COPLEY MEMORIAL HOSPITAL INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COPLEY MEMORIAL HOSPITAL INC (EIN 36-2170840)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-09
- IRS object ID
- 201311299349300816
- Schema version
- 2011v1.5
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-09T18:20:23-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861065772 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Deloitte Tax LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 111 South Wacker Drive | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60606 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362170840 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Copley Memorial Hospital Inc | BusinessNameLine1 |
| Business Name Line2 | c/o Rush-Copley Medical Ctr | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COPL | NameControl |
| Phone | 6309786200 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Ogden Avenue | AddressLine1 |
| City | Aurora | City |
| State | IL | State |
| ZIP Code | 605044206 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Brenda VanWyhe | Name |
| Title | CFO | Title |
| Phone | 6309786200 | Phone |
| Date Signed | 2013-05-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Margaret Grinnell | Name |
| PTIN | P00538660 | PTIN |
| Phone | 3124861000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Barry Finn | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Ogden Avenue | AddressLine1 |
| City | Aurora | City |
| State | IL | State |
| ZIP Code | 605044206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 424299394 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.rushcopley.com | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1886 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | To provide advanced medicine with quality outcomes and extraordinary care. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 19 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 16 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1854 | TotalNbrEmployees |
| Total Nbr Volunteers | 300 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1965618 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1233078 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 267943666 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 259634483 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 3639156 | InvestmentIncomePriorYear |
| Investment Income Current Year | 9412271 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 703514 | OtherRevenuePriorYear |
| Other Revenue Current Year | 684692 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 274251954 | TotalRevenuePriorYear |
| Total Revenue Current Year | 270964524 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 24679 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 20545 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 109990657 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 116659646 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 136590734 | OtherExpensePriorYear |
| Other Expenses Current Year | 117710952 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 246606070 | TotalExpensesPriorYear |
| Total Expenses Current Year | 234391143 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 27645884 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 36573381 | RevenuesLessExpensesCY |
| Total Assets BOY | 311504046 | TotalAssetsBOY |
| Total Assets EOY | 367178403 | TotalAssetsEOY |
| Total Liabilities BOY | 172324068 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 213125243 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 139179978 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 154053160 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | The mission of Rush-Copley is to provide advanced medicine with quality outcome and extraordinary care. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 177920074 | Expense |
| Grants | 20545 | Grants |
| Revenue | 259619994 | Revenue |
| Description | Copley Memorial Hospital's mission is to provide advanced medicine with quality outcomes and extraordinary care. The focus on advanced medicine is concentrated in Copley Memorial Hospital's centers of excellence or "Institutes". Institutes represent the major service lines of the Medical Center: Cancer Care; Emergency Services; Heart & Vascular; Neuroscience; and Women's Health. The designation of Institutes allows the organization to prioritize among diverse opportunities and focus resources on these service lines. To that end, the medical center seeks to serve the community in ways that engage, educate and empower. In 2011, Copley Memorial Hospital proudly collaborated with dozens of civic and community groups to impact the knowledge, health and well being of the community. Copley Memorial Hospital offers free educational programs ranging from hand hygiene education aimed at preschool and primary grade school aged children to annual seminars educating adults about diabetes, heart health, cancer prevention, weight control, smoking cessation and more.A bimonthly newsletter is published and highlights health information and calendar of events info to 70,000+ households throughout the hospital service area. Free and reduced cost health screenings are regularly offered including free blood pressure monitoring on a walk-in basis.Highlighted Health Programming includes:During 2011, Copley Memorial Hospital (the "Hospital") sponsored, partnered or participated in nearly 600 community-based programs and events with special emphasis on improving the health and wellness of adults, children and underserved populations. Nutrition and Weight LossSeven programs aimed at providing sound nutrition advice and weight loss strategies were held during the year. Topics included healthy lunch preparation, women and weight loss, vegetarian cooking and grocery store tours. 54 people attended.Diabetes Presentations about diabetes and related screenings were conducted throughout the year at various community locations. Fasting glucose and blood pressure screenings were provided to 635 community members.Smoking CessationThe Freedom from Smoking class was offered four times with a total of 23 participants. This free eight-week program provides support and the skills needed to quit smoking.Cancer Awareness and InformationSeven classes and programs focusing on cancer were held in the community with over 400 participants. Topics ranged from prostate cancer to skin cancer as well as a course on survivorship. An ongoing yoga series is offered as well as a special celebration of National Cancer Survivors Day.Latina Talks (Platicas Para Mujeres)Latina Talks (Platicas Para Mujeres) is an educational series geared toward the healthcare needs of Latina women. Latina Talks is offered nine times a year from September through May targeting Latina women in the Fox Valley area. Topics presented by professional healthcare providers include From Girl to Young Woman, Menopause, Breast Health, Healthy Cooking demonstration, Discipline and Children and more. Typically, between thirty and fifty women attend the monthly sessions. In addition, Rush-Copley partners with Aurora University nursing students to provide daycare and blood pressure screenings to the women. Over 200 women have benefited from the presentations in the last year.Older Adult EducationEducational and interactive talks designed to provide seniors with health information and education are presented regularly at the Beecher Community Center in Yorkville in collaboration with Kendall County Senior Services. This programming reaches over 400 seniors annually healthcare topics presented by healthcare providers followed by question and answer sessions. These sessions are offered to the senior community at large and take place at Sunnymere, an assisted living facility. Topics include Cholesterol Management, Bone and Joint Health and Acid Reflux Disease. Bi-monthly presentations are attended by annually by 120 seniors.Pregnancy and ChildbirthPrenatal education classes are offered to couples who are pregnant or considering having a baby. Class topics include New Advances in Infertility, Thinking About Having a Baby Healthy Pregnancy Healthy You, Bringing Home Baby and Child Safety. Tours of the Family Birth Center are also provided. Nearly 1,200 people participated in 2011.Physician Referral LineCopley Memorial Hospital offers a free physician and information referral telephone service to the community. This service allows community members to talk with a call advisor to match a person's health needs and preferences with the physician of their choice or link callers to services provided by the medical center. Over 27,000 people used this service in 2011.WebsiteCopley Memorial Hospital's website, rushcopley.com, with translation available into dozens of languages, offers access to free health information including interactive quizzes and assessments, a health encyclopedia, video library, guide to the body and its 12 systems, a symptom checker along with health and wellness tools to assess personal health conditions. In 2011, there were over 700,000 visitors to rushcopley.com.Copley Memorial Hospital provides a free speaker's bureau to community-based groups and routinely participates and sponsors health fairs aimed at minority populations including the yearly African American Health Fair and the annual Latina Health Festival.Together, these initiatives provided a positive influence for thousands of residents in the communities served by Copley Memorial Hospital.Charity Care - It is an inherent part of the Hospital's mission to provide necessary medical care free of charge, or at a discount, to individuals without insurance or other means of paying for such care. As the amounts determined to qualify for charity care are not pursued for collection, they are not reported as patient service revenue. The Hospital has an established charity care policy and maintains records to identify and monitor the level of charity care it provides. The Hospital provides free care to all patients who apply and support income and asset levels of less than 300% of the current-year poverty level and discounts balances under 600% of the poverty level. Interest-free payment plans are also provided. These charity care records include the estimated cost of unreimbursed services provided and supplies furnished under its charity care policy and the excess of cost over reimbursement for Medicaid patients. The Hospital also monitors the unreimbursed cost of patient bad debts. | Description |
| Total Program Service Expense | 177920074 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 1 | Hospital |
| Financial Stmt Attached | 1 | FinancialStmtAttached |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 1 | TaxExemptBonds |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBonds |
| Escrow Account | 0 | EscrowAccount |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuer |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 109 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1854 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 19 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 16 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 1 | InvestmentInJointVenture |
| Written Policy Or Procedure | 1 | WrittenPolicyOrProcedure |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Brenda VanWyhe | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6309786200 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Ogden Avenue | AddressLine1 |
| City | Aurora | City |
| State | IL | State |
| ZIP Code | 60504 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (36 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Mark Metzger | ||||||||
| Board Chairman | 1.00 | X | 0 | 0 | 0 | |||
| William Skoglund | ||||||||
| Board Vice Chairman | 1.00 | X | 0 | 0 | 0 | |||
| Trish Anen | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Cati Cederoth start 1011 | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Bruce Dienst | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Richard Edelman | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Tom Fisher | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Santosh Gill MD | ||||||||
| Past Chief of Staff/Director | 40.00 | X | 566285 | 0 | 55749 | |||
| Ronald Hem | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Dennis Keane MD | ||||||||
| Chief of Staff/Director | 1.00 | X | 13750 | 0 | 0 | |||
| Herbert Knight | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| John Lies | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Maryanne Locklin | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Jack McEachern End 1011 | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Dave Mead | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Avery Miller | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Jerome Roberts | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Christine Sobek | ||||||||
| Director | 1.00 | X | 0 | 0 | 0 | |||
| Suresh Velagapudi MD | ||||||||
| Vice Chief of Staff/Director | 1.00 | X | 0 | 0 | 0 | |||
| Barry Finn | ||||||||
| President & CEO/Director | 40.00 | X | 1463800 | 0 | 373282 | X | ||
| Brenda VanWyhe | ||||||||
| Sr. VP, Finance & CFO/Treasurer | 40.00 | 320176 | 0 | 73383 | X | |||
| Ryan Asmus | ||||||||
| VP, General Counsel/Secretary | 40.00 | 258280 | 0 | 67895 | X | |||
| Lynn Scott | ||||||||
| Assistant Secretary | 40.00 | 71874 | 0 | 18141 | X | |||
| Steve Lowenthal MD | ||||||||
| Sr. VP, Medical Affairs & CMO | 40.00 | 623868 | 0 | 45111 | X | |||
| John Diederich | ||||||||
| Sr. VP, Operations & COO | 40.00 | 465776 | 0 | 159760 | X | |||
| Diane Homan MD | ||||||||
| VP, Quality & PSO | 40.00 | 437416 | 0 | 100716 | X | |||
| Dennis DeMasie | ||||||||
| VP, Information Technology & CIO | 40.00 | 329547 | 0 | 85568 | X | |||
| Mary Shilkaitis | ||||||||
| VP, Patient Care Services & CNO | 40.00 | 317738 | 0 | 81690 | X | |||
| Gail Bumgarner | ||||||||
| Sr. VP, Strategy | 40.00 | 343586 | 0 | 63861 | X | |||
| Barbara Graham | ||||||||
| VP, Philanthropy & CDO | 40.00 | 217743 | 0 | 19419 | X | |||
| Suzanne Sterchi | ||||||||
| Assistant VP, Patient Care | 40.00 | 151514 | 0 | 31885 | X | |||
| Sepehr Sani MD | ||||||||
| Physician | 40.00 | 1178320 | 0 | 25673 | X | |||
| Todd Guynn MD | ||||||||
| Physician | 40.00 | 763010 | 0 | 59493 | X | |||
| Teressa Alexander MD | ||||||||
| Physician | 40.00 | 563499 | 0 | 54705 | X | |||
| Edward Lipman MD | ||||||||
| Physician | 40.00 | 532036 | 0 | 47512 | X | |||
| Vijay Shah MD | ||||||||
| Physician | 40.00 | 515847 | 0 | 54816 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 9134065 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 1418659 | TotalOtherCompensation |
| Number Individuals GT100 K | 165 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| Sodexho | |||||
| 4880 Paysphere Circle | Chicago | IL | 60674 | Food and Cleaning Service | 3325656 |
| Anthelio | |||||
| One Lincoln Center Suite 200 5400 | Dallas | TX | 75240 | Medical Records Management | 875000 |
| Advocate Medical Group | |||||
| 1875 Dempster Suite 325 | Park Ridge | IL | 60068 | Medical Services | 864669 |
| Fox Valley Acute Dialysis | |||||
| 1300 Waterford Drive Lower Level | Aurora | IL | 60504 | Dialysis | 625524 |
| Anderson Mikos Architects | |||||
| 1420 Kensington Road Suite 306 | Oak Brook | IL | 60523 | Architects | 326259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 14 | NumberOfContractorsGT100K |
| Related Organizations | 655243 | RelatedOrganizations |
| Government Grants | 577835 | GovernmentGrants |
| Total Contributions | 1233078 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Net Patient Revenue | 621110 | 247647803 | 247647803 |
| Medicaid Tax Revenue | 621110 | 13466454 | 13466454 |
| Other Program Revenue | 900099 | -1479774 | -1479774 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 259634483 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3199765 | TotalRevenueColumn |
| Exclusion | $3,199,765 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 136796 | TotalRevenueColumn |
| Exclusion | $136,796 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1764893 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1399109 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 365784 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 365784 | TotalRevenueColumn |
| Exclusion | $365,784 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 157978137 | Securities |
| Other | 33334 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 151935761 | Securities |
| Other | 0 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6042376 | Securities |
| Other | 33334 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6075710 | TotalRevenueColumn |
| Exclusion | $6,075,710 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| Outside Service Rev. | 621990 | 617976 | 617976 | |
| Gift Shop Revenue | 453220 | 213434 | $213,434 | |
| Cafeteria Revenue | 621990 | 111335 | $111,335 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -623837 | TotalRevenueColumn |
| Related Or Exempt Function Income | -632465 | RelatedOrExemptFunctionIncome |
| Exclusion | $8,628 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 318908 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 270964524 | TotalRevenueColumn |
| Related Or Exempt Function Income | 259619994 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $10,111,452 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20545 | Total |
| Program Services | 20545 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6932166 | Total |
| Management And General | 6932166 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 84140187 | Total |
| Program Services | 63115453 | ProgramServices |
| Management And General | 21024734 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3467343 | Total |
| Program Services | 2600507 | ProgramServices |
| Management And General | 866836 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14884935 | Total |
| Program Services | 11163701 | ProgramServices |
| Management And General | 3721234 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7235015 | Total |
| Program Services | 5426261 | ProgramServices |
| Management And General | 1808754 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4836976 | Total |
| Program Services | 3627732 | ProgramServices |
| Management And General | 1209244 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 627439 | Total |
| Management And General | 627439 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 165349 | Total |
| Management And General | 165349 | ManagementAndGeneral |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 117305 | Total |
| Program Services | 87979 | ProgramServices |
| Management And General | 29326 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3357952 | Total |
| Program Services | 2518464 | ProgramServices |
| Management And General | 839488 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1194742 | Total |
| Program Services | 1194742 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53469284 | Total |
| Program Services | 40101963 | ProgramServices |
| Management And General | 13367321 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9801435 | Total |
| Program Services | 7351076 | ProgramServices |
| Management And General | 2450359 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4447766 | Total |
| Program Services | 3335824 | ProgramServices |
| Management And General | 1111942 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113019 | Total |
| Program Services | 84764 | ProgramServices |
| Management And General | 28255 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 128787 | Total |
| Program Services | 96590 | ProgramServices |
| Management And General | 32197 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7191469 | Total |
| Program Services | 7191469 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16108420 | Total |
| Program Services | 16108420 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7289879 | Total |
| Program Services | 5467409 | ProgramServices |
| Management And General | 1822470 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices |
|---|---|---|
| Medicaid Provider Tax | 7125302 | 7125302 |
| Laundry | 813487 | 813487 |
| Consulting | 524892 | 524892 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 397449 | Total |
| Program Services | -36506 | ProgramServices |
| Management And General | 433955 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 234391143 | Total |
| Program Services | 177920074 | ProgramServices |
| Management And General | 56471069 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 24936230 | BOY |
| EOY | 32064640 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38268349 | BOY |
| EOY | 44464193 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4136968 | BOY |
| EOY | 4474935 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2916629 | BOY |
| EOY | 9839546 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 316958825 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 180893548 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 136686624 | BOY |
| EOY | 136065277 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 97918642 | BOY |
| EOY | 115889739 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6640604 | BOY |
| EOY | 24380073 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 311504046 | BOY |
| EOY | 367178403 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74513594 | BOY |
| EOY | 108752898 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91253999 | BOY |
| EOY | 90552297 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6556475 | BOY |
| EOY | 13820048 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 172324068 | BOY |
| EOY | 213125243 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135284712 | BOY |
| EOY | 149675080 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3895266 | BOY |
| EOY | 4378080 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 139179978 | BOY |
| EOY | 154053160 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 311504046 | BOY |
| EOY | 367178403 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 36573381 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -21700199 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Both | X | FinancialStatementBoth |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | Volunteers |
| Paid Staff Or Management | 0 | PaidStaffOrManagement |
| Media Advertisements | 0 | MediaAdvertisements |
| Mailings Members | 0 | MailingsMembers |
| Publications Or Broadcast | 0 | PublicationsOrBroadcast |
| Grants Other Organizations | 0 | GrantsOtherOrganizations |
| Direct Contact Legislators | 0 | DirectContactLegislators |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $34,525 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 34525 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Part IV, Supplemental Information: | Identifier |
| Explanation | Part II-B, Line 1i: Copley Memorial Hospital is a member of various organizations that advocate on legal and policy issues that affect healthcare. A portion of the annual membership dues paid by Copley Memorial Hospital to these organizations is attributable to lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 10648390 | BeginningOfYearBalance |
| Contributions | 1409175 | Contributions |
| Investment Earnings Or Losses | 364134 | InvestmentEarningsOrLosses |
| Other Expenditures | 1290495 | OtherExpenditures |
| End Of Year Balance | 11131204 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 9770170 | BeginningOfYearBalance |
| Contributions | 878220 | Contributions |
| Investment Earnings Or Losses | 1349773 | InvestmentEarningsOrLosses |
| Other Expenditures | 1349773 | OtherExpenditures |
| End Of Year Balance | 10648390 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 9053445 | BeginningOfYearBalance |
| Contributions | 716725 | Contributions |
| Investment Earnings Or Losses | 613671 | InvestmentEarningsOrLosses |
| Other Expenditures | 613671 | OtherExpenditures |
| End Of Year Balance | 9770170 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 8795988 | BeginningOfYearBalance |
| Contributions | 257457 | Contributions |
| Investment Earnings Or Losses | -747024 | InvestmentEarningsOrLosses |
| Other Expenditures | -747024 | OtherExpenditures |
| End Of Year Balance | 9053445 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 0.62200 | PermanentEndowmentEOYBalance |
| Term Endowment EOY Balance | 0.37800 | TermEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 1 | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | 1 | AreRelatedOrgsListedScheduleR |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 16749318 | OtherCostOrOtherBasis |
| Book Value | 16749318 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 191596683 | OtherCostOrOtherBasis |
| Depreciation | 99324069 | Depreciation |
| Book Value | 92272614 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 108415544 | OtherCostOrOtherBasis |
| Depreciation | 81569479 | Depreciation |
| Book Value | 26846065 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 197280 | OtherCostOrOtherBasis |
| Book Value | 197280 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 136065277 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (6 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| Long Term Malpractice AR Gross-Up | 20300417 |
| Unamortized Financing Costs | 2279228 |
| Invest Riverwest Oncology | 1774527 |
| Invest Home Health | 463483 |
| Invest Rush Copley Cardiovascular | -445582 |
| Other | 8000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 24380073 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Long Term Market Adjustment Swap Liability | $10,460,170 |
| Long Term SERP | $3,127,714 |
| Long Term Deferred Rent Obligation | $232,164 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 13820048 | TotalOfAmounts |
| Total Revenue | 270964524 | TotalRevenue |
| Total Expenses | 234391143 | TotalExpenses |
| Excess Or Deficit For Year | 36573381 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -6296956 | NetUnrealizedGLOnInvestments |
| Other | -$15,403,243 | OtherAmount |
| Total Adjustments | -21700199 | TotalAdjustments |
| Excess Or Deficit Per FS | 14873182 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 267080727 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -6296956 | NetUnrealizedGainsInvestments |
| Other Revenues | 2413159 | OtherRevenues |
| Revenue Not Rptd F990 | -3883797 | RevenueNotRptdF990 |
| Revenue Subtotal | 270964524 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 270964524 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 242125276 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 7734133 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 7734133 | ExpensesNotRptdF990 |
| Expenses Subtotal | 234391143 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 234391143 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Description of Intended Use of Endowment Funds: | Part V, Line 4: | Rush Copley Foundation holds the Voris (income for CMH Cancer Care), Kobisk (Board restricted income to CMH), Copley (income unrestricted) and Dobbins (income for CMH Women's Health) Endowments. These funds are held for the benefit of Copley Memorial Hospital. |
| Part XI, Line 8 - Other Adjustments: | Change in interest in net assets of Foundation 209,341. Swap value adjustment -5,320,974. Transfer of assets to affiliate-net -10,291,610. Total to Schedule D, Part XI, Line 8: -15,403,243. | |
| Part XII, Line 2d - Other Adjustments: | RCCC revenue to reconcile to CMH corporate not consolidated 4,329,487. RCCC revenue elimination to reconcile to CMH corporate not consolidated 2,020,710. Rental expenses-2020 Ogden POB1 & 1100 W Veterans Pkwy Yorkville POB 1,383,936. Swap value adjustment -5,320,974. | |
| Part XIII, Line 2d - Other Adjustments: | RCCC expenses to reconcile to CMH corporate not consolidated 6,350,197. Rental expenses-2020 Ogden POB1 & 1100 W Veterans Pkwy Yorkville POB 1,383,936. |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.000000000000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 600.000000000000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | 1 | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | 1 | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | 1 | ExpensesExceededBudget |
| Unable To Provide Care | 0 | UnableToProvideCare |
| Annual Community Benefit Report | 1 | AnnualCommunityBenefitReport |
| Report Publically Available | 1 | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8375614 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8375614 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03570 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 47506857 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 38087510 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9419347 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04020 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 55882471 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 38087510 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17794961 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.07590 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 488817 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 488817 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00210 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2926480 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 622791 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2303689 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00980 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 20545 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 20545 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 3435842 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 622791 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 2813051 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01200 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 59318313 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 38710301 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 20608012 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.08790 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $23,540,541 | BadDebtExpenseAmount |
| Amount Attributable To | 2354054 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 68342536 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 80518219 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | -12175683 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | 1 | WrittenDebtCollectionPolicy |
| Provision For Charity Care | 1 | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Copley Memorial Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Ogden Avenue | AddressLine1 |
| City | Aurora | City |
| State | IL | State |
| ZIP Code | 605044206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Copley Memorial Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Eligibility Criteria Explained | 1 | EligibilityCriteriaExplained |
| Uses FPG Free | 1 | UsesFPGFree |
| FPG Free Percent | 300.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 1 | UsesFPGDiscounted |
| FPG Discount Percent | 600.000000000000 | FPGDiscountPercent |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Available On Request | X | AvailableOnRequest |
| Other Publicity | X | OtherPublicity |
| Actions On Nonpayment | 1 | ActionsOnNonpayment |
| Collection Activities | 0 | CollectionActivities |
| Nondiscrim Emergency Care Policy | 1 | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | 0 | AmountsGenerallyBilled |
| Gross Charges | 0 | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 4 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (4 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| River West Radiation Center LLC | ||||
| 1221 N Highland Avenue | Aurora | IL | 605044206 | JV Oncology |
| Community Alliance Home Health | ||||
| 4050 Healthway Drive | Aurora | IL | 605044206 | JV Home Health |
| Rush-Copley Healthcare Center | ||||
| 1100 West Veterans Parkway | Yorkville | IL | 60560 | Convenient Care |
| Rush-Copley Cardiovascular Consultants | ||||
| 2000 Ogden Avenue | Aurora | IL | 605044206 | Cardiovascular Services |
Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: A cost accounting system was used to calculate the amounts reported in the table and a cost to charge ratio was utilized. The cost accounting system addresses all patient segments (Inpatient, Outpatient, Emergency Room, Private Insurance, Medicaid, Medicare, Uninsured and Self-Pay. | ||
| Part III, Line 4: Net patient service revenue is reported at the estimated net realizable amounts from third-party payors, patients, and others for services rendered. The Hospital has agreements with third-party payors that provide for payments at amounts different from established rates. Payment arrangements include prospectively determined rates per discharge, reimbursed costs, per diem payments, and discounted charges, including estimated retroactive settlements under payment agreements with third-party payors.The Hospital recognizes patient service revenue associated with services provided to patients who have third-party payor coverage on the basis of contractual rates for the services rendered. Provisions for adjustments to net patient service revenue are accrued on an estimated basis in the period the related services are rendered and adjusted in future periods as final settlements are determined. For uninsured patients that do not qualify for charity care, the Hospital recognizes revenue based on its discounted rates. On the basis of historical experience, a significant portion of the Hospital's uninsured patients will be unable or unwilling to pay for the services provided. Thus, the Hospital records a significant provision for uncollectible accounts related to uninsured patients in the period the services are provided. Patient service revenue, net of contractual allowances and discounts (but before the provision for uncollectible accounts), recognized in the period from these major payor sources, is as follows:Patient Service Revenue (Net of Contractual Allowances and Discounts) Third-Party PayorsFiscal year 2012 - $265,679Fiscal year 2011 - $254,246Self-PayFiscal year 2012 - $22,180Fiscal year 2011 - $16,757Total All PayorsFiscal year 2012 - $287,859Fiscal year 2011 - $271,003Patient accounts receivable are based on gross charges and stated at net realizable value. Accounts receivable are reduced by an allowance for contractual adjustments, based on expected payment rates from payors under current reimbursement methodologies, and also by an allowance for doubtful accounts. In evaluating the collectability of accounts receivable, the Hospital analyzes its past history and identifies trends for each of its major payor sources of revenue to estimate appropriate allowance for doubtful accounts and provision for uncollectible accounts based upon management's assessment of historical and expected net collections considering business and economic conditions, trends in health care coverage, and other collection indicators. Management regularly reviews data about these major payor sources of revenue in evaluating the sufficiency of the allowance for contractual adjustments and allowance for doubtful accounts.For receivables associated with services provided to patients who have third-party coverage, the Hospital analyzes contractually due amounts and provides an allowance for doubtful accounts and a provision for uncollectible accounts (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), the Hospital records a significant provision for uncollectible accounts 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 discounted rates and the amounts actually collected after all reasonable collection efforts have been exhausted is charged off against the allowance for doubtful accounts in the period they are determined uncollectible.The Hospital's allowance for doubtful accounts for self-pay patients increased from 33% of self-pay accounts receivable at June 30, 2011, to 34% of self-pay accounts receivable as of June 30, 2012. In addition, the Hospital's self-pay write-offs decreased by $5,006, from $29,597 for fiscal year 2011 to $24,591 for fiscal year 2012. The increase in percent of self-pay accounts was due to higher self-pay volumes. The decrease in self-pay write-offs was due to an increase in patients qualifying for charity. The Hospital does not maintain a material allowance for doubtful accounts from third-party payors, nor did it have significant write-offs from third-party payors.Bad debt amounts reported on Part III, Line 2 are reported at charges. | ||
| Part III, Line 8: All of the shortfall reported in line 7 should be treated as community benefit because if we did not provide the service, the burden of the costs would fall on the government. Costs of treating Medicare patients are calculated using the IRS calculated percentage. | ||
| Part III, Line 9b: It is our policy not to pursue collection practices against patients known to qualify for Charity Care or other financial assistance. In certain cases it may not be easily determined whether or not a patient qualifies for Charity Care or financial assistance. However, if after collection practices have begun, it later becomes known the patient qualifies, the collection efforts cease. | ||
| Part V, Section B, Line 13g: A summary of the FAP policy is available on the website and at the hospital emergency room and admissions areas. | Copley Memorial Hospital | |
| Part V, Section B, Line 19d: Self Pay discount of 30% applied to the same total charges billed to all patients. | Copley Memorial Hospital | |
| Part VI, Line 2: Community need is assessed through review of community and hospital data, periodic assessments with physician and clinicians, and reporting of information from hospital committees. Further input from the community arises from the community based board of directors, various forms of patient input, and hospital involvement with government, health industry, and community agencies. The hospital also actively participates in formal needs assessments conducted by government and community agencies. | ||
| Part VI, Line 3: At the time of service, Copley Memorial Hospital patients are given a billing brochure, which describes the financial assistance/charity program availability. This information is also posted at the registration check-in desks, in an inpatient guide, and on the Rush Copley website. Financial counselors are available to explain the program in detail to patients who are seen without insurance coverage. All patient billing statements advise the patients to call and inquire on the details as needed. | ||
| Part VI, Line 4: Copley Memorial Hospital's primary service area is approximately Kane County and Kendall County, Illinois located 45 to 55 miles Southwest of Chicago. Kane County has a population of 512,000 people and is predominantly urban and suburban. Nearly 29% of the population is of Hispanic or Latino origin. Persons over the age of 65 comprise 8.6% of the population, and the poverty rate is 9.0%. Aurora, the second largest city in Illinois, dominates the county. Historically an industrial city, Aurora has experienced a considerable loss of manufacturing jobs and is transitioning its economy. Kendall County, to the south of Kane, has a population of 105,000. Persons over the age of 65 comprise 6.7% of the population and the poverty rate is 3.4%. The Northwest section of the county is suburban while the remainder is rural. | ||
| Part VI, Line 5: Copley Memorial Hospital's mission is to provide advanced medicine with quality outcomes and extraordinary care. To that end, the Medical Center seeks to serve the community in ways that engage, educate and empower. Copley Memorial Hospital serves all patients who present for care and serves the surrounding community along with a Board of Directors with a strong community base. The Board Members are independent community leaders and are selected based upon their expertise and experience in a variety of areas of benefit to the organization and their role as Board Members who direct and guide management in carrying out our mission. Board Members are not compensated for their service. As a charitable organization, all surplus funds are used to further our charitable purpose, mission and to serve the community. Some of our primary programs are: community health fairs, breastfeeding education classes, child care classes, etc. Copley Memorial Hospital provides access to physician, acute care, diagnostic, and rehabilitative services to people, regardless of ability to pay, through a number of facilities and services located throughout the service area. It provides programming relating to health education, prevention, and support targeted to specific populations. Medical education extends to clinical settings for nursing education and a family practice residency. Employees fill board and committee leadership positions for a number of economic development and social service agencies in communities throughout the service area. | ||
| Part VI, Line 6: Copley Memorial Hospital has an affiliation with Rush University Medical Center that covers governance and other organizational relationships. Both organizations are parties to a master trust indenture that established an obligated group for purposes of issuing long-term debt. | ||
| IL | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Payments | X | IdemnificationGrossUpPayments |
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 0 | SubstantiationRequired |
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 1 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (17 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Santosh Gill MD | |||||||||||||
| 345497 | 0 | 157912 | 0 | 62876 | 0 | 13853 | 0 | 41896 | 0 | 622034 | 0 | 0 | 0 |
| Barry Finn | |||||||||||||
| 563803 | 0 | 810624 | 0 | 89373 | 0 | 332445 | 0 | 40837 | 0 | 1837082 | 0 | 0 | 0 |
| Brenda VanWyhe | |||||||||||||
| 219498 | 0 | 94275 | 0 | 6403 | 0 | 49870 | 0 | 23513 | 0 | 393559 | 0 | 0 | 0 |
| Ryan Asmus | |||||||||||||
| 164243 | 0 | 86190 | 0 | 7847 | 0 | 35024 | 0 | 32871 | 0 | 326175 | 0 | 0 | 0 |
| Steve Lowenthal MD | |||||||||||||
| 374699 | 0 | 192001 | 0 | 57168 | 0 | 13946 | 0 | 31165 | 0 | 668979 | 0 | 0 | 0 |
| John Diederich | |||||||||||||
| 293278 | 0 | 146700 | 0 | 25798 | 0 | 125949 | 0 | 33811 | 0 | 625536 | 0 | 0 | 0 |
| Diane Homan MD | |||||||||||||
| 267337 | 0 | 138493 | 0 | 31586 | 0 | 63544 | 0 | 37172 | 0 | 538132 | 0 | 0 | 0 |
| Dennis DeMasie | |||||||||||||
| 207288 | 0 | 109512 | 0 | 12747 | 0 | 48329 | 0 | 37239 | 0 | 415115 | 0 | 0 | 0 |
| Mary Shilkaitis | |||||||||||||
| 201743 | 0 | 105963 | 0 | 10032 | 0 | 46676 | 0 | 35014 | 0 | 399428 | 0 | 0 | 0 |
| Gail Bumgarner | |||||||||||||
| 227630 | 0 | 101430 | 0 | 14526 | 0 | 49363 | 0 | 14498 | 0 | 407447 | 0 | 0 | 0 |
| Barbara Graham | |||||||||||||
| 148234 | 0 | 62850 | 0 | 6659 | 0 | 6873 | 0 | 12546 | 0 | 237162 | 0 | 0 | 0 |
| Suzanne Sterchi | |||||||||||||
| 146084 | 0 | 4750 | 0 | 680 | 0 | 7181 | 0 | 24704 | 0 | 183399 | 0 | 0 | 0 |
| Sepehr Sani MD | |||||||||||||
| 630621 | 0 | 400000 | 0 | 147699 | 0 | 13946 | 0 | 11727 | 0 | 1203993 | 0 | 0 | 0 |
| Todd Guynn MD | |||||||||||||
| 697950 | 0 | 0 | 0 | 65060 | 0 | 13946 | 0 | 45547 | 0 | 822503 | 0 | 0 | 0 |
| Teressa Alexander MD | |||||||||||||
| 263229 | 0 | 272777 | 0 | 27493 | 0 | 13946 | 0 | 40759 | 0 | 618204 | 0 | 0 | 0 |
| Edward Lipman MD | |||||||||||||
| 344247 | 0 | 179432 | 0 | 8357 | 0 | 13946 | 0 | 33566 | 0 | 579548 | 0 | 0 | 0 |
| Vijay Shah MD | |||||||||||||
| 344247 | 0 | 148529 | 0 | 23071 | 0 | 13146 | 0 | 41670 | 0 | 570663 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Part I, Line 1a | Three officers, one director, seven key employees, one former key employee, and five highest compensated employees receive gross-up payments related to benefit plans. The gross-up payments made were in relation to a program that was discontinued in 2011. Such payments are no longer provided by the organization. The organization provides to all employees the use of an athletic facility that is owned and operated by a related tax exempt organization. | |
| Part I, Line 4b | SERP PLAN of CMH (Accruals): Barry Finn $318,499, Mary Shilkaitis $35,250, John Diederich $112,003, Steve Lowenthal $0, Dennis DeMasie $36,412, Diane Homan $50,215, Brenda VanWyhe $37,323, Gail Bumgarner $37,117 and Ryan Asmus $27,620. Please note that these amounts are included in the amounts listed on Schedule J, Part II, Column C. There is no constructive receipt of these amounts by the individuals until they are paid out as they are subject to a substantial risk of forfeiture. Any individual payouts would be included as reportable compensation on the recipient's annual W2 form. There were no payouts in 2011. | |
| Part I, Line 7 | Incentive bonus plan based on a series of approved strategic accomplishments. | |
| Part III | Part II, Column (B)(ii), Barry Finn Bonus & incentive compensation: A portion of this bonus payment was for performance provided over a five year time period, which was equivalent to $100,000 a year. | Supplemental Information |
| Part III | Part II, Column (B)(ii), Physician Bonus & incentive compensation: Physician bonuses were paid based on individual productivity goals. | Supplemental Information |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)
| Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|
| Illinois Finance Authority | |||||||
| 861091967 | 45200FHN2 | 2008-05-28 | 34772005 | See Part VI | 0 | 0 | 0 |
| Illinois Finance Authority | |||||||
| 861091967 | 45200FTZ2 | 2009-02-10 | 34075527 | Construction of Replace Hosp & ICU addition | 0 | 0 | 0 |
| Illinois Finance Authority | |||||||
| 861091967 | 45200FYT0 | 2009-07-29 | 25912180 | New Construction Hospital Campus | 0 | 0 | 0 |
Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)
| Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Capital ExpendituresCapitalExpenditures | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind | Year Of Subst CompletionYearOfSubstCompletion |
|---|---|---|---|---|---|---|---|---|
| 34772005 | 3099542 | 540878 | 34231127 | 1 | 0 | 1 | 1 | |
| 34075527 | 3413692 | 498260 | 32745950 | 0 | 0 | 1 | 1 | 2009 |
| 25912180 | 2585732 | 401472 | 22919490 | 0 | 0 | 1 | 1 | 2009 |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Any Research AgreementsAnyResearchAgreements | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Post Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs | Engage Bond Counsel ContractsEngageBondCounselContracts |
|---|---|---|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 | |
| 0 | 0 | 1 | 0 | 0.00000 | 0.00000 | 0.00000 | 1 | 1 |
Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)
| Form8038 T FiledForm8038TFiled | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Gross Proceeds InvestedGrossProceedsInvested | Exception To RebateExceptionToRebate |
|---|---|---|---|---|---|
| 0 | 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 0 | 1 |
| 0 | 0 | 0 | 0 | 0 | 1 |
Form990 Schedule K Part VI Form990ScheduleKPartVI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Schedule K Supplental Information | Identifier |
| Explanation | Schedule K, Part I, line A, column (e): Issue Price of bonds of $34,772,005 does not tie to Form 8038 Part III Line 21(b) of $98,278,724. This is because the $34,772,005 is Copley Memorial Hospital's 35.38% prorata share of the $98,278,724 Obligated Group amount issued. Schedule K, Part I, line A, column (f): The Series 2006B Fixed Rate bonds currently refunded (as a reissuance) the Series 2006B Auction Rate bonds issued 8/17/2006, which were issued to refund pre-2003 bond issues. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| Form 990, Part VI, Section A, line 2 | Many of the persons listed on Part VII have a "business relationship" with each other by virtue of sitting on related Rush-Copley Medical Center entity boards. Barry Finn, CMH President & CEO/Director, and William Skoglund, CMH Vice Chairman of the Board/Director, have a business relationship. Barry Finn is a board member at Old Second National Bank and William Skoglund is the Chairman and CEO at Old Second National Bank. Mr. Skoglund does not serve on Copley Memorial Hospital's compensation committee and has recused himself from any discussions or votes that involve Mr. Finn's salary. | |
| Form 990, Part VI, Section A, line 6 | Rush-Copley Medical Center, Inc. ("RCMC") is the sole corporate member of Copley Memorial Hospital, Inc. ("CMH"), Rush-Copley Medical Group, NFP ("RCMG"), Copley Ventures, Inc. ("CV"), and Rush-Copley Foundation ("RCF"). | |
| Form 990, Part VI, Section A, line 7a | CMH's Board of Directors includes at least nine (9) individuals elected by the sole corporate member, RCMC. Each of these elected directors is also a member of the Governing Board of CMH's sole corporate member, RCMC. The election and re-election of all CMH directors is at the direction of RCMC at the annual Governing Board meeting. Vacancies on the CMH Board of Directors are filled by CMH's sole corporate member, RCMC. In accordance with certain procedural requirements stated in the bylaws, elected directors may be removed by the affirmative vote of two-thirds of the board of directors of CMH's sole corporate member, RCMC. | |
| Form 990, Part VI, Section A, line 7b | The Board of Directors of CMH's sole corporate member, RCMC, has the following exclusive powers over CMH: (1) the borrowing of any sum, the principal of which exceeds $500,000.00, or which has a stated term of greater than one year, or which is secured by a mortgage of all or any portion of CMH's real property or the creation of a security interest in CMH's assets, including personal property and revenues, for the benefit of the lender, lessor or vendor, or the defeasance, advance payment or cancellation of any outstanding debt of the category described herein; (2) any voluntary dissolution, merger, consolidation, sale or transfer of any of CMH's assets which exceeds one percent (1%) of CMH's total assets or any creation of a subsidiary or affiliate of CMH; (3) application to the Illinois Health Facilities Planning Board or any successor for a permit or certificate of need for a proposed activity, whether or not involving a capital expenditure; (4) approval of all annual and long-term capital and operational budgets; (5) any amendment to the Articles of Incorporation or Bylaws of CMH; (6) any agreement or transaction, either of which is of a material nature, with another corporation controlled by or affiliated with CMH's sole corporate member, RCMC, or which is a subsidiary of RCMC; (7) approval of any new or changes to existing long-term or master strategic plan; and (8) sale of any of CMH's real property or interest therein or purchases of any additional real estate. | |
| Form 990, Part VI, Section B, line 11 | The Form 990 tax return is prepared by our external tax advisor with data provided by our organization. A draft of the Form 990 is provided to management for review and comment. The Board of Directors is provided with an approved copy of the Form 990 before it is filed. | |
| Form 990, Part VI, Section B, line 12c | Annually, Officers, Directors, Key Employees, Management Team (Department Directors and Managers), and Billing Office personnel of Copley Memorial Hospital, Inc. are required to disclose interests that could give rise to conflicts. The conflict of interest statements are submitted and reviewed by the Chief Compliance Officer and the Audit and Corporate Integrity Committee of the Board. Those key personnel with conflicts are advised to recuse themselves from participating in decision-making related to the conflict. | |
| Form 990, Part VI, Section B, line 15 | With respect to the CEO/VP's of the organization and key senior management, the organization follows a compensation approval procedure annually that involves approval of proposed and final compensation arragements by the organization's Compensation Committee and full board of Directors using comparability data, as well as contemporaneous documentation of compensation decisions in minutes. | |
| Form 990, Part VI, Section C, line 19 | Form 990 available upon request. The organization does not make its governing documents or conflict of interest policy available to the public. Copies of the financial statements (whether or not audited) are provided upon reasonable request such as for a bank loan or to a bond rating agency. The financial statements are available on the Attorney General's website. | |
| Form 990, Part VII, Section A: | 1 hour per week devoted to related organization (Rush Copley Medical Center)- Barry Finn, Brenda VanWyhe, Ryan Asmus, Lynn Scott, Santosh Gill, M.D., Mark Metzger, William Skoglund, Trish Anen, Cati Cederoth, Bruce Dienst, Richard Edelman, Tom Fisher, Dennis Keane, Herbert Knight, Ronald Hem, John Lies, Maryanne Locklin, Dave Mead, Avery Miller, Jerome Roberts, Christine Sobek, Suresh Velagapudi. 1 hour per week devoted to related organization (Copley Ventures)- Barry Finn, Brenda VanWyhe, Ryan Asmus, Lynn Scott, John Diedrich. 1 hour per week devoted to related organization (Rush Copley Foundation)- Barry Finn, Brenda Vanwyhe, Ryan Asmus, Christine Weincek. | Average hours devoted to related organizations: |
| Form 990, Part XI, line 5: | Net unrealized losses on investments: -6,296,956. Change in interest in net assets of Foundation 209,341. Swap value adjustment -5,320,974. Transfer of assets to affiliate-net -10,291,610. Total to Form 990, Part XI, Line 5: -21,700,199. | Changes in Net Assets or Fund Balances: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Direct Controlling Entity NADirectControllingEntityNA | Controlled OrgControlledOrg | Business Name Line1DirectControllingEntityName/BusinessNameLine1 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Rush Copley Medical Center Inc | |||||||||||
| 2000 Ogden Avenue | Aurora | IL | 60504 | 363193787 | Parent Company | IL | 501(c)(3) | 11A | N/A | 0 | |
| Rush Copley Health Care System Inc | |||||||||||
| 2000 Ogden Avenue | Aurora | IL | 60504 | 363584043 | Bridge Board RCMC & RUMC | IL | 501(c)(3) | 11A | N/A | 0 | |
| Rush-Copley Foundation | |||||||||||
| 2000 Ogden Avenue | Aurora | IL | 60504 | 363093877 | Grants to Charitable Organizations | IL | 501(c)(3) | 7 | 1 | Rush-Copley Medical Center Inc | |
| Copley Ventures Inc | |||||||||||
| 2000 Ogden Avenue | Aurora | IL | 60504 | 363370216 | Rental Prop., Infirmary care, and Healthplex Fitness Center | IL | 501(c)(3) | 3 | 1 | Rush-Copley Medical Center Inc | |
| Rush University Medical Center | |||||||||||
| 1700 West Van Buren Street | Chicago | IL | 60612 | 362174823 | Hospitals | IL | 501(c)(3) | 3 | N/A | 0 | |
Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Direct Controlling Entity NADirectControllingEntityNA | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Predominant Income TypePredominantIncomeType | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Disproportionate AllocationsDisproportionateAllocations | General Or Managing PartnerGeneralOrManagingPartner | Percentage OwnershipPercentageOwnership |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Yorkville Physical Therapy & Sports Medicine Center LLC | ||||||||||||||
| 2000 Ogden Avenue | Aurora | IL | 60504 | 364236345 | Physical Therapy & Sports Medicine | IL | N/A | |||||||
| Rush Copley Cardiovascular Consultants LLC | ||||||||||||||
| 2000 Ogden Avenue | Aurora | IL | 60504 | 273234201 | Cardiovascular Medicine | IL | Copley Medical Center Inc | Related | -20202 | 3424233 | 0 | 0 | 1.00000 | |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rush Copley Medical Group NFP | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 Ogden Avenue | AddressLine1 |
| City | Aurora | City |
| State | IL | State |
| ZIP Code | 60504 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363235315 | EIN |
| Primary Activity | Physician Practices | PrimaryActivity |
| Legal Domicile State | IL | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Rush-Copley Medical Center Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of Total Income | -4869291 | ShareOfTotalIncome |
| Share Of EOY Assets | 6647800 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 1 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 1 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (5 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Rush Copley Medical Group NFP | ||
| A | 998329 | Fair Market Value |
| Rush Copley Foundation | ||
| C | 655243 | Fair Market Value |
| Rush Copley Medical Center Inc | ||
| H | 10291610 | Fair Market Value |
| Copley Ventures Inc | ||
| J | 569325 | Fair Market Value |
| Copley Ventures Inc | ||
| Q | 468000 | Fair Market Value |
Comments