Little Company of Mary Hospital Inc: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
Little Company of Mary Hospital Inc (EIN 36-2246719)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-15
IRS object ID
201221369349303922
Schema version
2010v3.7
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

FieldValueIRS element (for citing)
Timestamp2012-05-15T12:40:37-05:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 2600AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362246719EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Little Company of Mary Hospital IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlLITTNameControl
Phone7082295111Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12800 W 95th StreetAddressLine1
CityEvergreen ParkCity
StateILState
ZIP Code60805ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRANDY RUTHERName
TitleCHIEF FINANCIAL OFFICERTitle
Date Signed2012-05-14DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817440Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRandy RutherNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12800 W 95th StreetAddressLine1
CityEvergreen ParkCity
StateILState
ZIP Code60805ZIPCode
FieldValueIRS element (for citing)
Gross Receipts240311751GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.lcmh.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1893YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionIN SOLIDARITY WITH THE SISTERS OF THE LITTLE COMPANY OF MARY, WE ARE ENTRUSTED TO SERVE THE COMMUNITY THROUGH OUR MINISTRY OF CATHOLIC HEALTH CARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body17NbrVotingMembersGoverningBody
Nbr Independent Voting Members15NbrIndependentVotingMembers
Total Nbr Employees2248TotalNbrEmployees
Total Nbr Volunteers600TotalNbrVolunteers
Total Gross UBI4TotalGrossUBI
Contributions Grants Prior Year2240144ContributionsGrantsPriorYear
Contributions Grants Current Year910757ContributionsGrantsCurrentYear
Program Service Revenue Prior Year189793186ProgramServiceRevenuePriorYear
Program Service Revenue CY184869458ProgramServiceRevenueCY
Investment Income Prior Year18819186InvestmentIncomePriorYear
Investment Income Current Year51441933InvestmentIncomeCurrentYear
Other Revenue Prior Year2945298OtherRevenuePriorYear
Other Revenue Current Year2901145OtherRevenueCurrentYear
Total Revenue Prior Year213797814TotalRevenuePriorYear
Total Revenue Current Year240123293TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year101317GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY170000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year96927501SalariesEtcPriorYear
Salaries Etc Current Year99981519SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year92103458OtherExpensePriorYear
Other Expenses Current Year93079205OtherExpensesCurrentYear
Total Expenses Prior Year189132276TotalExpensesPriorYear
Total Expenses Current Year193230724TotalExpensesCurrentYear
Revenues Less Expenses Prior Year24665538RevenuesLessExpensesPriorYear
Revenues Less Expenses CY46892569RevenuesLessExpensesCY
Total Assets BOY656684135TotalAssetsBOY
Total Assets EOY790236572TotalAssetsEOY
Total Liabilities BOY313442168TotalLiabilitiesBOY
Total Liabilities EOY355664717TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY343241967NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY434571855NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionIN SOLIDARITY WITH THE SISTERS OF THE LITTLE COMPANY OF MARY, WE ARE ENTRUSTED TO SERVE THE COMMUNITY THROUGH OUR MINISTRY OF CATHOLIC HEALTH CARE. WE ARE THE EMPOWERED LAITY - THE GREATER COMPANY OF MARY. ROOTED IN A DEEP HERITAGE OF PRAYERFUL SUPPORT OF THE SICK AND DYING, WE STRIVE TO ENHANCE THE SACREDNESS OF LIFE AND HUMAN DIGNITY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense143440580Expense
Grants170000Grants
Revenue187618787Revenue
DescriptionProvide care and treatment to the sick, to provide spiritual, religious and other health care services and charitable purposes to the community it services.Description

Activity2 Activity2

FieldValueIRS element (for citing)
DescriptionDonated services in the amount of $773,703 were received. The donated services are not included in the $143,468,870 program service expense.Description
FieldValueIRS element (for citing)
Total Program Service Expense143440580TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmttrueConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitaltrueHospital
Financial Stmt AttachedtrueFinancialStmtAttached
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualstrueGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondstrueTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MembertrueBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntitytrueDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096206NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees2248NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members17NbrVotingGoverningBodyMembers
Number Independent Voting Members15NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodyfalseForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLCOM Hospital - Finance DeptNamePerson
Telephone Number7082295100TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12800 W 95th StreetAddressLine1
CityEvergreen ParkCity
StateILState
ZIP Code60805ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (29 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Sister Kathleen McIntyre LCM
Chairperson1.0X000
Thomas M Fahey
Vice Chairperson1.0X000
Dennis Reilly
President & CEO40.0X760950020774X
Dennis Kelly
Treasurer1.0X000
Sister Jean Stickney LCM
Secretary1.0X000
Violet M Clark
Director1.0X000
Brian P Farrell MD
Director1.0X000
Patrick Folliard
Director1.0X000
John P Hanlon MD
Director1.0X000
Jayanthi Ramadurai MD
Director1.0X000
Janice Stewart
Director1.0X000
Jay B Sterns
Director1.0X000
Sister Sharon Ann Walsh LCM
Director1.0X000
Joseph Pedota
Director1.0X000
Daniel Rowan DO
Director1.0X7682500
Robert Sheehy
Director1.0X000
Michael Thomas DO
President of Medical Staff1.0X000
Randy Ruther
Chief Financial Officer40.0466269020774X
Mary Freyer
COO40.030436500X
Dennis Day
V.P. Support Services40.021325000X
Jane Sullivan
V.P. of Care Services/CNO40.020102600X
Kevin Rehder
V.P. Clinical Svs & Facilities40.019132500X
Kent Armbruster MD
Vice President Medical Affairs40.025772000X
Ann Haskins
V.P. Phy & Ambulatory Network40.027810105737X
Emuata Ufok Bassey MD
OB Hospitalist40.023211200X
Colleen Rohan
Director of Human Resources40.015322700X
Manuel Orlanzino
Physicist40.014230300X
Vincent Cesaro
Dir of Physical/Occup Therapy40.012311100X
Mary Ryan Gallik
Director of Patient Care40.012134200X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3521926TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation47285TotalOtherCompensation
Number Individuals GT100 K43NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
SIGNATURE HEALTHCARE SOLUTIONS SC
47 W DIVISION STREET SUITE 269CHICAGOIL60610PHYSICIAN SERVICES1453429
MAYO MEDICAL LABORATORIES
PO BOX 9146MINNEAPOLISMN554809146MEDICAL SERVICES808824
ANDERSON RASOR PARTNERS
55 EAST MONROE SUITE 3650CHICAGOIL60603LEGAL SERVICES541675
EVERGREEN EMERGENCY SERVICES
PO BOX 428080EVERGREEN PARKIL60805MEDICAL SERVICES525600
DANIEL DUFFYJOHN KRALOVEC ASSOCI
60 W RANDOLPHCHICAGOIL60601MALPRACT SETTLEMENT500000
FieldValueIRS element (for citing)
Number Of Contractors GT100 K24NumberOfContractorsGT100K
Related Organizations543208RelatedOrganizations
All Other Contributions367549AllOtherContributions
Total Contributions910757TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICES900099181519753181519753
OTHER PROG SERVICES90009915487901548790
FOOD SERVICE REVENUE900099708123708123
RELATED SUPPLY SERVICES90009910292611029261
ADULT DAY CARE9000996353163531
FieldValueIRS element (for citing)
Total Program Service Revenue184869458TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column13895903TotalRevenueColumn
Unrelated Business Revenue4UnrelatedBusinessRevenue
Exclusion$13,895,899ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real309824Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real188458Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real121366Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column121366TotalRevenueColumn
Exclusion$121,366ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities37153199Securities
Other392831Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities37153199Securities
Other392831Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column37546030TotalRevenueColumn
Exclusion$37,546,030ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
SELF INSURANCE90009927492592749259
MISCELLANEOUS90009915188$15,188
VENDING90009915332$15,332
FieldValueIRS element (for citing)
Total Other Revenue2779779TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column240123293TotalRevenueColumn
Related Or Exempt Function Income187618717RelatedOrExemptFunctionIncome
Unrelated Business Revenue4UnrelatedBusinessRevenue
Exclusion$51,593,815ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total170000Total
Program Services170000ProgramServices

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1141422Total
Program Services1141422ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total94301Total
Program Services66011ProgramServices
Management And General28290ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total79308158Total
Program Services55144994ProgramServices
Management And General24163164ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total4597089Total
Program Services3217962ProgramServices
Management And General1379127ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7758426Total
Program Services5430898ProgramServices
Management And General2327528ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total7082123Total
Program Services4957486ProgramServices
Management And General2124637ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total10968Total
Program Services8774ProgramServices
Management And General2194ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total140266Total
Program Services126239ProgramServices
Management And General14027ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total135000Total
Program Services121500ProgramServices
Management And General13500ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total11030027Total
Program Services8824022ProgramServices
Management And General2206005ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total545201Total
Program Services436161ProgramServices
Management And General109040ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total33635154Total
Program Services26908123ProgramServices
Management And General6727031ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1145948Total
Program Services916758ProgramServices
Management And General229190ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total3078560Total
Program Services2308920ProgramServices
Management And General769640ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total114706Total
Program Services57353ProgramServices
Management And General57353ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total113056Total
Program Services79139ProgramServices
Management And General33917ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total3638022Total
Program Services3274220ProgramServices
Management And General363802ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total11502566Total
Program Services8051796ProgramServices
Management And General3450770ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total10329606Total
Program Services7230724ProgramServices
Management And General3098882ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
STATE MEDICARE FUND82521408252140
PROVISION FOR BAD DEBTS739231251746182217694
LINENS15308781377790153088
SPECIAL EVENTS262966262966
EMPLOYEE AWARDS1377369641541321

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total84093Total
Program Services67115ProgramServices
Management And General16978ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total193230724Total
Program Services143440580ProgramServices
Management And General49790144ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY21592511BOY
EOY5798053EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY24966511BOY
EOY22538502EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY375487BOY
EOY231193EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1198468BOY
EOY1131012EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY2921383BOY
EOY12576480EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis283116716LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec179814138LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY91676155BOY
EOY103302578EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY498501381BOY
EOY627873102EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY10441171BOY
EOY11642318EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY5011068BOY
EOY5143334EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY656684135BOY
EOY790236572EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY31181006BOY
EOY31273022EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY127925000BOY
EOY195539557EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY154336162BOY
EOY128852138EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY313442168BOY
EOY355664717EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY342662879BOY
EOY433699301EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY579088BOY
EOY872554EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY343241967BOY
EOY434571855EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY656684135BOY
EOY790236572EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses46892569ReconcilationRevenueExpenses
Reconcilation Other Changes44437319ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmtsArtPublicExhibitionAmts
Held Works Of Art AmtsHeldWorksOfArtAmts

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis8954323InvestmentCostOrOtherBasis
Book Value8954323BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis145077189InvestmentCostOrOtherBasis
Depreciation104923009Depreciation
Book Value40154180BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis9343739InvestmentCostOrOtherBasis
Depreciation4772179Depreciation
Book Value4571560BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis90651447InvestmentCostOrOtherBasis
Depreciation70118950Depreciation
Book Value20532497BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis29090018InvestmentCostOrOtherBasis
Book Value29090018BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings103302578TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
SELF INSURANCE RESERVE$86,744,282
EST SETTLEMENTS DUE TO 3RD PARTY$42,107,856
FieldValueIRS element (for citing)
Total Of Amounts128852138TotalOfAmounts

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage600.DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically IndigenttrueFreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity CaretrueAmountsBudgetedForCharityCare
Expenses Exceeded BudgettrueExpensesExceededBudget
Unable To Provide CarefalseUnableToProvideCare
Annual Community Benefit ReporttrueAnnualCommunityBenefitReport
Report Publically AvailabletrueReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense5528296TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense5528296NetCommunityBenefitExpense
Percent Of Total Expense0.02970PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense21087851TotalCommunityBenefitExpense
Direct Offsetting Revenue14187472DirectOffsettingRevenue
Net Community Benefit Expense6900379NetCommunityBenefitExpense
Percent Of Total Expense0.03710PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense26616147TotalCommunityBenefitExpense
Direct Offsetting Revenue14187472DirectOffsettingRevenue
Net Community Benefit Expense12428675NetCommunityBenefitExpense
Percent Of Total Expense0.06680PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1692971TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1692971NetCommunityBenefitExpense
Percent Of Total Expense0.00910PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1692971TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense1692971NetCommunityBenefitExpense
Percent Of Total Expense0.00910PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense28309118TotalCommunityBenefitExpense
Direct Offsetting Revenue14187472DirectOffsettingRevenue
Net Community Benefit Expense14121646NetCommunityBenefitExpense
Percent Of Total Expense0.07590PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$1,596,998BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare74465820AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare80310489CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-5844669MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1LITTLE COMPANY OF MARY HOSPITALBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12800 W 95TH STREETAddressLine1
CityEVERGREEN PARKCity
StateILState
ZIP Code60805ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1LITTLE COMPANY OF MARY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities3NumberOfOtherFacilities

Other Facilities OtherFacilities (3 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
HOME CARE & HOSPICE BUILDING
9800 S SOUTHWEST HIGHWAYOAK LAWNIL60453HOME CARE & HOSPICE
HALSTED BUILDING
736 W 95TH STREETCHICAGOIL60628HEALTHCARE
HERITAGE BUILDING
2800 W 87 STREETCHICAGOIL60652HEALTHCARE

Form990 Schedule H Part VI Form990ScheduleHPartVI (14 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
PART I, LINE 3C:THE ORGANIZATION USES FEDERAL POVERTY GUIDELINES, AS DESCRIBED ON SCHEDULE H, PART I, TO DETERMINE ELIGIBILITY FOR FREE OR DISCOUNTED CARE.
PART I, LINE 6A:THE ORGANIZATION'S COMMUNITY BENEFIT REPORT IS PREPARED IN A SEPARATE REPORT PREPARED BY THE ORGANIZATION.
PART I, LINE 7:The organization used the same Medicare Cost to Charge Ratio as was used in fiscal year 06/30/10 on the Medicare Cost Report (Worksheet C, Part l).
PART I, LINE 7G:THE ORGANIZATION DID NOT INCLUDE AS SUBSIDIZED HEALTH SERVICES ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC.
PART I, LINE 7, COLUMN F:The amount of bad debt expense included on form 990 Part IX line 25 column A, and subtracted in calculating community benefit percentage on column F of schedule H part I, is 7,392,312.
PART III, LINE 4:The Hospital evaluates the collectability of its account receivable based on the length of time the receivable is outstanding, payor class, and the anticipated future uncollectible amounts based on historical experience. Accounts receivable are charged to the allowance for doubtful accounts when the accounts are deemed uncollectible. The Hospital's concentration of credit risk related to accounts receivable is limited due to the diversity of patients and payors. Methodology used to calculate bad debt at cost is the Medicare cost to charge ratio.
PART III, LINE 8:The organization used the same Medicare Cost to Charge Ratio as was used in fiscal year 06/30/10 on the Medicare Cost Report (Worksheet C, Part l).
PART III, LINE 9B:For patients who are classified as uninsured, the financial counselor will complete a Financial Evaluation Worksheet to determine if the patient qualifies for a government assistance program. If not, the counselor will ascertain whether the patient is eligible under the Hospital's Charity Care policy. Also, for insured patients there will be no collection agency referral if the patient has requested a reasonable payment plan or requested financial assistance and is eligible under the Hospital's Charity policy.
PART V:THE ORGANIZATION HAS NO HEALTH CARE FACILITIES ASIDE FROM THAT WHICH IS LICENSED AS A HEALTH CARE FACILITY UNDER STATE LAW.
NEEDS ASSESSMENT:The Hospital gathers information on the community's health needs from many sources including the following: 1) Internal Records - a reliable source of timely information about what services are used by our community. Information is compiled and analyzed on many levels including by major diagnostic category and diagnostic related group to track changes in the community's utilizaztion of health services. 2) Patient Surveys - results are reviewed and program, screening and health lectures are added and modified based on this feedback from the community. 3) External data - the Hospital engages outside studies of services used by the community. 4) Physican Input - physicans are periodically surveyed to assess the health care services needed by their patients. In addition to surveys physician input is gathered through the Medical Executive Committee and departmental meetings. Physicians also serve on the Hospital's Board of Directors, Strategic Planning Committee, Mission Committee and Performance Improvement Council.
PATIENT EDUCATION OF ELIGIBILITY FOR ASSISTANCE:At registration, patient's employment status or lack of basic insurance coverage will prompt the staff to offer a charity application. Notice of this charity assistance policy is posted in locations visible to the public including the Emergency Department, admission areas and the business office. Notices are available in general patient brochures, on the Hospital's website and on patient billing statements on how to apply for charity consideration.
COMMUNITY INFORMATION:The Hospital is located in Evergreen Park, Illinois and is just twenty minutes from downtown Chicago. The Hospital's primary service areas include many Chicago neighborhoods as well as the suburban communities of Oak Lawn and Hometown. Data was complied by analysis of inpatient and outpatient discharges by zip code.
PROMOTION OF COMMUNITY HEALTH:The Hospital currently has well over 60 separate programs ranging from wellness events, health screening, senior billing assistance, Mobile Medical bring home visits by our staff physicians and nurses, Diabetes Center and sponsorships/partnering or support services to local elementary/high schools, church parishes and local community service organizations. AFFILIATED HEALTH CARE SYSTEM ROLES: N/A
STATE FILING OF COMMUNITY BENEFIT REPORTIL,990 SCHEDULE H, PART VI

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Form990 Schedule I Part III Form990ScheduleIPartIII

FieldValueIRS element (for citing)
Type Of GrantSCHOOL TUITIONTypeOfGrant
Number Of Recipients22NumberOfRecipients
Amount Of Cash Grant170000AmountOfCashGrant

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierForm 990, Schedule IIdentifier
Return ReferenceDescription of Organization's Procedures for Monitoring the Use of GrantsReturnReference
ExplanationHOSPITAL MONITORS USE OF GRANTS IN SCHOLARSHIPS BY FOLLOWING ITS POLICY. THE DIRECTOR OF HUMAN RESOURCES MAKES SURE THAT EACH SCHOLARSHIP RECIPIENT ADHERES TO THE POLICY AND THE AGREEMENT THAT EACH RECIPIENT SIGNED. ANY DEVIATION RESULTS IN THE RECIPIENT HAVING TO REPAY TO THE HOSPITAL THE GRANT GIVEN.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Travel For CompanionsXTravelForCompanions
Written Policy Re T And E ExpensestrueWrittenPolicyReTAndEExpenses
Substantiation RequiredtrueSubstantiationRequired
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (10 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Dennis Reilly
525950023500000000207740781724000
Dennis Day
1919780212720000000213250000
Randy Ruther
363769010250000000207740487043000
Jane Sullivan
1802790207470000000201026000
Kevin Rehder
1613250300000000000191325000
Kent Armbruster MD
2427200150000000000257720000
Mary Freyer
2593650450000000000304365000
Ann Haskins
2256610524400000057370283838000
Emuata Ufok Bassey MD
2081120240000000000232112000
Colleen Rohan
1354740177530000000153227000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
Return ReferenceSchedule J, Part III, LINE 1AReturnReference
ExplanationTRAVEL WITH SPOUSE OR FAMILY: IF OTHER PERSONS ACCOMPANY AN EMPLOYEE OR BOARD MEMBER ON HOSPITAL BUSINESS, THE HOSPITAL WILL PAY THE COST FOR THE EMPLOYEE OR BOARD MEMBER ONLY UNLESS APPROVED IN ADVANCE BY THE CEO. ANY COST INCURRED AS A RESULT OF EXTENDING A TRIP FOR PERSONAL REASONS WILL BE THE RESPONSIBILITY OF THE EMPLOYEE OR BOARD MEMBER. ANY ADDITIONAL COST INCURRED BY A COMPANION THAT HAS BEEN PAID BY THE HOSPITAL WILL BE REPORTED ON IRS FORM 1099 AS TAXABLE INCOME OF THE COMPANION.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Illinois Finance Authority
86109196745200ffv62008-04-29134340000See Part Vfalsefalsefalse
Illinois Finance Authority
86109196745200F6D62010-10-2071159646See Part Vfalsefalsefalse

Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)

Total ProceedsTotalProceedsIssuance Costs From ProceedsIssuanceCostsFromProceedsCredit EnhancementCreditEnhancementCapital ExpendituresCapitalExpendituresOther Spent ProceedsOtherSpentProceedsYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind
13448363370449225000137300971200240442008truefalsetruetrue
71229134618241706108932010falsefalsetruetrue

Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPrcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthersPercentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBITotal Private Business UseTotalPrivateBusinessUsePost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
falsetruetruefalsefalse0.000000.000000.00000true
falsefalsefalsefalsefalse0.000000.000000.00000true

Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
falsetruefalsefalsefalsetrue
falsefalsefalsefalsefalsefalse

Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of PurposeForm 990, Schedule K, Part I, Column (f)BOND A: THE 4/29/2008 BONDS Were USED to (i) REFINANCE A BANK LOAN; (ii) REIMBURSE THE HOSPITAL FOR CAPITAL EXPENDITURES; AND (iii) PAY EXPENSES INCURRED WITH THE ISSUANCE OF THE BONDS AND CREDIT ENHANCEMENTS. ON MARCH 13, 2008 THE HOSPITAL ENTERED INTO A REVOLVING CREDIT AGREEMENT WITH JP MORGAN CHASE BANk AND APPLIED THE PROCEEDS OF THE TERM LOAN ADVANCED THEREUNDER TO CURRENTLY REFUND THE SERIES 1997B BONDS, ISSUED 11/20/1997, ON MARCH 13, 2008 AND THE SERIES 2007 BONDS, ISSUED 8/16/2007 ON APRIL 1, 2008. PROCEEDS OF $120,024,044 FROM THE BONDS WERE USED TO REFUND THE BANK LOAN. BOND B: THE PROCEEDS OF THE SERIES 2010 BONDS, WERE USED TO (I) CONSTRUCT AND EQUIP A NEW, APPROXIMATELY 295,000 SQUARE FOOT PAVILION (II) MODERNIZE 40,000 SQUARE FEET IN THE CORPORATION'S TWO OLDEST BUILDINGS THAT PROVIDE PATIENT CARE (BUILT IN 1956 AND 1984, AND (III) FOLLOWING COMPLETION OF THE DEMOLITION OF THE TOWER BUILDING, BUILD-OUT A STRUCTURAL LINK BETWEEN THE NORTH PAVILION AND THE WEST PAVILION, AND CONSTRUCT AND LANDSCAPE THE EAST ENTRY OF THE WEST PAVILION. THE PROJECT ALSO INCLUDES THE CONSTRUCTION OF THE AREA'S FIRST COMPREHENSIVE WOMEN'S HEALTH CENTER (THE WOMEN'S CENTER FOR LIFE AND HEALTH).
TOTAL PROCEEDS OF ISSUEForm 990, Schedule K, Part II, Line 3BOND A: THE TOTAL PROCEEDS OF ISSUE INCLUDE $143,633 OF INVESTMENT EARNINGS. BOND B: THE TOTAL PROCEEDS OF ISSUE INCLUDE $$69,488 OF INVESTMENT EARNINGS.

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Mary Coners
FAMILY MEM DENNIS REILLY57186EMPLOYMENTfalse
Elizebeth Freyer
FAMILY MEM MARY FREYER37115EMPLOYMENTfalse

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Description of Classes of Members or StockholdersForm 990, Part VI, Question 6THE AMERICAN PROVINCE OF THE LITTLE COMPANY MARY SISTERS IS AN ILLINOIS NOT-FOR-PROFIT CORPORATION WHOSE PURPOSE IS TO REPRESENT THE INTEREST OF THE CONGREGATION OF LITTLE COMPANY OF MARY SISTERS. THE AMERICAN PROVINCE CONSTITUTES THE CORPORATE MEMBER OF LITTLE COMPANY OF MARY HOSPITAL, AND RETAINS RESERVED POWERS TO APPROVE, AMONG OTHER THINGS, THE HOSPITAL'S ANNUAL BUDGET, ELECTION OF DIRECTORS, AND THE INCURRENCE OF DEBT OR TRANSFER OF PROPERTY IN EXCESS OF CERTAIN LIMITS. Description of Classes of Persons and the Nature of Their Rights Form 990, Part VI, Question 7a AMERICAN PROVINCE OF LITTLE COMPANY OF MARY SISTERS 9350 S. CALIFORNIA AVENUE EVERGREEN PARK, IL 60805 Descr Classes of Persons, Decisions Requiring Appr & Type of Voting Rights Form 990, Part VI, Question 7b 1 EY ENGAGEMENT FOR AUDIT AND TAX SERVICES AUDITED FINANCIAL STATEMENTS 2 NEW APPOINTMENTS TO THE BOARD OF DIRECTORS 3 ANNUAL REAPPOINTMENT OF OFFICERS TO THE BOARD 4 OPERATING AND CAPITAL BUDGETS 5 RESOLUTIONS AUTHORIZING ISSUANCE OF BONDS REVISIONS TO LITTLE COMPANY OF MARY HOSPITAL BYLAWS 6 SALE OF PROPERTY Describe the Process used by Management &/or Governing Body to Review Form 990 Form 990, Part VI, Question 11 THE 990 FORM RETURN IS REVIEWED BY THE ACCOUNTING MANAGER AND CFO.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cEACH DIRECTOR, PRINCIPAL OFFICER AND MEMBERS OF A COMMITTEE WITH BOARD DELEGATED POWERS SHALL ANNUALLY SIGN A CONFLICT OF INTEREST STATEMENT WHICH AFFIRMS THAT SUCH PERSON: 1) HAS RECEIVED A COPY OF THE CONFLICT OF INTEREST DIRECTIVE 2) HAS READ AND UNDERSTANDS THE DIRECTIVE 3) HAS AGREED TO COMPLY WITH THE DIRECTIVE 4) UNDERSTANDS THAT THE CORPORATION IS A CHARITABLE ORGANIZATION AND THAT IN ORDER TO MAINTAIN ITS FEDERAL TAX EXEMPTION, IT MUST ENGAGE PRIMARILY IN ACTIVITIES WHICH ACCOMPLISH ONE OR MORE OF ITS TAX EXEMPT PURPOSES. 5) ONE HUNDRED PERCENT RESPONSE IS MANDATORY. ALL CONFLICT OF INTEREST STATEMENTS ARE REVIEWED ANNUALLY BY THE CEO AND THE CORPORATE COMPLIANCE OFFICER AND THE RESULTS PRESENTED TO THE CORPORATE COMPLIANCE COMMITTEE. THE RESULTS AND ANY RECOMMENDATIONS ARE REPORTED AT THE NEXT BOARD OF DIRECTORS' MEETING. IF THE BOARD OR COMMITTEE HAS REASONABLE CAUSE TO BELIEVE THAT A MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM THE MEMBER OF THE BASIS FOR SUCH BELIEF AND AFFORD THE MEMBER AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF THE MEMBER AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD OR COMMITTEE DETERMINES THAT THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT TAKES APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION INCLUDING REMOVAL FROM OFFICE IF SO DETERMINED BY THE BOARD.
Offices & Positions for Which Process was Used, & Year Process was BegunForm 990, Part VI, Questions 15a & 15bTHE BOARD EXECUTIVE COMMITTEE ANNUALLY REVIEWS EXTERNAL BENCHMARK COMPENSATION DRAFTS AND DETERMINES COMPENSATION ADJUSTMENTS BASED ON MARKET DATA AND INTERNAL PERFORMANCE RESULTS FOR THE CEO, CFO, AND COO POSITIONS. THE ORGANIZATION ALSO USES AN OUTSIDE CONSULTANT TO DETERMINE APPROPRIATENESS OF EXECUTIVE PAY.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19THE CONFLICT OF INTEREST POLICY IS AVAILABLE BY REQUEST. FORMS 990 ARE IN THE PUBLIC DOMAIN AND COPIES ARE AVAILABLE BY REQUEST. Other Changes in net assets or fund balances Form 990, Part IX, Question 5 Unrealized gain on investment 24,645,037 Net asset transfer 350,000 Pension related charges other than periodic pension cost 20,049,890 Net assets released from restrictions (607,608) ----------- Total 44,437,319

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (4 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Direct Controlling Entity NADirectControllingEntityNA
LITTLE CO OF MARY HEALTH SYS-EVERGREEN
2800 WEST 95TH STREETEVERGREEN PARKIL60805363823627HEALTH SVCSIL501(c)(3)1Am Province
LITTLE COMPANY OF MARY AFFILIATED SVCS
2800 WEST 95TH STREETEVERGREEN PARKIL60805363383867HEALTH SVCSIL501(C)(3)7LCOM EVGR PK
LITTLE CO OF MARY HOSPITAL FOUNDATION
2800 WEST 95TH STREETEVERGREEN PARKIL60805363993337SUPPORT ORGIL501(c)(3)11 TYPE 1LCOM HOSP
AM PROVINCE OF THE LITTLE CO OF MARY
2800 WEST 95TH STREETEVERGREEN PARKIL60805237294648RELIGIOUSIL501(c)(3)1N/A

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1DURABLE MEDICAL EQUIPMENTBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12800 WEST 9TH STAddressLine1
CityEVERGREEN PARKCity
StateILState
ZIP Code60805ZIPCode
FieldValueIRS element (for citing)
EIN363511877EIN
Primary ActivityDURABLE GOODPrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1LITTLE CO MARYBusinessNameLine1
FieldValueIRS element (for citing)
Predominant Income TypeExcludedPredominantIncomeType
Share Of Total Income1221646ShareOfTotalIncome
Share Of EOY Assets1072329ShareOfEOYAssets
Disproportionate AllocationsfalseDisproportionateAllocations
Code V$4CodeVAmount
General Or Managing PartnertrueGeneralOrManagingPartner
Percentage Ownership0.99500PercentageOwnership

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityShare Of Total IncomeShareOfTotalIncomeShare Of EOY AssetsShareOfEOYAssetsPercentage OwnershipPercentageOwnership
Little Company of Mary Health Providers
2800 WEST 95TH STREETEVERGREEN PARKIL60805363425870MANAGED CAREILLCOM HOSPC CORP-1443921256711.00000
Little Company of Mary Captive Insurance
76 St Paul Street Suite 500BurlingtonVA05401030304812captive insuranceILLCOM HOSPC Corp0593401.00000
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiestrueReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgtrueGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgstrueRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgstrueRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiestrueSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgtrueOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (8 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
LCM Affiliated Services
I135852
LCM Affiliated Services
J100404
LCM Affiliated Services
P11300000
LCMH Foundation
P1156792
AM Province Little Company of Mary Sisters
P243050
DURABLE MEDICAL EQUIPMENT
P954565
DURABLE MEDICAL EQUIPMENT
R350000
LCMH Foundation
c543208

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.