ROSELAND COMMUNITY HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ROSELAND COMMUNITY HOSPITAL (EIN 36-1703630)
- Tax period
- 2012-04-01 to 2013-03-31
- Filed
- 2015-06-12
- IRS object ID
- 201511639349300956
- Schema version
- 2012v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2015-06-12T12:57:26-07:00 | Timestamp |
| Tax Period End Date | 2013-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LOPEZ & CO CPAS LTD | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2702 W CHICAGO AVE | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 606228510 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 361703630 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROSELAND COMMUNITY HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ROSE | NameControl |
| Phone | 7739953000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 WEST 111TH STREET | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60628 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TIMOTHY EGAN | Name |
| Title | PRESIDENT & CEO | Title |
| Phone | 7739953000 | Phone |
| Date Signed | 2014-08-29 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ENRIQUE LOPEZ | Name |
| Phone | 7736348335 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TIMOTHY EGAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 WEST 111TH ST | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60628 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 53117978 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1924 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | To provide general healthcare services to residents within the Pullman, Riverdale, and Roseland neighborhoods, including inpatient, outpatient, and emergency room physician and other services. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 653 | TotalNbrEmployees |
| Total Nbr Volunteers | 13 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 713694 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 7192752 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 48826262 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 45529157 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 14405 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2567 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 256027 | OtherRevenuePriorYear |
| Other Revenue Current Year | 393502 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 49810388 | TotalRevenuePriorYear |
| Total Revenue Current Year | 53117978 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 54467415 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 52912015 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expenses Current Year | 0 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 54467415 | TotalExpensesPriorYear |
| Total Expenses Current Year | 52912015 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -4657027 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 205963 | RevenuesLessExpensesCY |
| Total Assets BOY | 40383566 | TotalAssetsBOY |
| Total Assets EOY | 35361339 | TotalAssetsEOY |
| Total Liabilities BOY | 37508918 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 32280728 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2874648 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3080611 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide general healthcare | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 41887718 | Expense |
| Revenue | 45529157 | Revenue |
| Description | ROSELAND COMMUNITY HOSPITAL HAS PROVIDED THE COMMUNITY WITH QUALITY MEDICAL AND HEALTHCARE SERVICES FOR OVER 70 YEARS. THEY PROVIDE THE FOLLOWING CLINICS TO ACCOMMODATE THE NEEDS OF THE SURROUNDING COMMUNITIES: URGENT CARE, HIV, PEDIATRIC CARDIOLOGY, PEDIATRIC ASTHMA/ALLERGY, STROKE STUDY, EAR, NOSE, AND THROAT. | Description |
| Total Program Service Expense | 41887718 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | true | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 55 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 653 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | TIMOTHY EGAN | NamePerson |
| Telephone Number | 7739953000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 WEST 111TH ST | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60628 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (25 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee | Key EmployeeKeyEmployee |
|---|---|---|---|---|---|---|---|---|
| GENIVEE CHAPMAN | ||||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| TUNJI LADIPO | ||||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 | ||
| WILLIAM TOWNS | ||||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 | ||
| OLLIE KNIGHT | ||||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 | ||
| SALIM AL NURRIDIN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| LARRY MITCHELL | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ALMEDA DUNN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| CARL VANCOL | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MICHAEL W STUTTLEY | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MELINDA MALECKI | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| AUDRENA SPENCE | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| RAJESH IYENGAR | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| KIMBERLY J BROWN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JOHN BRADLEY | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DIAN POWELL | ||||||||
| PRESIDENT & CEO | 40 | X | 256008 | |||||
| JOY WEST | ||||||||
| PHYSICIAN | 40 | 225744 | X | |||||
| ANGELA MAHOME | ||||||||
| PHYSICIAN | 40 | 203811 | X | |||||
| MARIBEL TORRES | ||||||||
| CHIEF NURSING OFFICER | 40 | 185886 | X | |||||
| PAMELA SMITH | ||||||||
| PHYSICIAN | 54 | 175300 | X | |||||
| ROBERT CHASE | ||||||||
| PHYSICIAN | 40 | 147247 | X | |||||
| DOUGLAS BECK | ||||||||
| VP SUPPORT SERVICES | 40 | 143766 | X | |||||
| SHARON THURMAN | ||||||||
| VP COMMUNITY AFFAIRS | 40 | 116841 | X | |||||
| REGINALD THREATT | ||||||||
| PHYSICIAN | 40 | 115837 | X | |||||
| SHELIA MARTIN | ||||||||
| PHYSICIAN | 40 | 114706 | X | |||||
| DARLENE BROWN | ||||||||
| PHYSICIAN | 40 | 109566 | X | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 2114884 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 14 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EMERGENCY MEDICAL SPECIALIST | |||||
| 1012 LAKE SHORE BLVD | EVANSTON | IL | 60202 | ER PHYSICIAN SERVICES | 1407921 |
| FITCH HEALTHCARE CONSULTING | |||||
| 903 COMMERCE DR 160 | OAK BROOK | IL | 60523 | OPERATIONAL CONSULTING | 992631 |
| MIDWEST MEDICAL SUPPLY | |||||
| PO BOX 955588 | ST LOUIS | MO | 63195 | EQUIPMENT AND SUPPLIES | 980580 |
| MEDICAL INFORMATION TECHNOLOGY | |||||
| MEDITECH CIRCLE | WESTWOOD | MA | 02090 | IT CONSULTING | 905937 |
| DMS PHARMACEUTICAL | |||||
| 810 BUSSE HIGHWAY | PARK RIDGE | IL | 60068 | PHARMACEUTICAL WHOLESALER | 777914 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 6974959 | GovernmentGrants |
| All Other Contributions | 217793 | AllOtherContributions |
| Total Contributions | 7192752 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn |
|---|---|---|
| MEDICARE/MEDICAID | 621110 | |
| NET PATIENT REVENUE | 621110 | 45529157 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 45529157 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2567 | TotalRevenueColumn |
| Exclusion | $2,567 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 98712 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 98712 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 98712 | TotalRevenueColumn |
| Exclusion | $98,712 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| CAFETERIA | 722210 | 105895 | $105,895 |
| VENDING/GIFT SHOP | 453220 | 23881 | $23,881 |
| MISCELLANEOUS REVENUE | 900099 | 165014 | $165,014 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 294790 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 53117978 | TotalRevenueColumn |
| Related Or Exempt Function Income | 45529157 | RelatedOrExemptFunctionIncome |
| Exclusion | $396,069 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 441894 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 441894 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25198359 | Total |
| Program Services | 14615956 | ProgramServices |
| Management And General | 10582403 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27271762 | Total |
| Program Services | 27271762 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52912015 | Total |
| Program Services | 41887718 | ProgramServices |
| Management And General | 11024297 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2701058 | BOY |
| EOY | 358025 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5940011 | BOY |
| EOY | 2558081 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4113199 | BOY |
| EOY | 3167036 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 487498 | BOY |
| EOY | 647590 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1388401 | BOY |
| EOY | 347575 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 54834942 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 26598933 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25544274 | BOY |
| EOY | 28236009 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 209125 | BOY |
| EOY | 47023 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40383566 | BOY |
| EOY | 35361339 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14634929 | BOY |
| EOY | 12606995 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6196817 | BOY |
| EOY | 4180549 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16677172 | BOY |
| EOY | 15493184 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 37508918 | BOY |
| EOY | 32280728 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -635374 | BOY |
| EOY | -429411 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3510022 | BOY |
| EOY | 3510022 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2874648 | BOY |
| EOY | 3080611 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 40383566 | BOY |
| EOY | 35361339 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 205963 | ReconcilationRevenueExpenses |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | false | FSAudited |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Medical Research Org170b1 Aiii | X | MedicalResearchOrg170b1Aiii |
Hospital Name And Address HospitalNameAndAddress
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROSELAND COMMUNITY HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| City | CHICAGO | City |
| State | IL | State |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 0 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Pertcentage170 | 0 | PublicSupportPertcentage170 |
| Public Support Total509 | 0 | PublicSupportTotal509 |
| Public Support Percentage509 | 0 | PublicSupportPercentage509 |
| Investment Income Percentage | 0 | InvestmentIncomePercentage |
Schedule C IRS990ScheduleC
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 923853 | OtherCostOrOtherBasis |
| Book Value | 923853 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 32969778 | OtherCostOrOtherBasis |
| Depreciation | 26598933 | Depreciation |
| Book Value | 6370845 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 142343 | OtherCostOrOtherBasis |
| Book Value | 142343 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 19963891 | OtherCostOrOtherBasis |
| Book Value | 19963891 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 835077 | OtherCostOrOtherBasis |
| Book Value | 835077 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 28236009 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets (2 entries)
| DescriptionDescription | Book ValueBookValue |
|---|---|
| DUE FROM THIRD-PARTY PAYORS | 1788 |
| OTHER ASSETS | 45235 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 47023 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (4 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| SELF-INSURANCE LIABILITIES | $2,830,326 |
| CAPITAL LEASE OBLIGATIONS | $2,570,693 |
| DUE TO THIRD-VENDORS | $5,752,583 |
| NEW MARKET TAX LIABILITY | $4,339,582 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 15493184 | TotalOfAmounts |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
Other Percentage OtherPercentage
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Free Other Percentage | 300.00000 | FreeOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FPG Reference Discounted Care | true | FPGReferenceDiscountedCare |
Discounted Other DiscountedOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | X | Other |
| Discounted Other Percentage | 600.00000 | DiscountedOtherPercentage |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 8513361 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 8513361 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.16090 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 24358084 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 15525443 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 8832641 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.16690 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 15325516 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 25157632 | DirectOffsettingRevenue |
| Net Community Benefit Expense | -9832116 | NetCommunityBenefitExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 48196961 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 40683075 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7513886 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.32780 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 48196961 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 40683075 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 7513886 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.32780 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $18,634,613 | BadDebtExpenseAmount |
| Amount Attributable To | 4658653 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 46440958 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 15706007 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 30734951 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | false | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROSELAND COMMUNITY HOSPITAL ASSOCIATION | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 WEST 111TH STREET | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60628 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Licensed Hospital | X | LicensedHospital |
| General Medical And Surgical | X | GeneralMedicalAndSurgical |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROSELAND COMMUNITY HOSPITAL ASSOCIATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 300 | FPGFreePercent |
| Uses FPG Discounted | true | UsesFPGDiscounted |
| FPG Discount Percent | 600 | FPGDiscountPercent |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Medical Indigency | X | MedicalIndigency |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Medicaid Medicare | X | MedicaidMedicare |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Permit Other Actions | X | PermitOtherActions |
| Collection Activities | false | CollectionActivities |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Used Other Method | X | UsedOtherMethod |
| Amounts Generally Billed | true | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part VI Form990ScheduleHPartVI (15 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt V Sec B 15e | INDIVIDUAL ASSESSMENTS MADE |
| Pt V Sec B 1j | ROSELAND HAS IMPLEMENTED A FINANCIAL ASSISTANCE POLICY (FAP) THAT MEETS THE |
| Pt V Sec B 14g | REQUIREMENTS OF ILLINOIS PUBLIC ACT 095-0965 "HOSPITAL UNINSURED PATIENT DISCOUNT ACT". |
| THIS POLICY WAS ALSO EXTENDED TO ALL CLINICALLY NECESSARY PROCEDURES AND WAS NOT | |
| LIMITED TO EMERGENCY CARE ONLY. | |
| Pt III Line 2 | THE COST METHODOLOGY USED TO CALCULATE THE AMOUNT REPORTED AS BAD DEBT EXPENSE, |
| AT COST, IS THE COST-TO-CHARGE RATIO DERIVED FROM THE IRS' SCHEDULE H, WORKSHEET 2 | |
| Pt III Line 3 | THE COST METHODOLOGY USED TO CALCULATE THE AMOUNT REPORTED AS BAD DEBT EXPENSE |
| ATTRIBUTBLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY, | |
| AT COST, IS THE COST-TO-CHARGE RATIO DERIVED FROM THE IRS' SCHEDULE H, WORKSHEET 2 | |
| Pt III Line 4 | THE COLLECTION OF RECEIVABLES FROM THIRD-PARTY PAYORS AND PATIENTS IS THE HOSPITAL'S PRIMARY SOURCE |
| OF CASH FOR OPERATIONS AND IS CRITICAL TO ITS OPERATING PERFORMANCE. THE PRIMARY | |
| COLLECTION RISKS RELATE TO UNINSURED PATIENT ACCOUNTS AND PATIENT ACCOUNTS | |
| FOR WHICH THE PRIMARY INSURANCE PAYOR HAS PAID, BUT PATIENT RESPONSIBILITY | |
| AMOUNTS (DEDUCTIBLES AND COPAYMENTS) REMAIN OUTSTANDING |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg | Other Compensation Filing OrgOtherCompensationFilingOrg |
|---|---|---|
| DIAN POWELL | ||
| 256008 | 256008 | |
| JOY WEST | ||
| 224473 | 225744 | 1271 |
| ANGELA MAHOME | ||
| 198250 | 203811 | 5561 |
| MARIBEL TORRES | ||
| 175178 | 185886 | 10708 |
| PAMELA SMITH | ||
| 175300 | 175300 | |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (10 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt VI, Line 11b | BOARD OF DIRECTORS REVIEWS 990 PRIOR FILING |
| Pt VI, Line 12c | SIGNED DOCUMENT SUBMITTED ANNUALLY AND KEPT ON FILE. ANY POTENTIAL CONFLICTS |
| ARE EXAMINED AND ACTIONS ARE TAKEN TO RESOLVE OR DISCLOSE SUCH CONFLICTS. | |
| Pt VI, Line 15a | ROSELAND SECURED THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT |
| TO PERFORM A SALARY SURVEY FOR THE CEO. | |
| THE COMPENSATON COMMITTEE RECOMMENDS A SALARY THAT IS SUBSEQUENTLY | |
| REVIEWED BY THE BOARD OF DIRECTORS BEFORE APPROVAL BY BOARD. | |
| Pt VI, Line 15b | ROSELAND SECURED THE SERVICES OF AN INDEPENDENT COMPENSATION |
| CONSULTANT TO PERFORM A SALARY SURVEY FOR KEY EXECUTIVES. | |
| Pt XII, Line 3b | ORGANIZATION IS CURRENTLY UNDERGOING ITS AUDIT |
Schedule R IRS990ScheduleR
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | false | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | false | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | false | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | false | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | false | OtherTransferToOtherOrg |
| Other Transfer From Other Org | false | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROSELAND COMMUNITY HOSPITAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | m | TransactionType |
| Method Of Amt Determination | MARKET VALUE | MethodOfAmtDetermination |