2024-08-15T15:40:17-05:00 2023-09-30 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2022-10-01 361564290 HUMBOLDT PARK HEALTH HUMB 7732928200 1044 NORTH FRANCISCO AVENUE CHICAGO IL 60622 KENNETH COE CFO 7732928200 2024-08-15 1 1 DAVID LOWENTHAL P00378651 3122071040 2024-08-15 2022 2024-08-08 14:25:15Z JOSE R SANCHEZ 1044 NORTH FRANCISCO AVENUE CHICAGO IL 60622 148160205 0 X WWW.HPH.CARE X 1935 IL HUMBOLDT PARK HEALTH PROVIDES QUALITY AND COMPASSIONATE HEALTH CARE SERVICES BY PARTNERING WITH PATIENTS AND THEIR FAMILIES, OUR EMPLOYEES, PHYSICIANS AND THE COMMUNITIES WE SERVE. 12 11 969 12 0 0 19411449 8093917 122926716 138711212 488782 861490 129338 493586 142956285 148160205 0 0 0 0 57344981 65173146 0 0 0 81955027 81493626 139300008 146666772 3656277 1493433 138263380 152990581 73283146 85784093 64980234 67206488 X HUMBOLDT PARK HEALTH PROVIDES QUALITY AND COMPASSIONATE HEALTH CARE SERVICES BY PARTNERING WITH PATIENTS AND THEIR FAMILIES, OUR EMPLOYEES, PHYSICIANS AND THE COMMUNITIES WE SERVE. 0 0 101361247 139204798 HUMBOLDT PARK HEALTH (HOSPITAL) IS A PREMIER HEALTH CARE PROVIDER WHERE THE PATIENT COMES FIRST. AS AN ORGANIZATION OF CAREGIVERS, HUMBOLDT PARK HEALTH INSPIRES TO CONSISTENTLY HIGH STANDARDS OF QUALITY, FAMILY-CENTERED HEALTH CARE SERVICES AND COST EFFECTIVENESS. HUMBOLDT PARK HEALTH SEEKS TO PROMOTE WELLNESS WITHIN THE FAMILY AND TO BE DYNAMIC PARTNERS IN HEALTH WITH THE COMMUNITIES IT SERVES. FOR THE FISCAL YEAR ENDED SEPTEMBER 30, 2023, HUMBOLDT PARK HEALTH ESTIMATES IT PROVIDED $3,085,083 IN CHARITY CARE COST FOR HEALTHCARE SERVICES AND SUPPLIES PROVIDED TO MEMBERS OF THE COMMUNITIES SERVED UNDER ITS CHARITY CARE POLICY. THESE MEMBERS DID NOT HAVE THE ABILITY TO PAY FOR SERVICES RECEIVED. HUMBOLDT PARK HEALTH ALSO PROVIDED CARE TO PATIENTS WHO ARE BENEFICIARIES OF MEDICARE, MEDICAID, BLUE CROSS AND MANAGED CARE REIMBURSEMENT PROGRAMS. REIMBURSEMENT AMOUNTS FOR THESE PROGRAMS ARE LESS THAN CHARGES AND IN SOME CASES LESS THAN COST. FOR FISCAL YEAR 2023, HUMBOLDT PARK HEALTH SERVED 5,296 PATIENTS ADMITTED WHO RECEIVED 35,496 DAYS OF HEALTHCARE SERVICES. 101361247 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 1 1 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 1 1 0 0 1 105 0 1 969 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 IL X KENNETH COE CFO 7732928200 1044 NORTH FRANCISCO AVENUE CHICAGO IL 60622 DR DAGOBERTO CAMACHO PRESIDENT OF MEDICAL STAFF - THRU 9/23 40.00 0.00 X 349131 0 173 ARUN VERMA BOARD TRUSTEE 40.00 0.00 X 270601 0 1854 RICHARD A BLABOLIL CHAIRMAN 5.00 0.00 X X 0 0 0 BILLY OCASIO VICE-CHAIRMAN 4.00 0.00 X X 0 0 0 JOHN MONTEVERDE SECRETARY 8.00 0.00 X X 0 0 0 MIGUEL TOVAR TREASURER - THRU 5/2023 8.00 0.00 X X 0 0 0 OSCAR BEDOLLA BOARD TRUSTEE 2.00 0.00 X 0 0 0 ADAM A BORIS BOARD TRUSTEE 2.00 0.00 X 0 0 0 KEVIN CMUNT BOARD TRUSTEE 4.00 0.00 X 0 0 0 ANTONIO GUILLEN BOARD TRUSTEE 2.00 0.00 X 0 0 0 GUADALUPE HERNANDEZ RN BOARD TRUSTEE - THRU 4/2023 2.00 0.00 X 0 0 0 DENNIS ONTANEDA BOARD TRUSTEE 2.00 0.00 X 0 0 0 MICHAEL E REED BOARD TRUSTEE 2.00 5.00 X 0 0 0 DAN YUNKER BOARD TRUSTEE 2.00 0.00 X 0 0 0 JOSE R SANCHEZ PRESIDENT & CEO 40.00 0.00 X 922349 0 1497136 ABHA AGRAWAL CHIEF MED OFFICER 40.00 0.00 X 456819 0 5499 AMY THOMAS CHIEF INFORMATION OFFICER 40.00 0.00 X 256095 0 694 TOM GARVEY INTERIM CFO 40.00 1.00 X 204000 0 0 KENNETH C HENDREN CFO - PART YEAR 40.00 1.00 X 190789 0 0 TAM THAI PHYSICIAN, ER 40.00 0.00 X 591386 0 2468 SALMAN MAMDANI MEDICAL DIRECTOR, ER 40.00 0.00 X 530965 0 223 RAMON BARAJAS PHYSICIAN OB/GYN 40.00 0.00 X 526428 0 539 ATUL KUMAR NANDA PHYSICIAN 40.00 0.00 X 481160 0 2533 SAMIR N SHAHEN PHYSICIAN-PROG DIR MED ED 40.00 0.00 X 456102 0 5952 5235825 0 1517071 114 0 1 0 STAFFENCY LLC 221 W COLLEGE AVE 2ND FL APPLETON WI 54911 TEMP STAFFING 11905225 SHIFTWISE 200 SW MARKET STREET PORTLAND OR 97201 TEMP STAFFING 7689303 QUEST DIAGNOSTICS 1355 MITTEL BLVD WOOD DALE IL 60191 LAB SERVICES 4839556 NORTH AMERICAN PARTNERS IN PO BOX 69 GLEN HEAD NY 11545 ANESTHESIA SERVICES 3106809 ETTAIN GROUP PO BOX 60070 GLEN HEAD NY 11545 IT CONSULTING SERVICES 773057 64 462474 7631443 8093917 MEDICAID ASSESSMENT/ACA ACCESS RE 621110 58732479 58732479 MEDICARE/MEDICAID PAYMENTS 621110 53040879 53040879 NET PATIENT SERVICE REVENUE 621110 19986096 19986096 OTHER OPERATING REVENUE 621110 6951758 6951758 138711212 861490 861490 493586 0 493586 493586 493586 148160205 139204798 0 861490 X 2661156 2661156 53922871 47192426 6730445 500973 500973 8088146 3309431 4778715 423280 13749 409531 157550 157550 176980 176980 44384 44384 44467034 33706759 10760275 40192 40192 11629047 10485905 1143142 1869499 256061 1613438 983392 137438 845954 4783752 2351831 2431921 3276939 57971 3218968 IL MEDICAID AND ACA TAX 9791901 9791901 PROVISION FOR BAD DEBT 3849676 3849676 146666772 101361247 45305525 0 27647920 18203291 6271265 6569042 6165764 10874686 13643265 2147587 1261274 1389239 976762 192634486 130378751 51251053 62255735 19944341 17957406 18737289 25958042 138263380 152990581 25427951 32738679 4032951 731627 23464190 29763225 20358054 22550562 73283146 85784093 X 50934576 51566561 14045658 15639927 64980234 67206488 138263380 152990581 X 1493433 115255 617566 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 0 1 152000 0 1 24980 176980 0 PART II-B, LINE 1: HOSPITAL REPRESENTATIVES HAVE DIRECT CONTACT WITH LEGISLATORS, THEIR STAFF, AND OFFICIALS WITHIN THE ADMINISTRATION REGARDING ISSUES RELATED TO THE PROVISION OF HEALTHCARE AND HEALTHCARE FINANCING. HOSPITAL REPRESENTATIVES HAVE ENGAGED IN DIRECT MEETINGS WITH LEGISLATORS, LEGISLATIVE STAFF, AND AGENCY STAFF. THEY HAVE ALSO HAD PHONE CONVERSATIONS AND CORRESPONDED BY EMAIL. WRITTEN COMMUNICATION IN THE FORM OF MEMOS AND LETTERS IS ALSO USED. ADDITIONALLY, A PORTION OF MEMBERSHIP DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION AND THE METROPOLITAN HEALTHCARE COUNCIL ARE USED FOR LOBBYING PURPOSES. 0 0 4840913 4840913 87298446 64197757 23100689 3747431 3414753 332678 73925168 62766241 11158927 22822528 22822528 62255735 BENEFICIAL INTEREST IN NET ASSETS OF FOUNDATION 6976170 DUE FROM AFFILIATES 1720930 INSURANCE RECOVERIES RECEIVABLE 4533130 INVESTMENT IN JOINT VENTURE 176841 INVESTMENT IN SUBSIDIARY -167683 OTHER ASSETS 5182117 PROPERTY HELD FOR FUTURE USE 1189446 ASSETS LIMITED TO USE 6347091 25958042 ACCRUED PROFESSIONAL LIABILITY 14186574 CONDITIONAL ASSET RETIREMENT OBLIGATION 2380817 ESTIMATED THIRD PARTY PAYOR SETTLEMENTS PAYABLE 2611947 ACCRUED PENSION AND POSTRETIREMENT BENEFIT OBLIGATION 3371224 22550562 1 1 1 X 1 X 600.000000000000 1 1 1 0 1 1 3085083 3085083 0.02160 66006082 73306736 0 0.00000 69091165 73306736 3085083 0.02160 854545 399978 454567 0.00320 3333409 3745019 0 0.00000 4187954 4144997 454567 0.00320 73279119 77451733 3539650 0.02480 1 3849676 0 12838069 15694613 -2856544 X 1 1 1 CENTURY PHO INC TO OBTAIN AND MANAGE CONTRACTS WITH HEALTH MAINTENANCE ORGANIZATIONS. 0.50000 0.00000 0.50000 1 1 HUMBOLDT PARK HEALTH 1044 N FRANCISCO CHICAGO IL 60660 WWW.HPH.CARE X X X X HUMBOLDT PARK HEALTH 0 0 1 X X X X X X X X X 22 1 1 1 1 X TINYURL.COM/274NT8TM 1 22 1 TINYURL.COM/BDUS4MVD 0 1 X 200.000000000000 600.000000000000 X X X X 1 1 X X X 1 X TINYURL.COM/YU5WYDV3 X TINYURL.COM/25A82D9T X TINYURL.COM/J4KU4VDJ X X X X X X X 1 X 0 X X X X 1 X 0 0 HUMBOLDT PARK HEALTH PART V, SECTION B, LINE 5: THE CHNA COMBINED ROBUST PUBLIC HEALTH DATA, COMMUNITY INPUT, EXISTING RESEARCH, EXISTING PLANS, AND EXISTING ASSESSMENTS TO DOCUMENT THE HEALTH STATUS OF COMMUNITIES WITHIN CHICAGO AND SUBURBAN COOK COUNTY AND TO HIGHLIGHT SYSTEMIC INEQUITIES THAT ARE NEGATIVELY IMPACTING HEALTH. THE CHNA ALSO PROVIDED INSIGHT INTO COMMUNITY-BASED ASSETS AND RESOURCES THAT WOULD BENEFIT FROM SUPPORT AND LEVERAGE DURING THE IMPLEMENTATION OF HEALTH IMPROVEMENT STRATEGIES.PRIMARY AND SECONDARY DATA FROM A DIVERSE RANGE OF SOURCES WERE UTILIZED FOR ROBUST DATA ANALYSIS AND TO IDENTIFY COMMUNITY HEALTH NEEDS IN CHICAGO AND SUBURBAN COOK COUNTY. THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI) WORKED WITH THE CHNA COMMITTEE AND STEERING COMMITTEE TO DESIGN AND FACILITATE A COLLABORATIVE, COMMUNITY-ENGAGED ASSESSMENT.AS WITH THE 2018-2019 COLLABORATIVE CHNA, THE 2022 CHNA PROCESS WAS ADAPTED FROM THE MOBILIZING FOR ACTION THROUGH PLANNING AND PARTNERSHIPS (MAPP) FRAMEWORK, A COMMUNITY-ENGAGED STRATEGIC PLANNING FRAMEWORK THAT WAS DEVELOPED BY THE NATIONAL ASSOCIATION FOR COUNTY AND CITY HEALTH OFFICIALS (NACCHO) AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC). BOTH THE CHICAGO AND COOK COUNTY DEPARTMENTS OF PUBLIC HEALTH USE THE MAPP FRAMEWORK FOR COMMUNITY HEALTH ASSESSMENT AND PLANNING. THE MAPP FRAMEWORK PROMOTES A SYSTEM FOCUS, EMPHASIZING THE IMPORTANCE OF COMMUNITY ENGAGEMENT, PARTNERSHIP DEVELOPMENT, AND THREE TYPES OF DATA--SECONDARY DATA, COMMUNITY INPUT, AND SYSTEM ANALYSIS. AHE CHOSE THIS INCLUSIVE, COMMUNITY-DRIVEN PROCESS TO LEVERAGE AND ALIGN WITH HEALTH DEPARTMENT ASSESSMENTS AND TO ACTIVELY ENGAGE STAKEHOLDERS, INCLUDING COMMUNITY MEMBERS, IN IDENTIFYING AND ADDRESSING STRATEGIC PRIORITIES TO ADVANCE HEALTH EQUITY.PRIMARY DATA FOR THE CHNA WAS COLLECTED THROUGH THREE METHODS:1. COMMUNITY INPUT SURVEY2. COMMUNITY RESIDENT FOCUS GROUPS3. SOCIAL SERVICE PROVIDER FOCUS GROUPSCOMMUNITY INPUT SURVEY: THE COMMUNITY INPUT SURVEY WAS A QUALITATIVE TOOL DESIGNED TO UNDERSTAND COMMUNITY HEALTH NEEDS AND ASSETS FROM COMMUNITY MEMBERS, WITH A FOCUS ON HEARING FROM COMMUNITY MEMBERS MOST IMPACTED BY HEALTH INEQUITIES. THE COMMUNITY INPUT SURVEYS, ALONG WITH FOCUS GROUP DATA, INFORMED THE PRIORITY AREAS AND STRATEGIES FOR COMMUNITY HEALTH IMPROVEMENT IN CHICAGO AND SUBURBAN COOK COUNTY. 828 SURVEYS WERE COLLECTED.COMMUNITY FOCUS GROUPS AND SOCIAL SERVICE PROVIDER FOCUS GROUPS:BETWEEN AUGUST 2021 AND FEBRUARY 2022, THE ILLINOIS PUBLIC HEALTH INSTITUTE (IPHI) WORKED WITH ALLIANCE FOR HEALTH EQUITY PARTNERS TO HOLD A TOTAL OF 43 FOCUS GROUPS WITH PRIORITY POPULATIONS SUCH AS VETERANS, INDIVIDUALS LIVING WITH MENTAL ILLNESS, COMMUNITIES OF COLOR, OLDER ADULTS, CAREGIVERS, TEENS AND YOUNG ADULTS, LGBTQ+ COMMUNITY MEMBERS, ADULTS AND TEENS EXPERIENCING HOMELESSNESS, FAMILIES WITH CHILDREN, FAITH COMMUNITIES, ADULTS WITH DISABILITIES, AND CHILDREN AND ADULTS LIVING WITH CHRONIC CONDITIONS SUCH AS DIABETES AND ASTHMA. IN TOTAL, 17 FOCUS GROUPS WERE HELD WITH COMMUNITY MEMBERS AND SERVICE PROVIDERS WITHIN HUMBOLDT PARK HEALTH'S SERVICE AREA. HUMBOLDT PARK HEALTH PART V, SECTION B, LINE 6A: THE ALLIANCE FOR HEALTH EQUITY COMPLETED THE COLLABORATIVE CHNA BETWEEN MARCH 2021 AND MARCH 2022. THE ALLIANCE FOR HEALTH EQUITY IS A COLLABORATIVE OF 30 HOSPITALS WORKING WITH HEALTH DEPARTMENTS AND REGIONAL AND COMMUNITY-BASED ORGANIZATIONS TO IMPROVE HEALTH EQUITY, WELLNESS, AND QUALITY OF LIFE ACROSS CHICAGO AND SUBURBAN COOK COUNTY. A COMPLETE LIST OF COLLABORATING HOSPITALS CAN BE FOUND ON THE ALLIANCE FOR HEALTH EQUITY'S 2022 CHNA FOR CHICAGO AND SUBURBAN COOK COUNTY. HUMBOLDT PARK HEALTH PART V, SECTION B, LINE 6B: THE COLLABORATIVE CHNA WAS CONDUCTED WITH THE FOLLOWING HEALTH DEPARTMENTS AND COMMUNITY ORGANIZATIONS:- ALLIANCE FOR HEALTH EQUITY- CHICAGO DEPARTMENT OF PUBLIC HEALTH- COOK COUNTY DEPARTMENT OF PUBLIC HEALTH- ILLINOIS PUBLIC HEALTH INSTITUTE HUMBOLDT PARK HEALTH PART V, SECTION B, LINE 11: THROUGH THE 2021-2022 COUNTYWIDE COMMUNITY HEALTH NEEDS ASSESSMENT (CHNA), THE ALLIANCE FOR HEALTH EQUITY IDENTIFIED THE FOLLOWING KEY HEALTH NEEDS ACROSS CHICAGO AND COOK COUNTY.ISSUES INVOLVING SOCIAL AND STRUCTURAL DETERMINANTS OF HEALTH INCLUDE:1. ADDRESSING STRUCTURAL RACISM AND ADVANCING RACIAL EQUITY;2. ADVOCATING FOR POLICIES THAT ADVANCE EQUITY AND PROMOTE PHYSICAL AND MENTAL WELL-BEING;3. WORKING TOWARDS CONDITIONS THAT SUPPORT HEALTHY EATING AND ACTIVE LIVING;4. SHIFTING POWER FOR COMMUNITY ENGAGEMENT IN DECISION-MAKING;5. ECONOMIC VITALITY AND WORKFORCE DEVELOPMENT;6. EDUCATION AND YOUTH DEVELOPMENT;7. FOOD SECURITY AND FOOD ACCESS;8. HOUSING, TRANSPORTATION, AND NEIGHBORHOOD ENVIRONMENT;9. ADDRESSING TRAUMA, VIOLENCE AND SOCIAL ISOLATIONISSUES INVOLVING ACCESS TO CARE AND COMMUNITY RESOURCES INCLUDE:1. ADDRESSING STRUCTURAL RACISM AND DISCRIMINATION IN HEALTHCARE;2. CULTURALLY AND LINGUISTICALLY APPROPRIATE CARE;3. DATA SYSTEMS;4. EMERGENCY AND PANDEMIC PREPAREDNESS;5. RESOURCES, REFERRALS, COORDINATION, AND CONNECTION TO COMMUNITY-BASED SERVICES;6. INCREASED TIMELY LINKAGE TO APPROPRIATE CARE, INCLUDING BEHAVIORAL HEALTH AND SOCIAL SERVICES;7. TRAUMA-INFORMED CARE;8. WORKFORCE DEVELOPMENT AND SUPPORT FOR HEALTHCARE, BEHAVIORAL HEALTH, AND HUMAN SERVICES WORKERS;ADDRESSING PRIORITY HEALTH CONDITIONS1. CHRONIC CONDITIONS;2. COVID-19;3. INJURY, INCLUDING VIOLENCE-RELATED INJURY;4. MATERNAL AND CHILD HEALTH, INCLUDING MATERNAL AND INFANT MORTALITY;5. MENTAL HEALTH;6. SUBSTANCE USE DISORDERS HUMBOLDT PARK HEALTH: PART V, SECTION B, LINE 7A:HTTPS://WWW.HPH.CARE/WP-CONTENT/UPLOADS/2024/08/2022_CHNA-REPORT_COMPLETE.PDFPART V, SECTION B, LINE 10:HTTPS://WWW.HPH.CARE/HOME/COMMUNITY-RELATIONS/ HUMBOLDT PARK HEALTH: PART V, SECTION B, LINE 16I & 16J:PATIENTS WILL BE INFORMED OF FINANCIAL ASSISTANCE THROUGH VARIOUS METHODS. NOTICES INFORMING PATIENTS OF FINANCIAL ASSISTANCE WILL BE POSTED IN ADMISSION AND REGISTRATION AREAS. IT WILL ALSO BE PROVIDED TO PATIENTS, OR GUARANTORS, IN THEIR ADMISSION PACKET AND IN BILLING STATEMENTS. THIS INFORMATION, AND THE NOTICE POSTED IN HOSPITAL LOCATIONS, WILL BE IN ENGLISH, AND IN ANY OTHER LANGUAGE THAT IS THE PRIMARY LANGUAGE SPOKEN BY AT LEAST 5% OF THE RESIDENTS IN THE SERVICE AREA. TRANSLATIONS IN SPANISH AND POLISH CAN BE OBTAINED BY CALLING THE HOSPITAL'S PATIENT FINANCIAL SERVICES AND ARE CURRENTLY AVAILABLE ON THE HOSPITAL'S WEBSITE: HTTPS://WWW.HPH.CARE/PATIENT-FINANCIAL-SERVICES-3/ HUMBOLDT PARK HEALTH: PART V, SECTION B, LINE 22D:THE HOSPITAL DETERMINES THE MAXIMUM AMOUNT THAT CAN BE CHARGED TO THE FAP-ELIGIBLE INDIVIDUALS BY CALCULATING THE UNINSURED PATIENT DISCOUNT AMOUNT AND APPLYING IT TO PATIENT ACCOUNT. THE DISCOUNT AMOUNT IS CALCULATED BY SUBTRACTING FROM 100% THE PRODUCT OF THE HOSPITAL'S COST TO CHARGE RATIO (FROM WORKSHEET C PART 1 FROM THE MEDICARE COST REPORT) AND 135% (MEDICARE COST ALLOWED TO CHARGE TO UNINSURED PATIENTS). HUMBOLDT PARK HEALTH HOSPITAL'S UNINSURED DISCOUNT FOR FY 2023 IS 56% AS ROUNDED FROM THE CALCULATION AS SHOWN BELOW. 2023 COST TO CHARGE RATIO = 32.34%32.34% X 135% = 43.65%100% - 43.65% = 56.35%THE HOSPITAL PROVIDES A 72% DISCOUNT TO UNINSURED PATIENTS. NOTE, THE 72% UNINSURED DISCOUNT PROVIDED TO OUR PATIENTS EXCEEDS THE MINIMUM REQUIREMENT UNDER ILLINOIS LAW. PART I, LINE 3C: HUMBOLDT PARK HEALTH USES THE FPG TO DETERMINE FREE AND DISCOUNTED CARE. PATIENTS WITH ELIGIBLE ASSETS AND INCOME ABOVE THE 200%, BUT NOT EXCEEDING 600% OF FPG, ADJUSTED FOR FAMILY SIZE, WILL RECEIVE A DISCOUNT ON MEDICALLY NECESSARY SERVICES PROVIDED TO THEM, BASED UPON A SLIDING SCALE ESTABLISHED BY HOSPITAL POLICY. PART I, LINE 7: THE COSTING METHODOLOGY USED TO CALCULATE THE AMOUNTS REPORTED ON LINES 7A AND 7B IS THE COST-TO-CHARGE RATIO DERIVED FROM THE IRS'S SCHEDULE H, WORKSHEET 2 INSTRUCTIONS. HUMBOLDT PARK HEALTH USED ITS INTERNAL ACCOUNTING RECORDS TO CALCULATE THE AMOUNTS REPORTED IN LINES 7E AND 7F.MANAGEMENT DOES NOT CONCUR WITH WORKSHEET 3 INSTRUCTIONS IN REGARDS TO INCLUDING THE PROVIDER TAX EXPENSES IN WITH COLUMN (C) TOTAL COMMUNITY BENEFIT EXPENSE, AS WELL AS INCLUDING THE PROVIDER TAX REVENUE IN COLUMN (D) DIRECT OFFSETTING REVENUE. IF THESE WERE REMOVED FROM THE WORKSHEET 3 CALCULATION, NET COMMUNITY BENEFIT EXPENSE ON LINE 7B, COLUMN (E) WOULD HAVE BEEN $35,929,329 OR 25.16 PERCENT OF TOTAL EXPENSE. THIS WOULD HAVE INCREASED THE TOTAL NET COMMUNITY BENEFIT EXPENSE ON LINE 7K, COLUMN (E) FROM $3,539,650 OR 2.48 PERCENT OF EXPENSES TO $39,468,979 OR 27.64 PERCENT OF TOTAL EXPENSE. PART I, LINE 7G: HUMBOLDT PARK HEALTH DID NOT INCLUDE ANY COSTS ATTRIBUTABLE TO A PHYSICIAN CLINIC AS SUBSIDIZED HEALTH SERVICES. PART III, LINE 2: THE BAD DEBT EXPENSE REPORTED ON PART III, LINE 2, IS THE BAD DEBT EXPENSE REPORTED ON FORM 990, PART IX. PART III, LINE 3: ALL OF THE HOSPITAL'S PATIENTS AUTOMATICALLY QUALIFY FOR FINANCIAL ASSISTANCE IF THEY DO NOT HAVE INSURANCE (THEY ARE CONSIDERED "SELF-PAY AND GIVEN 72% DISCOUNT). ONCE THE HOSPITAL DETERMINES THAT A PATIENT HAS NO INSURANCE, THEY AUTOMATICALLY DISCOUNT THE BILL BY 72%. SO THERE ARE NO INDIVIDUALS THAT MAY HAVE BEEN ELIGIBLE FOR FINANCIAL ASSISTANCE AND DID NOT RECEIVE ANY. BAD DEBT EXPENSE IS ATTRIBUTABLE TO PATIENTS WITH INSURANCE THAT MAY NOT HAVE PAID THEIR SHARE/CO-PAY OF THE BILL OR ATTRIBUTABLE TO PATIENTS THAT RECEIVED FINANCIAL ASSISTANCE (72% DISCOUNT) BUT DID NOT PAY THEIR 28%. THEREFORE, ZERO HAS BEEN REPORTED IN PART III, LINE 3. PART III, LINE 4: AUDITED FINANCIAL STATEMENTS FOOTNOTE REGARDING BAD DEBT EXPENSE: ACCOUNTS RECEIVABLE FOR PATIENTS, INSURANCE COMPANIES, AND GOVERNMENTAL AGENCIES ARE BASED ON GROSS CHARGES, REDUCED BY EXPLICIT PRICE CONCESSIONS PROVIDED TO THIRD PARTY PAYORS, DISCOUNTS PROVIDED TO QUALIFYING INDIVIDUALS AS PART OF OUR FINANCIAL ASSISTANCE POLICY, AND IMPLICIT PRICE CONCESSIONS PROVIDED PRIMARILY TO SELF-PAY PATIENTS. ESTIMATES FOR EXPLICIT PRICE CONCESSIONS ARE BASED ON PROVIDER CONTRACTS, PAYMENT TERMS FOR RELEVANT PROSPECTIVE PAYMENT SYSTEMS, AND HISTORICAL EXPERIENCE ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS.FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL), THE HOSPITAL RECORDS SIGNIFICANT IMPLICIT PRICE CONCESSIONS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE.PART III, LINE 6: MANAGEMENT DOES NOT CONCUR WITH PART III, SECTION B MEDICARE, LINE 6 REPORTING INSTRUCTIONS REGARDING UTILIZING ALLOWABLE COSTS FROM MEDICARE WORKSHEET B. IF MANAGEMENT USED THE ACTUAL AMOUNT OF COSTS TO CARE FOR MEDICARE PATIENTS, ALLOWABLE COST WOULD HAVE BEEN REPORTED AS $54,036,192 AND THE AMOUNT OF (SHORTFALL) WOULD HAVE BEEN $41,198,122. PART III, LINE 8: COSTING METHODOLOGY USED IS THE MEDICARE COST REPORT WHICH UTILIZES A STEP-DOWN METHOD OF COST ALLOCATION. THIS ORDER OF ALLOCATION FOR OVERHEADS HAS BEEN PREDETERMINED BY MEDICARE AND IS PRINTED OUT ON THE COST REPORT. THE MOST COMMON OVERHEAD IS ALLOCATED FIRST TO ALL OTHER OVERHEADS AND THE PATIENT CARE COST CENTERS. THEN THAT COST CENTER IS CLOSED AND THE NEXT MOST COMMON OVERHEAD IS ALLOCATED. THIS IS CONTINUED UNTIL ALL THE OVERHEADS ARE ALLOCATED OUT. THE SEPTEMBER 30, 2021 COST REPORT DID NOT SHOW A SHORTFALL. PART III, LINE 9B: THE COLLECTION POLICIES CONTAIN PROVISIONS ON THE COLLECTIONS PRACTICES TO BE FOLLOWED FOR PATIENTS THAT QUALIFY FOR FINANCIAL ASSISTANCE. SUCH PRACTICES ARE: CHARITY - UPON APPROVAL OF PATIENT'S CHARITY APPLICATION THE COLLECTIONS ARE STOPPED, PATIENT'S BALANCE IS WRITTEN OFF ACCORDINGLY AND PATIENT IS NOTIFIED IN WRITING; UNINSURED PATIENT - UPON DETERMINATION THAT PATIENT HAS NO INSURANCE, 72% DISCOUNT IS APPLIED TO PATIENT ACCOUNT AND PATIENT IS NOTIFIED IN WRITING FOR THE OUTSTANDING BALANCE. PART VI, LINE 2: HUMBOLDT PARK HEALTH'S COMMUNITY BENEFIT PLAN WAS DEVELOPED TO ESTABLISH STRATEGIES FOR IMPROVING ACCESS TO CARE AND POSITIVELY AFFECTING THE HEALTH OF THE COMMUNITIES THAT IT SERVES. ADDITIONALLY, THE PLAN SETS THE COURSE FOR STRENGTHENING EXISTING PARTNERSHIPS AND BUILDING NEW ONES WITH INDIVIDUALS AND ORGANIZATIONS WITHIN HUMBOLDT PARK HEALTH'S PRIMARY SERVICE AREAS IN ORDER TO LEVERAGE AND MAXIMIZE THE IMPACT OF ITS PROGRAMS. DEVELOPMENT OF THE PLAN IS DERIVED THROUGH THE STRATEGIC PLANNING OF HUMBOLDT PARK HEALTH'S BOARD OF TRUSTEES AND THROUGH ORGANIZATIONAL INVOLVEMENT IN COMMUNITY PARTNERSHIPS. THE GOALS DEVELOPED FOR PLANNING COMMUNITY SERVICES INVOLVED MEETING WITH PHYSICIANS AND COMMUNITY PARTNERS TO DETERMINE WHERE THE GAPS OF CARE AND SERVICES COULD BE FILLED THROUGH HUMBOLDT PARK HEALTH INVOLVEMENT. IN DEVELOPING ITS COMMUNITY BENEFITS PLAN, HUMBOLDT PARK HEALTH SET THE FOLLOWING GOALS:1) SERVE AS A CATALYST/CONVENER FOR THE OBESITY AND DIABETES INITIATIVES IN HUMBOLDT PARK.2) PROMOTE INITIATIVES THAT ENHANCE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED.3) HUMBOLDT PARK HEALTH LEADERSHIP TO ASSUME AN ACTIVE ROLE IN COMMUNITY BASED ORGANIZATIONS BOARDS, TASK FORCES AND COMMUNITY EVENTS. PART VI, LINE 3: HUMBOLDT PARK HEALTH INFORMS AND EDUCATES PATIENTS AND PERSONS, WHO MAY BE BILLED FOR PATIENT CARE, ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER FEDERAL, STATE OR LOCAL GOVERNMENT PROGRAMS OR UNDER THE ORGANIZATION'S CHARITY CARE POLICY ON ITS INTRANET AND THROUGH FLYERS. PATIENTS ARE PROVIDED THESE POLICIES AT THE TIME OF REGISTRATION AND ARE ALSO AVAILABLE UPON REQUEST. PART VI, LINE 4: HUMBOLDT PARK HEALTH SERVES A PRIMARY COMMUNITY AREA AND A SECONDARY COMMUNITY AREA. THE FOLLOWING INFORMATION WAS OBTAINED FROM THE US CENSUS BUREAU, 2010 CENSUS.THE PRIMARY COMMUNITY AREA CONSISTS OF THE FOLLOWING AREAS, ZIP CODES AND POPULATION:- AUSTIN- BELMONT-CRAGIN- HERMOSA- HUMBOLDT PARK- LOGAN SQUARE- WEST TOWN- IRVING PARK- NORTH CENTER- EAST GARFIELD PARK- WEST GARFIELD PARK- NORTH LAWNDALE WHITE HISPANIC AFRICAN-AMERICANPRIMARY ZIP CODES POPULATION - PERCENTAGE 60618 46,754 51% 42,771 46% 2,559 3%60622 33,399 64% 15,289 29% 3,860 7%60624 958 3% 1,160 3% 35,987 94%60639 8,056 9% 68,639 76% 13,712 15%60647 34,357 39% 47,697 55% 5,237 6%60651 2,538 4% 21,756 34% 39,973 62%THE SECONDARY AREA CONSISTS OF THE FOLLOWING AREAS, ZIP CODES AND POPULATION:- ARCHER HEIGHTS- BRIGHTON PARK- CAGE PARK- GARFIELD RIDGE- WEST ELSDON- SOUTH LAWNDALE- PORTAGE PARK- PULLMAN WHITE HISPANIC AFRICAN-AMERICANPRIMARY ZIP CODES POPULATION - PERCENTAGE 60612 8,738 26% 4,319 13% 20,412 61%60623 2,301 2% 59,438 65% 30,369 33%60625 47,050 60% 28,304 36% 3,297 4%60632 12,939 14% 76,902 84% 1,485 2%60641 32,054 45% 38,057 53% 1,552 2%60644 1,506 3% 1,583 3% 45,559 94%60640 44,239 67% 9,923 15% 11,628 18%HUMBOLDT PARK HEALTH'S AGE FOR THE FISCAL YEAR WAS AS FOLLOWS:AGE PERCENTAGE0-14 2%15-44 44%45-64 37%65-74 9%75+ 8%HUMBOLDT PARK HEALTH'S RACE AND ETHNICITY FOR THE FISCAL YEAR WAS AS FOLLOWS:RACE PERCENTAGEASIAN 1%AMERICAN INDIAN OR NATIVE ALASKAN 0%BLACK OR AFRICAN-AMERICAN 43%WHITE 13%OTHER 43%ETHNICITY PERCENTAGEHISPANIC 41%NON-HISPANIC 59% PART VI, LINE 5: IN ADDITION TO PROVIDING QUALITY INPATIENT AND OUTPATIENT SERVICES, HUMBOLDT PARK HEALTH REACHES BEYOND ITS WALLS AND INTO COMMUNITIES THROUGH AN ARRAY OF ACTIVITIES AND PROGRAMS DESIGNED AND DELIVERED TO BENEFIT THE COMMUNITIES IT SERVES. THESE COMMUNITY BENEFITS INCLUDE: - CARE THAT IS PROVIDED FREE, SUBSIDIZED OR WITHOUT FULL REIMBURSEMENT FROM MEDICARE, MEDICAID OR OTHER GOVERNMENT INSURANCE PROGRAMS.- SERVICES RESPONDING TO UNIQUE COMMUNITY NEEDS, SUCH AS DIABETES SERVICES, EMERGENCY CARE, BEHAVIORAL HEALTH SERVICES, SUBSTANCE ABUSE, PEDIATRIC CARE-A-VAN; AS WELL AS HEALTH SCREENINGS, IMMUNIZATION PROGRAMS, SCHOOL-BASED HEALTH CARE AND OTHER COMMUNITY OUTREACH PROGRAMS.- EDUCATION TO TRAIN PHYSICIANS, NURSES, RADIOLOGY TECHNICIANS, AND OTHER HIGHLY SKILLED HEALTH CARE PROFESSIONALS.- VOLUNTEER SERVICES PROVIDED BY HOSPITAL EMPLOYEES WHO VOLUNTEER IN THEIR COMMUNITIES AND COMMUNITY MEMBERS WHO VOLUNTEER AT THE HOSPITAL. IN FYE 2018, THE HOSPITAL CONTRIBUTED TO HURRICANE MARIA RELIEF EFFORTS BY SENDING PHYSICIANS AND NURSES TO PUERTO RICO TO DIRECTLY ASSIST WITH CARE. ADDITIONALLY, EMPLOYEES CONTRIBUTED THEIR PTO AND THE HOSPITAL FOUNDATION CONTRIBUTED MONETARILY.- LANGUAGE-ASSISTANCE SERVICES, SUCH AS TRANSLATORS, SIGNAGE, FORMS, BROCHURES, PATIENT EDUCATION MATERIALS AND OTHER INFORMATION IN LANGUAGES OTHER THAN ENGLISH.- DONATIONS BY HUMBOLDT PARK HEALTH OF MEETING AND CLINIC SPACE, AS WELL AS OTHER ASSISTANCE TO COMMUNITY GROUPS. PART VI, LINE 6: HUMBOLDT PARK HEALTH IS NOT PART OF AN AFFILIATED HEALTHCARE SYSTEM. PART VI, LINE 7, REPORTS FILED WITH STATES IL X 1 1 X X 0 1 0 0 0 0 0 1 0 JOSE R SANCHEZ PRESIDENT & CEO 549301 0 0 0 373048 0 1493326 0 3810 0 2419485 0 258000 0 TAM THAI PHYSICIAN, ER 530873 0 3281 0 57232 0 0 0 2468 0 593854 0 0 0 SALMAN MAMDANI MEDICAL DIRECTOR, ER 364065 0 8281 0 158619 0 0 0 223 0 531188 0 0 0 RAMON BARAJAS PHYSICIAN OB/GYN 234823 0 0 0 291605 0 0 0 539 0 526967 0 0 0 ATUL KUMAR NANDA PHYSICIAN 223996 0 0 0 257164 0 0 0 2533 0 483693 0 0 0 ABHA AGRAWAL CHIEF MED OFFICER 373819 0 41500 0 41500 0 0 0 5499 0 462318 0 0 0 SAMIR N SHAHEN PHYSICIAN-PROG DIR MED ED 224492 0 14976 0 216634 0 0 0 5952 0 462054 0 0 0 DR DAGOBERTO CAMACHO PRESIDENT OF MEDICAL STAFF - THRU 9/ 183475 0 13250 0 152406 0 0 0 173 0 349304 0 0 0 ARUN VERMA BOARD TRUSTEE 229078 0 0 0 41523 0 0 0 1854 0 272455 0 0 0 AMY THOMAS CHIEF INFORMATION OFFICER 229115 0 5000 0 21980 0 0 0 694 0 256789 0 0 0 TOM GARVEY INTERIM CFO 204000 0 0 0 0 0 0 0 0 0 204000 0 0 0 KENNETH C HENDREN CFO - PART YEAR 190789 0 0 0 0 0 0 0 0 0 190789 0 0 0 PART I, LINE 1A HPH PAYS MEMBERSHIP DUES ON BEHALF OF JOSE R. SANCHEZ, PRESIDENT AND CEO, TO A SOCIAL CLUB. THE MEMBERSHIP IS USED EXCLUSIVELY FOR BUSINESS PURPOSES. PART I, LINE 4B LINE 4B: JOSE R. SANCHEZ, PRESIDENT AND CEO, PARTICIPATED IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. MR. SANCHEZ RECEIVED $258,000 OF DISTRIBUTIONS FROM THE PLAN DURING CALENDAR YEAR 2022. PART I, LINE 7 AS INDICATED IN SCHEDULE J, PART II, SEVERAL OFFICERS AND HIGHEST COMPENSATED EMPLOYEES OF THE ORGANIZATION RECEIVED A BONUS BASED ON PERFORMANCE AND THE FINANCIAL RESULTS OF THE ORGANIZATION. THE BONUSES WERE APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. ST JOHN HEART CLINIC SC 100% CONTROLLED ENTITY OF TRUSTEE 160400 THE HOSPITAL PAID ST. JOHN HEART CLINIC S.C. FOR MEDICAL SERVICES. TRUSTEE JOHN MONTEVERDE OWNS 100% OF ST. JOHN HEART CLINIC. 0 FORM 990, PART VI, SECTION B, LINE 11B THE BOARD RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO PREPARE THE ORGANIZATION'S FORM 990. MEMBERS OF THE FISCAL SERVICES DEPARTMENT, THE CHIEF FINANCIAL OFFICER AND THE CHIEF EXECUTIVE OFFICER REVIEW THE COMPLETED FORM 990. PRIOR TO FILING THE CHIEF FINANCIAL OFFICER SIGNS THE FORM. THE CHIEF FINANCIAL OFFICER INFORMS MEMBERS OF THE GOVERNING BODY THAT A COPY OF THE SIGNED FORM IS MADE AVAILABLE TO THEM UPON REQUEST. FORM 990, PART VI, SECTION B, LINE 12C ALL TRUSTEES, OFFICERS, AND KEY EMPLOYEES AND KEY PHYSICIANS (AS DEFINED IN THE BOARD'S CONFLICT OF INTEREST POLICY) OF THE CORPORATION ARE SUBJECT TO THE CONFLICT OF INTEREST POLICY. IN ADDITION, ALL INDEPENDENT CONTRACTORS WHO PROVIDE SERVICES AND/OR MATERIALS TO THE CORPORATION IN EXCHANGE FOR $20,000 OR MORE IN PAYMENT DURING ANY FISCAL YEAR SHALL BE SUBJECT TO THESE PROVISIONS. ALL PERSONS SUBJECT HERETO SHALL BE HEREINAFTER REFERRED TO AS "COVERED PERSONS." THE CHIEF EXECUTIVE OFFICER OF THE CORPORATION IS RESPONSIBLE FOR PUBLICIZING THE PROVISIONS OF THIS ARTICLE TO THE PERSONS AFFECTED THEREBY. NO PERSON SHALL BECOME A TRUSTEE, OFFICER, OR EMPLOYEE OR MEDICAL DEPARTMENT DIRECTOR OF THE CORPORATION WITHOUT FIRST ACKNOWLEDGING IN WRITING TO THE CORPORATION THAT HE OR SHE HAS REVIEWED, FULLY UNDERSTANDS AND IS IN COMPLIANCE WITH THE PROVISIONS OF THE CONFLICT OF INTEREST POLICY. ALL COVERED PERSONS SHALL PROMPTLY DISCLOSE TO THE BOARD OF TRUSTEES OF THE CORPORATION ALL SUBSTANTIVE POTENTIAL CONFLICTS OF INTEREST WHICH SUCH PERSON DISCOVERS OR WHICH IS BROUGHT TO HIS OR HER ATTENTION. SUCH DISCLOSURE SHALL INCLUDE SUBMISSION TO THE BOARD OF A WRITTEN STATEMENT OF THE FACTS SURROUNDING THE CONFLICT OF INTEREST AND AN OPPORTUNITY TO MAKE A BRIEF ORAL STATEMENT TO THE BOARD WITH RESPECT TO THE MATTER IN QUESTION. AN ANNUAL DISCLOSURE STATEMENT SHALL BE CIRCULATED TO ALL COVERED PERSONS TO ASSIST THEM IN CONSIDERING SUCH DISCLOSURES. IN ADDITION, THE POLICY IS MONITORED PERIODICALLY THROUGHOUT THE YEAR FOR ANY CONFLICTS OF INTEREST. PROMPT DISCLOSURE NOTICES OF CONFLICT SHALL BE FILED WITH THE PRESIDENT OF THE CORPORATION OR ANY OTHER PERSON DESIGNATED BY HIM FROM TIME TO TIME TO RECEIVE SUCH NOTIFICATIONS. ALL DISCLOSURE NOTICES RECEIVED HEREUNDER SHALL BE NOTED FOR RECORD IN THE MINUTES OF A MEETING OF THE BOARD OF TRUSTEES. THE PRESENCE OF THE TRUSTEE WHO IS DIRECTLY OR INDIRECTLY A PARTY TO THE TRANSACTION IN QUESTION OR A TRUSTEE WHO IS OTHERWISE NOT DISINTERESTED MAY BE COUNTED IN DETERMINING WHETHER A QUORUM IS PRESENT FOR THE PURPOSE OF THE MEETING, BUT SHALL NOT BE PRESENT OR HAVE A VOTE WHEN THE BOARD OF TRUSTEES OR A COMMITTEE OF THE BOARD DISCUSSES AND TAKES ACTION ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER, CHIEF OPERATING OFFICER/VICE PRESIDENT MEDICAL AFFAIRS AND CHIEF FINANCIAL OFFICER WERE REVIEWED BY AN EXTERNAL ORGANIZATION SPECIALIZING IN COMPENSATION MANAGEMENT. A COMPENSATION ANALYSIS IS PERFORMED EVERY THREE YEARS BY AN INDEPENDANT CONSULTING FIRM. THE RESULTS OF THAT REVIEW ARE DOCUMENTED IN WRITING AND PROVIDED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF TRUSTEES. FORM 990, PART VI, SECTION C, LINE 19 HUMBOLDT PARK HEALTH MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PROFESSIONAL MEDICAL & NON-MEDICAL SERVICES AND PURCHASED PROCEDURES: PROGRAM SERVICE EXPENSES 33,706,759. MANAGEMENT AND GENERAL EXPENSES 10,760,275. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 44,467,034. FORM 990, PART XI, LINE 9: CHANGE IN NET ASSETS OF HPH FOUNDATION 1,594,269. PENSION RELATED CHANGES, OTHER THAN NET PERIOD PENSION COST 225,122. OTHER PENSION COSTS -1,297,532. CHANGE IN MTM SWAP 95,707. FORM 990, PART XII, LINE 3B: THE ORGANIZATION IS IN PROCESS OF COMPLETING THE REQUIRED AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HOWEVER THE AUDIT IS NOT COMPLETED AT THE TIME OF FILING FORM 990. HUMBOLDT PARK HEALTH FOUNDATION 1044 NORTH FRANCISCO AVENUE CHICAGO IL 60622 363257131 SUPPORTING FOUNDATION IL 501(C)(3) LINE 12A, I HUMBOLDT PARK HEALTH 1 HUMBOLDT PARK HEALTH COMMUNITY PHARMACY 1044 NORTH FRANCISCO AVENUE CHICAGO IL 60622 363394548 OUTPATIENT PHARMACY IL HUMBOLDT PARK HEALTH C 317330 1570575 1.00000 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 0 0 HUMBOLDT PARK HEALTH COMMUNITY PHARMACY A 9722 BOOK VALUE HUMBOLDT PARK HEALTH FOUNDATION A 3600 BOOK VALUE HUMBOLDT PARK HEALTH FOUNDATION C 462474 BOOK VALUE