2017-05-15T13:47:30-05:00 2016-06-30 420714325 RSM US LLP 1 S WACKER DRIVE STE 800 CHICAGO IL 60606 990 2015-07-01 362170143 La Rabida Children's Hospital LARA 7733636700 6501 S Promontory Drive Chicago IL 60649 Mark Renfree CFO & VP of Administration 7733636700 2017-05-11 1 Wayne Harder P00294296 3126343400 2015 2021-01-29 14:40:06Z Brenda Wolf 6501 S Promontory Drive Chicago IL 60649 164625912 0 X www.larabida.org X 1896 IL La Rabida Children's Hospital provides specialized, family-centered health care to children with medically complex conditions, disabilities, and chronic illness. Through expertise, compassion, and advocacy we help children and their families reach their fullest potential, regardless of their ability to pay. 36 35 559 186 0 0 4922335 3609530 46864075 51014836 11733135 2594035 606262 1565497 64125807 58783898 56107 45999 0 0 28935425 31742285 0 0 591376 20286472 20798067 49278004 52586351 14847803 6197547 183110163 185296213 11952943 16746098 171157220 168550115 X La Rabida Children's Hospital (LRCH) provides specialized, family-centered health care to children with medically complex conditions, disabilities, and chronic illness. Through expertise, compassion, and advocacy we help children and their families reach their fullest potential, regardless of their ability to pay. 0 0 28614426 45999 34179960 The primary service provided by La Rabida is inpatient services to children with chronic illnesses and disabilities. In fiscal year 2016 we had 432 admissions and 8,005 patient days of care. La Rabida Children's Hospital serves these children regardless of race, creed, sex, national origin, or ability to pay and is the most Medicaid dependent hospital in the State of Illinois, with more than 92% of its patient days of care rendered for Medicaid program beneficiaries. La Rabida Children's Hospital is a local expert and provides a site of training for residents and medical students. We train nearly 95 physician residents and medical students each year from the University of Chicago. La Rabida is also a training site for nursing, rehabilitation therapists, social work, psychology and respiratory therapy students. The hospital works to ensure that all hospital staff, both clinical and non-clinical, receives education on how to make the hospital a safe place for children. This includes quality initiatives for infection control, certification classes in CPR and Pediatric Advanced Life Support (PALS), running mock codes, classroom lectures for nurses, emergency preparedness training, and meetings on education and research. La Rabida also holds in-services as warranted for new products, policies and event-related occurrences. 9538142 8541217 The secondary services provided by La Rabida are various clinical outpatient services supportive of the special needs of our patients. These services include 4,726 treatment room visits, 11,071 physician clinic visits and 11,878 outpatient ancillary visits. The physician clinics are for children with chronic healthcare needs and their siblings. These services also include care coordinators, patient education, case management and numerous wrap around services such as nutrition and behavioral health. Included in the ancillary visits are physical therapy, speech therapy, occupational therapy and infant development specialty visits. 4098114 3432764 In conjunction with the inpatient and outpatient services provided, LRCH also provides several primarily grant funded program extensions. The largest are Children's Advocacy Center for Children who have been abused, neglected or have experienced trauma; Child and Family Connections which is a healthcare system point of entry for early intervention services for residents of southeast Chicago; and Integrated Assessment which conducts mental health assessments for children entering custody of the Department of Children Family Services. 2619767 4860895 The hospital formed the La Rabida Coordinated Care Network for Children with Complex Medical Needs (Network) as a Care Coordination Entity for Children with Special Needs (CSN CCE). As a CSN CCE, the Network develops alternative models of delivering care to Medicaid recipients through a provider-organized network. The hospital receives a fee from the Illinois Department of Healthcare and Family Services to coordinate care for Medicaid recipients enrolled with the Network. 2619767 4860895 44870449 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 1 0 1 1 0 1 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 1 47 0 1 559 1 0 0 0 0 0 1 1 0 0 0 0 X 36 35 0 0 0 0 1 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X Mark Renfree 7736366700 6501 S Promontory Drive Chicago IL 606491935 John Gyann Chair 1.00 X X 0 0 0 Fred Berglund Vice Chair 1.00 X X 0 0 0 Cedric Shaw Vice Chair 1.00 X X 0 0 0 Robert Arthur Secretary 1.00 X X 0 0 0 Howard Alper Trustee 1.00 X 0 0 0 Neal Baker Trustee 1.00 X 0 0 0 Richard Burridge Trustee 1.00 2.00 X 0 0 0 Michele Bush until June 2016 Trustee 1.00 X 0 0 0 John Clifford Trustee 1.00 X 0 0 0 Bruce Cohen Trustee 1.00 X 0 0 0 Brian Devane Trustee 1.00 X 0 0 0 Terence Donnelly Trustee 1.00 X 0 0 0 Adam Fox Trustee 1.00 X 0 0 0 Brian Gaspardo Trustee 1.00 X 0 0 0 John Harney Trustee 1.00 X 0 0 0 Patricia Brown Holmes Trustee 1.00 X 0 0 0 Drew Horowitz Trustee 1.00 X 0 0 0 Lisa Haley Huff Trustee 1.00 X 0 0 0 Mark Jacobs Trustee 1.00 X 0 0 0 Gloria Jacobson Trustee 1.00 X 0 0 0 Allen Kanter Trustee 1.00 X 0 0 0 Allen Kutchins Trustee 1.00 X 0 0 0 Randy Markowitz Trustee 1.00 X 0 0 0 Craig Miller Trustee 1.00 X 0 0 0 Kweku Obed until June 2016 Trustee 1.00 2.00 X 0 0 0 David Patzwald until June 2016 Trustee 1.00 X 0 0 0 Daniel Real Trustee 1.00 X 0 0 0 Richard Rodgers Trustee 1.00 X 0 0 0 Emilio Salvi Trustee 1.00 X 0 0 0 Kathy Schaeffer Trustee 1.00 X 0 0 0 John Smith until June 2016 Trustee 1.00 X 0 0 0 Frederick Thomas Trustee 1.00 X 0 0 0 Fred Walz Trustee 1.00 X 0 0 0 Patricia Halper Trustee 1.00 X 0 0 0 Mark Hanna as of June 2016 Trustee 1.00 X 0 0 0 Ryan Lawrence Trustee 1.00 X 0 0 0 Mark D Renfree VP Finance 38.00 3.00 X 310231 0 53252 Janet Haines VP Fund Dvlp. & External Affairs 40.00 X 197812 0 14441 Aden Henry VP Patient Care Service 40.00 X 249074 0 41496 Brenda Wolf President/CEO 38.00 X 390180 0 77527 Ana Carvalho VP Strat. Integ./Ex. Director 40.00 X 231633 0 35830 Dr David Soglin Chief Medical Officer 40.00 X 230450 0 16603 Shelah Cabrera Chief Information Officer 40.00 X 136600 0 8368 Michael Gallery Pharmacy Manager 40.00 X 152322 0 51374 Frances Lefkow Director of Human Resource 40.00 X 178943 0 53869 Sylvia Williams Director of Inpatient Nursing 40.00 X 160038 0 33724 Colleen Harper Director of Rehab/Development 40.00 X 143034 0 67719 Patricia DiFiglio Director of Quality Risk Management 40.00 X 133209 0 20878 2513526 0 475081 23 0 1 0 University of Chicago Medical Center 5841 Maryland Avenue Chicago IL 60637 Physician Staffing & Ancillary Services 2797401 Pediatric Faculty Foundation 2300 Childrens Plaza Chicago IL 60614 Physician Staffing & Ancillary Services 1436178 AMN Healthcare Inc 2735 Collection Center Drive Chicago IL 60693 Nurse Staffing Services 391842 Cornerstone Advisors Group LLC PO Box 569 Georgetown CT 06829 Software Implementation 353525 Health Management Associates 120 N Washington Square Suite 705 Lansing MI 48933 Consulting Services 217533 10 702888 1200000 1706642 137523 3609530 Patient Revenue 621110 42721177 42721177 Care Coordination Entity Revenue 621110 4860895 4860895 Other Patient Services Revenue 621110 3432764 3432764 51014836 2395957 2395957 105718616 105510593 9945 208023 -9945 198078 198078 256354 702888 321476 -65122 -65122 Income from MHN ACO, LLC 624100 1288323 1288323 Cafeteria 722210 176009 176009 166287 166287 1630619 58783898 52469446 0 2704922 X 45999 45999 2660489 852950 1589565 217974 23908004 21036976 2708842 162186 909980 749737 147222 13021 2453190 1781737 619143 52310 1810622 1491781 292933 25908 231688 170568 61120 147266 41496 105770 83576 83576 361501 361501 6477022 5490119 926288 60615 31463 1879 24906 4678 4314746 4136684 161005 17057 587585 500094 87491 2867012 2867012 113862 101958 10484 1420 3112846 3112846 639492 639492 Maintenance Contracts 766669 766669 Bad Debt Expense 392172 392172 Education 80662 58739 21923 Books & Subscriptions 19114 10043 6333 2738 571391 537922 33469 52586351 44870449 7124526 591376 4900240 4485741 3260341 4286127 2963401 2885937 403199 372534 513845 289954 61277104 31357620 31369336 29919484 101647638 105931524 50000 1172455 38002163 35952457 183110163 185296213 5117053 5106526 6835890 11639572 11952943 16746098 X 138245403 137982534 31804415 29459190 1107402 1108391 171157220 168550115 183110163 185296213 X 6197547 -2009809 -6794843 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 0 0 0 1 1272 1 70000 0 1 12304 83576 0 Part II-B, line 1(f) The grants to other organizations for lobbying purposes are made through dues paid to the National Association of Children's Hospitals. Part II-B, line 1(g) Fletcher, O'Brien, Kasper, & Nottage, P.C. is a firm hired by LRCH to assist in educating legislators on the specific financial situation of La Rabida and the importance of appropriate Medicaid reimbursement. Part II-B, line 1(i) A portion of the dues paid to Illinois Hospital Association and American Hospital Association are attributable to lobbying. 39933769 15528172 24405597 18770327 13678285 5092042 2573008 2151163 421845 29919484 City of Chicago License 3368275 Beneficial Interest in Assets Held by the Foundation 7266500 Interest in Restricted Net Assets of the Foundation 23529357 Insurance Recoveries Receivable 1788325 35952457 Payables to Third-Party Programs 511902 Pension Obligation 8593832 Self-Insurance 2533838 11639572 X 49547039 -2009809 -6473377 -8483186 58030225 361501 392172 753673 58783898 52154154 321476 321476 51832678 361501 392172 753673 52586351 Part X, Line 2: The Hospital is a tax-exempt organization under Internal Revenue Code Section 501(c)(3) and, accordingly, no income taxes are provided for in the accompanying financial statements. The Hospital follows the Financial Accounting Standards Board (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 this return is filed, it is highly certain that some positions taken would be sustained upon examination by the taxing authorities, while others may be 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 not-for-profit hospitals include such matters as the following: the tax-exempt status of the entity, the nature, characterization and taxability of joint venture income and various positions relative to potential sources of unrelated business income (UBI). The Hospital had no UBI for the years ended June 30, 2016 and 2015. The benefit of a tax position is recognized in the 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 percent 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 is reflected as a liability for unrecognized tax benefits in the accompanying balance sheets along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Forms 990 filed by the Hospital are 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 the tax years 2012 and prior. Part XI, Line 2d - Other Adjustments: Special Event Expenses 321,476. Change in Pension Obligation -5,314,312. Change in Interest in Net Assets of the Foundation -1,480,541. Part XI, Line 4b - Other Adjustments: Bad Debt Expense 392,172. Part XII, Line 2d - Other Adjustments: Special Event Expenses 321,476. Part XII, Line 4b - Other Adjustments: Bad Debt Expense 392,172. Gala 724655 536485 188170 31640 70912 120040 Golf Outing 166687 124303 42384 11077 17484 21868 14427 1 67900 42100 25800 33996 32 959242 702888 256354 11077 49124 126776 134499 321476 -65122 1 1 X 1 X 1 X 150.000000000000 1 1 0 1 1 70333 0 70333 0.00130 43453069 45490094 -2037025 0.00000 0 0 43523402 45490094 -1966692 0.00130 3581 0 3581 0.00010 530712 179185 351527 0.00670 4288603 2059775 2228828 0.04270 0 0 0 0 4822896 2238960 2583936 0.04950 48346298 47729054 617244 0.05080 1 392172 4289 6661 -2372 X 1 1 1 1 La Rabida Children's Hospital 6501 S Promontory Drive Chicago IL 60649 X X X La Rabida Children's Hospital 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X http://www.larabida.org/externals/files/2016%962018%20Community_Benefit_Rep X 1 15 1 http://www.larabida.org/externals/files/2016%962018%20Community_Benefit_Rep 0 0 1 X 100.000000000000 150.000000000000 X X X X X 1 1 X X X X 1 X http://www.larabida.org/page-Financial-Assistance X 1 X 0 X X X X 1 X 0 0 La Rabida Children's Hospital Part V, Section B, Line 5: As part of the Community Needs Assessment, La Rabida routinely receives information about community needs from a number of sources: industry groups such as the Illinois Health and Hospital Association and the Children's Hospital Association; local collaboratives, such as the Healthy Chicago Hospital Collaborative and the South Side Healthcare Collaborative; managed care organizations, with whom we collaborate on prevention and screening efforts; disease- or condition-specific groups such as the Sickle Cell Disease Association of Illinois and EverThrive; and collaborations, particularly with our two major academic medical center colleagues, University of Chicago Medicine and Lurie Children's Hospital. In addition, we receive briefings from Pediatrics Today Smartbrief and Chicago Department of Public Health, and also attend conferences, webinars, grand rounds and community meetings. For the preparation of the Community Health Needs Assessment, the scope of our service area was researched and it was determined that our primary area included approximately 50% of our patients from 9 zip code areas, our secondary area included approximately 25% patients from 18 zip codes areas, and the remaining service areas included 264 additional zip code areas. This research concluded that we are a small, but regional specialty hospital.Focusing on our primary service area, we then turned to the data collected by epidemiologists at the Chicago Department of Public Health, as published in Measuring Chicago's Health, which tracked a "hardship index", comprised of six indicators, as well as age, race, perceptions and practices via the Healthy Chicago survey. Comparing population changes from 2000 to 2010, and estimated changes through 2013 using census data, we determined that our area has experienced significant outmigration. Better job opportunities and safety were the primary reasons for the outmigration found in local research reported by the Tribune. We looked at changes in the health industry that impacted access to services in our area, as well as health and community assets.Finally, since we provide extensive wraparound services to our patients to address a variety of social determinants of health (food, income, housing, and transportation insecurity, access to other support services), we engage in deep conversation daily with our own patients about what they need. We surveyed our own patients, highlighting the specific issues that were found in the public survey data for our primary service area: access to health care, what was needed to improve health and health services, chronic conditions and primary sources of health information. Over a multiple-week period, three hundred surveys (presented in English and Spanish) were distributed to the primary family member whose child had a pre-scheduled appointment. The data reflected responses from 59 respondents who live in our primary service area. The leading issues identified in our survey agreed with the census data: concerns about unemployment and safety, as well as healthier food and better access to dental, mental health, and transportation services. La Rabida Children's Hospital Part V, Section B, Line 7d: The Community Health Needs Assessment is available to the public using the following URL:http://www.larabida.org/externals/files/201696201820Community_Benefit_Report.pdf This site offers the CHNA Report document in a format that: - When accessed, downloaded, viewed, and printed in hard copy, exactly reproduces the image of the report; - Grants access to download, view, and print the document without special computer hardware or software required for that format (other than software that is readily available to members of the public without payment of any fee) and without payment of a fee to the hospital organization or facility or to another entity maintaining the website.LRCH will provide any individual requesting a copy of the written report with the direct website address, or URL, where the document can be accessed. LRCH will also maintain at its facilities a hard copy of the CHNA report that may be viewed by anyone who requests it. La Rabida Children's Hospital Part V, Section B, Line 11: A wide range of priority issues emerged from the CHNA process. A committee of La Rabida senior executive staff reviewed the outcomes of the community health needs assessment and the clinic survey. La Rabida Children's Hospital also reviewed the prior implementation plan and we reviewed the plan of the major medical center that is closest to us, as well as some other community initiatives underway in which we have the option to participate.The significant needs identified in the CHNA which La Rabida elected not to address are: 1) Job and employment opportunities, as unemployment rated from ranges from 35% to 12% in our primary service area, compared to a long-term state average of 7%. - La Rabida will not address this issue in its Implementation plan, as job insecurity is not just a south side phenomenon, it is a city, county and state issue which is beyond the resources of La Rabida. However, we contribute where we can: for example, we buy local vegetables in season from Growing Home, an urban farm that employs local people with particularly difficult employment challenges, preparing them to enter the mainstream job market. 2) Having a safe place to walk and play was the second most cited concern in our patient survey. Although parks are fairly well distributed in many of our communities, the survey reports that the perception of their safety varies with age, ethnicity and poverty. - La Rabida will not address this issue in its Implementation plans, as the hospital does not have the internal assets nor resources to produce a significant impact on the resolution of this issue.La Rabida evaluated the unique role La Rabida plays as a small specialty hospital in the constellation of providers in our community and discussed the best ways to build on those assets to the benefit of the community. In general, we wish to bring enhanced services and/or access to services in areas of general behavioral health (#3 below), caregiver well-being (#4 below) and asthma intervention (#5 below). The following are the significant needs identified in the CHNA which La Rabida elected to address: 3) Mental Health services, as severe psychological distress is not correlated with age, gender or ethnicity, but it is highly correlated with poverty, with 10 percent of those living at or below the federal poverty level reporting distress compared to 1 percent of those living at 400% of the federal poverty level or above. - La Rabida plans to address this need by (1) embedding Behavior Health providers in our Outpatient Clinics and (2) training primary care providers to treat ADHD, depression and anxiety, including standard prescribing protocols. 4) Caregiver Well Being, as the adult measures of our survey reflects an increased prevalence of diseases including cancer, stroke, diabetes and asthma. The caregivers of the children we serve are juggling their own poor health while caring for their medically complex children. - La Rabida will address this need by (1) inserting caregiver well-being checks into standard visit templates and (2) insert inquiry into informal supports available to family (neighbors, church) into standard visit templates 5) Asthma Interventions, respondents of our survey were asked to name the top three health conditions their children were facing. Asthma was the leading condition named (37%), followed by allergies (27%), developmental delays (22%) and diabetes (17%). - La Rabida will collaborate with the University of Chicago Medical Center to improve asthma in the surrounding community. La Rabida Children's Hospital Part V, Section B, Line 22d: La Rabida is a children's hospital that provides care primarily to children on Medicaid. Approximately 85% of La Rabida's patients are insured through Medicaid. La Rabida charges all patients near cost with a cost to charge ratio of 86%. 5 1 - The Chicago Child Trauma Center 1111 E 87th Street Suite 8000 Chicago IL 60619 Trauma Center 2 - La Rabida Joli Burrell Center 200 Lakewood Boulevard Park Forest IL 60466 Children's Advocacy Trauma Center 3 - Child & Family Connections 1525 E 55th Street Suite 203 Chicago IL 60615 Office Building - Provide Child Early Intervention Services 4 - Community Hospital Outpatient Center 9660 Wicker Avenue St John IN 46373 Medical Office Facility 5 - Ann & Robert Lurie Outpatient Center 1870 Silver Cross Boulevard Suite 100 New Lenox IL 60451 Outpatient Center Part I, Line 7: A cost to charge ratio, calculated using the IRS worksheet, was used for the Part I, Line 7 table. Part I, Ln 7 Col(f): Bad debt expense of $392,172 was removed from total expenses. Part III, Line 2: The Hospital estimates the allowance for uncollectible accounts based upon management's evaluation of the collectability of its accounts receivable based on factors such as the length of time the receivable is outstanding, payor class, historical experience, trends in health care coverage, and business and economic conditions. Accounts receivable are written off against the allowance for uncollectible accounts when they are deemed uncollectible. Recoveries of receivables previously written off are recorded as a reduction of the provision for uncollectible accounts when received. Patient receivables, where a third-party payor is responsible for paying the amount, are carried at a net amount determined by the original charge for the service provided, less an estimate made for contractual adjustments or discounts provided to third-party payors. The past due status of receivables is determined on a case-by-case basis depending on the payor responsible. Interest is generally not charged on past due accounts. Receivables or payables related to estimated settlements on various payor contracts, primarily Medicaid, are reported as amounts due from or to third-party programs. Significant changes in payor mix, business office operations, economic conditions or trends in federal and state governmental health care coverage could affect the Hospital's collection of accounts receivable, cash flows and results of operations. Part III, Line 4: Bad debt expense at cost is based upon the actual charges that are the responsibility of the patient guarantor multiplied by a calculation ratio of cost to charges using the IRS worksheet. Part III, Line 8: Medicare costs are based upon the actual charges that are the responsibility of the patient guarantor multiplied by a calculation ratio of cost to charges calculated using the IRS worksheet. Part III, Line 9b: La Rabida offers financial assistance to patients who qualify. With the application process, decisions will be communicated by mail or telephone within 10 days of LRCH's receipt of the completed application. Eligibility is determined using the Financial Assistance Application. The application is available on LRCH's website and is also available for pick-up at the hospital's Patient Financial Services Department. Part VI, Line 2: Community Assessment: Goals and ProcessesOur families come from specific environments which can either enhance or challenge their abilities to care for their medically complex children. The goal of our community needs assessment is to understand the context in which our families live, specifically, as informed by Chicago's mission to improve community health (see Measuring Chicago's Health: Findings from the 2014 Healthy Chicago Survey) and the health status data which is gathered and made publicly available online by the Chicago Department of Public Health.We participate in two collaborates: the Chicago Southside HealthCare Collaborative (anchored by the University of Chicago) and the Healthy Chicago Hospital Collaborative. Both collaborates share information and combined efforts to improve community health. We participate in the Medical Home Network, an organization of safety net providers dedicated to improving health and service outcomes for those served by Medicaid. We provide care coordination on behalf of two Medicaid Managed Care organizations, both of which actively review resources, processes, and outcomes in order to improve services received by those served by Medicaid.Finally, because we work with families to reduce barriers to health and health services, both for children being cared for by La Rabida programs and for 2,500 children being cared for elsewhere across the region, we actively participate in daily conversations about the immediate and long term needs and options available to families in the region, and by collaborating with other agencies or health plans, to expand options available to our families.These sources drive enhancements and refinements to our programming to build on assets families already have, better meet challenges they face, and improve or expand the services we provide. For this report, we will look at the characteristics of the primary geographic areas we serve, and then at the results of a survey of our clinic attendees about the challenges they face. We expect both of these investigations and the information garnered from the relationships described above to inform program enhancements to be made over the next one to three years. Priority is given to ways we can boost our own programs and processes to help our subset of the population, families caring for medically complex children, reach their health goals. Part VI, Line 3: Patient Education of Eligibility for Assistance:At the time of registration, families are asked to provide any insurance information that may be used in paying for the services being rendered. If insurance is not available, the family is advised of the availability of Public Assistance and the need to complete the necessary paperwork. Preliminary paperwork is completed by the Hospital and provided to the necessary Agency for follow up by the family. It is the family's responsibility to meet with the Agency to ensure eligibility. The family is also notified about our financial assistance policy and the necessary forms for qualification are provided if requested. Part VI, Line 4: Community Information:Nearly fifty percent of La Rabida families (those who have used inpatient and/or outpatient services) come from 9 zip codes - what we are identifying as our primary service area - bounded by West Garfield and then E. 35th street to the north, State Street and then Western Avenue south to 95th street, then reaching further east and south to Racine and 130th or so, all the way east to the Indiana border. An additional 25% of patients come from 18 more zip codes (our secondary service area), reaching extensively into Chicago's south suburbs. The final 25% spans a broad region indeed, comprising of 264 additional zip codes, and demonstrating our role as a regional specialty hospital. Living below the federal poverty level: In our primary service area, the percentage of residents living below the federal poverty level ranges from 61% to 12%. By contrast the state average for Illinois is about 14.5%.Per capita income ranges from $8,535 to $28,977. Poverty is particularly localized in the northwest corner of our service area, though pockets of deep poverty occur elsewhere in the region, such as in Burnside, and the entire region is lower than average. By contrast, per capita income in the state is about $30,000. Unemployment: High rates of unemployment also occur throughout the region, ranging from a high of 35% in West Englewod to a low of 12% in the southeast community of South Deering.No high school diploma: East Side is notable as the community with the highest percentage of adults (35.5%) lacking a high school diploma (or GED equivalency), likely reflecting a higher concentration of immigrants. Otherwise, the data largely tracks the areas that exhibit the other hardship indicators.Dependency: Riverdale to the far south has a notably high dependency rate (50%) and Hyde Park stands out as a particularly low outliers (27%). All other communities cluster within range of 40%-38%. Crowded Housing: This is a proxy for the stress of living in crowded conditions; it measures the percent of occupied house in which there are more than one person per room. Our primary service area ranges from 8% in East Side to 0.6% in Avalon Park. Part VI, Line 5: Promotion of Community Health:La Rabida serves over 400 children and families through hospitalizations and 15,800 through outpatient clinics and urgent care visits annually. Almost half of La Rabida's patients (approximately 25%) are age five and under. La Rabida serves children and their families through age 18 and ensures that ongoing care is provided through referrals to local hospitals and clinics. In addition, La Rabida assists families in negotiating the new bureaucracies they will encounter once the child is no longer eligible for Medicaid upon reaching age 18. La Rabida is the most public insurance dependent hospital in the state of Illinois with Medicaid comprising over 85% of the hospital's income. The following are some of the programs used to meet the needs within our community.Trauma/Abuse Program:LRCH has one of the largest child abuse/trauma programs of any children's hospital in the country and has national recognition for cutting edge community based treatment and training programs. This program serves one of Chicago's and Chicago's south suburbs' most low-income areas. Adjunct services include forensic interviewing, case management, court services (i.e. accompanying children to court to testify against the perpetrator), liaison with community hospitals and community agencies. LRCH also provides outreach, training and consultation to child service programs in the community. LRCH currently provides ongoing consultation to the Chicago Department of Public Health Safe State Program, Ada S. McKinley Emergency Foster Care program, the Chicago Police Department Crisis Intervention team and the Vernon Park Church of God, among others. The program has provided training to many agencies, including: The Little City Foundation, Cook County State Attorney's Office, Cook County Public Guardian's Office, various Chicago Public Schools, the University of Chicago Department of Psychiatry and Department of Developmental and Behavioral Pediatrics, Casa Central and the Illinois Violence Prevention Authority. In addition, the Behavioral Sciences Department gives a number of lectures and community presentations throughout the year to school and professional groups.LRCH also assists DCFS in providing initial health screenings prior to placement for abused and neglected children who come into custody. LRCH assists the Illinois Department of Healthcare and Family Services as an enrollment site for a health insurance program for low income children and families.Medical Home Program:LRCH is a NCQA-recognized Patient-Centered Medical Home (PCMH) that offers children from birth to age 18 with developmental problems and/or medically complex conditions an interdisciplinary model for primary care. The program utilizes a cross-disciplinary pediatric care team to work in partnership with patients and families to ensure all of the medical and non-medical needs of the patient are met. Through the use of shared patient data in the EMR and robust case management, the program focuses on outcomes while reducing costs associated with duplicative and fragmented care. The American Journal of Managed Care recently published results from a study that showed pediatric PCMH patients were 23% less likely to be hospitalized, required 17% fewer ED services and cost 14.5% less than pediatric non-PCMH patients. Through the medical home program, LRCH provides ongoing healthcare and social supports to children with special needs and their families from infancy until adulthood. This program delivers care and service that is family-centered; comprehensive; holistically addressing the child's needs; coordinated; team driven; and culturally sensitive. LRCH's "one stop shopping" medical home is a particularly important model when working with families who not only have a child with special needs, but also are burdened with other economic stressors. This allows for better and easier access to care, as well as maximizing positive outcomes over the long term while lowering the use of high cost services like duplication of diagnostic procedures and treatments, unnecessary emergency room use and inpatient hospitalization.Case Management Program:The La Rabida Children's Hospital Case Management Program goal is to provide care coordination, assessment, and education across the inpatient and outpatient spectrum of care to children with chronic conditions and developmental delays and disabilities. The Program's team of case managers (nurses and social workers) has extensive experience and knowledge uniquely qualifying them to serve La Rabida's patients and families. Most of the social workers are Licensed Clinical Social Workers (LCSW). Nurse expertise includes Nurse Practitioners (who also serve as providers in the outpatient clinics), those trained to case manage specific chronic conditions, failure to thrive and technology dependent children.Together they provide services to over half of the hospital's patientpopulation each year. While case management services are available to all patients and families, their most intensive interventions focus on patients that are medically complex and with more than one health condition and/or health care provider. The Case Management Program makes it possible to effectively provide continuous chronic care to large groups of children with various conditions from infancy to adulthood.The program also assists the families of children with chronic conditions to navigate the necessary support systems. Each child and family is assessed to determine which community linkages need to be established. Case management coordinates care between LRCH providers and external providers such as subspecialists, Child and Family Connections, Chicago Board of Education and other Education Programs, Ounce of Prevention, Division of Specialized Care for Children (DSCC). Children's Home and Aid Society, Erickson Institute, Department of Child and Family Services, home health care agencies and medical equipment vendors. The Case Management Program has a significant impact on the ability of the family to provide necessary home care and to minimize hospitalization.The Case Management Program performs a large array of activities. While patients and their families may receive services anywhere from a few months to many years, these activities must occur year round on an ongoing basis to ensure children and their families receive needed services in a timely manner. Following is a list of the most common activities performed by Case Management staff.-Coordination of multiple medical services and providers, includingcoordination of the management of technology dependent children in the home.-Patient and caregiver education. For example, diabetes classes are given to caregivers, extended family and school personnel to understand how to manage the disease.-The State of Illinois mandates special classes for caregivers before a medically complex child can be released to the home. These weekly classes run in four week intervals, and include: G-tube care, Tracheotomy care, Ventilator care, and CPR/airway obstruction care.-Ordering of home care services (nursing and equipment).-Telephone Management (Diabetes). Toll free call in numbers for patients and their families staffed by diabetes specialists. In addition to providing children and their families with a way to update the Diabetes team on their current glucose readings, it provides patients and their families with 24/7 access to a clinical nurse specialist who gives recommendations on medication, nutrition and exercise adjustments over the telephone.-Feeding evaluations.-Follow up of newborn screening results (sickle cell diseases).-Wound management consultation.-Coordination of inpatient and outpatient rehabilitation program.-Collaboration with community agencies, such as Division of SpecializedCare for children (DSCC).-Coordination of school needs, including: assistance in preparation of 504 Plans, a legally binding document that spells out exactly what special education services the child will receive and why. It includes the child's specific disability placement, services such as a one-on-one aide and therapies, academic and behavioral goals, a behavior plan if needed, percentage of time in regular education, and progress reports from teachers and therapists. 0 Donations for hospital patients 45999 FMV Toys, blankets, and games. Part I, Line 2: Tangible items are given to patients, i.e., toys, blankets and games. No monitoring is required. 1 X X X 0 0 0 0 0 0 0 1 0 Mark D Renfree VP Finance 288474 0 20467 0 1290 0 31870 0 21382 0 363483 0 0 0 Janet Haines VP Fund Dvlp. & External Affairs 188351 0 8517 0 944 0 6008 0 8433 0 212253 0 0 0 Aden Henry VP Patient Care Service 232674 0 15830 0 570 0 22780 0 18716 0 290570 0 0 0 Brenda Wolf President/CEO 345120 0 37954 0 7106 0 56677 0 20850 0 467707 0 0 0 Ana Carvalho VP Strat. Integ./Ex. Director 214218 0 15435 0 1980 0 6726 0 29104 0 267463 0 0 0 Dr David Soglin Chief Medical Officer 219904 0 10000 0 546 0 0 0 16603 0 247053 0 0 0 Michael Gallery Pharmacy Manager 150342 0 0 0 1980 0 30882 0 20492 0 203696 0 0 0 Frances Lefkow Director of Human Resource 170128 0 6835 0 1980 0 33449 0 20420 0 232812 0 0 0 Sylvia Williams Director of Inpatient Nursing 153711 0 5062 0 1265 0 31196 0 2528 0 193762 0 0 0 Colleen Harper Director of Rehab/Development 134586 0 6788 0 1660 0 48818 0 18901 0 210753 0 0 0 Patricia DiFiglio Director of Quality Risk Management 123957 0 7578 0 1674 0 0 0 20878 0 154087 0 0 0 Part I, Line 7 Bonuses are subject to approval by the Executive Committee of the Board. Alper Services Inc Howard Alper, Trustee, is an owner of Alper Services, Inc. 205099 Insurance premiums in which Howard Alper received commissions for brokerage services. 0 X 4 35677 Market Quote X Various gifts for children 181 82996 FMV X Tickets 13 18850 FMV 0 0 0 1 Part I, Column (b): Number of transactions. Part I, Line 32b: La Rabida utilizes Bank of America Merrill Lynch to accept and liquidate stock contributions. The stock contributions are usually sold within 24 hours of the date of the donation, with the resulting cash proceeds immediately transferred to LaRabida. Form 990, Part VI, Section A, line 6 Members of LRCH's governing body consists of Active Trustees and Special Trustees of LRCH. Form 990, Part VI, Section B, line 11 Form 990 and appurtenant schedules are prepared by an outside accounting firm using information provided by financial management. Form 990 is reviewed by LRCH's finance leaders, Audit Committee, Executive Committee and Board of Trustees before filing. Form 990, Part VI, Section B, line 12c On a yearly basis, all Trustees and Officers are required to complete a conflict of interest document in accordance with hospital policy. A report of the disclosures is presented to the Contracts and Professional Services Committee for review and determination of any conflicts and their findings are presented to the Board of Trustees. Potential conflicts are regularly monitored throughout the year. Should a conflict arise, the Committee will determine the necessary action such as recusing the Trustee or Officer from decision-making regarding the transaction. Form 990, Part VI, Section B, line 15 The Compensation Committee of the Board of Trustees, as needed, engages external compensation consultants to advise it on competitive pay rates for the officers of the Hospital. The Compensation Committee is comprised of non-employee independent members. Discussion is held by the committee and a recommendation is presented to the Executive Committee of the Board of Trustees for approval. All compensation discussions and work performed is documented contemporaneously in the Board minutes. Form 990, Part VI, Section C, line 19 LRCH does not make its governing documents or conflict of interest policy available to the public. Financial Statements are available on the Illinois Attorney General's website. Form 990, Part IX, line 11g Purchased Medical Services: Program service expenses 4,349,820. Management and general expenses 0. Fundraising expenses 0. Total expenses 4,349,820. Other Professional Service Fees: Program service expenses 1,140,299. Management and general expenses 926,288. Fundraising expenses 60,615. Total expenses 2,127,202. Form 990, Part XI, line 9: Change in Interest of Foundation -1,480,531. Change in Pension Obligation -5,314,312. La Rabida Children's Foundation 6501 S Promontory Drive Chicago IL 606491935 363240477 Supporting Organization IL 501(C)(3) 11-Type III-Non-FI N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 La Rabida Children's Foundation C 1700000 FMV La Rabida Children's Foundation Q 21447 FMV