HOLY CROSS HOSPITAL: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
HOLY CROSS HOSPITAL (EIN 36-2170133)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-05-16
IRS object ID
201111369349304676
Schema version
2009v1.7
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)
Timestamp2011-05-16T14:09:09-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1RSM McGladrey IncBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1One South Wacker Drive Suite 800AddressLine1
CityChicagoCity
StateILState
ZIP Code606063392ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362170133EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Holy Cross HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlHOLYNameControl
Phone7738841604Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12701 West 68th StreetAddressLine1
CityChicagoCity
StateILState
ZIP Code60629ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMichael LawrenceName
TitleVP Finance & CFOTitle
Phone7738841604Phone
Date Signed2011-05-16DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameZack FortschName
Phone3126343400Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWayne LernerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12701 West 68th StreetAddressLine1
CityChicagoCity
StateILState
ZIP Code60629ZIPCode
FieldValueIRS element (for citing)
Gross Receipts112216788GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Group Exemption Number0928GroupExemptionNumber
Organization501cXOrganization501c
Web Sitewww.HolyCrossHospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1928YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionHoly Cross Hospital (HCH or the Hospital) is a Catholic Health Care Organization sponsored by the Sisters of Saint Casimir. By our commitment to witness to the Healing Mission of Jesus, we contribute to healthy communities and promote quality health care to all with compassion.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees1059TotalNbrEmployees
Total Nbr Volunteers19TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year9785000ContributionsGrantsPriorYear
Contributions Grants Current Year1115870ContributionsGrantsCurrentYear
Program Service Revenue Prior Year115571337ProgramServiceRevenuePriorYear
Program Service Revenue CY109389667ProgramServiceRevenueCY
Investment Income Prior Year117851InvestmentIncomePriorYear
Investment Income Current Year280643InvestmentIncomeCurrentYear
Other Revenue Prior Year1438397OtherRevenuePriorYear
Other Revenue Current Year968620OtherRevenueCurrentYear
Total Revenue Prior Year126912585TotalRevenuePriorYear
Total Revenue Current Year111754800TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year48874821SalariesEtcPriorYear
Salaries Etc Current Year52492687SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year64806630OtherExpensePriorYear
Other Expenses Current Year58616630OtherExpensesCurrentYear
Total Expenses Prior Year113681451TotalExpensesPriorYear
Total Expenses Current Year111109317TotalExpensesCurrentYear
Revenues Less Expenses Prior Year13231134RevenuesLessExpensesPriorYear
Revenues Less Expenses CY645483RevenuesLessExpensesCY
Total Assets BOY84983400TotalAssetsBOY
Total Assets EOY81348173TotalAssetsEOY
Total Liabilities BOY63242453TotalLiabilitiesBOY
Total Liabilities EOY62845912TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY21740947NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY18502261NetAssetsOrFundBalancesEOY
Mission DescriptionThe Hospital is a Catholic Health Care Organization sponsored by the Sisters of St. Casimir. By our commitment to witness to the healing mission of Jesus, we contribute to healthy communities and promote quality health care to all with compassion.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense105149934Expense
Revenue109389667Revenue
DescriptionThe Hospital is a not-for-profit Catholic hospital that serves a large area of Chicago's Southwest side. Located in Marquette Park, the Hospital provides emergency, medical/surgical, specialty, diagnostic and primary care services to communities that are home to mostly African American and Latino families. Many of the patients the Hospital serves are uninsured or underinsured. The emergency department sees an average of 50,000 patients per year and more ambulance daily visits than any other Illinois hospital. The Hospital is a Disproportionate Share Hospital and is a vital safety net hospital.Description
Total Program Service Expense105149934TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital1Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds1TaxExemptBonds
Invest Tax Exempt Bonds0InvestTaxExemptBonds
Escrow Account0EscrowAccount
On Behalf Of Issuer0OnBehalfOfIssuer
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP1LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10961092NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees1059NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders1MembersOrStockholders
Election Of Board Members1ElectionOfBoardMembers
Decisions Subject To Approval1DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMichael Lawrence CFONamePerson
Telephone Number7738845150TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12701 West 68TH StreetAddressLine1
CityChicagoCity
StateILState
ZIP Code60629ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Wayne Lerner
President & CEO40.00XX528999013597
Diane Howard
Board Chairperson0.50XX000
John R Ball MD MD MACP
Vice Chairperson0.50XX000
Anthony Bozzano MD
Medical Staff President0.50X000
Sister Regina Marie Dubickas
Secretary0.50XX000
Sr Theresa Dabulis
Trustee0.50X000
Barbara Fahey
Trustee0.50X000
Chia Huang MD
Trustee0.50X000
Larry Margolis
Trustee0.50X000
Nancy Streitmatter MD
Trustee40.00X13270105479
Sivaramaprasad Tummala MD
Trustee0.50X000
Sister M Immacula Wendt
Trustee0.50X000
Sister Margaret Zalot
Trustee0.50X000
Michael Lawrence
VP Finance & CFO40.00X29738308457
Paul Teodo
COO40.00X14338505692
Shelia Mischke
VP Patient Care Services40.0018607105968X
Dennis Ryan
VP Community & External Affairs40.0017087305510X
Sr Juline Revas
VP Mission Services40.0018267305110X
Cathy Kallal
Chief Medical Officer40.0026492003620X
Anna Carvalho
VP Business Development40.0014985702124X
Solomon Greer MD
Physician40.0022501408187X
Justin McCarthy
Director of Radiology40.0013850705549X
Edward Edu
Nurse40.0013216105473X
Leona Gibbons
Director of Compliance40.0012872006971X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2681264TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation81737TotalOtherCompensation
Number Individuals GT100 K44NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Noel Alcantara MDSC
PO Box 2909DarienIL60561Medical Services1275034
Aramark Servicemaster
PO Box 651009CharlotteNC28265Support Services1114746
Emergency Room Care Physicians
Dept 4034 PO 3065ChicagoIL60680Medical Services872566
Fisher Consulting Inc
Dept 108301 PO Box 67000DetroitMI48267Equipment Maintenance843996
Superior Health Linens LLC
2905 Syene RoadMadisonWI53713Support Services759150
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
Fundraising Events55312FundraisingEvents
Government Grants287858GovernmentGrants
All Other Contributions772700AllOtherContributions
Total Contributions1115870TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Medicare/Medicaid6241007297704872977048
Net Patient Revenue6241003641261936412619
FieldValueIRS element (for citing)
Total Program Service Revenue109389667TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column280643TotalRevenueColumn
Exclusion$280,643ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real582939Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real391159Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real191780Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column191780TotalRevenueColumn
Exclusion$191,780ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events70829GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events55312CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses70829FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Miscellaneous621400356472356472
Cafeteria621400315660315660
Parking621400104708104708
FieldValueIRS element (for citing)
Total Other Revenue776840TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column111754800TotalRevenueColumn
Related Or Exempt Function Income110166507RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$472,423ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2025500Total
Management And General2025500ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total42440073Total
Program Services40889221ProgramServices
Management And General1550852ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total308822Total
Program Services285043ProgramServices
Management And General23779ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total4533567Total
Program Services4184482ProgramServices
Management And General349085ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total3184725Total
Program Services2978010ProgramServices
Management And General206715ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total728970Total
Management And General728970ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total82500Total
Management And General82500ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total14681667Total
Program Services14097704ProgramServices
Management And General583963ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total18983Total
Program Services18983ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total2082178Total
Program Services2057122ProgramServices
Management And General25056ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total8819Total
Program Services4874ProgramServices
Management And General3945ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total12565Total
Program Services7191ProgramServices
Management And General5374ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total418033Total
Program Services418033ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total5850999Total
Program Services5850999ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total4941508Total
Program Services4941508ProgramServices

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies1241168512411685
Provision for Bad Debt80178148017814
Medicaid Assessment55092915509291
Miscellaneous28268052614812211993
Food77678172941747364

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total248032Total
Program Services133745ProgramServices
Management And General114287ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total111109317Total
Program Services105149934ProgramServices
Management And General5959383ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2662453BOY
EOY7708748EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY17388018BOY
EOY14476032EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY948387BOY
EOY225279EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY15938870BOY
EOY12321545EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY3000EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1461829BOY
EOY1582688EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY1384155BOY
EOY906913EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis131199804LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec90609351LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY42813005BOY
EOY40590453EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY1982192BOY
EOY2971590EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY404491BOY
EOY561925EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY84983400BOY
EOY81348173EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY19040499BOY
EOY16180473EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY14125000BOY
EOY12625000EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY3018991BOY
EOY1973841EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY27057963BOY
EOY32066598EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY63242453BOY
EOY62845912EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY20597735BOY
EOY17285406EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1143212BOY
EOY1216855EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21740947BOY
EOY18502261EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY84983400BOY
EOY81348173EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$200,000DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB200000TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1337233OtherCostOrOtherBasis
Book Value1337233BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis52105233OtherCostOrOtherBasis
Depreciation29884424Depreciation
Book Value22220809BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis133200OtherCostOrOtherBasis
Depreciation120990Depreciation
Book Value12210BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis75618064OtherCostOrOtherBasis
Depreciation59248525Depreciation
Book Value16369539BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2006074OtherCostOrOtherBasis
Depreciation1355412Depreciation
Book Value650662BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings40590453TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
Accrued Pension Benefit$28,434,598
Reserve for Professional Liability$3,632,000
FieldValueIRS element (for citing)
Total Of Amounts32066598TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
ExplanationIncome taxes: The Hospital has received a determination letter from the Internal Revenue Service stating that it is exempt from the payment of federal income taxes under Section 501(c)(3) of the Internal Revenue Code. On July 1, 2009, the Hospital adopted the FASB issued guidance for accounting for uncertainty in income taxes. The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When the return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. UBIT is reported on Form 990T, as appropriate. The benefit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more likely than not" recognition threshold are measured as the largest amount of tax benefit that is more than 50 percent likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above is reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Upon the adoption of the FASB guidance relative to uncertainty in income taxes and as of June 30, 2010, there were no unrecognized tax benefits identified and recorded as liabilities. Form 990 filed by the Hospital is subject to examination by the Internal Revenue Service (IRS) and the State of Illinois up to three years from the extended due date of each return. This return filed by the Hospital is no longer subject to examination for the years 2007 and prior.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Annual Fundraising DinnerNameOfEvent1
Gross Receipts Event1126141GrossReceiptsEvent1
Charitable Contributions Event155312CharitableContributionsEvent1
Gross Revenue Event170829GrossRevenueEvent1
Food And Beverage Event143431FoodAndBeverageEvent1
Other Direct Expenses Event127398OtherDirectExpensesEvent1
Gross Receipts Total126141GrossReceiptsTotal
Charitable Contributions Total55312CharitableContributionsTotal
Gross Revenue Total Events70829GrossRevenueTotalEvents
Food And Beverage Total Events43431FoodAndBeverageTotalEvents
Other Direct Expenses Total Events27398OtherDirectExpensesTotalEvents
Direct Expense Summary Events70829DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
FPG Reference Free Care1FPGReferenceFreeCare
Pcent100XPcent100
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage150.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget1ExpensesExceededBudget
Unable To Provide Care0UnableToProvideCare
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4774691TotalCommunityBenefitExpense
Net Community Benefit Expense4774691NetCommunityBenefitExpense
Percent Of Total Expense0.04300PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense32360473TotalCommunityBenefitExpense
Direct Offsetting Revenue30222048DirectOffsettingRevenue
Net Community Benefit Expense2138425NetCommunityBenefitExpense
Percent Of Total Expense0.01920PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense37135164TotalCommunityBenefitExpense
Direct Offsetting Revenue30222048DirectOffsettingRevenue
Net Community Benefit Expense6913116NetCommunityBenefitExpense
Percent Of Total Expense0.06220PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense16323TotalCommunityBenefitExpense
Net Community Benefit Expense16323NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense16323TotalCommunityBenefitExpense
Net Community Benefit Expense16323NetCommunityBenefitExpense
Percent Of Total Expense0.00010PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense37151487TotalCommunityBenefitExpense
Direct Offsetting Revenue30222048DirectOffsettingRevenue
Net Community Benefit Expense6929439NetCommunityBenefitExpense
Percent Of Total Expense0.06230PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$2,369,264BadDebtExpenseAmount
Amount Attributable To710779AmountAttributableTo
Amount Reimbursed By Medicare42755000AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare36498000CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall6257000MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1Holy Cross HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line12701 W 68TH StreetAddressLine1
CityChicagoCity
StateILState
ZIP Code60629ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Critical Access HospitalXCriticalAccessHospital
Er24 HoursXEr24Hours

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Costing Method UsedPart I, Line 7: A cost to charge ratio, calculated using the IRS worksheet, was used for the Part I, Line 7 table.CostingMethodUsed
Percent Of Total Expense ExplnPart I, Line 7f: Bad debt expense of $8,017,814 was removed from total expenses.PercentOfTotalExpenseExpln
Bad Debt FootnotePart III, Line 4: The collection of receivables from third-party payors and patients is the Hospital's primary source of cash for operations and is critical to its operating performance. The primary collection risks relate to uninsured patient accounts and patient accounts for which the primary insurance payor has paid, but patient responsibility amounts (deductibles and copayments) remain outstanding. Patient receivables, where a third-party payor is responsible for paying the amount, are carried at a net amount determined by the original charge for the service provided, less an estimate made for contractual adjustments or discounts provided to third-party payors. Patient receivables due directly from the patients are carried at the original charge for the service provided less amounts covered by third-party payors, discounts for patients that are uninsured and an estimated allowance for doubtful receivables. Management estimates this allowance based on the aging of its accounts receivable and its historical collection experience for each payor type. Recoveries of receivables previously written off are recorded as a reduction of bad debt expense when received.The past due status of receivables is determined on a case-by-case basis depending on the payor responsible. Interest is generally not charged on past due accounts. Prior to writing-off the amounts as bad debts expense, the Hospital's Patient Financial Services department reviews the self-pay balances. Where the patient has chosen not to cooperate with our charity care policy, the Hospital utilizes a program that accesses the patients' credit information and identifies patients that qualify for charity care under our policy. These reports show that over 90% of all uninsured patients and patients with a self-pay balance after insurance payment qualify for charity care. We believe that approximately $2,370,000 or 30% of the accounts written off as bad debts (total bad debt is $8,018,000) would have been eligible under the Hospital's charity care policy. Applying the cost to charge ratio of 29.55%, the estimated cost of the Hospital's bad debts expense attributable to charity care is $711,000. Bad debt recoveries are classified as a decrease to bad debt expense.BadDebtFootnote
Shortfall As Community BenefitPart III, Line 8: Medicare costs are allocated in accordance with Medicare regulations.ShortfallAsCommunityBenefit
Debt Collection PolicyPart III, Line 9b: The Hospital's policy is to provide those who are indigent, as defined by Regionally Adjusted Federal Poverty Guidelines, with Charity Care or Partial Charity Care to relieve the financial burden associated with medically necessary treatment. The Hospital's policy establishes appropriate procedures for providing free care to qualified patients. It also serves to ensure compliance with all applicable federal, state, and local laws. The Financial Aid policies are available to all of the Hospital's indigent patients, who may be uninsured/underinsured or have suffered a catastrophic injury. The Hospital's Self-pay Debt Reduction Policy provides uninsured, underinsured, low-income and medically indigent patients with debt reduction provisions in order to alleviate the burdensome financial obligations associated with receiving acute and unexpected medical care.DebtCollectionPolicy
Needs AssessmentPart VI, Line 2: The Hospital uses various methods to access the health care needs of the community it serves. Important information is gathered from the census updates, Illinois Department of Healthcare and Family Services, the Department of Public Health, Cook County Department of Public Health, City of Chicago Department of Public Health, University of Chicago Urban Health Initiatives, churches, community organizations and advocacy groups. Because of the Hospital's close relationship with leaders of the new communities program and the commissioner of the City of Chicago Department of Health, the Hospital was instrumental in establishing the Healthy Chicago Lawn advocacy coalition. The Hospital sponsors the Healthy Chicago Lawn administrative office and coalition mettings. The Hospital has served as the host site and primary health resource for the majority of Healthy Chicago Lawn Coalition's planning, education and advocacy initiatives. Healthy Chicago Lawn has promoted the development of many relational, educational and promotional health awareness activities in the Chicago Lawn community. As a result of the partnership and host status with Healthy Chicago Lawn, the Hospital has become more accessible to community groups and residents. There has been an increased awareness of the services provided by the Hospital as a result of these partnerships with community organizations. Leadership staff of the Hospital serve on the steering committee of Healthy Chicago Lawn.Since the inception of Healthy Chicago Lawn, there has been a positive and productive synergy between the Coalition and the Hospital to improve health awareness which has resulted in positive health outcomes in the communities served by the Hospital. The Hospital also assesses the needs of the community through the Parish Nurse program. Community Outreach nurse attend church meetings where information is received about the sick parishioners at home and in nursing homes. There are three large Catholic churches in the community that have a formal HCH Parish Nurse program. The Hospital has designated a nurse to service these churches. The nurse conducts blood pressure screenings and health assessments for 100 regular parishioners. New parishioners, who are uninsured, are assisted with referrals. Also, home visit arrangements are made for at risk seniors. The Hospital also has a volunteer team at churches to assist with health fairs and health education events, such as the MERCK Pharmaceuticals sponsored diabetes education program for the Latino community. Another source for assessing the health care needs of the community is through membership in community organizations. Community groups have requested the Hospital for health care professionals to join their boards and assist with the direction of their advocacy and policies. Unpaid Hospital staff have become members of board of these organizations, which has helped the Hospital identify the needs of the community and in turn communicate to the leadership of these organization the resources the Hospital has to serve them.NeedsAssessment
Patient Education AssistancePart VI, Line 3: The Hospital has posted in the Inpatient and Outpatient Admission areas and on its website the notice of its Charity Care Policies. This includes taking steps to ensure that Charity Care literature, Brochures and Applications Forms for Charity Care are readily accessible to patients at the Hospital's key locations. Notification of the availability of charity care is also printed on patient statements. Financial Counselors are located on campus that review the patient census for inpatient, outpatient and surgical areas to assist in-house patients identify the availability of potential insurance coverage and assist them with completing financial aid paperwork. At the earliest time feasible, HCH personnel obtains the necessary patient financial records and documentation regarding eligibility for any and all types of alternative funding to expedite processing of patient charity care applications.PatientEducationAssistance
Community InformationPart VI, Line 4: The Hospital has a primary service area ("PSA") consisting of six ZIP code areas with a population of 451,000, and a secondary service area ("SSA") consisting of five additional ZIP code areas with a population of 271,000. The entire PSA/SSA is located in the City of Chicago. In 2009, 68% of the patients admitted to the Hospital were African American and 11% were Latino. In 2009, only 13.7% of the patients admitted to the Hospital were covered by private health insurance, with 76% being covered through public sector programs (primarily Medicaid and Medicare). Approximately 9% of the Hospital's patients are classified as charity care. The Hospital's admissions are initiated to a very substantial extent (at least 70%) through the Hospital's Emergency Department. According to the Illinois Department of Public Health, the Hospital accepts more EMS transports than any other Hospital in Illinois - three times as many as John H. Stroger Hospital (formerly Cook County Hospital), the largest component of the health care services safety net for public sponsored health care in Chicago. As demonstrated by the insurance and admission status of its patient population, the Hospital has provided, and continues to provide necessary medical services to an underserved and underinsured community population that is heavily minority and poor. In fact, the PSA has experienced the second highest rate of foreclosures as compared to similar areas throughout the state. Finally, three of the zip codes in the PSA rank as the 1st, 2nd and 6th lowest average health status average in all of Chicago.CommunityInformation
Other InformationPart VI, Line 6: Parish Nurse Program - Through the Hospital's Parish Nurse Program, the Hospital has dedicated a nurse to conduct blood pressure screenings and ongoing health assessments for 100 regular parishioners. The nurse also attends church meetings where she receives information about the sick parishioners at home and in nursing homes. Arrangements are made to assist the sick parishioners. The hospital participates with seven catholic churches in conducting health education workshops and assist the uninsured with referrals.Senior Groups - There are 32 senior groups that meet once a month for diagnostic testing, health assessments and health education. Most of these seniors are in their 80's and 90's and the Hospital assists them with having ongoing physician appointments and helping them with their medical needs.Vaccine for Children Program with CDPH - The Hospital works closely with grade school and high school nurses in the community. The purpose of this program is to assist children who are in need of recommended immunizations to remain in school. Vaccines are administered during school hours. Most of these children are on Medicaid or have no insurance. The vaccines are obtained from CDPH and the parents are not charged for administering the vaccines. The Hospital also documents in the state I CARE REGISTRY all immunizations given and assists the school nurses with medical immunizations by verifying the student's immunizations found in the state system.Community Health Fairs - The Hospital's representatives attend community group events and fairs. The Hospital provides free health screenings and health education materials at these events. On average, there are approximately 45 events per year.Influenza Program - The Hospital administered 2,500 flu immunizations during the year. These flu shots were administered at senior group meetings, churches and health fairs for community groups.Hospital Referrals for At Risk Seniors - Under this program, in certain situations, the Hospital's health care professional will make a home visit to asses an at risk senior's living situation after discharge from the Hospital.Participation in Community Health Speakers Bureau - The Hospital's health care professional participate in promoting healthy lifestyles by volunteering to be speakers whenever Community and civic groups ask for assistance in having a speaker for their events.OtherInformation
Reports Filed With StatesILReportsFiledWithStates

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesXClubDuesOrFees
Written Policy Re T And E Expenses1WrittenPolicyReTAndEExpenses
Substantiation Required1SubstantiationRequired
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 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
Wayne Lerner
48899904000000024500111470542596000
Michael Lawrence
2773830200000002450060070305840000
Shelia Mischke
1760710100000001731042370192039000
Dennis Ryan
1458730250000001359041510176383000
Sr Juline Revas
172673010000000955041550187783000
Cathy Kallal
2549200100000002433011870268540000
Anna Carvalho
129857020000000119709270151981000
Solomon Greer MD
225014000002250059370233201000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePart I, Line 1aReturnReference
ExplanationHCH pays for the social club dues of Wayne Lerner. The social club is used for hospital business and the expense is not included in his compensation.Explanation

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI

Issuer Name IssuerName

FieldValueIRS element (for citing)
Business Name Line1Illinois Finance AuthorityBusinessNameLine1
FieldValueIRS element (for citing)
Issuer EIN861091967IssuerEIN
CUSIP Number45200FBH1CUSIPNumber
Date Issued2007-12-06DateIssued
Issue Price16000000IssuePrice
Description Of PurposeTO REFUND THE IHFA SERIES 1994 BONDSDescriptionOfPurpose
Defeased0Defeased
On Behalf Of Issuer0OnBehalfOfIssuer

Form990 Schedule K Part II Form990ScheduleKPartII

FieldValueIRS element (for citing)
Total Proceeds16000000TotalProceeds
Amount Defeased16000000AmountDefeased
Current Refunding1CurrentRefunding
Advance Refunding0AdvanceRefunding
Final Allocation Made0FinalAllocationMade
Adequate Books And Recds Maintaind1AdequateBooksAndRecdsMaintaind

Form990 Schedule K Part III Form990ScheduleKPartIII

FieldValueIRS element (for citing)
Owning Bond Financed Property0OwningBondFinancedProperty
Any Lease Arrangements0AnyLeaseArrangements
Mngment Cntrct Bond Financd Prprty0MngmentCntrctBondFinancdPrprty
Any Research Agreements0AnyResearchAgreements
Bond Counsel Routinely Engaged1BondCounselRoutinelyEngaged
Prcntge Prvt Business Use By Others0.00000PrcntgePrvtBusinessUseByOthers
Percentage Of Prvt Business Re UBI0.00000PercentageOfPrvtBusinessReUBI
Total Private Business Use0.00000TotalPrivateBusinessUse
Post Issuance Compliance Procdrs1PostIssuanceComplianceProcdrs

Form990 Schedule K Part IV Form990ScheduleKPartIV

FieldValueIRS element (for citing)
Form8038 T Filed0Form8038TFiled
Variable Rate Issue0VariableRateIssue
Hedge Identified In Books And Recds0HedgeIdentifiedInBooksAndRecds
Gross Proceeds Invested In GIC0GrossProceedsInvestedInGIC
Gross Proceeds Invested0GrossProceedsInvested
Exception To Rebate0ExceptionToRebate

Schedule L IRS990ScheduleL

Loan Table LoanTable

FieldValueIRS element (for citing)
Name PersonSolomon Greer MDNamePerson
Purpose Of LoanPayroll advancePurposeOfLoan
Loan From OrganizationXLoanFromOrganization
Original Principal$3,000OriginalPrincipalAmount
Balance Due3000BalanceDue
Default0Default
Approved By Board0ApprovedByBoard
Written Agreement1WrittenAgreement
FieldValueIRS element (for citing)
Total Balance Due3000TotalBalanceDue

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section A, line 6The members of the Hospital are the General Superior and the members of the General Council of The Sisters of Saint Casimir.
Form 990, Part VI, Section A, line 7aThe members of the Hospital have the exclusive power to appoint and remove, with or without cause, the Trustees of the Hospital and establish terms for such Trustees consistent with these Bylaws; and to remove the Officers of the Hospital.
Form 990, Part VI, Section A, line 7bThe Members have the exclusive power to: (a) Adopt, alter, amend and repeal statements of mission, philosophy or purpose; (b) Amend or repeal the Bylaws or Articles of Incorporation of the Hospital and to adopt new Bylaws or Articles of Incorporation of the Hospital; (c) Select auditors and legal counsel different from those retained by the Hospital. To provide independent review, counsel, audit, advice or representation to the extent deemed necessary in the discretion of the Members; (d) Acquire and/or dispose of, mortgage or otherwise encumber or hypothecate the Hospital's real property; and (e) Reserve the exercise of such rights as the Members deem necessary to ensure consistency with the mission and philosophy of the Sisters of Saint Casimir, or to comply with applicable law (civil or church).
Form 990, Part VI, Section B, line 11The Form 990 is prepared by our tax advisors based on information provided by HCH's accounting department. The Form 990 is reviewed by the Controller and the CFO.
Form 990, Part VI, Section B, line 12cThe Board of Trustees and Senior Management sign a conflict of interest statement annually agreeing to disclose any conflict.
Form 990, Part VI, Section B, line 15The Executive Committee of the Board of Trustees reviews compensation annually with information provided by independent consultants based on a current market survey of compensation to executives of institutions of similar size and positions.
Form 990, Part VI, Section C, line 19A copy of the tax return is made available to review by administration upon request by anyone.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1The Sisters of St CasimirBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12601 W Marquette RdAddressLine1
CityChicagoCity
StateILState
ZIP Code60629ZIPCode
FieldValueIRS element (for citing)
EIN362170966EIN
Primary ActivitiesReligious orderPrimaryActivities
Legal Domicile StateILLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status1PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Holy Cross Health Partners IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12701 West 68TH StreerAddressLine1
CityChicagoCity
StateILState
ZIP Code60629ZIPCode
FieldValueIRS element (for citing)
EIN364109153EIN
Primary ActivityCONTRACTING AND CLAIMS ADMINISTRATIONPrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1HOLY CROSS HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Type Of EntityCTypeOfEntity
Share Of EOY Assets1053616ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolved
Holy Cross Health Partners Inc
K966228
Holy Cross Health Partners Inc
P60000
Holy Cross Health Partners Inc
C300000

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