STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

JACKSON PARK HOSPITAL FOUNDATION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
JACKSON PARK HOSPITAL FOUNDATION (EIN 36-2448028)
Tax period
2013-04-01 to 2014-03-31
Filed
2015-10-15
IRS object ID
201512899349300416
Schema version
2013v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2015-10-15T17:37:44-07:00ReturnTs
Tax Period End2014-03-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2013-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN362448028EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JACKSON PARK HOSPITAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlJACKBusinessNameControlTxt
Phone7739477989PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17531 Stony Island AvenueAddressLine1
CityChicagoCity
StateILState
ZIP Code60649ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWilliam Dorsey MDPersonNm
Person TitleChairman/CEOPersonTitleTxt
Phone7739477989PhoneNum
Signature2014-09-27SignatureDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Amended ReturnYes (X)AmendedReturnInd
Principal OfficerWilliam Dorsey MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line17531 Stony Island AvenueAddressLine1
CityChicagoCity
StateILState
ZIP Code60649ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$96,164,268GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.jacksonparkhospital.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1960FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionThe mission of the physicians, staff, and Board of Directors of the organization is to provide compassionate and high quality healthcare services to meet the needs of the patients and communities we serve.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee835TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$13,622,330PYContributionsGrantsAmt
CY Contributions Grants$4,017,411CYContributionsGrantsAmt
PY Program Service Revenue$63,089,919PYProgramServiceRevenueAmt
CY Program Service Revenue$66,263,748CYProgramServiceRevenueAmt
PY Investment Income$6,038PYInvestmentIncomeAmt
CY Investment Income$37,102CYInvestmentIncomeAmt
PY Other Revenue$22,478,182PYOtherRevenueAmt
CY Other Revenue$25,846,007CYOtherRevenueAmt
PY Total Revenue$99,196,469PYTotalRevenueAmt
CY Total Revenue$96,164,268CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$41,507,450PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$40,041,696CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$48,455,243PYOtherExpensesAmt
CY Other Expenses$47,260,921CYOtherExpensesAmt
PY Total Expenses$89,962,693PYTotalExpensesAmt
CY Total Expenses$87,302,617CYTotalExpensesAmt
PY Revenues Less Expenses$9,233,776PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$8,861,651CYRevenuesLessExpensesAmt
Total Assets BOY$123,963,251TotalAssetsBOYAmt
Total Assets EOY$127,240,624TotalAssetsEOYAmt
Total Liabilities BOY$31,575,135TotalLiabilitiesBOYAmt
Total Liabilities EOY$26,016,819TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$92,388,116NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$101,223,805NetAssetsOrFundBalancesEOYAmt
MissionThe mission of the physicians, staff and Board of Directors of the organization is to provide compassionate and high quality healthcare services to meet the needs of the patients and communities we serve.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$83,660,305ExpenseAmt
Grant$0GrantAmt
Revenue$66,263,748RevenueAmt
DescJackson Park Hospital Foundation provides inpatient and outpatient medical care and behavioral medicine services to Chicago's south side communities regardless of the patients ability to pay. Jackson Park Hospital serves a economically challenged community with high rates of foreclosures, unemployment, violence and some of the worst health indices in the City of Chicago. Jackson Park Hospital itself is challenged to stay viable in such a poorly resourced area. However, Jackson Park Hospital works to deploy its limited resources in ways that most appropriately meets the needs of our community.Desc
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$83,660,305TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate HospitalYes (1)OperateHospitalInd
Audited Financial Stmt AttYes (1)AuditedFinancialStmtAttInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee835EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonNelson VasquezPersonNm
Phone7739477989PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line17531 Stony IslandAddressLine1
CityChicagoCity
StateILState
ZIP Code60649ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Dr Arol Augsburger
Director20Yes (X)$0$0$0
Bangalore Murthy MD
Director400Yes (X)$154,924$137,718$23,604
Sameera T Qureshi MD
Director400Yes (X)$84,982$81,554$24,178
James Nunn MD
Director400Yes (X)$67,721$341,694$23,688
James Clark III
Director20Yes (X)$0$0$0
Haroon Olomi MD
Director400Yes (X)$92,825$200,649$15,861
Lakshmi Dodda MD
Director400Yes (X)$209,700$0$655
Dr Erma Brooks Williams
Director20Yes (X)$0$0$0
William Dorsey MD
Chairman / CEO400Yes (X)$605,788$0$8,360Yes (X)
Harshad Mehta MD
Director400Yes (X)$125,415$0$3,966
Merritt Hasbrouck
President400$525,716$0$2,879Yes (X)
G Randall Smith
Executive Vice President400$517,331$0$17,924Yes (X)
Nelson Vasquez
VP Finance400$194,230$0$17,837Yes (X)
Barry Mandell
VP Special Projects400$154,443$0$17,837Yes (X)
Patricia Simon
VP Quality and Compliance400$141,650$0$12,564Yes (X)
Thodur Ranganathan MD
Physician400$237,385$0$23,688Yes (X)
Rose Ette RN
Registered Nurse600$213,125$0$15,387Yes (X)
Georgia Lubben MD
Physician400$131,539$33,657$84Yes (X)
Naveed Muhammad MD
Physician400$136,176$0$23,285Yes (X)
Nina Pope
Advance Practice Nurse400$123,296$0$23,966Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,716,246TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$795,272TotReportableCompRltdOrgAmt
Total Other Compensation$255,763TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K30IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
The George Sollitt Construction Company
790 N Central AveWood DaleIL60191Construction$2,684,993
McKesson
5995 Windward ParkwayAlpharettaGA30005Healthcare IT Services and Systems$1,648,824
EMCARE INC
7032 Collection CenterChicagoIL60693Provides Emergency Room Physicians$1,487,421
NICL Laboratories
306 ERA DriveBNorthbrookIL60062Laboratory Services$1,468,207
Rush Nursing Services
7501 Stony IslandChicagoIL60649Temporary Nurse Staff$1,403,454
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K54CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$0GovernmentGrantsAmt
All Other Contributions$4,017,411AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$4,017,411TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescThe provision of inpatient and outpatient healthcareDesc
Business622110BusinessCd
Total Revenue Column$66,263,748TotalRevenueColumnAmt
Related Or Exempt Func Income$66,263,748RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$66,263,748TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$37,102TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$37,102ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$120,783RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$120,783RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$120,783TotalRevenueColumnAmt
Related Or Exempt Func Income$120,783RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,725,224TotalRevenueColumnAmt
Related Or Exempt Func Income$25,725,224RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$25,725,224OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$96,164,268TotalRevenueColumnAmt
Related Or Exempt Func Income$92,109,755RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$37,102ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$3,035,672TotalAmt
Program Services$0ProgramServicesAmt
Management And General$3,035,672ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,439,645TotalAmt
Program Services$30,439,645ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$301,964TotalAmt
Program Services$301,964ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,793,658TotalAmt
Program Services$3,793,658ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,470,757TotalAmt
Program Services$2,470,757ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$263,859TotalAmt
Program Services$0ProgramServicesAmt
Management And General$263,859ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$185,121TotalAmt
Program Services$0ProgramServicesAmt
Management And General$185,121ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$157,660TotalAmt
Program Services$0ProgramServicesAmt
Management And General$157,660ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$23,446,133TotalAmt
Program Services$23,446,133ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,523,563TotalAmt
Program Services$1,523,563ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$487,446TotalAmt
Program Services$487,446ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,280,418TotalAmt
Program Services$2,280,418ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$852,529TotalAmt
Program Services$852,529ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Bad Debt$9,957,504$9,957,504$0$0
Provider Tax Expense$8,106,688$8,106,688$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$87,302,617TotalAmt
Program Services$83,660,305ProgramServicesAmt
Management And General$3,642,312ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,706,969BOYAmt
EOY$6,695,550EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

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

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$92,690,513BOYAmt
EOY$92,288,855EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$984,524BOYAmt
EOY$954,944EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,079,164BOYAmt
EOY$468,445EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$82,186,266LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$55,990,266LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$24,865,751BOYAmt
EOY$26,196,000EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$636,330BOYAmt
EOY$636,830EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$123,963,251BOYAmt
EOY$127,240,624EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,448,602BOYAmt
EOY$10,997,861EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,556,966BOYAmt
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$9,089,057BOYAmt
EOY$8,755,356EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,480,510BOYAmt
EOY$6,263,602EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$31,575,135BOYAmt
EOY$26,016,819EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$92,388,116BOYAmt
EOY$101,223,805EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

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

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$92,388,116BOYAmt
EOY$101,223,805EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$123,963,251BOYAmt
EOY$127,240,624EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$8,861,651ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$0NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets-$25,962OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$2,482,024InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Book Value$2,482,024BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$47,217,910InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$34,302,215DepreciationAmt
Book Value$12,915,695BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$349,716InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$266,402DepreciationAmt
Book Value$83,314BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$24,653,500InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$21,421,649DepreciationAmt
Book Value$3,231,851BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$7,483,116InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$7,483,116BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$26,196,000TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Self Insurance Liability$5,526,198
Pension Liability$737,404
FieldValueIRS element (for citing)
Total Liability$6,263,602TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$96,164,268TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$0NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Recoveries Prior Year Grants$0RecoveriesPriorYearGrantsAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$96,164,268RevenueSubtotalAmt
Investment Expenses Not Incld$0InvestmentExpensesNotIncldAmt
Other Revenues Not Included$0OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$96,164,268TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$87,302,617TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$0DonatedServicesUseFcltsAmt
Prior Year Adjustments$0PriorYearAdjustmentsAmt
Losses Reported$0LossesReportedAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$87,302,617ExpensesSubtotalAmt
Investment Expenses Not Incld2$0InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$0OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$87,302,617TotalExpensesPerForm990Amt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (1)FinancialAssistancePolicyInd
Written PolicyYes (1)WrittenPolicyInd
All Hospitals PolicyYes (X)AllHospitalsPolicyInd
FPG Reference Free CareYes (1)FPGReferenceFreeCareInd
Percent200Yes (X)Percent200Ind
FPG Reference Discounted CareYes (1)FPGReferenceDiscountedCareInd
Percent200 DYes (X)Percent200DInd
Free Care Medically IndigentYes (1)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (1)FinancialAssistanceBudgetInd
Expenses Exceed BudgetYes (1)ExpensesExceedBudgetInd
Unable To Provide Care0UnableToProvideCareInd
Annual Community Bnft ReportYes (1)AnnualCommunityBnftReportInd
Report Publically AvailableYes (1)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$5,988,104TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$5,988,104NetCommunityBenefitExpnsAmt
Total Expense0.0685TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$5,988,104TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$5,988,104NetCommunityBenefitExpnsAmt
Total Expense0.0685TotalExpensePct

Community Health Services CommunityHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$63,964TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$63,964NetCommunityBenefitExpnsAmt
Total Expense0.0007TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$3,112,193TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$3,112,193NetCommunityBenefitExpnsAmt
Total Expense0.0356TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,820,337TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,820,337NetCommunityBenefitExpnsAmt
Total Expense0.1009TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$11,996,494TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$11,996,494NetCommunityBenefitExpnsAmt
Total Expense0.1372TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Activities Or Programs0ActivitiesOrProgramsCnt
Persons Served0PersonsServedCnt
Total Community Benefit Expns$17,984,598TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$0DirectOffsettingRevenueAmt
Net Community Benefit Expns$17,984,598NetCommunityBenefitExpnsAmt
Total Expense0.2057TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (1)BadDebtExpenseReportedInd
Bad Debt Expense$5,146,042BadDebtExpenseAmt
Bad Debt Expense Attributable$2,592,142BadDebtExpenseAttributableAmt
Reimbursed By Medicare$19,354,014ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$19,354,014CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$0MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
FieldValueIRS element (for citing)
Written Debt Collection Policy0WrittenDebtCollectionPolicyInd
Hospital Facilities1HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Jackson Park Hospital FoundationBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line17531 Stony IslandAddressLine1
CityChicagoCity
StateILState
ZIP Code60649ZIPCode
FieldValueIRS element (for citing)
Website Addresswww.jacksonparkhospital.orgWebsiteAddressTxt
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Teaching HospitalYes (X)TeachingHospitalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd
OtherBehavioral MedicineOtherDesc

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1Jackson Park Hospital FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedYes (1)CHNAConductedInd
Community DefinitionYes (X)CommunityDefinitionInd
Community DemographicsYes (X)CommunityDemographicsInd
How Data ObtainedYes (X)HowDataObtainedInd
Community Health NeedsYes (X)CommunityHealthNeedsInd
Other Health IssuesYes (X)OtherHealthIssuesInd
Consulting ProcessYes (X)ConsultingProcessInd
CHNA Conducted13CHNAConductedYr
Take Into Account Others InputYes (1)TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts0CHNAConductedWithOtherFcltsInd
CHNA Report Widely Available0CHNAReportWidelyAvailableInd
Include Operational PlanYes (X)IncludeOperationalPlanInd
All Needs AddressedYes (1)AllNeedsAddressedInd
Organization Incur Excise Tax0OrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (1)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (1)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care200FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (1)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care200FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (1)ExplainedBasisInd
Income LevelYes (X)IncomeLevelInd
Asset LevelYes (X)AssetLevelInd
Medical IndigencyYes (X)MedicalIndigencyInd
Insurance StatusYes (X)InsuranceStatusInd
Uninsured DiscountYes (X)UninsuredDiscountInd
Medicaid MedicareYes (X)MedicaidMedicareInd
State RegulationYes (X)StateRegulationInd
App Financial Asst ExplnYes (1)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (1)IncludesPublicityMeasuresInd
Posted On WebsiteYes (X)PostedOnWebsiteInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
Available On RequestYes (X)AvailableOnRequestInd
FAP Actions On Nonpayment0FAPActionsOnNonpaymentInd
Permit Report To Credit AgencyYes (X)PermitReportToCreditAgencyInd
Collection ActivitiesYes (1)CollectionActivitiesInd
Reporting To Credit AgencyYes (X)ReportingToCreditAgencyInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
Nondis Emergency Care PolicyYes (1)NondisEmergencyCarePolicyInd
Amounts Generally Billed0AmountsGenerallyBilledInd
Gross Charges0GrossChargesInd

Supplemental Information SupplementalInformationGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule H, Part V, Section B, Line 3-Jackson Park Hospital FoundationFormAndLineReferenceDesc
ExplanationWe consulted with the Metropolitan Chicago Healthcare Council. They provided us with the results of intensive data analysis and focus group input for our specific service area.ExplanationTxt

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule H, Part I, Line 7The costing methodology used to calculate financial assistance at cost is the cost -to-charge ratio derived from the hospitals Medicare cost report. Worksheet S-10 line one.
Schedule H, Part I, Line 7, Column fThe hospital reported a total of $20,064,106
Schedule H, Part III, Section A, Line 4In July 2011, the FASB issued ASU 2011-07, Presentation and Disclosure of Patient Service Revenue, Provision for Bad Debt, and the Allowance for Doubtful Accounts for Certain Health Care Entities. ASU 2011-07 amends Accounting Standards Codification 954, Health Care Entities, to provide financial statement users with greater transparency about a health care entity's net patient service revenue, which is sometimes grossed up and recognized at the time the services are rendered regardless of whether the entity expects to collect that amount, and the related allowance for doubtful accounts. ASU 2011-07 provides information to assist financial statement users in assessing an entity's sources of net patient service revenue and related changes in its allowance for doubtful accounts. It requires health care entities that recognize significant amounts of patient service revenue at the time the services are rendered, even though they do not assess the patient's ability to pay, to present the provision for bad debts related to patient service revenue as a deduction from patient service revenue (net of contractual allowances and discounts) on their statement of operations. For non-public entities, ASU 2011-07 is effective for the first annual period ending after December 15, 2012 and interim and annual periods thereafter, with early adoption permitted. The Corporation adopted this new standard in fiscal year 2013.
Schedule H, Part III, Section B, Line 8The cost of providing care to Medicare patients was based on completion of the Medicare 2014 cost report.
Schedule H, Part VI, Line 2Jackson Park Hospital Foundation begins outreach and assessment of its community health by evaluating which health conditions and diseases are prevalent among its inpatient and outpatients. The hospital also purchased community health information services from the Metropolitan Chicago Health Care Council. Together, they confirm the need for education and other interventions for diabetes, asthma and behavioral medicine. The hospital has responded to these needs through the development of several community education programs and specialty clinics.
Schedule H, Part VI, Line 3The hospital has contracted with a third party that assists any patient through the application process of Medicaid or Medicare. This company will also assist a patient and or the family through the hospital's charity application process.
Schedule H, Part VI, Line 4Jackson Park Hospital's primary service area is 60649, 60619, 60620, 60617, and 60628. Our primary service area for behavioral patients is much broader and encompass the City of Chicago. The average income in the hospitals primary service area is approximately 46% of the State of Illinois average.
Schedule H, Part VI, Line 7Jackson Park Hospital Foundation prepared an annual Community Benefits Report which is submitted to the Attorney General of the State of Illinois annually. This report is also made available to the general public upon request.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
William Dorsey MD
Chairman / CEO$605,788$0$0$0$0$0$0$0$8,360$0$614,148$0$589,203$0
Merritt Hasbrouck
President$525,716$0$0$0$0$0$0$0$2,879$0$528,595$0$497,963$0
G Randall Smith
Executive Vice President$517,331$0$0$0$0$0$0$0$17,924$0$535,255$0$503,902$0
Haroon Olomi MD
Director$92,825$200,649$0$0$0$0$0$0$15,861$0$108,686$200,649$293,632$195,724
Thodur Ranganathan MD
Physician$237,385$0$0$0$0$0$0$0$23,688$0$261,073$0$276,801$0
Rose Ette RN
Registered Nurse$213,125$0$0$0$0$0$0$0$15,387$0$228,512$0$193,332$0
Lakshmi Dodda MD
Director$209,700$0$0$0$0$0$0$0$654$0$210,354$0$210,369$0
Nelson Vasquez
VP Finance$194,230$0$0$0$0$0$0$0$17,837$0$212,067$0$217,787$0
Sameera T Qureshi MD
Director$84,982$81,554$0$0$0$0$0$0$24,177$0$109,159$81,554$0$0
Georgia Lubben MD
Physician$131,539$33,657$0$0$0$0$0$0$84$0$131,623$33,657$128,664$32,831
Bangalore Murthy MD
Director$154,924$137,718$0$0$0$0$0$0$23,604$0$178,528$137,718$153,698$148,359
Barry Mandell
VP Special Projects$154,443$0$0$0$0$0$0$0$17,837$0$172,280$0$160,897$0
Patricia Simon
VP Quality and Compliance$141,650$0$0$0$0$0$0$0$12,564$0$154,214$0$144,715$0
James Nunn MD
Director$67,721$341,694$0$0$0$0$0$0$23,688$0$91,409$341,694$80,428$333,360
Naveed Muhammad MD
Physician$136,176$0$0$0$0$0$0$0$23,285$0$159,461$0$157,221$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Header, Line BThere was a audit adjustment made and I corrected the statements
Form 990, Part VI, Section B, Line 11bThe management and members of the audit committee review the return prior to its release.
Form 990, Part VI, Section B, Line 12cAll officers, directors or trustees, and key employees are required to complete a conflict of interest disclosure form every three years. Jackson Park Hospital Foundation is scheduled to complete this procedure in its fiscal year 2014.
Form 990, Part VI, Section B, Line 15Jackson Park Hospital Foundation has a compensation committee. The chairman of the board reviews the compensation of senior management and key employees on an annual basis.
Form 990, Part VI, Section C, Line 19Jackson Park Hospital Foundation makes its 990, conflict of interest policy, community benefit report and financial statements available to the public by appointment with its vice president of finance.
Form 990, Part VII, Section B, Line 1(A)George Sollitt Construction performs remodeling and renovation work at the hospital. NICL Laboratories performs laboratory services. McKesson provides health care Information Technology systems and services. EmCare provides emergency room physician staffing. Rush Nursing Services provides temporary registered nurse staffing.
Form 990, Part IX, Line 11gContract labor and purchased services $12,981,092. Supplies and other $7,365,305. Professional fees $3,140,989. Utilities $1,592,384. Repair and maintenance $496,566. Please note these amounts may include amounts that appear on other lines in Part IX.
Form 990, Part XI, Line 5Net unrealized gains (losses) on investments as reported by the hospitals pension trustee.
Form 990, Part XI, Line 9Pension gain during 2014.

Schedule R IRS990ScheduleR

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1The Friedell Clinic SCBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line17531 Stony Island AvenueAddressLine1
CityChicagoCity
StateILState
ZIP Code60649ZIPCode
FieldValueIRS element (for citing)
EIN363290656EIN
Primary ActivitiesPrimary Health CarePrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
Entity TypeCEntityTypeTxt
Share Of Total Income$100ShareOfTotalIncomeAmt
Share Of EOY Assets$100ShareOfEOYAssetsAmt
Ownership1OwnershipPct
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationThis is an amended return.ExplanationTxt