PRESENCE HOLY FAMILY MEDICAL CENTER: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
PRESENCE HOLY FAMILY MEDICAL CENTER (EIN 36-2439318)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-05-17
IRS object ID
201221389349301002
Schema version
2010v3.2
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)
Timestamp2012-05-17T16:33:53-07:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362439318EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Holy Family Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOLYNameControl
Phone8478133725Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 N River RoadAddressLine1
CityDes PlainesCity
StateILState
ZIP Code60016ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJohn AOrsini CPAName
TitleTreasurerTitle
Date Signed2012-05-17DateSigned
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJohn BairdNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1100 N River RdAddressLine1
CityDes PlainesCity
StateILState
ZIP Code60016ZIPCode
FieldValueIRS element (for citing)
Gross Receipts80568413GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Group Exemption Number0928GroupExemptionNumber
Organization501c3XOrganization501c3
Web Sitewww.reshealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1958YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionResurrection Health Care exists to witness God's sustaining love through compassionate. family centered care. Motivated by a reverence for life and respect for those we serve, we are committed to improving the health and well-being of our community.ActivityOrMissionDescription
Nbr Voting Members Governing Body7NbrVotingMembersGoverningBody
Nbr Independent Voting Members2NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers80TotalNbrVolunteers
Total Gross UBI36512TotalGrossUBI
Contributions Grants Prior Year215261ContributionsGrantsPriorYear
Contributions Grants Current Year52800ContributionsGrantsCurrentYear
Program Service Revenue Prior Year89760649ProgramServiceRevenuePriorYear
Program Service Revenue CY79194568ProgramServiceRevenueCY
Investment Income Prior Year-332917InvestmentIncomePriorYear
Investment Income Current Year-247059InvestmentIncomeCurrentYear
Other Revenue Prior Year776667OtherRevenuePriorYear
Other Revenue Current Year1321045OtherRevenueCurrentYear
Total Revenue Prior Year90419660TotalRevenuePriorYear
Total Revenue Current Year80321354TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year40470175SalariesEtcPriorYear
Salaries Etc Current Year40246411SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year42214166OtherExpensePriorYear
Other Expenses Current Year29069432OtherExpensesCurrentYear
Total Expenses Prior Year82684341TotalExpensesPriorYear
Total Expenses Current Year69315843TotalExpensesCurrentYear
Revenues Less Expenses Prior Year7735319RevenuesLessExpensesPriorYear
Revenues Less Expenses CY11005511RevenuesLessExpensesCY
Total Assets BOY47777967TotalAssetsBOY
Total Assets EOY53332465TotalAssetsEOY
Total Liabilities BOY80253038TotalLiabilitiesBOY
Total Liabilities EOY74802021TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY-32475071NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY-21469556NetAssetsOrFundBalancesEOY
Mission DescriptionResurrection Health Care exists to witness God's sustaining love through compassionate. family centered care. Motivated by a reverence for life and respect for those we serve, we are committed to improving the health and well-being of our community.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense62042781Expense
Revenue80321354Revenue
DescriptionHoly Family provided patient care of 35,101 Inpatient days and 22,391 Outpatient visits during FY2011. Surgeries totaled 1,636.Description
Total Program Service Expense62042781TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
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 FootnotetrueReportFin48Footnote
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 IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
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 MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingfalseComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Employment Tax Returns FiledfalseEmploymentTaxReturnsFiled
Unrelated Business IncometrueUnrelatedBusinessIncome
Form990-T FiledtrueForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members7NbrVotingGoverningBodyMembers
Number Independent Voting Members2NumberIndependentVotingMembers
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
Policies Reference ChaptersfalsePoliciesReferenceChapters
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
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonDavid WrigleyNamePerson
Telephone Number8478133728TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1100 N River RoadAddressLine1
CityDes PlainesCity
StateILState
ZIP Code60016ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekFormerFormerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorHighest Compensated EmployeeHighestCompensatedEmployeeOfficerOfficerKey EmployeeKeyEmployee
Tom Capobianco
Treas/EVP/CFO0.00X069418442637
Timothy Cahill DO
Dir/Med Dir11.000282150X
Thelma Lacson
Dir Nursing40.00011585320335X
Stephen J Talty
Dir/Med Dir3.000545870X
Sister Kathleen Ann Stadler CS
Director1.00000X
Sandra Bruce
Dir Pres/CEO1.00090316330928X
Pamela S Bell
Dir Prov Relations40.00015401019402X
Nicola Byrne
Asst Treas/VP1.00022546226915X
Marti Edwards
VP, CNO40.00016195930557X
Mannish Tanna MD
Director1.000166250X
Mahendra C Patel
Pharmacist40.0001132796783X
Keith Bakken
Syst Dir Prov Rela40.00010997725145X
John Walton
Dir/GVP EVP CEO1.000638238103181XX
John Heller III MHA MPA
Director1.00000X
John Baird
DIR/EVP/CEO40.00034251274949XX
John A Orsini CPA
Treas/EVP CFO1.00032755856589X
Jeannie Frey
Sec/SVP Legal1.00043959081847X
James Sykes
Asst Treas/VP1.00022438131001X
Ellen Ho
Dir Pharmacy40.00014028220175X
FieldValueIRS element (for citing)
Total Reportable Comp Frm Rltd Orgs4689875TotalReportableCompFrmRltdOrgs
Total Other Compensation570444TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers ListedtrueFormersListed
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
US Bank Corporate TrustShiftwise
POBox 70870St PaulMN55170Temporary Labor120923
Gerotec Inc
PO Box 43Highland ParkIL60035Management Services217474
GE Healthcare
PO Box 96483ChicagoIL60693Medical Services1131828
Elgin Laboratory Physicians Ltd
77 North Airlite StElginIL60123Physician Services160450
AlholmMonahan KlaukeHayOldenburg
221 N Lasalle St Suite 450ChicagoIL60601Legal Services108615
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Related Organizations52800RelatedOrganizations
Total Contributions52800TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnUnrelated Business RevenueUnrelatedBusinessRevenueRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
REFERENCE LAB6215003651236512
NET PATIENT SERVICE REV6221107915805679158056
FieldValueIRS element (for citing)
Total Program Service Revenue79194568TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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)
Real764835Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real764835Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column764835TotalRevenueColumn
Exclusion$764,835ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Other247059Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other-247059Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-247059TotalRevenueColumn
Related Or Exempt Function Income-247059RelatedOrExemptFunctionIncome

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

FieldValueIRS element (for citing)
DescriptionOther RevenueDescription
Total Revenue Column556210TotalRevenueColumn
Exclusion$556,210ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue556210TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column80321354TotalRevenueColumn
Related Or Exempt Function Income78910997RelatedOrExemptFunctionIncome
Unrelated Business Revenue36512UnrelatedBusinessRevenue
Exclusion$1,321,045ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

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)
Total609977Total
Program Services609977ProgramServices

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total31096598Total
Program Services31096598ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total2066330Total
Program Services2066330ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4223369Total
Program Services4223369ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total2250137Total
Program Services2250137ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total7273062Total
Management And General7273062ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

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)
Total1748037Total
Program Services1748037ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total87373Total
Program Services87373ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total133214Total
Program Services133214ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1848884Total
Program Services1848884ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total114274Total
Program Services114274ProgramServices

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total1341271Total
Program Services1341271ProgramServices

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4556383Total
Program Services4556383ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total194525Total
Program Services194525ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
Supplies85449258544925
Repairs380689380689
Purchased Services26336962633696
Other Expenses22396792239679
IL Medicaid Tax28692962869296

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total-4895876Total
Program Services-4895876ProgramServices

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total69315843Total
Program Services62042781ProgramServices
Management And General7273062ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY0EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1226607BOY
EOY1254070EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15268547BOY
EOY22042641EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1105030BOY
EOY905340EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1146536BOY
EOY1055903EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis123264221LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec95311749LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY28980638BOY
EOY27952472EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY50609BOY
EOY122039EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY47777967BOY
EOY53332465EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY10956406BOY
EOY9437253EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY30750771BOY
EOY29680013EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY38545861BOY
EOY35684755EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY80253038BOY
EOY74802021EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY-32475071BOY
EOY-21469556EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY-32475071BOY
EOY-21469556EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY47777967BOY
EOY53332465EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses11005511ReconcilationRevenueExpenses
Reconcilation Other Changes4ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis342000OtherCostOrOtherBasis
Book Value342000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis86758806OtherCostOrOtherBasis
Depreciation66510171Depreciation
Book Value20248635BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4077827OtherCostOrOtherBasis
Depreciation3887423Depreciation
Book Value190404BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis32085588OtherCostOrOtherBasis
Depreciation24914155Depreciation
Book Value7171433BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings27952472TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Self insurance liability$5,058,398
Due to affiliates$30,626,357
FieldValueIRS element (for citing)
Total Of Amounts35684755TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteRHC and affiliates recognize the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authorities based on the technical merits of the position RHC and affiliates do not have any liabilities for unrecognized tax benefits.
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesRounding $4

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
Pcent400XPcent400
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 Expense1207166TotalCommunityBenefitExpense
Net Community Benefit Expense1207166NetCommunityBenefitExpense
Percent Of Total Expense0.01630PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense1207166TotalCommunityBenefitExpense
Net Community Benefit Expense1207166NetCommunityBenefitExpense
Percent Of Total Expense0.01630PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense125771TotalCommunityBenefitExpense
Direct Offsetting Revenue10565DirectOffsettingRevenue
Net Community Benefit Expense115206NetCommunityBenefitExpense
Percent Of Total Expense0.00160PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense897990TotalCommunityBenefitExpense
Net Community Benefit Expense897990NetCommunityBenefitExpense
Percent Of Total Expense0.01210PercentOfTotalExpense

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense42852TotalCommunityBenefitExpense
Net Community Benefit Expense42852NetCommunityBenefitExpense
Percent Of Total Expense0.00060PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense1066613TotalCommunityBenefitExpense
Direct Offsetting Revenue10565DirectOffsettingRevenue
Net Community Benefit Expense1056048NetCommunityBenefitExpense
Percent Of Total Expense0.01430PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2273779TotalCommunityBenefitExpense
Direct Offsetting Revenue10565DirectOffsettingRevenue
Net Community Benefit Expense2263214NetCommunityBenefitExpense
Percent Of Total Expense0.03060PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedfalseBadDebtExpenseReported
Amount Attributable To-1256061AmountAttributableTo
Amount Reimbursed By Medicare33897616AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare34560102CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-662486MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

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

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number0FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Holy Family Medical CenterBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line1100 N River RdAddressLine1
CityDes PlainesCity
StateILState
ZIP Code60016ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
OtherSpecializes in Acute Long Term CareOther

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Holy Family Medical CenterBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part VI Form990ScheduleHPartVI (16 entries)

Return ReferenceReturnReferenceExplanationExplanation
Part VI - Additional InformationPart II Describe how community building activities promoted the health of the communities it serves.continueThese community building, health improvement and collaborative efforts indicate our belief that our community responsibilities extend well beyond the walls of our facility.Other examples of community building activities include: "The e-CARES program in which connections are made between employees who wish to donate used household items and community members who are suffering from economic distress and hardships and who could use these donated items. Employees have connected directly with the marginalized individuals in the community to donate furniture, appliances, clothing, food and other items of need."Holy Family Medical Center, through the parent corporation, maintains an ongoing partnership with Hospital Sisters Mission Outreach whose mission is the recovery and responsible redistribution of healthcare equipment and supplies to developing countries. The commitment attributes to local community health by being good stewards of our community resources and not contributing to the landfills within our communities. In addition, this activity promotes the health of the community that receives the equipment and supplies by giving them the tools that they need to better meet the health needs of their community. The Resurrection Health Care Mission statement declares that "motivated by a reverence for life and respect for those we serve, we are committed to improving the health and well-being of our community". Holy Family Medical Center strives to uphold its Mission.Part VI, 2: Needs Assessment continue..-RES-INFO is a widely utilized Resurrection Health Care telephone service/contact center that provides nurse advice, physician referrals, health information and health care class registrations to callers. Staffed by clinicians and other professionals, community members access RES-INFO by utilizing a toll-free number and the RHC Website. Summary reports indicate the types of health care providers callers seek, the symptoms they need assistance with, the health information they are seeking, and the health classes and seminars they would like to take. -The Resurrection Health Care Website (www.reshealth.org) provides an online health information library as well as information related to the full continuum of available health care services, the Resurrection financial assistance program, educational programs and screenings, an online physician search and online job application system, to name a few of the available topics. A parallel version of the site is also available in Spanish. Regular review of site usage statistics provides useful information about the health concerns of website visitors.-Resurrection Health Care clinical educators, health educators and physicians supply significant empirical research on the needs of the community. Resurrection Health Care operates several clinics in and around each hospital. Clinical and professional staffs also obtain patient data through health education, health screenings, health fairs and other clinical encounters. Part VI, 4 Community Information.continueWithin the Holy Family Medical Center core community, 13 % of the population is uninsured based on 2007 data. Des Plaines has the highest number of uninsured (10,698) within the core communityPart VI, 5 Promotion of Community Health..continueFinally, Holy Family Medical Center offers health and wellness fairs. Although these fairs are open to everyone in the community, they provide a significant source of information about personal health risk indicators as well as follow-up information, health resources and references to poor and low income individuals who have no other resource for this basic health care information. These programs are often sponsored by local elected officials (Mayors, Aldermen, and Congressmen) or local churches and congregations with Holy Family Medical Center providing the health care resources (staff, supplies, information, etc.).
Part V - Explanation of Number of Facility TypeHoly Family Medical Center does not have any organizations that are not licensed.
Part VI - States Where Community Benefit Report FiledIL
Part VI - Affilated Health Care System Roles and PromotionEffective March 1, 2001, the Sisters of the Holy Family of Nazareth and the Sisters of the Resurrection began the co-sponsorship of Resurrection Health Care in order to assure the provision of ongoing quality healthcare services to the communities served by the sponsors. A single governance structure for the system includes board members from the community, physicians, senior officers and external business and health care executives with an interest in serving Resurrection Health Care's communities.Resurrection Health Care is the parent corporation of all subsidiary corporations including, but not limited to, our Hospital Corporations, Resurrection Senior Services, Resurrection Services (including all ambulatory corporations), Resurrection Home Health Services, Resurrection Behavioral Health and Resurrection Development Foundation, to name the most significant ministries. Resurrection Health Care provides acute healthcare, acute long term care, long-term care services, behavioral health services and ambulatory care services to communities primarily located in north and northwest Chicago, at various locations throughout Cook County in Illinois.All Resurrection Health Care acute care facilities have robust community relations and patient and family focused care initiatives. While each community is different, similar methods of community engagement are employed at each hospital. Also, the Resurrection Development Foundation is an Illinois not-for-profit corporation organized to solicit, receive and account for charitable contributions that benefit all Resurrection Health Care entities. The mission of the Foundation is to build relationships and develop partnerships across Chicago to enhance Catholic-sponsored health care services to all who need them.In addition, through its affiliations with area medical schools, Saints Mary and Elizabeth Medical Center offers residency programs in family medicine and podiatry.From the very beginnings of our various ministries decades ago, Resurrection Health Care has been called to be much more than a just a provider of health services. Resurrection Health Care strives to live out its Mission every day for every patient or resident. It has communicated its mandate to all of its ministries that we are committed to responding to the needs of those we are privileged to serve. Our vision is to delivering high quality care that is accessible to all. It is this culture of caring and giving that drives our diligent efforts to ensure we return the optimal value of our charitable assets to our local communities. In addition, the Sponsoring Congregations of Resurrection Health Care have promulgated criteria (called Sponsor Expectations) that are directed toward the governance and management of all affiliated corporations and provide guidance for decisions, policies and everyday practices. Sponsor Expectation 7 stipulates that "Resurrection Health Care will be a moral force in society, working with other organizations to address the needs of the poor and the marginalized and affect the change needed to insure that all will have access to safe, quality health care across the continuum of care."Finally, it is the expectation of our Sponsors that every affiliate corporation live out our Mission mandate: "Motivated by a reverence for life and respect for those we serve, we are committed to improving the health and well-being of our community."
Part VI - Explanation Of How Organization Furthers Its Exempt PurposeResurrection Health Care Hospitals are faith based ministries that provide services based upon the ethical and religious directives of the Catholic Church. Resurrection Health Care operates five acute care hospitals and one long term acute care hospital. Resurrection Health Care's hospitals enhance the public health of our communities by:1.Ensuring our medical staff is open to all qualified physicians,2.All of our hospitals are accredited and in good standing with the Healthcare Facilities Accreditation Program (HFAP)3.Ensuring our board of directors is diverse and able to provide expertise, and made up of independent members of the communities we serve. Our board members must follow a conflict of interest policy.4.Surplus funds are reinvested into the organization to improve patient care though new programs and technology.5.Provide financial assistance and sliding scale discounts and have collection practices that are in compliance with state and federal guideline. In addition, we follow the financial assistance and charity guidelines of the Catholic Health Association.6.We participate in all government sponsored health care programs, Medicare, Medicaid, CHAMPUS, Tricare, SCHIP and others.7.We provide emergency room services in all of our communities and provide training to local fire departments and ambulances. Our emergency room participates with local police and fire departments in disaster drills.8.Our emergency room services and urgent care services are staffed by Board Certified Emergency Room Physicians and treat patients according to EMTALA guidelines and serve all patients regardless of ability to pay.9.Five of our hospitals qualified for disproportionate share.10.We have a significant commitment to the education and training of health professionals including doctors, nurses, radiology technicians and chaplains.In addition, we are committed to determining the needs of our communities and creating ways to meet those needs. The obligation to reach out to those in need and improve health flows directly from our Catholic identity and the heritage of our founding congregations. Below are a few examples of how Holy Family Medical Center promotes the health of the community served.At Holy Family Medical Center (HFMC) employees support the "Heart of Gold" initiative. This program consists of donations of food, clothing and free will cash donations to be used for the homeless and unemployed in the Des Plaines area. Many of the homeless people in this community live in the nearby forest preserve and depend on the food and clothing for their continued survival. HFMC partners with Catholic Charities to distribute the items and money to those most in need in the community. The donated money is converted to gift certificates and typically distributed to the mothers of the families.HFMC supports the "Care A Van" project. This service provides transportation to low income community residents to various health care appointments. In fiscal year 2011, a total of 2022 people were served by this program.HFMC is the only specialty hospital campus in Illinois with comprehensive outpatient services including same day surgery, G.I. lab, health, medical imaging, women's health, sleep disorder treatment, lab, cardiology and physical, occupational and speech therapies.There is an extensive substance abuse treatment program including inpatient detoxification, partial hospitalization and outpatient counseling services.HFMC provides an Immediate Care and Occupational Health Center partnership with Oakton Community College to help train senior nursing students.There is an onsite child care center for local children ages 6 weeks to 6 years.HFMC provides discounted outpatient services to community patients of Access Genesis Center in Des Plaines.Holy Family Medical Center also subsidizes the New Beginnings Program. This is a program that provides prenatal, delivery and post-partum care for low income women and families.
Part VI - Community Building ActivitiesChicago is a diverse city of unique neighborhoods. Holy Family Medical Center, like all Resurrection Health Care hospitals, has a Neighborhood Community Relations Committee made up of representatives of the hospital, local clergy, business groups, community service agencies and elected officials. These committees work together to identify community health needs and devise strategies and tactics to address those health needs together, with an overall goal of improving the health status of the community.Holy Family Medical Center, through its parent corporation Resurrection Health Care, is part of Building a Healthier Chicago (BHC), a collaborative of local and national stakeholders working to strengthen efforts to promote the health of Chicago residents. BHC seeks to create integrated, effective and sustained community-wide partnerships for health promotion. Its goal is to improve the health of Chicago residents by providing information on policies and programs to help promote healthier lifestyle choices for Chicago residents as well as the prevention and treatment of high blood pressure.Holy Family Medical Center engages in a variety of Community Building Activities. These activities include programs that address the root causes ofhealth problems, such as awareness of critical health care numbers, health care screenings and referrals, maternal and family outreach services, obesity awareness, the prevalence of diabetes and programs and services that promote fitness, weight loss, healthy nutrition and healthier lifestyles. For the reporting period, over 13, 745 persons were engaged in some form of community health improvement and community building services and activities. In addition, community building activities, whenever possible, were done in collaboration with other agencies and programs within the service area of Holy Family Medical Center. It is our belief that working in collaboration with other community partners helps in building the foundation of a healthier community.Examples of community collaborations includes working with City of Des Plaines Health and Human Services, Des Plaines Healthy Community Partnership Health Advocacy Coalition, Frisbie Senior Center, YMCA, Maryville Academy, Catholic Charities, American Lung Association, Avon Corporation (Breast Cancer prevention and awareness), Maine Township Senior Citizens Social Program -Mainestreamers, American Heart Association- Heart Walk, Senator Dan Kotowski's office and Des Plaines Ministerial Association to name a few. For the reporting period, these collaborative efforts resulted in over 8,500 persons served.
Part VI - Community InformationResurrection Health Care is a family of health care services providing advanced medical care and exceptional customer service with compassion and hope. Its hospitals, nursing homes, retirement communities, home health services, behavioral health programs and other services are conveniently located in many Chicagoland neighborhoods. Resurrection Health Care serves a diverse community of over two million people from forty (40) zip codes primarily located on the North/Northwest Side of Chicago and surrounding suburbs. This large and varied region requires comprehensive service to a number of populations: uninsured and poorly insured; all age categories-children, adults, seniors; various ethnic populations and immigrants; and individuals from various prominent disease categories. The primary service area of Resurrection Health Care hospitals in 2011 is characterized as follows: "The population is approximately 41.0% White, 33.2% Hispanic, 16.1% African-American, 7.0% Asian and 2.7% other non-Hispanic."The Hispanic population represents 33.2%of the population of the service area, compared to the national average of 16.1%."Approximately 19.6% of Resurrection Health Care's primary service area population is uninsured. "The unemployment rate in the primary service area is 10.6% of the total labor force The number of females of childbearing ages (15-44) is expected to decrease by 5.8% over the next five years."Individuals 65 and over are 11.2% of the primary service area."The overall population of the service area is expected to decrease by -0.2%over the next 5 years."The median 2011 household income for the primary service area is $51,223Resurrection Health Care is a not-for-profit Catholic organization sponsored by the Sisters of the Holy Family of Nazareth and the Sisters of the Resurrection.To determine our core community, a comprehensive list of factors were considered including inpatient, outpatient and emergency department patient origin, facility location, inpatient market share, net Resurrection Health Care market share, and ongoing community outreach efforts.The core communities served by Holy Family Medical Center is as follows:Des Plaines- 60016Des Plaines- 60018Mount Prospect- 60056Wheeling- 60090Prospect Heights- 60070 Holy Family Medical Center is a long-term acute care hospital caring for medically-complex patients, the only such hospital in Northwest Chicagoland. Holy Family specializes in providing care for patients who are critically ill with complex conditions and must be hospitalized an extended period. Holy Family Medical Center combines specialized expertise with the personalized, patient-focused attention. As a long-term acute care hospital, we offer a range of services through coordinated and focused care teams.Demographic Information (Based on 2011 data)The Holy Family Medical Center core community has a total population of 192,117, which is projected to decrease 0.5% by year 2016. Within the core community there are a total of 72,458 households with an average household income of $73,121. The median home value is $243,782 and the median age is 39. The core community is predominantly White (58.9%). However, there is a significant Hispanic population (22.8% Hispanic, 2.0% Black, and 14.3% Asian). The population within the core community has varying levels of education with 35.9% holding a bachelor's degree or greater.Within the core community, 10.8% of the population is uninsured in 2011. By 2016, the uninsured population will drop to 3.8%.Holy Family Medical Center's top five non-English languages are Spanish, Russian, Polish, Italian, and Gujarati. Resurrection Health Care hospitals offer either personal or telephonic medical interpretation services. There were 21,151 medical interpretations provided via telephone alone in FY11 across the system, in 71 different languages.Health Status Information.
Part VI - Patient Education of Eligibility for AssistanceThe hospital maintains effective methods of communicating the availability of Financial Assistance/Charity Care discounts to all patients, in multiple appropriate media and in multiple appropriate languages. The mechanisms that the Hospital will use to communicate the availability of Financial Assistance/Charity Care will include, but are not limited to the following:1.Signage. Signs shall be conspicuously posted in the admission, registration and other appropriate areas of the hospital stating that patients may be eligible for Financial Assistance/Charity Care discounts, and describing how to obtain more information, including identification of appropriate hospital representatives by title. Such signs shall be prepared in English, Spanish, and any other language that is the primary language of at least 5% of the patients served by the hospital annually.2.Provision of Financial Assistance Materials to Uninsured Patients. RHC hospitals will provide a summary of its Financial Assistance Programs and a Financial Assistance application to all persons receiving hospital care that it identifies as Uninsured Patients at the time of in-person registration, admission, or such later time at which the patient is first identified as an Uninsured Patient. For patients presenting in the Emergency Department, all RHC hospitals will provide such Financial Assistance materials at such time and in such manner as is consistent with their obligations under EMTALA to assess and stabilize the patient before making inquiry of the patient's ability to pay.3.Brochures. Brochures, information sheets and/or similar forms of written communication regarding the hospital's Financial Assistance/Charity Care policy shall be maintained in appropriate areas of the hospital (e.g., the Emergency Department, organized registration areas, and the Business Office) stating in at least English, Spanish and Polish, that the hospital offers Financial Assistance/Charity Care discounts, and describing how to obtain more information.4.Website. Each RHC's section of the Resurrection Health Care website must include: a notice in a prominent place that financial assistance is available at the hospital; a description of the financial assistance application process; and a copy of the RHC hospital financial assistance application form.5.Billing Notices. Each RHC hospital shall include a note on or with the Hospital bill and/or statement regarding the hospital's Financial Assistance/Charity Care program, and how the patient may apply for consideration under this program.6.Financial Counselors. Each RHC hospital shall have one or more financial counselors whose contact information is listed or provided with other information concerning the hospital's Financial Assistance/Charity Care discount program, who are available to discuss eligibility and other questions concerning the program, and to provide assistance with applications.7.Notification of Determination. When an RHC hospital has made a determination that a patient's bill is discounted or adjusted in whole or in part based on a determination of financial need, the hospital will notify the patient of such eligibility determination, and that there is no further collection action taken on the discounted portion of the patient's bill.
Part VI - Needs AssessmentIn order to ascertain the health care needs of the community served by Resurrection Health Care, a number of primary data sources sources were reviewed. This quantitative data focused on published health status indicators as well as our own direct measures of expressed community needs (via phone calls, website and survey responses). In addition, qualitative data was used which was obtained from the direct experience of RHC staff with clinical and health education responsibilities. For the upcoming fiscal year, we will be complementing these primary data sources with a formal process to obtain and utilize secondary data sources within the communities themselves.The current sources for assessing community health status and needs include the following:-Metropolitan Chicago Healthcare Council (MCHC) Needs Assessment is a comprehensive, data driven approach to determine the health status, and understand the behaviors and needs of the residents of Cook, Lake, and DuPage counties. This study can be used to address and understand the needs of individual communities. -Chicago Department of Public Health - Casting Chicago's Health Care Safety Net: A 12-Year Review of Chicago's Community-Based Primary Care System. The report highlights the changes that occurred in Chicago's community-based health care safety net system between 1990-2002. The report also explores, for the same 12-year period, changes in related indicators: general population characteristics, health status and insurance coverage. -Metro Chicago Information Center (MCIC) is an organization that details information on community needs assessments for the city of Chicago. The information identifies the demographics and community needs by categorizing the city into six distinct areas or communities. -We Plan 2005-2010 (in conjunction with The Cook County Department of Public Health) summarizes the process of assessment - a systematic collection and analysis in order to provide a basis for decision making - and community strategic planning. This information is a compilation of data and analysis, measurable objectives, available resources, interventions and preliminary implementation steps for three priority health indicators: chronic disease, violence and access to Care. -2009 Report on Chicago Region Poverty: In this ninth annual comprehensive analysis of poverty indicators in Illinois, the report explains that unemployment and poverty are correlated; rising unemployment precipitates an increase in poverty. With the Illinois unemployment rate already over 9 percent, the ripple effect on Illinoisans is severe, according to researchers-Illinois Department of Public Health (IDPH) publishes The Illinois Project for Local Assessment of Needs (IPLAN), a community health assessment and planning process and online tool that is conducted every five years (2006 is most current data) by local health jurisdictions in Illinois. -Healthy People 2020 is an updated initiative by the U.S. Department of Health and Human Services, composed of federal, state and territorial departments, to strategically focus on initiatives which can be measured and which promote healthy living and disease prevention. Their website offers information on many leading indicators that are currently being measured. In addition, all community benefit activities are reported and organized using the Community Benefit Inventory for Social Accountability (CBISA) software which utilizes the Healthy People 2010/2020 categories in its database.In addition to the data sources mentioned above, we also use available internal resources that arise from our direct connection to the community we serve. These sources include:-Resurrection Health Care's Strategic Planning Process, includes comprehensive assessments of service area demographics, identified needs, health care trends, market share, financial outcomes, capital needs, and other factors.
Part III, Line 9b - Provisions On Collection Practices For Qualified PatientsCollection policies are the same for all RHC entities which includes Holy Family Medical Center's patients. Patients are notified of Holy Family Medical Center's financial assistance policy at time of registration via posted notifications and on every account statement that is sent. We make this available in a number of languages. On receipt of the information, we will determine eligibility for financial assistance and notify the patient as quickly as possible. The Hospital does not pursue collection of amounts from patients who are being reviewed for financial assistance eligibility or who are determined to qualify for charity care.If at any point in the collection process, documentation is received that indicates the patient is potentially eligible for financial assistance but has not applied for it, the account is referred back for a financial assistance review.In addition, all patients having difficulty paying their bills are directed to financial counselors. The financial counselors will work with our patients to qualify them for charity care or government program such as Medicaid. After a patient meets the qualifications for financial assistance, the account balance is either partially or entirely written off in accordance with our financial assistance policy. If there is any remaining balance, only that balance would be subject to our debt collection policy.If a patient has requested and/or filled out a financial aid application, all debt collection activities stop until eligibility for financial assistance can be determined. Our policy provides that once we have received the necessary documentation we will not refer any accounts for collection until we can determine whether the individual is insured and not eligible for financial assistance.
Part III, Line 8 - Explanation Of Shortfall As Community BenefitThe shortfall of $662,486 on Part III, Line 7 is the unreimbursed cost of providing services for Medicare patients and should be treated as community benefit.
Part III, Line 4 - Bad Debt ExpenseThe footnotes to Resurrection Health Care's audited financial statements do not specifically address bad debt expense, rather, the footnote describes Resurrection Health Care's patient accounts receivable policy. Patient accounts receivable are stated at net realizable value. Resurrection Health Care evaluates the collectability of its accounts receivable based on the length of time the receivable is outstanding, payer class, historical collection experience, and trends in health care insurance programs. Accounts receivable are charged to the allowance for uncollectible accounts when they are deemed uncollectible. The costing methodology used in determining the amounts reported on line 2 is based on the ratio of patient care cost to charges. The bad debt (at cost) was calculated by applying the organization's cost to charge ratio to the organization's provision for uncollectible accounts receivable. Resurrection Health Care makes every effort to identify those patients who are eligible for charity care or other financial assistance by strictly adhering to its Charity Care policy. We believe that Resurrection has a population of patients who are uninsured or underinsured but who do not complete the charity care assessment. Although Resurrection responded to Part III, Line 3 as 0, the response would be accurately noted as unknown. We strongly believe, despite significant proactive measures, there are a percentage of bad debts that could be considered community benefit. However, at this time we do not believe we have the appropriate tools to determine this percentage accurately.
Part I, Line 7, Column F - Explanation of Bad Debt ExpensePer the 990H instructions, the bad debt expense amount of $(4,955,456) has been removed from the denominator in calculating percentage of total expenses for scheduled H Part I line 7.
Part I, Line 7 - Explanation of Costing MethodologyPer the 990H instructions, the cost to charge ratio used to determine 7a. Financial assistance at cost and 7b. Unreimbursed Medicaid was derived from Worksheet 2, Ratio of Patient Care Cost to Charges.
Part I, Line 6a - Related Organization Community Benefit ReportResurrection Health care, the parent corporation of Holy Family Medical Center, publishes an annual Report to Our Communities, which details the combined charitable impact our facilities, have within the communities we serve. This report is inclusive of our hospital and non-hospital ministries. The report is distributed to federal, local and state officials, community leaders, religious leaders and other groups. It is also posted on the World Wide Web and widely available on our consumer Web site (www.reshealth.org.)
Part I, Line 3c - Charity Care Eligibility Criteria (FPG Is Not Used)Discount for Low-Income Uninsured Patients. Financial Assistance/Charity Care discounts or discounted fee schedules is available for Medically Necessary Hospital Services provided to Uninsured Patients who are unable to pay all or part of the otherwise applicable charge for their care due to financial need, as documented in accordance with this Policy. Patients demonstrating financial need based on household income at or below one hundred percent (100%) of the Federal Poverty Level, combined with a general lack of liquid assets, will receive a one hundred percent (100%) discount on Medically Necessary Hospital Services. Patients generally lacking liquid assets who have household income between one hundred percent (100%) and up to four hundred percent (400%) of the Federal Poverty Level will receive a sliding-scale discount for such hospital care, at levels approved by the RHC Executive Leadership Team.Payment Caps Under Illinois Uninsured Patient Discount Act. To the extent required by the Illinois Uninsured Patient Discount Act, and subject to other eligibility standards and exclusions as set forth by such law including standards based on asset level, Uninsured Patients who are Illinois residents having household income of up to six hundred percent (600%) of the Federal Poverty Level shall not be required to pay to an RHC hospital more than twenty five percent (25%) of such patient's family gross income within a twelve (12) month period.Other Payment Caps. An Uninsured Patient who is eligible for Financial Assistance/Charity Care at an RHC Hospital pursuant to the criteria set forth in Section 5.1 or 5.3 below shall be eligible for a payment cap based on RHC's charitable commitment to catastrophic medical expenses assistance based on medical indigence, as follows:For an eligible Uninsured Patient who demonstrates that s/he has a household income of four hundred percent (400%) or less of the Federal Poverty Level, such patient's payment obligation within any 12-month period is limited to the higher of: (a) ten percent (10%) of the patient's annual gross household income; or (b) ten percent (10%) of the patient's Non-Retirement Household Liquid Assets.For an eligible Uninsured Patient who demonstrates that s/he has a household income over four hundred percent (400%) of the Federal Poverty Level, or less, such patient's payment obligation within any 12-month period is limited to the higher of: (a) fifteen percent (15%) of annual gross household income; or (b) fifteen percent (15%) of the patient's Non-Retirement Household Liquid Assets.Financial Assistance/Charity Care for Insured Patients. Subject to insurance and governmental program restrictions (which may limit the ability to grant a discount on co-pays or deductibles, versus discounts on co-insurance), insured individuals, federal program beneficiaries and other individuals who are not automatically eligible for Financial Assistance/Charity Care hereunder but who demonstrate medical indigence or other financial need, may receive a Financial Assistance/Charity Care discount in similar or different amounts as are available to Uninsured Patients under this policy, as determined appropriate under the circumstances by RHC Patient Financial Services.Discounts for Uninsured, Medically Indigent Patients. Uninsured Patients whose household income is greater than four hundred percent (400%) of the Federal Poverty Level or who do not meet the automatic eligibility criteria set forth in Section 5 below, will nevertheless be eligible to receive a financial assistance/charity care discount based on a determination of medical indigence, by virtue of having medical bills from an RHC hospital in an amount equal to or greater than fifteen percent (15%) of their household income and available assets. Such Financial Assistance/Charity Care discount for uninsured higher income but medically indigent patients shall be one that is reasonable in relation to the individual patient's househousehold financial circumstances and the health status of the patient.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymenttrueSeverancePayment
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 PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (11 entries)

Comp Based On Related OrgsCompBasedOnRelatedOrgsOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Related OrgsTotalCompensationRelatedOrgsBonus Related OrgsBonusRelatedOrgsComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Tom Capobianco
341261352923403002337736821
Sandra Bruce
9031631225018678934091
Pamela S Bell
12976079221148017341224250
Nicola Byrne
22546226915252377
Marti Edwards
155784617516794137631925166175
John Walton
6382389010413077741419
John Baird
3425125175123198417461
John A Orsini CPA
298683437951279438414728875
Jeannie Frey
40208737503514903035752143737503
James Sykes
224381248406161255382
Ellen Ho
1377828762114131604572500

Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Sch J, Part III, Additional InformationPart III, Additional InformationResurrection Health Care Corporation's (RHCC) Compensation and Benefits Committee Compensation establishes the compensation methodology used to determine key executive compensation and monitors the compensation for compliance including approving the compensation for all members of the affiliated group including Holy Family Medical Center. The CEO of Holy Family Medical Center is paid by Resurrection Medical Center and his salary is included in this review. To assure that RHCC and it s affiliates complies with Intermediate Sanctions guidelines on reasonable compensation, the RHCC Compensation and Benefits Committee monitors executive total compensation by approving all components of executive total compensation, positioning RHCC executive total compensation competitively and appropriately, annually reviewing and approving compensation changes for each executive, and reporting its activities regularly to the Resurrection Health Care Board.
Sch J, Part I, Line 7Part I, Line 7: Non-Fixed payments not listed aboveBonus payments were made to the following officers:John Orsini - Payments made as directed by the written employment agreement.Additional pay was made to the following key employee:John WaltonPayments made to compensate for additional duties assumed during the vacancy of the CFO position.Other Incentive payments were made the following highly compensated employees:Elllen Ho/Keith Bakken/Pamela Sue BellIncentive payments are based upon a formula. The payments are calculated after certain performance and operating goals are achieved.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
Form 990, Part VII, Section A & BResurrection Medical Center (RMC) FEIN 36-3330926 acts as the agent / common paymaster for Holy Family Medical Center (HFMC). Cash is swept from HFMC on a daily basis to RMC and RMC issues all payroll and accounts payable checks on behalf of and as agent for HFMC and the appropriate accounting entries are recorded.
Form 990 Part I Question 5 & Part V 1-2Compensation and Form W-3 Transmittal of Wages and Tax StatementHoly Family Medical Center (HFMC) reports 0 employees on Form 990 question 5 and Form 990 Part V question 2a as it is not required to file Form W-3, Transmittal of Wages and Tax Statement. As discussed in the note regarding Common Paymaster below, HFMC's compensation is paid by Resurrection Medical Center (RMC) and transferred to HFMC. The compensation amounts reported in this 990 reflect the amount transferred to HFMC from RMC.All Compensation presented is for the period January 1, 2010 to December 31, 2010.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableHoly Family Medical Center's articles of incorporation are on file with the state of Illinois. Resurrection Health Care Corporation and Affiliates audited financial statments are available from the national dissemination agent as required by our bond documents. Conflicts of interest policies are not made available to the public.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesCompensation at Resurrection Health Care Corporation(RHCC) and its affiliates is based upon a Board of Direcors approved strategy that guides the corporations in establishing total compensation opportunites for the organizations's executives. The overall purposes of the RHCC total compensation program are to enable the organization to recruit, motivate, rewared, recognize, and retain highly talented executives with the skills required to align performance measures with RHCC's Mission, Vision, and strategic initiatives, and to achieve outstanding results on a continuous basis. To ensure RHC attracts and retains high quality executives with the appropriate skills, the organization uses external labor market to validate its base salaries and total cash compensation opportunities. The marketplace in which RHCC assesses total compensation is both regional and national in scope and is primarily comprised of comparable healthcare systems and hospitals. To assure that RHCC complies with intermediate Sanctions guidelines on reasonable compensation, the Board's Compensation and Benefits Committe closely monitors executive total compensation by approving all components of executive total compensation, positioning RHCC executive total compensation competively and appropriately, annually reviewing and approving compensation changes for each executive, and reporting its activities regularly to the board.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsThe Vice President of Compliance coordinates an annual confilct of interest survey to deterrmine the compliance with the conflict of interest policy and takes the required actions based on the survey results.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessThe returns were prepared by the Resurrection accounting staff with assistance by the community benefit, payroll, human resources, and legal departments after which point the returns were reviewed by the Business Unit Chief Financial Officer. Any unusual items were discussed with outside advisors.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyThe sole member, Resurrection Health Care Corporation. elects members of the governing body.Form 990, Part VI, Line 7a
Form 990, Part VI, Line 6: Explanation of Classes of Members or ShareholderThe organization has one member, Resurrection Health Care CorporationForm 990, Part VI, Line 6

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (18 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
Mount Loretto Nursing Home
302 Swart Hill RoadAmsterdamNY12010141363014Senior LivingNY501(c)(3)3Resurrection Ministries of New Yorkfalse
Resurrection Nursing Home Inc
90 N Main StreetCastletonNY12033141348691Senior LivingNY501(c)(3)3Resurrection Ministries of New Yorkfalse
Holy Family Health Care System
100 N River RdDes PlainesIL60016363495969HealthcareIL501(c)(3)3Resurrection Health Care Corporationfalse
Resurrection Ambulatory Services
7435 W TalcottChicagoIL60631364286236HealthcareIL501(c)(3)3Resurrection Health Care Corporationfalse
Resurrection Ministries of New York
90 N Main StreetCastletonNY12033141720818senior livingNY501(c)(3)3Resurrection Health Care Corporationfalse
Resurrection Development Foundation
150 N River RdDes PlainesIL60016363330929FundraisingIL501(c)(3)7Resurrection Health Care Corporationfalse
Resurrection Home Health Services
5747 West DempsterMorton GroveIL60053362893936Home CareIL501(c)(3)3Resurrection Health Care Corporationfalse
Proviso Family Svcs dba RBH
1820 South 25th AveBroadviewIL60155362709982Health CareIL501(c)(3)3Resurrection Health Care Corporationfalse
Resurrection Services
7447 West Talcott AveChicagoIL60631363330928Health CareIL501(c)(3)3Resurrection Health Care Corporationfalse
Resurrection Senior Services
7435 West Talcott AveChicagoIL60631237061646Senior LivingIL501(c)(3)3Resurrection Health Care Corporationfalse
Cana West Ministry Services
7435 W Talcott AveChicagoIL60631362182170Health CareIL501(c)(3)3Resurrection Health Care Corporationfalse
Saint Joseph Hospital
2900 North Lake Shore DrChicagoIL60657363200170Health CareIL501(c)(3)3Resurrection Health Care Corpfalse
Saints Mary and Elizabeth Medical Center
2233 West Division StChicagoIL60622362171079Health CareIL501(c)(3)3Resurrection Health Care Corporationfalse
St Francis Hospital
355 Ridge AveEvanstonIL60202362167800Health CareIL501(c)(3)3Resurrection Health Care Corporationfalse
Cana Lakes Healthcare
7435 W TalcottCHicagoIL60631361649520Health CareIL501(c)(3)3Resurrection Health Care Corporationfalse
Our Lady of the Resurrection Medical Ctr
5645 West Addison StChicagoIL60634362644178Health CareIL501(c)(3)3Resurrection Health Care Corporationfalse
Resurrection Medical Center
7435 West Talcott AveChicagoIL60631363330926Health CareIL501(c)(3)3Resurrection Health Care Corporationfalse
Resurrection Health Care Corporation
7435 West Talcott AveChicagoIL60631362235165parent corp and senior livingIL501(c)(3)3nafalse

Form990 Schedule R Part III Form990ScheduleRPartIII (5 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Predominant Income TypePredominantIncomeTypeDisproportionate AllocationsDisproportionateAllocationsGeneral Or Managing PartnerGeneralOrManagingPartner
Belmont Harlem Surgery Ctr LLC
3101 North HarlemChicagoIL60634412237612Medical SvcILnanafalsefalse
RES Hlth Sleep Ctr of River Forest LLC
665 W North Ave 500LombardIL60148262189763Medical SvcILnanafalsefalse
RES Hlth Sleep Ctr of Evanston LLC
665 W North Ave 500LombardIL60148261519556Medical SvcILnanafalsefalse
RES Hlth Sleep Ctr of Chicago NW LLC
665 W North Ave 500LombardIL60148261519627Medical SvcILnanafalsefalse
RES Hlth Sleep Ctr of Lincoln Park LLC
665 W North Ave 500LombardIL60148261519667Medical SvcILnanafalsefalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (2 entries)

Address Line1AddressForeign/AddressLine1CityAddressForeign/CityCountryAddressForeign/CountryPrimary ActivityPrimaryActivityLegal Domicile Foreign CountryLegalDomicileForeignCountryBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINLegal Domicile StateLegalDomicileState
L Gilbraith Insurance SPC Ltd
68 1109 West Bay Rd PO Box 1109Grand CaymanCJInsuranceCJnaForeign Co.
Resurrection Health Care Preferred
Mgd Care ContractingnaC Corp100 N River RdDes PlainesIL60016363974620IL
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
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 OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgtrueReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Resurrection Development Foundation
c52800
Resurrection Medical Center
o56033808

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