2016-07-12T12:18:56-05:00 2015-08-31 861065772 Deloitte Tax LLP 111 Monument Circle Suite 4200 Indianapolis IN 462045108 990 2014-09-01 362256036 Rehabilitation Institute of Chicago REHA 3122381000 345 E Superior Street Chicago IL 606112654 Edward B Case Executive VP/CFO 3122381000 2016-07-12 1 Samantha Bokori P01057347 3174648600 2014 2016-09-27 15:27:22Z Edward B Case 345 E Superior Street Chicago IL 606112654 347372935 0 X www.ric.org X 1951 IL The Rehabilitation Institute of Chicago is dedicated to provide the highest-quality patient care. 17 16 2037 433 3116632 1323036 42887165 47532623 204622271 209238787 7208434 19946873 1378345 1242711 256096215 277960994 5065014 6777305 0 0 139475402 144932192 132213 51524 3428140 80708018 78033201 225380647 229794222 30715568 48166772 703482953 1003822277 280613692 571976235 422869261 431846042 X The Rehabilitation Institute of Chicago (RIC) is dedicated to providing the highest-quality patient care through integrated research, scientific discovery, and education for the purpose of maximizing the recovery of the individuals in our care. 0 0 157538252 25930 202279645 Clinical Care - Founded in 1951, RIC, an Illinois not-for-profit corporation, earned the distinction of being named the nation's #1-ranked provider of comprehensive physical medicine and rehabilitation care to patients from around the world for 25 years by U.S. News & World Report - a record for any U.S. hospital. RIC also is the nation's largest rehabilitation research enterprise, advancing the field globally through innovation of the most advanced treatments and technologies. RIC is the only rehabilitation hospital in the nation to hold a record eight federally designated research programs in the areas of computers and robots in therapy, mobility technologies, health and function in disabilities, neurologic rehabilitation, spinal cord injury, rehabilitation engineering, patient outcomes, and pediatric orthopedics. RIC's vision is to advance human ability through science and research. In January 2012, RIC opened 24 beds on a renovated patient floor that featured the world's first Ability Lab, an innovative treatment space that combines research and clinical care, surrounding the patient within the hospital setting. RIC's Care Quality and Delivery Highlights:RIC currently operates a system of care consisting of a 182 bed hospital and outpatient facility, located at 345 East Superior Street in Chicago, Illinois, as well as a number of other facilities and joint ventures. On February 5, 2013, the Illinois Health Facilities and Services Review Board granted RIC a licensure for 242 beds for its new research hospital and outpatient facility currently under construction at 355 East Erie, Chicago, IL. The Corporation offers a comprehensive range of inpatient, day rehabilitation and outpatient services throughout the System. Inpatient rehabilitation services are provided using a multidisciplinary approach. Day treatment rehabilitation consists of a multidisciplinary approach for individuals no longer requiring the 24-hour nursing services provided in an inpatient setting. Outpatient care is typically a singular discipline (e.g., physical therapy) and offers various levels of therapeutic intensity, depending on the patient's needs and goals. In FY 2015 RIC treated more than 6,300 inpatients throughout its system of care and delivered over a million outpatient therapy units. RIC's facilities are staffed by approximately 1,700 medical professionals and support personnel, a dedicated team who in FY 2015 treated patients from 43 states and handled referrals from 61 countries.Each patient at RIC is assigned a personalized care team consisting of the field's most well-trained rehabilitation doctors, nurses, therapists, care managers and clinical specialists. No other specialty hospital in the nation has a more experienced track record of being rated #1 for twenty-five consecutive years. RIC is one of only 2% of the nation's nearly 6,000 hospitals to have achieved three consecutive Magnet designations for nursing excellence from the American Nurses Credentialing Center (ANCC) and the only free-standing acute inpatient rehabilitation hospital to have this distinction. 22234202 6751375 2015226 Research Program - RIC's Research Program is the world's largest physical rehabilitation research enterprise in pursuit of clinical advancement through scientific discovery. The Research Program has at any given time approximately 300 research projects underway, funded by more than $100 million in donations from both private and public sources. Its experts regularly publish research in the world's foremost medical journals, including the Journal of the American Medical Association (JAMA) and its European equivalent, The Lancet, and it is home to a record eight federal research designations to develop cutting-edge solutions for patients.Computers and Robots in Therapy: An internationally acclaimed NIDILRR-funded center especially for patients with hemispheric stroke - the most debilitating kind. Seven studies address two elemental questions: When is the optimal time to use robotic and computer-based systems during therapy, and how do therapists best interact with robotic devices during therapy, often with minimal hands-on treatment coming from the clinician? Training of undergraduate rehabilitation engineers is included.Manipulation and Mobility Technologies: A NIDILRR-funded Rehabilitation Engineering Research Center award to fund six new projects researching innovations that are directly useful for patients, especially those who have experienced limb-loss or stroke. Projects include body-powered hand prostheses, use of powered exoskeleton for after-stroke patients, and a new wheelchair to allow both sitting and standing. Research will include both technology development and clinical testing.Health and Function in Physical Disability: This Rehabilitation and Training Center, funded by NIDILRR, was created to develop, evaluate, and implement methods to promote optimal health and function of people with physical disabilities. Through a variety of research, training and dissemination activities, we expect to gain a more comprehensive understanding of the efficacy and value of various interventions for achieving and maintaining health and function for people with a disability.Neurologic Rehabilitation Research: RIC hosts one of six programs in the country within the National Center for Medical Rehabilitation Research awarded by the National Institutes of Health. Within this network of experts, RIC is the only one focused on the groundbreaking application of neural engineering and robotic techniques to understand diagnose and treat such neurologic disorders as brain injury, multiple sclerosis and Parkinson's disease. Spinal Cord Injury Research: RIC operates the Midwest Regional Spinal Cord Injury Care System as designated by NIDILRR. One of only 14 SCI Model Systems nationwide, RIC advances spinal cord care through clinical research that identifies new standards of care for the industry. It leads multiple independent and collaborative research projects exploring walking therapy technologies that deliver the most effective treatment to advance ability.Engineering Research: Machines assist therapists in providing longer, more consistent and intensive therapies that track progress and improve functional performance. RIC is designated one of 20 NIDILRR Rehabilitation Engineering Research Centers dedicated to stroke research and the only one focused on robotics.Outcomes Research: RIC operates the only NIDILRR Outcomes Rehabilitation Research & Training Center in the nation leading the way for establishing global, standardized measures and evaluating clinical outcomes to ensure patients receive the best care and best outcomes. Orthopedic Robotics for Kids: This grant from NIDILRR supports the research and development of innovative technologies to improve rehabilitative treatment for children with orthopedic disabilities, including cerebral palsy, clubfoot, brittle bone disease, spina bifida and spinal cord injury. 7265498 1265005 Medical Education - Medical Residency Program: The Department of Physical Medicine and Rehabilitation at Northwestern University's Feinberg School of Medicine (Dept of PM&R) is housed within RIC, which has one of the largest and most highly respected residency programs in physical medicine and rehabilitation in the country. Resident physicians spend three to four years rotating through the Dept of PM&R, taught by RIC physicians who are experts in this specialty. In FY 2015, RIC trained 40 residents. The RIC medical education program also provides opportunities for first-year medical students to meet regularly with patients from RIC's spinal cord injury, general rehabilitation, or pediatric program to gain patients' insights on recovery and needs for independent living.RIC Academy: The RIC Academy Continuing Education program has been offering courses to help healthcare professionals stay at the forefront of their field for over 36 years. In FY 2015 one thousand students participated in academy courses which are taught by interdisciplinary teams of recognized specialists from RIC and visiting experts from across the country and around the world. These courses were offered in a variety of formats including webinars, on-site seminars and workshops, and outreach programs.Fellowships: RIC offers physician fellowships, funded primarily by donations, in pediatric rehabilitation, musculoskeletal sports and spine medicine, spinal cord injury, pain management, and traumatic brain injury. In FY 2015, seven physician fellows were named at RIC. RIC also supports fellowships for therapists, nurses and other non-physicians. Prosthetics and Orthotics (P&O) Residency: Each year, RIC's Prosthetics and Orthotics Clinical Center (POCC) selects two prosthetist and two orthotist residents for these highly sought after positions. Last year, the prosthetics residency program was expanded to 18 months to allow additional hands-on experience in research through our Center for Bionic Medicine. To accommodate additional growth, our orthotics residency program will grow from two to three positions. Through the training programs, P&O residents are mentored by RIC's certified, licensed professionals and get exposure to a variety of clinical presentations and pathologies, clinical evaluation, prescription recommendation, documentation, the actual fabrication of devices, and formal research. 4467152 1286470 Community Health and Education - RIC provides a variety of community health and education programs. LIFE Center: As an addition to its world renowned clinical services, RIC developed the LIFE (Learning, Innovation, Family, Empowerment) Center eleven years ago to address the range of emotional, interpersonal, physical and financial requirements for living with a disability. In response to the need for trusted resources in key areas of life, RIC provides this state-of-the-art multimedia education center and web portal as an integrated component of RIC patient care to support seamless and successful transitions throughout life. In FY 2015, total outreach and service efforts represented 21,386 person contacts. These included individualized patient, family, and community education programs, classes, special events, tours and a peer visit program. The Center's public computer area remained in high demand with 7,039 visits for Internet use and support. The Center's impact spreads globally through its website, which drew 367,280 page views per month, reflecting 18,608 unique users per month, with 4,407,361 page views annually in FY 2015. Cumulative page views since its launch in 2003 have surpassed 34 million from 183 countries. Sports and Fitness Program: The RIC Adaptive Sports and Fitness Program provides wellness opportunities to people with physical disabilities through sports and recreation as well as a full-service accessible health club. All services offered in the adaptive sports program, which marked its 34th year in FY 2015, are free of charge. The fitness program, which celebrated its 19th anniversary, provides access to a health club that operates from 6:15 am to 7 pm five days per week for a nominal annual fee. The sports and fitness program is funded primarily by grants and generous community donations and is operated by ten and three quarter full time equivalent staff. Additionally, volunteers logged nearly 26,498 hours in FY 2015. RIC's well-established program is considered a national leader in health promotion for people with disabilities. In FY 2015, the sports program recorded 9,952 visits by its 303 registered participants, and the fitness program recorded 33,279 visits by its 775 registered participants. A separate program for youth, the Caring for Kids program, recorded 1,716 visits by 185 Chicago children with disabilities.Vocational Rehabilitation Program: Beginning a career or returning to work following an illness or injury is important to a patient's financial security and emotional well-being. It can contribute to the achievement of a productive, independent and fulfilling life. For 50 years, RIC has been providing comprehensive vocational rehabilitation services tailored to meet the needs of each client. Services include initial assessment, diagnostic evaluation, work trial assessments, job analysis, return-to-work evaluation, job placement, resume writing and interviewing workshops, an Internet job skills course and internship coordination. RIC covers the cost of initial assessments, which are not covered by most third-party payers. Patients receive vocational services at eight RIC facilities, ensuring that employment assistance is closely tied to community reintegration. During the past five years, the program has served an average of 900 clients annually.Assistive Technology Programs: Three areas - Rehabilitation Engineering, the Technology Center, and the Wheelchair & Seating Center - comprise RIC's Assistive Technology Programs. In FY 2015, Assistive Technology Programs served more than 2,000 unique patients.Rehabilitation Engineering staff provide evaluation, design and technical expertise to modify commercially available products and fabricate custom equipment, creating individualized solutions for people with disabilities. RIC provides free care for services or products, hosts engineering student internships, provides hands-on experiences to students through Northwestern University's engineering design program and provides community-based workshops to disability groups about adaptive equipment, ergonomics and home safety.The RIC Technology Center provides computer access training, augmentative communication devices and electronic aids to daily living for people with disabilities. Occupational therapists and speech language pathologists evaluate and recommend equipment for each individual's needs. Through a lending library, patients can try items before purchasing them or borrow them for short-term use due to changing needs. Staff members speak to universities, schools, organizations for people with disabilities, senior centers and the general public. The center provides free service and home visits to clients who are unable to come to RIC.The Wheelchair Seating & Positioning Center staff evaluate and make recommendations for complex wheelchairs and customized seating systems for patients with significant physical needs. This includes manual wheelchairs; powered wheelchairs; individualized seat and back cushions to relieve pressure, prevent pressure sores, and maintain posture; and other durable medical equipment that help clients maintain or increase their mobility and independence. Staff help patients at all RIC sites, as well as in schools and other clinical facilities in the Chicago area. 4467152 1286470 191505104 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 0 1 0 0 1 1 0 1 1 0 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 0 0 0 1 X 207 0 1 2037 1 1 1 1 CA CJ EI LU NL 0 0 0 1 1 0 0 0 0 X 17 16 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 IL IN X Edward B Case 3122381000 345 E Superior Street Chicago IL 606112654 M Jude Reyes Chairman 1.00 1.00 X 0 0 0 Michael P Krasny Vice Chairman 1.00 1.00 X 0 0 0 Thomas A Reynolds III Vice Chairman 1.00 1.00 X 0 0 0 Wayne R Andersen Director 1.00 1.00 X 0 0 0 Brenda C Barnes Director 1.00 1.00 X 0 0 0 William J Cernugel Director 1.00 1.00 X 0 0 0 Daniel D Dolan Jr Director 1.00 1.00 X 0 0 0 Christopher L Gust Director 1.00 1.00 X 0 0 0 Michael L Keiser Director 1.00 1.00 X 0 0 0 James H Litinsky Director 1.00 1.00 X 0 0 0 William E Lowry Jr Director 1.00 1.00 X 0 0 0 David D Olson Director 1.00 1.00 X 0 0 0 Sheli Rosenberg Director 1.00 1.00 X 0 0 0 Mark Stephen Director 1.00 1.00 X 0 0 0 William S Wardrop Jr Director 1.00 1.00 X 0 0 0 Linda Wolf Director 1.00 1.00 X 0 0 0 Joanne C Smith MD President, CEO 40.00 1.00 X X 2122208 0 668011 Nancy E Paridy Sr. VP, General Counsel 40.00 1.00 X 545933 0 61473 Edward B Case Executive VP, CFO 40.00 1.00 X 1641879 0 235897 Lois M Huggins Sr. VP, Chief HR Officer 40.00 1.00 X 556963 0 69772 Peggy M Kirk Sr. VP, Clinical Operations 40.00 1.00 X 827362 0 333280 James Sliwa DO Chief Medical Officer 40.00 0.00 X 767032 0 300924 Collins Fitzpatrick MD Medical Director 40.00 0.00 X 1093613 0 59868 Michael S Marinko MD Medical Director 40.00 0.00 X 654844 0 70960 Elizabeth Owens Sr. VP & Chief Marketing & Innov. 40.00 0.00 X 611637 0 13837 Thomas Sullivan Sr. VP & Chief Development Officer 40.00 0.00 X 634041 0 25960 William Rymer MD PhD VP, Research 40.00 0.00 X 398534 0 25249 9854046 0 1865231 178 1 1 0 Power Construction Company LLC 2360 Palmer Drive Schaumburg IL 60173 Construction Services 163144229 Northwestern Memorial Hospital PO Box 73690 Chicago IL 606737690 Medical Services 4085863 Cerner Corporation PO Box 959156 St Louis MO 631959156 IT Services 4080089 Northwestern University 320 East Superior Street Chicago IL 60611 Research Subcontractor 3950952 Crothall 1500 Liberty Ridge Drive Wayne PA 19087 Facility Care Services 3007601 81 X 2344010 16674699 28513914 1253312 47532623 Net Patient Revenue 621990 189945134 189945134 Affiliation Income 900099 11253908 8601697 2652211 Sponsored Research Rev 541700 1882595 1882595 Medicare GME Payment 621990 945630 945630 Tuition 900099 267749 267749 4943771 4919771 24000 209238787 3416590 440421 2976169 3028 3028 44583 44583 26776 0 26776 26776 26776 85217448 68690193 16527255 16527255 16527255 780062 2344010 721748 58314 58314 Cafeteria Sales 900099 856044 856044 EHR Payments 621990 256994 256994 1113038 277960994 206846346 3116632 20465393 6369135 6369135 319054 319054 89116 89116 5705195 834425 4870770 110723126 96907399 11678096 2137631 9943774 8510916 1245453 187405 11061197 10470876 352970 237351 7498900 6524635 828869 145396 3192766 725158 2444608 23000 471348 63145 408203 319280 319280 288994 288994 51524 51524 917961 917961 15419697 14338086 916819 164792 1184672 67379 1081692 35601 4898822 4201823 624613 72386 4070823 3154305 874334 42184 6440283 5408798 828285 203200 1068271 946424 102763 19084 561236 504004 48066 9166 3015093 33005 2982088 10639704 8455154 2176699 7851 1837993 186221 1651772 Medical Supplies 11357409 11325503 31501 405 Medicaid Provider Tax 7168722 7168722 Patient Transportation 1679961 1679961 UBI Tax 262467 232157 30310 3237699 2989703 156832 91164 229794222 191505104 34860978 3428140 83848 42382 42740932 51225554 72714566 60442565 26136282 29978683 1452780 1537047 2572033 3036292 545380136 136199860 215400292 409180276 89335767 84828395 234013501 343857787 12762257 12109800 3721509 3515478 2549186 4068018 703482953 1003822277 47601018 60416523 3114908 1619726 1524768 143901100 398662282 87491848 108257754 280613692 571976235 X 249734151 273066831 121223270 106540110 51911840 52239101 422869261 431846042 703482953 1003822277 X 48166772 -24876174 -14313817 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 1 6511 0 1 282483 288994 0 Part II-B, Line 1: Rehabilitation Institute of Chicago lobbies Federal and State government on issues related to Medicare, Medicaid and other government health care programs related to the rehabilitation field. Most of the lobbying expenses are to third party lobbying firms as well as the Illinois Hospital Association and the American Medical Rehabilitation Providers Association. RIC does not participate in or intervene in (including the publishing or distributing of statements) any political campaign on behalf of (or in opposition to) any candidate for public office. 96081147 327261 -1328828 4003447 91076133 88246330 169168 11444840 3779191 96081147 82646831 158587 8939449 3498537 88246330 78482474 1187000 5923887 2946530 82646831 57290243 16669084 6784986 2214340 47499 78482474 0.01100 0.41540 0.57360 0 0 33719510 33719510 107932079 92840108 15091971 7914547 7914547 53895521 43359752 10535769 341918479 341918479 409180276 Cash and Cash Equivalents 140928402 F Absolute Return 52178526 F Hedged Equity 22684580 F International Equity 19683793 F International Hedged Equity 6028688 F Pvt Equity, Real Assets & Contracts 24986697 F Gov. Fixed Income & Corporate Bonds 77367101 F 343857787 185763 Self-Insurance Reserves 7716476 Accrued Pension 63671524 Swap Liability 13043657 Deferred Lease Liability 1299509 457 Plan Liabilities 15019749 Cerner Software Contract Liability 689460 Lease Incentive/Other 756968 Estimated Third Party Settlements Payable 5792681 Other Long Term Debt - Ikon/Xerox 81967 108257754 X Part V, Line 4: The intended use for each of the RIC endowment funds is established by the donor. The majority of the endowment funds are used to support medical education, clinical care, free care, research, medical leadership, fellowships and the RIC Academy. Part X, Line 2: RII and the Institute are not-for-profit corporations as described in Section 501(c)(3) of the Internal Revenue Code (the "Code") and are exempt from federal income taxes on related income pursuant to Section 501(a) of the Code. Despite the general exemption from income taxes, RII and the Institute are subject to federal and state income taxes at corporate rates on unrelated business income. Included in the consolidated statements of operations and changes in net assets is the provision for current taxes of $262,000 and $425,000 for the years ended August 31, 2015 and 2014, respectively. The corporations do not have any material tax positions as of August 31, 2015 and 2014. Part VI, Line 1c: Depreciation for leasehold improvements is included in the same general ledger account as building depreciation. There is related depreciation for leasehold improvements, but it cannot be bifurcated for Form 990 purposes. 1 North America 0 0 Program services Research 14100 Europe (including Iceland & Greenland) 0 0 Program services Research 75016 Middle East and North Africa 0 0 Program services Travel related to clinical care, presentation of papers, and business development 96490 0 0 0 0 0 0 185606 0 185606 North America Medical Research 14100 Electronic Fund/Wire Europe (including Iceland & Greenland) Medical Research 21380 Electronic Fund/Wire Europe (including Iceland & Greenland) Medical Research 53636 Electronic Fund/Wire 3 0 1 0 0 1 1 1 Part I, Line 2: Each research grant is assigned a Principal Investigator (PI) as well as a Research Administrator (RA). Grant expenditures charged to each grant are approved/reviewed by the respective PI and or RA to ensure allowability. In addition, compliance (A-133) audits are performed by an independent audit firm each year. X X X X X X 1 Donald Campbell & Company DBA Campbell & Company 1 E Wacker Drive Suite 3350 Chicago IL 60601 Advisory Services for campaign planning 0 0 46463 0 Wild Associates Inc 2703 Asbury Avenue Evanston IL 60201 Advisory Services for Planned Giving 0 0 5061 0 51524 IL Gala 1543849 947025 596824 0 48000 85277 135250 0 83591 SkyRise 1342241 1240156 102085 0 62952 0 2569 1235 251295 3 237982 156829 81153 0 0 6540 10325 0 34714 3124072 2344010 780062 110952 91817 148144 1235 369600 721748 58314 Schedule G, Part I, Line 2b, Column (v) RIC has an agreement for advisory services for the capital campaign related to its new Research Hospital as well as for planned giving. The agreements do not provide for separate reimbursement for expenses. 1 1 1 X 250.000000000000 1 X 600.000000000000 1 1 1 0 1 1 1075416 1075416 0.00470 30221448 25577029 4644419 0.02020 286072 162385 123687 0.00050 31582936 25739414 5843522 0.02540 3254541 413073 2841468 0.01240 7265498 1265005 6000493 0.02610 1212611 873397 339214 0.00150 28044700 20751700 7293000 0.03170 0.00000 39777350 23303175 16474175 0.07170 71360286 49042589 22317697 0.09710 1 336705 12038 48766178 52191351 -3425173 X 1 1 1 1 Rehabilitation Institute of Chicago 345 E Superior Street Chicago IL 60611 www.ric.org 0001958 X X X Physical Rehabilitation Rehabilitation Institute of Chicago 1 0 0 1 X X X X X X X X X 12 1 0 0 1 X http://www.ric.org/services/chna 1 12 0 1 0 1 X 250.000000000000 600.000000000000 X X X X X 1 1 X X X 1 X See Part V, Section C X See Part V, Section C X X X X 1 X 0 X X X X 0 X X 0 0 Rehabilitation Institute of Chicago Part V, Section B, Line 5: The ways in which RIC took into account input from persons who represent the community are more fully described in the CHNA. RIC conducted interviews and a focus group with leaders of the health community. RIC personnel conducted telephone interviews with a Clinical Associate Professor of Law at Northwestern Law School and the Founder and Chairman of the Board of the Gridiron Alliance. RIC also hosted a focus group as part of its effort developing the Assessment. Focus group participants included persons with special knowledge or expertise in public health, represented federal, state or local health departments, or agencies with current data or other information relevant to the health needs of the community. Participants also included leaders, representatives, or members of medically underserved, low-income, and minority populations and populations with chronic disease needs. Invites were extended to include representatives from Independent Living Centers, Mayor's Office for People with Disabilities, Chamber of Commerce, Public Schools, Community Park Districts / Fitness Programs, Faith-based Programs, International Exchange Programs, University Disability Services, Transportation Services, Housing, Legal Services, and Disability Advocacy Associations. Twenty people and/or agencies were invited with a 70% response rate of participation (N=14). The external focus group was held at RIC and lasted over two hours. Group discussion focused on rehabilitation health needs of people with physical disabilities, access to information and care, research and clinical trials, education and training, and support programs. Qualitative data was tabulated and analyzed by examining common themes and triangulating data with quantitative results from the paper survey. Comments from focus group members who were unable to attend, or comments from other participants in the community, may have further informed RIC's ability to assess the health needs of the community. A copy of the Focus Group presentation is included at Appendix B of the CHNA.The agencies and organizations consulted include: the City of Chicago (Mayor's Office for People with Disabilities), the Illinois Department of Human Services, Access Living, Brain Injury Association of Illinois, Chicagoland Chamber of Commerce (Workforce Development), Extended Home Living Services, Great Lakes ADA Center, MobilityWorks, Gridiron Alliance NFP, Northwestern Law School (Professor of Law), National Parkinson Foundation, World Chicago, and Zion Lutheran Church. Rehabilitation Institute of Chicago Part V, Section B, Line 11: The CHNA identified the following significant needs: Rehabilitation Health, Research, Improved Access to Information About Existing Resources, Education and Training, and Support Programs.In the area of Rehabilitation Health, RIC's clinical expertise in multiple programs and resources will continue to provide for the needs of RIC patients in the areas of stroke, spinal cord injury, brain injury, neuro-musculoskeletal conditions, pediatric care, and cancer. In FY 2015 RIC treated more than 6,300 inpatients throughout its system of care and delivered over a million outpatient therapy units. RIC's facilities are staffed by approximately 1,700 medical professionals and support personnel, a dedicated team who in FY 2015 treated patients from 43 states and handled referrals from 61 countries.In the area of Research, RIC continues construction of an innovative new Research Hospital. The innovative design of the Research Hospital will integrate, for the first time, research and rehabilitation medicine to truly engage in cutting edge translational research. The new Research Hospital is expected to open during the first half of 2017. In the area of Improved Access to Information, RIC's LIFE Center, a virtual and multimedia education center, provides the community with thousands of peer-reviewed resources across key topics relevant to the life-long needs of people with physical disabilities. In FY 2015, total outreach and service efforts represented 21,386 person contacts. These included individualized patient, family, and community education programs, classes, special events, tours and a peer visit program. The Center's public computer area remained in high demand with 7,039 visits for Internet use and support. The Center's impact spreads globally through its website, which drew 367,280 page views per month, reflecting 18,608 unique users per month, with 4,407,361 page views annually in FY 2015. Cumulative page views since its launch in 2003 have surpassed 34 million from 183 countries. In the area of Education and Training, RIC, as the Northwestern Feinberg School of Medicine's Department of Physical Medicine and Rehabilitation physiatry residency program, will continue to support the education needs of PM&R physicians. RIC will also continue its robust educational programming for allied health, patients, and their families in the community. In FY 2015, RIC trained 40 residents. The RIC medical education program also provides opportunities for first-year medical students to meet regularly with patients from RIC's spinal cord injury, general rehabilitation, or pediatric program to gain patients' insights on recovery and needs for independent living.In the area of Support Programs, RIC will continue to provide high-quality support programs to the community, including adolescent support programs and accessible physical fitness. RIC's commitment includes support for its adapted Sports & Fitness Center, which moved in 2012 to a newly designed and expanded, state-of-the-art accessible location. In FY 2015, the fitness program recorded 33,279 visits by its 775 registered participants.All significant health needs identified in RIC's most recently conducted CHNA are being addressed. Rehabilitation Institute of Chicago Part V, Section B, Line 16i: The admission consent forms at all facilities explain that financial assistance is available. These forms include a contact and phone number for obtaining financial assistance and alternative payment options. Rehabilitation Institute of Chicago Part V, Section B, Line 22d: The amounts billed to individuals who were uninsured were determined by the Medicare cost to charge ratio. This is provided annually to the Illinois Attorney General's office. Part V, Line 16a: The financial assistance policy (FAP) was widely available at the following URL: http://www.ric.org/about/insurance-and-billing/#Charity-Care-/-Ayuda -Financiera Part V, Line 16b: The FAP application form was widely available at the following URL: http://www.ric.org/about/insurance-and-billing/#Charity-Care-/-Ayuda -Financiera Part V, Section B, Line 16 Financial Assistance Policy Website Availability Rehabilitation Institute of Chicago Part V, Section B, line 16a website: See Part V, Section C Rehabilitation Institute of Chicago Part V, Section B, line 16b website: See Part V, Section C 12 RIC DayRehab Ctr & OP Ctr-Willowbrook 6705 Kingery Highway Willowbrook IL 60527 Day Rehabilitation & Outpatient Rehabilitation RIC DayRehab Ctr - Homewood 1055 W 175th Street Suite 101 Homewood IL 60430 Day Rehabilitation & Physician Practice RIC DayRehab Ctr & OP Ctr-Northshore 755 Skokie Boulevard Northbrook IL 60062 Day Rehabilitation & Outpatient Rehabilitation RIC DayRehab Ctr - Wheeling 5150 Capitol Drive Wheeling IL 60090 Day Rehabilitation RIC Spine and Sports Rehab Ctr 1030 N Clark Street Chicago IL 60610 Outpatient Rehabilitation & Physician Practice RIC Ctr for Pain Management 980 N Michigan Avenue Suite 800 Chicago IL 60611 Outpatient Rehabilitation & Physician Practice RIC DayRehab Ctr - River North 307 W Grand Avenue Chicago IL 60610 Day Rehabilitation RIC DayRehab Ctr - Ravenswood 1945 W Wilson Avenue Suite 100 Chicago IL 60640 Day Rehabilitation RIC Spine & Sports Rehab Ctr - River 420 Thatcher Avenue River Forest IL 60305 Outpatient Rehabilitation & Physician Practice RIC OP Center - Northshore (annex) 900 Skokie Boulevard Northbrook IL 60062 Outpatient Rehabilitation & Physician Practice RIC Pelvic Health Center 676 North St Clair Room 908 Chicago IL 60611 Outpatient Rehabilitation Alexian Rehab Hosp Physician Practice 935 Beisner Road Elk Grove Village IL 60007 Physician Practice Part I, Line 7: The best available data was used to calculate the cost amounts reported in item 7. The Medicare cost report was the source used where a program category was separately identifiable. In other cases the internal cost allocation model was used as the source of the cost. The Medicare cost report cost to charge ratio was used to determine the cost of charity and bad debt. Part III, Line 2: The bad debt expense was estimated by multiplying the cost to charge ratio from Worksheet C of the Medicare cost report times the provision for bad debt for the year. Part III, Line 3: Amounts have been reported on Schedule H, Part III, Line 3 for RIC joint ventures to estimate the amount of bad debt expense attributable to patients eligible under these organizations' financial assistance policies. Southern Illinois Hospital (SIH) provided the RIC share amounts for bad debt at cost and bad debt at cost attributable to patients eligible under the SIH financial assistance policy. The percentages of bad debt at cost attributable to patients eligible under the ABMC and IMMC financial assistance policies were taken from the filed Schedule H for Alexian Brothers Medical Center (ABMC) and Illinois Masonic Medical Center (IMMC) and were used to estimate the portion of RIC's share of bad debt for these two organizations that would be attributable to patients eligible for financial assistance under their respective policies.On Schedule H, Part III, Line 3 no amount was included for RIC for bad debt expense attributable to patients eligible under the RIC financial assistance policy. RIC's Presumptive Eligibility Policy sets forth the presumptive eligibility criteria by which a patient's financial need is determined and used by RIC to deem a patient eligible for hospital financial assistance without further scrutiny by RIC. Charity care may be provided to patients who are either uninsured or underinsured who do not have the financial resources to pay their RIC bill and who meet income and other guidelines specified by RIC. As soon as the need for financial assistance is identified, RIC provides the patient or Guarantor with a Program application. Patient Financial Services will review all patient accounts with self pay balances and determine presumptive eligibility after review of the patient's Charity Application and prior to sending the patient a bill requesting payment. Patient Financial Services may use third-party reporting to determine presumptive eligibility of a patient if the patient has not timely returned a completed Charity Application. If a patient is presumed eligible, their balances will not be written off to bad debt. Part III, Line 4: The organization is part of the Rehabilitation Institute, Inc. and Affiliates consolidated audit in which the footnote that discusses the bad debt expense is located on pages 7 and 8. Part III, Line 8: The portion of our Medicare shortfall reported on Part III, Line 7 which relates to patients that are dual eligible for both Medicare and Medicaid should be treated as community benefit consistent with our State of Illinois Annual Non Profit Hospital Community Benefits Plan Report. The amount on Line 7 related to these dual eligible patients is $1,035,417.The cost to charge ratio from Worksheet C of the Medicare cost report times the Medicare gross charges from the cost report less GME payments was used to determine Medicare allowable cost. Part III, Line 9b: The Executive Director-Revenue Cycle/designee will determine if the statutory conditions for pursuing collection have been met and provide written approval before a collection agency or law firm may initiate legal action against the patient for nonpayment of their bill. Part VI, Line 2: The needs of RIC's community are assessed on an ongoing basis as part of our routine operations. A formal assessment is performed related to the community health needs assessment. RIC receives input from our community through patient feedback programs, community support groups and through our clinicians and physicians who are interacting with patients every day. The RIC LIFE Center provides education and support for the disabled community regardless if they receive services from RIC or not. In FY 2015 LIFE Center web traffic averaged 367,280 page views per month with 4,407,361 page views annually. Unique users reflected 18,608 people each month. Total outreach and service efforts represented 21,386 person contacts. This included individualized teaching sessions with patients, families, staff, and visitors, as well as a wide variety of education programs, support groups, special events, and tours with prospective patients and families. Through this connection we are able to collect and track the resource needs of our community. We also have a number of disabled members on our governing and auxiliary boards. These individuals help guide the mission, vision and services at RIC. Additionally, in 2013, RIC undertook a formal process which included meetings and written surveys in order to assess and develop a Community Benefit Needs Assessment. Since that time, RIC has focused on implementing programs that were identified in that Assessment as well as continues to evolve and (as appropriate) develop additional programs to meet those needs of the community. Part VI, Line 3: RIC assures that each registration/admission location contains signage (in English and other predominant languages of the RIC patient population) notifying patients that financial assistance is available to qualified individuals. This notice is also posted on RIC's website (www.ric.org), along with RIC's Financial Assistance Program process and application. Information regarding the Financial Assistance Program and the application is available in each RIC registration/admission location. The information regarding financial assistance also appears on every self pay statement sent to our patients. In addition, when RIC care managers are involved in the patient's care, the care manager informs and assists the patients in enrolling in appropriate entitlement programs. Part VI, Line 4: As a specialty hospital, RIC defines the patients it serves broadly as the disabled community throughout the state of Illinois, the United States and around the world. Due to RIC's unique services and its reputation as the leader in rehabilitation medicine, many patients will travel long distances for care. Approximately 81% of RIC inpatients come from Chicago and its 7 surrounding counties. This represents a primary reach of 50 miles. In addition to those Chicago area patients, RIC staff also cared for patients from 43 states and handled referrals from 61 countries. RIC continues to increase its outreach and has impacted the lives of individuals in North, Central and South America; Europe; Africa; Asia (predominately the Middle East); and Australia.The largest users of rehabilitation medicine are those 45-64 years of age and those 65+. RIC continues to serve this group of people and conducts strategic planning around the needs of the "Baby Boomer" population, which is projected to have substantial growth in the Chicagoland area. Part VI, Line 5: RIC provides a number of services that generally do not generate revenue, solely for the purposes of improving the health and quality of life for our community. These services include: research to improve patient outcomes; educational resources on living with a disability available to anyone through the Internet; vocational training and placement services; support groups to assist in psychological adjustment; fitness and sports training program to promote physical activity and case management for high risk patients discharged to the community. Any surplus funds are used to support these non-revenue patient centered activities as well as develop programs, sponsor research and improve facilities. In the past several years, The Rehabilitation Institute of Chicago (RIC) has implemented multiple sustainable guidelines and procedures to ensure that it is using the most innovative, "green" practices when updating, remodeling, and redecorating facilities and structures. Part VI, Line 7, Reports Filed With States IL 1 Arizona Board of Regents - Arizona State University PO Box 876011 Tempe AZ 852876011 861096696 501(c)(3) 8186 Payments for research related activities Biomedical Research Foundation of South Texas Inc 7400 Merton Minter Blvd San Antonio TX 78229 742522436 501(c)(3) 138941 Payments for research related activities Case Western Reserve University Grants Contracts PO Box 1591 Nashville TN 37235 341018992 501(c)(3) 28686 Payments for research related activities Cleveland State University 2121 Euclid Ave Cleveland OH 44115 340966056 501(c)(3) 21210 Payments for research related activities COAPT LLC 222 W Ontario Suite 220 Chicago IL 60654 455122988 53582 Payments for research related activities Emory University 1599 Clifton Road NE - 4th Fl MS1599/001/1BH Atlanta GA 303224250 580566256 501(c)(3) 18197 Payments for research related activities Henry M Jackson Foundation 6720 A Rockledge Drive Suite 100 Bethesda MD 20817 521317896 501(c)(3) 8192 Payments for research related activities Illinois Institute of Technology 3300 S Federal St Room 201 Chicago IL 606163793 362170136 501(c)(3) 34551 Payments for research related activities Marquette University Office of the Comptroller Milwaukee WI 532011881 390806251 501(c)(3) 6797 Payments for research related activities Mary Free Bed Hospital & Rehabilitation Center 235 Wealthy St SE Grand Rapids MI 495035299 381359265 501(c)(3) 24623 Payments for research related activities Massachusetts Institute of Technology McGovern Institute for Brain Science BLDG46-6189 Cambridge MA 02140 042103594 501(c)(3) 521685 Payments for research related activities New York Institute of Technology Nothern Blvd Old Westbury NY 11568 111788788 501(c)(3) 25838 Payments for research related activities Northwestern University 710 N Lakeshore Drive Chicago IL 60611 362167817 501(c)(3) 2273480 Payments for research related activities President and Fellows of Harvard College DBA Harvard University 1033 Massachusetts Ave 2nd Fl Cambridge MA 02138 042103580 501(c)(3) 1381075 Payments for research related activities Regents of the University of Colorado 1800 Grant St 400 Denver CO 80203 846000555 501(c)(3) 43867 Payments for research related activities Regents of the University of Michigan 3003 S State St 2050 Wolverine Tower Ann Arbor MI 48109 386006309 501(c)(3) 29268 Payments for research related activities Regents of The University of Minnesota 2221 University Ave SE Suite 111 Minneapolis MN 55414 416007513 501(c)(3) 12837 Payments for research related activities Rush University Medical Center PO Box 73952 Chicago IL 606437939 362174823 501(c)(3) 13270 Payments for research related activities Spaulding Rehabilitation Hospital Corporation 125 Nashua Street Boston MA 02114 042551124 501(c)(3) 139814 Payments for research related activities Thomas Idstein DBA Akamai Electronics LLC 1668 Belle Haven Dr Grayslake IL 60030 551576581 5620 Payments for research related activities Trustees of Boston University 881 Commonwealth Ave Boston MA 02215 042103547 501(c)(3) 14016 Payments for research related activities University of Alabama - Birmingham 701 20th St South 770 Admin Bldg Birmingham AL 35294 636005396 501(c)(3) 94472 Payments for research related activities University of Arizona PO Box 3520 Tucson AZ 85722 742652689 501(c)(3) 11195 Payments for research related activities University of California - Irvine 111 Academy Way Suite 210 Irvine CA 926971050 952540117 501(c)(3) 86107 Payments for research related activities University of Colorado - Boulder 3100 Main St Boulder CO 803090572 846049811 501(c)(3) 327255 Payments for research related activities University of Delaware 20 Hullihen Hall Newark DE 19716 516000297 501(c)(3) 75366 Payments for research related activities University of Houston System 5000 Gulf Freeway Bldg 1 Rm 109 Houston TX 77204 746001399 501(c)(3) 47840 Payments for research related activities University of Illinois 1305 W Green St Urbana IL 61801 376006007 501(c)(3) 488932 Payments for research related activities University of Northern Iowa 213 E Bartlett Hall Cedar Falls IA 50614 426004333 501(c)(3) 8096 Payments for research related activities University of Notre Dame 731 Grace Hall Notre Dame IN 46556 350868188 501(c)(3) 53196 Payments for research related activities University of Wisconsin - Madison 1300 University Ave Madison WI 53706 396006492 501(c)(3) 267527 Payments for research related activities University of Wisconsin - Milwaukee PO Box 413 Milwaukee WI 532010413 391805963 501(c)(3) 32257 Payments for research related activities Washington University One Brookings Dr Box 1054 Saint Louis MO 63130 430653611 501(c)(3) 30679 Payments for research related activities Pathways c/o PJH Associates Inc 205 W Wacker Drive 1400 Chicago IL 60606 363677342 501(c)(3) 8500 General support 32 2 Stipends/Honorariums 22 13370 Research - Professional Services 15 85972 Subject Reimbursements 1738 219712 Part I, Line 2: Oversight is provided by executive leadership, supported by the research administration department where active interaction with principal investigators is maintained. Monitoring is done through continued relationships with grantee organizations, whether by membership or community liaison. For research grants, each grant is assigned a Principal Investigator (PI) as well as a Research Assistant (RA). Grant expenditures charged to each grant are approved/reviewed by the respective PI and/or RA to ensure allowability. In addition, compliance (A-133) as well as Financial audits are performed by an independent audit firm each year. X 0 1 X X X X X 0 1 0 0 0 0 0 1 0 Joanne C Smith MD President, CEO 802678 0 594000 0 725530 0 638148 0 29863 0 2790219 0 698279 0 Nancy E Paridy Sr. VP, General Counsel 318116 0 178200 0 49617 0 54324 0 7149 0 607406 0 45819 0 Edward B Case Executive VP, CFO 604007 0 328860 0 709012 0 213148 0 22749 0 1877776 0 699233 0 Lois M Huggins Sr. VP, Chief HR Officer 335477 0 189000 0 32486 0 54604 0 15168 0 626735 0 28745 0 Peggy M Kirk Sr. VP, Clinical Operations 419102 0 224120 0 184140 0 309820 0 23460 0 1160642 0 177828 0 James Sliwa DO Chief Medical Officer 357025 0 179400 0 230607 0 277464 0 23460 0 1067956 0 223117 0 Collins Fitzpatrick MD Medical Director 930525 0 92706 0 70382 0 37500 0 22368 0 1153481 0 67887 0 Michael S Marinko MD Medical Director 590735 0 0 0 64109 0 47500 0 23460 0 725804 0 60261 0 Elizabeth Owens Sr. VP & Chief Marketing & Innov. 395882 0 210600 0 5155 0 0 0 13837 0 625474 0 0 0 Thomas Sullivan Sr. VP & Chief Development Officer 439517 0 172500 0 22024 0 0 0 25960 0 660001 0 0 0 William Rymer MD PhD VP, Research 321158 0 62438 0 14938 0 17500 0 7749 0 423783 0 0 0 Part I, Line 1a Gross-up payments: The organization provides additional disability insurance for the Chief Executive Officer. The CEO purchases the policy and then is reimbursed by the organization. The amount is grossed up to cover applicable taxes. Part I, Line 1b The organization does not have a written policy. Reimbursements are made pursuant to an agreement. Part I, Line 4b Eligible executives participate in various non-qualified deferred compensation plans organized under code section 457(f). The exact purpose of each plan varies, but they include: compensation limitation make-up plans, voluntary deferral plans, deferral of a portion of incentive bonus type plans, etc. Any amount ultimately paid under the program to the executive is reported as compensation on Form 990, Schedule J, Part II, Column B in the year paid. The following individuals received a current year distribution: Joanne Smith - $698,279 Edward Case - $699,233 Nancy Paridy - $45,819 Lois Huggins - $28,745 Peggy Kirk - $177,828 James Sliwa - $223,117 Collins Fitzpatrick - $67,887 Michael S. Marinko - $60,261 Part I, Line 7 Executive leadership participate in a variable incentive compensation plan. Amounts are a percent of base salary. Certain financial and quality triggers need to be met, and then the percent awards are determined by institutional financial performance, patient satisfaction scores, and individual performance metrics. A Illinois Finance Authority 861091967 45203HTC6 2013-07-11 398898603 Refund of bonds issued 11/22/2005 and 12/10/2009 0 0 0 A 398901857 12380511 2577151 207768019 48006174 128170002 1 0 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 1 0 0 1 0 0 0 0 A 0 Schedule K, Part I, Bond Issues: (a) Issuer Name: Illinois Finance Authority (f) Description of Purpose: Refund bonds issued 11/22/2005 and 12/10/2009; build new research hospital Part I, Column (c): The CUSIP shown here, 45203HTC6, is for the latest maturity of the Series A bonds. The issue as a whole also consists of Series B through E bonds (which mature later than Series A), none of which bear CUSIP numbers. Part II, Line 12: Other unspent proceeds consist of $128,170,002 of trustee held funds. Part III: This section is completed with respect to the new money portion of the bonds, the refunded debt issued 12/10/2009 (which was related to the land for the new building project) and the portion that refunded debt issued 11/22/2005. With respect to the new money portion and the refunded debt issued 12/10/2009, the project has not been completed, so the measurement period has not yet begun. Part III, Line 9, Part IV, Line 7, and Part V: The organization does not have written compliance procedures. However, we are aware of each of these issues (section 1.141-12 self-remediation procedures, arbitrage restrictions, VCAP), and we will seek professional assistance at the appropriate time, as necessary. Part VI: Differences between the issue price (Part I) and total proceeds (Part II, Line 3) are due to investment earnings. See Part V See Part V 170734789 See Part V 0 Schedule L, Part IV: Business Transactions Involving Interested Persons:(a) Name of Person: Substantial Contributors(b) Relationship Between Interested Person and Organization: Substantial Contributors(d) Description of Transaction: Contractor arrangements, asset purchases, professional services, and banking.Schedule L, Part IV:Business Transactions Involving Interested Persons:All transactions between RIC and the organization were done at arms-length and for fair market value. X 25 1205312 Cost or selling price X Travel Pkg. 2 36000 Cost X Jewelry 1 12000 Cost 0 0 0 1 Part I, Column (b): The number in Column(b) refers to the number of contributors. Part I, Line 32b: Gifts of stock are processed by a third party, which has an immediate sell order for all stock gifts received. Form 990, Part VI, Section A, line 3 Crothall Services Group managed our facilities and housekeeping services; Morrison Management Specialists managed our food services, and Pharmacy Systems, Inc. managed our pharmacy. No officers, directors, trustees, or key employees (current or former) received compensation from any of these companies. Form 990, Part VI, Section A, line 6 Rehabilitation Institute, Inc. (RII) is the sole corporate member of RIC. Form 990, Part VI, Section A, line 7a RII has the ability to elect members of the governing body. Form 990, Part VI, Section A, line 7b RII is the sole member with the sole voting rights to do the following: appoint RIC board members; approve amendments to the articles of incorporation and bylaws; approve corporation annual budget and long-range plan; approve those contracts and loans in excess of $250,000 not included in previously approved budget; approve any merger, consolidation, voluntary dissolution or creation of any subsidiary; and approve the sale, lease, exchange, mortgage, pledge or other disposition of all or substantially all of the corporation assets. Form 990, Part VI, Section B, line 11 Data for the Form 990 is prepared internally, and a third party tax preparer then prepares the Form 990. It is then reviewed internally and presented in draft form electronically first to the Finance and Audit Committee of the Board and then distributed electronically to the full Board. Form 990, Part VI, Section B, line 12c All newly hired employees are required to complete a conflict of interest disclosure form at the time of new-employee orientation. In addition, all employees are required to complete such a form on an annual basis. Directors and Officers complete a Conflict of Interest Questionnaire on an annual basis. Form 990, Part VI, Section B, line 15 The Compensation and Leadership Development Committee of the Board has authority to approve total compensation for the CEO, officers, and key employees; an independent consultant specializing in the field of executive compensation and benefits is hired by the Compensation and Leadership Development Committee of the Board to review and provide an opinion about the executive compensation; namely, that it is fair, reasonable and market appropriate. During the annual review and approval of the total compensation, documentation of the decision related to total compensation for the CEO, officers and key employees was recorded in the minutes. The individuals involved were not present when their compensation was decided. RIC, acting through its Compensation and Leadership Development Committee of the Board, performed all of the above procedures to obtain the rebuttable presumption respecting compensation arrangements (per IRC Section 4958). Form 990, Part VI, Section C, line 19 RIC does not routinely make documents available to the general public, but the conflict of interest policy and financial statements are made available to the public on an as needed basis after thorough consideration for the use. Form 990, Part VIII, Line 1f: On February 5, 2013, the Illinois Health Facilities and Services Review Board granted RIC a licensure for 242 beds for its new research hospital and outpatient facility currently under construction at 355 East Erie, Chicago, IL. Contribution revenue includes $23,191,558 from RIC's fundraising campaign for this new facility. Of this amount $9,920,178 was pledges. The new facility is expected to open in early 2017. Form 990, Part XI, line 9: Pension Adjustment -14,313,817. Medical Services RIC 345 E Superior Street Chicago IL 60611 911999919 Physician Practice Billing and Collections IL 0 0 N/A Rehabilitation Institute Inc 345 E Superior Street Chicago IL 60611 363310838 Parent IL 501(c)(3) 11c, II N/A 0 Rehabilitation Institute of Chicago Enterprises 345 E Superior Street Chicago IL 60611 363428852 Medical Products/Medical Services IL Rehabilitation Institute Inc C 1.00000 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0