2015-05-06T14:00:09-05:00 2014-06-30 CROWE HORWATH LLP 225 WEST WACKER DRIVE SUITE 2600 CHICAGO IL 606061224 990 2013-07-01 366000085 THOREK MEMORIAL HOSPITAL THOR 7735256780 850 W Irving Park Road Chicago IL 60613 TIM HEINRICH CHIEF FINANCIAL OFFICER 2015-05-01 true Nicole Bencik P00756195 3128997000 2013 2016-02-25 16:41:14Z X EDWARD BUDD 850 W Irving Park Road Chicago IL 60613 84713070 false X WWW.THOREK.ORG X 1911 IL HEALTH CARE SERVICES 8 7 535 0 -26458 0 0 0 62486795 64651129 6052865 10157907 4269151 1878921 72808811 76687957 0 0 0 0 23166847 23879055 0 0 0 33455491 37221006 56622338 61100061 16186473 15587896 262725084 306779405 33762897 37719943 228962187 269059462 THOREK HOSPITAL IS COMMITTED TO PROVIDING APPROPRIATE PATIENT SERVICES IN A CARING AND COST-EFFECTIVE MANNER. THOREK HOSPITAL SEEKS TO SERVE ITS PATIENTS, PHYSICIANS, EMPLOYEES, AND COMMUNITY BY PROVIDING QUALITY SERVICES AND ENCOURAGING EMPLOYEE EXCELLENCE. THOREK HOSPITAL WILL SUPPORT EDUCATION AND WILL ACT AS A RESPONSIBLE MEMBER OF OUR COMMUNITY AND THE HEALTHCARE SYSTEM. false false 49370159 0 65276913 THOREK MEMORIAL HOSPITAL PROVIDES QUALITY MEDICAL HEALTHCARE REGARDLESS OF RACE, CREED, SEX, NATIONAL ORIGIN, HANDICAP, AGE, OR ABILITY TO PAY. ALTHOUGH REIMBURSEMENT FOR SERVICES RENDERED IS CRITICAL TO THE OPERATION AND STABILITY OF THOREK HOSPITAL, WE RECOGNIZE THAT IT IS THE HOSPITAL'S MISSION TO SERVE THE COMMUNITY BY PROVIDING HEALTHCARE SERVICES AND HEALTHCARE EDUCATION AND THAT NOT ALL INDIVIDUALS POSSESS THE ABILITY TO PAY FOR ESSENTIAL MEDICAL SERVICES. THEREFORE, IN KEEPING WITH THE HOSPITAL'S COMMITMENT TO SERVE ALL MEMBERS OF OUR COMMUNITY, WE PROVIDE FREE CARE AND OR SUBSIDIZED CARE TO INDIVIDUALS WHO ARE UNABLE TO PAY FOR ESSENTIAL SERVICES, AND PROVIDE HEALTH ACTIVITIES AND PROGRAMS TO SUPPORT OUR COMMUNITY. 49370159 true false false false false false false false false true true false false true true true false false false false false false false false false true true false false true false false false false false false false false false false false false false true true false false false true 92 0 true 535 true true true false false false false false false false false false X 8 7 false false false false false false false true true false false true true true true false true true true false IL X Tim Heinrich 7739756806 850 W Irving Park Road Chicago IL 60613 PETER KAMBEROS CHAIRMAN AND COO 40.00 0.00 X X 281153 0 0 EDWIN C LENNOX TREASURER 6.00 0.00 X 20000 0 0 ILONA CARLOS MEDICAL STAFF PRESIDENT 6.00 0.00 X 23506 0 0 JAGAN MOHAN MD ASSISTANT TREASURER 6.00 0.50 X 12500 0 0 JAMES E NUGENT VICE CHAIR 6.00 0.00 X 32000 0 0 MARIO ADAJAR TRUSTEE 6.00 0.00 X 12500 0 0 PHILIP GORELICK MD TRUSTEE 6.00 0.00 X 6920 0 0 ROBERT J BAUDINO TRUSTEE 6.00 0.00 X 20000 0 0 EDWARD BUDD PRESIDENT/CEO 40.00 1.00 X 277111 0 22290 KEVIN HIGDON CFO 40.00 0.00 X 209090 0 23096 MARY MCCAHILL CHIEF NURSING OFFICER 40.00 0.00 X 183516 0 7342 MORGAN FRANCIS MURPHY III SECRETARY 40.00 0.00 X 190736 0 7342 HELENAIDA ORTEGA PHYSICIAN 40.00 0.00 X 185759 0 22290 JOHN HUNNIFORD HOUSE PHYSICIAN 40.00 0.00 X 205005 0 0 MARIAN URIARTE HOUSE PHYSICIAN 40.00 0.00 X 167716 0 0 NITIN BARMAN CHIEF OF INTERVENTIONAL CARDIOLOGY 40.00 0.00 X 395194 0 17424 TATJANA GUZINA PHYSICIAN 40.00 0.00 X 150738 0 13544 FRANK SOLARE FORMER PRESIDENT/CEO 40.00 0.00 X 116804 0 0 2490248 0 113328 22 true true false EPMG OF ILLINOIS SC 2000 GREEN ROAD STE 300 ANN ARBOR MI 481051571 ER PHYSICIAN FEES 928606 CATALYST ANESTHESIA 1007 FRANKLIN AVENUE RIVER FOREST IL 60305 PHYSICIAN FEES 585025 QUEST DIAGNOSTIC 12989 COLLECTION CENTER DRIVE CHICAGO IL 60693 LAB SEND OUT 348351 FRESENIUS MANAGEMENT SERVICES INC 16343 COLLECTION CENTER DRIVE CHICAGO IL 60693 DIALYSIS 172290 PLANTE & MORAN PLLC PO BOX 2003 DETROIT MI 482792003 AUDIT 123050 6 0 MEDICARE 621110 17944283 17944283 MEDICAID 621110 11193878 11193878 BLUE CROSS 621110 17836212 17836212 OTHER PAYORS 621110 8921836 8921836 MEDICAID ASSESSMENT 621110 8176618 8176618 578302 578302 0 0 64651129 5637947 -26458 5664405 0 0 1082075 267338 814737 0 814737 814737 12277735 0 7685832 71942 4591903 -71942 4519960 4519960 0 0 0 INTEREST MEDICAID AND COMMERCIAL 621110 625784 625784 SETTLEMENT 900099 300000 300000 DIETARY CASH SALES 900099 86012 86012 52388 0 0 52388 1064184 76687957 65276913 -26458 11437502 0 0 0 0 1298523 13152 1285370 0 19680785 15014886 4665899 0 1422261 1137809 284452 1477486 1064735 412751 0 0 102144 102144 0 0 548863 548863 2645521 2417429 228092 0 108930 108930 1626290 1301032 325258 0 0 516109 437250 78859 46332 37066 9266 35223 28178 7045 0 726370 726370 0 4381214 3504971 876243 1245723 1245723 MEDICAL SUPPLIES 10890754 10890754 PURCHASED SERVICES 7410702 5928562 1482140 MEDICAID ASSESSMENT 4776884 4776884 BAD DEBT 1815616 1815616 344331 275466 68865 0 61100061 49370159 11729901 0 0 6446508 5130581 1434207 4541196 4612125 0 0 0 0 1008474 1107321 2738363 1239857 109610722 52929921 47306844 56680801 197134512 232567365 0 0 2114980 5441355 262725084 306779405 6027980 6908868 13147794 12612986 0 0 0 14587123 18198089 33762897 37719943 X 228962187 269059462 228962187 269059462 262725084 306779405 15587896 24509379 0 X false true X true false X 15602174 15602174 54905755 34102933 20802822 0 30401571 18826988 11574583 8701222 8701222 56680801 0 0 FIXED INCOME SECURITIES 56666953 F EQUITY SECURITY FUNDS 165786143 F GOVERNMENTAL SECURITIES 10114269 F 232567365 0 SELF-INSURANCE RESERVE 6551838 THIRD PARTY PAYOR SETTLEMENTS 11296251 LINE OF CREDIT 350000 18198089 X 99100195 24509379 -1815616 22693763 76406432 548863 -267338 281525 76687957 59002920 267338 267338 58735582 548863 1815616 2364479 61100061 Schedule D, Part X, Line 2, FIN 48 (ASC 740) footnote THE INTERNAL REVENUE SERVICE HAS RULED THAT THE HOSPITAL IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, AND ACCORDINGLY, NO TAX PROVISION IS REFLECTED IN THE FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE HOSPITAL AND RECOGNIZE A TAX LIABILITY IF THE HOSPITAL HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE HOSPITAL AND HAS CONCLUDED THAT AS OF JUNE 30, 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE HOSPITAL IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE HOSPITAL RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE HOSPITAL DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT JUNE 30, 2014 AND 2013. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO JUNE 30, 2011. Schedule D, Part XI, Line 2d, Other revenues in audited financial statements not in form 990 PROVISION FOR BAD DEBT - -1815616; Schedule D, Part XI, Line 4b, Other revenues in form 990 not in audited financial statements RENTAL EXPENSES - -267338; Schedule D, Part XII, Line 2d, Other expenses in audited financial statements not in form 990 RENTAL EXPENSES - 267338; Schedule D, Part XII, Line 4b, Other expenses in form 990 not in audited financial statements PROVISION FOR BAD DEBT - 1815616; true true X true X true X true true false true true 976318 976318 0.01650 16677391 18391763 -1714372 0.00000 0 0.00000 0 0 17653709 18391763 -738054 0.01650 531135 531135 0.00900 0 0.00000 1502812 1286036 216776 0.00360 0 0.00000 0 0.00000 0 0 2033947 1286036 747911 0.01260 0 0 19687656 19677799 9857 0.02910 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0.00000 0 0 0 0 0 0.00000 true 1815616 0 19141815 14039881 5101934 X true true 1 1 THOREK MEMORIAL HOSPITAL 850 W Irving Park Road CHICAGO IL 60613 WWW.THOREK.ORG 0005371 X X X THOREK MEMORIAL HOSPITAL 1 true X X X X X X X X X 12 true false true X www.thorek.org X X X X X X X X X true false true true 200 true 300 true X X X X X X true true X X X X X true false X X X X true X false false Schedule H, Part V Sec B, Line 3, Community Served by Needs Assessment (1) - THOREK MEMORIAL HOSPITAL: THE HOSPITAL HAS CONSULTED AND RECEIVED INPUT FROM MULTIPLE CONSTITUENTS WHO REPRESENT THE COMMUNITY IN WHICH THE HOSPITAL SERVES. MANAGEMENT ROUTINELY MEETS WITH WILLIAM PETTY FROM THE BUENA PARK NEIGHBORS (BNA), A NOT FOR PROFIT COMMUNITY ORGANIZATION, TO IDENTIFY NEEDS IN THE COMMUNITY OF BUENA PARK. THROUGH DONATIONS, MEETINGS WITH LEADERSHIP OF BNA, AND INVOLVEMENT IN VARIOUS ACTIVITIES OF BNA, THOREK ACTIVELY PARTICIPATES IN THE BUENA PARK COMMUNITY. THOREK ALSO ROUTINELY RECEIVES INPUT FROM ALDERMAN KAPPELMAN'S OFFICE REGARDING ITS STANDING WITHIN THE COMMUNITY AS WELL AS OPPORTUNITIES TO PROVIDE SERVICES OR RESOURCES TO LOCAL COMMUNITY AS NEEDS ARE IDENTIFIED. THOREK ALSO SEEKS AND RECEIVES INPUT FROM MANAGEMENT AT SEVERAL LOCAL CHICAGO HOUSING AUTHORITY BUILDINGS WITHIN ITS IMMEDIATE COMMUNITY AND SERVICE AREA. THIS INPUT PRIMARILY FOCUSES ON THE GERIATRIC NEEDS OF THE COMMUNITY AND LEADS TO PROGRAMS ANDS AND SERVICES DIRECTED TO MEET THE NEEDS OF SENIORS WITHIN THOREK'S COMMUNITY.; Schedule H, Part V Sec B, Line 20d, How amounts charged to FAP-eligible patients were determined (1) - THOREK MEMORIAL HOSPITAL: IF PATIENT'S INCOME IS LESS THAN 200% OF FPG THEN THE PATIENT IS ELIGIBLE FOR FREE CARE. IF THE INCOME IS ABOVE 200% BUT LESS THAN 300% OF FPG THE CARE IS DISCOUNTED AT 50%. IF THE PATIENT DOES NOT HAVE INSURANCE AND IS NOT ELIGIBLE FOR FAP THEN THE CHARGES ARE DISCOUNTED AT 53%.; 0 SCHEDULE H, PART I, LINE 6A, COMMUNITY BENEFIT REPORT THOREK PREPARES AND FILES THE ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT BY DECEMBER 31 OF EACH YEAR WITH THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. Schedule H, Part I, Line 7, Costing Methodology used to calculate financial assistance FINANCIAL ASSISTANCE AT COST AND UNREIMBURSED MEDICAID: RATIO OF PATIENT CARE COST TO CHARGES WAS CALCULATED USING WORKSHEET 2. Schedule H, Part I, Line 7, col(f), Bad Debt Expense excluded from financial assistance calculation 1,815,616 Schedule H, Part I, Line 7g, Subsidized Health Services THOREK HAS NOT INCLUDED COSTS ATTRIBUTABLE TO ANY PHYSICIAN CLINIC AS PART OF SUBSIDIZED HEALTH SERVICES. Schedule H, Part II, Community Building Activities IN 2014 THOREK FOCUSED MOST OF ITS COMMUNITY EFFORTS INTO OTHER COMMUNITY ACTIVITIES SUCH AS HEALTH FAIRS AND PROVIDING SERVICES TO CHICAGO HOUSING AUTHORITY RESIDENTS AND OTHER ACTIVITIES THAT WERE NOT "COMMUNITY BUILDING" AS DESCRIBED BY THE CATHOLIC HEALTH ASSOCIATION. Schedule H, Part III, Line 2, Bad debt expense - methodology used to estimate amount AN ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS IS ESTABLISHED ON AN AGGREGATE BASIS BY USING HISTORICAL WRITE-OFF RATE FACTORS APPLIED TO UNPAID ACCOUNTS BASED ON AGING. LOSS RATE FACTORS ARE BASED ON HISTORICAL LOSS EXPERIENCE AND ADJUSTED FOR ECONOMIC CONDITIONS AND OTHER TRENDS AFFECTING THE HOSPITAL'S ABILITY TO COLLECT OUTSTANDING AMOUNTS. UNCOLLECTIBLE AMOUNTS ARE WRITTEN OFF AGAINST THE ALLOWANCE FOR DOUBTFUL ACCOUNTS IN PERIOD THEY ARE DETERMINED TO BE UNCOLLECTIBLE. Schedule H, Part III, Line 4, Bad debt expense - financial statement footnote THE PROVISION FOR BAD DEBT IS BASED UPON MANAGEMENT'S ASSESSMENT OF HISTORICAL AND EXPECTED COLLECTIONS OF ACCOUNTS RECEIVABLE CONSIDERING BUSINESS AND ECONOMIC CONDITIONS, TRENDS AND HEALTHCARE COVERAGE, AND OTHER COLLECTION INDICATORS. ACCOUNTS RECEIVABLE ARE WRITTEN OFF AND CHARGED TO THE PROVISION FOR BAD DEBT AFTER COLLECTION EFFORTS HAVE BEEN MADE IN ACCORDANCE WITH THE HOSPITAL'S POLICY. RECOVERIES ARE TREATED AS A REDUCTION TO THE PROVISION FOR BAD DEBT. ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. PERIODICALLY, MANAGEMENT ASSESSES THE ADEQUACY OF THE ALLOWANCE FOR ESTIMATED COLLECTIBLE ACCOUNTS BASED UPON HISTORICAL WRITE-OFF EXPERIENCE BY MAJOR PAYOR CATEGORY. DATA ABOUT THE MAJOR PAYOR SOURCE IS ANALYZED TO ESTABLISH AN APPROPRIATE ALLOWANCE FOR COLLECTIBLE RECEIVABLES AND PROVISION FOR BAD DEBT. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, CONTRACTUALLY DUE AMOUNTS ARE ANALYZED AND COMPARED TO ACTUAL CASH COLLECTED OVER TIME TO ENHANCE THE QUALITY OF THE ESTIMATE OF THE ALLOWANCE FOR COLLECTIBLE ACCOUNTS AND THE PROVISION FOR BAD DEBT. FOR EXAMPLE, FOR UNEXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTY THAT MAKE THE REALIZATION OF THE AMOUNTS DUE UNLIKELY. FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS, WHICH INCLUDES BOTH PATIENTS WITHOUT INSURANCE AND PATIENTS WITH DEDUCTIBLE AND COPAYMENT BALANCES DUE FOR WHICH THIRD-PARTY COVERAGE EXISTS FOR PART OF THE BILL, AN ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS IS RECORDED ON THE BASIS OF HISTORICAL EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. AN ESTIMATE OF THE DIFFERENCE BETWEEN CONTRACTED RATES AND AMOUNTS COLLECTED, AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED, IS CHARGED TO THE PROVISION FOR PATIENT BAD DEBT AND CREDITED TO THE ALLOWANCE FOR ESTIMATED UNCOLLECTIBLE ACCOUNTS. Schedule H, Part III, Line 8, Community benefit & methodology for determining medicare costs MEDICARE COSTS ARE ALLOCATED BY COST CENTER IN ACCORDANCE WITH MEDICARE REGULATIONS. THE COSTS ARE CALCULATED USING A COST TO CHARGE RATIO. Schedule H, Part III, Line 9b, Collection practices for patients eligible for financial assistance THOREK SEEKS TO ENGAGE PATIENTS PROACTIVELY TO DETERMINE IF FINANCIAL ASSISTANCE IS NEEDED, ESPECIALLY AT THE TIME OF SERVICE. THIS SERVICE IS ACCOMPLISHED BY COMMUNICATING THE AVAILABILITY OF FINANCIAL ASSISTANCE TO THE PATIENT THROUGH POSTED SIGNS THROUGHOUT THE HOSPITAL AS WELL AS NOTICES ON THE HOSPITAL WEBSITE AND ALL BILLING CORRESPONDENCE. FURTHERMORE THE HOSPITAL FINANCIAL COUNSELORS PROVIDE ASSISTANCE RANGING FROM ASSISTANCE IN COMPLETING THE HOSPITAL'S FINANCIAL ASSISTANCE APPLICATION, TO PROVIDING PAYMENT PLANS TO THOSE WITHOUT INSURANCE OR WITH PATIENT RESPONSIBILITIES AFTER REIMBURSEMENT BY THE PRIMARY INSURANCE, AND SEEKING INSURANCE COVERAGE FOR THOSE PATIENTS UNINSURED. THE HOSPITAL'S FINANCIAL COUNSELORS SEEK TO MAKE CONTACT AND WORK WITH THE PATIENT OR THEIR FAMILY TO HELP THEM IN ANY WAY POSSIBLE TO MEET THEIR FINANCIAL RESPONSIBILITIES IN A SUPPORTIVE MANNER OR IDENTIFY ELIGIBILITY FOR THE HOSPITAL'S CHARITY CARE POLICY. FINANCIAL COUNSELORS WORK WITH PATIENTS IN PERSON WHILE STILL AN INPATIENT IF APPROPRIATE, AFTER AN OUTPATIENT SERVICE AT THE HOSPITAL, OR SOON AFTER SERVICE IS PROVIDED TELEPHONICALLY. AS PART OF THIS PROCESS, THE COUNSELORS ATTEMPT TO DETERMINE IF THERE ARE ANY THIRD PARTY PAYERS WHICH MAY BE AVAILABLE TO HELP THE PATIENT MEET THEIR OBLIGATIONS. THE COUNSELORS WORK WITH OUR PATIENTS TO DETERMINE IF THEY ARE ELIGIBLE FOR MEDICAID OR OTHER STATE OR LOCAL FUNDED PROGRAMS INCLUDING CRIME VICTIMS, ILLINOIS MARKET PLACE INSURANCE PLANS, ALTERNATIVE INSURANCE INCLUDING COBRA, WORKER'S COMPENSATION, AND/OR OTHER APPROPRIATE THIRD PARTY LIABILITY PAYOR. THE HOSPITAL CONTRACTS WITH AN OUTSIDE FIRM TO PROVIDE ONE FULL-TIME FINANCIAL COUNSELOR AND SUPPORTING STAFF THAT WORK WITH APPROXIMATELY 150 PATIENT ACCOUNTS PER MONTH. THE COLLECTION PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE BEGINS WITH A PHONE CALL OR MEETING WITH THE PATIENT TO COMPLETE THE HOSPITAL CHARITY CARE APPLICATION FORMS AND/OR PROVIDED EVIDENCE OF THE NEED FOR FINANCIAL ASSISTANCE. IF THE CHARITY CARE APPLICATION MEETS THE HOSPITAL CHARITY CARE GUIDELINES OF 200% OF THE FEDERAL POVERTY GUIDELINES, NO FURTHER COLLECTION ACTIVITY OCCURS AND THE AMOUNT IS APPROPRIATELY RECORDED AS CHARITY CARE AND WRITTEN OFF AFTER THE 53% INITIAL DISCOUNT IS APPLIED. IF THE APPLICATION MEETS THE 201%-300% OF FEDERAL POVERTY GUIDELINE THE ACCOUNT IS DISCOUNTED AT ADDITIONAL 50% AND THE PAYMENT PLAN IS INITIATED FOR THE REMAINING BALANCE. FOR PATIENTS THAT DO NOT MEET CHARITY CARE GUIDELINES, A 53% (BASED ON 300% OF FEDERAL POVERTY GUIDELINES) INITIAL DISCOUNT IS TAKEN. THE REMAINING AMOUNT IS PAID BASED UPON AN AGREED PAYMENT PLAN WITH THE PATIENT OR THE PATIENT RECEIVES A FURTHER DISCOUNT BASED UPON THE INDIVIDUAL PATIENT'S FINANCIAL SITUATION. ANY FINAL AMOUNT TO BE PAID IS DETERMINED AND PAID IN FULL OR ACCORDING TO AN AGREED UPON PAYMENT PLAN WITH THE PATIENT. EVERY OPPORTUNITY IS MADE TO ENSURE THE PATIENT HAS THE CHANCE TO PAY WHAT THEY CAN AFFORD BASED UPON THEIR FINANCIAL SITUATION AT THAT TIME. THE HOSPITAL DOES NOT ATTEMPT TO GARNISH ANY WAGES OF THE PATIENT, DOES NOT FILE LIENS ON ANY PERSONAL PROPERTY OF THE PATIENT, NOR DOES IT PURSUE ANY OTHER AGGRESSIVE COLLECTION TECHNIQUES IN PURSUIT OF PAYMENT. Schedule H, Part VI, Line 2, Needs assessment. THOREK UTILIZES A COMMUNITY HEALTH ASSESSMENT SURVEY (CONDUCTED IN 2012) WITH AN ASSISTANCE OF AN OUTSIDE RESEARCH FIRM IN ORDER TO CAPTURE PRIMARY AND SECONDARY DATA ON THE HEALTH STATUS AND OPPORTUNITIES FOR IMPROVEMENT OF HEALTH SERVICES IN ITS COMMUNITY. THE PRIMARY DATA WAS OBTAINED THROUGH A TELEPHONE SURVEY OF OVER 1,000 ADULTS IN COOK COUNTY THROUGH A 20-25 MINUTE INTERVIEW WITH 136 INDIVIDUAL QUESTIONS THAT ADDRESSED THE FOLLOWING ISSUES: SELF-REPORTED HEALTH STATUS, PHYSICAL AND MENTAL HEALTH STATUS, INFECTIOUS & CHRONIC DISEASE, MODIFIABLE HEALTH RISKS, ACCESS TO HEALTHCARE SERVICES, HEALTH EDUCATION & OUTREACH, AND HEALTH INFORMATION SOURCES. THESE SURVEYS WERE CONDUCTED IN ENGLISH AND SPANISH. THE PRIMARY DATA WAS SUPPLEMENTED WITH SECONDARY DATA INCLUDING SUCH SOURCES AS CDC, FBI, COUNTY AND STATE PUBLIC HEALTH DEPARTMENTS, NATIONAL CENTER FOR HEALTH STATISTICS, AND THE U.S. CENSUS BUREAU DATA. THE SECONDARY DATA INCLUDES BUT IS NOT LIMITED TO THE FOLLOWING TOPICS: LEADING CAUSES OF DEATH, AGE-ADJUSTED DEATH RATES, VACCINE-PREVENTABLE CONDITIONS (IT WAS NOTED THAT 70% OF ADULTS SURVEYED DID NOT RECEIVE A FLU SHOT WITHIN THE PAST TWELVE MONTHS), STDS, HIV, AND OTHER INFECTIOUS DISEASES, AND FBI CRIME INDEX. THOREK PLANS TO USE THE ASSESSMENT INFORMATION TO EXPAND EXISTING AND CREATE NEW COMMUNITY HEALTH PROGRAMS MOST NEEDED BY UNDERSTANDING THE PREVALENCE OF CHRONIC CONDITIONS, BARRIERS TO ACCESS, AND OTHER HEALTH ISSUES IN THE COMMUNITY. IN ADDITION TO THE SURVEY, THOREK HAS HISTORICALLY AND CONTINUES TO IDENTIFY PRIORITIES FOR COMMUNITY BENEFIT THROUGH THE FOLLOWING INTERNAL REVIEW: THE THOREK MEMORIAL HOSPITAL (TMH) COMMUNITY NEEDS ASSESSMENT IS AN ONGOING PROCESS CONDUCTED BY TMH MANAGEMENT AND SUMMARIZED ANNUALLY IN THE ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFIT PLAN REPORT SUBMITTED TO THE ATTORNEY GENERAL'S OFFICE OF THE STATE OF ILLINOIS. THIS PROCESS UTILIZES INFORMATION OBTAINED FROM HEALTH AGENCIES AND PRACTITIONERS, COMMUNITY ORGANIZATIONS, AND COMMUNITY REPRESENTATIVES. THIS INFORMATION HAS BEEN GATHERED EITHER THROUGH REVIEW OF PUBLISHED INFORMATION, WRITTEN FEEDBACK, OR DIRECT INTERVIEWS OR DISCUSSIONS WITH PHYSICIANS AND PATIENTS. INDIVIDUALS INCLUDED ARE PHYSICIANS AND ALLIED HEALTH PROFESSIONALS, REPRESENTATIVES FROM THE ELDERLY POPULATION, LOCAL EMPLOYERS, AND COMMUNITY REPRESENTATIVES. FINDINGS FROM THE ASSESSMENT INDICATE: - TMH SERVES A POPULATION HAVING LIMITED ECONOMIC MEANS - THE POPULATION SERVED BY TMH IS NOT BASED ON GEOGRAPHIC PROXIMITY - THERE IS A CONSENSUS BETWEEN TMH AND ITS MEDICAL STAFF REGARDING GOALS - THERE IS LOW CONSUMER AWARENESS OF TMH SERVICES, HOWEVER, THIS IS IMPROVING THE TOP PRIORITY UNMET HEALTH NEEDS, BY AGE GROUP, ARE AS FOLLOWS. - ADULTS: ACCESS TO SERVICES (INSURANCE, COST) - SENIORS:COST; MEDICATIONS; POST-HOSPITAL SUPPORT; AND TRANSPORTATION THOREK MEMORIAL HOSPITAL HAS ADDRESSED AND/OR PLANS TO ADDRESS THESE IDENTIFIED PRIORITY NEEDS IN THE FOLLOWING WAYS IN THE COMMUNITY: IMPROVE ACCESS TO SERVICES - AMBULATORY CARE. TMH HAS FOCUSED ON THE EXPANSION AND DIFFERENTIATION OF ITS AMBULATORY CARE PROGRAMS IN ORDER TO IMPROVE ACCESS AND SERVICE. THE AMBULATORY CARE DEPARTMENT HAS BEEN PHYSICALLY EXPANDED AND SEPARATED INTO DISTINCT COMPONENTS. - CENTER FOR PRIMARY CARE. TMH OPERATES ITS CENTER FOR PRIMARY CARE. THIS NOT ONLY INCREASED THE SPACE DEVOTED TO AMBULATORY CARE, BUT PROVIDES A PHYSICALLY DISTINCT AREA DESIGNED TO HAVE THE LOOK AND FEEL OF A PRIVATE MEDICAL OFFICE RATHER THAN A "WALK-IN CLINIC". - COMMUNITY AND LOCAL EMPLOYER HEALTH FAIRS AND EDUCATION SESSIONS FOCUS ON NEEDS AND CONCERNS OF SENIORS - CHA PROGRAM. TMH PROVIDES ACCESS TO MEDICAL SERVICES FOR RESIDENTS OF FIVE NEARBY CHICAGO HOUSING AUTHORITY (CHA) RESIDENTIAL FACILITIES BY OPERATING MEDICAL OFFICES IN THESE BUILDINGS. RESIDENTS OF THESE BUILDINGS ARE PREDOMINANTLY SENIORS WHO QUALIFY FOR SUBSIDIZED HOUSING BASED ON FINANCIAL NEED. TYPICAL OFFICE STAFFING CONSISTS OF AN RN AND A PHYSICIAN. IN ADDITION, PHARMACEUTICALS NEEDED BY RESIDENTS ARE DELIVERED FREE OF CHARGE FOR THOSE RESIDENTS THAT REQUIRE THEM BASED ON AN APPROPRIATE COMPLETED SCRIPTS BY THE PHYSICIANS. IN ADDITION TO THE PROVISION OF HEALTH SERVICES, EDUCATIONAL, SOCIAL, AND OTHER ACTIVITIES ARE ARRANGED BY STAFF FOR THE PATIENTS OF CHA AT FIVE SITES ON THE NORTH SIDE OF CHICAGO, IN THOREK'S PRIMARY SERVICE AREA. NO AMOUNTS ARE BILLED BY THE HOSPITAL FOR HEALTHCARE SERVICES PROVIDED AT THESE SITES. THOREK HOSPITAL ALSO HELPS TO PROVIDE ACCESS TO SPECIALTY (CONSULTANT) PHYSICIAN SERVICES TO MEMBERS ON AN AS NEEDED BASIS. - MEDICATION. RECOGNIZING THE NEED TO PROVIDE ACCESS, EXPAND ALTERNATIVES, AND IMPROVE CONVENIENCE TO THOSE WE SERVE, TMH CONTINUES TO PROVIDE MEDICATION THROUGH ITS OUTPATIENT PHARMACY TO HOSPITAL PATIENTS AND CHA RESIDENTS. - TRANSPORTATION. TMH PROVIDES TRANSPORTATION VIA HOSPITAL VAN AND CONTRACTED TRANSPORTATION SERVICES BASED ON HOSPITAL TRANSPORTATION POLICIES TO 50+ CLUB MEMBERS AND OTHERS WITHIN DESIGNATED GEOGRAPHIC BOUNDARIES, AS DETERMINED APPROPRIATE BASED ON NEED AND CLINICAL STATUS, WHEN HOSPITAL SERVICES HAVE BEEN SCHEDULED IN ACCORDANCE WITH THE HOSPITAL'S TRANSPORTATION POLICY. INCREASE AWARENESS OF HEALTH PROGRAMS AVAILABLE - COMMUNICATION OF SERVICES TO THE COMMUNITY AND ITS ORGANIZATIONS - COMMUNITY HEALTH EDUCATION PROGRAMS DISCUSSING PREVENTION AND WELLNESS - ACCESS TO HOSPITAL AND PHYSICIAN SERVICES Schedule H, Part VI, Line 3, Patient education of eligibility for assistance. THOREK UTILIZES SEVERAL METHODS TO COMMUNICATE ITS RESPONSIBILITY TO INFORM AND EDUCATE PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR FINANCIAL ASSISTANCE UNDER GOVERNMENTAL PROGRAMS OR THE HOSPITAL'S FINANCIAL ASSISTANCE AND CHARITY CARE POLICIES. THE HOSPITAL POSTS THE AVAILABILITY OF FINANCIAL ASSISTANCE AND CHARITY CARE IN ENGLISH AND SPANISH IN ALL REGISTRATION AND MOST WAITING AREAS THROUGHOUT THE HOSPITAL. MEMBERS OF THE BUSINESS OFFICE ALSO WORK WITH PATIENTS TO SEE WHAT OTHER COMMUNITY RESOURCES MAY BE AVAILABLE TO THE PATIENT FOR CURRENT AND FUTURE CARE PROVISION. THE FINANCIAL COUNSELOR AND MOST OTHER EMPLOYEES IN THE HOSPITAL BUSINESS OFFICE AND PATIENT REGISTRATION ARE FLUENT IN SPANISH, AND PHONE TRANSLATORS ARE USED FOR OTHER LANGUAGES. THE AVAILABILITY FOR CHARITY CARE AS WELL AS THE WORKSHEET TO CALCULATE ELIGIBILITY FOR CHARITY CARE IS POSTED ON THE HOSPITAL'S WEBSITE. IN ADDITION, ALL BILLS AND STATEMENTS SENT TO PATIENTS INCLUDE INFORMATION REGARDING THE FINANCIAL ASSISTANCE AND CHARITY CARE OPPORTUNITIES IN ENGLISH AND SPANISH. THE HOSPITAL ALSO CONTRACTS FOR A FULL TIME FTE TO PROVIDE FINANCIAL COUNSELING TO PATIENTS WHICH INCLUDES THE ASSISTANCE IN THE MEDICAID APPLICATION PROCESS AS WELL AS A SEARCH FOR OTHER COVERAGE OPTIONS AVAILABLE. Schedule H, Part VI, Line 4, Community information. THOREK MEMORIAL HOSPITAL IS REPRESENTATIVE OF THE WIDE CROSS-SECTION OF THE POPULATION THAT IT SERVES. ITS COMMUNITY INCLUDES A SIZABLE NUMBER OF AFRICAN AMERICAN, ASIAN, AND HISPANIC RESIDENTS AS WELL AS A VARIETY OF OTHER ETHNIC GROUPS. THOREK MEMORIAL HOSPITAL'S LONG-STANDING STATUS AS A PREFERRED PROVIDER OF MEDICAL SERVICES FOR EMPLOYERS, ALSO WITH A MULTI ETHNIC MEMBERSHIP, CONTRIBUTES TO A WELL-ESTABLISHED WORKING CLASS ETHNIC CUSTOMER BASE. THE DEMOGRAPHIC SECTION OF THIS PLAN INCLUDES A LISTING THAT GIVES THE ETHNIC DISTRIBUTION OF INPATIENTS FOR FY 2013. SINCE THOREK MEMORIAL HOSPITAL'S MEDICAL STAFF ALSO REFLECTS ETHNIC DIVERSITY, WE EXPECT TO MAINTAIN A SIGNIFICANT ETHNIC CUSTOMER BASE. ALTHOUGH THOREK MEMORIAL HOSPITAL SERVES PATIENTS THROUGHOUT THE CHICAGO METROPOLITAN AREA AND EVEN AS FAR AWAY AS INDIANA AND WISCONSIN, WE HAVE DEFINED OUR COMMUNITY BASED UPON GEOGRAPHIC PROXIMITY. A PRIMARY SERVICE AREA HAS BEEN IDENTIFIED CONSISTING OF NEARBY ZIP CODE AREAS. THOREK MEMORIAL HOSPITAL'S PRIMARY SERVICE AREA CONSISTS OF THE FOLLOWING: GRACELAND (60613),LINCOLN PARK (60614), KEDZIE-GRACE (60618), RAVENSWOOD (60625), UPTOWN (60640), LOGAN SQUARE (60647), EDGEWATER (60660), W.ROGERS PARK (60645), ROGERS PARK (60626), DIVISION (60651), AUSTIN (60644), CRAGIN (60639), GARFIELD PARK (60624), NEAR WEST (60612), HAWTHORNE (60623), PILSEN (60608), AND NEAR SOUTH (60616), AS WELL AS ZIP CODES 60653, 60615, 60621, 60637, 60620, 60619, 60649, AND 60628. THE PRIMARY NOT-FOR-PROFIT COMMUNITY HOSPITALS ALSO SERVING THIS AREA INCLUDE: WEISS MEMORIAL HOSPITAL, ILLINOIS MASONIC MEDICAL CENTER (ADVOCATE), SWEDISH COVENANT HOSPITAL, ST. JOSEPH HOSPITAL (RESURRECTION), NORWEGIAN AMERICAN HOSPITAL, METHODIST HOSPITAL, AND ST. MARY AND ST ELIZABETH HOSPITALS (RESURRECTION). APPROXIMATELY 85% OF ADMISSIONS SERVED AT THOREK ARE FEDERALLY FUNDED OR SELF PAY/CHARITY. THE HOSPITAL CONTINUES TO MEET THE CRITERIA FOR A DISPROPORTIONATE SHARE HOSPITAL FOR MEDICARE MEDICAID HIGH-VOLUME ADJUSTMENT FOR THE DEPARTMENT OF HUMAN SERVICES (PUBLIC AID). Schedule H, Part VI, Line 5, Promotion of community health A MAJORITY OF THE GOVERNING BODY OF THOREK IS COMPRISED OF PERSONS WHO RESIDE IN THE ORGANIZATION'S PRIMARY SERVICE AREA WHO ARE NEITHER EMPLOYEES NOR INDEPENDENT CONTRACTORS OF THE ORGANIZATION, NOR FAMILY MEMBERS THEREOF. FURTHERMORE, THOREK EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY. A NET COMMUNITY BENEFITS EXPENSE FOR THOREK IN 2014 IS AS FOLLOWS (FROM THE ANNUAL NON PROFIT HOSPITAL COMMUNITY BENEFITS PLAN REPORT FILED IN ACCORDANCE WITH THE ILLINOIS ATTORNEY GENERAL GUIDELINES): CHARITY CARE AT COST - $930,534 LANGUAGE ASSISTANT SERVICES - $9,293 DONATIONS - $20,838 SUBSIDIZED HEALTH SERVICES - $1,315,433 OTHER COMMUNITY BENEFIT PROGRAMS - $185,316 THE HOSPITAL PROVIDES (FREE OF CHARGE) GUARDIANSHIP SERVICES THROUGH A LOCAL LEGAL FIRM FOR THOSE INPATIENT PSYCHIATRIC PATIENTS WHO ARE NOT ABLE TO MAKE APPROPRIATE MEDICAL DECISIONS FOR THEMSELVES. ALSO INCLUDED IN OTHER COMMUNITY BENEFIT PROGRAMS IS THE PROVISION OF TRANSPORTATION TO HOSPITAL PATIENTS THAT REQUIRE THIS SERVICE TO RECEIVE APPROPRIATE MEDICALLY NECESSARY HEALTH CARE AND PHYSICIAN SERVICES. THE TRANSPORTATION FOR THESE PATIENTS IS PERFORMED IN ACCORDANCE WITH THE HOSPITAL TRANSPORTATION POLICY. HOSPITAL ORGANIZES THAI HEALTH FAIR AND PROVIDES DIABETIC EDUCATION WITH THE GOAL OF ADVOCATING AND PROMPTING THE HEALTH OF THE COMMUNITY. TOTAL CHARITY CARE AND COMMUNITY BENEFITS: $2,461,414. IN ADDITION, THOREK REPORTED BAD DEBT EXPENSE OF $1,815,616 Schedule H, Part VI, Line 7, State filing of community benefit report IL X X X X X true false false false false false false false false MARY MCCAHILL CHIEF NURSING OFFICER 158370 0 25146 0 0 0 0 0 7342 0 190858 0 0 0 FRANK SOLARE FORMER PRESIDENT/CEO 116804 0 0 0 0 0 0 0 0 0 116804 0 0 0 HELENAIDA ORTEGA PHYSICIAN 185613 0 146 0 0 0 0 0 22290 0 208049 0 0 0 KEVIN HIGDON CFO 180140 0 22500 0 6450 0 0 0 23096 0 232186 0 0 0 JOHN HUNNIFORD HOUSE PHYSICIAN 193359 0 11646 0 0 0 0 0 0 0 205005 0 0 0 EDWARD BUDD PRESIDENT/CEO 251963 0 25148 0 0 0 0 0 22290 0 299401 0 0 0 PETER KAMBEROS CHAIRMAN AND COO 256005 0 25148 0 0 0 0 0 0 0 281153 0 0 0 NITIN BARMAN CHIEF OF INTERVENTIONAL CARDIOLOGY 395046 0 148 0 0 0 0 0 17424 0 412618 0 0 0 MORGAN FRANCIS MURPHY III SECRETARY 168090 0 22646 0 0 0 0 0 7342 0 198078 0 0 0 MARIAN URIARTE HOUSE PHYSICIAN 167570 0 146 0 0 0 0 0 0 0 167716 0 0 0 TATJANA GUZINA PHYSICIAN 150592 0 146 0 0 0 0 0 13544 0 164282 0 0 0 Schedule J, Part I, Line 4a, Severance or change-of-control payment FRANK SOLARE - $116,804 FORM 990, PART I, LINE 1, AMENDED RETURN THE ORGANIZATION IS AMENDING ITS 2013 FORM 990 TO INCLUDE ITS FINAL AUDITED FINANCIAL STATEMENTS FOR THE YEAR-ENDED JUNE 30, 2014. NO PARTS OR SCHEDULES OF THE 2013 FORM 990 WERE AMENDED. Form 990, Part VI, Sec B, Line 11b, Review of form 990 by governing body HOSPITAL MANAGEMENT PREPARES A DRAFT OF THE FORM 990 RETURN WITH THE ASSISTANCE OF AN INDEPENDENT ACCOUNTING AND TAX FIRM. THE HOSPITAL'S INDEPENDENT ACCOUNTING AND TAX FIRM PRESENTS THIS DRAFT VERSION OF THE 990 TAX RETURN TO THE HOSPITAL BOARD OF TRUSTEES. THE BOARD OF TRUSTEES HAS THE OPPORTUNITY TO REVIEW THE RETURN, ASK QUESTIONS, AND SUGGEST CHANGES. THE BOARD OF TRUSTEES APPROVES THE FINAL VERSION OF THE RETURN AND MANAGEMENT FILES THIS RETURN WITH THE INTERNAL REVENUE SERVICE. Form 990, Part VI, Sec B, Line 12c, Conflict of interest policy THE HOSPITAL REGULARLY AND CONSISTENTLY MONITORS COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH AN ANNUAL REVIEW AND COMPLETION OF THE ANNUAL BOARD MEMBER QUESTIONNAIRE AND CONFLICT OF INTEREST POLICY BY EACH MEMBER OF THE BOARD OF TRUSTEES. THE CORPORATE COMPLIANCE OFFICER REVIEWS AND ENFORCES THE CONFLICT OF INTEREST POLICY. IF A CONFLICT ARISES, THE BOARD MEMBER ABSTAINS FROM VOTING ON THE RELEVANT ISSUE. Form 990, Part VI, Sec B, Line 15a, Process to establish compensation of top management official DURING FISCAL YEAR 2014 THE HOSPITAL ENGAGED SULLIVAN AND COTTER MCHC TO PROVIDE A COMPARATIVE SALARY ANALYSIS FOR CEO/PRESIDENT. THE INFORMATION WAS DISTRIBUTED TO THE COMPENSATION COMMITTEE OF THE BOARD. THE COMMITTEE WILL THEN MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES ON AN ANNUAL BASIS. ALL DECISIONS BY THE BOARD OF TRUSTEES ARE DOCUMENTED IN THE BOARD MINUTES. Form 990, Part VI, Sec B, Line 15b, Process to establish compensation of other employees DURING FISCAL YEAR 2014 THE HOSPITAL ENGAGED SULLIVAN AND COTTER MCHC TO PROVIDE A COMPARATIVE SALARY ANALYSIS FOR OTHER OFFICERS AND KEY EMPLOYEES. THE INFORMATION WAS DISTRIBUTED TO THE COMPENSATION COMMITTEE OF THE BOARD. THE COMMITTEE WILL THEN MAKE RECOMMENDATIONS TO THE BOARD OF TRUSTEES ON AN ANNUAL BASIS. ALL DECISIONS BY THE BOARD OF TRUSTEES ARE DOCUMENTED IN THE BOARD MINUTES. Form 990, Part VI, Sec C, Line 19, Required documents available to the public THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. THOREK MEMORIAL FOUNDATION 850 W IRVING PARK ROAD CHICAGO IL 60613 366124318 SUPPORT THOREK MEMORIAL HOSPITAL IL 501(C)(3) 11 - Type III - FI THOREK MEMORIAL HOSPITAL true false false false false false false false false false false false false false false true false true false false