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ROSELAND COMMUNITY HOSPITAL: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
ROSELAND COMMUNITY HOSPITAL (EIN 36-1703630)
Tax period
2013-04-01 to 2014-03-31
Filed
2015-06-17
IRS object ID
201521689349300112
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)
Return2015-06-17T08:06:22-07:00ReturnTs
Tax Period End2014-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LOPEZ & CO CPAS LTDBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12702 W CHICAGO AVEAddressLine1
CityCHICAGOCity
StateILState
ZIP Code606228510ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN361703630EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROSELAND COMMUNITY HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlROSEBusinessNameControlTxt
Phone7739953000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line145 WEST 111TH STREETAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60628ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY EGANPersonNm
Person TitlePRESIDENT & CEOPersonTitleTxt
Phone7739953000PhoneNum
Signature2015-06-10SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonENRIQUE LOPEZPreparerPersonNm
Phone7736348335PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTIMOTHY EGANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line145 WEST 111TH STAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60628ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$62,688,666GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1924FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionTo provide general healthcare services to residents within the Pullman, Riverdale, and Roseland neighborhoods, including inpatient, outpatient, and emergency room physician and other services.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee685TotalEmployeeCnt
Total Volunteers13TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$7,192,752PYContributionsGrantsAmt
CY Contributions Grants$20,380,310CYContributionsGrantsAmt
PY Program Service Revenue$45,529,157PYProgramServiceRevenueAmt
CY Program Service Revenue$41,227,315CYProgramServiceRevenueAmt
PY Investment Income$2,567PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$393,502PYOtherRevenueAmt
CY Other Revenue$1,081,041CYOtherRevenueAmt
PY Total Revenue$53,117,978PYTotalRevenueAmt
CY Total Revenue$62,688,666CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$52,912,015PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$26,891,004CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
CY Other Expenses$36,383,984CYOtherExpensesAmt
PY Total Expenses$52,912,015PYTotalExpensesAmt
CY Total Expenses$63,274,988CYTotalExpensesAmt
PY Revenues Less Expenses$205,963PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$586,322CYRevenuesLessExpensesAmt
Total Assets BOY$35,361,339TotalAssetsBOYAmt
Total Assets EOY$30,829,605TotalAssetsEOYAmt
Total Liabilities BOY$32,280,728TotalLiabilitiesBOYAmt
Total Liabilities EOY$29,654,586TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,080,611NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,175,019NetAssetsOrFundBalancesEOYAmt
MissionTo provide general healthcareMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$52,644,368ExpenseAmt
Revenue$41,227,315RevenueAmt
DescROSELAND 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.Desc
Total Program Service Expenses$52,644,368TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalYes (true)OperateHospitalInd
Audited Financial Stmt AttYes (true)AuditedFinancialStmtAttInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document70IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee685EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonTIMOTHY EGANPersonNm
Phone7739359000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line145 111TH STREETAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60628ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
GENIVEE CHAPMAN
CHAIR1.00Yes (X)Yes (X)$0$0$0
ALAN JACKSON
DIRECTOR1.00Yes (X)$0$0$0
RAJESH IYENGAR
DIRECTOR1.00Yes (X)$0$0$0
RUPERT M EVANS
DIRECTOR1.00Yes (X)$0$0$0
JAI DEV ARYA
DIRECTOR1.00Yes (X)$0$0$0
MELINDA KELLY
DIRECTOR1.00Yes (X)$0$0$0
JEFFERY J WADDY
DIRECTOR1.00Yes (X)$0$0$0
DIAN POWELL
PRESIDENT/CEO40.00Yes (X)$198,632$0$0
KATHLEEN KINSELLA
CHIEF ADMINISTRATIVE OFFICER40.00Yes (X)$50,000$0$0
JOY WEST
PHYSICIAN40.00$352,610$0$0Yes (X)
ANGELA MAHOME
PHYSICIAN40.00$224,195$0$0Yes (X)
DOUGLAS BECK
VP SUPPORT SERVICES40.00$209,823$0$0Yes (X)
BOB GRKINICH
PHYSICIAN40.00$190,046$0$0Yes (X)
NAPATIA M TRONSHAW
PSYCHIATRIST40.00$176,147$0$0Yes (X)
REGINALD THREATT
PHYSICIAN40$155,430Yes (X)
TIMOTHY EGAN
CHIEF RESTRUCTURING OFFICER40$99,368Yes (X)
SHARON THURMAN
VP COMMUNITY AFFAIRS40$120,493Yes (X)
SOMI NAGARAJ
PHYSICIAN40$115,553Yes (X)
RENEE C LOPICCOLA
PHARMACIST40$114,380Yes (X)
MARIBEL TORRES
CHIEF NURSING OFFICER40$113,316Yes (X)
PAMELA D GOODWIN
REGISTERED NURSE40$112,891Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$2,232,884TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
EMERGENCY MEDICAL SPECIALIST
1012 LAKE SHORE BLVDEVANSTONIL60202ER PHYSICIAN SERVICES$1,406,816
ALCANTARA
6951 FIELDSTONE DRIVEBURR RIDGEIL60527ANESTHESIOLOGY SERVICES$1,009,608
MIDWEST MEDICAL SUPPLY
PO BOX 955588ST LOUISMO63195EQUIPMENT AND SUPPLIES$900,881
MEDICAL INFORMATION TECHNOLOGY
MEDITECH CIRCLEWESTWOODMA02090IT CONSULTING$797,794
DMS PHARMACEUTICAL
810 BUSSE HIGHWAYPARK RIDGEIL60068PHARMACEUTICAL WHOLESALER$700,609
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K53CntrctRcvdGreaterThan100KCnt
Government Grants$20,380,310GovernmentGrantsAmt
Total Contributions$20,380,310TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmt
MEDICARE/MEDICAID621110
NET PATIENT REVENUE621110$41,227,315
FieldValueIRS element (for citing)
Total Program Service Revenue$41,227,315TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER OPERATINGDesc
Business900099BusinessCd
Total Revenue Column$1,081,041TotalRevenueColumnAmt
Exclusion$1,081,041ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$1,081,041OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$62,688,666TotalRevenueColumnAmt
Related Or Exempt Func Income$41,227,315RelatedOrExemptFuncIncomeAmt
Exclusion$1,081,041ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,506,883TotalAmt
Program Services$0ProgramServicesAmt
Management And General$1,506,883ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,630,002TotalAmt
Program Services$11,506,265ProgramServicesAmt
Management And General$9,123,737ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

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

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$4,754,119TotalAmt
Program Services$4,754,119ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,807,367TotalAmt
Program Services$8,807,367ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$2,137,742TotalAmt
Program Services$2,137,742ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,408,558TotalAmt
Program Services$1,408,558ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$500,647TotalAmt
Program Services$500,647ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$551,304TotalAmt
Program Services$551,304ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,384,839TotalAmt
Program Services$1,384,839ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$894,429TotalAmt
Program Services$894,429ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
BAD DEBT PROVISION$18,118,770$18,118,770$0$0
LEASES & RENTALS$1,268,307$1,268,307$0$0
DRUGS & SOLUTIONS$818,863$818,863$0$0
FOOD$493,158$493,158$0$0

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$63,274,988TotalAmt
Program Services$52,644,368ProgramServicesAmt
Management And General$10,630,620ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$358,025BOYAmt
EOY$234,737EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,558,081BOYAmt
EOY$559,857EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,167,036BOYAmt
EOY$1,626,380EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$647,590BOYAmt
EOY$280,941EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$347,575BOYAmt
EOY$20,627EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$54,834,942LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$28,069,046LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$28,236,009BOYAmt
EOY$26,765,896EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$47,023BOYAmt
EOY$1,341,167EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$35,361,339BOYAmt
EOY$30,829,605EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$12,606,995BOYAmt
EOY$9,506,126EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,180,549BOYAmt
EOY$4,027,770EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$15,493,184BOYAmt
EOY$16,120,690EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$32,280,728BOYAmt
EOY$29,654,586EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$429,411BOYAmt
EOY-$1,633,047EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$3,510,022BOYAmt
EOY$2,808,066EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,080,611BOYAmt
EOY$1,175,019EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$35,361,339BOYAmt
EOY$30,829,605EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$586,322ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$1,319,270PriorPeriodAdjustmentsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Medical Research OrganizationYes (X)MedicalResearchOrganizationInd

Hospital Name And Address HospitalNameAndAddressGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ROSELAND COMMUNITY HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
FieldValueIRS element (for citing)
Public Support Total170$0PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support CY1700PublicSupportCY170Pct
Public Support Total509$0PublicSupportTotal509Amt
Public Support CY5090PublicSupportCY509Pct
Investment Income CY0InvestmentIncomeCYPct

Schedule C IRS990ScheduleC

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$923,853OtherCostOrOtherBasisAmt
Book Value$923,853BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$32,969,778OtherCostOrOtherBasisAmt
Depreciation$28,069,046DepreciationAmt
Book Value$4,900,732BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$142,343OtherCostOrOtherBasisAmt
Book Value$142,343BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$19,963,891OtherCostOrOtherBasisAmt
Book Value$19,963,891BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$835,077OtherCostOrOtherBasisAmt
Book Value$835,077BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$26,765,896TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
DUE FROM THIRD-PARTY PAYERS$1,295,932
OTHER ASSETS$45,235
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,341,167TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
SELF-INSURANCE LIABILITIES$2,830,326
CAPITAL LEASE OBLIGATIONS$2,907,585
DUE TO THIRD VENDORS$5,643,197
NEW MARKET TAX LIABILITY$4,339,582
DUE TO RCH FOUNDATION$400,000
FieldValueIRS element (for citing)
Total Liability$16,120,690TotalLiabilityAmt

Schedule H IRS990ScheduleH

FieldValueIRS element (for citing)
Financial Assistance PolicyYes (true)FinancialAssistancePolicyInd
Written PolicyYes (true)WrittenPolicyInd
FPG Reference Free CareYes (true)FPGReferenceFreeCareInd

Free Care Oth Percentage FreeCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Free Care Other300.00000FreeCareOtherPct
FieldValueIRS element (for citing)
FPG Reference Discounted CareYes (true)FPGReferenceDiscountedCareInd

Discounted Care Oth Percentage DiscountedCareOthPercentageGrp

FieldValueIRS element (for citing)
OtherYes (X)OtherInd
Discounted Care Other600.00000DiscountedCareOtherPct
FieldValueIRS element (for citing)
Free Care Medically IndigentYes (true)FreeCareMedicallyIndigentInd
Financial Assistance BudgetYes (true)FinancialAssistanceBudgetInd
Expenses Exceed BudgetfalseExpensesExceedBudgetInd
Annual Community Bnft ReportYes (true)AnnualCommunityBnftReportInd
Report Publically AvailableYes (true)ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$8,513,361TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns$8,513,361NetCommunityBenefitExpnsAmt
Total Expense0.13450TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$24,358,084TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$15,525,443DirectOffsettingRevenueAmt
Net Community Benefit Expns$8,832,641NetCommunityBenefitExpnsAmt
Total Expense0.13960TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$15,325,516TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$25,157,632DirectOffsettingRevenueAmt
Net Community Benefit Expns-$9,832,116NetCommunityBenefitExpnsAmt

Total Financial Assistance Typ TotalFinancialAssistanceTyp

FieldValueIRS element (for citing)
Total Community Benefit Expns$48,196,961TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$40,683,075DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,513,886NetCommunityBenefitExpnsAmt
Total Expense0.27410TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

FieldValueIRS element (for citing)
Total Community Benefit Expns$48,196,961TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue$40,683,075DirectOffsettingRevenueAmt
Net Community Benefit Expns$7,513,886NetCommunityBenefitExpnsAmt
Total Expense0.27410TotalExpensePct
FieldValueIRS element (for citing)
Bad Debt Expense ReportedYes (true)BadDebtExpenseReportedInd
Bad Debt Expense$18,118,770BadDebtExpenseAmt
Bad Debt Expense Attributable$4,529,693BadDebtExpenseAttributableAmt
Reimbursed By Medicare$39,122,128ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr$12,924,437CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall$26,197,691MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

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

Hospital Facilities HospitalFacilitiesGrp

FieldValueIRS element (for citing)
Facility1FacilityNum

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROSELAND COMMUNITY HOSPITAL ASSOCIATIONBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line145 WEST 111TH STREETAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60628ZIPCode
FieldValueIRS element (for citing)
Licensed HospitalYes (X)LicensedHospitalInd
General Medical And SurgicalYes (X)GeneralMedicalAndSurgicalInd
Emergency Room24 HrsYes (X)EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

FieldValueIRS element (for citing)
Business Name Line1ROSELAND COMMUNITY HOSPITAL ASSOCIATIONBusinessNameLine1
FieldValueIRS element (for citing)
Facility1FacilityNum
CHNA ConductedfalseCHNAConductedInd
Organization Incur Excise TaxfalseOrganizationIncurExciseTaxInd
Elig Criteria ExplainedYes (true)EligCriteriaExplainedInd
FPG Used Deter Elig Free CareYes (true)FPGUsedDeterEligFreeCareInd
FPG Family Incm Lmt Free Care300FPGFamilyIncmLmtFreeCarePct
FPG Used Determ Elig Dscnt CareYes (true)FPGUsedDetermEligDscntCareInd
FPG Family Incm Lmt Dscnt Care600FPGFamilyIncmLmtDscntCarePct
Explained BasisYes (true)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
App Financial Asst ExplnYes (true)AppFinancialAsstExplnInd
Includes Publicity MeasuresYes (true)IncludesPublicityMeasuresInd
Attached To InvoiceYes (X)AttachedToInvoiceInd
Posted In Admission OfficeYes (X)PostedInAdmissionOfficeInd
FAP Actions On NonpaymentYes (true)FAPActionsOnNonpaymentInd
Permit Other ActionsYes (X)PermitOtherActionsInd
Collection ActivitiesfalseCollectionActivitiesInd
FAP Notified Upon AdmissionYes (X)FAPNotifiedUponAdmissionInd
FAP Notified Before DischargeYes (X)FAPNotifiedBeforeDischargeInd
FAP Notified All PatientsYes (X)FAPNotifiedAllPatientsInd
Documented Elig DeterminationYes (X)DocumentedEligDeterminationInd
Nondis Emergency Care PolicyYes (true)NondisEmergencyCarePolicyInd
Other Method UsedYes (X)OtherMethodUsedInd
Amounts Generally BilledYes (true)AmountsGenerallyBilledInd
Gross ChargesfalseGrossChargesInd

Supplemental Information SupplementalInformationGrp (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
ROSELAND COMMUNITY HOSPITAL ASSOCIATION Pt V Line 16eINDIVIDUAL ASSESSMENTS MADE
ROSELAND COMMUNITY HOSPITAL ASSOCIATION Pt V Line 1jROSELAND HAS IMPLEMENTED A FINANCIAL ASSISTANCE POLICY (FAP) THAT MEETS THE
ROSELAND COMMUNITY HOSPITAL ASSOCIATION Pt V Line 14gREQUIREMENTS 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.
FieldValueIRS element (for citing)
Facility0FacilityNum

Supplemental Information Detail SupplementalInformationDetail (11 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt III Line 2THE COST METHODOLOGY USED TO CALCULATE THE AMOUNT REPORTED AS BAD DEBT EXPENSE,
Pt III Line 2AT COST, IS THE COST-TO-CHARGE RATIO DERIVED FROM THE IRS' SCHEDULE H, WORKSHEET 2
Pt III Line 3THE COST METHODOLOGY USED TO CALCULATE THE AMOUNT REPORTED AS BAD DEBT EXPENSE
Pt III Line 3ATTRIBUTBLE TO PATIENTS ELIGIBLE UNDER THE ORGANIZATION'S FINANCIAL ASSISTANCE POLICY,
Pt III Line 3AT COST, IS THE COST-TO-CHARGE RATIO DERIVED FROM THE IRS' SCHEDULE H, WORKSHEET 2
Pt III Line 4THE COLLECTION OF RECEIVABLES FROM THIRD-PARTY PAYORS AND PATIENTS IS THE HOSPITAL'S PRIMARY SOURCE
Pt III Line 4OF CASH FOR OPERATIONS AND IS CRITICAL TO ITS OPERATING PERFORMANCE. THE PRIMARY
Pt III Line 4COLLECTION RISKS RELATE TO UNINSURED PATIENT ACCOUNTS AND PATIENT ACCOUNTS
Pt III Line 4FOR WHICH THE PRIMARY INSURANCE PAYOR HAS PAID, BUT PATIENT RESPONSIBILITY
Pt III Line 4AMOUNTS (DEDUCTIBLES AND COPAYMENTS) REMAIN OUTSTANDING
Pt III Line 8.3303613

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
DIAN POWELL
$198,632$198,632
JOY WEST
$352,610$352,610
ANGELA MAHOME
$224,195$224,195
DOUGLAS BECK
$209,823$209,823
BOB GRKINICH
$190,046$190,046
NAPATIA M TRONSHAW
$176,147$176,147
REGINALD THREATT
$155,430$155,430

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt VI, Line 11bBOARD OF DIRECTORS REVIEWS 990 PRIOR FILING
Pt VI, Line 12cSIGNED DOCUMENT SUBMITTED ANNUALLY AND KEPT ON FILE. ANY POTENTIAL CONFLICTS
Pt VI, Line 12cARE EXAMINED AND ACTIONS ARE TAKEN TO RESOLVE OR DISCLOSE SUCH CONFLICTS.
Pt VI, Line 15aROSELAND SECURED THE SERVICES OF AN INDEPENDENT COMPENSATION CONSULTANT
Pt VI, Line 15aTO PERFORM A SALARY SURVEY FOR THE CEO.
Pt VI, Line 15aTHE COMPENSATON COMMITTEE RECOMMENDS A SALARY THAT IS SUBSEQUENTLY
Pt VI, Line 15aREVIEWED BY THE BOARD OF DIRECTORS BEFORE APPROVAL BY BOARD.
Pt VI, Line 15bROSELAND SECURED THE SERVICES OF AN INDEPENDENT COMPENSATION
Pt VI, Line 15bCONSULTANT TO PERFORM A SALARY SURVEY FOR KEY EXECUTIVES.
Pt XII, Line 3bORGANIZATION IS CURRENTLY UNDERGOING ITS AUDIT

Schedule R IRS990ScheduleR

FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (true)SharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1ROSELAND COMMUNITY HOSPITAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypemTransactionTypeTxt
Method Of Amount DeterminationMARKET VALUEMethodOfAmountDeterminationTxt