SOUTH SHORE HOSPITAL CORPORATION: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: SOUTH SHORE HOSPITAL CORPORATION (EIN 36-1799520)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2021-11-15
IRS object ID: 202113199349319636
Schema version: 2020v4.0
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
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule G
Schedule H
Schedule J
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-11-15T15:04:35-06:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	350921680	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CROWE LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	225 West Wacker Drive Suite 2600	AddressLine1Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	606061224	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	361799520	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	South Shore Hospital Corporation	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	SOUT	BusinessNameControlTxt
Phone	7733565312	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8012 South Crandon Avenue	AddressLine1Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60617	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Timothy Caveney	PersonNm
Person Title	President and CEO	PersonTitleTxt
Signature	2021-11-15	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	Timothy	PersonFirstNm
Person Last	Caveney	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Kim Scifres	PreparerPersonNm
PTIN	P01316095	PTIN
Phone	3128997000	PhoneNum

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Timothy Caveney	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8012 South Crandon Avenue	AddressLine1Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60617	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$46,724,553	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.southshorehospital.com	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1976	FormationYr
Legal Domicile State	IL	LegalDomicileStateCd
Activity Or Mission	South Shore Hospital Corporation is a not-for-profit hospital dedicated to providing the highest quality of healthcare possible to the south shore community. The charges forgone for services furnished under its charity care policy during the year ended December 31, 2020 approximated $5,089,875.	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	556	TotalEmployeeCnt
Total Volunteers	35	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$5,625,619	PYContributionsGrantsAmt
CY Contributions Grants	$11,203,545	CYContributionsGrantsAmt
PY Program Service Revenue	$35,809,922	PYProgramServiceRevenueAmt
CY Program Service Revenue	$35,344,253	CYProgramServiceRevenueAmt
PY Investment Income	$22,706	PYInvestmentIncomeAmt
CY Investment Income	$24,118	CYInvestmentIncomeAmt
PY Other Revenue	$127,293	PYOtherRevenueAmt
CY Other Revenue	$152,637	CYOtherRevenueAmt
PY Total Revenue	$41,585,540	PYTotalRevenueAmt
CY Total Revenue	$46,724,553	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$22,282,509	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$25,222,909	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$17,345,341	PYOtherExpensesAmt
CY Other Expenses	$19,051,357	CYOtherExpensesAmt
PY Total Expenses	$39,627,850	PYTotalExpensesAmt
CY Total Expenses	$44,274,266	CYTotalExpensesAmt
PY Revenues Less Expenses	$1,957,690	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$2,450,287	CYRevenuesLessExpensesAmt
Total Assets BOY	$15,183,710	TotalAssetsBOYAmt
Total Assets EOY	$19,530,712	TotalAssetsEOYAmt
Total Liabilities BOY	$12,391,440	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$15,210,080	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$2,792,270	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$4,320,632	NetAssetsOrFundBalancesEOYAmt
Mission	South Shore Hospital Corporation is a not-for-profit hospital dedicated to providing the highest quality of healthcare possible to the south shore community. The costs for services and supplies furnished under its charity care policy during the year ended December 31, 2020 approximated $1,712,814.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$30,003,454	ExpenseAmt
Revenue	$35,410,064	RevenueAmt
Desc	THE HOSPITAL IS AN ACUTE CARE FACILITY PROVIDING SERVICES TO ALL PATIENTS REGARDLESS OF THEIR ABILITY TO PAY. THE HOSPITAL PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY AT NO CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE CHARGES FORGONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY DURING THE YEAR ENDED DECEMBER 31, 2020 APPROXIMATED $1,712,814. IN ADDITION TO CHARITY CARE, THE HOSPITAL ALSO OFFERS OTHER COMMUNITY BENEFITS SUCH AS PROVIDING MENTORS AND VOLUNTEERS, AND IT ALSO SPONSORS HEALTH FAIRS THROUGHOUT THE COMMUNITY. EMPLOYEES OF THE HOSPITAL PARTICIPATE IN A MENTORING PROGRAM FOR CHILDREN WITHIN THE COMMUNITY. THE PROGRAM'S GOAL IS TO MOTIVATE STUDENTS TO COMPLETE THEIR HIGH SCHOOL EDUCATION WITH AN EMPHASIS ON THE OVERALL IMPORTANCE OF EDUCATION AND PRE-EMPLOYMENT PREPARATION.	Desc
Total Program Service Expenses	$30,003,454	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	Yes (true)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	false	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	false	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	Yes (true)	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	Yes (true)	RelatedOrganizationCtrlEntInd
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	405	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	556	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Tim Caveney	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7733565200	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8012 SOUTH CRANDON AVENUE	AddressLine1Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60617	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Lupe Valadez
Vice President/Secretary	10.0	Yes (X)	Yes (X)	$0	$0	$0
Nick Valadez
Chairman of the Board	10.0	Yes (X)	Yes (X)	$0	$0	$0
Timothy Caveney
President and CEO	40.0	Yes (X)	Yes (X)	$280,933	$0	$40,159
Todd H Stroger
Treasurer	10.0	Yes (X)	Yes (X)	$0	$0	$0
Betty Johnson
Director	10.0	Yes (X)		$0	$0	$0
Blair Dietrich
Director	10.0	Yes (X)		$0	$0	$0
Elsie Walker-Thomas
Director	10.0	Yes (X)		$0	$0	$0
Jacqueline Hawkins RN
Director	10.0	Yes (X)		$0	$0	$0
Jason Chen
Director	60.0	Yes (X)		$256,609	$0	$0
Julius R Alexander II
Vice Chairman	10.0	Yes (X)		$0	$0	$0
Satya Ahuja
Director	10.0	Yes (X)		$0	$0	$0
Mary E Foley
Assistant Secretary	40.0		Yes (X)	$122,195	$0	$11,304
Femisayo Ajaja
On-call Registry Nurse	40.0			$165,888	$0	$0	Yes (X)
Kally McGill
On-call Registry Nurse	40.0			$181,452	$0	$4,186	Yes (X)
Lilia Glackin
Registered Nurse	40.0			$232,124	$0	$23,664	Yes (X)
Nikesha L Dunn
Registered Nurse	40.0			$163,997	$0	$0	Yes (X)
Vera H Ray
Director of Lab	40.0			$208,237	$0	$12,486	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,611,435	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$91,799	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	47	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
COMPLETE RX LTD
3100 S GESSNER SUITE 640	HOUSTON	TX	77063	PHARMACY MANAGEMENT	$1,882,412
ILIND EM-I MEDICAL SERVICES INC
7032 COLLECTION CENTER DR	CHICAGO	IL	60693	EMERGENCY ROOM PHYSICIANS	$970,578
STEVEN GREENWALD MD
8012 S CRANDON AVE	CHICAGO	IL	606171124	PHYSICIAN	$550,957
SYSCO FOOD SERVICE-CHICAGO INC
250 Wieboldt Dr	Des Plaines	IL	60016	FOOD SERVICE	$534,881
LABORATORY CORPORATION OF AMERICA
PO BOX 12140	BURLINGTON	NC	272162140	MEDICAL SUPPLIES	$434,231

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	37	CntrctRcvdGreaterThan100KCnt
Fundraising	$202	FundraisingAmt
Government Grants	$11,203,343	GovernmentGrantsAmt
Total Contributions	$11,203,545	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICARE/MEDICAID PAYMENTS	622110	$34,430,112	$34,430,112
PATIENT SERVICE REVENUE	622110	$735,497	$735,497
RENTAL INCOME	531120	$178,644	$178,644

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$35,344,253	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,799	TotalRevenueColumnAmt
Exclusion	$16,799	ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$7,319	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt
Other	$7,319	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,319	TotalRevenueColumnAmt
Exclusion	$7,319	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$1,948	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$202	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$0	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,948	TotalRevenueColumnAmt
Exclusion	$1,948	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	CAFETERIA REVENUE	Desc
Business	900099	BusinessCd
Total Revenue Column	$84,878	TotalRevenueColumnAmt
Exclusion	$84,878	ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$65,811	TotalRevenueColumnAmt
Related Or Exempt Func Income	$65,811	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$150,689	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$46,724,553	TotalRevenueColumnAmt
Related Or Exempt Func Income	$35,410,064	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$110,944	ExclusionAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part IX	Yes (X)	InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$454,591	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$454,591	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$21,092,536	TotalAmt
Program Services	$16,750,420	ProgramServicesAmt
Management And General	$4,342,116	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$248,610	TotalAmt
Program Services	$248,610	ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$2,134,291	TotalAmt
Program Services	$2,134,291	ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,292,881	TotalAmt
Program Services	$433,155	ProgramServicesAmt
Management And General	$859,726	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$60,000	TotalAmt
Program Services	$60,000	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Fundraising	$0	FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$10,710,506	TotalAmt
Program Services	$8,147,337	ProgramServicesAmt
Management And General	$2,563,169	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$496,913	TotalAmt
Program Services	$223,226	ProgramServicesAmt
Management And General	$273,687	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$662,372	TotalAmt
Program Services	$45,376	ProgramServicesAmt
Management And General	$616,996	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$1,152,119	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$1,152,119	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$472,940	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$472,940	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
Medicaid Provider Tax	$3,064,575	$0	$3,064,575	$0
MEDICAL SUPPLiES	$1,696,963	$1,696,963		$0
Food	$470,429	$264,076	$206,353	$0
Medicine	$264,540	$0	$264,540	$0

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$44,274,266	TotalAmt
Program Services	$30,003,454	ProgramServicesAmt
Management And General	$14,270,812	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,043,465	BOYAmt
EOY	$3,882,553	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$313,829	BOYAmt
EOY	$414,622	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$3,464,715	BOYAmt
EOY	$5,405,998	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$347,655	BOYAmt
EOY	$300,271	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$167,089	BOYAmt
EOY	$200,585	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$53,686,011	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$44,873,869	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$9,356,799	BOYAmt
EOY	$8,812,142	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$490,158	BOYAmt
EOY	$514,541	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$15,183,710	BOYAmt
EOY	$19,530,712	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$7,085,700	BOYAmt
EOY	$7,738,307	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,305,740	BOYAmt
EOY	$7,471,773	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$12,391,440	BOYAmt
EOY	$15,210,080	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows FASB117	Yes (X)	OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$2,792,270	BOYAmt
EOY	$4,320,632	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$2,792,270	BOYAmt
EOY	$4,320,632	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$15,183,710	BOYAmt
EOY	$19,530,712	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$2,450,287	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$793	NetUnrlzdGainsLossesInvstAmt
Prior Period Adjustments	-$922,718	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	false	FSAuditedInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	false	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	false	GrantsOtherOrganizationsInd
Direct Contact Legislators	false	DirectContactLegislatorsInd
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	Yes (true)	OtherActivitiesInd
Other Activities	$4,200	OtherActivitiesAmt
Total Lobbying Expenditures	$4,200	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Schedule C, Part II-B, Line 1 DETAILED DESCRIPTION OF THE LOBBYING ACTIVITY	FormAndLineReferenceDesc
Explanation	The Hospital is a member of the Illinois Health and Hospital Association and accordingly pays dues annually for its membership. A portion of South Shore's membership dues are attributable to lobbying activities, which is the amount reported on Schedule C, Part II-B, Line 1i.	ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,528,853	OtherCostOrOtherBasisAmt
Book Value	$2,528,853	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$28,821,202	OtherCostOrOtherBasisAmt
Depreciation	$23,202,687	DepreciationAmt
Book Value	$5,618,515	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$22,335,956	OtherCostOrOtherBasisAmt
Depreciation	$21,671,182	DepreciationAmt
Book Value	$664,774	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$0	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$0	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$8,812,142	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDesc	AmtAmt
ESTIMATED LIABILITY FOR PROFFESSIONAL AND GENERAL LIABILITY	$4,216,358
ESTIMATED THIRD-PARTY PAYER SETTLEMENTS	$3,156,187
CAPITAL LEASE OBLIGATIONS	$99,228

Field	Value	IRS element (for citing)
Total Liability	$7,471,773	TotalLiabilityAmt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Event1	Golf Outing	Event1Nm
Gross Receipts Event1	$2,150	GrossReceiptsEvent1Amt
Charitable Contri Event1	$202	CharitableContriEvent1Amt
Gross Revenue Event1	$1,948	GrossRevenueEvent1Amt
Gross Revenue Event2	$0	GrossRevenueEvent2Amt
Gross Revenue Other Events	$0	GrossRevenueOtherEventsAmt
Gross Receipts Total	$2,150	GrossReceiptsTotalAmt
Charitable Contributions Tot	$202	CharitableContributionsTotAmt
Gross Revenue Total Events	$1,948	GrossRevenueTotalEventsAmt

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent200	Yes (X)	Percent200Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent400	Yes (X)	Percent400Ind
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	Yes (true)	ExpensesExceedBudgetInd
Unable To Provide Care	false	UnableToProvideCareInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,712,814	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,712,814	NetCommunityBenefitExpnsAmt
Total Expense	0.0390	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$17,163,992	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,343,948	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$18,876,806	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$18,343,948	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,712,814	NetCommunityBenefitExpnsAmt
Total Expense	0.0390	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$198,229	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$198,229	NetCommunityBenefitExpnsAmt
Total Expense	0.0045	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$5,010,796	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,963,339	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,047,457	NetCommunityBenefitExpnsAmt
Total Expense	0.0694	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$5,209,025	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,963,339	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$3,245,686	NetCommunityBenefitExpnsAmt
Total Expense	0.0739	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$24,085,831	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$20,307,287	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$4,958,500	NetCommunityBenefitExpnsAmt
Total Expense	0.1129	TotalExpensePct

Physical Imprv And Housing PhysicalImprvAndHousingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Environmental Improvements EnvironmentalImprovementsGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Leadership Development LeadershipDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Coalition Building CoalitionBuildingGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Health Improvement Advocacy HealthImprovementAdvocacyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Other Communtity Building Acty OtherCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Activities Or Programs	0	ActivitiesOrProgramsCnt
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.0	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$279,557	BadDebtExpenseAmt
Reimbursed By Medicare	$12,817,629	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$14,145,789	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$1,328,160	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	South Shore Hospital Corporation	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8012 SOUTH CRANDON AVENUE	AddressLine1Txt
City	Chicago	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	60617	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.southshorehospital.com	WebsiteAddressTxt
State License	0003459	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	South Shore Hospital Corporation	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
Prior CHNA Impact	Yes (X)	PriorCHNAImpactInd
CHNA Conducted	19	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	https://www.southshorehospital.com/about-south-shore/	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	19	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	HTTPS://WWW.SOUTHSHOREHOSPITAL.COM/ABOUT-SOUTH-SHORE/	StrategyWebsiteURLTxt
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	200.0	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	400.0	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Insurance Status Criteria	Yes (X)	InsuranceStatusCriteriaInd
Underinsurance Stat Criteria	Yes (X)	UnderinsuranceStatCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Provided Hospital Contact	Yes (X)	ProvidedHospitalContactInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Available On Website	Yes (X)	FAPAvailableOnWebsiteInd
FAP Available On Website URL	https://www.southshorehospital.com/fap-policy/	FAPAvailableOnWebsiteURLTxt
FAP App Available On Website	Yes (X)	FAPAppAvailableOnWebsiteInd
FAP App Available On Website URL	https://www.southshorehospital.com/fap-policy/	FAPAppAvailableOnWebsiteURLTxt
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	https://www.southshorehospital.com/fap-policy/	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No Chrg	Yes (X)	FAPSumAvlblOnRequestNoChrgInd
Notified FAP Copy Bill Display	Yes (X)	NotifiedFAPCopyBillDisplayInd
Communtity Notified FAP	Yes (X)	CommuntityNotifiedFAPInd
FAP Translated	Yes (X)	FAPTranslatedInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
Provided Written Notice	Yes (X)	ProvidedWrittenNoticeInd
Made Effort Orally Notify	Yes (X)	MadeEffortOrallyNotifyInd
Processed FAP Application	Yes (X)	ProcessedFAPApplicationInd
Made Presumptive Elig Determ	Yes (X)	MadePresumptiveEligDetermInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Look Back Medicare Private	Yes (X)	LookBackMedicarePrivateInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part V, Section B, Line 5 Facility , 1	Facility , 1 - SOUTH SHORE HOSPITAL. Between August 2018 and February 2019, Alliance for Health Equity partners collaborated to conduct a total of 57 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. Thirty-six focus groups were conducted by IPHI and 21 Learning Map Sessions were led by West Side United, a regional collaboration of hospitals serving the West Side of Chicago and West Suburban Cook County, with notetaking by IPHI. IPHI developed the focus group questions using resources from existing CHNA toolkits and peer-reviewed studies, in consultation with the CHNA committee and colleagues at partner health departments. Each focus group was hosted by a hospital or community organization. The sessions were approximately 60-90 minutes long with an average of 8-12 participants. A total of 5 learning map sessions/focus groups were conducted with residents living within SSH's service area.
Schedule H, Part V, Section B, Line 6a Facility , 1	Facility , 1 - South Shore Hospital. SSH and members of the Alliance for Health Equity (AHE), a collaborative of 35 non-profit hospitals (displayed on page 6 of the CHNA), two public hospitals, six health departments, and nearly 100 community-based organizations, worked together between March 2018 through March 2019 to conduct a comprehensive Community Health Needs Assessment (CHNA) for Chicago and Suburban Cook County.
Schedule H, Part V, Section B, Line 6b Facility , 1	Facility , 1 - South Shore Hospital. SSH and members of the Alliance for Health Equity (AHE), a collaborative of 35 non-profit hospitals (displayed on page 6 of the CHNA), two public hospitals, six health departments, and nearly 100 community-based organizations, worked together between March 2018 through March 2019 to conduct a comprehensive Community Health Needs Assessment (CHNA) for Chicago and Suburban Cook County.
Schedule H, Part V, Section B, Line 11 Facility , 1	Facility , 1 - SOUTH SHORE HOSPITAL. SSH has a Geriatric Psych, Detox and Chemical Dependency programs. The Emergency Room had 12,747 visits in 2019. HEALTH PRIORITIES NOT CHOSEN FOR ACTION: CANCER-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS CANCER DEATHS. OTHER HOSPITALS IN THE COMMUNITY HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDE THIS AS AN AREA CHOSEN FOR ACTION. FAMILY PLANNING-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS FAMILY PLANNING ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. HEART DISEASE & STROKE-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS HEART DISEASE & STROKE ISSUES. OTHER COMMUNITY ORGANIZATIONS AND HOSPITAL HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. IMMUNIZATIONS-ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. INJURY & VIOLENCE PREVENTION-SSH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. MATERNAL & INFANT HEALTH-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS MATERNAL & INFANT HEALTH ISSUES. OTHER COMMUNITY ORGANIZATIONS AND HOSPITAL HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. ORAL HEALTH-ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. RESPIRATORY DISEASE-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS RESPIRATORY DISEASE ISSUES. OTHER COMMUNITY ORGANIZATIONS AND HOSPITAL HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. SEXUALLY TRANSMITTED DISEASES-SSH BELIEVES THAT THIS PRIORITY AREA FALLS MORE WITHIN THE PURVIEW OF THE COUNTY HEALTH DEPARTMENT AND OTHER COMMUNITY ORGANIZATIONS. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. TOBACCO USE-SSH HAS LIMITED RESOURCES, SERVICES AND EXPERTISE AVAILABLE TO ADDRESS TOBACCO USE ISSUES. OTHER COMMUNITY ORGANIZATIONS HAVE INFRASTRUCTURE AND PROGRAMS IN PLACE TO BETTER MEET THIS NEED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION. VISION-ADVISORY COMMITTEE MEMBERS FELT THAT MORE PRESSING HEALTH NEEDS EXISTED. LIMITED RESOURCES AND LOWER PRIORITY EXCLUDED THIS AS AN AREA CHOSEN FOR ACTION.

Field	Value	IRS element (for citing)
Facility	6	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (6 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	FacilityFacilityTxt
SENIORS & GENERAL WELLNESS CENTER
2525 EAST 83RD STREET	CHICAGO	IL	60617	PHYSICIAN OFFICE
EAST SIDE MEDICAL HEALTH CENTER
10551 SOUTH EWING AVENUE	CHICAGO	IL	60617	PHYSICIAN OFFICE
SOUTH SIDE PROFESSIONAL BUILDING
7906 SOUTH CRANDON AVENUE	CHICAGO	IL	60617	PHYSICIAN OFFICE
HIGHLAND MEDICAL CENTER
8201 SOUTH ASHLAND	CHICAGO	IL	60620	PHYSICIAN OFFICE
FAMILY MEDICAL CENTER
1424 WEST 87TH STREET	CHICAGO	IL	60620	PHYSICIAN OFFICE
SHARED PHYSICIAN OFFICE SPACE
8012 SOUTH CRANDON AVENUE	CHICAGO	IL	60617	PHYSICIAN OFFICE

Supplemental Information Detail SupplementalInformationDetail (13 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part III, Line 2 Bad debt expense - methodology used to estimate amount	THE BAD DEBT RESERVE IS AN ESTIMATE OF THE ACCOUNT BALANCES THAT WE EXPECT TO NOT COLLECT DESPITE THE PATIENTS ABILITY TO PAY. THE ESTIMATE WHICH IS UPDATED MONTHLY IS BASED ON HISTORICAL WRITE OFF PERCENTAGES. THESE PERCENTAGES ARE ADJUSTED TO REFLECT ANY BAD DEBT RECOVERIES.
Schedule H, Part III, Line 3 Bad Debt Expense Methodology	The Method used to determine the amount that reasonably could be attributed to patients who likely would qualify for financial assistance under our Financial Assistance Policy is based on our outside eligibility vendor's experience with qualifying accounts as financial assistance. Our vendor screens all self pay accounts, and based on an initial screening, will classify the account as falling under our Financial Assistance Program guidelines. OCCASIONALLY, PATIENT ACCOUNTS WILL BE WRITTEN OFF TO BAD DEBT BUT THEN ARE LATER DETERMINED TO BE UNCOLLECTIBLE DUE TO THE PATIENT BEING UNINSURED OR ELIGIBLE FOR PUBLIC AID. ONCE DETERMINED THAT THE PATIENT HAS NO ABILITY TO PAY, THE ACCOUNTS ARE WRITTEN OFF AS CHARITY WRITE-OFFS. THE METHODOLOGY IS TO TAKE TOTAL BAD EXPENSE LESS THE BAD DEBT FROM THE MEDICARE COST REPORT. THE HOSPITAL INCURS A LOSS FOR THE BENEFIT OF THE COMMUNITY.
Schedule H, Part III, Line 4 Bad debt expense - financial statement footnote	The provision for bad debts is based upon management's assessment of historical and expected collections of accounts receivable considering business and economic conditions, trends in healthcare coverage, and other collection indicators. Accounts receivable are written off and charged to the provision for bad debts after collection efforts have been made in accordance with the Hospital's policies. Recoveries are treated as a reduction to the provision for bad debts. Accounts receivable are reduced by an allowance for doubtful accounts. Periodically, management assesses the adequacy of the allowance for uncollectible accounts based upon historical write-off experience by major payor category. Income from incentive payments is subject to retrospective adjustment as the incentive payments are calculated using Medicare cost report data that is subject to audit. Data about the major payor sources of revenue is analyzed to establish an appropriate allowance for uncollectible receivables and provision for bad debts. For receivables associated with services provided to patients who have third-party coverage, contractually due amounts are analyzed and compared to actual cash collected over time to enhance the quality of the estimate of the allowance for doubtful accounts and the provision for bad debts (for example, for expected uncollectible deductibles and copayments on accounts for which the third-party payor has not yet paid, or for payors who are known to be having financial difficulties that make the realization of amounts due unlikely). 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), a significant allowance for doubtful accounts is recorded on the basis of historical experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. An estimate of the difference between contracted rates and amounts actually collected, after all reasonable collection efforts have been exhausted, is charged to the provision for bad debts and credited to the allowance for doubtful accounts.
Schedule H, Part III, Line 8 Community benefit & methodology for determining medicare costs	Medicare allowable costs were determined by applying the Medicare cost to charge ratio from the 2020 Medicare cost report to the Medicare charges. Approximately 60% of our patients are seniors with Medicare insurance, but are unable to pay their coinsurance and deductible amounts. Consistent with the Hospital's Financial Assistance policy, these accounts are either written off to Charity care or Bad Debt expense. Most of the Medicare shortfall is the result of these accounts. Hence, the Hospital is subsidizing the Medicare reimbursement as part of our community benefit program.
Schedule H, Part III, Line 9b Collection practices for patients eligible for financial assistance	In recognizing the medical needs of the indigent, South Shore Hospital provides quality medical health care regardless of race, creed, color, sex, natural origin, sexual orientation, handicap, age or ability to pay. Our financial assistance policy identifies circumstances under which South Shore Hospital will extend care free of charge or at a discount, commensurate with the ability to pay, to a patient whose financial status makes it impractical or impossible to pay for necessary medical expenses. The necessity for medical treatment of any patient is based upon clinical judgement without regard to the financial status of the patient. If a patient is determined to be eligible for financial assistance, then collection actions will be stopped.
Schedule H, Part V, Section B, Line 16a FAP website	- South Shore Hospital Corporation: Line 16a URL: https://www.southshorehospital.com/fap-policy/;
Schedule H, Part V, Section B, Line 16b FAP Application website	- South Shore Hospital Corporation: Line 16b URL: https://www.southshorehospital.com/fap-policy/;
Schedule H, Part V, Section B, Line 16c FAP plain language summary website	- South Shore Hospital Corporation: Line 16c URL: https://www.southshorehospital.com/fap-policy/;
Schedule H, Part VI, Line 2 Needs assessment	The Hospital goes above and beyond the core needs of the community as stipulated in the CHNA, by providing diabetes education, language assistance, and transportation services. Meetings are scheduled throughout the year with ministers, community leaders and representatives of the communities school districts.
Schedule H, Part VI, Line 3 Patient education of eligibility for assistance	All uninsured patients are advised of our financial assistance policy as part of the admissions process. Whenever possible, South Shore Hospital provides assistance to uninsured patients in obtaining health care insurance at no cost to the patient. This assistance includes visits with the patient while in the hospital, and follow-up visits to their home to ensure that insurance applications are completed and filed in a timely manner. Then appropriate follow up is done with Medicaid and other insurers to ensure the applications are processed timely. All self pays receive a charity application, and are assessed. They are given a discount based on the State of Illinois poverty guidelines. For patients that are presumptive eligible, they are written off to Charity once they go through the process and are denied. According to the Hospital's FAP: 1. Every patient will, upon admission as an inpatient or outpatient, receive a written notice that shall contain information about the availability of financial assistance, including information about this policy as well as contact information for a hospital employee or office from which the person may obtain further information about the policy. 2. Signs will be posted conspicuously in the admission and registration areas to notify patients and visitors about the availability of financial assistance. The signage will contain the following language, in accordance with the Illinois Hospital Fair Patient Billing Act: "You may be eligible for financial assistance under the terms and conditions the hospital offers to qualified patients. For more information contact South Shore Hospital Financial Counselors at 773-356-5212." 3. Each hospital bill, invoice, or other summary of charges to an uninsured patient shall include with it, or on it, a prominent statement, in accordance with the Illinois Hospital Uninsured Patient Discount Act, to the effect that an uninsured patient who meets certain income requirements may qualify for an uninsured discount and information regarding how an uninsured patient may apply for consideration under South Shore Hospital's FAP. 4. The FAP, Financial Assistance Application and plain language summary of the FAP will be available on South Shore Hospital's website at http://www.southshorehospital.com. The documents will be posted in a format that will allow any individual with access to the Internet to access, download, view, and print a hard copy of the documents without requiring special computer equipment and without the payment of a fee. South Shore Hospital will provide any individual who asks how to obtain online access to a copy of the FAP, Financial Assistance Application form, or plain language summary of the FAP with the direct website address, or URL, of the web page on which these documents are posted. 5. Paper copies of the FAP, Financial Assistance Application and plain language summary of the FAP will be readily available in the admitting department and waiting areas. Patients may also call to obtain a copy and it will be mailed it to them at no cost. 6. The Patient Access Department will also notify those patients with no insurance of the availability of Financial assistance and will give a copy of the Financial Assistance Application and plain language summary of the FAP to patients.
Schedule H, Part VI, Line 4 Community information	The South Shore Hospital service area consists of twelve zip codes in the southeast side of the city of Chicago. Six of the zip codes comprise about 80% of our admissions (Zips 60617, 60619, 60649, 60620, 60637, and 60628). These zip code areas have a combined estimated population of about 200,000. Some of the key healthcare needs of this core zip code area are: -There is a disproportionately large population of uninsured people in this area. As a result, South Shore Hospital treats a large percentage of our patients free of charge or at a discount. -There is a disproportionately large population of insured people in this area that cannot afford to pay their copays and deductibles. As a result, the annual Hospital bad debt expense is very large. -There is also a disproportionately large population of indigent people insured with Medicaid in this area. On average, about 25% of our Inpatients have Medicaid health coverage. About 30% of the emergency room outpatient visits are Medicaid patients using the emergency room as a doctors office. Drug abuse is a serious problem in our area with the need for Detox and Rehab services. An increasing number of people in our core zip codes are infected with HIV. There are three other hospital serving the community: St. Bernard Hospital, Advocate Trinity Hospital, and Jackson Park Hospital. South Shore Hospital serves the medically under served. African Americans are nearly 90 percent of inpatient admits.
Schedule H, Part VI, Line 5 Promotion of community health	In addition to the services previously noted in this schedule, the Hospital also provides free immunizations, patient education assistance, language assistance, transportation services, and senior wellness programs, at no cost to the patient. The Hospital also participates with local, independent organizations in conducting about 50 health screening events per year. In addition, the Hospital contributes funds to local, non-profit organizations actively engaged in meeting the social, economic, spiritual, mental and healthcare needs of our community. While most of our patients have healthcare insurance through Medicare or Medicaid, neither of these programs cover the cost of providing the care. As a result, the Hospital usually operates at a loss while subsidizing these programs. The members of the governing body are comprised of persons who reside in the organization's primary service area who are neither employees nor independent contractors of the organization, nor family members thereof. The organization extends medical staff privileges to all qualified physicians in the community for all of its departments and specialties.
Schedule H, Part VI, Line 7 State filing of community benefit report	IL

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Timothy Caveney
President and CEO	$272,412	$0	$0	$0	$8,521	$0	$17,042	$0	$23,117	$0	$321,092	$0	$0	$0
Jason Chen
Director	$256,609	$0	$0	$0	$0	$0	$0	$0	$0	$0	$256,609	$0	$0	$0
Vera H Ray
Director of Lab	$201,994	$0	$0	$0	$6,243	$0	$12,486	$0	$0	$0	$220,723	$0	$0	$0
Kally McGill
On-call Registry Nurse	$179,359	$0	$0	$0	$2,093	$0	$4,186	$0	$0	$0	$185,638	$0	$0	$0
Lilia Glackin
Registered Nurse	$225,063	$0	$0	$0	$7,061	$0	$14,122	$0	$9,542	$0	$255,788	$0	$0	$0
Femisayo Ajaja
On-call Registry Nurse	$165,888	$0	$0	$0	$0	$0	$0	$0	$0	$0	$165,888	$0	$0	$0
Nikesha L Dunn
Registered Nurse	$163,997	$0	$0	$0	$0	$0	$0	$0	$0	$0	$163,997	$0	$0	$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 20 AUDITED FINANCIAL STATEMENTS	SECTION 6033(B)(15)(B) REQUIRES HOSPITAL ORGANIZATIONS TO SUBMIT A COPY OF THEIR AUDITED FINANCIAL STATEMENTS TO THE IRS. PLEASE NOTE, AT THE TIME OF FILING, THE 2020 AUDITED FINANCIALS WERE NOT SIGNED AND ISSUED.
Form 990, Part VI, Line 1a Delegate broad authority to a committee	THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRMAN OF THE BOARD OF DIRECTORS AS CHAIRMAN, VICE-CHAIRMAN, THE PRESIDENT, TREASURER, AND SUCH OTHER DIRECTORS AS THE CHAIRMAN OF THE BOARD MAY APPOINT. THE PRESIDENT OF THE MEDICAL STAFF SHALL BE A MEMBER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE POWER TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION DURING THE INTERIM BETWEEN THE MEETINGS OF THE BOARD OF DIRECTORS, PROVIDED THAT ANY ACTION SHALL NOT CONFLICT WITH THE POLICIES AND EXPRESSED WISHES OF THE BOARD OF DIRECTORS. IN ADDITION, THE EXECUTIVE COMMITTEE MAY ACT IN ALL PERSONNEL MATTERS INVOLVING EXECUTIVE PERSONNEL AND MEDICAL STAFF AS WELL AS OTHER PERSONNEL, INCLUDING SEARCH, SELECTION, EMPLOYMENT, COMPENSATION, CONTRACTS, GENERAL WAGE SCALES, BENEFITS FOR ALL EMPLOYEES AND PERFORMANCE EVALUATION. THE CHAIRMAN MAY APPOINT AN AD HOC COMMITTEE TO RECOMMEND TO IT ANY PARTICULAR SITUATION.
Form 990, Part VI, Line 2 Family/business relationships amongst interested persons	LUPE VALADEZ & NICK VALADEZ - Family relationship
Form 990, Part VI, Line 11b Review of form 990 by governing body	PRINTED COPY OF THE FORM 990 WILL BE PROVIDED TO THE BOARD MEMBERS FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS.
Form 990, Part VI, Line 12c Conflict of interest policy	Each officer, director, trustee and key employee is subject to the conflict of interest policy. the board's conflict of interest committee reviews each member's conflict of interest statement on an annual basis. the board compares prior and current year conflict of interest statements, and reports any potential or actual conflicts of interest to the organization's human resources department. actual conflicts of interest are documented with the organization's human resources department annually. Officers, Directors, Trustees and employees are all covered under the organizations conflict of interest policy. Should there become known, at any time, a conflict of interest between any member staff, hospital personnel or other healthcare providers and the hospital, and the hospital or any of its agents, the individual (s) may excuse himself/ herself from discussions and/ or determinations with the identified healthcare provider(s).
Form 990, Part VI, Line 15a Process to establish compensation of top management official	The Compensation Committee of the board of directors reviews the CEO's performance on an annual basis. In setting the compensation of the organization's CEO, the Committee compares industry compensation figures to the CEO's compensation package. The final determination and deliberations regarding the CEO's compensation package are documented in the minutes of the board of directors meeting. The process for determining compensation of the CEO was last undertaken in 2020.
Form 990, Part VI, Line 15b Process to establish compensation of other employees	The Compensation Committee of the board of directors reviews the performance of the officers and key employees on an annual basis In setting the compensation of these individuals, the Committee compares industry compensation figures to their financial packages. If any individual's compensation is discussed during the meeting, that individual is required to recuse themselves. The process for determining compensation of other officers and key employees was last undertaken in 2020.
Form 990, Part VI, Line 19 Required documents available to the public	Financial statements, governing documents, and conflict of interest policies are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are available upon request
Form 990, Part VII, Section A Reportable Compensation	No board member received compensation for services performed as a board member. Board members who have reported compensation from the filing entity were paid for provision of other services to the organization.
Form 990, Part VIII, Line 11d Other Miscellaneous Revenue	Miscellaneous - Total Revenue: 65811, Related or Exempt Function Revenue: 65811, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part IX, Line 11g Other Fees	PURCHASED SERVICES - Total Expense: 5990646, Program Service Expense: 4297137, Management and General Expenses: 1693509, Fundraising Expenses: ; PHYSICIAN FEES - Total Expense: 2971967, Program Service Expense: 2892613, Management and General Expenses: 79354, Fundraising Expenses: ; REPAIRS AND MAINTENANCE - Total Expense: 608948, Program Service Expense: 296732, Management and General Expenses: 312216, Fundraising Expenses: ; OTHER - Total Expense: 1138945, Program Service Expense: 660855, Management and General Expenses: 478090, Fundraising Expenses: ;

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

Field	Value	IRS element (for citing)
Business Name Line1	SOUTH SHORE HOSPITAL AUXILIARY	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8012 S CRANDON AVE	AddressLine1Txt
City	CHICAGO	CityNm
State Abbreviation	IL	StateAbbreviationCd
ZIP	606171199	ZIPCd

Field	Value	IRS element (for citing)
EIN	363200759	EIN
Primary Activities	FUNDRAISING	PrimaryActivitiesTxt
Legal Domicile State	IL	LegalDomicileStateCd
Exempt Code Section	501(c)(3)	ExemptCodeSectionTxt
Public Charity Status	3	PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	SSHC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Controlled Organization	Yes (true)	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	false	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	false	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	false	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	false	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	false	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	false	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	false	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	false	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	false	TransferFromOtherOrgInd