN WITHIN THE COMMUNITY. THE PROGRAM'S GOAL IS TO MOTIVATE STUDENTS TO COMPLETE THEIR HIGH SCHOOL EDUCATION WITH AN EMPHASIS ON THE OVERALL IMPORTANCE OF EDUCATION AND PRE-EMPLOYMENT PREPARATION. 40971473 true true false false false false false false false true false false true true true true false false false false false false false true false true true false false true false false false false false false false false false false false false false true true false false false true 150 0 true 657 true false false false false false false false false false false X 10 8 true false false false false false false true true false false true true true true false true true true false IL X Jim Burstyn 7733565350 8012 SOUTH CRANDON AVENUE Chicago IL 60617 ARNOLD STEWART VICE CHAIRMAN 10.00 X X 0 0 888 DONALD MOLL TREASURER 10.00 X X 0 0 2120 JESSE ONG PRESIDENT AND CEO - 04/10/13 RETIRED 40.00 X X 84173 0 5400 LUPE VALDEZ VICE PRESIDENT/SECRETARY 10.00 X X 0 0 653 NICK VALDEZ CHAIRMAN OF THE BOARD 10.00 X X 0 0 0 TIMOTHY CAVENEY ASST TREASURER/CFO THRU 03/28/13; PRESIDENT & CEO 03/29/13-12/31/13 40.00 X X 213622 0 19783 JAMES ACHEBE MD DIRECTOR 10.00 X 0 0 0 JIA HWANG DIRECTOR 10.00 X 0 0 2041 SATYA AHUJA MD DIRECTOR 10.00 X 0 0 0 SUNDER VINDOKUMAR DIRECTOR 40.00 X 23266 0 13841 TODD H STROGER DIRECTOR 10.00 X 0 0 0 HELEN WIERSMA ASSISTANT SECRETARY 40.00 X 104576 0 8505 SCOTT SPENCER ASSISTANT TREASURER AND CFO - FROM 05/28/13 40.00 X 58647 0 34 ALMA AVALOS LEAD CHARGE NURSE 59.00 X 138686 0 10077 LESLIE ROGERS ASSISTANT ADMINISTRATOR 41.00 X 131625 0 23383 MILICIA LUKAC NURSE MANAGER 73.00 X 197857 0 5930 RUBIO RODOLFO DIRECTOR OF HOUSE DOCTORS 39.00 X 149383 0 18724 VERA RAY DIRECTOR OF LAB 39.00 X 180091 0 0 1281927 0 111380 25 false true false COMPLETE RX 3100 S GESSNER SUITE 640 HOUSTON TX 77063 CONTRACT SERVICES 2858063 HORIZON HEALTH PO BOX 840839 DALLAS TX 752840839 CONTRACT SERVICES 554027 CARDINAL HEALTH MEDICAL PRODUCTS & SERVICES P O BOX 70539 CHICAGO IL 606730539 CONTRACT SERVICES 518431 KIM ANESTHESIOLOGISTS 22 FOREST GATE CIRCLE OAK BROOK IL 605232129 CONTRACT SERVICES 455000 BERGLUND CONSTRUCTION 8410 SOUTH CHICAGO AVENUE CHICAGO IL 60617 CONTRACT SERVICES 415735 15 0 0 24259 0 171575 0 195834 MEDICARE/MEDICAID PAYMENTS 900099 26193777 26193777 PATIENT SERVICE REVENUE 900099 10929792 10929792 RENTAL INCOME 900099 41086 41086 0 0 0 0 0 0 0 0 37164655 748768 748768 0 0 0 0 0 0 0 0 11709 24259 18286 -6577 -6577 0 0 MEANINGFUL USE PAYMENTS 900099 2701587 2701587 CAFETERIA REVENUE 900099 167234 167234 PHYSICIAN BILLING 900099 101191 101191 36267 36267 0 0 3006279 41108959 40003700 0 909425 X 0 0 0 0 537549 537549 0 19039439 18194209 845230 285680 272998 12682 2039873 1955763 84110 1431727 1337870 93857 0 60905 60905 168423 168423 0 0 0 8653580 8563441 90139 0 10934 10934 695386 668322 27064 0 0 937667 937667 7202 7202 0 0 2721 2721 0 1522848 1419146 103702 1185045 1132437 52608 MEDICAID PROVIDER TAX 2894407 2894407 DRUGS 464100 464100 FOOD 470001 470001 2762911 2640255 122656 0 43170398 40971473 2198925 0 0 306780 1290389 1336134 1575716 4205702 5562026 0 0 0 0 314452 390191 155211 191206 51098985 36515830 14688799 14583155 0 0 0 0 11920062 6465998 32927140 30058681 3762683 3670595 563358 0 0 0 8513746 8966375 12839787 12636970 X 20087353 17421711 20087353 17421711 32927140 30058681 -2061439 -604203 0 X false true X true false X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1474845 1474845 17790291 8448427 9341864 0 30604991 28067403 2537588 1228858 1228858 14583155 DESIGNATED FOR PROPERTY AND EQUIPMENT 878266 MEDICAL LIABILITY TRUST FUND 5337732 WORKERS' COMPENSATION LIABILITY TRUST FUND 250000 6465998 0 ESTIMATED LIABILITY FOR PROFFESSIONAL AND GENERAL LIABILITY 6027197 ESTIMATED THIRD-PARTY PAYER SETTLEMENTS 2810373 CAPITAL LEASE OBLIGATIONS 128805 8966375 X 40504756 -604203 0 0 0 -604203 41108959 0 0 0 41108959 43170398 0 0 0 0 0 43170398 0 0 0 43170398 Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote THE HOSPITAL HAS ESTABLISHED ITS STATUS AS AN ORGANIZATION EXEMPT FROM INCOME TAXES UNDER THE INTERNAL REVENUE CODE ('THE CODE') SECTION 501(C)3 AND THE LAWS OF THE STATE IN WHICH IT OPERATES. A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. THE HOSPITAL RECOGNIZES INTEREST AND PENALTIES RELATED TO UNRECOGNIZED TAX BENEFITS IN INTEREST AND INCOME TAX EXPENSE, RESPECTIVELY. THE HOSPITAL HAS NO AMOUNTS ACCRUED FOR INTEREST OR PENALTIES AS OF DECEMBER 31, 2013 AND 2012, RESPECTIVELY. DUE TO ITS TAX-EXEMPT STATUS, THE HOSPITAL IS NOT SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE HOSPITAL IS NO LONGER SUBJECT TO EXAMINATION BY U.S. FEDERAL TAXING AUTHORITIES FOR YEARS BEFORE 2009 AND FOR ALL STATE INCOME TAXES THROUGH 2009. THE HOSPITAL DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. GOLF OUTING 35968 24259 11709 0 4088 6270 7699 0 229 0 0 35968 24259 11709 0 4088 6270 7699 0 229 18286 -6577 true true X true X true X true true true false true true 2448338 2448338 0.05670 12198336 9517504 2680832 0.06210 0 0 0 0.00000 0 0 14646674 9517504 5129170 0.11880 94195 94195 0.00220 0 0 0 0.00000 4030795 1043889 2986906 0.06920 0 0.00000 0 0.00000 0 0 4124990 1043889 3081101 0.07140 0 0 18771664 10561393 8210271 0.19020 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 true 2073136 1209600 18310079 20671822 -2361743 X true true 1 1 SOUTH SHORE HOSPITAL CORPORATION 8012 SOUTH CRANDON AVENUE CHICAGO IL 60617 WWW.SOUTHSHOREHOSPITAL.COM 0003459 X X X SOUTH SHORE HOSPITAL CORPORATION 1 true X X X X X X X X X 13 true false true X http://www.southshorehospital.com/ X X X X X X X X X false false true true 200 true 200 true X X X X X X true true X X X true false X X X X true X false false Schedule H, Part V Sec B, Line 7, Needs not addressed in Needs Assessment (1) - SOUTH SHORE HOSPITAL: HEALTH PRIORITIES NOT CHOSEN FOR ACTION: CANCER-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS CANCER DEATHS. OTHER HOSPITALS IN THE COMMUNITY HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDE THIS AS AN AREA CHOSEN FOR ACTION. FAMILY PLANNING-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS FAMILY PLANNING ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. HEART DISEASE & STROKE-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS HEART DISEASE & STROKE ISSUES. OTHER COMMUNITY ORGANIZATIONS AND HOSPITAL HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. IMMUNIZATIONS-ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. INJURY & VIOLENCE PREVENTION-SSH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. MATERNAL & INFANT HEALTH-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS MATERNAL & INFANT HEALTH ISSUES. OTHER COMMUNITY ORGANIZATIONS AND HOSPITAL HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. ORAL HEALTH-ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. RESPIRATORY DISEASE-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS RESPIRATORY DISEASE ISSUES. OTHER COMMUNITY ORGANIZATIONS AND HOSPITAL HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. SEXUALLY TRANSMITTED DISEASES-SSH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. TOBACCO USE-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS TOBACCO USE ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. VISION-ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION.; Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined (1) - SOUTH SHORE HOSPITAL: ALL PATIENTS ARE BILLED THE SAME. IF THEY QUALIFY FOR FAP, THEY ARE ADJUSTED TO CHARITY. THEY ARE NOT CHARGED MORE THAN MEDICARE PATIENTS.; 7 WEST PULLMAN CENTER 12251 SOUTH HALSTED STREET CHICAGO IL 60628 PHYSICIAN OFFICE SENIORS & GENERAL WELLNESS CENTER 2525 EAST 83RD STREET CHICAGO IL 60617 PHYSICIAN OFFICE EAST SIDE MEDICAL HEALTH CENTER 10551 SOUTH EWING AVENUE CHICAGO IL 60617 PHYSICIAN OFFICE SOUTH SIDE PROFESSIONAL BUILDING 7906 SOUTH CRANDON AVENUE CHICAGO IL 60617 PHYSICIAN OFFICE HIGHLAND MEDICAL CENTER 8201 SOUTH ASHLAND CHICAGO IL 60620 PHYSICIAN OFFICE FAMILY MEDICAL CENTER 1424 WEST 87TH STREET CHICAGO IL 60620 PHYSICIAN OFFICE SHARED PHYSICIAN OFFICE SPACE 8012 SOUTH CRANDON AVENUE CHICAGO IL 60617 PHYSICIAN OFFICE Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation 0 Schedule H, Part III, Line 2, Bad debt expense - methodology used to estimate amount THE BAD DEBT RESERVE IS AN ESTIMATE OF THE ACCOUNT BALANCES THAT WE EXPECT TO NOT COLLECT DESPITE THE PATIENTS ABILITY TO PAY. THE ESTIMATE WHICH IS UPDATED MONTHLY IS BASED ON HISTORICAL WRITE OFF PERCENTAGES. THESE PERCENTAGES ARE ADJUSTED TO REFLECT ANY BAD DEBT RECOVERIES. Schedule H, Part III, Line 3, Bad Debt Expense Methodology THE METHOD USED TO DETERMINE THE AMOUNT THAT REASONABLY COULD BE ATTRIBUTED TO PATIENTS WHO LIKE WOULD QUALIFY FOR FINANCIAL ASSISTANCE UNDER OUR FINANCIAL ASSISTANCE POLICY IS BASED ON OUR OUTSIDE ELIGIBILITY VENDOR'S EXPERIENCE WITH QUALIFYING ACCOUNTS AS FINANCIAL ASSISTANCE. OUR VENDOR SCREENS ALL SELF PAY ACCOUNTS, AND BASED ON AN INITIAL SCREENING, WILL CLASSIFY THE ACCOUNT AS FALLING UNDER OUR FINANCIAL ASSISTANCE PROGRAM GUIDELINES. OCCASIONALLY, PATIENT ACCOUNTS WILL BE WRITTEN OFF TO BAD DEBT BUT THEN ARE LATER DETERMINED TO BE UNCOLLECTIBLE DUE TO THE PATIENT BEING UNINSURED OR ELIGIBLE FOR PUBLIC AID. ONCE DETERMINED THAT THE PATIENT HAS NO ABILITY TO PAY, THE ACCOUNTS ARE WRITTEN OFF AS CHARITY WRITE-OFFS. THE METHODOLOGY IS TO TAKE TOTAL BAD EXPENSE LESS THE BAD DEBT DEBT FROM THE MEDICARE COST REPORT. THE HOSPITAL INCURS A LOSS FOR THE BENEFIT OF THE COMMUNITY. Schedule H, Part III, Line 4, Bad debt expense - financial statement footnote THE PROVISION FOR BAD DEBTS IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS OF ACCOUNTS RECEIVABLE CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS IN HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AND CHARGED TO THE PROVISION FOR BAD DEBTS AFTER COLLECTION EFFORTS HAVE BEEN MADE IN ACCORDANCE WITH THE HOSPITAL'S POLICIES. RECOVERIES ARE TREATED AS A REDUCTION TO THE PROVISION FOR BAD DEBTS. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYOR CATEGORY. INCOME FROM INCENTIVE PAYMENTS IS SUBJECT TO RETROSPECTIVE ADJUSTMENT AS THE INCENTIVE PAYMENTS ARE CALCULATED USING MEDICARE COST REPORT DATA THAT IS SUBJECT TO AUDIT. DATA ABOUT THE MAJOR PAYOR SOURCES OF REVENUE IS ANALYZED TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR UNCOLLECTIBLE RECEIVABLES AND PROVISION FOR BAD DEBTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, CONTRACTUALLY DUE AMOUNTS ARE ANALYZED AND COMPARED TO ACTUAL CASH COLLECTED OVER TIME TO ENHANCE THE QUALITY OF THE ESTIMATE OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS AND THE PROVISION FOR BAD DEBTS (FOR EXAMPLE, FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (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), A SIGNIFICANT ALLOWANCE FOR DOUBTFUL ACCOUNTS IS RECORDED ON THE BASIS OF HISTORICAL EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. AN ESTIMATE OF THE DIFFERENCE BETWEEN CONTRACTED RATES AND AMOUNTS ACTUALLY COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS CHARGED TO THE PROVISION FOR BAD DEBTS AND CREDITED TO THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. Schedule H, Part III, Line 8, Community benefit & methodology for determining medicare costs MEDICARE ALLOWABLE COSTS WERE DETERMINED BY APPLYING THE MEDICARE COST TO CHARGE RATIO FROM THE 2013 MEDICARE COST REPORT TO THE MEDICARE CHARGES. APPROXIMATELY 60% OF OUR PATIENTS ARE SENIORS WITH MEDICARE INSURANCE, BUT ARE UNABLE TO PAY THEIR COINSURANCE AND DEDUCTIBLE AMOUNTS. CONSISTENT WITH THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY, THESE ACCOUNTS ARE EITHER WRITTEN OFF TO CHARITY CARE OR BAD DEBT EXPENSE. MOST OF THE MEDICARE SHORTFALL IS THE RESULT OF THESE ACCOUNTS. HENCE, THE HOSPITAL IS SUBSIDIZING THE MEDICARE REIMBURSEMENT AS PART OF OUR COMMUNITY BENEFIT PROGRAM. Schedule H, Part III, Line 9b, Collection practices for patients eligible for financial assistance IN RECOGNIZING THE MEDICAL NEEDS OF THE INDIGENT, SOUTH SHORE HOSPITAL PROVIDES QUALITY MEDICAL HEALTH CARE REGARDLESS OF RACE, CREED, COLOR, SEX, NATURAL ORIGIN, SEXUAL ORIENTATION, HANDICAP, AGE OR ABILITY TO PAY. OUR FINANCIAL ASSISTANCE POLICY IDENTIFIES CIRCUMSTANCES UNDER WHICH SOUTH SHORE HOSPITAL WILL EXTEND CARE FREE OF CHARGE OR AT A DISCOUNT, COMMENSURATE WITH THE ABILITY TO PAY, TO A PATIENT WHOSE FINANCIAL STATUS MAKES IT IMPRACTICAL OR IMPOSSIBLE TO PAY FOR NECESSARY MEDICAL EXPENSES. THE NECESSITY FOR MEDICAL TREATMENT OF ANY PATIENT IS BASED UPON CLINICAL JUDGEMENT WITHOUT REGARD TO THE FINANCIAL STATUS OF THE PATIENT. SCHEDULE H, PART V, POLICIES AND PROCEDURES SOUTH SHORE HOSPITAL CORPORATION IS CURRENTLY IN THE PROCESS OF REVISING THE POLICIES FOR ITS HOSPITAL BASED ON THE GUIDANCE PROVIDED IN THE PROPOSED 501(R ) REGULATIONS ISSUED IN JUNE 2012. THE RESPONSES TO PART V REFLECT THE CURRENT POLICIES AND PROCEDURES IN PLACE AT THE HOSPITAL FOR THE 2013 YEAR. REVISED POLICIES HAVE BEEN IMPLEMENTED FOR 2014. SCHEDULE H, PART V, SECTION B, LINE 20D, FAP ELIGIBLE COSTS THE FINANCIAL ASSISTANCE POLICY IN PLACE FOR 2013 ENSURES THAN AN FAP ELIGIBLE PERSON WILL NOT PAY MORE THAN THOSE WITH COMMERCIAL INSURANCE. THE POLICY IS CURRENTLY IN THE PROCESS OF BEING REVISED BASED ON THE GUIDANCE IN THE PROPOSED 501(R) REGULATIONS ISSUED IN JUNE 2012. REVISED POLICIES WERE APPROVED DURING 2014. Schedule H, Part VI, Line 2, Needs assessment. THE HOSPITAL GOES ABOVE AND BEYOND THE CORE NEEDS OF THE COMMUNITY AS STIPULATED IN THE CHNA, BY PROVIDING DIABETES EDUCATION, LANGUAGE ASSISTANCE, AND TRANSPORTATION SERVICES. MEETINGS ARE SCHEDULED THROUGHOUT THE YEAR WITH MINISTERS, COMMUNITY LEADERS AND REPRESENTATIVES OF THE COMMUNITIES SCHOOL DISTRICTS. Schedule H, Part VI, Line 3, Patient education of eligibility for assistance. ALL UNINSURED PATIENTS ARE ADVISED OF OUR FINANCIAL ASSISTANCE POLICY AS PART OF THE ADMISSIONS PROCESS. WHENEVER POSSIBLE, SOUTH SHORE HOSPITAL PROVIDES ASSISTANCE TO UNINSURED PATIENTS IN OBTAINING HEALTH CARE INSURANCE AT NO COST TO THE PATIENT. THIS ASSISTANCE INCLUDES VISITS WITH THE PATIENT WHILE IN THE HOSPITAL, AND FOLLOW-UP VISITS TO THEIR HOME TO ENSURE THAT INSURANCE APPLICATIONS ARE COMPLETED AND FILED IN A TIMELY MANNER. THEN APPROPRIATE FOLLOW UP IS DONE WITH MEDICAID AND OTHER INSURERS TO ENSURE THE APPLICATIONS ARE PROCESSED TIMELY. ALL SELF PAYS RECEIVE A CHARITY APPLICATION, AND ARE ASSESSED. THEY ARE GIVEN A DISCOUNT BASED ON THE STATE OF ILLINOIS POVERTY GUIDELINES. FOR PATIENTS THAT ARE PRESUMPTIVE ELIGIBLE, THEY ARE WRITTEN OFF TO CHARITY ONCE THEY GO THROUGH THE MANG PROCESS AND ARE DENIED. Schedule H, Part VI, Line 4, Community information. THE SOUTH SHORE HOSPITAL SERVICE AREA CONSISTS OF TWELVE ZIP CODES IN THE SOUTHEAST SIDE OF THE CITY OF CHICAGO. SIX OF THE ZIP CODES COMPRISE ABOUT 80% OF OUR ADMISSIONS (ZIPS 60617, 60619, 60649, 60620, 60637, AND 60628). THESE ZIP CODE AREAS HAVE A COMBINED ESTIMATED POPULATION OF ABOUT 200,000. SOME OF THE KEY HEALTHCARE NEEDS OF THIS CORE ZIP CODE AREA ARE: -THERE IS A DISPROPORTIONATELY LARGE POPULATION OF UNINSURED PEOPLE IN THIS AREA. AS A RESULT, SOUTH SHORE HOSPITAL TREATS A LARGE PERCENTAGE OF OUR PATIENTS FREE OF CHARGE OR AT A DISCOUNT. -THERE IS A DISPROPORTIONATELY LARGE POPULATION OF INSURED PEOPLE IN THIS AREA THAT CANNOT AFFORD TO PAY THEIR COPAYS AND DEDUCTIBLES. AS A RESULT, THE ANNUAL HOSPITAL BAD DEBT EXPENSE IS VERY LARGE. -THERE IS ALSO A DISPROPORTIONATELY LARGE POPULATION OF INDIGENT PEOPLE INSURED WITH MEDICAID IN THIS AREA. ON AVERAGE, ABOUT 25% OF OUR INPATIENTS HAVE MEDICAID HEALTH COVERAGE. ABOUT 30% OF THE EMERGENCY ROOM OUTPATIENT VISITS ARE MEDICAID PATIENTS USING THE EMERGENCY ROOM AS A DOCTORS OFFICE. -DRUG ABUSE IS A SERIOUS PROBLEM IN OUR AREA, WITH THE NEED FOR DETOX AND REHAB SERVICES. -AN INCREASING NUMBER OF PEOPLE IN OUR CORE ZIP CODES ARE INFECTED WITH HIV. THERE ARE THREE OTHER HOSPITALS SERVING THE COMMUNITY: ST. BERNARD HOSPITAL, ADVOCATE TRINITY HOSPITAL, AND JACKSON PARK HOSPITAL. SOUTH SHORE HOSPITAL SERVES THE MEDICALLY UNDER SERVED. AFRICAN AMERICANS ARE 90.2 % OF INPATIENT ADMITS. Schedule H, Part VI, Line 5, Promotion of community health IN ADDITION TO THE SERVICES PREVIOUSLY NOTED IN THIS SCHEDULE, THE HOSPITAL ALSO PROVIDES FREE IMMUNIZATIONS, PATIENT EDUCATION ASSISTANCE, LANGUAGE ASSISTANCE, TRANSPORTATION SERVICES, AND SENIOR WELLNESS PROGRAMS, AT NO COST TO THE PATIENT. THE HOSPITAL ALSO PARTICIPATES WITH LOCAL, INDEPENDENT ORGANIZATIONS IN CONDUCTING ABOUT 50 HEALTH SCREENING EVENTS PER YEAR. IN ADDITION, THE HOSPITAL CONTRIBUTES FUNDS TO LOCAL, NON-PROFIT ORGANIZATIONS ACTIVELY ENGAGED IN MEETING THE SOCIAL, ECONOMIC, SPIRITUAL, MENTAL AND HEALTHCARE NEEDS OF OUR COMMUNITY. WHILE MOST OF OUR PATIENTS HAVE HEALTHCARE INSURANCE THROUGH MEDICARE OR MEDICAID, NEITHER OF THESE PROGRAMS COVER THE COST OF PROVIDING THE CARE. AS A RESULT, THE HOSPITAL USUALLY OPERATES AT A LOSS WHILE SUBSIDIZING THESE PROGRAMS. THE MEMBERS OF THE GOVERNING BODY ARE COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. THE ORGANIZATION EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ALL OF ITS DEPARTMENTS AND SPECIALTIES. Schedule H, Part VI, Line 7, State filing of community benefit report IL X X false false false false false false false false false TIMOTHY CAVENEY ASST TREASURER/CFO THRU 03/28/13; PRESIDENT & CEO 03/29/13-12/31/13 212065 0 0 0 1557 0 5636 0 14147 0 233405 0 0 0 MILICIA LUKAC NURSE MANAGER 197857 0 0 0 0 0 169 0 5761 0 203788 0 0 0 VERA RAY DIRECTOR OF LAB 180091 0 0 0 0 0 0 0 0 0 180091 0 0 0 RUBIO RODOLFO DIRECTOR OF HOUSE DOCTORS 149383 0 0 0 0 0 14088 0 4636 0 168107 0 0 0 LESLIE ROGERS ASSISTANT ADMINISTRATOR 131625 0 0 0 0 0 19938 0 3445 0 155008 0 0 0 Form 990, Part VI, Sec A, Line 2, Family/business relationships amongst interested persons LUPE VALADEZ & NICK VALADEZ - FAMILY RELATIONSHIP Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body A FULL COPY OF THE FORM 990 WILL BE PROVIDED TO THE BOARD MEMBERS VIA EMAIL FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy EACH OFFICER, DIRECTOR, TRUSTEE AND KEY EMPLOYEE IS SUBJECT TO THE CONFLICT OF INTEREST POLICY. THE BOARD'S CONFLICT OF INTEREST COMMITTEE REVIEWS EACH MEMBER'S CONFLICT OF INTEREST STATEMENT ON AN ANNUAL BASIS. THE BOARD COMPARES PRIOR AND CURRENT YEAR CONFLICT OF INTEREST STATEMENTS, AND REPORTS ANY POTENTIAL OR ACTUAL CONFLICTS OF INTEREST TO THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT. ACTUAL CONFLICTS OF INTEREST ARE DOCUMENTED WITH THE ORGANIZATION'S HUMAN RESOURCES DEPARTMENT ANNUALLY. OFFICERS, DIRECTORS, TRUSTEES AND EMPLOYEES ARE ALL COVERED UNDER THE ORGANIZATIONS CONFLICT OF INTEREST POLICY. SHOULD THERE BECOME KNOWN, AT ANY TIME, A CONFLICT OF INTEREST BETWEEN ANY MEMBER STAFF, HOSPITAL PERSONNEL OR OTHER HEALTHCARE PROVIDERS AND THE HOSPITAL, AND THE HOSPITAL OR ANY OF ITS AGENTS, THE INDIVIDUAL (S) MAY EXCUSE HIMSELF/ HERSELF FROM DISCUSSIONS AND/ OR DETERMINATIONS WITH THE IDENTIFIED HEALTHCARE PROVIDER(S). Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE CEO'S PERFORMANCE ON AN ANNUAL BASIS. IN SETTING THE COMPENSATION OF THE ORGANIZATION'S CEO, THE COMMITTEE COMPARES INDUSTRY COMPENSATION FIGURES TO THE CEO'S COMPENSATION PACKAGE. THE FINAL DETERMINATION AND DELIBERATIONS REGARDING THE CEO'S COMPENSATION PACKAGE ARE DOCUMENTED IN THE MINUTES OF THE BOARD OF DIRECTORS MEETING. THE PROCESS FOR DETERMINING COMPENSATION OF THE CEO WAS LAST UNDERTAKEN IN MARCH OF 2013. Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE PERFORMANCE OF THE OFFICERS AND KEY EMPLOYEES ON AN ANNUAL BASIS IN SETTING THE COMPENSATION OF THESE INDIVIDUALS, THE COMMITTEE COMPARES INDUSTRY COMPENSATION FIGURES TO THEIR FINANCIAL PACKAGES. IF ANY INDIVIDUAL'S COMPENSATION IS DISCUSSED DURING THE MEETING, THAT INDIVIDUAL IS REQUIRED TO RECUSE THEMSELVES. THE PROCESS FOR DETERMINING COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES WAS LAST UNDERTAKEN IN MARCH OF 2013. Form 990, Part VI, Sec C, Line 19, Required documents available to the public FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. Form 990, Part IX, Line 11g, Other Expenses PURCHASED SERVICES - TOTAL EXPENSE: 5231924, PROGRAM SERVICE EXPENSE: 5231924, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; PHYSICIAN FEES - TOTAL EXPENSE: 2610022, PROGRAM SERVICE EXPENSE: 2610022, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; REPAIRS AND MAINTENANCE - TOTAL EXPENSE: 811634, PROGRAM SERVICE EXPENSE: 721495, MANAGEMENT AND GENERAL EXPENSES: 90139, FUNDRAISING EXPENSES: ; SOUTH SHORE HOSPITAL AUXILIARY 8012 S CRANDON AVE CHICAGO IL 606171199 363200759 FUNDRAISING IL 501(C)(3) 3 SSHC true false false false false false false false false false false false false false false false false false false false