FURP.ORG / PUBLIC DATA EXPLORER

JACKSON PARK HOSPITAL FOUNDATION: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
JACKSON PARK HOSPITAL FOUNDATION (EIN 36-2448028)
Tax period
2009-04-01 to 2010-03-31
Filed
2011-02-14
IRS object ID
201120459349300222
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)
Timestamp2011-02-14T11:29:55-05:00Timestamp
Tax Period End Date2010-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MITCHELL & TITUS LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1ONE BATTERY PARK PLAZAAddressLine1
CityNEW YORKCity
StateNYState
ZIP Code10004ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362448028EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Jackson Park Hospital FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlJACKNameControl
Phone7739477989Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line17531 SOUTH STONY ISLAND AvenueAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60649ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMERRITT HASBROUCKName
TitlePRESIDENTTitle
Date Signed2011-02-11DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone2127094500Phone
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMerritt HasbrouckNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line17531 South Stony Island AvenueAddressLine1
CityChicagoCity
StateILState
ZIP Code60649ZIPCode
FieldValueIRS element (for citing)
Gross Receipts112659189GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web Sitewww.jacksonparkhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1912YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionThe mission of the physicians, staff, and Board of Directors of the organization is to provide compassionate and high quality healthcare services to meet the needs of the patients and communities we serve.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members8NbrIndependentVotingMembers
Total Nbr Employees968TotalNbrEmployees
Total Nbr Volunteers8TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year933601ContributionsGrantsPriorYear
Contributions Grants Current Year467457ContributionsGrantsCurrentYear
Program Service Revenue Prior Year109679051ProgramServiceRevenuePriorYear
Program Service Revenue CY106046224ProgramServiceRevenueCY
Investment Income Prior Year85647InvestmentIncomePriorYear
Investment Income Current Year22781InvestmentIncomeCurrentYear
Other Revenue Prior Year3144044OtherRevenuePriorYear
Other Revenue Current Year6122727OtherRevenueCurrentYear
Total Revenue Prior Year113842343TotalRevenuePriorYear
Total Revenue Current Year112659189TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year36618037SalariesEtcPriorYear
Salaries Etc Current Year39489900SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year61163632OtherExpensePriorYear
Other Expenses Current Year60335472OtherExpensesCurrentYear
Total Expenses Prior Year97781669TotalExpensesPriorYear
Total Expenses Current Year99825372TotalExpensesCurrentYear
Revenues Less Expenses Prior Year16060674RevenuesLessExpensesPriorYear
Revenues Less Expenses CY12833817RevenuesLessExpensesCY
Total Assets BOY79147818TotalAssetsBOY
Total Assets EOY93455032TotalAssetsEOY
Total Liabilities BOY23170088TotalLiabilitiesBOY
Total Liabilities EOY24829027TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY55977730NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY68626005NetAssetsOrFundBalancesEOY
Mission DescriptionThe mission of the physicians, staff, and Board of Directors of Jackson Park Hospital Foundation is to provide compassionate and high quality healthcare services to meet the needs of the patients and communities we serve.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense42229156Expense
Revenue34924306Revenue
DescriptionAcute inpatient hospital services.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense27616263Expense
Revenue37747768Revenue
DescriptionEmergency Room services.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense8773536Expense
Revenue6960820Revenue
DescriptionInpatient behavorial medicine services.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp15458504TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev26413330TotalOfOtherProgramServiceRev
Total Program Service Expense94077459TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiestrueLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
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
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
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
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With1096151NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees968NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members8NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonNELSON VASQUEZNamePerson
Telephone Number7739477989TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17531 SOUTH STONY ISLAND AVENUEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60649ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Dr Arol Augsburger
Director2.0X000
James I Clark III
Director2.0X000
Dr Lakshmi Dodda
Physician40.0X28646500
Dr William O Dorsey III
Chairman of the Board of Direc2.0X10016000
Dr Harshad Mehta
Director2.0X16640500
Dr Joyce R Miller
Director2.0X000
Kay L Murray
Director2.0X000
Dr Bangalore R Murthy
Director2.0X13910600
Dr Haroon Olomi
Director2.0X9054500
Dinah Ramirez
Director2.0X000
Alderman Todd Stroger
Director2.0X000
Michael Wilczynski
Director2.0X000
Dr Emra Brooks Williams
Director2.0X000
Merritt Hasbrouck
President40.044236000X
G Randall Smith
Executive Vice President40.044092000X
Margo Brooks-Pugh
Vice President40.011343100X
Alvin L Kruse
Secetary2.0000X
James M Schraidt
Assisisstant Secretary2.0000X
Edward J Silha
COO40.027888600X
Nelson Vasquez
VP of Finance40.018795800X
Thodur Ranganathan
Physician40.026920000X
Rose Ette
Registered Nurse81.016938100X
Chioma Uche
Registered Nurse66.013749000X
Gloria Ifebueme
Registered Nurse62.012907000X
Ohuonu Uchechi
Registered Nurse59.012345000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3074827TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K41NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
NICL Laboratories
306 Era DriveNORTHBROOKIL60062Pathology & Lab MGT3516233
Progressive Nursing Staffers
5514 Alma Lane Suite 201SPRINGFIELDVA22151Nurse Staffing2195372
Emcare
7032 Collection Center DriveCHICAGOIL60693EMERG MED PHYSICIANS1844193
Rush Nursing Agency
7501 South Stony IslandCHICAGOIL60649Nurse Staffing1536530
Amerisourcebergen
1001 West Taylor RoadROMEOVILLEIL60446DRUGS FOR PNT CARE1490024
FieldValueIRS element (for citing)
Number Of Contractors GT100 K25NumberOfContractorsGT100K
Related Organizations30000RelatedOrganizations
All Other Contributions437457AllOtherContributions
Total Contributions467457TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET PATIENT SERVICE REVENUE6117108932927589329275
PROVIDER TAX PROCEEDS6215001671694916716949
FieldValueIRS element (for citing)
Total Program Service Revenue106046224TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column22781TotalRevenueColumn
Exclusion$22,781ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
NET ASSETS RELEASED FROM RESTRICTIONS900099185542185542
RESTRICTED DONATIONS - VC FUND900099337282337282
OTHER REVENUE900099248320248320

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column5351583TotalRevenueColumn
Related Or Exempt Function Income5351583RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue6122727TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column112659189TotalRevenueColumn
Related Or Exempt Function Income112168951RelatedOrExemptFunctionIncome
Exclusion$22,781ExclusionAmount

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)
Total1899291Total
Program Services0ProgramServices
Management And General1899291ManagementAndGeneral
Fundraising0Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total29679099Total
Program Services29679099ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total7911510Total
Program Services7911510ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total492854Total
Program Services0ProgramServices
Management And General492854ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total93031Total
Program Services0ProgramServices
Management And General93031ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total60000Total
Program Services0ProgramServices
Management And General60000ManagementAndGeneral
Fundraising0Fundraising

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)
Total18032052Total
Program Services14829315ProgramServices
Management And General3202737ManagementAndGeneral
Fundraising0Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total9052245Total
Program Services9052245ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total2570509Total
Program Services2570509ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total150355Total
Program Services150355ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1711568Total
Program Services1711568ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total1448115Total
Program Services1448115ProgramServices
Management And General0ManagementAndGeneral
Fundraising0Fundraising

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
PROVISION FOR BAD DEBTS194696011946960100
PROVIDER TAX EXPENSES7131636713163600
PENSION EXPENSE12350612350600

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total99825372Total
Program Services94077459ProgramServices
Management And General5747913ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY5880653BOY
EOY6937276EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY54BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY56090053BOY
EOY66033613EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY717577BOY
EOY815193EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY349755BOY
EOY430644EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis66212239LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec47502853LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY15360530BOY
EOY18709386EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY749196BOY
EOY528920EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY79147818BOY
EOY93455032EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY11228415BOY
EOY10655571EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2441960BOY
EOY3013973EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2817864BOY
EOY4340709EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY6681849BOY
EOY6818774EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY23170088BOY
EOY24829027EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY55792188BOY
EOY68626005EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY185542BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY55977730BOY
EOY68626005EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY79147818BOY
EOY93455032EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

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)
Total Grassroots LobbyingTotalGrassrootsLobbying
Total Direct LobbyingTotalDirectLobbying
Total Lobbying ExpendituresTotalLobbyingExpenditures
Other Exempt Purpose ExpendituresOtherExemptPurposeExpenditures
Total Exempt Purpose ExpendituresTotalExemptPurposeExpenditures
Lobbying NontaxableLobbyingNontaxableAmount
Grassroots NontaxableGrassrootsNontaxableAmount
Tot Lobbying Grassroot Minus Non TxTotLobbyingGrassrootMinusNonTx
Tot Lobby Expend Mns Lobbying NontxTotLobbyExpendMnsLobbyingNontx
VolunteersfalseVolunteers
Paid Staff Or ManagementfalsePaidStaffOrManagement
Media AdvertisementsfalseMediaAdvertisements
Mailings MembersfalseMailingsMembers
Publications Or BroadcastfalsePublicationsOrBroadcast
Grants Other OrganizationsfalseGrantsOtherOrganizations
Direct Contact LegislatorstrueDirectContactLegislators
Direct Contact Legislators$130,500DirectContactLegislatorsAmount
Rallies DemonstrationsfalseRalliesDemonstrations
Other ActivitiesfalseOtherActivities
Total Lobbying Expenditures IIB130500TotalLobbyingExpendituresIIB
Not Described In501c3falseNotDescribedIn501c3
Form4720 Filed4912 TaxfalseForm4720Filed4912Tax

Schedule D IRS990ScheduleD

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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis2482024OtherCostOrOtherBasis
Book Value2482024BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis40985555OtherCostOrOtherBasis
Depreciation30955438Depreciation
Book Value10030117BookValue
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovements

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis21782410OtherCostOrOtherBasis
Depreciation16324934Depreciation
Book Value5457476BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis962250OtherCostOrOtherBasis
Depreciation222481Depreciation
Book Value739769BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings18709386TotalOfBookValueLandBuildings
Federal Income Tax Liability0FederalIncomeTaxLiability

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionSELF-INSURANCE LIABILITYDescription
Amount$6,818,774Amount
FieldValueIRS element (for citing)
Total Of Amounts6818774TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierAccounting for Uncertainty in Income TaxesIdentifier
Return ReferenceSchedule D, Part XReturnReference
ExplanationOn March 31, 2010, the Corporations adopted the requirements of Financial Accounting Standards Board (FASB) Accounting Standards Update (ASU) 2009-06 regarding uncertain tax positions. ASU 2009-06 defines how uncertain tax positions should be recognized, measured, presented, and disclosed in the financial statements. It requires entities to recognize a tax benefit from an uncertain tax position only if it is more likely than not that the position is sustainable, based solely on its technical merits and consideration of the relevant taxing authority's widely understood administrative practices and precedents. The Corporations have evaluated tax positions taken or expected to be taken to determine whether the tax positions are more likely than not to be sustained by the applicable taxing authority, and have determined that they currently do not have any uncertain tax positions.Explanation

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care PolicytrueCharityCarePolicy
Written PolicytrueWrittenPolicy
FPG Reference Free CaretrueFPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted CaretrueFPGReferenceDiscountedCare
Pcent200 DXPcent200D
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 Expense13040251TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense13040251NetCommunityBenefitExpense
Percent Of Total Expense0.13070PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense35604769TotalCommunityBenefitExpense
Direct Offsetting Revenue21395971DirectOffsettingRevenue
Net Community Benefit Expense14208798NetCommunityBenefitExpense
Percent Of Total Expense0.14230PercentOfTotalExpense

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense48645020TotalCommunityBenefitExpense
Direct Offsetting Revenue21395971DirectOffsettingRevenue
Net Community Benefit Expense27249049NetCommunityBenefitExpense
Percent Of Total Expense0.27300PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense2180378TotalCommunityBenefitExpense
Direct Offsetting Revenue379511DirectOffsettingRevenue
Net Community Benefit Expense1800867NetCommunityBenefitExpense
Percent Of Total Expense0.01800PercentOfTotalExpense

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue-57844118DirectOffsettingRevenue
Net Community Benefit Expense57844118NetCommunityBenefitExpense
Percent Of Total Expense0.57950PercentOfTotalExpense

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense2180378TotalCommunityBenefitExpense
Direct Offsetting Revenue-57464607DirectOffsettingRevenue
Net Community Benefit Expense59644985NetCommunityBenefitExpense
Percent Of Total Expense0.59750PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense50825398TotalCommunityBenefitExpense
Direct Offsetting Revenue-36068636DirectOffsettingRevenue
Net Community Benefit Expense86894034NetCommunityBenefitExpense
Percent Of Total Expense0.87050PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense ReportedtrueBadDebtExpenseReported
Bad Debt Expense$5,321,042BadDebtExpenseAmount
Amount Attributable To5345869AmountAttributableTo
Amount Reimbursed By Medicare23854905AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare24517727CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-662822MedicareSurplusOrShortfall
Costing Methodology UsedCostingMethodologyUsed
Written Debt Collection PolicytrueWrittenDebtCollectionPolicy
Provision For Charity CaretrueProvisionForCharityCare

Form990 Schedule H Part V Form990ScheduleHPartV

Name Name

FieldValueIRS element (for citing)
Business Name Line1JACKSON PARK HOSPITAL FOUNDATIONBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line17531 South Stony IslandAddressLine1
CitychicagoCity
StateILState
ZIP Code60649ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital

Form990 Schedule H Part VI Form990ScheduleHPartVI

FieldValueIRS element (for citing)
Subsidized Health Services ExplnProvision for bad debts of 19,469,601 was excludedSubsidizedHealthServicesExpln
Bad Debt FootnoteCost for determining bad debts and other community cost are based on the Medicare cost to charge ratio.BadDebtFootnote
Shortfall As Community BenefitThe short fall reported on Part III, Line seven should be treated as a community benefit because this amount represents the difference between the hospitals cost and amounts received from both Medicare and Medicaid.ShortfallAsCommunityBenefit
Debt Collection PolicyPatients who are known to qualify for charity care or financial assistance are placed into their own financial class in our business systems. This insures that they are not billed or placed into collections.DebtCollectionPolicy
Needs AssessmentJackson Park Hospital continually assesses the health care needs of its community through its Family Practice clinic, medical education program and school based clinic. These programs are community based and the hospital receives constant feedback from the medical professional in the field as to what services are needed in the community.NeedsAssessment
Patient Education AssistanceUpon registration or admission, un-insured patients are informed that they may be eligible for assistance under federal or state programs. We employ a specialized company that will work with the patient to qualify them for this assistance and or qualify the patient under our charity care policy.PatientEducationAssistance
Community InformationJackson Park Hospital primary services are the five zip codes of 60649, 60637, 60619,60617 and 60615 located on the far south side of the City of Chicago. The demographic profile of these zip codes is prominently African American with incomes generally below both the City of Chicago and State of Illinois income levels.CommunityInformation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (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
Dr Lakshmi Dodda
28646500000000028646501853730
Dr Harshad Mehta
16640500000000016640501113580
Merritt Hasbrouck
3179860120261041130000044236004502770
G Randall Smith
3179860120261026730000044092004486380
Edward J Silha
1609450115774021670000027888602788620
Nelson Vasquez
1825410445009670000018795802031680
Thodur Ranganathan
2685100006900000026920002506450
Rose Ette
1692600001210000016938101888200

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Question 11AThe Chairman of The Board and Audit Committee along with the senior management team reviews the Form 990 prior to its filing.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cAll officers, directors or trustees, and key employees are required to complete a conflict of interest disclosure form every three years. Jackson Park Hospital Foundation is scheduled to complete this procedure in its fiscial year 2011.
Offices & Positions for Which Process was Used, & Year Process was BegunForm 990, Part VI, Question 15a & BJackson Park Hospital Foundation has a compensation committee. The Chairman of The Board reviews the compensation of senior management and key employees on an annual basis.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19Jackson Park Hospital Foundations makes its 990, Conflict of Interest Policy, Community Benefit Report and Financial Statements available to the public by appointment with its Vice President of Finance.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1Foundation For Jackson Park HospitalBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17531 South Stony IslandAddressLine1
CitychicagoCity
StateILState
ZIP Code60649ZIPCode
FieldValueIRS element (for citing)
EIN270029181EIN
Primary ActivitieshealthcarePrimaryActivities
Legal Domicile StateILLegalDomicileState
Exempt Code Section11ExemptCodeSection
Public Charity Status501(c)(3)PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1naBusinessNameLine1

Form990 Schedule R Part IV Form990ScheduleRPartIV

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1Friedell ClinicBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line17531 South Stony IslandAddressLine1
CitychicagoCity
StateILState
ZIP Code60649ZIPCode
FieldValueIRS element (for citing)
EIN363290656EIN
Primary Activityhealthcare svPrimaryActivity
Legal Domicile StateILLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1naBusinessNameLine1
FieldValueIRS element (for citing)
Type Of Entityc corp.TypeOfEntity
Share Of Total Income100ShareOfTotalIncome
Share Of EOY Assets100ShareOfEOYAssets
Percentage Ownership1.00000PercentageOwnership
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 OrgfalseGiftGrantOrCapContrFrOtherOrg
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 EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1Friedell ClinicBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypenTransactionType
Amount Involved94030AmountInvolved