INGALLS MEMORIAL HOSPITAL: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- INGALLS MEMORIAL HOSPITAL (EIN 36-2170866)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-05-01
- IRS object ID
- 201411219349301011
- Schema version
- 2012v2.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule H
- Schedule J
- Schedule K
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-01T15:00:45-05:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWE HORWATH LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 70 West Madison Street | AddressLine1 |
| Address Line2 | Suite 700 | AddressLine2 |
| City | Chicago | City |
| State | IL | State |
| ZIP Code | 606024903 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 362170866 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE INGALLS MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | INGA | NameControl |
| Phone | 7083332300 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One Ingalls Drive | AddressLine1 |
| City | Harvey | City |
| State | IL | State |
| ZIP Code | 60426 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANDREW STEFO | Name |
| Title | CFO | Title |
| Date Signed | 2014-04-18 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | John V Woodhull | Name |
| PTIN | P01305268 | PTIN |
| Phone | 3128997000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
Name Of Principal Officer Business NameOfPrincipalOfficerBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KURT E JOHNSON | BusinessNameLine1 |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | One Ingalls Drive | AddressLine1 |
| City | Harvey | City |
| State | IL | State |
| ZIP Code | 60426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 300436899 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.INGALLS.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1922 | YearFormation |
| State Legal Domicile | IL | StateLegalDomicile |
| Activity Or Mission Description | THE INGALLS MEMORIAL HOSPITAL STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES BY INVESTING IN THE LATEST MEDICAL TECHNOLOGIES, THE STRUCTURAL NEEDS OF OUR FACILITIES, AND OUR EMPLOYEES. DURING THE YEAR CHARITY CARE SERVICES WERE PROVIDED, AS REPORTED ON THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 16 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 2952 | TotalNbrEmployees |
| Total Nbr Volunteers | 246 | TotalNbrVolunteers |
| Total Gross UBI | 1186877 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1126202 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1170993 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 302199111 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 288962537 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 28585473 | InvestmentIncomePriorYear |
| Investment Income Current Year | 7763738 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 1921309 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2000885 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 333832095 | TotalRevenuePriorYear |
| Total Revenue Current Year | 299898153 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 149694 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 124039341 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 122486619 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 174480747 | OtherExpensePriorYear |
| Other Expenses Current Year | 159409256 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 298669782 | TotalExpensesPriorYear |
| Total Expenses Current Year | 281895875 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 35162313 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 18002278 | RevenuesLessExpensesCY |
| Total Assets BOY | 448366287 | TotalAssetsBOY |
| Total Assets EOY | 505309486 | TotalAssetsEOY |
| Total Liabilities BOY | 192632889 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 210470089 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 255733398 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 294839397 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE INGALLS MEMORIAL HOSPITAL STRIVES TO IMPROVE THE HEALTH OF THE COMMUNITIES IT SERVES BY INVESTING IN THE LATEST MEDICAL TECHNOLOGIES, THE STRUCTURAL NEEDS OF OUR FACILITIES, AND OUR EMPLOYEES. (CONT. IN SCHEDULE O) | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 281579555 | Expense |
| Revenue | 287468343 | Revenue |
| Description | PATIENT CARE: THE INGALLS MEMORIAL HOSPITAL (IMH) INCLUDES A 500+ CERTIFIED BED HOSPITAL AND A NETWORK OF COMPREHENSIVE OUTPATIENT CENTERS THAT FEATURE A FULL ARRAY OF HIGH-TECH DIAGNOSTIC AND TREATMENT SERVICES. AS THE AREA'S ONLY INDEPENDENT NOT-FOR-PROFIT HEALTHCARE SYSTEM, IMH HAS THE ABILITY TO ENSURE THAT OUR RESOURCES ARE DIRECTED TO AREAS THAT RESULT IN THE GREATEST BENEFIT TO OUR PATIENTS AND THE COMMUNITY. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 316320 | Expense |
| Revenue | 1044060 | Revenue |
| Description | RESEARCH: THE INGALLS MEMORIAL HOSPITAL CONDUCTS RETINAL VASCULAR RESEARCH, A STUDY OF PATIENTS 50-85 YEARS OLD WITH LARGE BILATERAL DRUSEN AND ADVANCED AGE-RELATED MACULAR DEGENERATION. USE OF HIGH-DOSE ANTI-OXIDANTS AND ZINCS REDUCE PROGRESSION TO ADVANCED AGE-RELATED MACULAR DEGENERATION. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 281895875 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | true | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | true | Hospital |
| Financial Stmt Attached | true | FinancialStmtAttached |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | true | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | true | RelatedEntity |
| Related Org Controlled Entity | true | RelatedOrgControlledEntity |
| Transaction Related Entity | true | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 373 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 2952 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | true | UnrelatedBusinessIncome |
| Form990-T Filed | true | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 16 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | ElectionOfBoardMembers |
| Decisions Subject To Approval | true | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IL | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Andrew Stefo | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7083332300 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE INGALLS DRIVE | AddressLine1 |
| City | Harvey | City |
| State | IL | State |
| ZIP Code | 60426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (29 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|---|
| EUGENE M FEINGOLD | |||||||||
| CHAIRMAN OF THE BOARD | 1.00 | 3.00 | X | X | 0 | 0 | 0 | ||
| KURT E JOHNSON | |||||||||
| PRESIDENT & CEO | 40.00 | 5.00 | X | X | 1618535 | 0 | 38291 | ||
| RICHARD M KING | |||||||||
| BOARD MEMBER, SECRETARY/TREASURER | 1.00 | 2.00 | X | X | 0 | 0 | 0 | ||
| ROBERT G VELO | |||||||||
| BOARD MEMBER, VICE CHAIRMAN | 1.00 | 3.00 | X | X | 0 | 0 | 0 | ||
| DAVID H ORTH MD | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | X | 0 | 0 | 0 | |||
| DENNIS J IRVIN | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| HEATHER DAVIS | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| HENRY K JOHNSON | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| KEVIN PURCELL | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| LYNDELL S BECKHAM | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| MARK KOZLOFF MD | |||||||||
| BOARD MEMBER | 1.00 | 2.00 | X | 0 | 0 | 0 | |||
| MICHAEL P KAMRADT | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| NATHANIEL K SUTTON | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| NEAL E KITCHELL | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| ROBERT L HARRIS | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| SAMUEL J CUTRARA JR CPA | |||||||||
| BOARD MEMBER | 1.00 | 1.00 | X | 0 | 0 | 0 | |||
| ANDREW K STEFO | |||||||||
| VP - FINANCE/CFO | 40.00 | 5.00 | X | 710780 | 0 | 49316 | |||
| DIANE JACOBY | |||||||||
| ASSISTANT SECRETARY, VICE PRESIDENT, GENERAL COUNSEL | 40.00 | 4.00 | X | 618790 | 0 | 38291 | |||
| ALETHA ROSS | |||||||||
| VICE PRESIDENT OF HUMAN RESOURCES | 40.00 | 0 | 368297 | 0 | 37811 | X | |||
| JOSEPH M MOSER | |||||||||
| VP Development - Foundation | 1.00 | 40.00 | 397825 | 0 | 10847 | X | |||
| KATHLEEN MIKOS RN MSN | |||||||||
| CHIEF NURSING OFFICER | 40.00 | 0 | 516660 | 0 | 30922 | X | |||
| MICHAEL HICKS | |||||||||
| CHIEF OPERATING OFFICER | 40.00 | 0 | 369363 | 0 | 42171 | X | |||
| SCOTT C STRAUSSER | |||||||||
| VP - BUSINESS DEVELOPMENT | 40.00 | 0 | 557228 | 0 | 150866 | X | |||
| DR ROBERT J DUPUIS | |||||||||
| IMH HOUSE PHYSICIAN | 40.00 | 0 | 261642 | 0 | 17722 | X | |||
| HEIDI L RUHE | |||||||||
| IMH DIR BUSINESS DEVELOPMENT | 40.00 | 0 | 175316 | 0 | 39510 | X | |||
| LAWRENCE KLONOWSKI | |||||||||
| MANAGER MEDICAL PHYSICS | 40.00 | 0 | 190162 | 0 | 7770 | X | |||
| LINDA B CONWAY | |||||||||
| IMH ASSOCIATE GENERAL COUNSEL | 40.00 | 0 | 171611 | 0 | 10279 | X | |||
| MARY JO CRANDALL | |||||||||
| IMH LEAN FACILITATOR | 40.00 | 0 | 185237 | 0 | 5770 | X | |||
| MICHAEL J DEVORE | |||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 0 | 274733 | 0 | 17629 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 6416179 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 497194 | TotalOtherCompensation |
| Number Individuals GT100 K | 104 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ARAMARK CORPORATION | |||||
| 25271 NETWORK PLACE | CHICAGO | IL | 60673 | CONTRACT FOOD, PLANT, AND HOUSEKEEPING SERVICES | 14045394 |
| SIEMENS MEDICAL SOLUTIONS | |||||
| C/O MELLON BANK DEPT CH 14195 | PALATINE | IL | 600554195 | INORMATION OUTSOURCING | 9957681 |
| SYNERGY BEHAVIORAL HEALTHCARE | |||||
| 1566 W ALGONQUIN ROAD 3149 | HOFFMAN ESTATES | IL | 60192 | IN PT AND OUT PT PSYCHIATRIC SERVICES | 4948984 |
| KURTZ AMBULANCE SERVICES | |||||
| PO BOX 129 | NEW LENOX | IL | 60451 | AMBULANCE SERIVCES | 2038441 |
| PROCTOR HOSPITAL | |||||
| 5409 N KNOXVILLE AVE | PEORIA | IL | 61614 | ADDICTION RECOVERY SERVICES | 1701911 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 182 | NumberOfContractorsGT100K |
| Info In Schedule O Part VIII | X | InfoInScheduleOPartVIII |
| Related Organizations | 1085256 | RelatedOrganizations |
| Government Grants | 85737 | GovernmentGrants |
| Total Contributions | 1170993 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue |
|---|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 900099 | 276300708 | 276300708 | |
| RENTAL INCOME | 900099 | 1411021 | 1411021 | |
| CLIENT SERVICE REVENUE | 900099 | 788390 | 788390 | |
| LAB SERVICES | 621500 | 1207888 | 21011 | 1186877 |
| MEDIC TRAINING | 900099 | 208103 | 208103 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9046427 | TotalRevenueColumn |
| Related Or Exempt Function Income | 9046427 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 288962537 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1127352 | TotalRevenueColumn |
| Exclusion | $1,127,352 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 1080096 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 538746 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 541350 | Real |
| Personal | 0 | Personal |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 541350 | TotalRevenueColumn |
| Exclusion | $541,350 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6636386 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 6636386 | Securities |
| Other | 0 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6636386 | TotalRevenueColumn |
| Exclusion | $6,636,386 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| EXPENSE REIMBURSEMENT AND MGMT FEE | 900099 | 736743 | 736743 | |
| PARKING INCOME | 900099 | 109930 | 0 | $109,930 |
| CHILD CARE CENTER | 900099 | 612862 | 0 | $612,862 |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1459535 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 299898153 | TotalRevenueColumn |
| Related Or Exempt Function Income | 288512403 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 1186877 | UnrelatedBusinessRevenue |
| Exclusion | $9,027,880 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5901897 | Total |
| Program Services | 5901897 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 97013340 | Total |
| Program Services | 87607077 | ProgramServices |
| Management And General | 9406263 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3028336 | Total |
| Program Services | 2749435 | ProgramServices |
| Management And General | 278901 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9016403 | Total |
| Program Services | 8186018 | ProgramServices |
| Management And General | 830385 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7526643 | Total |
| Program Services | 6833461 | ProgramServices |
| Management And General | 693182 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8208123 | Total |
| Management And General | 8208123 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 143274 | Total |
| Program Services | 1483 | ProgramServices |
| Management And General | 141791 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 180000 | Total |
| Management And General | 180000 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1459578 | Total |
| Management And General | 1459578 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 45786708 | Total |
| Program Services | 36717896 | ProgramServices |
| Management And General | 9068812 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1676018 | Total |
| Program Services | 1503410 | ProgramServices |
| Management And General | 172608 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9723877 | Total |
| Management And General | 9723877 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 833024 | Total |
| Program Services | 538076 | ProgramServices |
| Management And General | 294948 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 684566 | Total |
| Program Services | 570729 | ProgramServices |
| Management And General | 113837 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4544013 | Total |
| Program Services | 3741995 | ProgramServices |
| Management And General | 802018 | ManagementAndGeneral |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16118226 | Total |
| Program Services | 14182427 | ProgramServices |
| Management And General | 1935799 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8616617 | Total |
| Program Services | 7898985 | ProgramServices |
| Management And General | 717632 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES/MISC EXPENSES | 50147009 | 49082003 | 1065006 |
| GIFT SHOP/MEDICAL STAFF OFFICE | 352081 | 0 | 352081 |
| PUBLIC AID ASSESSMENT | 9933451 | 9933451 | |
| LAUNDRY | 1002691 | 1002691 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 281895875 | Total |
| Program Services | 236451034 | ProgramServices |
| Management And General | 45444841 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Joint Costs TotalJointCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3357061 | BOY |
| EOY | 22686922 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 46929600 | BOY |
| EOY | 39347558 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5261618 | BOY |
| EOY | 5159392 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3666360 | BOY |
| EOY | 4102134 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 467743046 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 292742526 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 173529317 | BOY |
| EOY | 175000520 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 205232259 | BOY |
| EOY | 245574250 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3793189 | BOY |
| EOY | 3647850 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 388432 | BOY |
| EOY | 741880 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6208451 | BOY |
| EOY | 9048980 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 448366287 | BOY |
| EOY | 505309486 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 55919833 | BOY |
| EOY | 51811205 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 297170 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115230349 | BOY |
| EOY | 142315083 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21482707 | BOY |
| EOY | 16046631 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 192632889 | BOY |
| EOY | 210470089 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 251575523 | BOY |
| EOY | 290403537 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4157875 | BOY |
| EOY | 4435860 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 255733398 | BOY |
| EOY | 294839397 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 448366287 | BOY |
| EOY | 505309486 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 18002278 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 16540669 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 4563052 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Other Activities | $22,535 | OtherActivitiesAmount |
| Total Lobbying Expenditures IIB | 22535 | TotalLobbyingExpendituresIIB |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Description of the activities reported on Lines 1a through 1i | Identifier |
| Return Reference | Schedule C, Part II-B, Line 1 | ReturnReference |
| Explanation | A PORTION OF THE DUES PAID TO THE ILLINOIS HOSPITAL ASSOCIATION AND METROPOLITAN CHICAGO HEALTHCARE COUNCIL ARE USED FOR LOBBYING ACTIVITIES. | Explanation |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 304243 | OtherCostOrOtherBasis |
| Book Value | 304243 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 250532585 | OtherCostOrOtherBasis |
| Depreciation | 135661762 | Depreciation |
| Book Value | 114870823 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 12211665 | OtherCostOrOtherBasis |
| Depreciation | 9265460 | Depreciation |
| Book Value | 2946205 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 183883537 | OtherCostOrOtherBasis |
| Depreciation | 147815304 | Depreciation |
| Book Value | 36068233 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 20811016 | OtherCostOrOtherBasis |
| Book Value | 20811016 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 175000520 | TotalOfBookValueLandBuildings |
| Federal Income Tax Liability | 466804 | FederalIncomeTaxLiability |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| TENDER PREMIUM PAYABLE (SWAP VALUATION PAYABLE) | $8,208,180 |
| OTHER LONG TERM PAYABLES | $7,371,647 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 16046631 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | FIN 48 (ASC 740) footnote | Identifier |
| Return Reference | Schedule D, Part X, Line 2 | ReturnReference |
| Explanation | THE SYSTEM HAS ADOPTED ASC SUBTOPIC 740-10, INCOME TAXES - OVERALL, WHICH ADDRESSES THE DETERMINATION OF HOW TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER ASC SUBTOPIC 740-10, THE SYSTEM MUST RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFITS RECOGNIZED IN THE CONSOLIDATED FINANCIAL STATEMENTS FROM SUCH A POSITION ARE MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ASC SUBTOPIC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST, AND PENALTIES ON INCOME TAXES, AND ACCOUNTING IN INTERIM PERIODS, AND REQUIRES INCREASED DISCLOSURE. AS OF SEPTEMBER 30, 2013 AND 2012, THE SYSTEM DOES NOT HAVE A LIABILITY FOR UNRECOGNIZED TAX BENEFITS. | Explanation |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Charity Care Policy | true | CharityCarePolicy |
| Written Policy | true | WrittenPolicy |
| Policy Applied To All Hospitals | X | PolicyAppliedToAllHospitals |
| FPG Reference Free Care | true | FPGReferenceFreeCare |
| Pcent200 | X | Pcent200 |
| FPG Reference Discounted Care | false | FPGReferenceDiscountedCare |
| Free Disc Care Medically Indigent | true | FreeDiscCareMedicallyIndigent |
| Amounts Budgeted For Charity Care | true | AmountsBudgetedForCharityCare |
| Expenses Exceeded Budget | false | ExpensesExceededBudget |
| Annual Community Benefit Report | true | AnnualCommunityBenefitReport |
| Report Publically Available | true | ReportPublicallyAvailable |
Charity Care At Cost CharityCareAtCost
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 6097087 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 6097087 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.02160 | PercentOfTotalExpense |
Unreimbursed Medicaid UnreimbursedMedicaid
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 40057237 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 30431817 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 9625420 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.03420 | PercentOfTotalExpense |
Unreimbursed Costs UnreimbursedCosts
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Charity Care TotalCharityCare
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 46154324 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 30431817 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 15722507 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.05580 | PercentOfTotalExpense |
Community Health Services CommunityHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 344206 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 344206 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00120 | PercentOfTotalExpense |
Health Professions Education HealthProfessionsEducation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 406303 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 208103 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 198200 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00070 | PercentOfTotalExpense |
Subsidized Health Services SubsidizedHealthServices
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Research Research
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Benefit Expense | 0 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Cash And In Kind Contributions CashAndInKindContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expense | 882152 | TotalCommunityBenefitExpense |
| Net Community Benefit Expense | 882152 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00310 | PercentOfTotalExpense |
Total Other Benefits TotalOtherBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 1632661 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 208103 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 1424558 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.00500 | PercentOfTotalExpense |
Total Community Benefits TotalCommunityBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Benefit Expense | 47786985 | TotalCommunityBenefitExpense |
| Direct Offsetting Revenue | 30639920 | DirectOffsettingRevenue |
| Net Community Benefit Expense | 17147065 | NetCommunityBenefitExpense |
| Percent Of Total Expense | 0.06080 | PercentOfTotalExpense |
Physical Improvements And Housing PhysicalImprovementsAndHousing
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Economic Development EconomicDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Community Support CommunitySupport
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Environmental Improvements EnvironmentalImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Leadership Development LeadershipDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Coalition Building CoalitionBuilding
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Health Improvement Advocacy HealthImprovementAdvocacy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Workforce Development WorkforceDevelopment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Other Other
| Field | Value | IRS element (for citing) |
|---|---|---|
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
Total Total
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Activities Or Programs | 0 | NumberOfActivitiesOrPrograms |
| Persons Served | 0 | PersonsServed |
| Total Community Building Expense | 0 | TotalCommunityBuildingExpense |
| Direct Offsetting Revenue | 0 | DirectOffsettingRevenue |
| Net Community Building Expense | 0 | NetCommunityBuildingExpense |
| Percent Of Total Expense | 0.00000 | PercentOfTotalExpense |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | true | BadDebtExpenseReported |
| Bad Debt Expense | $28,722,319 | BadDebtExpenseAmount |
| Amount Attributable To | 17017974 | AmountAttributableTo |
| Amount Reimbursed By Medicare | 110017772 | AmountReimbursedByMedicare |
| Cost Of Care Reimbursed By Medicare | 108750038 | CostOfCareReimbursedByMedicare |
| Medicare Surplus Or Shortfall | 1267734 | MedicareSurplusOrShortfall |
Costing Methodology Used CostingMethodologyUsed
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | X | CostToChargeRatio |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | true | WrittenDebtCollectionPolicy |
| Provision For Charity Care | true | ProvisionForCharityCare |
| Number Of Hospital Facilities | 1 | NumberOfHospitalFacilities |
Form990 Schedule H Part V Section A Form990ScheduleHPartVSectionA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility Number | 1 | FacilityNumber |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INGALLS MEMORIAL HOSPITAL | BusinessNameLine1 |
Address Address
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE INGALLS DRIVE | AddressLine1 |
| City | HARVEY | City |
| State | IL | State |
| ZIP Code | 60426 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | WWW.INGALLS.ORG | WebsiteAddress |
| Licensed Hospital | X | LicensedHospital |
| Teaching Hospital | X | TeachingHospital |
| Er24 Hours | X | Er24Hours |
Form990 Schedule H Part V Section B Form990ScheduleHPartVSectionB
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INGALLS MEMORIAL HOSPITAL | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital Facility Number | 1 | HospitalFacilityNumber |
| CHNA Conducted | true | CHNAConducted |
| Community Definition | X | CommunityDefinition |
| Community Demographics | X | CommunityDemographics |
| Existing Resources | X | ExistingResources |
| How Data Obtained | X | HowDataObtained |
| Community Health Needs | X | CommunityHealthNeeds |
| Other Health Issues | X | OtherHealthIssues |
| Identifying Process | X | IdentifyingProcess |
| Consulting Process | X | ConsultingProcess |
| Information Gaps | X | InformationGaps |
| Needs Assessment Conducted | 12 | NeedsAssessmentConducted |
| Take Into Account | true | TakeIntoAccount |
| Other Facilities | false | OtherFacilities |
| CHNA Widely Available | true | CHNAWidelyAvailable |
| Own Website | X | OwnWebsite |
| On Request | X | OnRequest |
| Adopt Implement Strategy | X | AdoptImplementStrategy |
| Execute Implement Strategy | X | ExecuteImplementStrategy |
| Develop Community Plan | X | DevelopCommunityPlan |
| Participate Community Plan | X | ParticipateCommunityPlan |
| Include Operational Plans | X | IncludeOperationalPlans |
| Adopt Budget | X | AdoptBudget |
| Prioritize Health Needs | X | PrioritizeHealthNeeds |
| Prioritize Services | X | PrioritizeServices |
| All Needs Addressed | true | AllNeedsAddressed |
| Organization Incur Excise Tax | false | OrganizationIncurExciseTax |
| Eligibility Criteria Explained | true | EligibilityCriteriaExplained |
| Uses FPG Free | true | UsesFPGFree |
| FPG Free Percent | 200 | FPGFreePercent |
| Uses FPG Discounted | false | UsesFPGDiscounted |
| Explains Basis | true | ExplainsBasis |
| Income Level | X | IncomeLevel |
| Asset Level | X | AssetLevel |
| Insurance Status | X | InsuranceStatus |
| Uninsured Discount | X | UninsuredDiscount |
| Explains Application Method | true | ExplainsApplicationMethod |
| Includes Publicity Measures | true | IncludesPublicityMeasures |
| Posted On Website | X | PostedOnWebsite |
| Attached To Invoices | X | AttachedToInvoices |
| Posted In Emergency Room | X | PostedInEmergencyRoom |
| Posted In Admission Office | X | PostedInAdmissionOffice |
| Provided On Admission | X | ProvidedOnAdmission |
| Available On Request | X | AvailableOnRequest |
| Actions On Nonpayment | true | ActionsOnNonpayment |
| Collection Activities | false | CollectionActivities |
| Notify Upon Admission | X | NotifyUponAdmission |
| Notify Before Discharge | X | NotifyBeforeDischarge |
| Notified All Patients | X | NotifiedAllPatients |
| Documented Determination | X | DocumentedDetermination |
| Nondiscrim Emergency Care Policy | true | NondiscrimEmergencyCarePolicy |
| Medicare Rate | X | MedicareRate |
| Amounts Generally Billed | false | AmountsGenerallyBilled |
| Gross Charges | false | GrossCharges |
Form990 Schedule H Part V Section C Form990ScheduleHPartVSectionC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Other Facilities | 9 | NumberOfOtherFacilities |
Other Facilities OtherFacilities (11 entries)
| Address Line1Address/AddressLine1 | CityAddress/City | StateAddress/State | ZIP CodeAddress/ZIPCode | Facility TypeFacilityType |
|---|---|---|---|---|
| INGALLS FAMILY CARE CENTER | ||||
| 1600 TORRENCE AVENUE | CALUMET CITY | IL | 60409 | URGENT AID, PRIMARY CARE, AND SPECIALIST SERVICES |
| INGALLS FAMILY CARE CENTER | ||||
| 4647 WEST LINCOLN HIGHWAY | MATTESON | IL | 60443 | LABORATORY, IMAGING, AND DIAGNOSTIC SERVICES |
| INGALLS FAMILY CARE CENTER | ||||
| 6701 WEST 159TH STREET | TINLEY PARK | IL | 60477 | URGENT AID, PRIMARY CARE, AND SPECIALIST SERVICES |
| INGALLS CENTER FOR OUTPATIENT REHABILITATION | ||||
| 1551 HUNTINGTON DRIVE | CALUMET CITY | IL | 60409 | INDUSTRIAL AND MEDICAL REHABILITATION |
| INGALLS WELLNESS CENTER | ||||
| 2920 WELLNESS CENTER | HOMEWOOD | IL | 60430 | COMPLEMENTARY MEDICINE AND COMMUNITY HEALTH PROGRAMS |
| INGALLS FAMILY CARE CENTER | ||||
| 19550 GOVERNORS HIGHWAY | FLOSSMOOR | IL | 60422 | URGENT AID AND SPECIALIST SERVICES |
| THE CANCER SUPPORT CENTER | ||||
| 19250 EVERETT LANE | MOKENA | IL | 60448 | PREVENTION, SCREENING, AND EDUCATIONAL PROGRAMS |
| HORTON OCCUPATIONAL MEDICINE | ||||
| 16246 PRINCE DRIVE | SOUTH HOLLAND | IL | 60473 | PHYSICIAN OFFICES |
| SOUTHWEST INDUSTRIAL CARE | ||||
| 7600 WEST COLLEGE DRIVE SUITE 7A | PALOS HEIGHTS | IL | 60463 | PHYSICIAN OFFICES |
| INGALLS CARE CENTER | ||||
| 4742 CAL SAG ROAD | CRESTWOOD | IL | 60445 | QUICK CARE CENTER AND OCCUMPATIONAL HEALTH |
| THE VILLA AT SOUTH HOLLAND | ||||
| 16300 WAUSAU AVENUE | SOUTH HOLLAND | IL | 60473 | HEALTHCARE AND REHABILITATION CENTER |
Form990 Schedule H Part VI Form990ScheduleHPartVI (17 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Eligibility criteria for free or discounted care | Schedule H, Part I, Line 3c | INGALLS MEMORIAL HOSPITAL DOES NOT FOLLOW THE FPG GUIDLINES TO DETERMINE ANY SELF PAY DISCOUNTED CARE. A DISCOUNT OF 65% OF GROSS CHARGES, PROVIDED TO ALL UNINSURED PATIENTS WITHOUT REQUIRING EVIDENCE OF INABILITY TO PAY. THIS DISCOUNT IS DESIGNED TO ENSURE THAT PATIENTS ARE CHARGED AT A RATE GENERALLY COMPARABLE TO THAT APPLIED TO INSURED PATIENTS. 1. THERE IS NO APPLICATION PROCESS FOR THE PATIENT TO RECEIVE THE UNINSURED DISCOUNT. THE DISCOUNT IS APPLIED BASED ON THE ACCOUNT'S SELF-PAY/UNINSURED STATUS. 2. PATIENTS RECEIVING PRE-NEGOTIATED DISCOUNTS FOR HOSPITAL SERVICES WILL NOT BE ELIGIBLE FOR THIS UNINSURED DISCOUNT. 3. IF A PATIENT IS SUBSEQUENTLY APPROVED FOR FINANCIAL ASSISTANCE, THE AUTOMATIC DISCOUNT WILL BE REVERSED SO THAT THE FULL AMOUNT CAN BE RECOGNIZED AS A CHARITY ALLOWANCE. |
| Costing Methodology used to calculate financial assistance | Schedule H, Part I, Line 7 | INGALLS UTILIZES A COST TO CHARGE METHODOLGY., CHARGES ASSOCIATED WITH THE RELATED CATEGORIES ARE THEN USED TO DETERMINE COST RELATED TO SUCH REVENUE. THE COST TO CHARGE RATIO WAS DERIVED USING WORKSHEET 2. |
| Bad Debt Expense excluded from financial assistance calculation | Schedule H, Part I, Line 7, column(f) | 0 |
| Bad debt expense - methodology used to estimate amount | Schedule H, Part III, Line 2 | THE AMOUNT OF BAD DEBT REPORTED ON LINE 2 IS ESTIMATED USING THE SAME METHODOLOGY USED TO REPORT BAD DEBT IN THE HOSPITAL'S AUDITED FINANCIAL STATEMENTS. BAD DEBT EXPENSE IS DEFINED AS PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, WHO SHOULD HAVE THE ABILITY TO PAY THEIR RESPONSIBILITIES BUT HAVE NOT. DISCOUNTS ARE NOT APPLIED TO BALANCES WRITTEN OFF AS UNCOLLECTIBLE. |
| Bad debt expense - methodology used to estimate amount as community benefit | Schedule H, Part III, Line 3 | BASED ON THE POVERTY LEVELS OF THE SURROUNDING COMMUNITY, IT IS ESTIMATED THAT APPROXIMATELY 59.25% OF THE BAD DEBT EXPENSE IS ATTRIBITABLE TO PATIENTS WHO WOULD HAVE BEEN ELIGIBLE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. |
| Bad debt expense - financial statement footnote | Schedule H, Part III, Line 4 | PATIENTS' ACCOUNTS RECEIVABLE ARE REDUCED BY AN ALLOWANCE FOR DOUBTFUL ACCOUNTS. IN EVALUATING THE COLLECTABILITY OF PATIENTS' ACCOUNTS RECEIVABLES, THE SYSTEM ANALYZES THEIR PAST HISTORY AND IDENTIFIES TRENDS FOR EACH OF THEIR MAJOR PAYOR SOURCES OF REVENUE TO ESTIMATE THE APPROPRIATE ALLOWANCE FOR THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS. MANAGEMENT REGULARLY REVIEWS DATA ABOUT THESE MAJOR PAYOR SOURCES OF REVENUE IN EVALUATING THE SUFFICIENCY OF THE ALLOWANCE FOR DOUBTFUL ACCOUNTS. FOR RECEIVABLES ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY COVERAGE, THE SYSTEM ANALYZES CONTRACTUALLY DUE AMOUNTS AND PROVIDES AN ALLOWANCE TO THE PROVISION FOR UNCOLLECTIBLE ACCOUNTS, IF NECESSARY (E.G., FOR EXPECTED UNCOLLECTIBLE DEDUCTIBLES AND COPAYMENTS ON ACCOUNTS FOR WHICH THE THIRD-PARTY PAYOR HAS NOT YET PAID, OR FOR PAYORS WHO ARE KNOWN TO BE HAVING FINANCIAL DIFFICULTIES THAT MAKE THE REALIZATION OF AMOUNTS DUE UNLIKELY). FOR RECEIVABLES ASSOCIATED WITH SELF-PAY PATIENTS (WHICH INCLUDES PATIENTS WITHOUT INSURANCE), THE SYSTEM RECORDS A SIGNIFICANT PROVISION FOR UNCOLLECTIBLE ACCOUNTS IN THE PERIOD OF SERVICE ON THE BASIS OF ITS PAST EXPERIENCE, WHICH INDICATES THAT MANY PATIENTS ARE UNABLE OR UNWILLING TO PAY THE PORTION OF THEIR BILL FOR WHICH THEY ARE FINANCIALLY RESPONSIBLE. THE DIFFERENCE BETWEEN THE STANDARD RATES *OR THE DISCOUNTED RATES IF NEGOTIATED) AND THE AMOUNTS ACTUALLY COLLECTED AFTER ALL REASONABLE COLLECTION EFFORTS HAVE BEEN EXHAUSTED IS CHARGED OFF AGAINST THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS. THE SYSTEM ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FOR SELF-PAY PATIENTS INCREASED FROM 81.04% OF AT RISK ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2012, TO 81.06% OF SELF-PAY ACCOUNTS RECEIVABLE AT SEPTEMBER 30, 2013. IN ADDITION, THE SELF-PAY WRITE-OFFS INCREASED $2,665 FROM $27,159 FOR FISCAL YEAR 2012 TO $29,924 FOR FISCAL YEAR 2013 (DOLLARS IN THOUSANDS). THE SYSTEM DID NOT MAINTAIN A MATERIAL ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS FROM THIRD-PARTY PAYORS, NOR DID IT HAVE SIGNIFICANT WRITE-OFFS FROM THIRD-PARTY PAYORS. THE SYSTEM RECOGNIZED GROSS PATIENT SERVICE REVENUE ASSOCIATED WITH SERVICES PROVIDED TO PATIENTS WHO HAVE THIRD-PARTY PAYOR COVERAGE ON THE BASIS OF CONTRACTUAL RATES FOR THE SERVICES RENDERED. FOR UNINSURED PATIENTS THAT DO NOT QUALIFY FOR CHARITY CARE, REVENUE IS RECOGNIZED ON THE BASIS OF THEIR STANDARD RATES FOR SERVICES PROVIDED (OR ON THE BASIS OF DISCOUNTED RATES, IF NEGOTIATED OR PROVIDED BY POLICY). ON THE BASIS OF HISTORICAL EXPERIENCE, A SIGNIFICANT PORTION OF UNINSURED PATIENTS WILL BE UNABLE OR UNWILLING TO PAY FOR THE SERVICES PROVIDED. THUS, THE SYSTEM RECORDS A SIGNIFICANT PROVISION TO THE ALLOWANCE FOR UNCOLLECTIBLE ACCOUNTS RELATED TO UNINSURED PATIENTS IN THE PERIOD THE SERVICES ARE PROVIDED. |
| Community benefit & methodology for determining medicare costs | Schedule H, Part III, Line 8 | THE HOSPITAL BELIEVES THE FULL AMOUNT OF THE SHORTFALL FROM MEDICARE SHOULD BE TREATED AS COMMUNITY BENEFIT BECAUSE IT SERVE ALL PATIENTS REGARDLESS OF INSURANCE OR ABILITY TO PAY, AND IT CANNOT NEGOTIATE CONTRACTUAL RATES WITH THE MEDICARE PROGRAM. THE HOSPITAL MUST ACCEPT WHAT THE MEDICARE PROGRAM PAYS. THE METHODOLOGY USED IN DETERMINING MEDICARE USED IN THE COMMUNITY BENEFITS REPORT IS MEDICARE CHARGES MULTIPLIED BY THE MEDICARE COST REPORT, COST TO CHARGE RATIO |
| Collection practices for patients eligible for financial assistance | Schedule H, Part III, Line 9b | PATIENT ACCOUNTS QUALIFYING FOR CHARITY CARE, WITH A KNOWN BALANCE AT TIME OF APPROVAL RECEIVE A CHAIRTY CARE ADJUSTMENT CODE AT THAT TIME. PATIENTS WITHOUT A KNOWN BALANCE AT TIME OF APPROVAL, RECEIVE AN ADJUSTMENT CODE AFTER APPROVAL. ALL COLLECTION AGENCY PARTNERS REFERRED TO COLLECT PATIENT BILLS ARE TO PROMPTLY REFER ANY PATIENT WHO INDICATES FINANCIAL NEEDS. IT IS RECOGNIZED THROUGH OUR COLLECTION PRACTICES THAT ALL ACCOUNTS WILL BE TREATED IN THE SAME MANNER AND SOME WILL BE DEEMED AS UNCOLLECTABLE. IT IS OUR POLICY TO MAKE EVERY REASONABLE EFFORT TO COLLECT THE SELF-PAY PORTION OF AN ACCOUNT WITHIN 120 DAYS FROM THE DETERMINATION OF SELF-PAY LIABILITY. WE ALSO ACKNOWLEDGE A CERTAIN POPULATION WILL QUALIFY FOR OUR FINANCIAL ASSISTANCE PROGRAM (FAP) SHOULD THEY MEET THE INDIGENT CRITERION AS MANDATED BY THE STATE OF ILLINOIS. APPLICATIONS FOR FAP CAN BE OBTAINED PRIOR, DURING OR AFTER SERVICES HAVE BEEN PERFORMED. COMPLETED APPLICATION ARE TO BE FORWARDED TO THE PATIENT ACCOUNTS DEPARTMENT, WHERE ALL FINANCIAL AID APPLICATION ARE PROCESSED AND ELIGIBILITY ID DETERMINED BASED ON THE REQUIRED STATE GUIDELINES. |
| Community Served by Needs Assessment | Schedule H, Part V Section B, Line 3 | (1) INGALLS MEMORIAL HOSPITAL - THE COMMUNITY HEALTH NEEDS ASSESSMENT WAS SPONSORED BY INGALLS MEMORIAL HOSPITAL IN COOPERATION WITH THE METROPOLITAN CHICAGO HEALTHCARE COUNCIL. THE PROJECT ALSO RECEIVED INPUT FROM A COMMUNITY HEALTH NEEDS COMMITTEE, CREATED FOR THIS PURPOSE, WHICH WAS COMPRISED OF REPRESENTATIVES OF THE PARTNERNING ORGANIZATIONS AS WELL AS OTHER CITIZENS CHOSEN FOR THEIR RELEVANT EXPERIENCE AND INTERESTS.; |
| CHNA MADE AVAILABLE ON HOSPITAL FACILITY'S WEBSITE | SCHEDULE H, PART V, SECTION B, LINE 5A | THE COMMUNITY HEALTH NEEDS ASSESSMENT IS AVAILABLE TO THE PUBLIC USING THE FOLLOWING URL: HTTP://INGALLS.HEALTHFORECAST.NET. HEALTHFORECAST.NET IS AN INTERACTIVE, DYNAMIC TOOL DESIGNED TO SHARE CHNA DATA WITH COMMUNITY PARTNERS AND THE PUBLIC AT LARGE. THIS SITE: - INFORMS READERS THAT THE CHNA REPORT IS AVAILABLE AND PROVIDES INSTRUCTIONS FOR DOWNLOADING IT; - OFFERS THE CHNA REPORT DOCUMENT IN A FORMAT THAT, WHEN ACCESSED, DOWNLOADED, VIEWED, AND PRINTED IN HARD COPY, EXACTLY REPRODUCES THE IMAGE OF THE REPORT; - GRANTS ACCESS TO DOWNLOAD, VIEW, AND PRINT THE DOCUMENT WITHOUT SPECIAL COMPUTER HARDWARE OR SOFTWARE REQUIRED FOR THAT FORMAT (OTHER THAN SOFTWARE THAT IS READILY AVAILABLE TO MEMBERS OF THE PUBLIC WITHOUT PAYMENT OF ANY FEE) AND WITHOUT PAYMENT OF A FEE TO THE HOSPITAL ORGANIZATION OR FACILITY OR TO ANOTHER ENTITY MAINTAINING THE WEBSITE. LINKS TO THIS DEDICATED HEALTHFORECAST.NET SITE ARE ALSO MADE AVAILABLE AT IMH'S HOSPITAL WEBSITE AT: HTTP://WWW.INGALLS.ORG. |
| Used FPG to determine eligibility for providing discounted care criteria | Schedule H, Part V Section B, Line 11 | (1) INGALLS MEMORIAL HOSPITAL - A DISCOUNT OF 65% OF GROSS CHARGES, PROVIDED TO ALL UNINSURED PATIENTS WITHOUT REQUIRING EVIDENCE OF INABILITY TO PAY. THIS DISCOUNT IS DESIGNED TO ENSURE THAT PATIENTS ARE CHARGED AT A RATE GENERALLY COMPARABLE TO THAT APPLIED TO INSURED PATIENTS. 1. THERE IS NO APPLICATION PROCESS FOR THE PATIENT TO RECEIVE THE UNINSURED DISCOUNT. THE DISCOUNT IS APPLIED BASED ON THE ACCOUNT'S SELF-PAY/UNINSURED STATUS. 2. PATIENTS RECEIVING PRE-NEGOTIATED DISCOUNTS FOR HOSPITAL SERVICES WILL NOT BE ELIGIBLE FOR THIS UNINSURED DISCOUNT. 3. IF A PATIENT IS SUBSEQUENTLY APPROVED FOR FINANCIAL ASSISTANCE, THE AUTOMATIC DISCOUNT WILL BE REVERSED SO THAT THE FULL AMOUNT CAN BE RECOGNIZED AS A CHARITY ALLOWANCE. ; |
| Needs assessment. | Schedule H, Part VI, Line 2 | IN ADDITION TO THE COMMUNITY HEALTH NEEDS ASSESSMENT THAT WAS CONDUCTED, THE HOSPITAL HAS A COMMUNITY RELATIONS DEPARTMENT WHOSE SOLE PURPOSE IS TO ASSESS AND ADDRESS THE HEALTHCARE NEEDS OF THE COMMUNITY. THE HOSPITAL PARTNERS WITH COMMUNITY GROUPS TO IDENTIFY NEEDS, STRENGTHEN EXISTING COMMUNITY PROGRAMS, AND PLAN NEWLY NEEDED SERVICES. SPECIFIC ATTENTION IS PAID TO THE NEEDS OF LOW INCOME AND VULNERABLE POPULATIONS. |
| Patient education of eligibility for assistance. | Schedule H, Part VI, Line 3 | THE HOSPITAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THE ELIGIBILITY FOR ASSISTANCE BY POSTING SIGNS THROUGHOUT THE PATIENT REGISTRATION AREAS REGARDING PATIENT PAYMENT OPTIONS. IN ADDITION, PATIENTS ARE ALSO INFORMED VIA THE HOSPITAL'S WEBSITE, INDIVIDUAL PATIENT STATEMENTS AND FINANCIAL COUNSELORS. BELOW ARE ADDITIONAL DETAILS REGARDING HOW THE HOSPITAL INFORMS AND EDUCATES PATIENTS AND PERSONS WHO MAY BE BILLED FOR PATIENT CARE ABOUT THEIR ELIGIBILITY FOR ASSISTANCE UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. SIGNAGE: SIGNS OR SIMILAR WRITTEN NOTICES REGARDING THE AVAILABILITY OF FINANCIAL ASSISTANCE PROGRAM WILL BE VISIBLE AT ALL HOSPITAL POINTS OF SERVICE, TO CREATE AWARENESS OF THE FINANCIAL ASSISTANCE PROGRAM. AT A MINIMUM, SIGNAGE WILL BE POSTED IN THE EMERGENCY DEPARTMENT AND THE ADMISSION REGISTRATION AREA. ALL PUBLIC INFORMATION AND/OR FORMS REGARDING THE PROVISION OF FINANCIAL ASSISTANCE PROGRAM WILL USE LANGUAGES THAT ARE APPROPRIATE FOR THE SERVICE AREA IN ACCORDANCE WITH THE STATE'S LANGUAGE ASSISTANCE SERVICES ACT. HOSPITAL BILL/INVOICE: PATIENT BILLS OR STATEMENTS SHALL INCLUDE A PROMINENT STATEMENT THAT PATIENTS WHO MEETS CERTAIN INCOME REQUIREMENTS MAY QUALIFY FOR FINANCIAL ASSISTANCE AND INFORMATION REGARDING HOW A PATIENT MAY APPLY FOR CONSIDERATION UNDER THE HOSPITAL'S FINANCIAL ASSISTANCE POLICY. PATIENT HANDBOOK/BROCHURES: HANDBOOKS OR BROCHURES WILL BE AVAILABLE AT POINTS OF SERVICE AREAS. VIA INTERNET: A SUMMARY OF THE FINANCIAL ASSISTANCE PROGRAM WILL BE AVAILABLE PURSUANT TO THIS POLICY AND WILL BE AVAILABLE AT WWW.INGALLS.ORG. UPON REQUEST: UPON REQUEST, A COPY OF THE FINANCIAL ASSISTANCE PROGRAM POLICY WILL BE MADE AVAILABLE. APPLICATION FORMS: FORMS USED TO DETERMINE A PATIENT'S ELIGIBILITY FOR FINANCIAL ASSISTANCE WILL BE MADE AVAILABLE AT POINT OF SERVICE TO ALL PATIENTS OR FAMILY MEMBERS. FORMS ARE ALSO AVAILABLE AT WWW.INGALLS.ORG. |
| Community information. | Schedule H, Part VI, Line 4 | THE HOSPITAL'S IMMEDIATE SERVICES AREA FACES A NUMBER OF DIFFERENT CHALLENGES SUCH AS: *THE HIGHEST RATE IN THE METRO AREA FOR PERSONS BELOW POVERTY LEVEL, *THE GREATEST NUMBERS OF PERSONS ON MEDICAID, *THE HIGHEST RATES OF UNINSURED INDIVIDUALS, AND *THE HIGHEST RATES OF UNEMPLOYED INDIVIDUALS. THE MEDIAN INCOME FOR A HOUSEHOLD IN THE HOSPITAL'S SERVICE AREA WAS $29,235, AND THE MEDIAN INCOME FOR A FAMILY WAS $35,994. ABOUT 27.8% OF FAMILIES AND 33.1% OF THE POPULATION WERE BELOW THE POVERTY LINE, INCLUDING 48.4% OF THOSE UNDER AGE 18 AND 15.7% OF THOSE AGE 65 OR OVER. THE INFORMATION ABOVE WAS OBTAINED FROM THE UNITED STATES CENSUS BUREAU. HTTP//FACTFINDER.CENSUS.GOV. 2012 DATA |
| Promotion of community health | Schedule H, Part VI, Line 5 | THE HOSPITAL'S SERVICE AREA HAS HISTORICALLY SEEN THE HIGHEST PREGNANCY OUTCOME RISK INDEX IN THE STATE. AS SUCH, INGALLS HAS PARTNERED WITH LOCAL SERVICE AGENCIES TO OFFER THE HEALTHY BABY NETWORK WHICH PROVIDES MEDICAL CARE AND SOCIAL SERVICE PROGRAMS FOR MOTHERS AT RISK. INGALLS CONTRACTED WITH A LOCAL GROUP OF OB/GYNS TO PROVIDE AROUND THE CLOCK CARE IN OUR EMERGENCY ROOM FOR WOMEN WHO PRESENT WITH NO PRENATAL CARE AND ARE AT HIGHER RISK. THE AREA'S LOCAL CHILDREN ALSO HAVE AMONG THE REGION'S LOWEST IMMUNIZATION RATES. ACCORDINGLY, INGALLS HAS, FOR MANY YEARS, OFFERED FREE COMMUNITY PROGRAMS TO PROVIDE NEEDED VACCINATIONS. AS PART OF THE COMMUNITY HEALTH ASSESSMENT, TWO FOCUS GROUPS WERE HELD IN JUNE 2012. THE FIRST FOCUS GROUP INCLUDED SOCIAL SERVICE PROVIDERS AND OTHER COMMUNITY LEADERS. THE SECOND FOCUS GROUP INCLUDED KEY INFORMANTS ACROSS COOK COUNTY, INCLUDING: REPRESENTATIVES FROM PUBLIC HEALTH; PHYSICIANS AND OTHER HEALTH PROFESSIONALS; SOCIAL SERVICE PROVIDERS; AND OTHER COMMUNITY LEADERS. A LIST OF RECOMMENDED PARTICIPANTS FOR THE FOCUS GROUPS WAS PROVIDED BY THE SPONSORS. INGALLS BOARD OF DIRECTORS CONSISTS OF LOCAL BUSINESS AND COMMUNITY MEMBERS THAT LIVE LOCALLY. BESIDES THE PRESIDENT AND CEO WE HAVE ONE EMPLOYED PHYSICIAN THAT SERVES AS A DIRECTOR. NO MEMBERS ARE CONTRACTORS OR FAMILY MEMBERS OF A CONTRACTOR. ALL REQUESTS FOR APPLICATIONS ARE REVIEWED AND ACTED UPON BY OUR PROFESSIONAL AFFAIRS COMMITTEE. IF THIS COMMITTEE FEELS THAT THERE IS A NEED FOR A PARTICULAR SERVICE AND/OR A PATIENT NEED EXISTS, THE APPLICANT IS FELT TO MEET MINIMUM QUALIFICATIONS, AN APPLICATION IS OFFERED. THE MEDICAL STAFF SUPPORTS IMPROVEMENTS IN PATIENT CARE AND ONGOING EDUCATION TO THE MEDICAL AND PROFESSIONAL STAFF THROUGH FUNDING OF NUMEROUS MEDICAL EDUCATION ACTIVITIES. WE ARE ACCREDITED BY THE ILLINOIS STATE MEDICAL SOCIETY TO AWARD CME CATEGORY 1 CREDIT. THE CME COMMITTEE IS RESPONSIBLE FOR OVERSIGHT OF THE MONTHLY CME ACTIVITIES WHICH ARE SPONSORED BY THE HOSPITAL AND BOTH MEDICAL AND PROFESSIONAL (NURSING, QUALITY, ETC.) STAFF ARE INVITED AND ENCOURAGED TO ATTEND THE PROGRAMS. THE MEDICAL STAFF ALSO SUPPORTS THE HOSPITAL AND COMMUNITY BY CONTRIBUTING TO VARIOUS EVENTS INCLUDING THE ANNUAL BENEFIT. |
| Affiliated health care system | Schedule H, Part VI, Line 6 | THE INGALLS MEMORIAL HOSPITAL IS PART OF THE INGALLS HEALTH SYSTEM. THE INGALLS HEALTH SYSTEM WAS INCORPORATED TO SUPPORT AND ENCOURAGE HEALTH AND HUMAN SERVICES THROUGH THE FOLLOWING AFFILIATES: *THE INGALLS MEMORIAL HOSPITAL *INGALLS HEALTH VENTURES *MEDCENTRIX, INC. *INGALLS DEVELOPMENT FOUNDATION *INGALLS HOME CARE *INGALLS PROVIDER GROUP *INGALLS CASUALTY INSURANCE *INGALLS SAME DAY SURGERY, LTD. |
| State filing of community benefit report | Schedule H, Part VI, Line 7 | IL |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (14 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALETHA ROSS | ||||||||||||||
| VICE PRESIDENT OF HUMAN RESOURCES | 241158 | 0 | 125000 | 0 | 2139 | 0 | 9895 | 0 | 27916 | 0 | 406108 | 0 | 0 | 0 |
| ANDREW K STEFO | ||||||||||||||
| VP - FINANCE/CFO | 463749 | 0 | 225000 | 0 | 22031 | 0 | 10375 | 0 | 38941 | 0 | 760096 | 0 | 0 | 0 |
| DIANE JACOBY | ||||||||||||||
| ASSISTANT SECRETARY, VICE PRESIDENT, GENERAL COUNSEL | 414724 | 0 | 184375 | 0 | 19691 | 0 | 10375 | 0 | 27916 | 0 | 657081 | 0 | 0 | 0 |
| DR ROBERT J DUPUIS | ||||||||||||||
| IMH HOUSE PHYSICIAN | 184829 | 0 | 75000 | 0 | 1813 | 0 | 10375 | 0 | 7347 | 0 | 279364 | 0 | 0 | 0 |
| HEIDI L RUHE | ||||||||||||||
| IMH DIR BUSINESS DEVELOPMENT | 132912 | 0 | 41796 | 0 | 609 | 0 | 7348 | 0 | 32162 | 0 | 214826 | 0 | 0 | 0 |
| JOSEPH M MOSER | ||||||||||||||
| VP DEVELOPMENT - FOUNDATION | 262436 | 0 | 116850 | 0 | 18539 | 0 | 10097 | 0 | 750 | 0 | 408672 | 0 | 0 | 0 |
| KATHLEEN MIKOS RN MSN | ||||||||||||||
| CHIEF NURSING OFFICER | 332129 | 0 | 162500 | 0 | 22031 | 0 | 10375 | 0 | 20547 | 0 | 547582 | 0 | 0 | 0 |
| KURT E JOHNSON | ||||||||||||||
| PRESIDENT & CEO | 1084857 | 0 | 493594 | 0 | 40084 | 0 | 10375 | 0 | 27916 | 0 | 1656826 | 0 | 0 | 0 |
| LAWRENCE KLONOWSKI | ||||||||||||||
| MANAGER MEDICAL PHYSICS | 183091 | 0 | 0 | 0 | 7071 | 0 | 7770 | 0 | 0 | 0 | 197933 | 0 | 0 | 0 |
| LINDA B CONWAY | ||||||||||||||
| IMH ASSOCIATE GENERAL COUNSEL | 169854 | 0 | 0 | 0 | 1757 | 0 | 7113 | 0 | 3166 | 0 | 181890 | 0 | 0 | 0 |
| MARY JO CRANDALL | ||||||||||||||
| IMH LEAN FACILITATOR | 153734 | 0 | 30792 | 0 | 711 | 0 | 5770 | 0 | 0 | 0 | 191007 | 0 | 0 | 0 |
| MICHAEL HICKS | ||||||||||||||
| CHIEF OPERATING OFFICER | 228812 | 0 | 122188 | 0 | 18363 | 0 | 9837 | 0 | 32334 | 0 | 411534 | 0 | 0 | 0 |
| MICHAEL J DEVORE | ||||||||||||||
| CHIEF INFORMATION OFFICER | 216964 | 0 | 51400 | 0 | 6369 | 0 | 2150 | 0 | 15479 | 0 | 292361 | 0 | 0 | 0 |
| SCOTT C STRAUSSER | ||||||||||||||
| VP - BUSINESS DEVELOPMENT | 371912 | 0 | 165625 | 0 | 19691 | 0 | 107375 | 0 | 43491 | 0 | 708094 | 0 | 0 | 0 |
Schedule K IRS990ScheduleK
Form990 Schedule K Part I Form990ScheduleKPartI (2 entries)
| Bond ReferenceBondReferenceCd | Issuer EINIssuerEIN | CUSIP NumberCUSIPNumber | Date IssuedDateIssued | Issue PriceIssuePrice | Description Of PurposeDescriptionOfPurpose | DefeasedDefeased | On Behalf Of IssuerOnBehalfOfIssuer | Pool FinancingPoolFinancing |
|---|---|---|---|---|---|---|---|---|
| ILLINOIS FINANCE AUTHORITY | ||||||||
| A | 861091967 | 45200BHK7 | 2007-11-16 | 48000000 | REFUNDING OF 11/10/2004 BOND ISSUANCE | false | false | false |
| ILLINOIS FINANCE AUTHORITY | ||||||||
| B | 861091967 | 45203HPE6 | 2013-02-06 | 61860000 | REFUNDING OF 7/19/1994 BOND ISSUANCE; CAPITAL PROJECTS | false | false | false |
Form990 Schedule K Part II Form990ScheduleKPartII (2 entries)
| Bond ReferenceBondReferenceCd | Amount RetiredAmountRetired | Amount Bond DefeasedAmountBondDefeased | Total ProceedsTotalProceeds | Amount In Reserve FundAmountInReserveFund | Capitalized InterestCapitalizedInterest | Refunding EscrowRefundingEscrow | Issuance Costs From ProceedsIssuanceCostsFromProceeds | Credit EnhancementCreditEnhancement | Working Capital ExpendituresWorkingCapitalExpenditures | Capital ExpendituresCapitalExpenditures | Other Spent ProceedsOtherSpentProceeds | Amount UnspentAmountUnspent | Year Of Subst CompletionYearOfSubstCompletion | Current RefundingCurrentRefunding | Advance RefundingAdvanceRefunding | Final Allocation MadeFinalAllocationMade | Adequate Books And Recds MaintaindAdequateBooksAndRecdsMaintaind |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | 0 | 0 | 48000000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 48000000 | 0 | 2007 | true | false | true | true |
| B | 0 | 0 | 61860000 | 0 | 0 | 0 | 1183106 | 0 | 0 | 4170995 | 33471934 | 22853965 | true | false | false | true |
Form990 Schedule K Part III Form990ScheduleKPartIII (2 entries)
| Bond ReferenceBondReferenceCd | Owning Bond Financed PropertyOwningBondFinancedProperty | Any Lease ArrangementsAnyLeaseArrangements | Mngment Cntrct Bond Financd PrprtyMngmentCntrctBondFinancdPrprty | Engage Bond Counsel ContractsEngageBondCounselContracts | Any Research AgreementsAnyResearchAgreements | Engage Bond Counsel ResearchEngageBondCounselResearch | Prcntge Prvt Business Use By OthersPrcntgePrvtBusinessUseByOthers | Percentage Of Prvt Business Re UBIPercentageOfPrvtBusinessReUBI | Total Private Business UseTotalPrivateBusinessUse | Bond Iss Meet Prvt Security Pay TestBondIssMeetPrvtSecurityPayTest | Change In Use Bond Financed PropChangeInUseBondFinancedProp | Prcntge Bond Financed PropPrcntgeBondFinancedProp | Remedial Action TakenRemedialActionTaken | Non Qualified Bond Remed ProcdrsNonQualifiedBondRemedProcdrs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| A | false | false | false | false | false | false | 0.0000 | 0.0000 | 0.0000 | false | false | 0 | false | false |
| B | false | false | false | false | false | false | 0.0000 | 0.0000 | 0.0000 | false | false | 0 | false | false |
Form990 Schedule K Part IV Form990ScheduleKPartIV (2 entries)
| Bond ReferenceBondReferenceCd | Form8038 T FiledForm8038TFiled | Rebate Not Due YetRebateNotDueYet | Exception To RebateExceptionToRebate | No Rebate DueNoRebateDue | Variable Rate IssueVariableRateIssue | Hedge Identified In Books And RecdsHedgeIdentifiedInBooksAndRecds | Term Of HedgeTermOfHedge | Superintegrated HedgeSuperintegratedHedge | Hedge TerminatedHedgeTerminated | Gross Proceeds Invested In GICGrossProceedsInvestedInGIC | Term Of GICTermOfGIC | Regulatory Safe Harbor SatisfiedRegulatorySafeHarborSatisfied | Gross Proceeds InvestedGrossProceedsInvested | Written Proc To Monitor ReqsWrittenProcToMonitorReqs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MERRILL LYNCH | ||||||||||||||
| A | false | false | false | true | true | true | 29.5 | false | false | false | 0 | false | false | false |
| (no name) | ||||||||||||||
| B | false | true | false | false | false | false | 0.0 | false | false | false | 0.0 | false | false | false |
Form990 Schedule K Part V Form990ScheduleKPartV (2 entries)
| Bond ReferenceBondReferenceCd | Proc To Undertk Corrective ActionProcToUndertkCorrectiveAction |
|---|---|
| A | false |
| B | false |
Form990 Schedule K Part VI Form990ScheduleKPartVI (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| WRITTEN PROCEDURES TO ENSURE ALL NONQUALIFIED BONDS ARE REMEDIATED IN ACCORDANCE WITH REGULATIONS | SCHEDULE K, PART III, LINE 9 | THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES TO ENSURE ALL NONQUALIFIED BONDS (IF ANY) OF THE ISSUE ARE REMEDIATED IN ACCORDANCE WITH THE ASSOCIATED REGULATIONS. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS. |
| ISSUER NAME: Illinois Finance Authority: No Rebate Due. | Schedule K, Part IV, Line 2c | THE CALCULATION FOR COMPUTING NO REBATE DUE WAS PERFORMED ON 1/17/2013. |
| WRITTEN PROCEDURES TO MONITOR REQUIREMENTS OF SECTION 148 | SCHEDULE K, PART IV, LINE 7 | THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES TO MONITOR THE ORGANIZATION'S ABILITY TO REMAIN IN COMPLIANCE WITH THE ARBITRAGE REQUIREMENTS UNDER SECTION 148 OF THE INTERNAL REVENUE CODE. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS. |
| WRITTEN PROCEDURES TO ENSURE VIOLATIONS ARE IDENTIFIED AND CORRECTED THROUGH VCAP | SCHEDULE K, PART V | THE ORGANIZATION IS IN THE PROCESS OF ADOPTING WRITTEN PROCEDURES WHICH DICTATE HOW MANAGEMENT TIMELY IDENTIFIES AND CORRECTS VIOLATIONS OF FEDERAL TAX REQUIREMENTS USING THE VOLUNTARY CLOSING AGREEMENT PROGRAM (VCAP) PROVIDED BY THE IRS WHEN SELF-REMEDIATION IS NOT AVAILABLE TO THE ORGANIZATION. THE ORGANIZATION STRIVES TO STAY ABREAST OF FEDERAL REGULATIONS AND CONSIDERS THE REPERCUSSIONS OF ALL SIGNIFICANT ACTIVITIES WHICH COULD FORESEEABLY HAVE AN IMPACT ON THE ORGANIZATION'S TAX EXEMPT BONDS AND THE ASSOCIATED FEDERAL TAX REGULATIONS. IN THE EVENT A VIOLATION IS IDENTIFIED THE ORGANIZATION'S POLICY IS TO CORRECT THE VIOLATION AS SOON AS POSSIBLE, WHILE WORKING WITH THE FEDERAL AUTHORITIES AS NECESSARY TO ENSURE THAT SUFFICIENT CONTROLS ARE PRESENT WHICH WILL GUARD AGAINST FUTURE VIOLATIONS. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (13 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART III, LINE 1 | THE HOSPITAL PROVIDES CARE TO MEDICAID BENEFICIARIES AND OTHER PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. IN ADDITION, THE HOSPITAL IS INVOLVED IN NUMEROUS COMMUNITY BENEFIT ACTIVITIES. THESE ACTIVITIES ARE WIDE RANGING AND INCLUDE HEALTH EDUCATION, SUPPORT GROUPS, HEALTH SCREENINGS, HEALTH FAIRS, PASTORAL CARE, HOME-DELIVERED MEALS, TRANSPORTATION SERVICES, PROVISION OF SEMINARS AND SPEAKERS, HEALTH INFORMATION LINES, AND PUBLICATION OF HEALTH MAGAZINES. THESE ACTIVITIES ARE PROVIDED FREE OF CHARGE OR BELOW THE COST OF PROVIDING THEM. DURING THE YEAR ENDING SEPTEMBER 30, 2013, CHARITY CARE SERVICES PROVIDED WAS APPROXIMATELY $24,723,794, PER THE ORGANIZATION'S FINANCIAL STATEMENTS. |
| Classes of members or stockholders | Form 990, Part VI, Section A, Line 6 | PURSUANT TO THE ORGANIZATION'S GOVERNING DOCUMENTS, THE SOLE VOTING MEMBER OF THE ORGANIZATION IS INGALLS HEALTH SYSTEM (IHS), A RELATED TAX-EXEMPT ORGANIZATION. AS THE ORGANIZATION'S SOLE CORPORATE MEMBER, IHS HAS THE RIGHT TO PARTICIPATE IN THE ORGANIZATION'S GOVERNANCE. IHS HAS THE RIGHT TO ELECT, APPOINT, OR REMOVE ANY BOARD OF DIRECTOR OF THE ORGANIZATION WITHOUT CAUSE AT ANY TIME. IN ADDITION, THE SOLE CORPORATE MEMBER HAS THE EXCLUSIVE RIGHT TO APPROVE OR RATIFY SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY. SIGNIFICANT DECISIONS OF THE ORGANIZATION'S GOVERNING BODY INCLUDE, BUT ARE NOT LIMITED TO, THE RIGHT TO APPROVE LONG-TERM CAPITAL AND OPERATIONAL BUDGETS, TO APPROVE A PLAN OF DISSOLUTION OR MERGER WITH ANOTHER ORGANIZATION, AND TO APPROVE THE DEVELOPMENT, CONSTRUCTION OR IMPLEMENTATION OF ANY NEW HEALTHCARE FACILITY, PROGRAM, OR SERVICE. |
| Members or stockholders electing members of governing body | Form 990, Part VI, Section A, Line 7a | PLEASE SEE THE NARRATIVE FOR PART VI, SECTION A, LINE 6 |
| Decisions requiring approval by members or stockholders | Form 990, Part VI, Section A, Line 7b | PLEASE SEE THE NARRATIVE FOR PART VI, SECTION A, LINE 6 |
| Review of form 990 by governing body | Form 990, Part VI, Section B, Line 11b | THE FULL FORM 990, INCLUDING SUPPLEMENTAL SCHEDULES, WAS PRESENTED BY THE CHIEF FINANCIAL OFFICER TO THE EXECUTIVE COMMITTEE AT A COMMITTEE MEETING. THE FULL BOARD HAS GRANTED TO THE EXECUTIVE COMMITTEE AUTHORITY TO APPROVE THE FORM 990. THE FULL BOARD WILL RECEIVE A REPORT FROM THE EXECUTIVE COMMITTEE, DESCRIBING THE EXECUTIVE COMMITTEE'S REVIEW PERFORMED. THE FORM 990 WILL BE AVAILABLE AT THE ORGANIZATION'S BOARD MEETING FOR EACH MEMBER'S REVIEW. |
| Conflict of interest policy | Form 990, Part VI, Section B, Line 12c | ALL OFFICERS, DIRECTORS, BOARD MEMBERS, AND KEY EMPLOYEES MUST AVOID SITUATIONS IN WHICH THEIR PERSONAL INTERESTS MAY CONFLICT, OR APPEAR TO CONFLICT, WITH THE INTEREST OF INGALLS; AND INGALLS REVIEWS ITS OWN RELATIONSHIPS WITH OTHER CARE PROVIDERS, EDUCATIONAL INSTITUTIONS, AND PAYERS TO DETERMINE IF POTENTIAL CONFLICTS EXIST. EMPLOYEES SHALL HAVE THE CONTINUING AFFIRMATIVE DUTY TO REPORT TO THE PRESIDENT AND CHIEF EXECUTIVE OFFICER (CEO) OF INGALLS ANY PERSONAL OWNERSHIP INTEREST OR OTHER RELATIONSHIP THAT MIGHT AFFECT THEIR ABILITY TO EXERCISE IMPARTIAL, ETHICAL BUSINESS JUDGMENTS IN THE AREA OF THEIR RESPONSIBILITIES. PER THE ENTITY'S CONFLICT OF INTEREST POLICY, EMPLOYEES AT MANAGEMENT LEVEL WILL BE REQUIRED TO COMPLETE A "CERTIFICATION AND DISCLOSURE" FORM, ON A SCHEDULE DETERMINED BY THE CORPORATE COMPLIANCE OFFICER. COMPLETION OF THIS FORM IS A JOB REQUIREMENT FOR ALL MANAGERIAL EMPLOYEES, AND MAY BE REQUIRED OF NON-MANAGEMENT EMPLOYEES AS DETERMINED BY THE PRESIDENT AND CHIEF EXECUTIVE OFFICER AND THE CORPORATE COMPLIANCE OFFICER. EMPLOYEES ALSO HAVE A DUTY TO REPORT CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST OF WHICH THEY MAY BE AWARE INVOLVING OTHER EMPLOYEES. EACH SITUATION REPORTED SHALL BE REVIEWED BY THE PRESIDENT AND CEO, AND INGALLS CORPORATE COMPLIANCE OFFICER, AND A DETERMINATION SHALL BE MADE AS TO WHETHER A CONFLICT OF INTEREST EXISTS OR MAY ARISE FROM SUCH A SITUATION. THE DECISION OF THE PRESIDENT AND CEO AND CORPORATE COMPLIANCE OFFICER REGARDING WHETHER A CONFLICT EXISTS SHALL BE FINAL. THE EMPLOYEE HANDBOOK MENTIONS THE ENTITY'S CONFLICT OF INTEREST POLICY. EACH EMPLOYEE IS REQUIRED TO SIGN AN ACKNOWLEDGMENT OF THE HANDBOOK UPON EMPLOYMENT. |
| PROCESS USED TO DETERMINE COMPENSATION FOR TOP MANAGEMENT OFFICIAL | FORM 990, PART VI, LINE 15A | IN SETTING THE TOP MANAGEMENT OFFICIAL'S COMPENSATION, THE EXECUTIVE COMMITTEE RELIES ON RECENT COMPARABILITY STUDIES THAT PROVIDE COMPENSATION DATA FOR SIMILARLY QUALIFIED PERSONS IN COMPARABLE ORGANIZATIONS TO SUPPORT ITS DECISION-MAKING PROCESS. THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE TOP MANAGEMENT OFFICIAL'S COMPENSATION ARRANGEMENT. THE COMMITTEE ADEQUATELY DOCUMENTS ITS COMPENSATION DETERMINATIONS AND DELIBERATIONS REGARDING COMPENSATION IN THE MEETING MINUTES. THE PROCESSING FOR DETERMINING AND REVIEWING COMPENSATION FOR THE TOP MANAGEMENT OFFICIAL WAS LAST UNDERTAKEN IN THE PRIOR YEAR. |
| PROCESS USED TO DETERMINE COMPENSATION FOR OTHER OFFICERS AND KEY EMPLOYEES | FORM 990, PART VI, LINE 15B | AN OUTSIDE COMPENSATION CONSULTANT IS USED TO RENDER A REASONABLE OPINION AS TO WHAT PERCENTAGE OF INCREASE A VICE PRESIDENT SHOULD RECEIVE BY PERFORMING A MARKET COMPARISON FOR ALL VICE PRESIDENTS. THE PROCESS TO DETERMINE AN INCREASE IN COMPENSATION FOR VICE PRESIDENTS WAS PERFORMED IN THE PRIOR YEAR FOR THE CURRENT YEAR'S COMPENSATION. SALARY INCREASES ARE APPROVED ANNUALLY BY THE PRESIDENT AND EXECUTIVE COMMITTEE ONCE RECEIVED BY THE OUTSIDE CONSULTANT. DIRECTORS AND MANAGERS RECEIVE AN INCREASE IN COMPENSATION BASED ON WHETHER OR NOT PERFORMANCE GOALS HAVE BEEN REACHED. BEFORE A FISCAL YEAR STARTS PERFORMANCE GOALS ARE PUT TOGETHER BY THE DIRECTOR OR MANAGER AND SUBMITTED TO THE VICE PRESIDENT FOR APPROVAL. APPROVED GOALS ARE THEN REVIEWED BY ALL OTHER EXECUTIVES. ONCE APPROVED BY ALL, THESE ARE THE GOALS FOR THE YEAR. AFTER THE YEAR IS OVER THE PERFORMANCE GOALS ARE REVIEWED BY THE VP AND DIRECTOR OR MANAGER. MARKET ADJUSTMENTS ARE SET BY THE IMMEDIATE VP AND SENT TO ALL EXECUTIVES FOR THEIR APPROVAL. |
| Governing documents, conflict of interest policy and financial statements available to the public | Form 990, Part VI, Section C, Line 19 | FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICIES ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| EXPENSES FOR INGALLS HEALTH SYSTEM | FORM 990, PART VII, SECTION B, LINE 1 | EXPENSES OF INGALLS HEALTH SYSTEM (IHS) AND RELATED ENTITIES (SEE SCHEDULE R) ARE PAID BY IHS. IHS IS RESPONSIBLE FOR ISSUING THE 1099'S TO INDEPENDENT CONTRACTORS, AND SUBSEQUENTLY ALLOCATES A PERCENTAGE OF THE EXPENSE AND RECEIVES REIMBURSEMENT FROM THE RELATED ENTITIES. |
| GROSS AMOUNT OF SALES OF SECURITIES | FORM 990, PART VIII, LINE 7A | THE ORGANIZATION'S INVESTMENTS ARE HELD IN A POOLED INVESTMENT ACCOUNT MANAGED BY NORTHERN TRUST. REALIZED GAINS AND LOSSES ARE POOLED AND ALLOCATED TO THE PARTICIPANTS. THE INGALLS MEMORIAL HOSPITAL RECEIVES MONTHLY INFORMATION ON THE FUNDS FROM NORTHERN TRUST AND DETERMINES THE TOTAL GAIN OR LOSS AMOUNTS. HOWEVER DETAIL IS NOT PROVIDED. |
| Other Expenses | Form 990, Part IX, Line 11g | SUPPORT SERVICES -ARAMARK - TOTAL EXPENSE: 17721000, PROGRAM SERVICE EXPENSE: 14885640, MANAGEMENT AND GENERAL EXPENSES: 2835360, FUNDRAISING EXPENSES: ; OUTSOURCING OF BEHAVORIAL HEALTH SERVICES - TOTAL EXPENSE: 6225984, PROGRAM SERVICE EXPENSE: 5229827, MANAGEMENT AND GENERAL EXPENSES: 996157, FUNDRAISING EXPENSES: ; PATIENT FINANCIAL COLLECTION SERVICES - TOTAL EXPENSE: 2652312, PROGRAM SERVICE EXPENSE: , MANAGEMENT AND GENERAL EXPENSES: 2652312, FUNDRAISING EXPENSES: ; CONTRACTUAL AMBULANCE SERVICES - TOTAL EXPENSE: 2233278, PROGRAM SERVICE EXPENSE: 2233278, MANAGEMENT AND GENERAL EXPENSES: , FUNDRAISING EXPENSES: ; OTHER CONSULTING AND CONTRACT SERVICES - TOTAL EXPENSE: 16954134, PROGRAM SERVICE EXPENSE: 14369151, MANAGEMENT AND GENERAL EXPENSES: 2584983, FUNDRAISING EXPENSES: ; |
| Other changes in net assets or fund balances | Form 990 , Part XI, Line 9 | INTEREST RATE SWAP VALUATION - 5123861; NET ASSETS RELEASED FROM RESTRICTION FOR OPERATION - -910945; OTHER NON-OPERATING EXPENSES - -961301; ASSET MANAGEMENT FEES AND INTEREST EXPENSE - -498278; CONTRIBUTIONS FOR SPECIFIC PURPOSES - 1194088; TRANSFERS FROM AFFILIATES - 138866; NET RENTAL EXPENSES - 538746; RELATED ORGANIZATION REVENUE - -1085256; TIME SHARE OFFSET - -788390; MEDICAL STAFF EXPENSES - 101521; GIFT SHOP EXPENSES - 250560; INVESTMENT EXPENSES - 1459578; ROUNDING - 2; |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII (5 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | Primary ActivitiesPrimaryActivities | Legal Domicile StateLegalDomicileState | Exempt Code SectionExemptCodeSection | Public Charity StatusPublicCharityStatus | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Controlled OrgControlledOrg |
|---|---|---|---|---|---|---|---|---|---|
| INGALLS DEVELOPMENT FOUNDATION | |||||||||
| ONE INGALLS DRIVE | HARVEY | IL | 60426 | SUPPORT | IL | 501(C)(3) | 7 | IHS | false |
| INGALLS HOME CARE | |||||||||
| ONE INGALLS DRIVE | HARVEY | IL | 60426 | HEALTHCARE | IL | 501(C)(3) | 9 | IMH | true |
| INGALLS HEALTH SYSTEM | |||||||||
| ONE INGALLS DRIVE | HARVEY | IL | 60426 | MANAGEMENT | IL | 501(C)(3) | 11 - Type I | NA | false |
| INGALLS HEALTH VENTURES | |||||||||
| ONE INGALLS DRIVE | HARVEY | IL | 60426 | AMBULATORY | IL | 501(C)(3) | 3 | IHS | false |
| PRIMARY HEALTHCARE ASSOCIATES SC | |||||||||
| 71 W 156TH STREET | HARVEY | IL | 60426 | HEALTHCARE | IL | 501(C)(3) | 9 | IHS | false |
Form990 Schedule R Part III Form990ScheduleRPartIII
Name Of Related Org NameOfRelatedOrg
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INGALLS SAME DAY SURGERY CENTER LTD | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6701 W 159TH STREET | AddressLine1 |
| City | TINLEY PARK | City |
| State | IL | State |
| ZIP Code | 60477 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363368549 | EIN |
| Primary Activity | SURGERY CENTER | PrimaryActivity |
| Legal Domicile State | IL | LegalDomicileState |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Predominant Income Type | N/A | PredominantIncomeType |
Form990 Schedule R Part IV Form990ScheduleRPartIV (4 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EINEIN | Primary ActivityPrimaryActivity | Legal Domicile StateLegalDomicileState | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Type Of EntityTypeOfEntity | Share Of Total IncomeShareOfTotalIncome | Share Of EOY AssetsShareOfEOYAssets | Percentage OwnershipPercentageOwnership | Controlled OrgControlledOrg | Legal Domicile Foreign CountryLegalDomicileForeignCountry |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| INGALLS PROVIDER GROUP | |||||||||||||
| ONE INGALLS DRIVE | HARVEY | IL | 60426 | 363485578 | INSURANCE SERVICE | IL | IMH | C CORPORATION | 0 | 6407532 | 1 | true | |
| MEDCENTRIX INC | |||||||||||||
| ONE INGALLS DRIVE | HARVEY | IL | 60426 | 363374228 | BILLING & MGMT | IL | NA | C CORPORATION | |||||
| INGALLS CASUALTY INSURANCE LTD | |||||||||||||
| ONE INGALLS DRIVE | HARVEY | IL | 60426 | 980485714 | LIAB INSURANCE | NA | C CORPORATION | CJ | |||||
| INGALLS HEALTH COUNCIL | |||||||||||||
| ONE INGALLS DRIVE | HARVEY | IL | 60426 | 273226539 | PURCHASING GROUP | IL | NA | C CORPORATION | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | true | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | false | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | true | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | false | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | false | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | false | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | false | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | false | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | false | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | false | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | false | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | true | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | true | SharingOfFacilities |
| Sharing Of Paid Employees | true | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | true | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | true | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | true | OtherTransferToOtherOrg |
| Other Transfer From Other Org | true | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INGALLS HOME CARE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | A | TransactionType |
| Amount Involved | 84000 | AmountInvolved |
| Method Of Amt Determination | FMV | MethodOfAmtDetermination |