THOREK MEMORIAL HOSPITAL: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- THOREK MEMORIAL HOSPITAL (EIN 36-6000085)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201321359349305937
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-15T13:37:08-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 381357951 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 TRADE CENTRE WAY STE 300 | AddressLine1 |
| City | PORTAGE | City |
| State | MI | State |
| ZIP Code | 49002 | 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 | 366000085 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THOREK MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | THOR | NameControl |
| Phone | 7735256780 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 W IRVING PARK ROAD | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60613 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | EDWARD BUDD | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 7735256780 | Phone |
| Date Signed | 2013-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CAROL LALONDE CPA | Name |
| PTIN | P00181637 | PTIN |
| Phone | 2695674500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | EDWARD BUDD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 W IRVING PARK ROAD | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 175092705 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.THOREK.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1911 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | HEALTH CARE SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 7 | NbrIndependentVotingMembers |
| Total Nbr Employees | 561 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 210 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 0 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 0 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 62183249 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 67930991 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 10019692 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3854232 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1158207 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1942354 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 73361148 | TotalRevenuePriorYear |
| Total Revenue Current Year | 73727577 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 23308722 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 22689433 | 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 | 31852484 | OtherExpensePriorYear |
| Other Expenses Current Year | 31316524 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 55161206 | TotalExpensesPriorYear |
| Total Expenses Current Year | 54005957 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 18199942 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 19721620 | RevenuesLessExpensesCY |
| Total Assets BOY | 233276455 | TotalAssetsBOY |
| Total Assets EOY | 231137649 | TotalAssetsEOY |
| Total Liabilities BOY | 43344618 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 30142594 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 189931837 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 200995055 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THOREK HOSPITAL IS COMMITTED TO PROVIDING APPROPRIATE PATIENT SERVICES IN A CARING AND COST-EFFECTIVE MANNER. THOREK HOSPITAL SEEKS TO SERVE ITS PATIENTS, PHYSICIANS, EMPLOYEES, AND COMMUNITY BY PROVIDING QUALITY SERVICES AND ENCOURAGING EMPLOYEE EXCELLENCE. THOREK HOSPITAL WILL SUPPORT EDUCATION AND WILL ACT AS A RESPONSIBLE MEMBER OF OUR COMMUNITY AND THE HEALTHCARE SYSTEM. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 42729404 | Expense |
| Revenue | 67930991 | Revenue |
| Description | THOREK MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THOREK HOSPITAL, WE RECOGNIZE THAT IT IS THE HOSPITAL'S MISSION TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION AND THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF OUR COMMUNITY, WE PROVIDE FREE CARE AND OR SUBSIDIZED CARE TO INDIVIDUALS WHO ARE UNABLE TO PAY FOR ESSENTIAL SERVICES; AND PROVIDE HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT OUR COMMUNITY. | Description |
| Total Program Service Expense | 42729404 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | 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 | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 0 | TaxExemptBonds |
| 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 | 1 | 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 | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 72 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 561 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| 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 |
| 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 | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 7 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | 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 | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| 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 | EDWARD BUDD | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7739756806 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 W IRVING PARK ROAD | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | FormerFormer |
|---|---|---|---|---|---|---|---|---|
| PETER KAMBEROS | ||||||||
| CHAIRMAN AND COO | 40.00 | X | X | 257239 | 0 | 1434 | ||
| MARIO ADAJAR | ||||||||
| SECRETARY | 6.00 | X | 3600 | 0 | 0 | |||
| EDWIN C LENNOX | ||||||||
| TREASURER | 6.00 | X | X | 7800 | 0 | 0 | ||
| JAMES E NUGENT | ||||||||
| VICE CHAIR | 6.00 | X | X | 7800 | 0 | 0 | ||
| JAY MOHAN MD | ||||||||
| TRUSTEE | 6.00 | X | 0 | 0 | 0 | |||
| ROBERT J BAUDINO | ||||||||
| TRUSTEE | 6.00 | X | 7600 | 0 | 0 | |||
| ANASTASIOS MALLIARIS | ||||||||
| TRUSTEE - PART YEAR | 6.00 | X | 6400 | 0 | 0 | |||
| PHILIP GORELICK MD | ||||||||
| TRUSTEE | 6.00 | X | 2800 | 0 | 0 | |||
| JAMES DIESFELD MD | ||||||||
| MEDICAL STAFF PRESIDENT - | 6.00 | X | 5663 | 0 | 0 | |||
| EDWARD BUDD | ||||||||
| CEO | 40.00 | X | 201977 | 0 | 11551 | |||
| MORGAN FRANCIS MURPHY III | ||||||||
| SECRETARY | 40.00 | X | 173735 | 0 | 5027 | |||
| MARY MCCAHILL | ||||||||
| CHIEF NURSING OFFICER | 40.00 | X | 168505 | 0 | 4932 | |||
| KEVIN HIGDON | ||||||||
| CFO - AS OF 3/19/12 | 40.00 | X | 0 | 0 | 0 | |||
| NITIN BARMAN | ||||||||
| CHIEF OF INTERVENTIONAL CARDIOLOGY | 40.00 | 354506 | 0 | 7854 | X | |||
| JOHN HUNNIFORD | ||||||||
| PHYSICIAN | 40.00 | 233294 | 0 | 4586 | X | |||
| THOMAS TRIANTAFILLOU | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 169336 | 0 | 0 | X | |||
| VIVEK GUPTA | ||||||||
| PHYSICIAN | 40.00 | 164055 | 0 | 0 | X | |||
| MARIAN URIARTE | ||||||||
| HOUSE PHYSICIAN | 40.00 | 153636 | 0 | 780 | X | |||
| FRANK SOLARE | ||||||||
| FORMER PRESIDENT AND CEO | 40.00 | 267325 | 0 | 11551 | X | |||
| FIDEL CASTILLO | ||||||||
| FORMER HCE - HOUSE PHYSICIAN | 40.00 | 125824 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2311095 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 47715 | TotalOtherCompensation |
| Number Individuals GT100 K | 18 | NumberIndividualsGT100K |
| Formers Listed | 1 | 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 |
|---|---|---|---|---|---|
| LEOPARDO COMPANIES INC | |||||
| 5200 PRAIRIE STONE PARKWA | HOFFMAN ESTATE | IL | 60192 | SERVICES | 1064643 |
| UNITED MAINTENANCE SERVICE | |||||
| 1550 S INDIANA AVE STE 300 | CHICAGO | IL | 60605 | SERVICES | 626570 |
| THE NORTHERN TRUST COMPANY | |||||
| 300 ATLANTIC STREET STE 400 | STANFORD | CT | 069013540 | SERVICES | 601453 |
| EPMG OF ILLINOIS SC | |||||
| 2000 GREEN ROAD STE 300 | ANN ARBOR | MI | 481051571 | SERVICES | 536090 |
| UNITED SECURITY SERVICES | |||||
| 1550 S INDIANA AVE STE 300 | CHICAGO | IL | 60192 | SERVICES | 437382 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 31 | NumberOfContractorsGT100K |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| NET PATIENT REVENUE | 621110 | 60876728 | 60876728 |
| MEDICAID ASSESSMENT RE | 621110 | 7042217 | 7042217 |
| CAPITATION REVENUE | 621110 | 12046 | 12046 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 67930991 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3942674 | TotalRevenueColumn |
| Exclusion | $3,942,674 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 722544 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 722544 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 722544 | TotalRevenueColumn |
| Exclusion | $722,544 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 101276686 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 101346825 | Securities |
| Other | 18303 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -70139 | Securities |
| Other | -18303 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -88442 | TotalRevenueColumn |
| Exclusion | -$88,442 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|
| REFERENCE LAB | 900003 | 1093585 | 210 | $1,093,375 |
| DIETARY CASH SALES | 900099 | 113751 | $113,751 | |
| MISCELLANEOUS | 900099 | 12474 | $12,474 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1219810 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 73727577 | TotalRevenueColumn |
| Related Or Exempt Function Income | 67930991 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 210 | UnrelatedBusinessRevenue |
| Exclusion | $5,796,376 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1243215 | Total |
| Management And General | 1243215 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18751283 | Total |
| Program Services | 15772401 | ProgramServices |
| Management And General | 2978882 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2694935 | Total |
| Program Services | 2153643 | ProgramServices |
| Management And General | 541292 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71987 | Total |
| Management And General | 71987 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80265 | Total |
| Management And General | 80265 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1880819 | Total |
| Program Services | 1485962 | ProgramServices |
| Management And General | 394857 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23242 | Total |
| Program Services | 23242 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 215879 | Total |
| Program Services | 215879 | ProgramServices |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 774818 | Total |
| Program Services | 774818 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3658655 | Total |
| Program Services | 2890562 | ProgramServices |
| Management And General | 768093 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1650418 | Total |
| Management And General | 1650418 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 9432667 | 7452386 | 1980281 |
| PURCHASED SERVICES | 7395228 | 5842684 | 1552544 |
| MEDICAID ASSESSMENT | 3864386 | 3864386 | |
| BAD DEBT | 2198047 | 2198047 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 70113 | Total |
| Program Services | 55394 | ProgramServices |
| Management And General | 14719 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54005957 | Total |
| Program Services | 42729404 | ProgramServices |
| Management And General | 11276553 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17229055 | BOY |
| EOY | 15622212 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 1100000 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4246004 | BOY |
| EOY | 11146042 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 878903 | BOY |
| EOY | 1042784 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1238181 | BOY |
| EOY | 826221 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 96216765 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 50912696 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39003589 | BOY |
| EOY | 45304069 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 160615205 | BOY |
| EOY | 154246166 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 10065518 | BOY |
| EOY | 1850155 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 233276455 | BOY |
| EOY | 231137649 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5259059 | BOY |
| EOY | 6088907 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15275744 | BOY |
| EOY | 13657602 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 101055 | BOY |
| EOY | 13918 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22708760 | BOY |
| EOY | 10382167 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 43344618 | BOY |
| EOY | 30142594 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 189931837 | BOY |
| EOY | 200995055 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 189931837 | BOY |
| EOY | 200995055 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 233276455 | BOY |
| EOY | 231137649 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 19721620 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -8658402 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12825957 | OtherCostOrOtherBasis |
| Book Value | 12825957 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 50161928 | OtherCostOrOtherBasis |
| Depreciation | 30477952 | Depreciation |
| Book Value | 19683976 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1531919 | OtherCostOrOtherBasis |
| Depreciation | 1296865 | Depreciation |
| Book Value | 235054 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 27057741 | OtherCostOrOtherBasis |
| Depreciation | 19137879 | Depreciation |
| Book Value | 7919862 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4639220 | OtherCostOrOtherBasis |
| Book Value | 4639220 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 45304069 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (3 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| FIXED INCOME SECURITIES | 54186085 | F |
| EQUITY SECURITY FUNDS | 91906226 | F |
| GOVERNMENTAL SECURITIES | 8153855 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 154246166 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| SELF-INSURANCE RESERVE | $4,864,051 |
| THIRD PARTY PAYOR SETTLEMENTS | $5,282,591 |
| CONTINGENT LIABILITIES | $235,525 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 10382167 | TotalOfAmounts |
| Total Revenue | 73727577 | TotalRevenue |
| Total Expenses | 54005957 | TotalExpenses |
| Excess Or Deficit For Year | 19721620 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -8658402 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -8658402 | TotalAdjustments |
| Excess Or Deficit Per FS | 11063218 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 65069175 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -8658402 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -8658402 | RevenueNotRptdF990 |
| Revenue Subtotal | 73727577 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 73727577 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 54005957 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 54005957 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 54005957 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL, AND HAS CONCLUDED THAT AS OF JUNE 30, 2012, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2009. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | 0 | FPGReferenceDiscountedCare |
| 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 | 816083 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 816083 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01580 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15406630 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19451025 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -4044395 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16222713 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 19451025 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -3228312 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01580 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 223546 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 223546 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00430 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2520699 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1920772 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 599927 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01160 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 2744245 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 1920772 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 823473 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.01590 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 18966958 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 21371797 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -2404839 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03170 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,198,047 | BadDebtExpenseAmount |
| Amount Attributable To | 1318829 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 22239436 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 13810224 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 8429212 | 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 | THOREK MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 W IRVING PARK ROAD | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| 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 | THOREK 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 | 200.000000000000 | FPGFreePercent |
| Uses FPG Discounted | 0 | UsesFPGDiscounted |
| Explains Basis | 1 | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| State Regulation | X | StateRegulation |
| Explains Application Method | 1 | ExplainsApplicationMethod |
| Includes Publicity Measures | 1 | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| 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 VI Form990ScheduleHPartVI (15 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| PART I, LINE 3C: THOREK PROVIDES MEDICALLY NECESSARY SERVICES TO ALL PATIENTS THAT REQUIRE IT, REGARDLESS OF RACE, CREED, COLOR, GENDER, OR COUNTRY OF NATIONAL ORIGIN AND WITHOUT REGARDS TO ABILITY OF THE PATIENT TO PAY FOR SUCH SERVICES. THOREK PROVIDES A MINIMUM 53% DISCOUNT OF CHARGES FOR ALL PATIENTS WITHOUT INSURANCE, REGARDLESS OF INCOME OR ASSETS. PATIENTS ARE ELIGIBLE FOR AN ADDITIONAL 25% QUICK PAY DISCOUNT ON THE REMAINING AMOUNT DUE AFTER THE INTIAL 53% DISCOUNT. PATIENTS ARE ELIGIBLE FOR ADDITIONAL PAYMENT REDUCTIONS AND OR INTEREST FREE PAYMENT PLANS UP TO AND INCLUDING COMPLETE WRITEOFF OF CHARGES FOR PATIENTS THAT ARE ELIGIBLE FOR THE HOSPITAL'S CHARITY CARE POLICY OR SHOW SEVERE FINANCIAL DISTRESS. | ||
| PART I, LINE 6A: THOREK PREPARES AND FILES THE ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT BY DECEMBER 31 OF EACH YEAR WITH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. | ||
| PART I, LINE 7: FINANCIAL ASSISTANCE AT COST AND UNREIMBURSED MEDICAID: A COST TO CHARGE METHODOLOGY BASED ON THE MEDICARE COST REPORTS WAS USED TO CALCULATE THE COSTS OF CHARITY CARE. COSTS WERE DETERMINED IN ACCORDANCE WITH GUIDELINES PUBLISHED BY THE CATHOLIC HEALTH ASSOCIATION IN CONJUNCTION WITH THE AMERICAN HOSPITAL ASSOCIATION INCLUDING THE FOLLOWING METHODOLOGIES; DIRECT COSTS INCLUDE THE HOURLY WAGES OF EMPLOYEES PROVIDING SERVICES, COST OF SUPPLIES, COST OF SPACE UTILIZED TO PROVIDE SERVICES, AND ANY OTHER DIRECT COSTS INCURRED IN THE PROVISION OF SERVICES AND A COST TO CHARGE METHODOLOGY BASED ON THE MEDICARE COST REPORTS. INDIRECT COSTS WERE INCLUDED WHERE APPLICABLE BASED UPON A COST TO CHARGE METHODOLOGY BASED ON THE MEDICARE COST REPORTS OR CALCULATED FROM THE HOSPITAL'S COST ACCOUNTING SYSTEM. FOR ALL COSTS, THE BEST AVAILABLE DATA WAS USED TO CALCULATE THE COST AMOUNTS REPORTED IN THIS SECTION AS WELL AS THROUGHOUT SCHEDULE H. FOR SOME COSTS, THE BEST AVAILABLE DATA WAS OBTAINED VIA THE HOSPITAL'S COST ACCOUNTING SYSTEM. IN OTHER INSTANCES, A COST TO CHARGE RATIO WAS CALCULATED AND APPLIED TO THOSE CHARGES FOR THOSE SERVICES. | ||
| PART I, LINE 7G: THOREK HAS NOT INCLUDED COSTS ATTRIBUTABLE TO ANY PHYSICIAN CLINIC AS PART OF SUBSIDIZED HEALTH SERVICES. | ||
| PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 2198047. | ||
| PART II: IN 2012, THOREK FOCUSED MOST OF ITS COMMUNITY EFFORTS IN TO OTHER COMMUNITY ACTIVITIES SUCH AS HEALTH FAIRS AND PROVIDING SERVICES TO CHICAGO HOUSING AUTHORITY RESIDENTS AND OTHER ACTIVITIES THAT WERE NOT "COMMUNITY BUILDING" AS DESCRIBED BY THE CATHOLIC HEALTH ASSOCIATION. | ||
| PART III, LINE 4: THE COST OF BAD DEBT AS REFLECTED IN PART III LINE 2, WAS CALCULATED USING A COST TO CHARGE RATIO USING THE MEDICARE COST REPORTS. ANY DISCOUNTS PROVIDED OR ANY PAYMENTS RECEIVED AND APPLIED TO A PATIENT ACCOUNT ARE APPLIED TO THE ACCOUNT PRIOR TO ANY BAD DEBT WRITE-OFFS AND ARE NOT INCLUDED IN THE PROVISION FOR BAD DEBT IN THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS. THE PROVISION FOR DOUBTFUL ACCOUNTS IS CALCULATED BASED ON HISTORICAL NET COLLECTIONS AND BAD DEBT WRITE-OFFS CONSIDERING ECONOMIC AND PATIENT FINANCIAL CONDITIONS, CHANGES IN HEALTHCARE COVERAGES, AND OTHER COLLECTION INDICATORS. MANAGEMENT WILL PERIODICALLY ASSESS THE APPROPRIATENESS OF THIS ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS BASED ON HISTORICAL WRITE-OFF PERCENTAGES BY PAYOR. FOR ACCOUNTS WITH REMAINING PATIENT RESPONSIBILITY AFTER INSURANCE PAYMENT, THOREK WILL FOLLOW ITS POLICY (AND REQUIRED BY PAYORS INCLUDING MEDICARE) FOR PLACING CERTAIN OF THESE ACCOUNTS WITH PAST DUE BALANCES AND NO PAYMENT OR COMMUNICATION BY THE PATIENT WITH OUTSIDE AGENCIES SUBJECT TO THE RESTRICTIONS PLACED ON THIS ACTIVITY BY THE HOSPITAL MANAGEMENT. THOREK PATIENT ACCOUNTS MANAGEMENT MANUALLY REVIEWS ALL SELF-PAY ACCOUNTS PRIOR TO PLACING THE ACCOUNTS FOR BAD DEBT. LARGE ACCOUNTS (GREATER THAN $5,000) WILL BE REFERRED TO SENIOR MANAGEMENT FOR REVIEW. THROUGH THIS PROCESS, THE PATIENTS' CREDIT HISTORY AND SCORE IS EXAMINED TO DETERMINE IF THE PATIENT HAS FINANCIAL MEANS TO PAY ANY OF THE AMOUNT OWED. IF THE PATIENT IS NOT COOPERATIVE WITH THIS PROCESS AND THE PATIENT DOES NOT QUALIFY UNDER THE HOSPITAL'S CHARITY CARE POLICY, THE ACCOUNT MAY BE FORWARDED TO A COLLECTION SERVICE, BUT ONLY WHEN ALL OTHER METHODS HAVE FAILED. WE BELIEVE THAT GREATER THAN 60% OF THE ACCOUNTS CHARGED AS BAD DEBT ARE LIKELY ELIGIBLE FOR CHARITY CARE BUT SUFFICIENT INFORMATION OR DOCUMENTATION IS NOT RECEIVED FROM PATIENT IN ORDER TO ALLOW CLASSIFICATION AS CHARITY CARE. THOREK, THEREFORE, BELIEVES THIS PERCENTAGE APPLIES TO THE TOTAL BAD DEBT EXPENSE AS A WHOLE. THEREFORE, OF THE $2,198,048 OF BAD DEBT EXPENSE, THOREK BELIEVES APPROXIMATELY 60% OF THIS AMOUNT, OR $1,318,829, LIKELY REPRESENTS CHARITY CARE.THE FINANCIAL STATEMENTS FOR THOREK MEMORIAL HOSPITAL FOR THE YEAR ENDING JUNE 30, 2012 DID NOT CONTAIN A FOOTNOTE THAT REFERENCED THE PROVISION FOR BAD DEBT EXPENSE FOR THE 2012 FISCAL YEAR AUDIT. HOWEVER, THE HOSPITAL DID PROVIDE SIGNIFICANT AMOUNTS OF UNCOMPENSATED CARE TO ITS UNDERINSURED AND UNINSURED PATIENTS DURING THE FISCAL YEARS ENDING 2012. THE HOSPITAL'S PROVISION FOR BAD DEBT WAS INCLUDED IN THE STATEMENT OF OPERATIONS FOR FISCAL YEARS ENDING JUNE 30, 2012 AND AGGREGATED $2,198,048 IN CHARGES. ANY CONTRACTUAL ADJUSTMENTS OR OTHER DISCOUNTS AND PAYMENTS ARE NOT INCLUDED IN THE PROVISION FOR BAD DEBT EXPENSE IN THE THOREK MEMORIAL HOSPITAL FINANCIAL STATEMENTS UNLESS THE PAYMENT REPRESENTS A RECOVERY OF AN AMOUNT THAT HAD BEEN PREVIOUSLY WRITTEN OFF AND CLASSIFIED AS PROVISION FOR BAD DEBT EXPENSE. THE RECOVERY IS RECORDED IN THE TIME PERIOD IN WHICH IT OCCURS. | ||
| PART III, LINE 8: MEDICARE COSTS ARE ALLOCATED BY COST CENTER IN ACCORDANCE WITH MEDICARE REGULATIONS. THE COSTS ARE CALCULATED USING A COST TO CHARGE RATIO. | ||
| PART III, LINE 9B: THOREK PROVIDES FINANCIAL ASSISTANCE TO ALL PATIENTS THAT REQUEST IT. IN ADDITION, THOREK SEEKS TO ENGAGE PATIENTS PROACTIVELY TO DETERMINE IF FINANCIAL ASSISTANCE IS NEEDED, ESPECIALLY AT THE TIME OF SERVICE. THIS SERVICE IS ACCOMPLISHED BY COMMUNICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THE PATIENT THROUGH POSTED SIGNS THROUGHOUT THE HOSPITAL AS WELL AS NOTICES ON THE HOSPITAL WEBSITE AND ALL BILLING CORRESPONDENCE. FURTHERMORE THE HOSPITAL FINANCIAL COUNSELORS WILL PROVIDE ASSISTANCE RANGING FROM ASSISTANCE IN COMPLETING THE HOSPITAL'S CHARITY CARE POLICY, TO PROVIDING PAYMENT PLANS TO THOSE WITHOUT INSURANCE OR WITH PATIENT RESPONSIBILITIES AFTER REIMBURSEMENT BY THE PRIMARY INSURANCE, AND WILL SEEK INSURANCE COVERAGE FOR THOSE PATIENTS UNINSURED. THE HOSPITAL'S FINANCIAL COUNSELORS WILL SEEK TO MAKE CONTACT AND WORK WITH THE PATIENT OR THEIR FAMILY TO HELP THEM IN ANY WAY POSSIBLE TO MEET THEIR FINANCIAL RESPONSIBILITIES IN A SUPPORTIVE MANNER OR IDENTIFY ELIGIBILITY FOR THE HOSPITAL'S CHARITY CARE POLICY. FINANCIAL COUNSELORS WORK WITH PATIENTS IN PERSON WHILE STILL AN INPATIENT IF APPROPRIATE, AFTER AN OUTPATIENT SERVICE AT THE HOSPITAL, OR SOON AFTER SERVICE IS PROVIDED TELEPHONICALLY. AS PART OF THIS PROCESS, THE COUNSELORS WILL ATTEMPT TO DETERMINE IF THERE ARE ANY THIRD PARTY PAYERS WHICH MAY BE AVAILABLE TO HELP THE PATIENT MEET THEIR OBLIGATIONS. THE COUNSELORS WILL WORK WITH OUR PATIENTS TO DETERMINE IF THEY ARE ELIGIBLE FOR MEDICAID OR OTHER STATE OR LOCAL FUNDED PROGRAMS INCLUDING CRIME VICTIMS, ALTERNATIVE INSURANCE INCLUDING COBRA, WORKER'S COMPENSATION, AND/OR OTHER APPROPRIATE THIRD PARTY LIABILITY PAYOR. THE HOSPITAL CONTRACTS WITH AN OUTSIDE FIRM TO PROVIDE ONE FULL-TIME FINANCIAL COUNSELOR AND SUPPORTING STAFF THAT WORK WITH APPROXIMATELY 150 PATIENT ACCOUNTS PER MONTH.THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE BEGINS WITH A PHONE CALL OR MEETING WITH THE PATIENT TO COMPLETE THE HOSPITAL CHARITY CARE APPLICATION FORMS AND/OR PROVIDED EVIDENCE OF THE NEED FOR FINANCIAL ASSISTANCE. IF THE CHARITY CARE APPLICATION MEETS THE HOSPITAL CHARITY CARE GUIDELINES OF 200% OF THE FEDERAL POVERTY GUIDELINES, NO FURTHER COLLECTION ACTIVITY OCCURS AND THE AMOUNT IS APPROPRIATELY RECORDED AS CHARITY CARE AND WRITTEN OFF AFTER THE 53% INITIAL DISCOUNT IS APPLIED. FOR PATIENTS THAT DO NOT MEET CHARITY CARE GUIDELINES, A 53% (BASED ON 400% OF FEDERAL POVERTY GUIDELINES) INITIAL DISCOUNT IS TAKEN. THE REMAINING AMOUNT WILL BE PAID BASED UPON AN AGREED UPON PAYMENT PLAN WITH THE PATIENT OR WILL RECEIVE FURTHER DISCOUNT BASED UPON THE INDIVIDUAL PATIENT'S FINANCIAL SITUATION. ANY FINAL AMOUNT THAT WILL BE PAID IS DETERMINED AND PAID IN FULL OR ACCORDING TO AN AGREED UPON PAYMENT PLAN WITH THE PATIENT. EVERY OPPORTUNITY WILL BE MADE TO ENSURE THE PATIENT HAS THE CHANCE TO PAY WHAT THEY CAN AFFORD TO BASED UPON THEIR FINANCIAL SITUATION AT THAT TIME. THE HOSPITAL DOES NOT ATTEMPT TO GARNISH ANY WAGES OF THE PATIENT, DOES NOT FILE LIENS ON ANY PERSONAL PROPERTY OF THE PATIENT, NOR DOES IT PURSUE ANY OTHER AGGRESSIVE COLLECTION TECHNIQUES IN PURSUIT OF PAYMENT. | ||
| PART V, SECTION B, LINE 19D: UTILIZED THE STANDARD DISCOUNT PER ILLINOIS STATE REQUIREMENT. | THOREK MEMORIAL HOSPITAL | |
| PART VI, LINE 2: THOREK WILL BE UTILIZING A COMMUNITY HEALTH ASSESSMENT SURVEY (CONDUCTED IN 2009) WITH AN ASSISTANCE OF AN OUTSIDE RESEARCH FIRM IN ORDER TO CAPTURE PRIMARY AND SECONDARY DATA ON THE HEALTH STATUS AND OPPORTUNITIES FOR IMPROVEMENT OF HEALTH SERVICES IN ITS COMMUNITY. THE PRIMARY DATA WAS OBTAINED THROUGH A TELEPHONE SURVEY OF OVER 1,000 ADULTS IN COOK COUNTY THROUGH A 20-25 MINUTE INTERVIEW WITH 136 INDIVIDUAL QUESTIONS THAT ADDRESSED THE FOLLOWING ISSUES: SELF-REPORTED HEALTH STATUS, PHYSICAL AND MENTAL HEALTH STATUS, INFECTIOUS & CHRONIC DISEASE, MODIFIABLE HEALTH RISKS, ACCESS TO HEALTHCARE SERVICES, HEALTH EDUCATION & OUTREACH, AND HEALTH INFORMATION SOURCES. THESE SURVEYS WERE CONDUCTED IN ENGLISH AND SPANISH. THE PRIMARY DATA WAS SUPPLEMENTED WITH SECONDARY DATA INCLUDING SUCH SOURCES AS CDC, FBI, COUNTY AND STATE PUBLIC HEALTH DEPARTMENTS, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU DATA. THE SECONDARY DATA INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING TOPICS: LEADING CAUSES OF DEATH, AGE-ADJUSTED DEATH RATES, VACCINE-PREVENTABLE CONDITIONS (IT WAS NOTED THAT 70% OF ADULTS SURVEYED DID NOT RECEIVE A FLU SHOT WITHIN THE PAST TWELVE MONTHS), STDS, HIV, AND OTHER INFECTIOUS DISEASES, AND FBI CRIME INDEX. THOREK PLANS TO USE THE ASSESSMENT INFORMATION TO EXPAND EXISTING AND CREATE NEW COMMUNITY HEALTH PROGRAMS MOST NEEDED BY UNDERSTANDING THE PREVALENCE OF CHRONIC CONDITIONS, BARRIERS TO ACCESS, AND OTHER HEALTH ISSUES IN THE COMMUNITY.IN ADDITION TO THE SURVEY, THOREK HAS HISTORICALLY AND WILL CONTINUE TO IDENTIFY PRIORITIES FOR COMMUNITY BENEFIT THROUGH THE FOLLOWING INTERNAL REVIEW:THE THOREK MEMORIAL HOSPITAL (TMH) COMMUNITY NEEDS ASSESSMENT IS AN ONGOING PROCESS CONDUCTED BY TMH MANAGEMENT AND SUMMARIZED ANNUALLY IN THE ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT SUBMITTED TO THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. THIS PROCESS UTILIZES INFORMATION OBTAINED FROM HEALTH AGENCIES AND PRACTITIONERS, COMMUNITY ORGANIZATIONS, AND COMMUNITY REPRESENTATIVES. THIS INFORMATION HAS BEEN GATHERED EITHER THROUGH REVIEW OF PUBLISHED INFORMATION, WRITTEN FEEDBACK, OR DIRECT INTERVIEWS OR DISCUSSIONS WITH PHYSICIANS AND PATIENTS. INDIVIDUALS INCLUDED ARE PHYSICIANS AND ALLIED HEALTH PROFESSIONALS, REPRESENTATIVES FROM THE ELDERLY POPULATION, LOCAL EMPLOYERS, AND COMMUNITY REPRESENTATIVES. FINDINGS FROM THE ASSESSMENT INDICATE: - TMH SERVES A POPULATION HAVING LIMITED ECONOMIC MEANS - THE POPULATION SERVED BY TMH IS NOT BASED ON GEOGRAPHIC PROXIMITY - THERE IS A CONSENSUS BETWEEN TMH AND ITS MEDICAL STAFF REGARDING GOALS - THERE IS LOW CONSUMER AWARENESS OF TMH SERVICES, HOWEVER, THIS IS IMPROVINGTHE TOP PRIORITY UNMET HEALTH NEEDS, BY AGE GROUP, ARE AS FOLLOWS. - ADULTS: ACCESS TO SERVICES (INSURANCE, COST) - SENIORS:COST; MEDICATIONS; POST-HOSPITAL SUPPORT; AND TRANSPORTATIONTHOREK MEMORIAL HOSPITAL HAS ADDRESSED AND/OR PLANS TO ADDRESS THESE IDENTIFIED PRIORITY NEEDS IN THE FOLLOWING WAYS IN THE COMMUNITY:IMPROVE ACCESS TO SERVICES - AMBULATORY CARE. TMH HAS FOCUSED ON THE EXPANSION AND DIFFERENTIATION OF ITS AMBULATORY CARE PROGRAMS IN ORDER TO IMPROVE ACCESS AND SERVICE. THE AMBULATORY CARE DEPARTMENT HAS BEEN PHYSICALLY EXPANDED AND SEPARATED INTO DISTINCT COMPONENTS. - CENTER FOR PRIMARY CARE. TMH OPERATES ITS CENTER FOR PRIMARY CARE. THIS NOT ONLY INCREASED THE SPACE DEVOTED TO AMBULATORY CARE, BUT PROVIDES A PHYSICALLY DISTINCT AREA DESIGNED TO HAVE THE LOOK AND FEEL OF A PRIVATE MEDICAL OFFICE RATHER THAN A "WALK-IN CLINIC". - COMMUNITY AND LOCAL EMPLOYER HEALTH FAIRS AND EDUCATION SESSIONSFOCUS ON NEEDS AND CONCERNS OF SENIORS - CHA PROGRAM. TMH PROVIDES ACCESS TO MEDICAL SERVICES FOR RESIDENTS OF FIVE NEARBY CHICAGO HOUSING AUTHORITY (CHA) RESIDENTIAL FACILITIES BY OPERATING MEDICAL OFFICES IN THESE BUILDINGS. RESIDENTS OF THESE BUILDINGS ARE PREDOMINANTLY SENIORS WHO QUALIFY FOR SUBSIDIZED HOUSING BASED ON FINANCIAL NEED. TYPICAL OFFICE STAFFING CONSISTS OF AN RN AND A PHYSICIAN. IN ADDITION, PHARMACEUTICALS NEEDED BY RESIDENTS ARE DELIVERED FREE OF CHARGE FOR THOSE RESIDENTS THAT REQUIRE THEM BASED ON AN APPROPRIATE COMPLETED SCRIPTS BY THE PHYSICIANS. IN ADDITION TO THE PROVISION OF HEALTH SERVICES, EDUCATIONAL, SOCIAL, AND OTHER ACTIVITIES ARE ARRANGED BY STAFF FOR THE PATIENTS OF CHA AT FIVE SITES ON THE NORTH SIDE OF CHICAGO, IN THOREK'S PRIMARY SERVICE AREA. NO AMOUNTS ARE BILLED BY THE HOSPITAL FOR HEALTHCARE SERVICES PROVIDED AT THESE SITES. THOREK HOSPITAL ALSO HELPS TO PROVIDE ACCESS TO SPECIALTY (CONSULTANT) PHYSICIAN SERVICES TO MEMBERS ON AN AS NEEDED BASIS. - MEDICATION. RECOGNIZING THE NEED TO PROVIDE ACCESS, EXPAND ALTERNATIVES, AND IMPROVE CONVENIENCE TO THOSE WE SERVE, TMH CONTINUES TO PROVIDE MEDICATION THROUGH ITS OUTPATIENT PHARMACY TO HOSPITAL PATIENTS AND CHA RESIDENTS. - TRANSPORTATION. TMH PROVIDES TRANSPORTATION VIA HOSPITAL VAN AND CONTRACTED TRANSPORTATION SERVICES BASED ON HOSPITAL TRANSPORTATION POLICIES TO 50+ CLUB MEMBERS AND OTHERS WITHIN DESIGNATED GEOGRAPHIC BOUNDARIES, AS DETERMINED APPROPRIATE BASED ON NEED AND CLINICAL STATUS, WHEN HOSPITAL SERVICES HAVE BEEN SCHEDULED IN ACCORDANCE WITH THE HOSPITAL'S TRANSPORTATION POLICY. INCREASE AWARENESS OF HEALTH PROGRAMS AVAILABLE - COMMUNICATION OF SERVICES TO THE COMMUNITY AND ITS ORGANIZATIONS - COMMUNITY HEALTH EDUCATION PROGRAMS DISCUSSING PREVENTION AND WELLNESS - ACCESS TO HOSPITAL AND PHYSICIAN SERVICES | ||
| PART VI, LINE 3: THOREK UTILIZES SEVERAL METHODS TO COMMUNICATE ITS RESPONSIBILITY TO INFORM AND EDUCATE PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER GOVERNMENTAL PROGRAMS OR THE HOSPITAL'S FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES. THE HOSPITAL POSTS THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE IN ENGLISH AND SPANISH IN ALL REGISTRATION AND MOST WAITING AREAS THROUGHOUT THE HOSPITAL. THE AVAILABILITY FOR CHARITY CARE AS WELL AS THE WORKSHEET TO CALCULATE ELIGIBILITY FOR CHARITY CARE IS POSTED ON THE HOSPITAL'S WEBSITE. IN ADDITION, ALL BILLS AND STATEMENTS SENT TO PATIENTS INCLUDE INFORMATION REGARDING THE FINANCIAL ASSISTANCE AND CHARITY CARE OPPORTUNITIES IN ENGLISH AND SPANISH. THE HOSPITAL ALSO CONTACTS FOR A FULL TIME FTE TO PROVIDE FINANCIAL COUNSELING TO PATIENTS WHICH INCLUDES THE ASSISTANCE IN THE MEDICAID APPLICATION PROCESS AS WELL AS A SEARCH FOR OTHER COVERAGE OPTIONS AVAILABLE. MEMBERS OF THE BUSINESS OFFICE ALSO WORK WITH PATIENTS TO SEE WHAT OTHER COMMUNITY RESOURCES MAY BE AVAILABLE TO THE PATIENT FOR CURRENT AND FUTURE CARE PROVISION. THE FINANCIAL COUNSELOR AND MOST OTHER EMPLOYEES IN THE HOSPITAL BUSINESS OFFICE AND PATIENT REGISTRATION ARE FLUENT IN SPANISH, AND PHONE TRANSLATORS ARE USED FOR OTHER LANGUAGES. | ||
| PART VI, LINE 4: THOREK MEMORIAL HOSPITAL IS REPRESENTATIVE OF THE WIDE CROSS-SECTION OF THE POPULATION THAT IT SERVES. ITS COMMUNITY INCLUDES A SIZABLE NUMBER OF AFRICAN AMERICAN, ASIAN, AND HISPANIC RESIDENTS AS WELL AS A VARIETY OF OTHER ETHNIC GROUPS. THOREK MEMORIAL HOSPITAL'S LONG-STANDING STATUS AS A PREFERRED PROVIDER OF MEDICAL SERVICES FOR EMPLOYERS, ALSO WITH A MULTI-ETHNIC MEMBERSHIP, CONTRIBUTES TO A WELL-ESTABLISHED WORKING CLASS ETHNIC CUSTOMER BASE. THE DEMOGRAPHIC SECTION OF THIS PLAN INCLUDES A LISTING THAT GIVES THE ETHNIC DISTRIBUTION OF INPATIENTS FOR FY 2012. SINCE THOREK MEMORIAL HOSPITAL'S MEDICAL STAFF ALSO REFLECTS ETHNIC DIVERSITY, WE EXPECT TO MAINTAIN A SIGNIFICANT ETHNIC CUSTOMER BASE.ALTHOUGH THOREK MEMORIAL HOSPITAL SERVES PATIENTS THROUGHOUT THE CHICAGO METROPOLITAN AREA AND EVEN AS FAR AWAY AS INDIANA AND WISCONSIN, WE HAVE DEFINED OUR COMMUNITY BASED UPON GEOGRAPHIC PROXIMITY. A PRIMARY SERVICE AREA HAS BEEN IDENTIFIED CONSISTING OF NEARBY ZIP CODE AREAS. THOREK MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF THE FOLLOWING:GRACELAND (60613),LINCOLN PARK (60614), KEDZIE-GRACE (60618), RAVENSWOOD (60625), UPTOWN (60640), LOGAN SQUARE (60647), EDGEWATER (60660), W.ROGERS PARK (60645), ROGERS PARK (60626), DIVISION (60651), AUSTIN (60644), CRAGIN (60639), GARFIELD PARK (60624), NEAR WEST (60612), HAWTHORNE (60623), PILSEN (60608), AND NEAR SOUTH (60616), AS WELL AS ZIP CODES 60653, 60615, 60621, 60637, 60620, 60619, 60649, AND 60628. THE PRIMARY NOT-FOR-PROFIT COMMUNITY HOSPITALS ALSO SERVING THIS AREAINCLUDE: WEISS MEMORIAL HOSPITAL, ILLINOIS MASONIC MEDICAL CENTER (ADVOCATE), SWEDISH COVENANT HOSPITAL, ST. JOSEPH HOSPITAL (RESURRECTION), NORWEIGAN AMERICAN HOSPITAL, METHODIST HOSPITAL, AND ST. MARY AND ST ELIZABETH HOSPITALS (RESURRECTION). APPROXIMATELY 85% OF ADMISSIONS SERVED AT THOREK ARE FEDERALLY FUNDED OR SELF PAY/CHARITY. THE HOSPITAL CONTINUES TO MEET THE CRITERIA FOR A DISPROPORTIONATE SHARE HOSPITAL FOR MEDICARE MEDICAID HIGH-VOLUME ADJUSTMENT FOR THE DEPARTMENT OF HUMAN SERVICES (PUBLIC AID). | ||
| PART VI, LINE 5: NET COMMUNITY BENEFITS EXPENSE FOR THOREK IN 2012 IS AS FOLLOWS (FROM THE ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT FILED IN ACCORDANCE WITH THE ILLINOIS ATTORNEY GENERAL GUIDELINES):CHARITY CARE AT COST - $816,083LANGUAGE ASSISTANT SERVICES - $11,726SUBSIDIZED HEALTH SERVICES - $476,157OTHER COMMUNITY BENEFIT PROGRAMS - $211,820THESE COSTS INCLUDE THE COSTS TO PROVIDE STAFFING AND SERVICES AT VARIOUS HEALTH FAIRS HELD IN THE COMMUNITY THROUGHOUT THE YEAR. THESE HEALTH FAIRS ARE STAFFED BY PHYSICIANS, NURSES, AND MEDICAL ASSISTANTS THAT ARE EMPLOYEES OF THE HOSPITAL. THE SERVICES PROVIDED AT THESE FAIRS INCLUDE BLOOD PRESSURE CHECKS, BLOOD GLUCOSE SCREENINGS, CHOLESTEROL TESTS AS WELL AS FLU SHOTS. ALL SERVICES ARE PROVIDED FREE OF CHARGE AT THESE HEALTH FAIRS. IN ADDITION, THE HOSPITAL PROVIDES (FREE OF CHARGE) GUARDIANSHIP SERVICES THROUGH A LOCAL LEGAL FIRM FOR THOSE INPATIENT PSYCHIATRIC PATIENTS WHO ARE NOT ABLE TO MAKE APPROPRIATE MEDICAL DECISIONS FOR THEMSELVES. ALSO INCLUDED IN OTHER COMMUNITY BENEFIT PROGRAMS IS THE PROVISION OF TRANSPORTATION TO HOSPITAL PATIENTS THAT REQUIRE THIS SERVICE TO RECEIVE APPROPRIATE MEDICALLY NECESSARY HEALTH CARE AND PHYSICIAN SERVICES. THE TRANSPORTATION FOR THESE PATIENTS IS PERFORMED IN ACCORDANCE WITH THE HOSPITAL TRANSPORTATION POLICY TOTAL CHARITY CARE AND COMMUNITY BENEFITS - $2,256,968IN ADDITION, THOREK REPORTED BAD DEBT EXPENSE OF $2,198,047 IN 2012.THOREK EXTENDS MEDICAL STAFF PRIVLEGES TO QUALIFIED PHYSICIANS IN AND AROUND OUR COMMUNITIES AND SEEKS TO PROVIDE THE PHYSICIANS, NURSES, TECHNICIANS, AND ALL OTHERS INVOLVED IN THE DELIVERY OF CARE WITH THE SAFEST AND MOST CURRENT TECHNOLOGICALLY ADVANCED HEALTHCARE ENVIRONMENT POSSIBLE. ALL SURPLUS FUNDS ARE REINVESTED IN THE ORGANIZATION IN ORDER TO CONTINUE TO PROVIDE HIGH QUALITY YET EFFICIENT HEALTH CARE SERVICES TO THOREK'S COMMUNITIES IT SERVES AND TO CARRY OUT ITS MISSION FOR PATIENT CARE, EDUCATION, AND OTHER SERVICES AS NEEDED IN THE COMMUNITY. MEMBERS OF THE BOARD OF TRUSTEES ARE APPOINTED ON THE BASIS OF THEIR EXPERTISE AND EXPERIENCE IN A VARIETY OF AREAS BENEFICIAL TO THOREK. | ||
| IL | REPORTS FILED WITH STATES | PART VI, LINE 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | 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 | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PETER KAMBEROS | |||||||||||||
| 237129 | 0 | 20110 | 0 | 0 | 0 | 0 | 0 | 1434 | 0 | 258673 | 0 | 0 | 0 |
| EDWARD BUDD | |||||||||||||
| 181770 | 0 | 20207 | 0 | 0 | 0 | 0 | 0 | 11551 | 0 | 213528 | 0 | 0 | 0 |
| MORGAN FRANCIS MURPHY III | |||||||||||||
| 153634 | 0 | 20101 | 0 | 0 | 0 | 0 | 0 | 5027 | 0 | 178762 | 0 | 0 | 0 |
| MARY MCCAHILL | |||||||||||||
| 143395 | 0 | 25110 | 0 | 0 | 0 | 0 | 0 | 4932 | 0 | 173437 | 0 | 0 | 0 |
| NITIN BARMAN | |||||||||||||
| 354399 | 0 | 107 | 0 | 0 | 0 | 0 | 0 | 7854 | 0 | 362360 | 0 | 0 | 0 |
| JOHN HUNNIFORD | |||||||||||||
| 233191 | 0 | 103 | 0 | 0 | 0 | 0 | 0 | 4586 | 0 | 237880 | 0 | 0 | 0 |
| THOMAS TRIANTAFILLOU | |||||||||||||
| 166733 | 0 | 2603 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 169336 | 0 | 0 | 0 |
| VIVEK GUPTA | |||||||||||||
| 164004 | 0 | 51 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 164055 | 0 | 0 | 0 |
| MARIAN URIARTE | |||||||||||||
| 153426 | 0 | 210 | 0 | 0 | 0 | 0 | 0 | 780 | 0 | 154416 | 0 | 0 | 0 |
| FRANK SOLARE | |||||||||||||
| 267218 | 0 | 107 | 0 | 0 | 0 | 0 | 0 | 11551 | 0 | 278876 | 0 | 0 | 0 |
| FIDEL CASTILLO | |||||||||||||
| 125824 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 125824 | 0 | 0 | 0 |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV
Name Of Interested Person NameOfInterestedPerson
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | PETER KAMBEROS | NamePerson |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship | CHAIRMAN OF THE BOARD AND COO | Relationship |
| Amount Of Transaction | 53139 | AmountOfTransaction |
| Description Of Transaction | PETER'S NEPHEW THERON PAPPAS WAS EMPLOYED BY THOREK MEMORIAL HOSPITAL THROUGH 8/1/11. | DescriptionOfTransaction |
| Sharing Of Revenues | 0 | SharingOfRevenues |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | HOSPITAL MANAGEMENT PREPARES A DRAFT OF THE FORM 990 RETURN WITH THE ASSISTANCE OF AN INDEPENDENT ACCOUNTING AND TAX FIRM. THE HOSPITAL'S INDEPENDENT ACCOUNTING AND TAX FIRM PRESENTS THIS DRAFT VERSION OF THE 990 TAX RETURN TO THE HOSPITAL BOARD OF TRUSTEES. THE BOARD OF TRUSTEES HAS THE OPPORTUNITY TO REVIEW THE RETURN, ASK QUESTIONS, AND SUGGEST CHANGES. THE BOARD OF TRUSTEES APPROVES THE FINAL VERSION OF THE RETURN AND MANAGEMENT FILES THIS RETURN WITH THE INTERNAL REVENUE SERVICE. | |
| FORM 990, PART VI, SECTION B, LINE 12C | THE HOSPITAL REGULARLY AND CONSISTENTLY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL REVIEW AND COMPLETION OF THE ANNUAL BOARD MEMBER QUESTIONNAIRE AND CONFLICT OF INTEREST POLICY BY EACH MEMBER OF THE BOARD OF TRUSTEES. THE CORPORATE COMPLIANCE OFFICER REVIEWS AND ENFORCES THE CONFLICT OF INTEREST POLICY. IF A CONFLICT ARISES, THE BOARD MEMBER ABSTAINS FROM VOTING ON THE RELEVANT ISSUE. | |
| FORM 990, PART VI, SECTION B, LINE 15 | DURING FISCAL YEAR 2012, THE HOSPITAL ENGAGED SULLIVAN AND COTTER MCHC TO PROVIDE A COMPARATIVE SALARY ANALYSIS FOR OFFICERS. THE INFORMATION WAS DISTRIBUTED TO THE COMPENSATION COMMITTEE OF THE BOARD. THE COMMITTEE WILL THEN MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES ON AN ANNUAL BASIS. ALL DECISIONS BY THE BOARD OF TRUSTEES ARE DOCUMENTED IN THE BOARD MINUTES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. | |
| FORM 990, PART VII: | NED BUDD WORKED AN AVERAGE OF AT LEAST 1 HOUR PER WEEK AT A RELATED ORGANIZATION. JAGAN MOHAN WORKED AN AVERAGE OF AT LEAST .5 HOURS PER WEEK AT A RELATED ORGANIZATION. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -8,658,402. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | THERE WAS NO CHANGE FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE THOREK FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 850 WEST IRVING ROAD | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60613 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 366124318 | EIN |
| Primary Activities | SUPPORT THOREK MEMORIAL HOSPITAL | PrimaryActivities |
| Legal Domicile State | IL | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11C | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THOREK MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | 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 | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | 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 | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |