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NORTHWESTERN MEMORIAL HEALTHCARE: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
NORTHWESTERN MEMORIAL HEALTHCARE (EIN 36-2169179)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-10-26
IRS object ID
201643009349300014
Schema version
2015v2.1
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)
Return2016-10-26T08:46:48-05:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN420714325PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RSM US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11 S WACKER DRIVE STE 800AddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP60606ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362169179EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Palos Community HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlPALOBusinessNameControlTxt
Phone7089234000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line112251 S 80th AvenueAddressLine1Txt
CityPalos HeightsCityNm
State AbbreviationILStateAbbreviationCd
ZIP604630930ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDr Terrence MoisanPersonNm
Person TitlePresident & CEOPersonTitleTxt
Phone7089234000PhoneNum
Signature2016-10-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWayne HarderPreparerPersonNm
PTINP00294296PTIN
Phone3126343400PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2017-02-10 21:41:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDr Terrence MoisanPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line112251 S 80th AvenueAddressLine1Txt
CityPalos HeightsCityNm
State AbbreviationILStateAbbreviationCd
ZIP604630930ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$595,844,386GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.paloscommunityhospital.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1972FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionPalos Community Hospital (Palos) is a 501(c)(3) community hospital whose primary objective is the provision of inpatient and outpatient services that are responsive to the health care needs of the residents of southwestern Cook County and northeastern sections of Will County.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee3310TotalEmployeeCnt
Total Volunteers836TotalVolunteersCnt
Total Gross UBI$84,325TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm-$48,080NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$750,923PYContributionsGrantsAmt
CY Contributions Grants$576,708CYContributionsGrantsAmt
PY Program Service Revenue$354,038,951PYProgramServiceRevenueAmt
CY Program Service Revenue$384,875,076CYProgramServiceRevenueAmt
PY Investment Income$30,031,252PYInvestmentIncomeAmt
CY Investment Income$4,644,726CYInvestmentIncomeAmt
PY Other Revenue$8,013,703PYOtherRevenueAmt
CY Other Revenue$6,260,677CYOtherRevenueAmt
PY Total Revenue$392,834,829PYTotalRevenueAmt
CY Total Revenue$396,357,187CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$197,457,271PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$204,598,821CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$109,172CYTotalFundraisingExpenseAmt
PY Other Expenses$156,213,497PYOtherExpensesAmt
CY Other Expenses$178,899,051CYOtherExpensesAmt
PY Total Expenses$353,670,768PYTotalExpensesAmt
CY Total Expenses$383,497,872CYTotalExpensesAmt
PY Revenues Less Expenses$39,164,061PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$12,859,315CYRevenuesLessExpensesAmt
Total Assets BOY$875,786,472TotalAssetsBOYAmt
Total Assets EOY$705,059,588TotalAssetsEOYAmt
Total Liabilities BOY$517,581,046TotalLiabilitiesBOYAmt
Total Liabilities EOY$540,736,804TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$358,205,426NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$164,322,784NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionThe primary objective of Palos is to provide high quality patient care that is responsive to the health care needs of the residents of southwestern Cook County and northeastern sections of Will County. Palos is committed to a continued review and analysis of the changing needs of the community it serves and to respond with services based upon those needs.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$221,950,634ExpenseAmt
Revenue$283,526,716RevenueAmt
DescIt is the policy of Palos Community Hospital to provide quality medicalhealth care to all persons regardless of race, creed, sex, national origin, handicap, age, or ability to pay. Palos recognizes that not all individuals possess the ability or means to purchase essential medical services and further, that our mission is to serve our community with respect to providing healthcare services and healthcare education. Therefore, in keeping with Palos's commitment to serve all members of the community, charity and/or subsidized care will be considered where the need and/or inability to pay are identified.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$24,224,024ExpenseAmt
Revenue$27,842,406RevenueAmt
DescPalos Community Hospital provides a continuum of cardiovascular services - from diagnosis and treatment through recovery and rehabilitation - to ensure that our patients receive the care they need close to home. Prior to the start of the program in 2005, Palos transferred patients from the local community to other hospitals. Within 3 years, Palos ranked 14th in Illinois for heart volume. This community need has grown as can be seen with continued increases in volume since the program began. In a recent report from the Society of Thoracic Surgeons, data revealed that with respect to in hospital mortality and cardiopulmonary bypass time as well as complications, Palos performed better than the median statistics for similar facilities. For many patients, heart failure and/or COPD can be difficult to manage with the increased chance of hospital readmission and other complications. To help patients stay healthy, Palos offers a Heart Failure and COPD Wellness Clinic. While admitted to the hospital, nurses teach patients about their condition to help them better understand living with chronic illness. In the clinic, an Advanced Practice Nurse or a Respiratory Therapist, provides one-on-one, disease specific education including a focused physical assessment and treatments or medications at the time of the visit. The clinic staff focuses on helping patients manage their health to avoid readmission. The newly constructed electrophysiology lab at Palos provides the cardiologists with advanced technology to treat complex heart dysrhythmias. Palos now provides our community with a comprehensive state of the art approach to prevention, diagnosing, treating and managing heart disease. Palos recently earned a Blue Distinction Center+ designation for Cardiac Care.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$21,647,308ExpenseAmt
Revenue$21,501,796RevenueAmt
DescCare delivered by Palos Community Hospital extends beyond the four walls of the hospital building through care coordination efforts including Home Health, Private Duty, and Hospice, the Home Delivered Meal Program and Lifeline. During 2015 a multidisciplinary team comprised of physicians, nurses, ancillary professionals, and information technology specialists developed, revised and implemented systems and process to provide a seamless continuum of care for our patients both inside and outside of the hospital. This collaborative effort focuses on promoting wellness and preventing admission and readmission. Coordination of care through the Nurse Navigators and Care Coordinators support the patients, families and physicians by directing them to the appropriate resources to help to provide high quality care for the patients. Palos established clinical affiliations to bring specialty/tertiary care to the community. Through our clinical affiliation with Loyola Medicine, cancer treatment services with academic level specialists has been established in the community at the Palos South Campus. This enables local residents access to tertiary level services without leaving the community and is an example of organizations collaborating intended to bring the patients the right care at the right place. In addition, Palos initiated a telestroke program with Loyola allowing for real time clinical evaluation by Loyola specialists of patients with stroke symptoms in Palos Hospital or the emergency department and facilitating expedited treatment, intervention or transfer of these patients to enhance outcomes. This collaboration and a common electronic medical record platform, EPIC, has also allowed for HIPAA compliant exchange of patient information between institutions facilitating continuity of care. During the past year, Palos has instituted a number of collaborative efforts with medical staff members focused on the promotion of population based health including the establishment of a heart failure clinic, participation in the Medicare Shared Savings Program for specific bundles, the development of a palliative care service and other post-acute care efforts focused on decreased readmissions and enhanced care coordination. Palos' Home Health, Private Duty and Hospice services provide quality personal care and support to patients in their homes, nursing homes or hospitals. The Home Health staff assists the chronically ill, persons with functional impairments, those needing specialized skilled care at home, those recovering from a hospital stay and the terminally ill. In 2015, Home Health staff from Palos made more than 99,000 home care visits, more than 31,000 hospice visits and provided nearly 40,000 hours of private duty nursing assistance. Palos also assists the homebound and elderly in the community with two special programs, Home Delivered Meals and Lifeline. Home Delivered Meals are provided to people who are homebound, live alone and are unable to prepare their own meals. The program offers recipients two meals a day which are planned by hospital dietitians, prepared in the hospital kitchen and delivered by Palos volunteers five days a week. The meals are available at a discounted rate by the hospital. The Home Delivered Meals program has an average of 50 recipients living in Palos Heights, Palos Hills, Palos Park, Orland Park and Orland Hills. To further support homebound and elderly area residents, Palos offers Lifeline, a medical alert system. The device, installed in participants' homes, can help detect falls and provide a simplified means to signal for assistance from a loved one or emergency services if needed. Palos can support up to 170 participants at a time.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (4 entries)

ExpenseExpenseAmtRevenueRevenueAmtDescDesc
$15,190,224$10,903,636Palos Medical Group is a physician practice that employs primary care physicians and select specialists to help better serve the needs of the community as it relates to the projected shortage of such physicians.
$15,122,367$34,054,989The Palos Emergency Department has increasingly become a resource for health care in the community. During the last three years annual visits have increased by 9,000. A performance improvement project increased capacity in the Emergency Department through earlier patient discharges, improved efficiencies in imaging and laboratory service. Overall patient satisfaction increased.
$14,671,758$6,794,439Palos has long served as a community resource for musculoskeletal care. Community education is provided on a variety of topics such as orthopaedic surgery, nutrition and exercise as well as information on improving balance and safety. Additionally, for patients having joint replacement surgery, a transition care coordinator works with patients to streamline their surgical care and track their progress. Patients attend a comprehensive preoperative education program to help better understand the surgical process, how to prepare for surgery, what is involved in the recovery process and what options there are for post hospital care.
$9,045,052$4,549,067Palos has continued to offer behavioral health care services as other providers have limited access. The commitment to these services incorporates both inpatient and outpatient programs intended to respond to crisis situations while providing ongoing treatment and support programs intended to meet the needs of individuals and families in the community struggling with relationship problems, emotional issues, psychological disorders and substance abuse. The programs include alcohol treatment; chemical dependency; group therapies for mental health or substance abuse issues; intensive outpatient programs; Kids Recover Too, since children in the family can be especially hard-hit by a parent's chemical abuse or dependency; and the Partial Hospital Program for those needing more intensive treatment for a psychiatric or dual diagnosis.
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$54,029,401TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$56,302,131TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$321,851,367TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign ActivitiesYes (1)ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt BondsYes (1)TaxExemptBondsInd
Invest Tax Exempt Bonds0InvestTaxExemptBondsInd
Escrow Account0EscrowAccountInd
On Behalf Of Issuer0OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded EntityYes (1)DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document210IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee3310EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial AccountYes (1)ForeignFinancialAccountInd
Foreign CountryCJForeignCountryCd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRoger RussellPersonNm
Phone7089234000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line112251 S 80th AvenueAddressLine1Txt
CityPalos HeightsCityNm
State AbbreviationILStateAbbreviationCd
ZIP604630930ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (28 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
Edward Mulcahy
Chairman2.001.00Yes (X)Yes (X)$0$0$0
Gordon B Nash Jr
Vice Chair2.001.00Yes (X)Yes (X)$0$0$0
Lawrence Hunt
Secretary/Director2.00Yes (X)Yes (X)$0$0$0
Dr Terrence Moisan
President & CEO40.0011.00Yes (X)Yes (X)$903,888$0$107,490
Lucie Boyadjian
Director2.00Yes (X)$0$0$0
Dr Charles Polcaster
Director2.001.00Yes (X)$0$0$0
Philip A Salvador
Director (until 9/23)2.00Yes (X)$0$0$0
Dr Mark Sinibaldi
Director/Physician42.002.00Yes (X)$329,022$0$36,426
Dr Michael Sobczak
Director2.00Yes (X)$0$0$0
Jack Vainauskas
Director2.001.00Yes (X)$0$0$0
Gary Collins
Director2.00Yes (X)$0$0$0
William King
Director (until 12/1)2.00Yes (X)$0$0$0
Timothy J McCarthy
Director2.00Yes (X)$0$0$0
Charles E Reiter III
Executive VP/General Counsel40.0010.00Yes (X)$442,381$0$61,699
Barbara Medley
Asst. Secretary40.00Yes (X)$79,065$0$0
Tom Honan
Interim Financial Officer40.00Yes (X)$389,827$0$0
Roger Russell
VP Finance/Treasurer40.0010.00Yes (X)$113,587$0$14,278
David B Manchester
VP Prof. Services (until 1/24)40.00$246,111$0$5,955Yes (X)
Mary C Denisienko
VP Human Resources40.00$297,554$0$36,573Yes (X)
Rosann S Demask
VP Nursing40.00$284,082$0$44,777Yes (X)
Patricia Heerlein
VP Clinical Services40.00$240,571$0$21,949Yes (X)
Muhamad Krad
Physician40.00$426,072$0$25,160Yes (X)
Amit Joshi
Physician40.00$394,979$0$43,318Yes (X)
Alex DeJong
Physician40.00$386,736$0$38,744Yes (X)
Michael Lynch
Physician40.00$383,972$0$36,665Yes (X)
Richard DeJong
Physician40.00$373,944$0$38,673Yes (X)
Dr Thomas Vasdekas
Former Director0.00$65,000$0$0Yes (X)
Hugh A Rose
Former VP Finance/CFO0.00$108,174$0$496Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$5,464,965TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$512,203TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K126IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Pepper Construction Company
18505 W Creek DriveTinley ParkIL60477Construction Services$31,021,617
Epic Systems Corporation
1979 Milky WayVeronaWI53593Computer Software Services$5,624,079
Matthei & Colin Associates
332 S Michigan AvenueChicagoIL60604Architectural Services$3,145,174
Manpower
21271 Network PlaceChicagoIL60673Food Service & Housekeeping Services$1,499,258
Walsh Construction II LLC
929 W Adams StreetChicagoIL60607Construction Services$1,467,004
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K56CntrctRcvdGreaterThan100KCnt
All Other Contributions$576,708AllOtherContributionsAmt
Total Contributions$576,708TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmt
Net Patient Revenue621110$374,275,568$374,191,243$84,325
Provider Tax Revenue900099$10,690,717$10,690,717
MRI Joint Venture900099-$91,209-$91,209
FieldValueIRS element (for citing)
Total Program Service Revenue$384,875,076TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,576,068TotalRevenueColumnAmt
Exclusion$2,576,068ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,374,378RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$880,316RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$494,062RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$494,062TotalRevenueColumnAmt
Exclusion$494,062ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$200,568,000SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$198,499,342SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$2,068,658SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,068,658TotalRevenueColumnAmt
Exclusion$2,068,658ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$208,900FundraisingGrossIncomeAmt
Fundraising Direct Expenses$107,541FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$101,359TotalRevenueColumnAmt
Exclusion$101,359ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtExclusionExclusionAmt
Intercompany Revenue900099$2,785,102$2,785,102
Cafeteria Revenue900099$1,282,958$1,282,958
Meaningful Use900099$16,034$16,034

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,581,162TotalRevenueColumnAmt
Related Or Exempt Func Income$1,581,162RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,665,256OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$396,357,187TotalRevenueColumnAmt
Related Or Exempt Func Income$389,173,049RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$84,325UnrelatedBusinessRevenueAmt
Exclusion$6,523,105ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$4,273,240TotalAmt
Management And General$4,273,240ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$160,796,651TotalAmt
Program Services$137,243,096ProgramServicesAmt
Management And General$23,553,555ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$8,797,083TotalAmt
Program Services$7,313,696ProgramServicesAmt
Management And General$1,483,387ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$19,111,898TotalAmt
Program Services$15,826,833ProgramServicesAmt
Management And General$3,285,065ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$11,619,949TotalAmt
Program Services$9,656,230ProgramServicesAmt
Management And General$1,963,719ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,557,218TotalAmt
Program Services$11,850ProgramServicesAmt
Management And General$2,545,368ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$1,434,245TotalAmt
Program Services$1,157,153ProgramServicesAmt
Management And General$277,092ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$172,474TotalAmt
Management And General$172,474ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$467,697TotalAmt
Management And General$467,697ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$13,033,170TotalAmt
Program Services$8,658,629ProgramServicesAmt
Management And General$4,374,541ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$899,302TotalAmt
Program Services$9,429ProgramServicesAmt
Management And General$889,873ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,306,077TotalAmt
Program Services$3,419,864ProgramServicesAmt
Management And General$1,886,213ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$5,172,084TotalAmt
Program Services$1,125,203ProgramServicesAmt
Management And General$4,046,881ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$4,394,826TotalAmt
Program Services$3,674,047ProgramServicesAmt
Management And General$720,779ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$427,044TotalAmt
Program Services$411,135ProgramServicesAmt
Management And General$15,909ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$211,067TotalAmt
Program Services$172,816ProgramServicesAmt
Management And General$38,251ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$11,507,047TotalAmt
Program Services$11,507,047ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$23,556,852TotalAmt
Program Services$18,897,577ProgramServicesAmt
Management And General$4,659,275ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,933,771TotalAmt
Program Services$6,069,368ProgramServicesAmt
Management And General$864,403ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies$59,720,555$59,720,555
Bad Debt Expense$22,167,134$22,167,134
IL Bed Tax Assessment$11,558,835$11,558,835
Repairs and Maintenance$4,179,269$4,179,269

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$5,200,384TotalAmt
Program Services$3,250,870ProgramServicesAmt
Management And General$1,840,342ManagementAndGeneralAmt
Fundraising$109,172FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$383,497,872TotalAmt
Program Services$321,851,367ProgramServicesAmt
Management And General$61,537,333ManagementAndGeneralAmt
Fundraising$109,172FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,925BOYAmt
EOY$6,155EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$10,621,147BOYAmt
EOY$2,873,527EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$43,591,141BOYAmt
EOY$46,375,342EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$6,324,715BOYAmt
EOY$2,175,909EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,335,433BOYAmt
EOY$2,683,773EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,528,664BOYAmt
EOY$2,955,992EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$722,702,145LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$240,579,264LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$440,373,629BOYAmt
EOY$482,122,881EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$359,983,334BOYAmt
EOY$155,934,830EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$1,857,799BOYAmt
EOY$1,766,590EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$102,500EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$8,165,685BOYAmt
EOY$8,062,089EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$875,786,472BOYAmt
EOY$705,059,588EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$105,505,271BOYAmt
EOY$118,773,863EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$367,670,000BOYAmt
EOY$379,540,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$44,405,775BOYAmt
EOY$42,422,941EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$517,581,046BOYAmt
EOY$540,736,804EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$358,092,770BOYAmt
EOY$164,112,397EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$112,656BOYAmt
EOY$210,387EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$358,205,426BOYAmt
EOY$164,322,784EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$875,786,472BOYAmt
EOY$705,059,588EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$12,859,315ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$5,785,306NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$200,956,651OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,330,629OtherCostOrOtherBasisAmt
Book Value$14,330,629BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$491,837,722OtherCostOrOtherBasisAmt
Depreciation$138,060,974DepreciationAmt
Book Value$353,776,748BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$172,232,241OtherCostOrOtherBasisAmt
Depreciation$102,518,290DepreciationAmt
Book Value$69,713,951BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,301,553OtherCostOrOtherBasisAmt
Book Value$44,301,553BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$482,122,881TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
Tax Exempt Bond Liability Premium$2,732,466
Due to Affiliates$2,311,159
Supplemental Executive Retirement Plan Liability$223,100
Professional Liability Insurance Reserve$34,016,099
Other Long-term Liabilities$3,140,117
FieldValueIRS element (for citing)
Total Liability$42,422,941TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X, Line 2:FormAndLineReferenceDesc
ExplanationThe 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. Palos Medical Group is a disregarded entity and through December 31, 2014, was considered part of St. George Corporation for income tax filing purposes. Effective January 1, 2015, Palos Medical Group is considered part of the Hospital for income tax filing purposes. St. George Assurance is incorporated under the laws of the Cayman Islands, which imposes no tax on income or capital gains. However, St. George Assurance is subject to U.S. federal corporate taxation to the extent that it generates income that is effectively connected with a U.S. trade or business. St. George Assurance is not engaged in any such trade or business in the U.S. Accordingly, income taxes are not provided for in the accompanying financial statements. 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 this return is 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 taxable income (UBTI). UBTI is reported on Form 990T, as appropriate. The benefit 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 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. Upon the adoption of the FASB-issued guidance at January 1, 2007, and since that date through December 31, 2015, there were no unrecognized tax benefits identified and recorded as a liability. Forms 990 and 990T 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 and 990T filed by the Hospital are no longer subject to examination for the years 2011 and prior.ExplanationTxt

Schedule F IRS990ScheduleF

Account Activities Outside US AccountActivitiesOutsideUSGrp

FieldValueIRS element (for citing)
RegionCentral America and the CaribbeanRegionTxt
Type Of Activities ConductedInvestmentsTypeOfActivitiesConductedTxt
Region Total Expenditures$100,000RegionTotalExpendituresAmt
FieldValueIRS element (for citing)
Subtotal Offices0SubtotalOfficesCnt
Subtotal Employees0SubtotalEmployeesCnt
Continutation Total Office0ContinutationTotalOfficeCnt
Continutation Total Employee0ContinutationTotalEmployeeCnt
Total Office0TotalOfficeCnt
Total Employee0TotalEmployeeCnt
Subtotal Spent$100,000SubtotalSpentAmt
Continuation Spent$0ContinuationSpentAmt
Total Spent$100,000TotalSpentAmt
Transfer To Foreign CorpYes (1)TransferToForeignCorpInd
Interest In Foreign Trust0InterestInForeignTrustInd
Foreign Corp OwnershipYes (1)ForeignCorpOwnershipInd
Passive Foreign Investmest Co0PassiveForeignInvestmestCoInd
Foreign Partnership0ForeignPartnershipInd
Boycott Countries0BoycottCountriesInd

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1Dinner/CelebrationEvent1Nm
Gross Receipts Event1$208,900GrossReceiptsEvent1Amt
Gross Revenue Event1$208,900GrossRevenueEvent1Amt
Rent Facility Costs Event1$91,630RentFacilityCostsEvent1Amt
Other Direct Expenses Event1$15,911OtherDirectExpensesEvent1Amt
Gross Receipts Total$208,900GrossReceiptsTotalAmt
Gross Revenue Total Events$208,900GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$91,630RentFcltyCostsTotalEventsAmt
Oth Direct Expnss Total Events$15,911OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$107,541DirectExpenseSummaryEventsAmt
Net Income Summary$101,359NetIncomeSummaryAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other1000.000000000000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed Budget0ExpensesExceedBudgetInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$2,849,720TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$2,849,720NetCommunityBenefitExpnsAmt
Total Expense0.00790TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Activities Or Programs1ActivitiesOrProgramsCnt
Total Community Benefit Expns$37,932,659TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$28,585,689DirectOffsettingRevenueAmt
Net Community Benefit Expns$9,346,970NetCommunityBenefitExpnsAmt
Total Expense0.02590TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Total Community Benefit Expns$40,782,379TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$28,585,689DirectOffsettingRevenueAmt
Net Community Benefit Expns$12,196,690NetCommunityBenefitExpnsAmt
Total Expense0.03380TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs5ActivitiesOrProgramsCnt
Total Community Benefit Expns$863,342TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$91,361DirectOffsettingRevenueAmt
Net Community Benefit Expns$771,981NetCommunityBenefitExpnsAmt
Total Expense0.00210TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$200,100TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$103,477DirectOffsettingRevenueAmt
Net Community Benefit Expns$96,623NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Activities Or Programs3ActivitiesOrProgramsCnt
Total Community Benefit Expns$24,738,808TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$16,856,663DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,882,145NetCommunityBenefitExpnsAmt
Total Expense0.02180TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

FieldValueIRS element (for citing)
Activities Or Programs2ActivitiesOrProgramsCnt
Total Community Benefit Expns$124,176TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$124,176NetCommunityBenefitExpnsAmt
Total Expense0.00030TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs10ActivitiesOrProgramsCnt
Total Community Benefit Expns$25,926,426TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$17,051,501DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,874,925NetCommunityBenefitExpnsAmt
Total Expense0.02450TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs12ActivitiesOrProgramsCnt
Total Community Benefit Expns$66,708,805TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$45,637,190DirectOffsettingRevenueAmt
Net Community Benefit Expns$21,071,615NetCommunityBenefitExpnsAmt
Total Expense0.05830TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$22,167,134BadDebtExpenseAmt
Reimbursed By Medicare$116,239,497ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$131,079,053CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall-$14,839,556MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
Cost To Charge RatioYes (X)CostToChargeRatioInd
FieldValueIRS element (for citing)
Written Debt Collection PolicyYes (1)WrittenDebtCollectionPolicyInd
Financial Assistance PrvsnYes (1)FinancialAssistancePrvsnInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Palos Community HospitalBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line112251 South 80th AvenueAddressLine1Txt
CityPalos HeightsCityNm
State AbbreviationILStateAbbreviationCd
ZIP60463ZIPCd
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Palos Community HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Facility1FacilityNum
First Licensed CY Or PY0FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY0TaxExemptHospitalCYOrPYInd
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
Existing ResourcesYes (X)ExistingResourcesInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Community Hlth Needs Id ProcessYes (X)CommunityHlthNeedsIdProcessInd
Consulting ProcessYes (X)ConsultingProcessInd
Information GapsYes (X)InformationGapsInd
CHNA Conducted15CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other FcltsYes (1)CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts0CHNAConductedWithNonFcltsInd
CHNA Report Widely AvailableYes (1)CHNAReportWidelyAvailableInd
Rpt Available On Own WebsiteYes (X)RptAvailableOnOwnWebsiteInd
Own Website URLwww.paloscommunityhospital.org/CHNAOwnWebsiteURLTxt
Other WebsiteYes (X)OtherWebsiteInd
Other Website URLhttp://www.palos.healthforecast.net/OtherWebsiteURLTxt
Paper Copy Public InspectionYes (X)PaperCopyPublicInspectionInd
Implementation Strategy AdoptYes (1)ImplementationStrategyAdoptInd
Implementation Strategy Adpt15ImplementationStrategyAdptYr
Strategy Posted Website0StrategyPostedWebsiteInd
Strategy AttachedYes (1)StrategyAttachedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Family Incm Lmt Free DscntYes (X)FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care200.000000000000FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care1000.000000000000FPGFamilyIncmLmtDscntCarePct
Asset Level CriteriaYes (X)AssetLevelCriteriaInd
Medical Indigency CriteriaYes (X)MedicalIndigencyCriteriaInd
Insurance Status CriteriaYes (X)InsuranceStatusCriteriaInd
Underinsurance Stat CriteriaYes (X)UnderinsuranceStatCriteriaInd
Residency CriteriaYes (X)ResidencyCriteriaInd
Explained BasisYes (1)ExplainedBasisInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Described InfoYes (X)DescribedInfoInd
Described Suprt DocYes (X)DescribedSuprtDocInd
Provided Hospital ContactYes (X)ProvidedHospitalContactInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
FAP Available On WebsiteYes (X)FAPAvailableOnWebsiteInd
FAP Available On Website URLhttp://www.paloscommunityhospital.org/app/files/public/1999FAPAvailableOnWebsiteURLTxt
FAP App Available On WebsiteYes (X)FAPAppAvailableOnWebsiteInd
FAP App Available On Website URLhttp://www.paloscommunityhospital.org/app/files/public/1996FAPAppAvailableOnWebsiteURLTxt
FAP Summary On WebsiteYes (X)FAPSummaryOnWebsiteInd
FAP Summary On Website URLhttp://www.paloscommunityhospital.org/patients-visitors/billing/FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No ChargeYes (X)FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No ChrgYes (X)FAPAppAvlblOnRequestNoChrgInd
FAP Sum Avlbl On Request No ChrgYes (X)FAPSumAvlblOnRequestNoChrgInd
FAP Notice DisplayedYes (X)FAPNoticeDisplayedInd
FAP Actions On NonpaymentYes (1)FAPActionsOnNonpaymentInd
Collection Activities0CollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Medicare RatesYes (X)MedicareRatesInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledYes (1)AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Palos Community HospitalPart V, Section B, Line 5: As part of the community health needs assessment, survey administrators sought input from key informants, those individuals who have a broad interest in the health of the community. A list of recommended participants was provided by MCHC member hospitals. This list included names and contact information for physicians, public health representatives, other health professionals, social service providers and a variety of other community leaders. Potential participants were chosen because of their ability to identify primary concerns of the populations with whom they work, as well as of the community overall. Key informants were contacted by email, introducing the purpose of the survey and providing a link to take the survey online; reminder emails were sent as needed to increase participation. In all, 29 community stakeholders in the Palos Community Hospital service area took part in the Online Key Informant Survey.
Palos Community HospitalPart V, Section B, Line 6a: The 2015 Community Health Needs Assessment was facilitated by the Metropolitan Chicago Healthcare Council (MCHC) on behalf of participating member hospitals and health systems. These hospitals and health systems include: Alexian Brothers Health System/Amita Health (Alexian Brothers Behavioral Health Hospital, Alexian Brothers Medical Center, St. Alexius Medical Center); Amita Health (Adventist Bolingbrook Hospital, Adventist GlenOaks Hospital, Adventist Hinsdale Hospital, Adventist LaGrange Memorial Hospital); Edward Elmhurst Healthcare (Edward Hospital & Health Services, Elmhurst Memorial Hospital); Franciscan Alliance (Franciscan St. James Health); Ingalls Health System (Ingalls Memorial Hospital); Little Company of Mary Hospital and Health Care Centers; Loretto Hospital; Northwest Community Healthcare (Northwest Community Hospital, Northwestern Memorial Hospital); Northwestern Medicine (Central DuPage Hospital, Northwestern Lake Forest Hospital); Palos Community Hospital; Rush System for Health (Rush Oak Park Hospital, Rush University Medical Center); Saint Anthony Hospital; St. Bernard Hospital and Health Care Center; Swedish Covenant Hospital; Thorek Memorial Hospital; and the University of Chicago Medicine.
Palos Community HospitalPart V, Section B, Line 11: Palos Community Hospital formed an internal, multi-disciplinary committee to review the results of the CHNA and to evaluate, discuss and prioritize health issues as identified. The committee used the criteria focused on magnitude, scope/severity, Palos' ability to impact and the risk of inaction in determination of the areas of opportunity on which to focus.In consideration of the top health priorities identified through 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 Palos would focus on developing and/or supporting strategies and initiatives to improve: - Access to Health Care Services - Cancer - Diabetes - Stroke, Heart Disease & Respiratory Diseases - Immunizations & Infectious Diseases - Mental Health & Substance AbuseIn acknowledging the wide range of priority health issues that emerged from the CHNA process, Palos Community 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. As a consequence there were areas of opportunity identified in the CHNA which Palos has not prioritized to address due to the availability of other community based programs and services to better address these opportunities and the low volume of respondents within Palos' immediate service area requiring services. The areas of opportunity not addressed include: - Infant Health and Family Planning - Chronic Kidney Disease - HIV/AIDS - Tobacco Use - Nutrition, Physical Activity and Weight - Sexually Transmitted Diseases - Potentially Disabling Conditions - Oral Health - Injury and Violence PreventionWhile these opportunities were not addressed as priorities, it should be noted that many of the issues associated with these opportunities are routinely addressed through programs and services which have been developed in response to areas of opportunities on which Palos is focused. For example, nutrition counseling would always be an integral component in the provision of services focused on cardiac disease, cancer and diabetes. Likewise, substance abuse services would incorporate the teaching of harm reduction strategies as means for primary prevention of HIV/AIDS. Palos also offers access to smoking cessation information and education and incorporates smoking risk information in all clinical programs. Furthermore, Palos offers access to services to improve ADL and mobility through its home care and rehab services along with internal and external education initiatives designed to support independence and support people with activity limitations.Please refer to attached CHNA Implantation Plan for additional details.
Palos Community HospitalPart V, Section B, Line 22d: Palos Community Hospital implemented a financial assistance policy that goes above and beyond the requirements of Illinois Public Act 095-0965 "Hospital Uninsured Patient Discount Act". This state law was enacted with an effective date of April 1, 2009 and required that hospitals offer uninsured patients who met the minimum financial requirements (i.e. earnings less than 600% of the FPG and certain asset limitations) a rate equal to 135% of the hospital's most recently filed Medicare cost to charge ratio. Palos expanded the reach of this policy by extending the minimum financial requirements to 1,000% of the FPG to help more of its community qualify for a financial benefit and to give families that earn a lower percentage of the FPG deeper discounts. This policy was also extended to all clinically-necessary procedures and was not limited to emergency care only. Using the FPG, Palos created a set of discounts for patients without insurance that ranged from free care for those who earned less than 200% of the FPG to a 40% discount off of regularly billed charges for any uninsured patient who earned less than 1,000% of the FPG. Palos also created a policy to help those who are underinsured. Similar to its uninsured policy, the underinsured policy creates a set of discounts that can be applied to co-payments and deductibles owed for those patients that earn less than 300% of the FPG.
Palos Community HospitalPart V, Section B, Line 23: Please see explanation in Part V, Section B, Line 22d above.
Part V, Section B, line 3The sample design used for this effort consisted of a random sample of 216 individuals age 18 and older in the Palos Community Hospital Service Area. All administration of the surveys, data collection and data analysis was conducted by Professional Research Consultants, Inc. (PRC).
FieldValueIRS element (for citing)
Facility5FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdFacilityFacilityTxt
1 - Palos Home Health Care
15295 E 127th StLemontIL60439Home Health Care
2 - Palos Primary Care Center
15300 West Avenue Suite 122Orland ParkIL60462Primary Care Center
3 - Palos Diagnostic & Women's Center
17333 S LaGrange RdTinley ParkIL60477Diagnostic Testing and Women's Health
4 - Palos Intermediate Care Center
7340 W College DrivePalos HeightsIL60463Intermediate Care Center
5 - Palos Sleep Disorders Center
11900 Southwest HighwayPalos ParkIL60464Sleep Studies

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part I, Line 3c:Palos Community Hospital charity care is administered on a sliding scale based on the Federal Poverty Guidelines (FPG). Palos set the sliding scale to allow charity in excess of the regional minimum amount set forth by Illinois in the Hospital Uninsured Patient Discount Act by extending discounted care to patients with income levels up to 1,000% of the FPG vs. the minimum 600% as determined by law.All self-pay patients are provided information regarding our charity care program at the time of registration and are asked to complete a one-page application. This enables the Hospital to expedite the charity care approval process. For balances after insurance, patients are made aware of our charity care program via the statement they receive. Additional information is available on the Hospital's website.The Financial Counselors see approximately 10 patients daily for assistance with screening for Medicaid applications, financial assistance, payment plans, estimated pricing for services, account review/inquiries/complaints, Medicare liability, etc. The Financial Counselors assist patients with current, past and future visits. The Financial Counselors and Self Pay Collectors processed 3702 financial assistance applications in 2015. There were 2116 charity adjustments, 397 presumptive eligibility charity adjustments, 338 Medicare Bad Debt charity adjustments. There has been a decrease in the number of charity applications due to the Affordable Health Care Act. With the expansion of the Medicaid programs we have a significant increase in the number of patients who are already covered and/or qualify for Medicaid or Medicaid Replacement Plans.
Part I, Line 7:Cost amounts reported in Item 7 were calculated using available data including the overall hospital cost to charge ratio as well as direct and indirect costs for certain specific departments of the hospital.
Part I, Line 7, Column (f):The Bad Debt expense included on Form 990, Part IX, Line 25, Column (A), but subtracted for purposes of calculating the percentage in this column is $ 22,167,134.
Part II, Community Building Activities:Our focus has been on providing quality medical services to residents of the service area. However, Palos has also taken seriously its role as a corporate citizen and one of the area's largest employers. As such we have implemented and/or maintained programs/relationships that we feel help to improve the overall health of the community and the wellness of the people we serve. Palos Community Hospital serves as a site for transitional employment training through the Southwest Cook County Cooperative Association for Special Education. This program is intended to introduce career options for youths with disabilities as they transition from school to adult life better positioned for employment success.Palos Community Hospital representatives serve on committees focused on the betterment of the surrounding community. One representative is a member of the City of Palos Heights Economic Development Committee. This committee acts as an advisory board to the city council on matters of business district redevelopment, special events and more to assist in the promotion of current businesses. Another representative serves on the board of the Palos Chamber of Commerce focused on promoting the businesses as well as community amenities to the surrounding communities. Representatives from Palos' Behavioral Health department actively participate in a community-based collaborative effort to address the increasing use of illegal drugs in the surrounding area. The Orland Park Substance Awareness Forum includes representatives from village administration, police and fire departments, along with other agencies that assist in addressing substance abuse. Palos believes that given limited resources and time this serves our community more appropriately than the community building activities as defined in this schedule.
Part III, Line 2:Estimated bad debt expense is calculated by totaling the amounts from patient accounts written off as uncollectible plus an estimate of the uncollectible portion of accounts receivable, aged by financial class, all multiplied by the appropriate cost to charge ratio.
Part III, Line 3:Information to determine this amount is not available.
Part III, Line 4:Patient receivables due directly from patients are carried at the original charge for the service provided less amounts covered by third-party payors and less estimated allowances for doubtful accounts and charity care. Management estimates the allowance for doubtful accounts based on the aging of its accounts receivable and its historical collection experience for each payor type. Management estimates the allowance for charity care based on the Hospital's charity care policy and historical charity care experience. Recoveries of accounts receivable previously written off as uncollectible are recorded as a reduction of the provision for uncollectible accounts when received.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. The Hospital's allowance for uncollectible accounts for self-pay patients was approximately 36 and 22 percent of patient accounts receivable at December 31, 2015 and 2014, respectively. The Hospital's self-pay write-offs were $8,403 and $9,615 in 2015 and 2014, respectively. The increase in the allowance for uncollectible accounts is primarily the result of an increase in self pay portions that do not qualify for charity care and an increase in high copay/deductible plans under the Affordable Care Act that are uncollectible and the result of writing off fewer accounts in 2015. While the Hospital has experienced a decrease in self pay accounts, there has been an increase in these high copay/deductible plans. The Hospital updated its charity care and uninsured discount policies during 2014. The Hospital does not maintain a material allowance for uncollectible accounts from third-party payors, nor did it have significant write-offs from third-party payors.
Part III, Line 8:Medicare costs are calculated using the hospital wide cost to charge ratio. Palos does include the Medicare shortfall in its Illinois state community benefits report as Palos continues to treat its Medicare community despite the fact that its costs for these patients exceed reimbursement.
Part III, Line 9b:It is the policy of Palos not to pursue collection practices against patient balances known to qualify under the financial assistance policy.
Part VI, Line 2:In addition to the CHNA, Palos monitors trends in diseases, medical conditions, utilization of medical services and demographics that may affect the patients served and community at large. Palos uses this information as it designs and modifies programs and services to meet the needs of its patients and community either on its own or in collaboration with other entities. This information has demonstrated the need to focus on the management of an aging patient population, chronic health conditions, the incidence of readmission, and coordination of care from pre-hospitalization to post-acute.Specific initiatives undertaken by Palos in response to the assessment of the health care needs of its patients and the community include: - Participation in the Bundled Payments Care Improvement (BPCI)Initiatives for joint replacement, heart failure and stroke. - The development of a Heart and Lung Wellness Center - The initiation of a Palliative Care Program - The opening of a Clinical Decision Unit - Institution of the EPIC Healthy Planet accountable care and population health module.
Part VI, Line 3:At the time of registration, each patient is referred to a copy of Palos' financial assistance policy and asked to fill out a simple registration form that may help them qualify for charity care. This policy lays out the eligibility requirements and what the patient must do to qualify. Also at registration, any patient without insurance is advised as to what other programs they may qualify for and are given assistance in applying as necessary. Palos employs a company that helps patients apply for Medicaid coverage and SSI disability. Upon discharge, each patient receives a summary bill that includes information related to eligibility for financial assistance. All inpatients without insurance are visited by a financial counselor who helps direct the patient and their families to the appropriate level of assistance. Brochures explaining the charity care policy are displayed and available at registration areas and in the Emergency Department. Palos also displays the plain language summary of the financial assistance policy on the website along with the financial assistance application.
Part VI, Line 4:Communities within the hospital's service area have seen overall growth in population of approximately 7.6% from 2000 to 2014 with a current estimated population of 622,571. From 2014 to 2019, the population is expected to grow by 1.3%. Zip codes within the Palos Community Hospital service area include:60462, 60467, 60463, 60464, 60465, 60482, 60445, 60452, 60477, 60487, 60453, 60455, 60457, 60458, 60459, 60415, 60805, 60655, 60803, 60439, 60441, 60491, 60423, 60448, 60451Of those living within the service area of Palos Community Hospital:51% are female87% are white84% use English as their primary language at homeThe median age is 40.2 years30% are high school graduates23% have had some college, and30% have earned a bachelor's degree or beyond.7% of households are estimated to fall under the national poverty level.There are no other hospitals located in Palos' primary service area.
Part VI, Line 5:Palos Community Hospital is an acute care facility with 425 licensed beds, 14 operating rooms, nearly 600 medical staff physicians and approximately 3,100 employees. Within the service area, Palos serves as a resource for health education and wellness initiatives for residents. Palos continues to monitor the health care needs of its service area to insure the need for the services it offers and evaluate the opportunity to develop new programs and services as necessary. Palos works with and in support of other not-for-profit, educational, governmental, civic or community organizations, as appropriate, to promote health and wellness through awareness, education, research, access or support. Demonstrating Palos' commitment to disease prevention and wellness, more than 150 community education programs were held with approximately 3,000 participants during the year. These include programs such as Survive and Thrive, an event geared toward cancer survivors; Fall Prevention Fair, targeted at seniors to help them avoid falling; and The Ultimate Food Fight, informing attendees on how diet can prevent cancer. Recently, Palos established a relationship with The Cancer Support Center to bring additional support services to patients battling cancer and their loved ones. This includes a support group, group yoga and individualized visits from a Support Center representative. Additionally, Palos serves as a resource for health information to community members. Palos participated in health-focused events in Palos Heights, Orland Park and Homer Glen providing health screenings focused on either heart or bone health. Palos uses direct mail to inform service area residents about certain health conditions, community education programs offered through the hospital by subject matter experts as well as the related services available at Palos. To support local non-profit organizations, Palos provided more than twenty speaking presentations throughout 2015. Topics covered during these presentations include heart health, stress management and healthy eating. Palos supports an employee volunteer program to support local non-profit organizations. The employee volunteer program provides opportunities for staff members to contribute their time or donate goods to support community organizations helping area residents in need. Employee volunteers helped at a number of events such as the American Cancer Association's Making Strides against Breast Cancer Walk. Food, coat and pajama drives were held to support Together We Cope, a local organization serving families in 27 communities of Chicago's south suburbs to help prevent homelessness.Palos patients and the surrounding community benefit from many of the services provided by the American Cancer Society. During 2015, Palos sponsored the ACS's Making Strides Against Breast Cancer event in Orland Park. ACS uses monies raised to support groundbreaking breast cancer research; provide free, educational materials: support breast cancer patients and their loved ones; and help people take steps to reduce their breast cancer risk or find cancer early when it is most treatable.To educate area residents about heart disease as well as to support the American Heart Association with their outreach efforts, Palos participates in the AHA Heart Walk as along with 200 employees and their loved ones in Palos Hills. Additionally, Palos supported the AHA via sponsorship of the Heart Ball which uses funds to support such life-saving efforts as research, education, advocating for better health, improving patient care and reaching populations at risk. Palos served as a sponsor for an event benefitting the Crisis Center of South Suburbia, a non-profit community organization that provides emergency shelter and other essential services for individuals and families victimized by domestic violence, while addressing the societal issues that contribute to domestic violence.Palos is sponsoring the 2016 Southwest Half Marathon taking place in the community. This premier running event brings many elite athletes to the Palos community each year as well as providing a Healthcare Expo for the community focused on healthy living, etc.Palos assists members of the nursing staff by administering the Lois G. Kwak Scholarship fund. An annual scholarship of $2,000 is awarded to two nurses continuing their education. Each year, community cancer screening programs, as well as the direction of the Cancer Program at Palos, are designed in response to our community's needs based on guidance provided by the Palos Oncology Committee. This group, consisting of hospital leaders, caregivers and physicians, provides direction on how to better meet the needs of cancer patients in our community. In 2015, Palos hosted a skin cancer screening event and offered free colorectal cancer screening kits. The low-dose CT Lung Cancer Screening program continues. The Palos cancer program received the 2014 Outstanding Achievement Award from the Commission on Cancer (CoC) of the American College of Surgeons. Palos is one of a select group of five hospitals in Illinois and only 75 hospitals in the United States with accredited cancer programs to receive the prestigious award.Palos Community Hospital is governed by the Board of Directors, comprised of community leaders from the hospital's service area. Further demonstrating the hospital's connection to the community is the representation from community members to help shape our programs to better meet the needs of our residents. An example of this is the Diabetes Advisory Council. This group, consisting of community members as well as hospital leaders, provides input on how to better shape our diabetes program to meet the needs of our residents. In 2015, Palos hosted its annual Diabetes Fair to help individuals with diabetes and their loved ones learn how to manage the condition. The Palos Volunteer program provides more than 100 high school student with the opportunity to fulfill community service requirements annually. Additionally, hundreds of adult volunteers donate their time to Palos while having the opportunity to make new friends and experience the feeling of contributing to the community.Palos serves as a Senior Health Insurance Program (SHIP) site. This is a free statewide health insurance counseling service for Medicare beneficiaries and their caregivers. The hospital provides office space and other resources to support volunteers offering community members information and resources regarding applying for Medicare and Medicare coverage.Palos provides financial assistance to people with limited means. Uninsured or underinsured individuals may be eligible for discounts on the cost of care. Financial counselors are available to help patients determine terms befitting of the financial situation, as well as provide patients with information regarding local, state and federal assistance programs.Palos provides the influenza vaccination to all employees, volunteers and patients during flu season. To help heart failure and COPD inpatients transition from the hospital to home, Palos Community Hospital offers the Heart Failure/COPD Wellness Clinic.
Part VI, Line 6:Palos Community Hospital is not part of an affiliated health care system.
Part VI, Line 7, Reports Filed With StatesIL

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (1)SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Dr Terrence Moisan
President & CEO$886,608$0$0$0$17,280$0$84,000$0$23,490$0$1,011,378$0$0$0
Dr Mark Sinibaldi
Director/Physician$329,022$0$0$0$0$0$17,762$0$18,664$0$365,448$0$0$0
Charles E Reiter III
Executive VP/General Counsel$424,381$0$0$0$18,000$0$40,000$0$21,699$0$504,080$0$0$0
Tom Honan
Interim Financial Officer$389,827$0$0$0$0$0$0$0$0$0$389,827$0$0$0
David B Manchester
VP Prof. Services (until 1/24)$66,165$0$0$0$179,946$0$5,955$0$0$0$252,066$0$0$0
Mary C Denisienko
VP Human Resources$279,554$0$0$0$18,000$0$26,420$0$10,153$0$334,127$0$0$0
Rosann S Demask
VP Nursing$266,082$0$0$0$18,000$0$25,847$0$18,930$0$328,859$0$0$0
Patricia Heerlein
VP Clinical Services$234,321$0$0$0$6,250$0$13,033$0$8,916$0$262,520$0$0$0
Muhamad Krad
Physician$426,072$0$0$0$0$0$0$0$25,160$0$451,232$0$0$0
Amit Joshi
Physician$394,979$0$0$0$0$0$18,105$0$25,213$0$438,297$0$0$0
Alex DeJong
Physician$386,736$0$0$0$0$0$19,875$0$18,869$0$425,480$0$0$0
Michael Lynch
Physician$365,972$0$0$0$18,000$0$19,875$0$16,790$0$420,637$0$0$0
Richard DeJong
Physician$373,944$0$0$0$0$0$19,875$0$18,798$0$412,617$0$0$0
Dr Thomas Vasdekas
Former Director$65,000$0$0$0$0$0$0$0$0$0$65,000$0$0$0
Hugh A Rose
Former VP Finance/CFO$0$0$0$0$108,174$0$0$0$496$0$108,670$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart I, Lines 4a-bFormAndLineReferenceDesc
ExplanationDavid Manchester and Hugh Rose received severance packages from Palos Community Hospital that were within the terms and conditions of the agreements. The severance was based on length of service and responsibilities. Additional terms and conditions of the confidential severance agreements will be provided to the IRS upon request. Amounts paid during the current period are properly reflected on the employees W-2. The following individuals particpate in a 457(f) plan and the amounts are the contributions to each plan during 2015: Dr. Terrence Moisan - $84,000 Charles E. Reiter, III - $40,000 Rosann S. Demask - $6,626 Mary C. Denisienko - $6,545 Roger Russell - $8,125ExplanationTxt

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp (2 entries)

Bond ReferenceBondReferenceCdBond Issuer EINBondIssuerEINCUSIPCUSIPNumBond IssuedBondIssuedDtIssue PriceIssuePriceAmtPurposePurposeDescDefeasedDefeasedIndOn Behalf Of IssuerOnBehalfOfIssuerIndPool FinancingPoolFinancingInd
Ill Fin AuthorityPalos Comm Hospital
A86109196745200F2Z12010-05-06$151,146,301Fund construction of new bed tower and modernization of existing bed tower0Yes (1)0
Ill Fin AuthorityPalos Comm Hospital
B861091967NoneAvail2015-10-01$232,015,000Refinanced Series 2015A bonds and advance refund Series 2007A bonds0Yes (1)0

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp (2 entries)

Bond ReferenceBondReferenceCdTotal ProceedsTotalProceedsAmtIssuance Costs From ProceedsIssuanceCostsFromProceedsAmtCapital ExpendituresCapitalExpendituresAmtSubstantial CompletionSubstantialCompletionYrCurrent RefundingCurrentRefundingIndAdvance RefundingAdvanceRefundingIndFinal Allocation MadeFinalAllocationMadeIndAdequate Books And Rec MaintAdequateBooksAndRecMaintIndRefunding EscrowRefundingEscrowAmt
A$151,146,301$1,950,637$149,195,664201200Yes (1)Yes (1)
B$232,015,000$1,149,8292015Yes (1)Yes (1)Yes (1)Yes (1)$230,865,171

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp (2 entries)

Bond ReferenceBondReferenceCdOwning Bond Financed PropertyOwningBondFinancedPropertyIndAny Lease ArrangementsAnyLeaseArrangementsIndMgmt Contract Bond Fincd PropMgmtContractBondFincdPropIndAny Research AgreementsAnyResearchAgreementsIndPrivate Bus Use By OthersPrivateBusUseByOthersPctTotal Private Business UseTotalPrivateBusinessUsePctBond Iss Meet Prvt Sec Pymt TestBondIssMeetPrvtSecPymtTestIndChange In Use Bond Financed PropChangeInUseBondFinancedPropIndProcs Nonqualified Bond RemdtdProcsNonqualifiedBondRemdtdInd
A00000.000000.0000000Yes (1)
B00000.000000.0000000Yes (1)

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp (2 entries)

Bond ReferenceBondReferenceCdForm8038 T FiledForm8038TFiledIndRebate Not Due YetRebateNotDueYetIndException To RebateExceptionToRebateIndNo Rebate DueNoRebateDueIndVariable Rate IssueVariableRateIssueIndHedge Identified In Bks And RecHedgeIdentifiedInBksAndRecIndGross Proceeds Invested In GICGrossProceedsInvestedInGICIndGross Proceeds InvestedGrossProceedsInvestedIndWritten Proc To Monitor ReqsWrittenProcToMonitorReqsInd
A000Yes (1)0000Yes (1)
B0Yes (1)00Yes (1)000Yes (1)

Procedures Corrective Action ProceduresCorrectiveActionGrp (2 entries)

Bond ReferenceBondReferenceCdProcedures Corrective ActionProceduresCorrectiveActionInd
AYes (1)
BYes (1)

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceDate Rebate Computation PerformedFormAndLineReferenceDesc
ExplanationIssuer Name: Ill Fin Authority/Palos Comm Hospital Date the Rebate Computation was Performed: 02/25/2015ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Dr Terrence MoisanBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionDirectorRelationshipDescriptionTxt
Transaction$102,500TransactionAmt
TransactionPalos Community Hospital purchased assets from Dr. Terrence Moisan's medical practice, Midwest Environmental.TransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section A, line 4The bylaws of the organization were revised during June 2015 to distiguish which officers are required to be Board members. Only the Chairman, Vice Chairman, and the President are required to be Board members of the Corporation.
Form 990, Part VI, Section A, line 6St. George Corporation is the sole Corporate Member.
Form 990, Part VI, Section A, line 7aSt. George Corporation holds the power to appoint members of the governing body.
Form 990, Part VI, Section A, line 7bSt. George Corporation can exercise action on the following matters: (a) removal of directors, with or without cause; (b) all amendments to the bylaws or the Corporation's Articles of Incorporation; (c) the sale or transfer of substantially all of the property of the corporation, except for leases in excess of one year; (d) all long term borrowing in excess of one year; (e) merger or consolidation by the Corporation with any other institution, hospital, corporation or legal entity; (f) formal affiliation with a medical school or research facility; (g) acceptance of any gift, bequest or legacy that imposes a permanent or continuing obligation on the Corporation for a period of more than one year; (h) decisions to authorize voluntary dissolution of the Corporation or to revoke proceedings therefor; (i) adoption of a plan for the distribution of the assets of the Corporation; and (j) any other matters required by law to be submitted to the Corporate Member or which the Board determines by resolution to submit.
Form 990, Part VI, Section B, line 11Senior management reviewed the Form 990 that was prepared by our tax advisors with the information we provided to them. Once reviewed by senior management it was made available to our Board prior to filing.
Form 990, Part VI, Section B, line 12cOn an annual basis directors, key personnel (VP, department heads (budget administrators)), and all purchasing staff must complete a Conflict of Interest Form disclosing any conflict of interest that may exist or be perceived to exist between themselves and/or family members and vendors, contractors and others Palos has a contract/transaction agreement. These annual disclosure statements of key personnel are reviewed by the VP of Human Resources. Any issue identified as part of this annual disclosure is referred to the Compliance Officer, in consultation with General Counsel, for disposition. The full Board reviewed the disclosure statements of each Director that identified an interest.
Form 990, Part VI, Section B, line 15Palos engaged an independent consultant to complete a market analysis of executive positions. The market analysis included base rates, bonuses and benefits resulting in a total remuneration benchmark. They compared Palos executives to executives in organizations of similar size and with similar characteristics. The consultants presented their report and findings to the Compensation Committee of the Board. The independent members of the Compensation Committee approved compensation and this approval was documented in the minutes at the time of approval.
Form 990, Part VI, Section C, line 19All policies, governing documents and financial statements required to be available to the public are available upon request. Requests can be made from the Finance Department of Palos Community Hospital. Documents are available for the same period of disclosure as set forth in IRC Section 6104(d).
Form 990, Part XI, line 9:Net Asset Transfer To Affiliate -193,975,217. Change in Temporarily Restricted Net Assets 97,731. Loss on Early Extinguishment of Debt -7,079,165.

Schedule R IRS990ScheduleR

Id Disregarded Entities IdDisregardedEntitiesGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdTotal IncomeTotalIncomeAmtEnd Of Year AssetsEndOfYearAssetsAmtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
Palos Medical Group LLC
12251 S 80th AvenuePalos HeightsIL60463271472342Health CareIL$10,903,644$483,761Palos Community Hospital
Chicago Health Colleagues LLC
12251 S 80th AvenuePalos HeightsIL60463362169179Health CareIL$0$0Palos Community Hospital

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtDirect Controlling NADirectControllingNACdControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Txt
St George Corporation
12251 S 80th AvenuePalos HeightsIL60463364383840Holding CompanyIL501(c)(3)11 a, Type IIN/A0
St George Wellness Center
15430 W AvenueOrland ParkIL60462364383845Fitness CenterIL501(c)(3)90St George Corporation

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1St George Assurance LTDBusinessNameLine1Txt

Foreign Address ForeignAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1159 878 W Bay RdAddressLine1Txt
CityGrand CaymanCityNm
CountryCJCountryCd
Foreign PostalKY1-1102ForeignPostalCd
FieldValueIRS element (for citing)
EIN981313176EIN
Primary ActivitiesCaptive InsurancePrimaryActivitiesTxt
Legal Domicile Foreign CountryCJLegalDomicileForeignCountryCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Palos Community HospitalBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeCEntityTypeTxt
Share Of EOY Assets$39,318,618ShareOfEOYAssetsAmt
Ownership1.00000OwnershipPct
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other OrgYes (1)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
St George Assurance LTD
B$100,000FMV
St George Assurance LTD
R$24,810,000FMV