JACKSON PARK HOSPITAL FOUNDATION: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- JACKSON PARK HOSPITAL FOUNDATION (EIN 36-2448028)
- Tax period
- 2019-04-01 to 2020-03-31
- Filed
- 2020-12-08
- IRS object ID
- 202003449349301455
- Schema version
- 2019v5.0
- Note
- A later return for the same period supersedes this one.
- 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 D
- Schedule H
- Schedule J
- Schedule L
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-12-08T13:51:54-07:00 | ReturnTs |
| Tax Period End | 2020-03-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362448028 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JACKSON PARK HOSPITAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | JACK | BusinessNameControlTxt |
| Phone | 7739477500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island Avenue | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | William Dorsey MD | PersonNm |
| Person Title | Chairman/CEO | PersonTitleTxt |
| Phone | 7739477500 | PhoneNum |
| Signature | 2020-12-08 | SignatureDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | William Dorsey MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 South Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $85,579,723 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.jacksonparkhospital.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1960 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | The Mission of the physicians, Staff and Board of Directors of the organization is to provide compassionate care and high quality healthcare services to meet the needs of the patients and communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 1 | VotingMembersIndependentCnt |
| Total Employee | 829 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $146,683 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,120,779 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,543,392 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $46,558,622 | CYProgramServiceRevenueAmt |
| PY Investment Income | $209,065 | PYInvestmentIncomeAmt |
| CY Investment Income | $117,839 | CYInvestmentIncomeAmt |
| PY Other Revenue | $39,656,422 | PYOtherRevenueAmt |
| CY Other Revenue | $35,782,483 | CYOtherRevenueAmt |
| PY Total Revenue | $55,555,562 | PYTotalRevenueAmt |
| CY Total Revenue | $85,579,723 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $45,296,520 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $44,600,031 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $37,909,644 | PYOtherExpensesAmt |
| CY Other Expenses | $34,672,390 | CYOtherExpensesAmt |
| PY Total Expenses | $83,206,164 | PYTotalExpensesAmt |
| CY Total Expenses | $79,272,421 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$27,650,602 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,307,302 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $113,295,304 | TotalAssetsBOYAmt |
| Total Assets EOY | $106,434,592 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $35,933,980 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $34,504,905 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $77,361,324 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $71,929,687 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of the physicians, staff and Board of Directors of the organization is to provide compassionate and high quality healthcare services to meet the needs of the patients and communities we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $45,166,236 | ExpenseAmt |
| Revenue | $66,086,063 | RevenueAmt |
| Desc | Jackson Park Hospital Foundation provides inpatient and outpatient medical care to Chicago's south side communities regardless of the patient's ability to pay Inpatient services including medical surgical, ICU and hospice In 2019 the hospital served 3,593 acute care admissions which amounted to 16,052 patient days. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $16,125,430 | ExpenseAmt |
| Revenue | $13,852,798 | RevenueAmt |
| Desc | Jackson Park Hospital Foundation provides inpatient and outpatient behavioral medicine services to the greater Chicagoland area Jackson park Hospital is one of the few hospitals in Chicago that continues to provide behavioral medicine to its community In 2019 Jackson Park Hospital served 2,629 inpatient behavioral medicine patients which amounted to 11,075 patient days | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,988,004 | ExpenseAmt |
| Revenue | $12,552,495 | RevenueAmt |
| Desc | Jackson park Hospital Provides basic emergency room services to its community 24 hours a day 7 days a week regardless of the patients ability to pay in 2019 the hospital served 24,001 emergency patients | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,398,643 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | See Schedule O , Statement 2 Medical Education | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,398,643 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $71,678,313 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 84 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 829 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 1 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Nelson Vasquez | PersonNm |
| Phone | 7739477989 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Matthew Malters MD | |||||||||
| Physician | 2 | 38 | Yes (X) | $23,276 | $681,866 | $11,084 | |||
| William Dorsey MD | |||||||||
| Chairman/CEO | 40 | $704,992 | $0 | $11,084 | Yes (X) | Yes (X) | |||
| G Randall Smith | |||||||||
| Executive Vice President | 40 | 0 | $604,406 | $0 | $29,079 | Yes (X) | |||
| Merritt Hasbrouck | |||||||||
| President | 40 | 0 | $607,087 | $0 | $12,226 | Yes (X) | |||
| Surrenthia Parker MD | |||||||||
| Director | 4 | 36 | $49,521 | $389,983 | $29,079 | Yes (X) | |||
| Siddiq Hasan MD | |||||||||
| Director | 4 | 36 | $122,196 | $280,196 | $29,079 | Yes (X) | |||
| Caryn Carranza MD | |||||||||
| Physician | 0 | 40 | Yes (X) | $0 | $379,497 | $0 | |||
| Ruksana Sajid-Nazneen MD | |||||||||
| Physician | 25 | 15 | Yes (X) | $156,856 | $141,786 | $29,079 | |||
| Lakshmi Dodda MD | |||||||||
| Director | 25 | 15 | $195,087 | $96,313 | $29,079 | Yes (X) | |||
| Joseph D'Silva MD | |||||||||
| Physician | 0 | 40 | Yes (X) | $0 | $314,400 | $0 | |||
| Jayesh Madhani MD | |||||||||
| Physician | 2 | 38 | Yes (X) | $71,400 | $210,196 | $29,079 | |||
| Bangalore Murthy MD | |||||||||
| Director | 25 | 15 | $161,745 | $65,637 | $29,079 | Yes (X) | |||
| Haroon Olomi MD | |||||||||
| Director | 4 | 36 | $16,970 | $209,996 | $29,079 | Yes (X) | |||
| Nelson Vasquez | |||||||||
| Vice President Finance | 40 | 0 | $219,335 | $0 | $29,079 | Yes (X) | |||
| Harshad Mehta MD | |||||||||
| Director | 40 | $205,780 | $0 | $19,052 | Yes (X) | ||||
| M Patrica Simon | |||||||||
| Senior Vice President Quality & Compliance | 40 | 0 | $185,236 | $0 | $19,052 | Yes (X) | |||
| Barry Mandell | |||||||||
| Vice President Special Projects | 40 | 0 | $170,087 | $0 | $29,079 | Yes (X) | |||
| Danny Rollins | |||||||||
| VP of Ancillary Services | 40 | 0 | $186,641 | $0 | $9,526 | Yes (X) | |||
| Thomas Pankow | |||||||||
| Chief Information Officer | 40 | 0 | $136,618 | $0 | $0 | Yes (X) | |||
| James Clark | |||||||||
| Director | 2 | $0 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,817,233 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,769,870 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $372,814 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 73 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Address Line2ContractorAddress/USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|
| Powers & Sons Construction | ||||||
| 2636 West 15th Avenue | Gary | IN | 46404 | Construction | $3,660,398 | |
| EBP Trust | ||||||
| 1501 North Plano Road | Richardson | TX | 75081 | Health Insurace | $3,318,614 | Suite 100 |
| Simple Laboratories | ||||||
| 5960 North Milwaukee Avenue | Chicago | IL | 60646 | Lab Services | $2,540,970 | |
| White Cap Nursing | ||||||
| 2600 South Michigan Avenue | Chicago | IL | 60616 | Temporary Nurse Staff | $1,629,712 | |
| Amerisource Bergen | ||||||
| PO Box 27550 | Chicago | IL | 60653 | Drug Supplies | $1,532,825 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 58 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $0 | FederatedCampaignsAmt |
| Membership Dues | $0 | MembershipDuesAmt |
| Fundraising | $0 | FundraisingAmt |
| Related Organizations | $0 | RelatedOrganizationsAmt |
| Government Grants | $2,989,152 | GovernmentGrantsAmt |
| All Other Contributions | $131,627 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $3,120,779 | TotalContributionsAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,558,622 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $46,558,622 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $46,558,622 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $117,839 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $117,839 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| 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 |
Royalties Revenue RoyaltiesRevenueGrp
| 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 |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $292,938 | RealAmt |
| Personal | $0 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $292,938 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $292,938 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $292,938 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $0 | ContriRptFundraisingEventAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt | ExclusionExclusionAmt |
|---|---|---|---|---|---|
| Provider Tax Proceeds | 622110 | $33,521,547 | $33,521,547 | $0 | $0 |
| Other Income | 622000 | $246,094 | $246,094 | $0 | $0 |
| Other Revenue | 622000 | $1,721,904 | $1,721,904 | $0 | $0 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| 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) |
|---|---|---|
| Other Revenue Total | $35,489,545 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $85,579,723 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,458,944 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,817,233 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,817,233 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,385,588 | TotalAmt |
| Program Services | $33,385,588 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,117,139 | TotalAmt |
| Program Services | $1,117,139 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,613,445 | TotalAmt |
| Program Services | $3,209,100 | ProgramServicesAmt |
| Management And General | $404,345 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,666,626 | TotalAmt |
| Program Services | $2,666,626 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $790,769 | TotalAmt |
| Program Services | $790,769 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $292,821 | TotalAmt |
| Management And General | $292,821 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,654,164 | TotalAmt |
| Program Services | $15,378,744 | ProgramServicesAmt |
| Management And General | $275,420 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,884,543 | TotalAmt |
| Program Services | $6,903,329 | ProgramServicesAmt |
| Management And General | $981,214 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,214,565 | TotalAmt |
| Program Services | $1,214,565 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $653,638 | TotalAmt |
| Program Services | $613,372 | ProgramServicesAmt |
| Management And General | $40,266 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,231,586 | TotalAmt |
| Program Services | $3,032,512 | ProgramServicesAmt |
| Management And General | $199,074 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,013,502 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,013,502 | ManagementAndGeneralAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,936,802 | TotalAmt |
| Program Services | $3,366,569 | ProgramServicesAmt |
| Management And General | $570,233 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,272,421 | TotalAmt |
| Program Services | $71,678,313 | ProgramServicesAmt |
| Management And General | $7,594,108 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,003,082 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,015,925 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $78,558,780 | BOYAmt |
| EOY | $73,899,067 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,152,092 | BOYAmt |
| EOY | $1,310,960 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $196,479 | BOYAmt |
| EOY | $148,624 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $98,924,730 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $74,389,405 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,897,795 | BOYAmt |
| EOY | $24,535,325 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,871 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,032,657 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $487,076 | BOYAmt |
| EOY | $486,163 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,295,304 | BOYAmt |
| EOY | $106,434,592 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,394,609 | BOYAmt |
| EOY | $11,803,336 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,187,258 | BOYAmt |
| EOY | $5,777,799 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,352,113 | BOYAmt |
| EOY | $16,923,770 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,933,980 | BOYAmt |
| EOY | $34,504,905 | 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 | $77,361,324 | BOYAmt |
| EOY | $71,929,687 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| 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 | $77,361,324 | BOYAmt |
| EOY | $71,929,687 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,295,304 | BOYAmt |
| EOY | $106,434,592 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,307,302 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | -$11,738,939 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consol And Sep Basis Fincl Stmt | Yes (X) | ConsolAndSepBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | 0 | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,482,024 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Book Value | $2,482,024 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $61,225,175 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $43,769,138 | DepreciationAmt |
| Book Value | $17,456,037 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $3,178 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $3,178 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $35,214,353 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,620,267 | DepreciationAmt |
| Book Value | $4,594,086 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| 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 | $24,535,325 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| Pension Liability | $1,083,928 |
| Professional Liability | $5,746,283 |
| Other Liabilities | $10,093,559 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,923,770 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule D, Part X, Line 2 | FormAndLineReferenceDesc |
| Explanation | Uncertain tax positions U. S. GAAP requires management to evaluate uncertain tax positions taken by the Corporation. The financial statement effects of a tax position are recognized when a position is more likely than not, based on technical merits, to be sustained by the examination by the Internal Revenue Service. The Corporation has evaluated tax positions taken or expected to be taken to determine whether the tax positions are more likely than not to be sustained by the applicable taxing authority and has determined that it currently does not have any uncertain tax positions as of March 31, 2020. The Corporation has recognized no interest or penalties related to uncertain tax positions. The Corporation is subject to routine audits by taxing jurisdictions, however, there are currently no audits for any tax periods in progress. Management believes it is no longer subject to income tax examinations for years prior to 2013. | ExplanationTxt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent200 D | Yes (X) | Percent200DInd |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | Yes (1) | FinancialAssistanceBudgetInd |
| Expenses Exceed Budget | Yes (1) | ExpensesExceedBudgetInd |
| Unable To Provide Care | 0 | UnableToProvideCareInd |
| Annual Community Bnft Report | Yes (1) | AnnualCommunityBnftReportInd |
| Report Publically Available | Yes (1) | ReportPublicallyAvailableInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $1,992,149 | TotalCommunityBenefitExpnsAmt |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $1,992,149 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $2,398,644 | TotalCommunityBenefitExpnsAmt |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $7,567,738 | TotalCommunityBenefitExpnsAmt |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $9,966,382 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activities Or Programs | 0 | ActivitiesOrProgramsCnt |
| Persons Served | 0 | PersonsServedCnt |
| Total Community Benefit Expns | $11,958,531 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $0 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $0 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $7,567,738 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $7,567,738 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $15,805,470 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $15,805,470 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | $0 | 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 (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | 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 | Jackson Park Hospital Foundation | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | jacksonparkhospital.org | WebsiteAddressTxt |
| State License | 0001115 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| General Medical And Surgical | Yes (X) | GeneralMedicalAndSurgicalInd |
| Teaching Hospital | Yes (X) | TeachingHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jackson Park Hospital Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | 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 | 17 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | jacksonparkhospital.org | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 18 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | jacksonparkhospital.org | StrategyWebsiteURLTxt |
| Strategy Attached | 0 | StrategyAttachedInd |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 200 | FPGFamilyIncmLmtDscntCarePct |
| Explained Basis | Yes (1) | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | jacksonparkhospital.org | FAPAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | jacksonparkhospital.org | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| 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 (1) | FAPActionsOnNonpaymentInd |
| Permit Report To Credit Agency | Yes (X) | PermitReportToCreditAgencyInd |
| Collection Activities | 0 | 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 (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare Private | Yes (X) | LookBackMedicarePrivateInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part V, Section B, Line 5-Jackson Park Hospital Foundation | Focus groups were conducted with members of our community. |
| Schedule H, Part V, Section B, Line 11-Jackson Park Hospital Foundation | The hospital implemented a senior program that included free transportation to older adults 55+. Due to the ongoing pandemic, the expansion of community based programs were suspended. Because of the large negative financial impact the O.B. product line was having on the hospital operations, it was closed in August 2019. |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule H, Part I, Line 7 | Charity Care Cost is based on the total cost to charge ratio derived from the Medicare Cost Report for services provided to patients. |
| Schedule H, Part III, Section A, Line 4 | The cost of bad debt expense is based on the cost to charge derived from the hospitals Medicare Cost Report |
| Schedule H, Part III, Section B, Line 8 | There is no shortfall between Medicare reimbursement and the hospitals cost. |
| Schedule H, Part III, Section C, Line 9b | The hospital has a presumptive eligibility policy as required by the State of Illinois. |
| Schedule H, Part VI, Line 2 | Jackson Park Hospital Foundation outreach and assessment of its community health by evaluating which health conditions and diseases are prevalent among its inpatient and outpatients. The hospital prepared its community health needs assessment using a professional company experienced in assisting hospitals in the process. Together we confirmed the need for education and other inventions for diabetes, asthma, and behavioral medicine. The hospital has responded to these needs through the development of several community programs and specialty clinics. The hospital implemented free transportation for patients who are unable to keep appointments with their primary care provider or consultant. |
| Schedule H, Part VI, Line 3 | The hospital has contracted with a third party named First Source to assist any patient through the financial application process to qualify for Medicaid, Medicare, and the Affordable Care Act. This same company will also assist a patient and or family through the hospitals charity application process. |
| Schedule H, Part VI, Line 4 | Jackson Park Hospitals primary service area is 60649,60621,60637,60619 and 60617. Our primary care area for behavioral patients is much broader and encompasses the City of Chicago. The average income in the hospitals primary service area is approximately 53% of the State of Illinois average. |
| Schedule H, Part VI, Line 5 | In addition to various education programs within the hospital, the hospital has begun regular education and outreach programs at local grocery stores and banks in 2019. The hospital began an outreach program for senior patients. This senior program will manage the primary healthcare needs and match the patient with the physician. |
| Schedule H, Part VI, Line 7 | Jackson park Hospital prepares and submits an annual Community Benefits report to the Attorney General of the State of Illinois. This report is also made available to the public upon request. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Lakshmi Dodda MD | ||||||||||||||
| Director | $195,087 | $96,313 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $224,166 | $96,313 | $0 | $0 |
| William Dorsey MD | ||||||||||||||
| Chairman/CEO | $704,992 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $11,084 | $0 | $716,076 | $0 | $0 | $0 |
| Siddiq Hasan MD | ||||||||||||||
| Director | $122,196 | $280,196 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $151,275 | $280,196 | $0 | $0 |
| Harshad Mehta MD | ||||||||||||||
| Director | $205,780 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,052 | $0 | $224,832 | $0 | $0 | $0 |
| Bangalore Murthy MD | ||||||||||||||
| Director | $161,745 | $65,637 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $190,824 | $65,637 | $0 | $0 |
| Haroon Olomi MD | ||||||||||||||
| Director | $16,970 | $209,996 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $46,049 | $209,996 | $0 | $0 |
| Surrenthia Parker MD | ||||||||||||||
| Director | $49,251 | $389,983 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $78,330 | $389,983 | $0 | $0 |
| Merritt Hasbrouck | ||||||||||||||
| President | $607,087 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,226 | $0 | $619,313 | $0 | $0 | $0 |
| G Randall Smith | ||||||||||||||
| Executive Vice President | $604,406 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $633,485 | $0 | $0 | $0 |
| M Patrica Simon | ||||||||||||||
| Senior Vice President Quality & Compliance | $185,236 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,052 | $0 | $204,288 | $0 | $0 | $0 |
| Barry Mandell | ||||||||||||||
| Vice President Special Projects | $170,087 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $199,166 | $0 | $0 | $0 |
| Nelson Vasquez | ||||||||||||||
| Vice President Finance | $219,335 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $248,414 | $0 | $0 | $0 |
| Thomas Pankow | ||||||||||||||
| Chief Information Officer | $136,618 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $136,618 | $0 | $0 | $0 |
| Matthew Malters MD | ||||||||||||||
| Physician | $23,276 | $681,866 | $0 | $0 | $0 | $0 | $0 | $0 | $11,084 | $0 | $34,360 | $681,866 | $0 | $0 |
| Caryn Carranza MD | ||||||||||||||
| Physician | $0 | $379,497 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $379,497 | $0 | $0 |
| Joseph D'Silva MD | ||||||||||||||
| Physician | $0 | $314,400 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $314,400 | $0 | $0 |
| Jayesh Madhani MD | ||||||||||||||
| Physician | $71,400 | $210,196 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $100,479 | $210,196 | $0 | $0 |
| Ruksana Sajid-Nazneen MD | ||||||||||||||
| Physician | $156,856 | $141,786 | $0 | $0 | $0 | $0 | $0 | $0 | $29,079 | $0 | $185,935 | $141,786 | $0 | |
| Danny Rollins | ||||||||||||||
| VP of Ancillary Services | $186,641 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,526 | $0 | $196,167 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (3 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Bangalore Murthy MD | |||
| Director | $621,138 | Temporary Staffing | 0 |
| Bangalore Murthy MD | |||
| Director | $725 | Medical Education | 0 |
| Bangalore Murthy MD | |||
| Director | $71,604 | Medical Education Billing | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, Line 3 | Due to growing operating losses, the O.B. product line was closed in August 2019 |
| Form 990, Part VI, Section B, Line 11b | Several individuals review the 990 before it is submitted. This includes Assistant VP of Finance, VP of Finance, Executive VP, President, and CEO |
| Form 990, Part VI, Section B, Line 12c | The Compliance Officer reviews policies on annual basis. |
| Form 990, Part VI, Section B, Line 15 | Jackson Park Hospital Foundation has an audit/compensation committee. The Chairman of the Audit/Compensation committee reviews the compensation of senior management and key employees on an annual basis. |
| Form 990, Part VI, Section C, Line 19 | Jackson Park Hospital Foundation makes its Community Health Needs Assessment available on its own website and by appointment with its Vice President of Finance. The Conflict of Interest Policy, Community Benefit Report, Form 990 and Financial Statements are available to the public by appointment with its Vice President of Finance or its Senior Vice President of Quality and Compliance. |
| Form 990, Part IX, Line 11g | Contract Labor, Purchased Services, and Professional Fees |
| Form 990, Part XII, Line 3b | We have an extension until February 15, 2021. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Friedell Clinic SC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7531 Stony Island | AddressLine1Txt |
| City | Chicago | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60649 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363290656 | EIN |
| Primary Activities | Primary Health Care | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Jackson Park Hospital Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Ownership | 1 | OwnershipPct |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | We have an extension until February 15, 2021. | ExplanationTxt |