2020-07-15T11:36:36-05:00 2019-06-30 420714325 RSM US LLP 1 S Wacker Drive STE 800 Chicago IL 60606 990 2018-07-01 362246719 Little Company of Mary Hospital Inc LITT 7082295111 2800 West 95th Street Evergreen Park IL 60805 Michael Allen Chief Financial Officer 7082295111 2020-07-14 1 Rebekuh Eley P01247672 3126343400 73.74.100.171 2020-07-14 14:30:16 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 0E3200EA8E12EF20DE9AC86D87358EA52CBD945C 2018 2020-09-23 17:36:50Z John Hanlon 2800 West 95th Street Evergreen Park IL 60805 315885194 0 X osfhealthcare.org/little-company-of-mary/ X 1893 IL In solidarity with the Sisters of the Little Company of Mary, we are entrusted to serve the community through our ministry of Catholic Health Care. We are the empowered laity - the Greater Company of Mary. Rooted in a deep heritage of prayerful support of the sick and dying, we strive to enhance the sacredness of life and human dignity. 12 11 2293 600 0 0 1067863 2130009 197921640 201102853 56036827 54878303 5160326 1786179 260186656 259897344 40000 99889 0 0 110667357 125255081 0 0 0 112940929 116123104 223648286 241478074 36538370 18419270 1032155567 1030450165 333662757 322235295 698492810 708214870 X In solidarity with the Sisters of the Little Company of Mary, we are entrusted to serve the community through our ministry of Catholic Health Care. We are the empowered laity - the Greater Company of Mary. Rooted in deep heritage of prayerful support of the sick and dying, we strive to enhance the sacredness of life and human dignity. 0 0 187349126 99889 201102853 Little Company of Mary operates 278 staffed beds in its hospital facilities. During fiscal year ended June 30, 2019, the Hospital admitted 11,331 patients and also had 3,743 observation cases. These admissions drove the 53,062 patient days the hospital had during the fiscal year. Futhermore, the Hospital provided its outpatients with 54,397 of equivalent patient days worth of care. The Hospital had 46,864 emergency room visits during the fiscal year.Some of the major service lines the Hospital offers are in the fields of cardiology, dermatology, endocrinology, GI medicine, hematology, infectious disease, medical trauma, neurology, oncology, pulmonary medicine, renal care, rheumatology, gynecology and obstetrics, behavioral health, cardiac surgery, cancer surgery, dental surgery, general surgery, GI surgery, neuro surgery, orthopedic surgery, trauma surgery, urology surgery, and vascular surgery.Little Company of Mary Hospital strives to offer excellent quality care. This can be seen in the many accreditations that it currently holds. Some of the accreditations are: -American College of Radiology Commission on Radiation Quality and Safety;-Baby Friendly Status from Baby Friendly USA;-Stroke Center Accredited by the Joint Commission on Accreditation of Healthcare Organizations;-Breast Health Center Accredited by the American College of Surgeons;-Gold Seal of Approval by the Joint Commission;-2014 Women's Choice award winner by America's Best Breast Centers;-Seal of Approval by the National Accreditation Program for Breast Centers;-Breast Imaging Center of Excellence by American College of Radiology;-American Diabetes Association recognizes the Hospital's diabetes center as meeting the national standards for diabetes self-management education;-Cancer Center has been recognized by the Commission on Cancer of the American College of Surgeons as offering the very best in cancer care;-Sleep Disorder Center accredited by American Academy of Sleep Medicine. 187349126 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 237 0 1 2293 1 0 0 0 0 0 0 0 0 0 0 0 0 X 12 11 0 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X Timothy Kelleher 7082294946 2800 West 95th Street Evergreen Park IL 60805 Sister Sharon Ann Walsh Chairperson 1.00 1.00 X X 0 0 0 Thomas Fahey Vice Chairperson 1.00 1.00 X X 0 0 0 John Hanlon President & CEO 40.00 2.00 X X 430769 0 30786 Dennis Kelly Treasurer 1.00 X X 0 0 0 Joseph Pedota Secretary 1.00 X X 0 0 0 Randy Ruther Asst. Treasurer & CFO (To 10/1/18) 40.00 2.00 X X 1085469 0 20835 Nancy Barett Director 1.00 X 0 0 0 Sister Renee Cunningham Director 1.00 X 0 0 0 Patrick Folliard CPA Director 1.00 X 0 0 0 Grace Gorka Director 1.00 X 0 0 0 Lawrence Kelly Director 1.00 X 0 0 0 Jay B Sterns Director 1.00 X 0 0 0 Michael D'Astice MD Director 1.00 X 0 0 0 Daniel Rowan DO Director (To 12/31/18) 1.00 1.00 X 0 0 0 Tim Kelleher CFO (As of Nov 2018) 40.00 1.00 X 119488 0 33580 Lisa Dimarco CNO & VP Pat. Care Serv. (To 3/19/19) 40.00 X 283522 0 26140 Ann Haskins VP of Business Development 40.00 1.00 X 312076 0 15075 Kevin Rehder VP Practice Management 40.00 1.00 X 241005 0 26237 Cynthia Deuser VP of Quality Improvement 40.00 X 172074 0 26251 Colleen Rohan Director HR 40.00 X 192128 0 34081 Emuata Bassey OB Hospitalist 40.00 X 249388 0 15873 Mary Fugett Physician 40.00 X 238440 0 36155 Richard Lopez Physician 40.00 X 201156 0 14980 Gina Knox General Counsel 40.00 X 226509 0 23629 Dennis Reilly Former President and CEO 0.00 0.00 X 780280 0 17670 4532304 0 321292 87 1 1 0 Inpatient Consultants of IL PC PO Box 844929 Los Angeles CA 90084 Hospitalist Services 2474452 University of Chicago PED 5721 S Maryland Ave K160 Chicago IL 60637 Pediatric Hospitalists 2103940 Anderson Rasor & Partners LLP 150 S Wacker Dr Suite 350 Chicago IL 60606 Legal Services 630752 Alliance Healthcare Services PO Box 96485 Chicago IL 60693 Diagnostic Imaging Services 606048 Shearwater Health 20 Burton Hills Suite 400 Nashville TN 37215 Nursing Services 419359 24 2001576 128433 2130009 Patient Services 621400 200029191 200029191 Related Support Services 900099 1611875 1611875 Related Organization Rent 532000 174557 174557 Joint Venture 900099 -712770 -712770 201102853 30113653 30113653 181158 0 181158 181158 181158 80600000 152500 55748129 239721 24851871 -87221 24764650 24764650 Food Service Revenue 900099 668951 668951 Revenue from Affiliates 900099 653357 653357 Vending 900099 24822 24822 257891 257891 1605021 259897344 201102853 0 56664482 99889 99889 2979046 2273906 705140 108157 55479 52678 87166414 67339305 19827109 13208174 1163084 12045090 14795225 11453599 3341626 6998065 5417493 1580572 210997 210997 104500 104500 21958411 15485547 6472864 453402 453402 7845112 5099323 2745789 2901327 2321062 580265 3438023 2922320 515703 48066 46880 1186 153424 85743 67681 4683578 4210664 472914 15000385 10503841 4496544 4095505 3812539 282966 Medical Supplies 33738262 33738262 IL Medicaid Assessment 11058785 11058785 Provision for Bad Debts 9058353 9058353 1374974 1203052 171922 241478074 187349126 54128948 0 6245225 6445675 21442545 28254463 39559 0 1717830 1841862 9039647 10413984 441435550 190312987 232149999 251122563 757236213 728233597 4284549 4138021 1032155567 1030450165 29566137 30332323 195885313 190925056 108211307 100977916 333662757 322235295 X 694799523 704087782 3693287 4127088 698492810 708214870 1032155567 1030450165 X 18419270 -1346150 -7351060 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1650000 210166 210166 1650000 1650000 141086 141086 1650000 1650000 164274 164274 1650000 1650000 170959 170959 1650000 1650000 54014 54014 1650000 1.00000 0 1 1 9018035 9018035 311776148 182748344 129027804 109888247 7564643 102323604 10753120 10753120 251122563 Self-Insurance Reserve 72763410 Settlements Due to Third Party 28214506 100977916 X Part V, Line 4: The endowment funds are intended to be used for nursing scholarship opportunities for future employed nurses, palliative and end of life care, outreach and education programs for the under-served people in the community, subsidies for services and programs for underinsured and uninsured people in the community, and financial support for services, programs, facility renovation and new construction to meet the future needs of the people served by Little Company of Mary Hospital and Health Care Centers. Part X, Line 2: The Hospital has received a determination letter from the Internal Revenue Service stating that it is exempt from the payment of income taxes under Section 501(c)(3) of the Internal Revenue Code. The Hospital follows the FASB-issued guidance for accounting for uncertainty in income taxes. The Hospital files a Form 990 (Return of Organization Exempt from Income Tax) annually. When these returns are filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others are subject to uncertainty about the merits of the position taken or the amount of the position that would ultimately be sustained. Examples of tax positions common to health systems include such matters as the following: the tax-exempt status of each entity, the continued tax-exempt status of bonds issued by the obligated group, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business income (UBI). The benfit of a tax position is recognized in the consolidated financial statements in the period during which, based on all available evidence, management believes that it is more likely than not that the position will be sustained upon examination, including the resolution of appeals or litigation processes, if any. Tax positions are not offset or aggregated with other positions. Tax positions that meet the "more-likely-than-not" recognition threshold are measured as the largest amount of tax benefit that is more than 50% likely to be realized on settlement with the applicable taxing authority. The portion of the benefits associated with tax positions taken that exceeds the amount measured as described above would be reflected as a liability for unrecognized tax benefits in the accompanying consolidated balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Upon the adoption of the FASB-issued guidance on July 1, 2007, and since that date through June 30, 2019, there were no unrecognized tax benefits identified and recorded as a liability. Form 990 filed by the Hospital is subject to examination by the Internal Revenue Service (IRS) up to three years from the extended due date of each return. Forms 990 filed by the Hospital are no longer subject to examination for fiscal years 2015 and prior. 1 1 X 1 X 1 X 600.000000000000 1 1 1 0 1 1 6090765 6090765 0.02620 29399061 19388098 10010963 0.04310 35489826 19388098 16101728 0.06930 2164244 2164244 0.00930 2164244 2164244 0.00930 37654070 19388098 18265972 0.07860 1 9058353 72643446 91426116 -18782670 X 1 1 1 1 Little Company of Mary Hospital Inc 2800 West 95th Street Evergreen Park IL 60805 osfhealthcare.org/little-company-of-ma IL License #: 0001271 X X X Little Company of Mary Hospital Inc 1 0 0 1 X X X X X X X X X 18 1 0 0 1 X www.osfhealthcare.org/about/community-health/ X lcmh.healthforecast.net X 1 18 0 1 0 1 X 200.000000000000 600.000000000000 X X X X 1 1 X X X X 1 X osfhealthcare.org/billing/financial-assistance/ X osfhealthcare.org/billing/financial-assistance/ X osfhealthcare.org/billing/financial-assistance/ X X X X X X 1 X 0 X X X X 1 X 0 0 Little Company of Mary Hospital, Inc. Part V, Section B, Line 5: As part of the community health needs assessment, a survey was conducted that included responses from a random sample of 400 individuals (aged 18+) in LCMH's primary and secondary service areas. In addition to this survery, an online key informant survey was implemented. The key informant survey allowed for input from persons with special knowledge of or expertise in public health, as well as others who represent the broad interests of the community served by the Hospital. Participants included 17 community stakeholders including physicians, other health professionals, social service representatives, public health experts, and business and other community leaders. Little Company of Mary Hospital, Inc. Part V, Section B, Line 11: In acknowledging the wide range of priority health issues that emerged from the CHNA process - and taking into account hospital resources and overall alignment with the hospital's mission, goals, and strategic priorities - it was determined that LCMH would focus on developing and/or supporting strategies and initiatives to improve: Heart Disease & Stroke, Diabetes, Mental Health, Cancer, and Nutrition, Physical Activity & Weight. Please see the following action plan summaries used to address these health needs.Heart Disease & Stroke - LCMH will increase opportunities for blood pressure screening and education through the following intiatives: 1) Health Ed Center will provide free BP screening twice per week at the hospital 2) LCMH will incorporate blood pressure screening into all lab screening programs and 3) the Health Ed Center will reach out to new community groups (churches, senior groups, etc.) and calcium scoring screening will be added.Diabetes - LCMH will increase opportunities for cummunity members to have their blood glucose checked. LCMH will add information about this program to the already established Diabetes Toolkit program. LCMH will offer optional blood glucose screening in conjunction with established weekly blood pressure screening clinics. Mental Health - LCMH will increase channels for communicating mental health issues by partnering with community partners to increase awareness and access to resources. LCMH will produce Facebook Live events with two counselors discussing mental health issues, offer a stress-management lecture, co-produce a webinar series with St. Xavier University and Mother McAuley High School to increase awareness to students, and produce a pocket guide to mental health resources. In addition, the LCMH renovated Emergency Department will include four treatment rooms designed for patients presenting with behavioral health issues and LCMH Public Safety will offer 4-hour de-escalation team trainings to all LCMH employees. Cancer - LCMH will increase the number of participants in cancer-awareness and prevention event each year by 20%. LCMH will identify individuals at high risk for colorectal cancer through the following initiatives: 1) LCMH will implement colon cancer risk stratification survey to be administered to all participants in HEC screening programs 2) LCMH will provide three physician led programs for colorectal cancer awareness and screening updates and 3) LCMH will develop a self-referral colonoscopy screening program. In addition, LCMH will plan ACS awareness event to cover three top cancers.Nutrition, Physical Activity, & Weight - LCMH will continue and expand current programs offerings that encourage weight loss and healthy eating options. These programs include a weight loss challenge, team walking challenge, healthy lifestyle choices for lunch and dinner in the Hospital Cafeteria, and offering hypnosis for weight loss.In acknowledging the wide range of priority health issues that emerged from the CHNA process, Little Company of Mary Hospital determined that it could only effectively focus on those which it deemed most pressing, most under-addressed, and most within its ability to influence. Other health needs identified by the CHNA and not focused on by LCMH are primarily a result of other community organizations having infrastructure and programs in place to better meet these needs and limited resources. 12 1 - The Cancer Center 2800 W 95th Street Evergreen IL 60805 Healthcare 2 - Carestation West 6700 West 95th Street Oak Lawn IL 60453 Other Outpatient Center 3 - Carestation East 5660 West 95th Street Oak Lawn IL 60453 Other Outpatient Center 4 - Mary Potter Physicians Pavillion 2850 West 95th Street Evergreen IL 60805 Other Outpatient Center 5 - Homecare and Hospice Building 9800 S Southwest Highway Oak Lawn IL 60453 Home Care and Hospice 6 - Burbank Building 4901 West 79th Street Burbank IL 60459 Healthcare 7 - Halsted Building 736 West 95th Street Chicago IL 60628 Healthcare 8 - Heritage Building 2800 West 87th Street Chicago IL 60652 Healthcare 9 - Palos Medical Office Center 12450 S Harlem Palos Heights IL 60463 Physician Offices 10 - Little Company of Mary Diagnostic Center 12432 S Harlem Palos Heights IL 60463 Diagnostic Center 11 - LCM Medical Group Mt Greenwood Location 10961 S Kedzie Avenue Chicago IL 60655 Physician Offices 12 - Southwest Medical Center 5550 W 111th Street Oak Lawn IL 60453 Physician Offices Part I, Line 3c: The Hospital uses Federal Poverty Guidelines to determine eligibility for free or discounted care. Part I, Line 6a: The Hospital's community benefit report is prepared in a separate report presented by the organization. Part I, Line 7: The Hospital used the cost to charge ratio from the Medicare cost report (Worksheet C, Part 1). Part I, Ln 7 Col(f): Bad debt expense of $9,058,353 was included on Form 990, Part IX, Line 25, Column (A) but subtracted for purposes of calculating the community benefit percentage on Schedule H, Part I, Line 7, Column (f). Part III, Line 2: Please refer to the explanation for Schedule H, Part III, line 4 below for more information about evaluating the length of time receivables are outstanding, the payor source, historical collection experience, and trends in healthcare. Part III, Line 3: Not applicable. Part III, Line 4: Patient accounts receivable are stated at net realizable value. The Hospital evaluates the collectibility of its accounts receivable based on the length of time the receivable is outstanding, major payor sources of revenue, historical collection experience, and trends in health care insurance programs to estimate the appropriate allowance for uncollectible accounts and provision for bad debts. For receivables associated with services provided to patients who have third-party payor coverage, the Hospital analyzes contractually due amounts and provides an allowance for uncollectible accounts and a provision for bad debts. For receivables from self-pay patients, the Hospital records a significant provision for bad debts in the period of service on the basis of its past experience, which indicates that many patients are unable or unwilling to pay the portion of their bill for which they are financially responsible. These allowance are recorded on an estimated basis and are adjusted as needed in future periods. Part III, Line 8: The Hospital used the cost to charge ratio from the Medicare cost report (Worksheet C, Part 1). Part III, Line 9b: For patients who are classified as uninsured, the financial counselor will complete a financial evaluation worksheet to determine if the patient qualifies for a government assistance program. If not, the counselor will ascertain whether the patient is eligible under the Hospital's charity care policy. Also, for insured patients there will be no collection agency referral if the patient has requested a reasonable payment plan or requested financial assistance and is eligible under the Hospital's charity policy. Part VI, Line 2: Needs Assessment:The Hospital gathers information on the community's health needs from many sources including the following: 1) Community Health Needs Assessment - We provide health care access to the community by offering programs for specifically identified health improvement needs to populations at risk 2) Internal records - These records provide a reliable source of timely information about what services are used by our community. Information is compiled and analyzed on many levels, including by major diagnostic category and diagnostic related group, to track changes in the community's utilization of health services. 3) Patient surveys - Results are reviewed and program, screening, and health lectures are added and modified based on this feedback from the community. 4) Internal/External data - The Hospital engages outside studies of services used by the community. 5) Physician input - Physicians are periodically surveyed to assess the healthcare services needed by their patients. In addition to surveys, physician input is gathered through the Medical Executive Committee and departmental meetings. Physicians also serve on the Hospital's Board of Directors, Strategic Planning Committee, Mission Committee and Performance Improvement Council. Part VI, Line 3: Patient Education of Eligibility for Assistance: At registration, patient's employment status or lack of basic insurance coverage will prompt the staff to offer a charity application. Notice of this charity assistance policy is posted in locations visible to the public including the emergency department, admission areas and the business office. Notices are available in general patient brochures, on the Hospital's website and on patient billing statements explaining how to apply for charity consideration. Part VI, Line 4: Community Information:The Hospital is located in Evergreen Park, Illinois and is just 20 minutes from downtown Chicago. The Hospital's primary service area includes many Chicago neighborhoods as well as the south suburban communities of Chicago. The general demographics of the LCMH Service Area are as follows:GENDERMale -39%Female - 61%AGE17 and Under - 11.1%18-44 - 33.1%45-64 - 30.0%65+ - 25.8%ETHNICITYNon-Hispanic White - 37.8%Non-Hispanic Black - 38.2%Hispanic - 21.4%Other - 2.6% Part VI, Line 5: Promotion of Community Health:The hospital currently has well over 60 separate programs to provide ongoing care to its target population, including:-Wellness Events-Health screenings-Physician-led community programs-Senior billing assistance-Mobile medical home visits by our staff physicians and nurses-Diabetes center and diabetes education and awareness forums-Weight management programs for the community, hypnosis, and multiple physician presentations on nutrition-Smoking cessation classes -Weekly healthy heart screenings-Wakeup call screenings (for stroke awareness)-Monthly blood pressure screenings-Sponsorship/partnering or support services to local elementary and high schools, church parishes and local community organizationsThe Hospital furthers relationships with local townships, villages and schools by holding quarterly meetings with health service coordinators and by participating in collaborative health and wellness initiatives in its community through the Healthier Evergreen Committee by holding multiple meetings throughout the year.The majority of the Hospital's governing body is comprised of persons residing in and around the primary service area who are not employees or independent contractors (nor family members thereof) of the Hospital.The Hospital extends medical staff priveleges to all qualified physicians in its community. Part VI, Line 6: The Hospital communicates with the community to provide ongoing care to its target population by providing physician-led community programs, health fairs, and health events.LCM Affiliated Services promotes the health of the community by providing ambulatory services and employing physicians in a variety of specialties. The employed physicians see and treat patients from the community and are part of the health programs offered by the Hospital.LCM Foundation promotes the health of the community by supporting the Hospital. The Foundation collects donations which are used to fund the programs of the Hospital. Part VI, Line 7, Reports Filed With States IL 1 Student Nursing Tuition 38 99889 Part I, Line 2: The hospital monitors use of grants in scholarships by following its policy. The director of human resoures makes sure that each scholarship recipient adheres to the policy and the agreement that each recipient signed. Any deviation results in the recipient having to repay the grant to the hospital. X X X X 1 1 0 0 0 0 0 1 0 John Hanlon President & CEO 400225 0 25000 0 5544 0 5500 0 25286 0 461555 0 0 0 Randy Ruther Asst. Treasurer & CFO (To 10/1/18) 559436 0 90000 0 436033 0 5500 0 15335 0 1106304 0 0 0 Tim Kelleher CFO (As of Nov 2018) 110592 0 8376 0 520 0 2366 0 31214 0 153068 0 0 0 Lisa Dimarco CNO & VP Pat. Care Serv. (To 3/19/19 250910 0 29000 0 3612 0 5137 0 21003 0 309662 0 0 0 Ann Haskins VP of Business Development 288532 0 18000 0 5544 0 5500 0 9575 0 327151 0 0 0 Kevin Rehder VP Practice Management 32705 0 25000 0 183300 0 3120 0 23117 0 267242 0 0 0 Cynthia Deuser VP of Quality Improvement 150069 0 20000 0 2005 0 3157 0 23094 0 198325 0 0 0 Colleen Rohan Director HR 168432 0 20000 0 3696 0 3548 0 30533 0 226209 0 0 0 Emuata Bassey OB Hospitalist 229062 0 20000 0 326 0 4635 0 11238 0 265261 0 0 0 Mary Fugett Physician 237970 0 0 0 470 0 4907 0 31248 0 274595 0 0 0 Richard Lopez Physician 200773 0 0 0 383 0 4078 0 10902 0 216136 0 0 0 Gina Knox General Counsel 217870 0 6637 0 2002 0 3244 0 20385 0 250138 0 0 0 Dennis Reilly Former President and CEO 477295 0 300000 0 2985 0 5500 0 12170 0 797950 0 0 0 Part I, Lines 4a-b During 2018, Kevin Rehder received a severance payment of $182,197. This was reported as taxable compensation on his W-2. During 2018, Randy Ruther received a $429,630 payment from a split-interest life insurance plan. This was reported as taxable compensation on his W-2. Part I, Line 7 The Board of Directors exercises discretion over executive bonus payments. A Illinois Finance Authority 861091967 45200FFV6 2008-04-29 134340000 See Part VI 0 0 0 B Illinois Finance Authority 861091967 000000000 2015-08-18 102000000 See Part VI 0 0 0 A 44665000 134483633 704492 25000 13730097 120024044 2008 1 0 1 1 B 102000000 335431 27825707 73838862 1 0 1 1 A 0 0 1 1 1 0 0 0 1 B 0 1 0 1 1 0 0 0 1 A 1 B 1 Date Rebate Computation Performed Issuer Name: Illinois Finance Authority Date the Rebate Computation was Performed: 03/07/2011 Issuer Name: Illinois Finance Authority Date the Rebate Computation was Performed: 02/08/2017 Schedule K, Part I, Line 1, 2008 Bond Issuance: The issuance was composed of two bonds. Below are the two CUSIP numbers: 2008A - 45200FFV6 2008B - 45200FFW4 Schedule K, Part I, Line A, Column F Bond A: The 4/29/2008 bonds were used to (I) refinance a bank loan; (II) pay expenses incurred with the issuance of the bonds and credit enhancements. On March 13, 2008 the Hospital entered into a revolving credit agreement with JP Morgan Chase Bank and applied proceeds of the term loan advanced thereunder to currently refund the series 1997B bonds, issued 11/20/1997, on March 13, 2008 and the series 2007 bonds, issued 8/16/2007 on April 1, 2008. Proceeds of $120,024,044 from the bonds were used to refund the bank loan. Schedule K, Part I, Line B, Column F Bond B: The 8/18/15 bond was used to refund the outstanding Illinois Finance Authority Revenue Bonds Series 2010 and to modernize and equip operating rooms and patient care areas in the hospital's 1984 building. Schedule K, Part II, Line 3: The difference between the issuance price and the total proceeds of issue represents investment earnings. Mary Conors Family Member of Dennis Reilly, Former President and CEO 55479 Employment 0 Timothy Ruther Family Member of Randy Ruther, Asst. Treasurer & CFO 52678 Employment 0 Form 990, Part VI, Section A, line 6 Little Company of Mary Sisters-USA is the sole corporate member and is an Illinois not-for-profit corporation whose purpose is to represent the interest of the congregation of Little Company of Mary Sisters. Form 990, Part VI, Section A, line 7a Little Company of Mary Sisters-USA has the power to appoint members of the governing body. Form 990, Part VI, Section A, line 7b The sole corporate members retain reserved powers to approve, among other things, the Hospital's annual budget, election of directors, and the incurrence of debt or transfer of property in excess of certain limits. Form 990, Part VI, Section B, line 11b Form 990 is reviewed by the Director of Finance, Controller, and CFO prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Each director, principal officer, key employee, and member of a committee with Board delegated powers shall annually sign a conflict of interest statement which affirms that such person has received, read, understood and agreed to comply with the directive. All conflict of interest statements are reviewed annually by the CEO and the Corporate Compliance Officer and the results presented to the Corporate Compliance Committee. The results and any recommendations are reported at the next Board of Directors' meeting. If a conflict is deemed to exist, such person shall not vote on, nor use his or her personal influence on, nor participate (other than to present factual information or to respond to questions) in the discussions of deliberations with respect to such contract or transaction. Such person may not be counted in determining the existence of a quorum at any meeting where the contract of transaction is under discussion or is being voted upon. The minutes of the meeting shall reflect the disclosure made, the vote thereon and, where applicable, the abstention from voting and participation, and whether a quorum was present. Form 990, Part VI, Section B, line 15 The Board Executive Committee annually reviews external benchmark compensation drafts and determines compensation adjustments based on market data and internal performance results for the CEO, CFO, and COO positions. The organization uses an outside consultant and outside surveys to determine appropriateness of executive pay. The process of determining executive compensation is documented and retained by the CEO. For other top management positions, the compensation committee is comprised of the CEO, CFO, and COO. Form 990, Part VI, Section C, line 19 The governing documents, conflict of interest policy and financial statements are available to the public upon request, for the same period of time as set forth in Internal Revenue Code section 6104(d). Form 990, Part XI, line 9: Net Asset Transfers -14,652,872. Pension-Related Changes 8,584,938. Net Assets Released from Restriction -1,283,126. Little Company of Mary Health Systems 2800 West 95th Street Evergreen Park IL 60805 363823627 Health Services IL 501(c)(3) Line 1 Little Company of Mary Sisters - USA 1 Little Company of Mary Affiliated Services 2800 West 95th Street Evergreen Park IL 60805 363383867 Health Services IL 501(c)(3) Line 10 Little Company of Mary Health Systems 1 Little Company of Mary Hospital Foundation 2800 West 95th Street Evergreen Park IL 60805 363993337 Supporting Organization IL 501(c)(3) Line 12a, I Little Company of Mary Hopsital 1 Little Company of Mary Sisters - USA 2800 West 95th Street Evergreen Park IL 60805 237294648 Religious IL 501(c)(3) Line 1 N/A 0 LCHM-UCMC Radiation Oncology Joint Venture LLC 2800 West 95th Street Evergreen Park IL 60805 Health Services IL Little Company of Mary Hospital Related -1101718 0 1 0.60000 Southwest Health Systems Inc 2800 West 95th Street Evergreen Park IL 60805 363425870 Managed Care IL Little Company of Mary Hospital C 10379760 2463038 1.00000 1 Mary Cap Insurance Inc 76 St Paul Street Ste 500 Burlington VA 05401 030304812 Captive Insurance VA Little Company of Mary Hospital C 107956 1.00000 1 0 0 1 0 0 0 0 0 0 1 1 1 1 0 0 0 1 1 0 Little Company of Mary Hospital Foundation C 2001576 FMV Little Company of Mary Affiliated Services R 14000000 FMV Little Company of Mary Hospital Foundation R 652872 FMV Little Company of Mary Affiliated Services J 174557 FMV Little Company of Mary Affiliated Services Q 9500000 FMV Little Company of Mary Hospital Foundation Q 3000000 FMV