STRATEGY STUDIO / PUBLIC DATA EXPLORER

GRANT HOSPITAL OF CHICAGO: Form 990PF, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
GRANT HOSPITAL OF CHICAGO (EIN 36-2167090)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-06-19
IRS object ID
201701709349100165
Schema version
2016v3.0
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 ReturnHeader

FieldValueIRS element (for citing)
Return2017-06-19T14:28:07-05:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN364049282PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1PASQUESI SHEPPARD LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1585 BANK LANEAddressLine1Txt
CityLAKE FORESTCityNm
State AbbreviationILStateAbbreviationCd
ZIP60045ZIPCd
FieldValueIRS element (for citing)
Return Type990PFReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362167090EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GRANT HOSPITAL OF CHICAGOBusinessNameLine1Txt
Business Name Line2D/B/A GRANT HEALTHCARE FOUNDATIONBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlGRANBusinessNameControlTxt
Phone8477351590PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1500 NORTH WESTERN AVENUE NO 204AddressLine1Txt
CityLAKE FORESTCityNm
State AbbreviationILStateAbbreviationCd
ZIP60045ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKATE O'CONNORPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone8477351590PhoneNum
Signature2017-06-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDENNIS P O'BRIENPreparerPersonNm
PTINP00008832PTIN
Phone8472345000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address50.224.107.130IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-06-09IPDt
IP Tm10:22:59IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdC4137922BBBF26BE7A05C53C15AE00C88AFB4267AtSubmissionCreationDeviceId
At Submission Filing Device IdC4137922BBBF26BE7A05C53C15AE00C88AFB4267AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2018-03-14 21:41:22ZBuildTS

Form 990-PF IRS990PF

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
FMV Assets EOY$14,834,388FMVAssetsEOYAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd

Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses

FieldValueIRS element (for citing)
Contri Rcvd Rev And Expnss$20,991ContriRcvdRevAndExpnssAmt
Dividends Rev And Expnss$218,397DividendsRevAndExpnssAmt
Dividends Net Invst Incm$218,397DividendsNetInvstIncmAmt
Net Gain Sale Ast Rev And Expnss-$19,816NetGainSaleAstRevAndExpnssAmt
Gross Sales Price$2,755,591GrossSalesPriceAmt
Cap Gain Net Incm Net Invst Incm$0CapGainNetIncmNetInvstIncmAmt
Other Income Rev And Expnss$16,147OtherIncomeRevAndExpnssAmt
Other Income Net Invst Incm$14,825OtherIncomeNetInvstIncmAmt
Total Rev And Expnss$235,719TotalRevAndExpnssAmt
Total Net Invst Incm$233,222TotalNetInvstIncmAmt
Comp Ofcr Dir Trst Rev And Expnss$135,000CompOfcrDirTrstRevAndExpnssAmt
Comp Ofcr Dir Trst Net Invst Incm$6,750CompOfcrDirTrstNetInvstIncmAmt
Comp Ofcr Dir Trst Dsbrs Chrtbl$121,500CompOfcrDirTrstDsbrsChrtblAmt
Accounting Fees Rev And Expnss$6,600AccountingFeesRevAndExpnssAmt
Accounting Fees Net Invst Incm$330AccountingFeesNetInvstIncmAmt
Accounting Fees Chrtbl Prps$5,940AccountingFeesChrtblPrpsAmt
Other Prof Fees Rev And Expnss$57,684OtherProfFeesRevAndExpnssAmt
Other Prof Fees Net Invst Incm$57,684OtherProfFeesNetInvstIncmAmt
Other Prof Fees Dsbrs Chrtbl$0OtherProfFeesDsbrsChrtblAmt
Interest Rev And Expnss$7,640InterestRevAndExpnssAmt
Interest Net Invst Incm$0InterestNetInvstIncmAmt
Interest Dsbrs Chrtbl$0InterestDsbrsChrtblAmt
Taxes Rev And Expnss$26,085TaxesRevAndExpnssAmt
Taxes Net Invst Incm$7,579TaxesNetInvstIncmAmt
Taxes Dsbrs Chrtbl$10,355TaxesDsbrsChrtblAmt
Deprec And Dpltn Rev And Expnss$220DeprecAndDpltnRevAndExpnssAmt
Deprec And Dpltn Net Invst Incm$0DeprecAndDpltnNetInvstIncmAmt
Occupancy Rev And Expnss$12,150OccupancyRevAndExpnssAmt
Occupancy Net Invst Incm$608OccupancyNetInvstIncmAmt
Occupancy Dsbrs Chrtbl$10,935OccupancyDsbrsChrtblAmt
Trav Conf Meeting Rev And Expnss$6,623TravConfMeetingRevAndExpnssAmt
Trav Conf Meeting Net Invst Incm$331TravConfMeetingNetInvstIncmAmt
Trav Conf Meeting Dsbrs Chrtbl$5,961TravConfMeetingDsbrsChrtblAmt
Printing And Pub Rev And Expnss$343PrintingAndPubRevAndExpnssAmt
Printing And Pub Net Invst Incm$17PrintingAndPubNetInvstIncmAmt
Printing And Pub Dsbrs Chrtbl$309PrintingAndPubDsbrsChrtblAmt
Other Expenses Rev And Expnss$47,384OtherExpensesRevAndExpnssAmt
Other Expenses Net Invst Incm$2,369OtherExpensesNetInvstIncmAmt
Other Expenses Dsbrs Chrtbl$42,646OtherExpensesDsbrsChrtblAmt
Tot Opr Expenses Rev And Expnss$299,729TotOprExpensesRevAndExpnssAmt
Tot Opr Expenses Net Invst Incm$75,668TotOprExpensesNetInvstIncmAmt
Tot Opr Expenses Dsbrs Chrtbl$197,646TotOprExpensesDsbrsChrtblAmt
Contri Paid Rev And Expnss$740,000ContriPaidRevAndExpnssAmt
Contri Paid Dsbrs Chrtbl$740,000ContriPaidDsbrsChrtblAmt
Total Expenses Rev And Expnss$1,039,729TotalExpensesRevAndExpnssAmt
Total Expenses Net Invst Incm$75,668TotalExpensesNetInvstIncmAmt
Total Expenses Dsbrs Chrtbl$937,646TotalExpensesDsbrsChrtblAmt
Excess Revenue Over Expenses-$804,010ExcessRevenueOverExpensesAmt
Net Investment Income$157,554NetInvestmentIncomeAmt

Form990 PF Balance Sheets Form990PFBalanceSheetsGrp

FieldValueIRS element (for citing)
Cash BOY$88,611CashBOYAmt
Cash EOY$29,555CashEOYAmt
Cash EOYFMV$29,555CashEOYFMVAmt
Sav And Temp Cash Invst EOY$120,697SavAndTempCashInvstEOYAmt
Sav And Temp Cash Invst EOYFMV$120,697SavAndTempCashInvstEOYFMVAmt
Corporate Stock BOY$801,860CorporateStockBOYAmt
Corporate Stock EOY$996,082CorporateStockEOYAmt
Corporate Stock EOYFMV$996,082CorporateStockEOYFMVAmt
Other Investments BOY$13,333,409OtherInvestmentsBOYAmt
Other Investments EOY$13,098,579OtherInvestmentsEOYAmt
Other Investments EOYFMV$13,098,579OtherInvestmentsEOYFMVAmt
Land Bldg Equip Cost Or Other Bss$10,368LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,996LandBldgEquipAccumDeprecAmt
Land BOY$425LandBOYAmt
Land EOY$2,372LandEOYAmt
Land EOYFMV$2,372LandEOYFMVAmt
Other Assets BOY$577,947OtherAssetsBOYAmt
Other Assets EOY$587,103OtherAssetsEOYAmt
Other Assets EOYFMV$587,103OtherAssetsEOYFMVAmt
Total Assets BOY$14,802,252TotalAssetsBOYAmt
Total Assets EOY$14,834,388TotalAssetsEOYAmt
Total Assets EOYFMV$14,834,388TotalAssetsEOYFMVAmt
Accounts Payable BOY$102,807AccountsPayableBOYAmt
Accounts Payable EOY$79,801AccountsPayableEOYAmt
Total Liabilities BOY$102,807TotalLiabilitiesBOYAmt
Total Liabilities EOY$79,801TotalLiabilitiesEOYAmt
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind
Unrestricted BOY$14,248,940UnrestrictedBOYAmt
Unrestricted EOY$14,303,500UnrestrictedEOYAmt
Temporarily Restricted BOY$107,197TemporarilyRestrictedBOYAmt
Temporarily Restricted EOY$107,197TemporarilyRestrictedEOYAmt
Permanently Restricted BOY$343,308PermanentlyRestrictedBOYAmt
Permanently Restricted EOY$343,890PermanentlyRestrictedEOYAmt
Tot Net Ast Or Fund Balances BOY$14,699,445TotNetAstOrFundBalancesBOYAmt
Tot Net Ast Or Fund Balances EOY$14,754,587TotNetAstOrFundBalancesEOYAmt
Total Liabilities Net Ast BOY$14,802,252TotalLiabilitiesNetAstBOYAmt
Total Liabilities Net Ast EOY$14,834,388TotalLiabilitiesNetAstEOYAmt

Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp

FieldValueIRS element (for citing)
Tot Net Ast Or Fund Balances BOY$14,699,445TotNetAstOrFundBalancesBOYAmt
Excess Revenue Over Expenses-$804,010ExcessRevenueOverExpensesAmt
Other Increases$859,152OtherIncreasesAmt
Subtotal$14,754,587SubtotalAmt
Other Decreases$0OtherDecreasesAmt
Tot Net Ast Or Fund Balances EOY$14,754,587TotNetAstOrFundBalancesEOYAmt

Cap Gains Loss Tx Invst Incm Detail CapGainsLossTxInvstIncmDetail

Cap Gains Loss Tx Invst Incm CapGainsLossTxInvstIncmGrp (38 entries)

PropertyPropertyDescHow AcquiredHowAcquiredCdAcquiredAcquiredDtSoldSoldDtGross Sales PriceGrossSalesPriceAmtCost Or Other BasisCostOrOtherBasisAmtGain Or LossGainOrLossAmtGains Minus Excess Or LossesGainsMinusExcessOrLossesAmt
DODGE & COX FUNDS INTLSTK FDP2015-12-222016-04-15$27,850$34,492-$6,642-$6,642
DODGE & COX FUNDS INTLSTK FDP2015-01-012016-04-15$420,325$520,572-$100,247-$100,247
DODGE & COX FUNDS INTLSTK FDP2015-01-012016-04-15$776,540$914,275-$137,735-$137,735
HARBOR FD INTL FDP2007-02-212016-12-09$384,976$408,644-$23,668-$23,668
LEUTHOLD GLOBAL INSTP2011-02-252016-12-09$504,952$554,737-$49,785-$49,785
ECKHARDTP2015-01-012016-12-31$53,122$53,122$53,122
DRIEHAUSP2015-01-012016-12-31$21,649-$21,649-$21,649
BAKER HUGHESP2016-06-012016-11-15$12,172$9,338$2,834$2,834
EXXON MOBILP2015-08-272016-06-30$16,779$15,891$888$888
LOREDO PETROLEUM HLDGSP2015-09-282016-04-29$16,875$12,874$4,001$4,001
PRAIRIESKY ROYALTYP2016-06-032016-09-09$456$426$30$30
SOUTHWESTERN ENERGYP2015-11-242016-04-05$5,775$6,496-$721-$721
APACHEP2012-06-142016-09-29$1,976$2,575-$599-$599
BAKER HUGHESP2013-07-012016-04-07$8,318$9,398-$1,080-$1,080
BAKER HUGHESP2013-07-012016-11-08$16,399$14,908$1,491$1,491
BAKER HUGHESP2013-07-012016-11-15$13,389$13,931-$542-$542
CALIFORNIA RESOURCESP2014-05-132016-04-04$31$45-$14-$14
CHEVRONP2015-04-302016-11-04$21,024$22,254-$1,230-$1,230
CIMAREX ENERGYP2014-10-172016-06-09$10,931$9,825$1,106$1,106
CIMAREX ENERGYP2014-10-172016-07-13$9,572$8,734$838$838
ENERGENP2013-11-042016-12-01$6,315$7,702-$1,387-$1,387
ENERGENP2013-11-042016-06-20$4,811$7,702-$2,891-$2,891
EXXON MOBILP2015-06-172016-06-30$27,965$25,449$2,516$2,516
SOUTHWESTERN ENERGYP2014-06-272016-04-04$8,435$45,060-$36,625-$36,625
SOUTHWESTERN ENERGYP2014-10-172016-04-05$3,300$12,888-$9,588-$9,588
APACHEP2015-01-012016-09-29$19,758$29,604-$9,846-$9,846
CALIFORNIA RESOURCESP2009-11-022016-04-04$31$36-$5-$5
CHEVRONP2009-10-202016-03-08$11,523$9,992$1,531$1,531
CHEVRONP2009-10-202016-06-14$8,097$6,155$1,942$1,942
CHEVRONP2009-12-152016-11-04$9,461$6,971$2,490$2,490
EOG RESOURCESP2010-12-272016-05-25$16,580$8,988$7,592$7,592
EOG RESOURCESP2010-12-272016-06-09$3,392$1,798$1,594$1,594
EOG RESOURCESP2010-12-272016-08-31$32,115$16,178$15,937$15,937
OCCIDENTAL PETROLEUMP2015-01-012016-07-06$10,549$10,553-$4-$4
PIONEER NATURAL RESOURCESP2010-03-182016-07-13$6,225$2,107$4,118$4,118
PIONEER NATURAL RESOURCESP2010-03-182016-09-08$7,491$2,107$5,384$5,384
PIONEER NATURAL RESOURCESP2010-03-182016-12-01$3,859$1,053$2,806$2,806
CAPITAL GAINS DIVIDENDSP$274,222$274,222$274,222
FieldValueIRS element (for citing)
Capital Gain Net Income-$19,816CapitalGainNetIncomeAmt

Qlfy Und Sect4940e Reduced Tax QlfyUndSect4940eReducedTaxGrp

FieldValueIRS element (for citing)
Liable Section4942 Tax0LiableSection4942TaxInd
Adjusted Qlfy Distri Yr1$1,285,938AdjustedQlfyDistriYr1Amt
Net Vl Noncharitable Assets Yr1$14,964,850NetVlNoncharitableAssetsYr1Amt
Distribution Yr10.085931DistributionYr1Rt
Adjusted Qlfy Distri Yr2$1,318,146AdjustedQlfyDistriYr2Amt
Net Vl Noncharitable Assets Yr2$17,255,208NetVlNoncharitableAssetsYr2Amt
Distribution Yr20.076391DistributionYr2Rt
Adjusted Qlfy Distri Yr3$1,165,829AdjustedQlfyDistriYr3Amt
Net Vl Noncharitable Assets Yr3$16,427,334NetVlNoncharitableAssetsYr3Amt
Distribution Yr30.070969DistributionYr3Rt
Adjusted Qlfy Distri Yr4$1,223,954AdjustedQlfyDistriYr4Amt
Net Vl Noncharitable Assets Yr4$15,945,636NetVlNoncharitableAssetsYr4Amt
Distribution Yr40.076758DistributionYr4Rt
Adjusted Qlfy Distri Yr5$1,269,710AdjustedQlfyDistriYr5Amt
Net Vl Noncharitable Assets Yr5$16,918,039NetVlNoncharitableAssetsYr5Amt
Distribution Yr50.075051DistributionYr5Rt
Total Distribution0.385100TotalDistributionRt
Average Distribution0.077020AverageDistributionRt
Net Vl Noncharitable Assets$14,596,045NetVlNoncharitableAssetsAmt
Adj Net Vl Noncharitable Assets$1,124,187AdjNetVlNoncharitableAssetsAmt
Net Investment Income Pct$1,576NetInvestmentIncomePctAmt
Adj Nonchrtbl Net Invst Incm Pct$1,125,763AdjNonchrtblNetInvstIncmPctAmt
Qualifying Distributions$937,646QualifyingDistributionsAmt

Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp

FieldValueIRS element (for citing)
Investment Income Excise Tax$3,151InvestmentIncomeExciseTaxAmt
Tax Under Section511$0TaxUnderSection511Amt
Subtotal$3,151SubtotalAmt
Subtitle A Tax$0SubtitleATaxAmt
Tax Based On Investment Income$3,151TaxBasedOnInvestmentIncomeAmt
Estimated Plus Ovpmt Incm Tx$8,960EstimatedPlusOvpmtIncmTxAmt
Total Payments And Credits$8,960TotalPaymentsAndCreditsAmt
Overpayment$5,809OverpaymentAmt
Applied To ES Tax$5,809AppliedToESTaxAmt
Refund$0RefundAmt

Statements Regarding Acty StatementsRegardingActyGrp

FieldValueIRS element (for citing)
Legislative Political Acty0LegislativePoliticalActyInd
More Than100 Spent0MoreThan100SpentInd
Form1120 POL Filed0Form1120POLFiledInd
Section4955 Organization Tax$0Section4955OrganizationTaxAmt
Section4955 Managers Tax$0Section4955ManagersTaxAmt
Tax Reimbursed$0TaxReimbursedAmt
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Changes To Articles Or Bylaws0ChangesToArticlesOrBylawsInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Section508e Rqr SatisfiedYes (1)Section508eRqrSatisfiedInd
At Least5000 In AssetsYes (1)AtLeast5000InAssetsInd
Org Report Or Register StateILOrgReportOrRegisterStateCd
Form990 PF Filed With Atty GenYes (1)Form990PFFiledWithAttyGenInd
Private Operating Foundation0PrivateOperatingFoundationInd
New Substantial Contributors0NewSubstantialContributorsInd
Own Controlled Entity0OwnControlledEntityInd
Donor Advised Fund0DonorAdvisedFundInd
Comply With Public Insp RqrYes (1)ComplyWithPublicInspRqrInd
Website AddressWWW.GRANTHEALTHCARE.ORGWebsiteAddressTxt
Individual With BooksKATE GRUBBS O'CONNORIndividualWithBooksNm
Phone8477351590PhoneNum

Location Of Books US Address LocationOfBooksUSAddress

FieldValueIRS element (for citing)
Address Line1500 N WESTERN AVE SUITE 204AddressLine1Txt
CityLAKE FORESTCityNm
State AbbreviationILStateAbbreviationCd
ZIP60045ZIPCd
FieldValueIRS element (for citing)
Foreign Accounts Question0ForeignAccountsQuestionInd

Statements Regarding Acty4720 StatementsRegardingActy4720Grp

FieldValueIRS element (for citing)
Sale Or Exch Disqualified Prsn0SaleOrExchDisqualifiedPrsnInd
Brrw Or Lend Disqualified Prsn0BrrwOrLendDisqualifiedPrsnInd
Furn Goods Disqualified Prsn0FurnGoodsDisqualifiedPrsnInd
Pay Comp Disqualified Prsn0PayCompDisqualifiedPrsnInd
Transfer Ast Disqualified Prsn0TransferAstDisqualifiedPrsnInd
Payment To Government Official0PaymentToGovernmentOfficialInd
Uncorrected Prior Acts0UncorrectedPriorActsInd
Undistributed Income PY0UndistributedIncomePYInd
Business Holdings0BusinessHoldingsInd
Jeopardy Investments0JeopardyInvestmentsInd
Uncorrected PY Jeopardy Invst0UncorrectedPYJeopardyInvstInd
Influence Legislation0InfluenceLegislationInd
Influence Election0InfluenceElectionInd
Grants To Individuals0GrantsToIndividualsInd
Grants To Organizations0GrantsToOrganizationsInd
Noncharitable Purpose0NoncharitablePurposeInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd

Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp

Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (6 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdTitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
JOSEPH S CARR
500 NORTH WESTERN AVENUELAKE FORESTIL60045CHAIRMAN1.00$0$0$0
GEORGE M COVINGTON
500 NORTH WESTERN AVENUELAKE FORESTIL60045DIRECTOR1.00$0$0$0
ROBERT L FRIEDLANDER
500 NORTH WESTERN AVENUELAKE FORESTIL60045DIRECTOR1.00$0$0$0
RICHARD M NORTON
500 NORTH WESTERN AVENUELAKE FORESTIL60045DIRECTOR1.00$0$0$0
RICHARD M ROSS JR
500 NORTH WESTERN AVENUELAKE FORESTIL60045SECRETARY/TREASURER1.00$0$0$0
KATE GRUBBS O'CONNOR
500 NORTH WESTERN AVENUELAKE FORESTIL60045EXECUTIVE DIRECTOR40.00$135,000$0$0
FieldValueIRS element (for citing)
Comp Of Hghst Pd Empl Or NONENONECompOfHghstPdEmplOrNONETxt
Other Employee Paid Over50k0OtherEmployeePaidOver50kCnt
Comp Of Hghst Pd Cntrct Or NONENONECompOfHghstPdCntrctOrNONETxt
Contractor Paid Over50k0ContractorPaidOver50kCnt

Sum Of Program Related Invst SumOfProgramRelatedInvstGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Minimum Investment Return MinimumInvestmentReturnGrp

FieldValueIRS element (for citing)
Average Monthly FMV Of Sec$14,114,964AverageMonthlyFMVOfSecAmt
Average Monthly Cash Balances$119,432AverageMonthlyCashBalancesAmt
FMV All Other Noncharitable Ast$583,924FMVAllOtherNoncharitableAstAmt
Total FMV Of Unused Assets$14,818,320TotalFMVOfUnusedAssetsAmt
Reduction Claimed$0ReductionClaimedAmt
Acquisition Indebtedness$0AcquisitionIndebtednessAmt
Adjusted Total FMV Of Unused Ast$14,818,320AdjustedTotalFMVOfUnusedAstAmt
Cash Deemed Charitable$222,275CashDeemedCharitableAmt
Net Vl Noncharitable Assets$14,596,045NetVlNoncharitableAssetsAmt
Minimum Investment Return$729,802MinimumInvestmentReturnAmt

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
Minimum Investment Return$729,802MinimumInvestmentReturnAmt
Tax Based On Investment Income$3,151TaxBasedOnInvestmentIncomeAmt
Total Tax$3,151TotalTaxAmt
Distributable Before Adj$726,651DistributableBeforeAdjAmt
Recoveries Qualfied Distri$0RecoveriesQualfiedDistriAmt
Distributable Before Ded$726,651DistributableBeforeDedAmt
Deduction From Distributable$0DeductionFromDistributableAmt
Distributable As Adjusted$726,651DistributableAsAdjustedAmt

Qualifying Distri Part XII QualifyingDistriPartXIIGrp

FieldValueIRS element (for citing)
Expenses And Contributions$937,646ExpensesAndContributionsAmt
Program Related Invst Total$0ProgramRelatedInvstTotalAmt
Qualifying Distributions$937,646QualifyingDistributionsAmt
Pct Sect4940e Org Net Invst Incm$0PctSect4940eOrgNetInvstIncmAmt
Adjusted Qualifying Distri$937,646AdjustedQualifyingDistriAmt

Undistributed Income UndistributedIncomeGrp

FieldValueIRS element (for citing)
Distributable As Adjusted$726,651DistributableAsAdjustedAmt
Undistributed Income PY$0UndistributedIncomePYAmt
Total For Prior Years$0TotalForPriorYearsAmt
Excess Distribution Cyov Yr5$434,514ExcessDistributionCyovYr5Amt
Excess Distribution Cyov Yr4$434,890ExcessDistributionCyovYr4Amt
Excess Distribution Cyov Yr3$362,804ExcessDistributionCyovYr3Amt
Excess Distribution Cyov Yr2$476,094ExcessDistributionCyovYr2Amt
Excess Distribution Cyov Yr1$555,593ExcessDistributionCyovYr1Amt
Total Excess Distribution Cyov$2,263,895TotalExcessDistributionCyovAmt
Qualifying Distributions$937,646QualifyingDistributionsAmt
Applied To Year1$0AppliedToYear1Amt
Applied To Prior Years$0AppliedToPriorYearsAmt
Treated As Distri From Corpus$0TreatedAsDistriFromCorpusAmt
Applied To Current Year$726,651AppliedToCurrentYearAmt
Remaining Distri From Corpus$210,995RemainingDistriFromCorpusAmt
Excess Distri Cyov App CY Corpus$0ExcessDistriCyovAppCYCorpusAmt
Excess Distribution Cyov App CY$0ExcessDistributionCyovAppCYAmt
Total Corpus$2,474,890TotalCorpusAmt
Prior Year Undistributed Incm$0PriorYearUndistributedIncmAmt
Prior Year Deficiency Or Tax$0PriorYearDeficiencyOrTaxAmt
Taxable1$0Taxable1Amt
Taxable2$0Taxable2Amt
Undistributed Income CY$0UndistributedIncomeCYAmt
Corpus Distri170b1 E Or4942g3$0CorpusDistri170b1EOr4942g3Amt
Excess Distri Cyov From Yr5$434,514ExcessDistriCyovFromYr5Amt
Excess Distri Cyov To Next Yr$2,040,376ExcessDistriCyovToNextYrAmt
Excess From Year4$434,890ExcessFromYear4Amt
Excess From Year3$362,804ExcessFromYear3Amt
Excess From Year2$476,094ExcessFromYear2Amt
Excess From Year1$555,593ExcessFromYear1Amt
Excess From Current Year$210,995ExcessFromCurrentYearAmt

Supplementary Information SupplementaryInformationGrp

Application Submission Info ApplicationSubmissionInfoGrp

FieldValueIRS element (for citing)
Recipient PersonKATE GRUBBS O'CONNOR GRANT HEALTHCARecipientPersonNm

Recipient US Address RecipientUSAddress

FieldValueIRS element (for citing)
Address Line1500 NORTH WESTERN AVENUE SUITE 204AddressLine1Txt
CityLAKE FORESTCityNm
State AbbreviationILStateAbbreviationCd
ZIP60045ZIPCd
FieldValueIRS element (for citing)
Recipient Phone8477351590RecipientPhoneNum
Form And Info And MaterialsGRANT FORM USEDFormAndInfoAndMaterialsTxt
Submission DeadlinesJULYSubmissionDeadlinesTxt
Restrictions On AwardsTHE FIELD OF HEALTHCARE IN THE GREATER CHICAGOLAND AREARestrictionsOnAwardsTxt

Grant Or Contribution Pd Dur Yr GrantOrContributionPdDurYrGrp (39 entries)

Address Line1RecipientUSAddress/AddressLine1TxtAddress Line2RecipientUSAddress/AddressLine2TxtCityRecipientUSAddress/CityNmState AbbreviationRecipientUSAddress/StateAbbreviationCdZIPRecipientUSAddress/ZIPCdRecipient RelationshipRecipientRelationshipTxtRecipient Foundation StatusRecipientFoundationStatusTxtGrant Or Contribution PurposeGrantOrContributionPurposeTxtAmtAmt
AMERICAN CANCER SOCIETY INC
100 TRI-STATE INTERNATIONAL SUITE125LINCOLNSHIREIL60069NONEPCPATIENT NAVIGATION AT COOK COUNTY HEALTH SYSTEM AND HOSPITAL$10,000
BREAKTHROUGH URBAN MINISTRY
402 N ST LOUIS STCHICAGOIL60624NONEPCBEHAVIORAL HEALTH FOR HOMELESS ADULTS$15,000
CANINE THERAPY CORPS
1700 W IRVING PARK RDCHICAGOIL60651NONEPCGENERAL OPERATING SUPPORT$12,000
CARE FOR FRIENDS ORG
530 W FULLERTONCHICAGOIL60614NONEPCGENERAL OPERATING SUPPORT - FOOT AND HEALTH CLINIC$10,000
CATHOLIC CHARITIES OF THE ARCHDIOCESE OF CHICAGO
721 N LASALLECHICAGOIL60654NONEPCHOSPITAL TRANSITION PROGRAM$25,000
CENTER ON HALSTED
3858 N HALSTED STCHICAGOIL60613NONEPCBEHAVIORAL HEALTH SERVICES$20,000
CHICAGO CHILDREN'S ADVOCACY CENTER
1240 SOUTH DAMEN AVECHICAGOIL60608NONEPCFAMILY HOPE CENTER$20,000
CHICAGO FAMILY HEALTH CENTER
9119 SOUTH EXCHANGE AVECHICAGOIL60617NONEPCGENERAL OPERATING SUPPORT$20,000
COMMUNITY HEALTH
2811 W CHICAGO AVECHICAGOIL60622NONEPCGENERAL OPERATING SUPPORT$20,000
DENTAL LIFELINE NETWORK ILLINOIS
PO BOX 211NORTHBROOKIL60085NONEPCCHICAGO DONATED DENTAL SERVICES (DDS) PROGRAM$15,000
ERIE FAMILY HEALTH CENTER
1701 W SUPERIOR STCHICAGOIL60622NONEPCPATIENT-CENTERED CARE INEGRATION (PCCI) INITIATIVE$20,000
ESPERANZA HEALTH CENTERS
2001 S CALIFORNIA AVECHICAGOIL60608NONEPCCARE COORDINATION PROGRAM$10,000
FAMILY FOCUS
310 S PEORIACHICAGOIL60607NONEPCTRAUMA-INFORMED THERAPEUTIC SERVICES$20,000
GADS HILL CENTER
1919 W CULLERTONCHICAGOIL60608NONEPCHEALTHY MINDS, HEALTHY SCHOOLS$16,000
GOLDIE'S PLACE
5705 N LINCOLN AVECHICAGOIL60659NONEPCGENERAL OPERATING SUPPORT$20,000
HOLIDAY HOME CAMP
PO BOX 10WILLIAMS BAYWI53191NONEPCHEALTHCARE OPERATIONS, SALARIES AND PROGRAMS$12,000
HOWARD AREA COMMUNITY CENTER
7648 N PAULINA STCHICAGOIL60626NONEPCELEANOR WESTER DENTAL CLINIC$10,000
ILLINOIS COLLEGE OF OPTOMETRY
3241 S MICHIGAN AVECHICAGOIL60616NONEPCCHICAGO VISION OUTREACH$20,000
INNER CITY MUSLIM ACTION NETWORK
2744 W 63RD STCHICAGOIL60629NONEPCIMAN HEALTH CLINIC - GENERAL OPERATING SUPPORT$20,000
LAWNDALE CHRISTIAN HEALTH CENTER
3860 W OGDEN AVECHICAGOIL60623NONEPCGENERAL OPERATING SUPPORT$25,000
LINCOLN PARK ZOOLOGICAL SOCIETY
2001 N CLARK STCHICAGOIL60614NONEPCWILDLIFE AND HUMAN HEALTH INITIATIVE$40,000
LUSTER LEARNING INSTITUTE
1126 HILLCRESTHIGHLAND PARKIL60035NONEPCGENERAL OPERATING SUPPORT$20,000
METROSQUASH
6100 S COTTAGE GROVE AVECHICAGOIL60637NONEPCHEALTH AND WELLNESS PROGRAM$5,000
MIDWEST ACCESS PROJECT
PO BOX 13173CHICAGOIL60613NONEPCGENERAL OPERATING SUPPORT$15,000
OLD IRVING PARK COMMUNITY CLINIC
5425 W ADDISON STCHICAGOIL60641NONEPCGENERAL OPERATING SUPPORT$10,000
PCC COMMUNITY WELLNESS CENTER
14 LAKE STOAK PARKIL60302NONEPCGENERAL OPERATING SUPPORT$20,000
PEER HEALTH EXCHANGE
330 N WABASHCHICAGOIL60011NONEPCGENERAL OPERATING SUPPORT$20,000
PLANNED PARENTHOOD OF ILLINOIS
18 S MICHIGAN AVECHICAGOIL60603NONEPCGENERAL OPERATING SUPPORT$50,000
PRESENCE SAINT JOSEPH HOSPITAL
2900 N LAKE SHORE DRCHICAGOIL60657NONEPCLABOURE CLINIC$10,000
PRIMO CENTER FOR WOMEN AND CHILDREN
4241 W WASHINGTON BLVDCHICAGOIL60624NONEPCTRAUMA-INFORMED MENTAL HEALTH SERVICES IN CONGREGATE CARE$25,000
RESPOND NOW
PO BOX 215CHICAGO HEIGHTSIL60411NONEPCPRESCRIPTION ASSISTANCE PROGRAM$20,000
RUSH UNIVERSITY MEDICAL CENTER
1700 W VAN BURENCHICAGOIL60612NONEPCRUSH ADOLESCENT FAMILY CENTER$20,000
SECOND SENSE
65 E WACKER DRCHICAGOIL60601NONEPCSUPPORT FOR VISION REHABILITATION TO MOVE BEYOND VISION LOSS$10,000
SISTERHOUSE
851 N LEAMINGTON AVECHICAGOIL60651NONEPCGENERAL OPERATING SUPPORT$15,000
THE NIGHT MINISTRY
4711 N RAVENSWOOD AVECHICAGOIL60640NONEPCOUTREACH AND HEALTH MINISTRY$15,000
THE UNIVERSITY OF CHICAGO
5801 S ELLIS AVECHICAGOIL60637NONEPCURBAN HEALTHCARE INNOVATION BUILDING BEHAVIORAL HEALTH CAPACITY FOR VUNERABLE COMMUNITIES$30,000
THRESHOLDS
4101 N RAVENSWOOD AVECHICAGOIL60613NONEPCSUBSTANCE USE TREATMENT AND DIVERSION PROGRAM$25,000
UCAN (UHLICH CHILDREN'S ADVANTAGE NETWORK)
3737 N MOZART STCHICAGOIL60618NONEPCUCAN NORTH LAWDALE CAMPUS - CAPITAL REQUEST$25,000
WOMEN'S REPRODUCTIVE RIGHTS ASSISTANCE PROJECT
2934 1/2 BEVERLY GLEN CIRCLE 169LOS ANGELESCA90077NONEPCGENERAL OPERATING SUPPORT$25,000
FieldValueIRS element (for citing)
Total Grant Or Contri Pd Dur Yr$740,000TotalGrantOrContriPdDurYrAmt
Total Grant Or Contri Apprv Fut$0TotalGrantOrContriApprvFutAmt

Analysis Income Producing Acty AnalysisIncomeProducingActyGrp

Div And Int From Sec Part VII DivAndIntFromSecPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$218,397ExclusionAmt

Other Investment Incm Part VII OtherInvestmentIncmPartVIIGrp

FieldValueIRS element (for citing)
Exclusion14ExclusionCd
Exclusion$16,147ExclusionAmt

Gain Sales Ast Oth Than Invntry GainSalesAstOthThanInvntryGrp

FieldValueIRS element (for citing)
Exclusion18ExclusionCd
Exclusion-$19,816ExclusionAmt

Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp

FieldValueIRS element (for citing)
Unrelated Business Taxbl Incm$0UnrelatedBusinessTaxblIncmAmt
Exclusion$214,728ExclusionAmt
Related Or Exempt Function Incm$0RelatedOrExemptFunctionIncmAmt
FieldValueIRS element (for citing)
Total Income Producing Acty$214,728TotalIncomeProducingActyAmt

Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp

FieldValueIRS element (for citing)
Trnsfr Of Cash To Nonchrtbl EO0TrnsfrOfCashToNonchrtblEOInd
Trnsfr Other Asset Nonchrtbl EO0TrnsfrOtherAssetNonchrtblEOInd
Sales Or Exchanges Of Assets0SalesOrExchangesOfAssetsInd
Purchase Of Assets Nonchrtbl EO0PurchaseOfAssetsNonchrtblEOInd
Rental Of Facilities Oth Assets0RentalOfFacilitiesOthAssetsInd
Reimbursement Arrangements0ReimbursementArrangementsInd
Loans Or Loan Guarantees0LoansOrLoanGuaranteesInd
Performance Of Services Etc0PerformanceOfServicesEtcInd
Sharing Of Facilities Etc0SharingOfFacilitiesEtcInd
Relationships Nonchrtbl EO0RelationshipsNonchrtblEOInd

Schedule B IRS990ScheduleB

FieldValueIRS element (for citing)
Organization501c3 Exempt PFYes (X)Organization501c3ExemptPFInd
General RuleYes (X)GeneralRuleInd

Contributor Information ContributorInformationGrp (2 entries)

ContributorContributorNumAddress Line1ContributorUSAddress/AddressLine1TxtCityContributorUSAddress/CityNmState AbbreviationContributorUSAddress/StateAbbreviationCdZIPContributorUSAddress/ZIPCdTotal ContributionsTotalContributionsAmtPerson ContributionPersonContributionInd
WILLIAM C MADLENER TRUST
1C/O US TRUST 231 S LASALLE STCHICAGOIL60697$17,502Yes (X)
INGRED HIBBELER
2500 N WESTERN AVELAKE FORESTIL60045$3,489Yes (X)

Accounting Fees Schedule AccountingFeesSchedule

Accounting Fees Detail AccountingFeesDetail

FieldValueIRS element (for citing)
CategoryACCOUNTING FEESCategoryTxt
Amt$6,600Amt
Net Investment Income$330NetInvestmentIncomeAmt
Disbursements Charitable Prps$5,940DisbursementsCharitablePrpsAmt

Depreciation Schedule DepreciationSchedule

Depreciation Property DepreciationPropertyGrp (4 entries)

PropertyPropertyDescAcquiredAcquiredDtCost Or Other BasisCostOrOtherBasisAmtPrior Year DepreciationPriorYearDepreciationAmtComputation MethodComputationMethodTxtLifeLifeRtCurrent Year ExpenseCurrentYearExpenseAmtNet Investment IncomeNetInvestmentIncomeAmt
OFFICE EQUIPMENT2006-09-01$7,548$7,548SL7.000000000000$0$0
LAP TOP COMPUTER2012-05-16$653$228SL10.000000000000$65$0
LENOVO IDEACENTER COMPUTER2016-04-11$917SL5.000000000000$92$0
DESK AND CONFERENCE TABLE2016-06-14$1,250SL10.000000000000$63$0

Investments Corp Stock Schedule InvestmentsCorpStockSchedule

Investments Corporate Stock InvestmentsCorporateStockGrp

FieldValueIRS element (for citing)
StockEQUITIESStockNm
EOY Book Value$996,082EOYBookValueAmt
EOYFMV$996,082EOYFMVAmt

Investments Other Schedule2 InvestmentsOtherSchedule2

Investments Other InvestmentsOtherGrp (3 entries)

Category Or ItemCategoryOrItemTxtListed At Cost Or FMVListedAtCostOrFMVCdBook ValueBookValueAmtEOYFMVEOYFMVAmt
MUTUAL FUNDSFMV$11,510,526$11,510,526
PARTNERSHIPSAT COST$902,483$902,483
EXCHANGE TRADED FUNDSFMV$685,570$685,570

Land Etc Schedule2 LandEtcSchedule2

Land Etc LandEtcGrp (4 entries)

Category Or ItemCategoryOrItemTxtCost Or Other BasisCostOrOtherBasisAmtAccumulated DepreciationAccumulatedDepreciationAmtBook ValueBookValueAmt
OFFICE EQUIPMENT$7,548$7,548$0
LAP TOP COMPUTER$653$293$360
LENOVO IDEACENTER COMPUTER$917$92$825
DESK AND CONFERENCE TABLE$1,250$63$1,187

Other Assets Schedule OtherAssetsSchedule

Other Assets Schedule OtherAssetsScheduleGrp (2 entries)

DescDescBOY Book ValueBOYBookValueAmtEOY Book ValueEOYBookValueAmtEOYFMVEOYFMVAmt
CASH SURRENDER VALUE - INSURANCE$234,639$243,213$243,213
BENEFICAL INTEREST IN A PERPETUAL TRUST$343,308$343,890$343,890

Other Expenses Schedule OtherExpensesSchedule

Other Expenses Schedule OtherExpensesScheduleGrp

FieldValueIRS element (for citing)
DescOFFICE EXPENSEDesc
Revenue And Expenses Per Books$47,384RevenueAndExpensesPerBooksAmt
Net Investment Income$2,369NetInvestmentIncomeAmt
Disbursements Charitable Prps$42,646DisbursementsCharitablePrpsAmt

Other Income Schedule2 OtherIncomeSchedule2

Other Income Detail OtherIncomeDetail

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Revenue And Expenses Per Books$16,147RevenueAndExpensesPerBooksAmt
Net Investment Income$14,825NetInvestmentIncomeAmt
Adjusted Net Income$16,147AdjustedNetIncomeAmt

Other Increases Schedule OtherIncreasesSchedule

Other Increases Detail OtherIncreasesDetail (2 entries)

DescDescAmtAmt
UNREALIZED GAIN(LOSS) ON INVESTMENTS$858,570
UNREALIZED GAIN(LOSS) ON INVESTMENTS$582

Other Professional Fees Schedule OtherProfessionalFeesSchedule

Other Professional Fees Detail OtherProfessionalFeesDetail

FieldValueIRS element (for citing)
CategoryINVESTMENT MANAGEMENT FEESCategoryTxt
Amt$57,684Amt
Net Investment Income$57,684NetInvestmentIncomeAmt
Disbursements Charitable Prps$0DisbursementsCharitablePrpsAmt

Taxes Schedule TaxesSchedule

Taxes Detail TaxesDetail (3 entries)

CategoryCategoryTxtAmtAmtNet Investment IncomeNetInvestmentIncomeAmtDisbursements Charitable PrpsDisbursementsCharitablePrpsAmt
PAYROLL TAXES$11,506$575$10,355
FEDERAL EXCISE TAX$7,575$0$0
FOREIGN TAXES$7,004$7,004$0