NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
NORTHWESTERN MEMORIAL HEALTHCARE (EIN 36-2169179)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-11-15
IRS object ID
201133199349302468
Schema version
2010v3.4
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2011-11-15T09:01:43-06:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

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 Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN362169179EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Palos Community HospitalBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPALONameControl
Phone7089234000Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line112251 S 80th AvenueAddressLine1
CityPalos HeightsCity
StateILState
ZIP Code604630930ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameSister Margaret WrightName
TitleCEOTitle
Phone7089234000Phone
Date Signed2011-11-04DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameZack FortschName
Phone3126343400Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonSister Margaret WrightNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line112251 S 80th AvenueAddressLine1
CityPalos HeightsCity
StateILState
ZIP Code604630930ZIPCode
FieldValueIRS element (for citing)
Gross Receipts2944507933GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.paloscommunityhospital.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1972YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionHealthcare ProviderActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members10NbrIndependentVotingMembers
Total Nbr Employees3219TotalNbrEmployees
Total Nbr Volunteers649TotalNbrVolunteers
Total Gross UBI78065TotalGrossUBI
Net Unrelated Business Txbl Income-4331NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year993999ContributionsGrantsPriorYear
Contributions Grants Current Year1191063ContributionsGrantsCurrentYear
Program Service Revenue Prior Year304944368ProgramServiceRevenuePriorYear
Program Service Revenue CY318318207ProgramServiceRevenueCY
Investment Income Prior Year14503689InvestmentIncomePriorYear
Investment Income Current Year23525216InvestmentIncomeCurrentYear
Other Revenue Prior Year3757554OtherRevenuePriorYear
Other Revenue Current Year4805348OtherRevenueCurrentYear
Total Revenue Prior Year324199610TotalRevenuePriorYear
Total Revenue Current Year347839834TotalRevenueCurrentYear
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 Year192633736SalariesEtcPriorYear
Salaries Etc Current Year200533228SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year107336726OtherExpensePriorYear
Other Expenses Current Year116937596OtherExpensesCurrentYear
Total Expenses Prior Year299970462TotalExpensesPriorYear
Total Expenses Current Year317470824TotalExpensesCurrentYear
Revenues Less Expenses Prior Year24229148RevenuesLessExpensesPriorYear
Revenues Less Expenses CY30369010RevenuesLessExpensesCY
Total Assets BOY494187592TotalAssetsBOY
Total Assets EOY688313537TotalAssetsEOY
Total Liabilities BOY276740536TotalLiabilitiesBOY
Total Liabilities EOY436532750TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY217447056NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY251780787NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPalos Community Hospital (PCH) is a not-for-profit community hospital, which is operated in accordance with the Ethical and Religious Directives for Catholic Healthcare Facilities. The primary objective of PCH is the provision of inpatient and outpatient services that are responsive to the health care needs of the residents of southwestern Cook County and northeastern sections of Will County.In providing any service - be it preventive, curative or palliative - the overriding concern of the institution shall be that the quality of that service be of the highest caliber. PCH shall be committed to a continued review and analysis of the changing needs of the community it serves and shall respond to those needs with services that are readily available in a form that enhances their efficient use by physicians and patients. In addition, PCH shall maintain an ability to adapt to changes and influence forces in its environment effectively and expeditiously.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense190955774Expense
Revenue273273869Revenue
DescriptionIt is the policy of Palos Community Hospital to provide quality medical health care to all persons regardless of race, creed, sex, national origin, handicap, age, or ability to pay. The Hospital recognizes that not all individuals possess the ability or means to purchase essential medical services and further, that our mission is to serve our community with respect to providing healthcare services and healthcare education. Therefore, in keeping with the hospital's commitment to serve all members of the community, charity and/or subsidized care will be considered where the need and/or inability to pay are identified.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense36494038Expense
Revenue25865408Revenue
DescriptionCardiovascular ServicesPalos Community Hospital provides a total continuum of cardiovascular services - from diagnosis and treatment through recovery and rehabilitation - to ensure that our patients receive the complete care they need close to home. Prior to the start of the program in 2005, Palos transferred patients from their local community to other hospitals. Within 3 years, Palos ranked 14th in Illinois for heart volume. This community need has grown as can be seen with continued increases in volume since the program began.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense21009156Expense
Revenue18578977Revenue
DescriptionHome HealthPalos Community Hospital Home Health, Private Duty, and Hospice services provide quality personal care and support to patients in their homes, nursing homes or hospitals. The Home Health staff assists the chronically ill, persons with functional impairments, those needing specialized skilled care at home, those recovering from a hospital stay and the terminally ill. In 2010, Home Health staff from Palos made more than 87,000 home care visits, 23,000 hospice visits and provided more than 39,000 hours of private nursing duty assistance.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense10191040Expense
Revenue3916138Revenue
DescriptionBehavioral HealthBehavioral Health Services at Palos meet the needs of individuals and families in the community struggling with relationship problems, emotional issues, psychological disorders and even chemical dependency. The programs include alcohol treatment; chemical dependency; group therapies for mental health or substance abuse issues; intensive outpatient programs; Kids Recover Too, since children in the family can be especially hard-hit by a parent's chemical abuse or dependency; and the Partial Hospital Program for those needing more intensive treatment for a psychiatric or dual diagnosis.Description
FieldValueIRS element (for citing)
Total Of Other Program Service Exp10191040TotalOfOtherProgramServiceExp
Total Of Other Program Service Rev3916138TotalOfOtherProgramServiceRev
Total Program Service Expense258650008TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
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
Financial Stmt Attached1FinancialStmtAttached
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 DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization1BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp1OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity1RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With1096162NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees3219NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members10NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
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 Venture1InvestmentInJointVenture
Written Policy Or Procedure1WrittenPolicyOrProcedure
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Hugh A Rose CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number7089234000TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line112251 S 80th AvenueAddressLine1
CityPalos HeightsCity
StateILState
ZIP Code604630930ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
Edward Mulcahy
Chairman2.00X000
Margaret Lustig
Vice Chair2.00X000
Sister Anna Doyle
Secretary1.00X000
Thomas F Courtney
Director2.00X000
Lawrence Hunt
Director2.00X000
Joseph Neverauskas
Director2.00X000
Sheila Pacholski
Director2.00X000
James Reilly
Director2.00X000
Carole Ruzich
Director2.00X000
Philip A Salvador
Director2.00X000
Christie Sever
Director2.00X000
John Ward
Director2.00X000
Sister Margaret Wright
President40.00X000X
Thomas J Lavery
VP Medical Affairs40.00472411028605X
David B Manchester
VP Professional Services40.00415537028605X
Hugh A Rose
VP Finance/CFO40.00337248023575X
Randall J Oles
VP Support Services40.00328667033736X
Timothy J Brosnan
VP Planning/Community Relations40.00324608033736X
Marion J Baron
VP Facilities & System Management40.00283863028605X
Mary C Denisienko
VP Human Resources40.00255105023575X
Rosann S Demask
VP Nursing40.00213497026295X
Margaret J Carroll
Chief Information Officer40.00212680025412X
Bryan D Counts
Staff Physician50.00223540025311X
Paul G Striegel
Staff Physician43.00194801030351X
David A Cornell
Staff Physician44.00199900024156X
Robert P Marino
Staff Physician43.00193650024021X
Michelle B Burns
Staff Physician42.00191465030104X
FieldValueIRS element (for citing)
Total Reportable Comp From Org3846972TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation386087TotalOtherCompensation
Number Individuals GT100 K56NumberIndividualsGT100K
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
Pepper Construction Company
18505 W Creek DriveTinley ParkIL60477Construction Services19524109
Matthei & Colon Associates
332 S Michigan AvenueChicagoIL60604Architectural Services3770537
Inner Wireless Inc
1155 Kas Drive Ste 200RichardsonTX75081Information Services1265421
Palos Anesthesia & Associates
40 Shuman Blvd Suite 275NapervilleIL60563Anesthesia Services870837
Imperial Laundry Systems LLC
1236 13th StreetRacineWI53405Laundry Services666107
FieldValueIRS element (for citing)
Number Of Contractors GT100 K178NumberOfContractorsGT100K
Fundraising Events184650FundraisingEvents
All Other Contributions1006413AllOtherContributions
Total Contributions1191063TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenue
Net Patient Revenue62111018428411018420604578065
Medicare & Medicaid Re900099126734817126734817
Provider Tax Revenue90009971996437199643
MRI Joint Venture9000999963799637
FieldValueIRS element (for citing)
Total Program Service Revenue318318207TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column78988175TotalRevenueColumn
Exclusion$78,988,175ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1457080Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1457080Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1457080TotalRevenueColumn
Exclusion$1,457,080ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities2541084758Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities2596547717Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-55462959Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-55462959TotalRevenueColumn
Exclusion-$55,462,959ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events74400GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events184650CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses120382FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-45982TotalRevenueColumn
Exclusion-$45,982ExclusionAmount

Other Revenue Misc OtherRevenueMisc (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
Cafeteria Revenue900099971665971665
Gift Shop Revenue900099335729335729
Medical Records900099195128195128

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column1891728TotalRevenueColumn
Related Or Exempt Function Income1891728RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue3394250TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column347839834TotalRevenueColumn
Related Or Exempt Function Income321634392RelatedOrExemptFunctionIncome
Unrelated Business Revenue78065UnrelatedBusinessRevenue
Exclusion$24,936,314ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total2843616Total
Management And General2843616ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total152237428Total
Program Services122992207ProgramServices
Management And General29245221ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total9448211Total
Program Services7493220ProgramServices
Management And General1954991ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total25005362Total
Program Services19831338ProgramServices
Management And General5174024ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total10998611Total
Program Services8722816ProgramServices
Management And General2275795ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total1882028Total
Management And General1882028ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total98544Total
Management And General98544ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total179088Total
Management And General179088ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total985748Total
Management And General985748ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total7034061Total
Program Services1672763ProgramServices
Management And General5361298ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total807598Total
Program Services12873ProgramServices
Management And General794725ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total3986670Total
Program Services2390579ProgramServices
Management And General1596091ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total1987935Total
Program Services256176ProgramServices
Management And General1731759ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total393956Total
Program Services378664ProgramServices
Management And General15292ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total146427Total
Program Services113734ProgramServices
Management And General32693ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total6733182Total
Program Services6733182ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total13208308Total
Program Services10612864ProgramServices
Management And General2595444ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total1574388Total
Program Services1038791ProgramServices
Management And General535597ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Medical Supplies4849167648491676
Bad Debt Expense1568075415680754
Illinois Provider Tax79071037907103
Utilities33058032644642661161
Taxes & Licenses371117371117

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total2163210Total
Program Services1676626ProgramServices
Management And General486584ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total317470824Total
Program Services258650008ProgramServices
Management And General58820816ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2348502BOY
EOY2141128EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY25809914BOY
EOY30995801EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY1205076EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY1322833BOY
EOY1451761EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY4366103BOY
EOY4667429EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis380747459LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec207672516LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY145600484BOY
EOY173074943EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY279556640BOY
EOY434477791EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY35183116BOY
EOY40299608EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY494187592BOY
EOY688313537EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY121925427BOY
EOY123687286EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY120145000BOY
EOY268120000EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY34670109BOY
EOY44725464EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY276740536BOY
EOY436532750EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY217447056BOY
EOY251618119EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY162668EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY217447056BOY
EOY251780787EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY494187592BOY
EOY688313537EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses30369010ReconcilationRevenueExpenses
Reconcilation Other Changes3964721ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement ConsolidatedXFinancialStatementConsolidated
Federal Grant Audit Required0FederalGrantAuditRequired

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 Basis13838804OtherCostOrOtherBasis
Book Value13838804BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis226716677OtherCostOrOtherBasis
Depreciation100792454Depreciation
Book Value125924223BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis140191978OtherCostOrOtherBasis
Depreciation106880062Depreciation
Book Value33311916BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings173074943TotalOfBookValueLandBuildings

Other Assets OtherAssets (3 entries)

DescriptionDescriptionBook ValueBookValue
Investment in Affiliate2354651
Collateral Received for Securities Loaned33500000
Deferred Financing Costs4444957
FieldValueIRS element (for citing)
Total Book Value Other Assets40299608TotalBookValueOtherAssets

Other Liabilities OtherLiabilities (3 entries)

DescriptionDescriptionAmountAmount
Obligation for Collateral Received for Securities Loaned$33,500,000
Tax Exempt Bond Liability Premium$7,539,506
Provider Tax Liability$3,685,958
FieldValueIRS element (for citing)
Total Of Amounts44725464TotalOfAmounts

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDescription of Uncertain Tax Positions Under FIN 48:Identifier
Return ReferencePart X:ReturnReference
ExplanationThe Corporation adopted the FASB-issued guidance for accounting for uncertainty in income taxes on January 1, 2007. St. George, the Hospital and the Wellness Center all file a Form 990 (Return of Organization Exempt from Income Tax) annually. When these returns are 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. Examples of tax positions common to health systems include such matters as the following: the tax exempt status of each entity, the continued tax exempt status of bonds issued by the obligated group, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business taxable income (UBIT). 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 issued guidance at January 1, 2007, and since that date through December 31, 2010, there were no unrecognized tax benefits identified and recorded as a liability.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1DinnerNameOfEvent1
Gross Receipts Event1259050GrossReceiptsEvent1
Charitable Contributions Event1184650CharitableContributionsEvent1
Gross Revenue Event174400GrossRevenueEvent1
Rent Facility Costs Event146129RentFacilityCostsEvent1
Food And Beverage Event159066FoodAndBeverageEvent1
Entertainment Event115103EntertainmentEvent1
Other Direct Expenses Event184OtherDirectExpensesEvent1
Gross Receipts Total259050GrossReceiptsTotal
Charitable Contributions Total184650CharitableContributionsTotal
Gross Revenue Total Events74400GrossRevenueTotalEvents
Rent Facility Costs Total Events46129RentFacilityCostsTotalEvents
Food And Beverage Total Events59066FoodAndBeverageTotalEvents
Entertainment Total Events15103EntertainmentTotalEvents
Other Direct Expenses Total Events84OtherDirectExpensesTotalEvents
Direct Expense Summary Events120382DirectExpenseSummaryEvents
Net Income Summary-45982NetIncomeSummary

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Charity Care Policy1CharityCarePolicy
Written Policy1WrittenPolicy
Policy Applied To All HospitalsXPolicyAppliedToAllHospitals
FPG Reference Free Care1FPGReferenceFreeCare
Pcent200XPcent200
FPG Reference Discounted Care1FPGReferenceDiscountedCare

Discounted Other DiscountedOther

FieldValueIRS element (for citing)
OtherXOther
Discounted Other Percentage1000.000000000000DiscountedOtherPercentage
FieldValueIRS element (for citing)
Free Disc Care Medically Indigent1FreeDiscCareMedicallyIndigent
Amounts Budgeted For Charity Care1AmountsBudgetedForCharityCare
Expenses Exceeded Budget0ExpensesExceededBudget
Annual Community Benefit Report1AnnualCommunityBenefitReport
Report Publically Available1ReportPublicallyAvailable

Charity Care At Cost CharityCareAtCost

FieldValueIRS element (for citing)
Total Community Benefit Expense4524261TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue
Net Community Benefit Expense4524261NetCommunityBenefitExpense
Percent Of Total Expense0.01430PercentOfTotalExpense

Unreimbursed Medicaid UnreimbursedMedicaid

FieldValueIRS element (for citing)
Total Community Benefit Expense18990406TotalCommunityBenefitExpense
Direct Offsetting Revenue8377705DirectOffsettingRevenue
Net Community Benefit Expense10612701NetCommunityBenefitExpense
Percent Of Total Expense0.03340PercentOfTotalExpense

Unreimbursed Costs UnreimbursedCosts

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Charity Care TotalCharityCare

FieldValueIRS element (for citing)
Total Community Benefit Expense23514667TotalCommunityBenefitExpense
Direct Offsetting Revenue8377705DirectOffsettingRevenue
Net Community Benefit Expense15136962NetCommunityBenefitExpense
Percent Of Total Expense0.04770PercentOfTotalExpense

Community Health Services CommunityHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense1152391TotalCommunityBenefitExpense
Direct Offsetting Revenue150864DirectOffsettingRevenue
Net Community Benefit Expense1001527NetCommunityBenefitExpense
Percent Of Total Expense0.00320PercentOfTotalExpense

Health Professions Education HealthProfessionsEducation

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Subsidized Health Services SubsidizedHealthServices

FieldValueIRS element (for citing)
Total Community Benefit Expense31449968TotalCommunityBenefitExpense
Direct Offsetting Revenue22151679DirectOffsettingRevenue
Net Community Benefit Expense9298289NetCommunityBenefitExpense
Percent Of Total Expense0.02930PercentOfTotalExpense

Research Research

FieldValueIRS element (for citing)
Total Community Benefit Expense0TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Cash And In Kind Contributions CashAndInKindContributions

FieldValueIRS element (for citing)
Total Community Benefit Expense177860TotalCommunityBenefitExpense
Direct Offsetting Revenue0DirectOffsettingRevenue

Total Other Benefits TotalOtherBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense32780219TotalCommunityBenefitExpense
Direct Offsetting Revenue22302543DirectOffsettingRevenue
Net Community Benefit Expense10299816NetCommunityBenefitExpense
Percent Of Total Expense0.03250PercentOfTotalExpense

Total Community Benefits TotalCommunityBenefits

FieldValueIRS element (for citing)
Total Community Benefit Expense56294886TotalCommunityBenefitExpense
Direct Offsetting Revenue30680248DirectOffsettingRevenue
Net Community Benefit Expense25436778NetCommunityBenefitExpense
Percent Of Total Expense0.08020PercentOfTotalExpense
FieldValueIRS element (for citing)
Bad Debt Expense Reported1BadDebtExpenseReported
Bad Debt Expense$4,235,372BadDebtExpenseAmount
Amount Attributable To0AmountAttributableTo
Amount Reimbursed By Medicare118223124AmountReimbursedByMedicare
Cost Of Care Reimbursed By Medicare157682405CostOfCareReimbursedByMedicare
Medicare Surplus Or Shortfall-39459281MedicareSurplusOrShortfall

Costing Methodology Used CostingMethodologyUsed

FieldValueIRS element (for citing)
Cost To Charge RatioXCostToChargeRatio
FieldValueIRS element (for citing)
Written Debt Collection Policy1WrittenDebtCollectionPolicy
Provision For Charity Care1ProvisionForCharityCare
Number Of Hospital Facilities1NumberOfHospitalFacilities

Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA

FieldValueIRS element (for citing)
Facility Number1FacilityNumber

Name Name

FieldValueIRS element (for citing)
Business Name Line1Palos Community HospitalBusinessNameLine1

Address Address

FieldValueIRS element (for citing)
Address Line112251 South 80th AvenueAddressLine1
CityPalos HeightsCity
StateILState
ZIP Code60463ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalXLicensedHospital
General Medical And SurgicalXGeneralMedicalAndSurgical
Er24 HoursXEr24Hours

Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1PALOS COMMUNITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Hospital Facility Number1HospitalFacilityNumber

Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC

FieldValueIRS element (for citing)
Number Of Other Facilities4NumberOfOtherFacilities

Other Facilities OtherFacilities (4 entries)

Address Line1Address/AddressLine1CityAddress/CityStateAddress/StateZIP CodeAddress/ZIPCodeFacility TypeFacilityType
Orland Primary Care Center
15300 West Avenue Suite 122Orland ParkIL60462Primary Care Center
Palos Immediate Care Center
7340 W College DrivePalos HeightsIL60463Immediate Care Center
Homer Family Health Center
15327 W 143rd StreetLockportIL60441Primary Care Center
PCH Home Health Services
15295 E 127th StreetLemontIL60439Home Health Services

Form990 Schedule H Part VI Form990ScheduleHPartVI (12 entries)

ExplanationExplanationIdentifierIdentifierReturn ReferenceReturnReference
Part I, Line 3c: PCH's charity care is based on a sliding scale of the Federal Poverty Guidelines. PCH set the sliding scale to far exceed the minimum amounts set forth by the State of Illinois in The Hospital Uninsured Patient Discount Act by extending discounted care up to 1000% of the FPG vs. the minimum 600% as dictated by this law.
Part I, Line 7: The best available data was used to calculate the cost amounts reported in Item 7. This includes the overall hospital cost to charge ratio as well as direct and indirect costs for certain specific departments of the hospital.
Part II: The health of the communities that PCH serves is a very important piece of PCH's mission statement. To date, our focus has been on providing the care needed within our community at high level of quality. As such we have implemented and/or maintained programs that we feel help to improve the wellness of the people we serve. PCH believes that given limited resources and time this serves our community better than community building activities as defined in this schedule.
Part III, Line 4: PCH calculates Charity Care cost using the hospital wide cost to charge ratio and applying that ratio to the charges written off to charity care per the hospital policy. No other Bad Debt amounts are included in the community benefit report.
Part III, Line 8: Medicare costs are calculated using the hospital wide cost to charge ratio. PCH does include the Medicare shortfall in our Illinois state community benefits report since PCH continues to treat our Medicare community despite the fact that our costs for these patients exceed our reimbursement.
Part III, Line 9b: It is the policy of PCH not to pursue collection practices against patients known to qualify under the Charity Care policy. In some cases, this determination is not immediately known and collection processes are followed, but once it has been determined that a patient does qualify for charity care, these practices are ceased.
Part VI, Line 2: PCH consistently seeks to serve the needs of its community in a variety of ways. In order to better identify these needs, PCH teamed up with the Metropolitan Chicago Healthcare Council (MCHC) to prepare a Community Health Assessment for the primary counties that PCH serves. This Community Health Assessment is a systematic, data-driven approach to determining the health status, behaviors and needs of residents in Cook, DuPage and Lake counties, Illinois. This Community Health Assessment will serve as a tool toward reaching three basic goals:- To improve residents' health status, increase their life spans, and elevate their overall quality of life. A healthy community is not only one where its residents suffer little from physical and mental illness, but also one where its residents enjoy a high quality of life.- To reduce the health disparities among residents. By gathering demographic information along with health status and behavior data, it will be possible to identify population segments that are most at-risk for various diseases and injuries. Intervention plans aimed at targeting these individuals may then be developed to combat some of the socio-economic factors which have historically had a negative impact on residents' health.- To increase accessibility to preventive services for all community residents. More accessible preventive services will prove beneficial in accomplishing the first goal (improving health status, increasing life spans, and elevating the quality of life), as well as lowering the costs associated with caring for late-stage diseases resulting from a lack of preventive care.
Part VI, Line 3: PCH utilizes several techniques to communicate a patient's eligibility for assistance under various programs. At the time of registration, each patient is referred to a copy of PCH's Charity Care Policy and asked to fill out a simple registration form that may help them qualify for Charity Care. This policy clearly lays out the eligibility requirements and what the patient must do to qualify. Also at registration, any patient without insurance is advised as to what other programs they may qualify for and are given assistance in applying as necessary. PCH employs a company that helps patients apply for Medicaid coverage and SSI disability. Upon discharge, each patient receives a summary bill that includes information related to eligibility for the Charity Care Policy. All inpatients without insurance are visited by a financial counselor who helps direct the patient and their families to the appropriate level of assistance. Finally, PCH proudly displays the assistance polices on their website along with a Charity application form.
Part VI, Line 4: Palos Community Hospital serves growing communities that expect to experience further growth in the coming years. Communities within the hospital's service area have seen overall growth in population of approximately 8.8% from 2000 to 2009 with a current estimated population of 622,128. Continued growth is anticipated. From 2009 to 2014, the population is expected to reach 650,312. Of those living within the service area of Palos Community Hospital: 50.92% are female88.84% are white86.54% are English speakingThe median age is 38.2 years31.76% are high school graduates31.52% have had some college, and 23.62% have earned a bachelor's degree or beyond.
Part VI, Line 6: PCH will assure the availability of quality inpatient, outpatient, emergency and home care services to the community at all times. Access to these services will be determined by clinical presentation and medical needs of the patient without consideration of the patient's ability to pay.PCH will be a resource for health education and wellness initiatives for residents of the service area.PCH will monitor the health care needs of its service area to assure the need for the services it offers and evaluate the opportunity to develop new programs and services as necessary.PCH will work together with and in support of other not-for-profit, educational, governmental, civic or community organizations, as appropriate, to promote health and wellness through awareness, education, research, access or support.PCH will have policies and procedures in place to provide for charity care for patients without financial resources, including the unreimbursed costs of government sponsored indigent health care.PCH will provide language assistance services as necessary to assure effective communication in the delivery of patient care.
Part VI, Line 7: Palos Community Hospital is not part of an affiliated health care system.
ILReports Filed With StatesPart VI, Line 7

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 (14 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
Thomas J Lavery
455911000165000183750148080505594000
David B Manchester
399037000165000183750126950446607000
Hugh A Rose
32074800016500018375089540364577000
Randall J Oles
312167000165000183750168940363936000
Timothy J Brosnan
308108000165000183750166030359586000
Marion J Baron
267363000165000183750125520314790000
Mary C Denisienko
23860500016500018375075220281002000
Rosann S Demask
196997000165000160650121810241743000
Margaret J Carroll
196805000158750160710103950239146000
Bryan D Counts
207040000165000150810112030249824000
Paul G Striegel
19480100000149900157340225525000
David A Cornell
19990000000139260110880224914000
Robert P Marino
1936500000014680097140218044000
Michelle B Burns
19146500000147430157340221942000

Schedule K IRS990ScheduleK

Form990 Schedule K Part I Form990ScheduleKPartI (3 entries)

Issuer EINIssuerEINCUSIP NumberCUSIPNumberDate IssuedDateIssuedIssue PriceIssuePriceDescription Of PurposeDescriptionOfPurposeDefeasedDefeasedOn Behalf Of IssuerOnBehalfOfIssuerPool FinancingPoolFinancing
Ill Fin AuthorityPalos Comm Hospital
86109196745200B3U02007-05-17124814955Fund construction of parking garage & power plant010
ILl Fin AuthorityPalos Comm Hospital
86109196745200F2Z12010-05-06151146301Fund construction of new patient bed pavilion010
Ill Fin AuthorityPalos Comm Hospital
8610919672010-04-12100000000Fund construction of new patient bed pavilion010

Form990 Schedule K Part II Form990ScheduleKPartII (3 entries)

Total ProceedsTotalProceedsRefunding EscrowRefundingEscrowIssuance Costs From ProceedsIssuanceCostsFromProceedsCapital ExpendituresCapitalExpendituresYear Of Subst CompletionYearOfSubstCompletionCurrent RefundingCurrentRefundingAdvance RefundingAdvanceRefundingFinal Allocation MadeFinalAllocationMadeAdequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaindAmount UnspentAmountUnspent
1248149555568057426758716645851020101011
1511463011950637174398620000133288544
100000000500000000099500000

Form990 Schedule K Part III Form990ScheduleKPartIII (3 entries)

Owning Bond Financed PropertyOwningBondFinancedPropertyAny Lease ArrangementsAnyLeaseArrangementsMngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprtyAny Research AgreementsAnyResearchAgreementsBond Counsel Routinely EngagedBondCounselRoutinelyEngagedPost Issuance Compliance ProcdrsPostIssuanceComplianceProcdrs
000011
000011
000011

Form990 Schedule K Part IV Form990ScheduleKPartIV (3 entries)

Form8038 T FiledForm8038TFiledVariable Rate IssueVariableRateIssueHedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecdsGross Proceeds Invested In GICGrossProceedsInvestedInGICGross Proceeds InvestedGrossProceedsInvestedException To RebateExceptionToRebate
000000
000000
010000

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)

RelationshipRelationshipAmount Of TransactionAmountOfTransactionDescription Of TransactionDescriptionOfTransactionSharing Of RevenuesSharingOfRevenues
Thomas F Courtney Associates
Thomas F. Courtney, Director, is owner of Thomas F. Courtney & Associates225492Thomas F. Courtney & Associates assists Palos with collecting certain workers compensation and motor vehicle accident claims0
Dr Mark Sinibaldi
Medical Director of Palos Psychiatric Services, Former Director125000Medical Director0

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
Form 990, Part VI, Section B, line 11Before filing the Form 990, the organization will present the completed Form 990 to the Finance Committee of the Board for their review and approval. After the Finance Committee has approved the Form 990, it will be submitted to the Board for final approval. Copies of the Form 990 will be available to the Board as requested.
On an annual basis key personnel (VP, department heads (budget administrators)) and all purchasing staff must complete a Conflict of Interest Form disclosing any conflict of interests that may exist or perceived to exist between themselves and/or family members and vendors, contractors and others PCH has a contract/transaction agreement. These annual disclosure statements are reviewed by the VP of Human Resources. Any issue identified as part of this annual disclosure is referred to the President of PCH for disposition. The Conflict of Interest Policy is 1-2-9 in the Administrative Policy Book. The policy includes a copy of the annual disclosure statement.Form 990, Part VI, Section B, line 12c
The CEO contract is a management contract with the religious order. The Executive Committee of the Board of Directors has the responsibility for the contract and fees. Annually Human Resources gathers market data on executive positions from a variety of published survey sources such as Metropolitan Healthcare Council (MCHC), Mercer, Watson Wyatt, etc. The market data is analyzed for organizations of our size and characteristics (FTE's, revenue, beds, region, non-for profit, stand alone institutions, etc.) The mean, median and if available the 90th percentile rates are provided to the President/CEO for consideration and reviewed with the Board of Directors.Form 990, Part VI, Section B, line 15
All policies, governing documents and financial statements required to be available to the public are available upon request. Requests can be made from the Financial Department of Palos Community Hospital.Form 990, Part VI, Section C, line 19
Changes in Net Assets or Fund Balances:Net unrealized gains on investments: 3,802,053. Assets Temporarily Restricted 162,668. Total to Form 990, Part XI, Line 5: 3,964,721.Form 990, Part XI, line 5:

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusDirect Controlling Entity NADirectControllingEntityNAControlled OrgControlledOrgBusiness Name Line1DirectControllingEntityName/BusinessNameLine1
St George Corporation
12251 S 80th AvenuePalos HeightsIL60463364383840Health Care ProviderIL501(c)(3)Line 11a, IN/A0
St George Wellness Center
15430 West AvenueOrland ParkIL60462364383845Fitness CenterIL501(c)(3)Line 91St George Corporation
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 Orgs1RentalOfFacilitiesToOtherOrgs
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

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1St George Wellness CenterBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeITransactionType
Amount Involved36936AmountInvolved
Method Of Amt DeterminationFMVMethodOfAmtDetermination

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