HOLY CROSS HOSPITAL: Form 990, tax year 2010
View the entire original 990 at ProPublica ↗
- Organization
- HOLY CROSS HOSPITAL (EIN 36-2170133)
- Tax period
- 2010-07-01 to 2011-06-30
- Filed
- 2012-05-15
- IRS object ID
- 201221369349302167
- Schema version
- 2010v3.4
- 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 G
- Schedule H
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-05-15T09:37:17-05:00 | Timestamp |
| Tax Period End Date | 2011-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | McGladrey LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 S Wacker Dr Suite 800 | 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 | 2010-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362170133 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Holy Cross Hospital | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | HOLY | NameControl |
| Phone | 7738841604 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2701 West 68th Street | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60629 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Michael Lawrence | Name |
| Title | VP Finance & CFO | Title |
| Phone | 7738841604 | Phone |
| Date Signed | 2012-05-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Zack Fortsch | Name |
| Phone | 3126343400 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2010 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Wayne Lerner | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2701 West 68th Street | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60629 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 117376544 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Group Exemption Number | 0928 | GroupExemptionNumber |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.HolyCrossHospital.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1928 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | Holy Cross Hospital (HCH or the Hospital) is a Catholic Health Care Organization sponsored by the Sisters of Saint Casimir. By our commitment to witness to the healing mission of Jesus, we contribute to healthy communities and promote quality health care to all with compassion. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 1092 | TotalNbrEmployees |
| Total Nbr Volunteers | 20 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1115870 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 584498 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 109389667 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 114975146 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 280643 | InvestmentIncomePriorYear |
| Investment Income Current Year | 170396 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 968620 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1374833 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 111754800 | TotalRevenuePriorYear |
| Total Revenue Current Year | 117104873 | 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 | 52492687 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 55556350 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 56737 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 58616630 | OtherExpensePriorYear |
| Other Expenses Current Year | 59666506 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 111109317 | TotalExpensesPriorYear |
| Total Expenses Current Year | 115222856 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 645483 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1882017 | RevenuesLessExpensesCY |
| Total Assets BOY | 81348173 | TotalAssetsBOY |
| Total Assets EOY | 70478447 | TotalAssetsEOY |
| Total Liabilities BOY | 62845912 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 36556814 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 18502261 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 33921633 | NetAssetsOrFundBalancesEOY |
| Mission Description | The Hospital is a Catholic Health Care Organization sponsored by the Sisters of St. Casimir. By our commitment to witness to the healing mission of Jesus, we contribute to healthy communities and promote quality health care to all with compassion. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 107377419 | Expense |
| Revenue | 115885052 | Revenue |
| Description | The Hospital is a not-for-profit Catholic hospital that serves a large area of Chicago's Southwest side. Located in Marquette Park, the Hospital provides emergency, medical/surgical, specialty, diagnostic and primary care services to communities that are home to mostly African American and Latino families. Many of the patients the Hospital serves are uninsured or underinsured. The emergency department sees an average of 50,000 patients per year and have more ambulance daily visits than any other Illinois hospital. The Hospital is a Disproportionate Share Hospital and is a vital safety net hospital. | Description |
| Total Program Service Expense | 107377419 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 1 | LobbyingActivities |
| 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 | 0 | 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 | 1 | 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 | 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 | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 97 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 1092 | 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 | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| 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 | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | 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 | 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 | 0 | 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 | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Michael Lawrence CFO | NamePerson |
| Telephone Number | 7738845150 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2701 West 68TH Street | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60629 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (23 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Wayne Lerner | ||||||||
| President & CEO | 40.00 | X | X | 509001 | 0 | 11866 | ||
| Diane Howard | ||||||||
| Board Chairperson | 0.50 | X | X | 0 | 0 | 0 | ||
| John R Ball MD JD MACP | ||||||||
| Vice Chairperson | 0.50 | X | X | 0 | 0 | 0 | ||
| Anthony Bozzano MD | ||||||||
| Medical Staff President | 0.50 | X | 0 | 0 | 0 | |||
| Sister Regina Marie Dubickas | ||||||||
| Secretary | 0.50 | X | X | 0 | 0 | 0 | ||
| Sr Theresa Dabulis | ||||||||
| Trustee | 0.50 | X | 0 | 0 | 0 | |||
| Barbara Fahey | ||||||||
| Trustee | 0.50 | X | 0 | 0 | 0 | |||
| Chia Huang MD | ||||||||
| Trustee | 0.50 | X | 0 | 0 | 0 | |||
| Larry Margolis | ||||||||
| Trustee | 0.50 | X | 0 | 0 | 0 | |||
| Nancy Streitmatter MD | ||||||||
| Trustee | 40.00 | X | 150010 | 0 | 5869 | |||
| Sivaramaprasad Tummala MD | ||||||||
| Trustee | 0.50 | X | 0 | 0 | 0 | |||
| Sister M Immacula Wendt | ||||||||
| Trustee | 0.50 | X | 0 | 0 | 0 | |||
| Sister Margaret Zalot | ||||||||
| Trustee | 0.50 | X | 0 | 0 | 0 | |||
| Michael Lawrence | ||||||||
| VP Finance & CFO | 40.00 | X | 329996 | 0 | 8641 | |||
| Paul Teodo | ||||||||
| COO | 40.00 | X | 220496 | 0 | 6525 | |||
| Shelia Mischke | ||||||||
| VP Patient Care Services | 40.00 | 193745 | 0 | 6211 | X | |||
| Dennis Ryan | ||||||||
| VP Community & External Affairs | 40.00 | 169809 | 0 | 5771 | X | |||
| Cathy Kallal | ||||||||
| Chief Medical Officer | 40.00 | 275000 | 0 | 3953 | X | |||
| Sr Juline Revas | ||||||||
| VP Mission Services | 40.00 | 146513 | 0 | 4230 | X | |||
| Anna Carvalho | ||||||||
| VP Business Development | 40.00 | 147817 | 0 | 2476 | X | |||
| Solomon Greer MD | ||||||||
| Physician | 40.00 | 240529 | 0 | 7006 | X | |||
| Justin McCarthy | ||||||||
| Director of Radiology | 40.00 | 143998 | 0 | 2749 | X | |||
| Kenneth Pelehac | ||||||||
| Physician | 40.00 | 180192 | 0 | 6248 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2707106 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 71545 | TotalOtherCompensation |
| Number Individuals GT100 K | 44 | 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 |
|---|---|---|---|---|---|
| Professional Nursing Inc | |||||
| 325 N Wells Street 9th Floor | Chicago | IL | 60610 | Medical Services | 2040377 |
| Rehabcare Group Inc | |||||
| POBox 502096 | St Louis | MO | 63150 | Medical Services | 1943138 |
| Noel Alcantara MDSC | |||||
| PO Box 2909 | Darien | IL | 60561 | Medical Services | 1665920 |
| Aramark Servicemaster | |||||
| 25271 Network Place | Chicago | IL | 60673 | Support Services | 1384182 |
| Superior Health Linens LLC | |||||
| 2905 Syene Road | Madison | WI | 53713 | Support Services | 900516 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 23 | NumberOfContractorsGT100K |
| Fundraising Events | 71881 | FundraisingEvents |
| Government Grants | 156958 | GovernmentGrants |
| All Other Contributions | 355659 | AllOtherContributions |
| Total Contributions | 584498 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Medicare/Medicaid | 624100 | 79813167 | 79813167 |
| Net Patient Revenue | 624100 | 35161979 | 35161979 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 114975146 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 195043 | TotalRevenueColumn |
| Exclusion | $195,043 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 648368 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 183441 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 464927 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 464927 | TotalRevenueColumn |
| Exclusion | $464,927 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 6800 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 31447 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -24647 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -24647 | TotalRevenueColumn |
| Exclusion | -$24,647 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 56783 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 71881 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 56783 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| Cafeteria | 621400 | 321083 | 321083 |
| Parking | 621400 | 103066 | 103066 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 485757 | TotalRevenueColumn |
| Related Or Exempt Function Income | 485757 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 909906 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 117104873 | TotalRevenueColumn |
| Related Or Exempt Function Income | 115885052 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $635,323 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2142377 | Total |
| Management And General | 2142377 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44934874 | Total |
| Program Services | 42599200 | ProgramServices |
| Management And General | 2335674 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 248653 | Total |
| Program Services | 229507 | ProgramServices |
| Management And General | 19146 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4944856 | Total |
| Program Services | 4564102 | ProgramServices |
| Management And General | 380754 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3285590 | Total |
| Program Services | 3092383 | ProgramServices |
| Management And General | 193207 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1368562 | Total |
| Management And General | 1368562 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136806 | Total |
| Management And General | 136806 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14880500 | Total |
| Program Services | 14163742 | ProgramServices |
| Management And General | 716758 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4142 | Total |
| Program Services | 4142 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2246398 | Total |
| Program Services | 2219191 | ProgramServices |
| Management And General | 27207 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13523 | Total |
| Program Services | 11279 | ProgramServices |
| Management And General | 2244 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24871 | Total |
| Program Services | 14905 | ProgramServices |
| Management And General | 9966 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 215505 | Total |
| Program Services | 215505 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5511261 | Total |
| Program Services | 5511261 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3709520 | Total |
| Program Services | 3709520 | ProgramServices |
Other Expenses OtherExpenses (5 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| Medical Supplies | 11912015 | 11912015 | |
| Provision for Bad Debt | 9860018 | 9860018 | |
| Medicaid Assessment | 5509291 | 5509291 | |
| Food | 804804 | 746668 | 58136 |
| Membership | 145997 | 2091 | 143906 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3323293 | Total |
| Program Services | 3012599 | ProgramServices |
| Management And General | 253957 | ManagementAndGeneral |
| Fundraising | 56737 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115222856 | Total |
| Program Services | 107377419 | ProgramServices |
| Management And General | 7788700 | ManagementAndGeneral |
| Fundraising | 56737 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7708748 | BOY |
| EOY | 4921220 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14476032 | BOY |
| EOY | 9391489 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 225279 | BOY |
| EOY | 104206 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12321545 | BOY |
| EOY | 10807555 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3000 | BOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1582688 | BOY |
| EOY | 1625775 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 906913 | BOY |
| EOY | 531108 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 131857642 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 94758818 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40590453 | BOY |
| EOY | 37098824 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2971590 | BOY |
| EOY | 5158389 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 561925 | BOY |
| EOY | 839881 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81348173 | BOY |
| EOY | 70478447 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16180473 | BOY |
| EOY | 15599799 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12625000 | BOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1973841 | BOY |
| EOY | 1513053 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 32066598 | BOY |
| EOY | 19443962 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 62845912 | BOY |
| EOY | 36556814 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 17285406 | BOY |
| EOY | 33258171 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1216855 | BOY |
| EOY | 663462 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18502261 | BOY |
| EOY | 33921633 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 81348173 | BOY |
| EOY | 70478447 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 1882017 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 13537355 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
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 | 1 | DirectContactLegislators |
| Direct Contact Legislators | $201,042 | DirectContactLegislatorsAmount |
| Rallies Demonstrations | 0 | RalliesDemonstrations |
| Other Activities | 1 | OtherActivities |
| Other Activities | $29,699 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 230741 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | 0 | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Explanation of Other Lobbying Activities: | Identifier |
| Return Reference | Part II-B, Line 1i: | ReturnReference |
| Explanation | $29,699 represented 32% of the American Hospital Association and Illinois Hospital Association membership dues that are allocable to lobbying activities. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1337233 | OtherCostOrOtherBasis |
| Book Value | 1337233 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 52957624 | OtherCostOrOtherBasis |
| Depreciation | 31429631 | Depreciation |
| Book Value | 21527993 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 75738165 | OtherCostOrOtherBasis |
| Depreciation | 61954764 | Depreciation |
| Book Value | 13783401 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1824620 | OtherCostOrOtherBasis |
| Depreciation | 1374423 | Depreciation |
| Book Value | 450197 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 37098824 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities (4 entries)
| DescriptionDescription | Book ValueBookValue | Method Of ValuationMethodOfValuation |
|---|---|---|
| Investments Designated Under Debt Agreements | 1340445 | F |
| Investments Designated Under Workmen's Compensation Agreements | 543971 | F |
| Other Investments | 100000 | F |
| Investments Designated Under Self-Insurance Trust Agreement | 3173973 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 5158389 | TotalOfBookValueSecurities |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Accrued Pension Benefit | $14,836,940 |
| Reserve for Professional Liability | $4,607,022 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 19443962 | TotalOfAmounts |
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 Hospital has received a determination letter from the Internal Revenue Service stating that it is exempt from the payment of federal income taxes under Section 501(c)(3) of the Internal Revenue Code. The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When the return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. UBIT is reported on Form 990T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. | Explanation |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | Annual Fundraising Dinner | NameOfEvent1 |
| Gross Receipts Event1 | 128664 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 71881 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 56783 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 2500 | CashPrizesEvent1 |
| Rent Facility Costs Event1 | 6961 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 39837 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 3000 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 4485 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 128664 | GrossReceiptsTotal |
| Charitable Contributions Total | 71881 | CharitableContributionsTotal |
| Gross Revenue Total Events | 56783 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 2500 | CashPrizesTotalEvents |
| Rent Facility Costs Total Events | 6961 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 39837 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 3000 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 4485 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 56783 | DirectExpenseSummaryEvents |
| Net Income Summary | 0 | NetIncomeSummary |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | 1 | CharityCarePolicy |
| Written Policy | 1 | WrittenPolicy |
| FPG Reference Free Care | 1 | FPGReferenceFreeCare |
| Pcent100 | X | Pcent100 |
| FPG Reference Discounted Care | 1 | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 150.000000000000 | 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 | 5250344 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 5250344 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04560 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 34417113 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 36492393 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -2075280 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 39667457 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 36492393 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3175064 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04560 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16358 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 16358 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 16358 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 16358 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00010 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 39683815 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 36492393 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 3191422 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.04570 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | 1 | BadDebtExpenseReported |
| Bad Debt Expense | $2,620,000 | BadDebtExpenseAmount |
| Amount Attributable To | 2451799 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 47018884 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 40468437 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 6550447 | 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 | Holy Cross Hospital | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2701 W 68TH Street | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60629 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Critical Access Hospital | X | CriticalAccessHospital |
| 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 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 1 | NumberOfOtherFacilities |
Other Facilities OtherFacilities
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Archer Clinic | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | at 6084 S Archer | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60638 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Type | OP clinic | FacilityType |
Form990 Schedule H Part VI Form990ScheduleHPartVI (10 entries)
| ExplanationExplanation | IdentifierIdentifier | Return ReferenceReturnReference |
|---|---|---|
| Part I, Line 7: A cost to charge ratio, calculated using the IRS worksheet, was used for the Part I, Line 7 table. | ||
| Part I, L7 Col(f): Bad debt expense of $9,860,018 was included on Form 990, Part IX, Line 25, column A but subtracted from the total expenses for purposes of calculating the percentage in this column. | ||
| Part III, Line 4: The collection of receivables from third-party payors and patients is the Hospital's primary source of cash for operations and is critical to its operating performance. The primary collection risks relate to uninsured patient accounts and patient accounts for which the primary insurance payor has paid, but patient responsibility amounts (deductibles and copayments) remain outstanding. Patient receivables, where a third-party payor is responsible for paying the amount, are carried at a net amount determined by the original charge for the service provided, less an estimate made for contractual adjustments or discounts provided to third-party payors. Patient receivables due directly from the patients are carried at the original charge for the service provided less amounts covered by third-party payors, discounts for patients that are uninsured and an estimated allowance for doubtful receivables. Management estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each payor type. Recoveries of receivables previously written off are recorded as a reduction of bad debt expense when received. Using the cost to charge ratio of 28.8%, the cost of bad debt is approximately $2,620,000. The past due status of receivables is determined on a case-by-case basis depending on the payor responsible. Interest is generally not charged on past due accounts. Prior to writing-off the amounts as bad debts expense, the Hospital's Patient Financial Services department reviews the self-pay balances. Where the patient has chosen not to cooperate with our charity care policy, the Hospital utilizes a program that accesses the patients' credit information and identifies patients that qualify for charity care under our policy. These reports show that over 90% of all uninsured patients and patients with a self-pay balance after insurance payment qualify for charity care. The estimated amount of bad debt expenses at cost attributable to patients eligible under the Hospital charity care policy is estimated to be $2,451,800. | ||
| Part III, Line 8: Medicare costs are allocated in accordance with Medicare regulations. | ||
| Part III, Line 9b: The Hospital's policy is to provide those who are indigent, as defined by Regionally Adjusted Federal Poverty Guidelines, with Charity Care or Partial Charity Care to relieve the financial burden associated with medically necessary treatment. The Hospital's policy establishes appropriate procedures for providing free care to qualified patients. It also serves to ensure compliance with all applicable federal, state, and local laws. The Financial Aid policies are available to all of the Hospital's indigent patients, who may be uninsured, underinsured or have suffered a catastrophic injury. The Hospital's Self-pay Debt Reduction Policy provides uninsured, underinsured, low-income and medically indigent patients with debt reduction provisions in order to alleviate the burdensome financial obligations associated with receiving acute and unexpected medical care. | ||
| Part VI, Line 2: The Hospital uses various methods to access the health care needs of the community it serves. Important information is gathered from the census updates, Illinois Department of Healthcare and Family Services, the Department of Public Health, Cook County Department of Public Health, City of Chicago Department of Public Health, University of Chicago Urban Health Initiatives, churches, community organizations and advocacy groups. Because of the Hospital's close relationship with leaders of the new communities program and the commissioner of the City of Chicago Department of Health, the Hospital was instrumental in establishing the Healthy Chicago Lawn advocacy coalition. The Hospital sponsors the Healthy Chicago Lawn administrative office and coalition mettings. The Hospital has served as the host site and primary health resource for the majority of Healthy Chicago Lawn Coalition's planning, education and advocacy initiatives. Healthy Chicago Lawn has promoted the development of many relational, educational and promotional health awareness activities in the Chicago Lawn community. As a result of the partnership and host status with Healthy Chicago Lawn, the Hospital has become more accessible to community groups and residents. There has been an increased awareness of the services provided by the Hospital as a result of these partnerships with community organizations. Leadership staff of the Hospital serve on the steering committee of Healthy Chicago Lawn.Since the inception of Healthy Chicago Lawn, there has been a positive and productive synergy between the Coalition and the Hospital to improve health awareness which has resulted in positive health outcomes in the communities served by the Hospital. The Hospital also assesses the needs of the community through the Parish Nurse program. Community Outreach nurse attend church meetings where information is received about the sick parishioners at home and in nursing homes. There are three large Catholic churches in the community that have a formal HCH Parish Nurse program. The Hospital has designated a nurse to service these churches. The nurse conducts blood pressure screenings and health assessments for 100 regular parishioners. New parishioners, who are uninsured, are assisted with referrals. Also, home visit arrangements are made for at risk seniors. The Hospital also has a volunteer team at churches to assist with health fairs and health education events, such as the MERCK Pharmaceuticals sponsored diabetes education program for the Latino community. Another source for assessing the health care needs of the community is through membership in community organizations. Community groups have requested that the Hospital's health care professionals join their boards and assist with the direction of their advocacy and policies. Unpaid Hospital staff have become members of board of these organizations, which has helped the Hospital identify the needs of the community and in turn communicate to the leadership of these organizations the resources the Hospital can provide to them. | ||
| Part VI, Line 3: The Hospital has posted in the Inpatient and Outpatient Admission areas and on its website the notice of its Charity Care Policies. This includes taking steps to ensure that Charity Care literature, Brochures and Applications Forms for Charity Care are readily accessible to patients at the Hospital's key locations. Notification of the availability of charity care is also printed on patient statements. Financial Counselors are located on campus that review the patient census for inpatient, outpatient and surgical areas to assist in-house patients identify the availability of potential insurance coverage and assist them with completing financial aid paperwork. At the earliest time feasible, HCH personnel obtains the necessary patient financial records and documentation regarding eligibility for any and all types of alternative funding to expedite processing of patient charity care applications. | ||
| Part VI, Line 4: The Hospital has a primary service area ("PSA") consisting of six ZIP code areas with a population of 451,000, and a secondary service area ("SSA") consisting of five additional ZIP code areas with a population of 271,000. The entire PSA/SSA is located in the City of Chicago. For the fiscal year ended 6/30/2011, 71% of the patients admitted to the Hospital were African American and 12% were Latino. Also only 13.2% of the patients admitted to the Hospital were covered by private health insurance, with 76.8% being covered through public sector programs (primarily Medicaid and Medicare). Approximately 6.3% of the Hospital's patients are classified as charity care. The Hospital's admissions are initiated to a very substantial extent (at least 72%) through the Hospital's Emergency Department. According to the Illinois Department of Public Health, the Hospital accepts more EMS transports than any other Hospital in Illinois - three times as many as John H. Stroger Hospital (formerly Cook County Hospital), the largest component of the health care services safety net for public sponsored health care in Chicago. As demonstrated by the insurance and admission status of its patient population, the Hospital has provided, and continues to provide necessary medical services to an underserved and underinsured community population that is heavily minority and poor. In fact, the PSA has experienced the second highest rate of foreclosures as compared to similar areas throughout the state. Finally, three of the zip codes in the PSA rank as the 1st, 2nd and 6th lowest average health status in all of Chicago. | ||
| Part VI, Line 6: Parish Nurse Program - Through the Hospital's Parish Nurse Program, the Hospital has dedicated a nurse to conduct blood pressure screenings and ongoing health assessments for approximately 100 regular parishioners. The nurse also attends church meetings where she receives information about the sick parishioners at home and in nursing homes. Arrangements are made to assist the sick parishioners. The hospital participates with seven catholic churches in conducting health education workshops and assist the uninsured with referrals.Senior Groups - There are approximately 30 senior groups that meet once a month for diagnostic testing, health assessments and health education. Most of these seniors are in their 80's and 90's and the Hospital assists them with having ongoing physician appointments and helping them with their medical needs.Vaccine for Children Program with CDPH - The Hospital works closely with grade school and high school nurses in the community. The purpose of this program is to assist children who are in need of recommended immunizations to remain in school. Vaccines are administered during school hours. Most of these children are on Medicaid or have no insurance. The vaccines are obtained from CDPH and the parents are not charged for administering the vaccines. The Hospital also documents in the state I CARE REGISTRY all immunizations given and assists the school nurses with medical immunizations by verifying the student's immunizations found in the state system.Community Health Fairs - The Hospital's representatives attend community group events and fairs. The Hospital provides free health screenings and health education materials at these events. On average, there are approximately 45 events per year.Influenza Program - The Hospital was involved in flu immunizations for the community during the year. These flu shots were administered at senior group meetings, churches and health fairs for community groups.Hospital Referrals for At Risk Seniors - Under this program, in certain situations, the Hospital's health care professional will make a home visit to asses an at risk senior's living situation after discharge from the Hospital.Participation in Community Health Speakers Bureau - The Hospital's health care professional participate in promoting healthy lifestyles by volunteering to be speakers whenever Community and civic groups ask for assistance in having a speaker for their events. | ||
| IL | Reports Filed With States | Part VI, Line 7 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | X | ClubDuesOrFees |
| Written Policy Re T And E Expenses | 1 | WrittenPolicyReTAndEExpenses |
| Substantiation Required | 1 | SubstantiationRequired |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Wayne Lerner | |||||||||||||
| 489001 | 0 | 20000 | 0 | 0 | 0 | 2450 | 0 | 9416 | 0 | 520867 | 0 | 0 | 0 |
| Nancy Streitmatter MD | |||||||||||||
| 150010 | 0 | 0 | 0 | 0 | 0 | 1500 | 0 | 4369 | 0 | 155879 | 0 | 0 | 0 |
| Michael Lawrence | |||||||||||||
| 274996 | 0 | 55000 | 0 | 0 | 0 | 2450 | 0 | 6191 | 0 | 338637 | 0 | 0 | 0 |
| Paul Teodo | |||||||||||||
| 209996 | 0 | 10500 | 0 | 0 | 0 | 2100 | 0 | 4425 | 0 | 227021 | 0 | 0 | 0 |
| Shelia Mischke | |||||||||||||
| 184995 | 0 | 8750 | 0 | 0 | 0 | 1850 | 0 | 4361 | 0 | 199956 | 0 | 0 | 0 |
| Dennis Ryan | |||||||||||||
| 150009 | 0 | 19800 | 0 | 0 | 0 | 1500 | 0 | 4271 | 0 | 175580 | 0 | 0 | 0 |
| Cathy Kallal | |||||||||||||
| 260000 | 0 | 15000 | 0 | 0 | 0 | 2600 | 0 | 1353 | 0 | 278953 | 0 | 0 | 0 |
| Sr Juline Revas | |||||||||||||
| 139813 | 0 | 6700 | 0 | 0 | 0 | 0 | 0 | 4230 | 0 | 150743 | 0 | 0 | 0 |
| Anna Carvalho | |||||||||||||
| 141317 | 0 | 6500 | 0 | 0 | 0 | 1413 | 0 | 1063 | 0 | 150293 | 0 | 0 | 0 |
| Solomon Greer MD | |||||||||||||
| 240529 | 0 | 0 | 0 | 0 | 0 | 2405 | 0 | 4601 | 0 | 247535 | 0 | 0 | 0 |
| Kenneth Pelehac | |||||||||||||
| 180192 | 0 | 0 | 0 | 0 | 0 | 1802 | 0 | 4446 | 0 | 186440 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | Part I, Line 1a | ReturnReference |
| Explanation | HCH pays for the social club dues of Wayne Lerner. The social club is used for hospital business and the expense is not included in his compensation. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | ExplanationExplanation | Return ReferenceReturnReference |
|---|---|---|
| Form 990, Part VI, Section A, line 6 | The members of the Hospital are the General Superior and the members of the General Council of The Sisters of Saint Casimir. | |
| Form 990, Part VI, Section A, line 7a | The members of the Hospital have the exclusive power to appoint and remove, with or without cause, the Trustees of the Hospital and establish terms for such Trustees consistent with these Bylaws; and to remove the Officers of the Hospital. | |
| Form 990, Part VI, Section A, line 7b | The Members have the exclusive power to: (a) Adopt, alter, amend and repeal statements of mission, philosophy or purpose; (b) Amend or repeal the Bylaws or Articles of Incorporation of the Hospital and to adopt new Bylaws or Articles of Incorporation of the Hospital; (c) Select auditors and legal counsel different from those retained by the Hospital. To provide independent review, counsel, audit, advice or representation to the extent deemed necessary in the discretion of the Members; (d) Acquire and/or dispose of, mortgage or otherwise encumber or hypothecate the Hospital's real property; and (e) Reserve the exercise of such rights as the Members deem necessary to ensure consistency with the mission and philosophy of the Sisters of Saint Casimir, or to comply with applicable law (civil or church). | |
| Form 990, Part VI, Section B, line 11 | The Form 990 is prepared by our tax advisors based on information provided by HCH's accounting department. The Form 990 is reviewed by the Controller and the CFO. | |
| Conflict of Interest statements are completed by members of the Board and senior management each year. The Executive Committee follows up on any conflict of interest which is brought to its attention whether from an executive, an employee or a Board member. They would investigate and decide on an action plan which could either resolve the conflict or assure that it would not interfere with the operations of the Hospital. At the present time, no members of the Board or senior management team have any involvement with the hospital which could be seen as a conflict of interest. | Form 990, Part VI, Section B, line 12c | |
| The Executive Committee acts as the Compensation Committee of the Board. Their actions are documented in committee minutes in the customary fashion. They act on all recommendations for changes in compensation as presented by the President/CEO. | Form 990, Part VI, Section B, line 15 | |
| Copies of all governing documents (except those relating to executive sessions) are available upon request. Individuals should make inquiries through the Office of the President/CEO. Once requested and upon the approval of the Board Chair, documents would be made available for review. | Form 990, Part VI, Section C, line 19 | |
| Changes in Net Assets or Fund Balances: | Net unrealized losses on investments: -26,027. Change in Minimum Pension Liability 13,699,515. Temporarily Restricted Contributions -136,133. Total to Form 990, Part XI, Line 5: 13,537,355. | Form 990, Part XI, line 5: |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Sisters of St Casimir | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2601 W Marquette Rd | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60629 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362170966 | EIN |
| Primary Activities | Religious order | PrimaryActivities |
| Legal Domicile State | IL | LegalDomicileState |
| Exempt Code Section | 501(c)(3) | ExemptCodeSection |
| Public Charity Status | 1 | PublicCharityStatus |
| Direct Controlling Entity NA | N/A | DirectControllingEntityNA |
| Controlled Org | 0 | ControlledOrg |
Form990 Schedule R Part IV Form990ScheduleRPartIV
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Holy Cross Health Partners Inc | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2701 West 68TH Streer | AddressLine1 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 60629 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364109153 | EIN |
| Primary Activity | CONTRACTING AND CLAIMS ADMINISTRATION | PrimaryActivity |
| Legal Domicile State | IL | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOLY CROSS HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Type Of Entity | C | TypeOfEntity |
| Share Of EOY Assets | 1226773 | ShareOfEOYAssets |
| Percentage Ownership | 1.00000 | PercentageOwnership |
| 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 | 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 | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 1 | 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 | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| Holy Cross Health Partners Inc | ||
| K | 778380 | FMV |
| Holy Cross Health Partners Inc | ||
| P | 72000 | FMV |
| Holy Cross Health Partners Inc | ||
| C | 300000 | FMV |
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